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Sample records for cardia

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

    Directory of Open Access Journals (Sweden)

    Ajit Gupta

    2012-01-01

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

  2. 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.

  3. 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.

  4. 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

    . 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...

  5. 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...

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

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    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

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

    Directory of Open Access Journals (Sweden)

    Ke Pan

    2012-12-01

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

  8. 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.

  9. 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.

  10. 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 ...

  11. 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...

  12. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  14. 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.

  15. Two distinct etiologies of gastric cardia adenocarcinoma: interactions among pH, Helicobacter pylori, and bile acids.

    Science.gov (United States)

    Mukaisho, Ken-Ichi; Nakayama, Takahisa; Hagiwara, Tadashi; Hattori, Takanori; Sugihara, Hiroyuki

    2015-01-01

    Gastric cancer can be classified as cardia and non-cardia subtypes according to the anatomic site. Although the gastric cancer incidence has decreased steadily in several countries over the past 50 years, the incidence of cardia cancers and esophageal adenocarcinoma (EAC) continue to increase. The etiological factors involved in the development of both cardia cancers and EACs are associated with high animal fat intake, which causes severe obesity. Central obesity plays roles in cardiac-type mucosa lengthening and partial hiatus hernia development. There are two distinct etiologies of cardia cancer subtypes: one associated with gastroesophageal reflux (GER), which predominantly occurs in patients without Helicobacter pylori (H. pylori) infection and resembles EAC, and the other associated with H. pylori atrophic gastritis, which resembles non-cardia cancer. The former can be developed in the environment of high volume duodenal content reflux, including bile acids and a higher acid production in H. pylori-negative patients. N-nitroso compounds, which are generated from the refluxate that includes a large volume of bile acids and are stabilized in the stomach (which has high levels of gastric acid), play a pivotal role in this carcinogenesis. The latter can be associated with the changing colonization of H. pylori from the distal to the proximal stomach with atrophic gastritis because a high concentration of soluble bile acids in an environment of low acid production is likely to act as a bactericide or chemorepellent for H. pylori in the distal stomach. The manuscript introduces new insights in causative factors of adenocarcinoma of the cardia about the role of bile acids in gastro-esophageal refluxate based upon robust evidences supporting interactions among pH, H. pylori, and bile acids. PMID:26029176

  16. 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

  17. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  19. 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%).

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

    Institute of Scientific and Technical Information of China (English)

    Li Xiangsheng; Ding Yunling; Wu Xuliang

    1998-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Adenocarcinomas of lower oesophagus, gastro-oesophageal junction and cardia in humans are highly invasive tumours with poor prognosis. The localisation of urokinase-type plasminogen activator receptor (uPAR) was determined in 66 patients; 60 with adenocarcinomas and six cases with Barrett...

  2. Two distinct etiologies of gastric cardia adenocarcinoma: interactions among pH, Helicobacter pylori, and bile acids

    Directory of Open Access Journals (Sweden)

    Ken-ichi eMukaisho

    2015-05-01

    Full Text Available Gastric cancer can be classified as cardia and noncardia subtypes according to the anatomic site. Although the gastric cancer incidence has decreased steadily in several countries over the past 50 years, the incidence of cardia cancers and esophageal adenocarcinoma (EAC continue to increase. The etiological factors involved in the development of both cardia cancers and EACs are associated with high animal fat intake, which causes severe obesity. Central obesity plays roles in cardiac-type mucosa lengthening and partial hiatus hernia development. There are two distinct etiologies of cardia cancer subtypes: one associated with gastroesophageal reflux (GER, which predominantly occurs in patients without Helicobacter pylori (H. pylori infection and resembles EAC, and the other associated with H. pylori atrophic gastritis, which resembles noncardia cancer. The former can be developed in the environment of high volume duodenal content reflux, including bile acids and a higher acid production in H. pylori–negative patients. N-nitroso compounds, which are generated from the refluxate that includes a large volume of bile acids and are stabilized in the stomach (which has high levels of gastric acid, play a pivotal role in this carcinogenesis. The latter can be associated with the changing colonization of H. pylori from the distal to the proximal stomach with atrophic gastritis because a high concentration of soluble bile acids in an environment of low acid production is likely to act as a bactericide or chemorepellent for H. pylori in the distal stomach with H. pylori infection. The manuscript introduces new insights in causative factors of adenocarcinoma of the cardia about the role of bile acids in gastro-esophageal refluxate based upon robust evidences supporting interactions among pH, H. pylori, and bile acids.

  3. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  5. 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.

  6. [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

  7. 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.``

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

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

  9. 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.

  10. 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.

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

    Science.gov (United States)

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

    1989-06-01

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

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

    彭侠彪; 陈万青; 陈志峰; 梁智恒; 欧志雄; 魏矿荣

    2014-01-01

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

  14. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2009-01-01

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

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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 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 (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

  3. 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.

  4. 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

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

    Science.gov (United States)

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

    2012-05-01

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

  6. 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.

  7. 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

  8. 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.

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

    Science.gov (United States)

    Lin, C H

    1989-10-01

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

  10. SNP-by-fitness and SNP-by-BMI interactions from seven candidate genes and incident hypertension after 20 years of follow-up: the CARDIA Fitness Study.

    Science.gov (United States)

    Sarzynski, M A; Rankinen, T; Sternfeld, B; Fornage, M; Sidney, S; Bouchard, C

    2011-08-01

    The association of single nucleotide polymorphisms (SNPs) from seven candidate genes, including genotype-by-baseline fitness and genotype-by-baseline body mass index (BMI) interactions, with incident hypertension over 20 years was investigated in 2663 participants (1301 blacks, 1362 whites) of the Coronary Artery Risk Development in Young Adults Study (CARDIA). Baseline cardiorespiratory fitness was determined from duration of a modified Balke treadmill test. A total of 98 SNPs in blacks and 89 SNPs in whites from seven candidate genes were genotyped. Participants that became hypertensive (295 blacks and 146 whites) had significantly higher blood pressure and BMI (both races), and lower fitness (blacks only) at baseline than those who remained normotensive. Markers at the peroxisome proliferative activated receptor gamma coactivator 1α (PPARGC1A) and bradykinin β2 receptor (BDKRB2) genes were nominally associated with greater risk of hypertension, although one marker each at the BDKRB2 and endothelial nitric oxide synthase-3 (NOS3) genes were nominally associated with lower risk. The association of baseline fitness with risk of hypertension was nominally modified by genotype at markers within the angiotensin converting enzyme, angiotensinogen, BDKRB2 and NOS3 genes in blacks and the BDKRB2, endothelin-1 and PPARGC1A genes in whites. BDKRB2 rs4900318 showed nominal interactions with baseline fitness on the risk of hypertension in both races. The association of baseline BMI with risk of hypertension was nominally modified by GNB3 rs2301339 genotype in whites. None of the above associations were statistically significant after correcting for multiple testing. We found that SNPs in these candidate genes did not modify the association between baseline fitness or BMI and risk of hypertension in CARDIA participants. PMID:20944660

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  12. 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

  13. The relation between body size perception and change in body mass index over 13 years: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

    Science.gov (United States)

    Lynch, Elizabeth; Liu, Kiang; Wei, Gina S; Spring, Bonnie; Kiefe, Catarina; Greenland, Philip

    2009-04-01

    The authors assessed associations of body size perception and weight change over 13 years in black men and women and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1992-2005). The perceptions of self and ideal body size were measured by using the Stunkard 9-figure scale at the year 7 examination (1992-1993). Figures were classified into underweight, normal weight, overweight, and obese. Self-ideal discrepancy yielded 4 body size satisfaction categories. Body mass index (BMI) (measured at years 7, 10, 15, and 20) was the dependent variable in gender-specific adjusted multiple regression models stratified by year 7 BMI. Obese women who perceived themselves as obese lost 0.09 BMI units annually, while those who perceived themselves as normal weight gained 0.31 units annually (P = 0.0005); obese women who considered their body size much too large had less annual weight gain than did those who considered their body size a bit too large (0.21 vs. 0.38 BMI units; P = 0.009). Obese women with overweight ideal body size gained less weight annually than did those with normal weight ideal body size (0.12 vs. 0.27 BMI units; P = 0.04). Results for men showed fewer and weaker associations. When obese women perceive themselves as obese and feel that their body size is too large, they gain less weight over time. PMID:19221119

  14. 膈肌脚在贲门食管区疾病手术治疗中的作用%Function on diaphragmatic foot in the surgical treatment of cardia esophageal region

    Institute of Scientific and Technical Information of China (English)

    佘德国

    2011-01-01

    目的:研究和总结膈肌脚在贲门食管区疾病手术中的作用.方法:回顾性分析研究1998年1月~2009年12月我院腹腔镜和开腹手术治疗贲门食管区疾病的临床资料,选取符合入组条件的住院贲门食管区疾病手术患者140例,将所有患者按手术路径分为两组,对照组40例(经胸组31例,经胸腹组9例),治疗组经腹100例.通过切开膈肌脚、扩大食管裂孔、膈肌成形重建食管裂孔,手术治疗贲门失弛缓症、贲门癌、胃上部癌112例;缝合、收紧、修补膈肌脚治疗反流性食管炎、胃食管反流病、食管裂孔疝28例;分析膈肌脚、迷走神经等解剖标志的识别方法.结果:本组贲门食管区疾病手术,手术时间明显缩短,术中出血少,部分患者避免了经胸手术,无严重手术并发症,术后长期疗效确切.结论:膈肌脚是贲门食管区的重要的解剖结构,通过切开膈肌脚,扩大食管裂孔,缝合、收紧膈肌脚,腔镜手术,解剖标志膈肌脚的正确识别,比较合理、准确、有效的手术治疗贲门食管区疾病.%Objective: To study and summarize the function on diaphragmatic foot in the surgical treatment of cardia esophageal region. Methods: A retrospective analysis of the clinical data of cardiac esophageal region treated with la-paroscopy and laparotomy surgeries from January 1998 to December 2009 was carried out. 140 patients with cardia esophageal region treated with surgery were eligible for inclusion. All patients were divided into two groups according to the surgical approach, with 40 patients (31 patients for the transthoracic group and 9 patients for the transabdominal group) for the control group and 100 transabdominal patients for the treatment group. 112 patients with cardia achalasia, cardia cancer and upper gastric cancer received surgical treatment by cutting open the diaphragm foot, expanding esophageal hiatus and reconstructing esophageal hiatus with diaphragm shaping. 28

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  16. Instrumental-Variables Simultaneous Equations Model of Physical Activity and Body Mass Index: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    Science.gov (United States)

    Meyer, Katie A; Guilkey, David K; Tien, Hsiao-Chuen; Kiefe, Catarina I; Popkin, Barry M; Gordon-Larsen, Penny

    2016-09-15

    We used full-system-estimation instrumental-variables simultaneous equations modeling (IV-SEM) to examine physical activity relative to body mass index (BMI; weight (kg)/height (m)(2)) using 25 years of data (1985/1986 to 2010/2011) from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (n = 5,115; ages 18-30 years at enrollment). Neighborhood environment and sociodemographic instruments were used to characterize physical activity, fast-food consumption, smoking, alcohol consumption, marriage, and childbearing (women) and to predict BMI using semiparametric full-information maximum likelihood estimation to control for unobserved time-invariant and time-varying residual confounding and differential measurement error through model-derived discrete random effects. Comparing robust-variance ordinary least squares, random-effects regression, fixed-effects regression, single-equation-estimation IV-SEM, and full-system-estimation IV-SEM, estimates from random- and fixed-effects models and the full-system-estimation IV-SEM were unexpectedly similar, despite the lack of control for residual confounding with the random-effects estimator. Ordinary least squares tended to overstate the significance of health behaviors in BMI, while results from single-equation-estimation IV-SEM were notably different, revealing the impact of weak instruments in standard instrumental-variable methods. Our robust findings for fixed effects (which does not require instruments but has a high cost in lost degrees of freedom) and full-system-estimation IV-SEM (vs. standard IV-SEM) demonstrate potential for a full-system-estimation IV-SEM method even with weak instruments. PMID:27614300

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

    Science.gov (United States)

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

    2016-02-23

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王国平; 韩小友; 丁悌; 苏文; 李建民; 高泽锋

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨建洲; 纪爱芳; 魏武; 原建慧; 王金胜

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘建东; 魏文杰; 杨景国

    2001-01-01

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

  2. 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.

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

    Institute of Scientific and Technical Information of China (English)

    张力军

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    马莱; 黄灿; 徐春华

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    宋锦文; 印建国; 杨艳; 刘晓红; 王志宏

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐启良

    2014-01-01

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

  9. 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

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

    Institute of Scientific and Technical Information of China (English)

    黄昌明; 卢辉山; 李平; 谢建伟; 林碧娟; 张祥福

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    1987-01-01

    in 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...

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  14. 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

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

    NARCIS (Netherlands)

    J.W.P.M. van Baal; S.H. Diks; R.J.A. Wanders; A.M. Rygiel; F. Milano; J. Joore; J.J.G.H.M. Bergman; M.P. Peppelenbosch; K.K. Krishnadath

    2006-01-01

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

  16. 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 (fast food consumption, walking, biking, or running. PMID:25723792

  17. 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

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

    Science.gov (United States)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    1989-01-01

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

  20. Surgical approach selection for elderly patients with carcinoma of gastric cardia%高龄贲门癌手术径路选择的探讨

    Institute of Scientific and Technical Information of China (English)

    李叙; 魏小东; 栗兰凯; 昌其; 谢骏; 潘伟

    2011-01-01

    目的 探讨高龄贲门癌手术径路的合理选择对术后恢复疗效的影响.方法 回顾性分析114例高龄贲门癌病例的临床资料,进行统计分析,比较经胸、经腹两种手术径路的切端残留率、心脏并发症发生率、呼吸系统并发症发生率的差异.结果 两组间切端残留率无明显差异(P>0.05),经胸组心脏并发症发生率、呼吸系统并发症发生率、术后平均住院时间与经腹组相比有统计学意义(P0. 05). There were significant differences in the incidence of postoperative heart complications, the incidence of postoperative respiratory complications and the average postoperative hospital stay (P < 0. 05 ). Conclusion The choice of the operative approach should be based on the patient individually.

  1. 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.

  2. 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.

  3. Study on Roux-en-Y Stasis Syndrome after Cardia Cancer Total Gastrectomy%贲门癌根治性全胃切除术后 Roux-en-Y 滞留综合征的研究

    Institute of Scientific and Technical Information of China (English)

    张水龙; 侯霞; 毕小刚; 张燕忠

    2014-01-01

    Objective To analyze the occurrence and prevention of Roux-en-Y stasis syndrome after cardiac carcinoma total gastrectomy .Methods The clinical data of 57 cases of total gastrectomy of cardiac cancer patients with Roux-en-Y stasis syndrome were retrospectively analyzed .Results In 57 patients,51 cases were followed up .There were 8 cases of obvious gastro-intestinal symptoms:2 cases of nausea ,vomiting only;3 cases of abdominal pain ,abdominal distension ,symptoms increased after eating;3 cases of abdominal pain ,abdominal distension accompanied by nausea ,vomiting.7 cases were confirmed as Roux-en-Y stasis syndrome,1 cases of tumor recurrence .Incidence rate of Roux-en-Y stasis syndrome was 13.7%(7/51).All the 7 patients were treated conservatively .Conclusion Roux-en-Y stasis syndrome was associated with Roux intestinal loop length and total gastrectomy.Early postoperative enteral nutrition and low dose of erythromycin can prevent its occurrence .%目的:分析贲门癌全胃切除术后Roux-en-Y滞留综合征发生的原因及其防治。方法回顾性分析57例贲门癌根治性全胃切除术后发生Roux-en-Y滞留综合征患者的临床资料。结果57例患者中51例获得随访,其中8例出现明显的胃肠道症状:2例出现单纯的恶心、呕吐;3例出现腹痛、腹胀,进食后症状加重;3例出现腹痛、腹胀同时伴恶心、呕吐。7例证实为Roux-en-Y滞留综合征,1例为肿瘤复发。术后Roux-en-Y滞留综合征发病率为13.7%(7/51),7例患者均行保守治疗。结论 Roux-en-Y滞留综合征的发生与Roux肠袢的长度及是否全胃切除有关,术后早期应用肠内营养剂及低剂量红霉素可预防其发生。

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

    Institute of Scientific and Technical Information of China (English)

    颜朝晖

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Robson Luis Silveira Jara

    2007-03-01

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

  6. General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    Steffen, Annika; Huerta, José-Maria; Weiderpass, Elisabete; Bueno-de-Mesquita, H B As; May, Anne M; Siersema, Peter D; Kaaks, Rudolf; Neamat-Allah, Jasmine; Pala, Valeria; Panico, Salvatore; Saieva, Calogero; Tumino, Rosario; Naccarati, Alessio; Dorronsoro, Miren; Sánchez-Cantalejo, Emilio; Ardanaz, Eva; Quirós, J Ramón; Ohlsson, Bodil; Johansson, Mattias; Wallner, Bengt; Overvad, Kim; Halkjaer, Jytte; Tjønneland, Anne; Fagherazzi, Guy; Racine, Antoine; Clavel-Chapelon, Françoise; Key, Tim J; Khaw, Kay-Tee; Wareham, Nick; Lagiou, Pagona; Bamia, Christina; Trichopoulou, Antonia; Ferrari, Pietro; Freisling, Heinz; Lu, Yunxia; Riboli, Elio; Cross, Amanda J; Gonzalez, Carlos A; Boeing, Heiner

    2015-01-01

    General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumferen

  7. 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

  8. Trans-abdominal ultrasonography in diagnosis of achalasia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-quan; CHEN Xiao-hua

    2002-01-01

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

  9. 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.

  10. 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.)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  16. "Western" diet, but not high fat diet, causes maladaptation of cardiac fatty acid metabolism and cardiac dysfunction in the Wistar rat

    Science.gov (United States)

    Obesity and diabetes are associated with increased fatty acid availability in excess of fatty acid oxidation capacity. This mismatch is implicated in the pathogenesis of cardiac contractile dysfunction. We tested the hypothesis that a "western" or a high fat diet will lead to maladaptation of cardia...

  17. Western diet, but not high fat diet, causes maladaptation of cardiac fatty acid metabolism and cardiac dysfunction in the Wistar rat

    Science.gov (United States)

    Obesity and diabetes are associated with increased fatty acid availability in excess of fatty acid oxidation capacity. This mismatch is implicated in the pathogenesis of cardiac contractile dysfunction. We tested the hypothesis that a "western" or a high fat diet will lead to maladaptation of cardia...

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

    NARCIS (Netherlands)

    Hedman, A; Meijer, DKF

    1998-01-01

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

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Rodolfo J. Oviedo, MD, FACS

    2016-01-01

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

  1. 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

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

    Science.gov (United States)

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

    2014-10-13

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

  3. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-10-01

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

  5. Triple A syndrome with ophthalmic manifestations in two siblings.

    Science.gov (United States)

    Babu, Kalpana; Murthy, Krishna R; Babu, Narendra; Ramesh, S

    2007-01-01

    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. PMID:17595484

  6. 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.

  7. 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 (...

  8. 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...

  9. 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

  10. 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.

  11. 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 (...

  12. Cardiac arrythmias

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

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

  13. 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...

  14. 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...

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  17. Incidence and survival of oesophageal and gastric cancer in England between 1998 and 2007, a population-based study

    Directory of Open Access Journals (Sweden)

    Coupland Victoria H

    2012-01-01

    Full Text Available Abstract Background Major changes in the incidence of oesophageal and gastric cancers have been reported internationally. This study describes recent trends in incidence and survival of subgroups of oesophageal and gastric cancer in England between 1998 and 2007 and considers the implications for cancer services and policy. Methods Data on 133,804 English patients diagnosed with oesophageal and gastric cancer between 1998 and 2007 were extracted from the National Cancer Data Repository. Using information on anatomical site and tumour morphology, data were divided into six groups; upper and middle oesophagus, lower oesophagus, oesophagus with an unspecified anatomical site, cardia, non-cardia stomach, and stomach with an unspecified anatomical site. Age-standardised incidence rates (per 100,000 European standard population were calculated for each group by year of diagnosis and by socioeconomic deprivation. Survival was estimated using the Kaplan-Meier method. Results The majority of oesophageal cancers were in the lower third of the oesophagus (58%. Stomach with an unspecified anatomical site was the largest gastric cancer group (53%. The incidence of lower oesophageal cancer increased between 1998 and 2002 and remained stable thereafter. The incidence of cancer of the cardia, non-cardia stomach, and stomach with an unspecified anatomical site declined over the 10 year period. Both lower oesophageal and cardia cancers had a much higher incidence in males compared with females (M:F 4:1. The incidence was also higher in the most deprived quintiles for all six cancer groups. Survival was poor in all sub-groups with 1 year survival ranging from 14.8-40.8% and 5 year survival ranging from 3.7-15.6%. Conclusions An increased focus on prevention and early diagnosis, especially in deprived areas and in males, is required to improve outcomes for these cancers. Improved recording of tumour site, stage and morphology and the evaluation of focused early

  18. 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

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

    Science.gov (United States)

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

    2012-12-15

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

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

    Science.gov (United States)

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

    2014-01-01

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

  1. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  3. 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.

  4. 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

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

    OpenAIRE

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

    2011-01-01

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

  6. 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.

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

    Science.gov (United States)

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

    2013-05-01

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

  8. 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

  9. 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.

  10. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Jean-Louis Dulucq; Pascal Wintringer; Ahmad Mahajna

    2007-01-01

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

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    尹先哲; 尹德印; 刘新群; 丁旭萌

    2001-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Ashis Mukhopadhya; Sumita Danda; Angela Huebner; Ashok Chacko

    2006-01-01

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

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    Creig Eisemanni

    2000-10-01

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

  20. 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

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Nagraj

    2015-03-01

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

  3. 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......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...

  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

    Epidermal growth factor (EGF) is considered to be important in mammalian neonatal growth and development. In order to clarify its developmental role, we have investigated, by immunohistochemistry, the localization of EGF and the time of its first appearance in various organs from a series of 25 m...... of the surface epithelia seems to precede staining of the EGF-producing glandular structures and EGF is not present in the glands before these have already differentiated....... 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. The human thoracic duct is functionally innervated by adrenergic nerves

    DEFF Research Database (Denmark)

    Telinius, Niklas; Baandrup, Ulrik; Rumessen, Jüri;

    2014-01-01

    Lymphatic vessels from animals have been shown to be innervated. While morphological studies have confirmed human lymphatic vessels are innervated, functional studies supporting this are lacking. The present study demonstrates a functional innervation of the human thoracic duct (TD) that is predo......Lymphatic vessels from animals have been shown to be innervated. While morphological studies have confirmed human lymphatic vessels are innervated, functional studies supporting this are lacking. The present study demonstrates a functional innervation of the human thoracic duct (TD......) that is predominantly adrenergic. TDs harvested from 51 patients undergoing esophageal and cardia cancer surgery were either fixed for structural investigations or maintained in vitro for the functional assessment of innervation by isometric force measurements and electrical field stimulation (EFS). Electron microscopy...

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

    Science.gov (United States)

    Bremner, C G; Demeester, T R

    1998-01-01

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

  7. 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.

  8. Outpatient experience with oesophageal endoscopic dilation.

    Science.gov (United States)

    Jani, P G; Mburugu, P G

    1998-07-01

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

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

    Science.gov (United States)

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

    2012-06-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Interstitial cells of Cajal in the striated musculature of the mouse esophagus

    DEFF Research Database (Denmark)

    Rumessen, J J; de Kerchove d'Exaerde, A; Mignon, S;

    2001-01-01

    Interstitial cells of Cajal (ICC) are important regulatory cells in the smooth muscle coats of the digestive tract. Expression of the Kit receptor tyrosine kinase was used in this study as a marker to study their distribution and development in the striated musculature of the mouse esophagus...... scarce in both muscle layers of the thoracic esophagus, while their number increased steeply toward the cardia in the striated portion of the intraabdominal esophagus. They did not form networks and had no relationship with intrinsic myenteric ganglia and motor end-plates. They were often close to nerve...... but absent in adult ICC-deficient KitW-lacZ/KitWv mice. Interstitial cells of Cajal were identified by electron microscopy by their ultrastructure in the striated muscle of the esophagus and exhibited Xgal labeling, while fibroblasts and muscle cells were unlabeled. Interstitial cells of Cajal are scattered...

  14. Genetic ancestry-smoking interactions and lung function in African Americans: a cohort study.

    Directory of Open Access Journals (Sweden)

    Melinda C Aldrich

    Full Text Available BACKGROUND: Smoking tobacco reduces lung function. African Americans have both lower lung function and decreased metabolism of tobacco smoke compared to European Americans. African ancestry is also associated with lower pulmonary function in African Americans. We aimed to determine whether African ancestry modifies the association between smoking and lung function and its rate of decline in African Americans. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated a prospective ongoing cohort of 1,281 African Americans participating in the Health, Aging, and Body Composition (Health ABC Study initiated in 1997. We also examined an ongoing prospective cohort initiated in 1985 of 1,223 African Americans in the Coronary Artery Disease in Young Adults (CARDIA Study. Pulmonary function and tobacco smoking exposure were measured at baseline and repeatedly over the follow-up period. Individual genetic ancestry proportions were estimated using ancestry informative markers selected to distinguish European and West African ancestry. African Americans with a high proportion of African ancestry had lower baseline forced expiratory volume in one second (FEV₁ per pack-year of smoking (-5.7 ml FEV₁/ smoking pack-year compared with smokers with lower African ancestry (-4.6 ml in FEV₁/ smoking pack-year (interaction P value  = 0.17. Longitudinal analyses revealed a suggestive interaction between smoking, and African ancestry on the rate of FEV(1 decline in Health ABC and independently replicated in CARDIA. CONCLUSIONS/SIGNIFICANCE: African American individuals with a high proportion of African ancestry are at greater risk for losing lung function while smoking.

  15. 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.

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

    Science.gov (United States)

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

    2011-03-01

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

  17. 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.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

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

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    Dzyubanovsky I.Ya.

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    章建全; 陈晓华

    2001-01-01

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

  4. 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

  5. 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

  6. 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

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

    Institute of Scientific and Technical Information of China (English)

    江泽熙

    1986-01-01

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

  8. 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.

  9. 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

  10. 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)

  11. 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.

  12. Novel therapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Yue; Zhang; Shenhong; Wu

    2015-01-01

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

  13. 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.

  14. 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.

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Directory of Open Access Journals (Sweden)

    M. A. Beltrán

    2014-11-01

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

  18. 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.

  19. 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.

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

    Science.gov (United States)

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

    2007-01-01

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

  2. 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

  3. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  5. 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.

  6. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  8. 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.

  9. Epidemiological trends in stomach-related diseases.

    Science.gov (United States)

    Milosavljević, Tomica; Kostić-Milosavljević, Mirjana; Krstić, Miodrag; Sokić-Milutinović, Aleksandra

    2014-01-01

    Epidemiology is a study of disease variations by geography, population demographics and time. Temporal influences can manifest themselves as age effects, period effects, cohort effects, seasonal or monthly variations. The acquisition of Helicobacter pylori infection during early childhood and the ensuing risk for the future development of peptic ulcer or gastric cancer represents a typical example for a cohort effect in digestive diseases. The incidence and prevalence of uncomplicated peptic ulcer have decreased in recent years, largely because of the availability of treatment to eradicate H. pylori and the decreasing prevalence of H. pylori infection. Nowadays, gastric and duodenal ulcers tend to occur in older people, who were more likely to have been exposed to H. pylori in their childhood than recently born generations. The overall incidence of gastric cancers is declining; however, there has been a relative increase in the incidence of tumors of the esophagogastric junction and gastric cardia. Thus, by extrapolating the strong, stable and consistent mortality rate declines in recent decades, gastric cancer was projected to become increasingly less important as a cause of death in Europe in the next decades. PMID:24732185

  10. 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.

  11. 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

  12. 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.

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

    Science.gov (United States)

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

    1987-01-01

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

  14. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    秦鸣放; 赵宏志

    2011-01-01

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

  17. 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.

  18. Collagenous gastritis in a Korean child: a case report.

    Science.gov (United States)

    Park, Sanghui; Kim, Dong Hoon; Choe, Youn Ho; Suh, Yeon-Lim

    2005-02-01

    Collagenous gastritis, a counterpart of collagenous colitis, is an extremely rare disorder. The first case of collagenous gastritis in a Korean boy in his pre-teens who had been receiving treatment for refractory iron deficiency anemia has been reported. The patient had been suffering from intermittent abdominal pain, recurrent blood-tinged vomiting and poor oral intake. The gastric endoscopy revealed diffuse cobblestone appearance of the mucosa with easy touch bleeding throughout the stomach but no abnormalities in the esophagus, duodenum, and colon. Pathologic examination of the gastric biopsies from the antrum, body and cardia showed a subepithelial collagen deposition with entrapped dilated capillaries, moderate infiltrates of lympho-plasma cells and eosinophils of the lamina propria, and marked hypertrophy of the muscularis mucosa. The collagen deposition appeared as discontinuous bands with focally irregular extension into the deeper part of the antral mucosa. It measured up to 150 microm. Helicobacter pylori infection was not detected. The biopsies from the duodenum, esophagus and colon revealed no pathologic abnormalities. PMID:15716621

  19. 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

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

    Science.gov (United States)

    Petropoulos, P C

    1981-01-01

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

  1. 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

  2. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Zhibin Niu; Keren Zhang; Weilin Wang

    2006-01-01

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

  4. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙宝林; 余守强; 甄福喜

    2016-01-01

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

  7. Body mass index, serum total cholesterol, and risk of gastric high-grade dysplasia: A case-control study among Chinese adults.

    Science.gov (United States)

    Huang, Ya-Kai; Kang, Wei-Ming; Ma, Zhi-Qiang; Liu, Yu-Qin; Zhou, Li; Yu, Jian-Chun

    2016-08-01

    Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized.A case-control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men and 356 women) and 902 controls (543 men and 359 women) were enrolled from January 2000 to October 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, and a multivariate analysis was conducted.After adjusting for age, alcohol consumption, smoking status, family history of gastric cancer or esophageal cancer, and serum total cholesterol level, a BMI ranging from 27.5 to 29.9 was significantly related to an increased risk of gastric high-grade dysplasia in both men (adjusted OR = 1.87, 95% CI = 1.24-2.81) and women (adjusted OR = 2.72, 95% CI = 1.44-5.16). The 2 highest BMI categories (27.5-29.9 and ≥30.0) were identified as risk factors for gastric cardia high-grade dysplasia in both men (BMI = 27.5-29.9: adjusted OR = 1.78, 95% CI = 1.02-3.10; BMI ≥ 30.0: adjusted OR = 2.54, 95% CI = 1.27-5.08) and women (BMI = 27.5-29.9: adjusted OR = 2.88, 95% CI = 1.27-6.55; BMI ≥ 30.0: adjusted OR = 2.77, 95% CI = 1.36-5.64), whereas only a BMI ranging from 27.5 to 29.9 was a risk factor for gastric noncardia high-grade dysplasia in both men (adjusted OR = 1.98, 95% CI = 1.25-3.14) and women (adjusted OR = 2.88, 95% CI = 1.43-5.81). In addition, higher serum total cholesterol was associated with an increased risk of gastric noncardia high-grade dysplasia (adjusted OR = 1.83, 95% CI = 1.25-2.69) in women.Increased BMI was associated with an increased risk of gastric high-grade dysplasia in

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

    Institute of Scientific and Technical Information of China (English)

    周远东

    2013-01-01

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

  9. 胎生蜥蜴消化道4种内分泌细胞的免疫组织化学研究%Immunohistochemical Study of the Four Kinds of Endocrine Cells in the Digestive Tract of Lacerta vivipara

    Institute of Scientific and Technical Information of China (English)

    吴昊; 李淑兰; 刘志涛; 刘鹏; 赵文阁

    2012-01-01

    为了探索胎生蜥蜴消化道内分泌细胞的形态与分布规律.应用胃泌素(Gas)、胰高血糖素(Glu)、胰多肽(PP)和P-物质(SP)4种特异性抗血清,对胎生蜥蜴(Lacerta vivipara)消化道内分泌细胞进行了免疫组织化学定位研究和形态学观察.用免疫组织化学ABC法(avidin-biotin compex method)以揭示其消化道内分泌细胞的分布规律及特点.结果表明:Gas细胞分布在贵门、幽门和小肠,其中以十二指肠处分布密度最高,贲门次之.Glu细胞主要分布在幽门和小肠前段,小肠后段偶见,并且幽门处的分布密度明显高于其他部位.在幽门、十二指肠和回肠都检测到了PP细胞,并且在十二指肠分布最多.仅在幽门部检测到了少量的SP细胞.4种内分泌细胞以圆形和锥体形为主,它们广泛分布于上皮细胞之间、腺泡上皮细胞之间及上皮细胞基部.上述内分泌细胞的分布特点可能与其食性、食物组成和生活环境有关.%To clarify the morphological features and region distribution of the endocrine cells in the digestive tract of the Lacerta vivipara. The localization and morphology of endocrine cells in the digestive tract of Lacertavivipara were studied with Gastrin (Gas), Glucagon (Glu), Pancreatic Polypeptide (PP) and substance P-(SP) four kinds of specific antisera. Immunohistochemical ABC method (avidin-biotin complex method) was used to reveal the law and characters of endocrine cells in the digestive tract. The results showed that Gas cells located in the cardia, pylorus and small intestine, with the highest density in the duodenum, followed by the cardia. Glu cells were mainly in the pylorus and the anterior small intestine, the back of the small intestine occasionally, and the pylorus' s distribution of density was significantly higher than any other parts. PP cells were detected in the pylorus, duodenum and ileum, with the largest distribution in the duodenum. SP cells were only found in the

  10. 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

  11. 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

  12. 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.

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

    Science.gov (United States)

    Abedi-Ardekani, Behnoush; Hainaut, Pierre

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Oladipo O. Omotosho

    2016-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-04-18

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

  16. 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.

  17. 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.

  18. The Characteristics of Gastrin Receptor Expression in Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张珈宁; 张欣; 李淑兰

    2012-01-01

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

  20. 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)

  1. Evaluation of Intraoperative Radiotherapy for Gastric Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Huanlong Qin; Chaohong Lin; Xiulong Zhang

    2005-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2012-09-15

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

  4. 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.  

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

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

  9. 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.

  10. 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

  11. 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

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

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    Abedi-Ardekani, Behnoush; Hainaut, Pierre

    2014-04-01

    Cancers of the upper gastro-intestinal tract (UGIT) comprise esophageal, esophago-gastric junction, stomach and duodenal cancers. Together, these cancers represent over 1.5 million cases and are the cause of about 1.25 million deaths annually. This group of cancers encompasses diseases with marked disparities in etiology, geographic distribution, histopathological features and frequency. Based on histological origin, squamous cell carcinoma of the esophagus (ESCC), which arises through a dysplasia-carcinoma sequence within the squamous mucosa, is a completely different cancer than junction, stomach and duodenal cancers, which develop within glandular epithelia through cascades involving inflammation, metaplasia, dysplasia and carcinoma. At the frontline between these two histological domains, cancers of the esophago-gastric junction constitute a mixed group of glandular tumors including distal esophageal adenocarcinomas and cancers arising within the most proximal part of the stomach - the cardia. Most of UGIT cancers are sporadic, although familial susceptibility genes have been identified for stomach and rare cases of ESCC. We have used the COSMIC database (http://www.sanger.ac.uk/genetics/CGP/cosmic/) to identify genes commonly mutated in UGIT cancers. Regardless of etiology and histopathology, three genes are mutated in at least 5% of UGIT cancers: TP53, CDKN2a and PIK3CA. Another three genes, NFE2L2, PTCH1 and NOTCH1, are mutated in ESCC only. Conversely, genes of the RAS family and of the CDH1/APC/CTNNB1 pathway are mutated only in non-squamous cancers, with differences in mutated genes according to topography. We review the potential functional significance of these observations for understanding mechanisms of UGIT carcinogenesis. PMID:24724606

  14. Mammalian African trypanosome VSG coat enhances tsetse's vector competence.

    Science.gov (United States)

    Aksoy, Emre; Vigneron, Aurélien; Bing, XiaoLi; Zhao, Xin; O'Neill, Michelle; Wu, Yi-Neng; Bangs, James D; Weiss, Brian L; Aksoy, Serap

    2016-06-21

    Tsetse flies are biological vectors of African trypanosomes, the protozoan parasites responsible for causing human and animal trypanosomiases across sub-Saharan Africa. Currently, no vaccines are available for disease prevention due to antigenic variation of the Variant Surface Glycoproteins (VSG) that coat parasites while they reside within mammalian hosts. As a result, interference with parasite development in the tsetse vector is being explored to reduce disease transmission. A major bottleneck to infection occurs as parasites attempt to colonize tsetse's midgut. One critical factor influencing this bottleneck is the fly's peritrophic matrix (PM), a semipermeable, chitinous barrier that lines the midgut. The mechanisms that enable trypanosomes to cross this barrier are currently unknown. Here, we determined that as parasites enter the tsetse's gut, VSG molecules released from trypanosomes are internalized by cells of the cardia-the tissue responsible for producing the PM. VSG internalization results in decreased expression of a tsetse microRNA (mir-275) and interferes with the Wnt-signaling pathway and the Iroquois/IRX transcription factor family. This interference reduces the function of the PM barrier and promotes parasite colonization of the gut early in the infection process. Manipulation of the insect midgut homeostasis by the mammalian parasite coat proteins is a novel function and indicates that VSG serves a dual role in trypanosome biology-that of facilitating transmission through its mammalian host and insect vector. We detail critical steps in the course of trypanosome infection establishment that can serve as novel targets to reduce the tsetse's vector competence and disease transmission. PMID:27185908

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

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

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

  16. 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.

  17. 22 years of photodynamic therapy in China

    Science.gov (United States)

    Li, Jun-Heng

    2005-07-01

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

  18. Laparoscopic antireflux surgery--technique and results.

    Science.gov (United States)

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

    1997-09-01

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

  19. A Case Report of Pulmonary Thromboembolism with Sputum Smear Positive Tuberculosis

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    F. Keramat

    2014-10-01

    Full Text Available Introduction: Pulmonary tuberculosis (TB is caused by the bacteria Mycobacterium tubercu-losis (MT. Rare cases of pulmonary thromboembolism along pulmonary or extra pulmonary TB were reported during the first weeks of anti-tuberculosis therapy. Case Report: A 28-year-old woman was admitted with complaints of ankles pain, fever, noc-turnal sweating, dyspnea and productive coughs. Patchy consolidations were seen on her chest x-ray and three sputum positive acid-fast bacillus (AFB smears were reported in her investigations. The patient underwent anti-tuberculosis drugs and her clinical condition was improving while at the eight day of the treatment, the patient conditions suddenly deterio-rated and suffered from severe dyspnea, chest pain and haemoptysis. Moreover, sinus tachy-cardia with T waves inversion in precordial leads (V1-V3 were seen on the electrocardio-gram. Diagnosis of pulmonary thromboembolism was confirmed on computed tomography contrast angiography. In addition, echocardiography and color Doppler sonography of the lower extremities were normal. There was no evidence for hypercoagolopathy impairments in the patient. The patient was treated with warfarin and anti-tuberculosis drugs for six months, and she was completely cured and became smear negative at the end of the therapy. Conclusion: As a result, although pulmonary thromboembolism is a rare complication of TB it should be considered in the patient with TB particularly during the first weeks of anti-TB treatment when respiratory symptoms exacerbations occur. (Sci J Hamadan Univ Med Sci 2014; 21 (3: 245-250

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  2. Trajectories of metabolic syndrome development in young adults.

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    Vivian T W Poon

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

  3. 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

  4. 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.

  5. 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

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

    Science.gov (United States)

    Miesfeld, Joel B; Link, Brian A

    2014-08-01

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

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

    Directory of Open Access Journals (Sweden)

    E. Vázquez-Sequeiros

    2009-08-01

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

  8. 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

  9. 食管胃结合部腺癌流行趋势、病因及防治%Adenocarcinoma of the esophagogastric junction:epidemic trends, causes, prevention and therapy

    Institute of Scientific and Technical Information of China (English)

    陈志峰

    2012-01-01

    Population epidemiology analysis of esophageal cancer for the high risk region in China finds that: incidence of esophageal squamous cell carcinoma has decreased and that of adenocarcinoma of the esophagogastric junction(AEG) has increased significantly. European and American scholars believe that obesity and stomach-esophageal reflux disease are independent risk factors of the two types of cancer. In the high risk region of esophageal cancer in China, the heritability is (29.67±4.32)% and the segregation ratio is 0.181, 95% CI (0.15-0.21). Esophageal cancer belongs to multi-gene genetic disease. According to the evolution of the pathological mechanism of gastric cardia adenocarcinoma and the WHO's clinical treatment principles, cardiac severe atypicalhyperplasia were mainly endoscopic resection in the high riskregion in China. Paying attention to the intervention ofatrophic gastritis or active gastritis may be the realisticmeasures to reduce intestinal metaplasia and the incidence ofAEG.%国内食管癌高发区人群流行病学分析发现:食管鳞癌发病率下降;食管胃结合部腺癌(AEG)发病率显著上升.欧美学者认为,肥胖和胃食管反流性疾病是这两类肿瘤的独立危险因素.我国食管癌高发区的遗传度为(29.67±4.32)%,分离比0.181,95%CI:0.15~0.21,属于多基因遗传病.根据AEG的病理演变机理和WHO的临床处理原则,目前食管癌高发区对贲门重度不典型增生者主要采用内镜下切除;而重视萎缩性或活动性胃炎的干预治疗,对降低肠化,减少AEG的发病也可能是比较现实的措施之一.

  10. 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。

  11. Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

    Science.gov (United States)

    Jenab, M; Riboli, E; Ferrari, P; Friesen, M; Sabate, J; Norat, T; Slimani, N; Tjønneland, A; Olsen, A; Overvad, K; Boutron-Ruault, M-C; Clavel-Chapelon, F; Boeing, H; Schulz, M; Linseisen, J; Nagel, G; Trichopoulou, A; Naska, A; Oikonomou, E; Berrino, F; Panico, S; Palli, D; Sacerdote, C; Tumino, R; Peeters, P H; Numans, M E; Bueno-de-Mesquita, H B; Büchner, F L; Lund, E; Pera, G; Chirlaque, M D; Sánchez, M-J; Arriola, L; Barricarte, A; Quirós, J R; Johansson, I; Johansson, A; Berglund, G; Bingham, S; Khaw, K-T; Allen, N; Key, T; Carneiro, F; Save, V; Giudice, G Del; Plebani, M; Kaaks, R; Gonzalez, C A

    2006-01-01

    Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, their total plasma concentration, retinol and α- and γ-tocopherol, with the risk of gastric adenocarcinoma in a case–control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and α-tocopherol on GCs by anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk was observed in the highest vs the lowest quartiles of plasma β-cryptoxanthin (odds ratio (OR)=0.53, 95% confidence intervals (CI)=0.30–0.94, Ptrend=0.006), zeaxanthin (OR=0.39, 95% CI=0.22–0.69, Ptrend=0.005), retinol (OR=0.55, 95% CI=0.33–0.93, Ptrend=0.005) and lipid-unadjusted α-tocopherol (OR=0.59, 95% CI=0.37–0.94, Ptrend=0.022). For all analytes, no heterogeneity of risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was observed with the highest vs lowest quartile of lipid-unadjusted α-tocopherol (OR=0.26, 95% CI=0.11–0.65, Ptrend=0.003). These results show that higher plasma concentrations of some carotenoids, retinol and α-tocopherol are associated with reduced risk

  12. Dietary Flavonols Intake and Risk of Esophageal and Gastric Cancer: A Meta-Analysis of Epidemiological Studies

    Directory of Open Access Journals (Sweden)

    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.

  13. Los estudios longitudinales en la prevención de las enfermedades cardiovasculares

    Directory of Open Access Journals (Sweden)

    Ignacio Balaguer Vintró

    2004-01-01

    Full Text Available Los estudios longitudinales de cohortes bien definidas han contribuido a la identificación de los factores de riesgo de la cardiopatía coronaria y otras complicaciones clínicas de la aterosclerosis. Después de comentar las conclusiones de los estudios de la aterosclerosis experimental y los factores de riesgo sugeridos por el estudio de una serie de infartos de miocardio en adultos jóvenes en comparación con controles apareados, se expone la metodología, el desarrollo y los resultados de los estudios longitudinales realizados en Estados Unidos desde 1949: Twin Cities, Framingham, Pooling Project, Western Collaborative, Puerto Rico, Evans County, NI-HONSAN, San Francisco, Harvard, Bogalusa y CARDIA. Se presta especial atención a las hipótesis propuestas al inicio del estudio de Framingham y a los obstáculos y cambios para continuar el proyecto después de los primeros veinticuatro años. A continuación se expone el Seven Countries Study, ideado y dirigido por Ancel Keys y primer estudio realizado con metodología centralizada en varios países, y los estudios longitudinales realizados en diversos países de Europa: Whitehall, Manresa, París, British Regional, Northwick Park, Caerphilly, Speedwell, PROCAM. Se analiza el papel de los estudios longitudinales en la metodología de los estudios posteriores: hijos e hijas de los participantes en Framingham, estudios longitudinales basados en cuestionarios, estudios de otros posibles factores de riesgo, prevalencia de factores de riesgo en estudios retrospectivos, ensayos de intervención primaria (MRFT, WHO European Collaborative Trial y el de Goteburgo y la participación de los equipos entrenados en el Proyecto MONICA. Se señalan los temas todavía en debate en relación con la metodología y los resultados de los estudios longitudinales: exámenes periódicos de los participantes en las cohortes de los estudios epidemiológicos, cambios en la definición de nuevos casos de accidentes

  14. 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, pfood 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 observed differential price effects on HOMA-IR (inverse for lower educational status and at middle income) and BMI (inverse for blacks, lower education, and middle income; positive for whites, high education, and high income). Conclusions We found greater fast food price

  15. 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.

  16. Gastric polypoid lesions: Analysis of 150 endoscopic polypectomy specimens from 91 patients

    Institute of Scientific and Technical Information of China (English)

    Rasim Gencosmanoglu; Ebru Sen-Oran; Ozlem Kurtkaya-Yapicier; Erol Avsar; Aydin Sav; Nurdan Tozun

    2003-01-01

    AIM: To analyze gastric polypoid lesions in our patientpopulation with respect to histopathologic features and demographic, clinical, and endoscopic characteristics of patients.METHODS: Clinical records and histopathologic reports of patients with gastric polypoid lesions were analyzed retrospectively. All lesions had been totally removed by either endoscopic polypectomy or hot biopsy forceps. The histopathologic slides were re-evaluated by the same histopathologist.RESULTS: One-hundred and fifty gastric polypoid lesions were identified in 91 patients. There were 53 (58%) women and 38 (42%) men with a median age of 53 (range, 31 to 82) years. The most frequent presenting symptom was dyspepsia that was observed in 35 (38.5%) patients.Symptoms were mostly related to various associated gastric abnormalities such as chronic gastritis or H pylori infection rather than polypoid lesion itself. Polypoid lesions were commonly located in the antrum followed by cardia. Out of 150 lesions, 80 (53%) had the largest dimensions less than or equal to 5 mm and only 7 were pedunculated. The frequencies of hyperplastic polyps, foveolar hyperplasia, and fundic gland polyps were 46%, 18%, and 14% respectively.We also detected gastritis varioliformis in 12 specimens,lymphoid follicles in 9, 4 adenomatous polyps in 4, polypoid lesions with edematous mucosa in 4, inflammatory polyps in 3, and carcinoid tumor in 1. Adenomatous changes were observed within two hyperplastic polyps and low grade dysplasia in one adenoma. Histopathologic evaluation of the surrounding gastric mucosa demonstrated chronic gastritis in 72 (79%) patients and H pylori infection in 45 (49%).CONCLUSION: Hyperplastic polyps are the most frequently encountered subtype of gastric polypoid lesions. They are usually associated with chronic gastritis or H pylori gastritis. Contrary to the previous belief, they may harbour adenomatous changes or dysplastic foci.Therefore, endoscopic polypectomy seems as a safe and fast

  17. 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.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Echocardiographic Diagnosis of 63 Children with Dextrocardia%超声心动图诊断小儿右位心63例

    Institute of Scientific and Technical Information of China (English)

    金兰中; 马桂琴; 李国敏

    2001-01-01

    目的:探讨超卢心动图对右位心及其伴随的心血管畸形的诊断价值。方法:探头移至胸骨右缘显示心脏。按van Pranph方法对右位心进行诊断分型。结果:63例右位心,右旋心型41例,合并心血管畸形的38例。镜像右位心型17例,心内结构正常的9例。未定位型(中心型)5例,均合并复杂心血管畸形。结论:当确定心脏大部分及心火位于右侧胸腔,可观察左右心房关系以确定右位心类型。超声心动图能快速、准确及可靠地诊断右位心。%To evaluate the clinical utility of echocardiography in the diagnosis of dextrocardia and concomitant cardiovascular malformations. Methods:The detector was set on the right edge of sternums to display hearts on the screen, and the diagnostic classification was made based on Van Pranph Method. Results: Among the 63 patients diagnosed of dextrocardia, 41 patients were diagnosed as dexversion, 38 patients were found to have concomifant cardiovascular malformations, 17 patients were diagnosed as mirror-image dextrocardia, 9 patients were found with normal intracardial structure, and 5 patients were diagnosed as mesocardia or uncertain-cardia annexed with complicated cardiovascular malformation. Conclusions: When a majority of the heart and its apex are found to lie on the right side of the thorax, diagnostic classification of dextrocardia can be confirmed by investigating the relationship between the left and right atria, Echocardiography is a reliable and convenient method for diagnosis of dextrocardia.

  1. Epidemiology of Helicobacter pylori and gastric cancer.

    Science.gov (United States)

    Kikuchi, Shogo

    2002-01-01

    Findings in epidemiological studies of the relationship between Helicobacter pylori and gastric cancer have been inconsistent: many studies have yielded a positive relationship, whereas several studies have shown no relationship. The inconsistency arises because of the occurrence of seroreversion during the period between the time that H. pylori exerts a carcinogenic effect and the time of blood sampling. When this seroreversion is taken into account, there is an epidemiologically positive association between H. pylori status and the risk for gastric cancer. In addition to the epidemiological evidence, experimental studies using Mongolian gerbils have shown that H. pylori infection elevates the risk for gastric cancer. It is concluded that H. pylori is a causal factor for gastric cancer. In the creation of preventive strategies against gastric cancer by the eradication of H. pylori, determination of the time at which H. pylori plays a role as a carcinogen is important. Three hypotheses have been proposed in regard to this timing: that H. pylori infection in childhood or the teenage years acts as a factor that produces precancerous lesions with irreversible damage in the gastric mucosa, that in adulthood it acts as an initiator, and also in adulthood, that it acts as a promoter. As these hypotheses are not mutually exclusive, the extent to which each hypothesis plays a part in explaining gastric carcinogenesis should be evaluated. Only a small proportion of subjects infected with H. pylori have gastric cancer during their lifetime. Interleukin-1 polymorphism, a host factor, and CagA, a virulence factor of H. pylori, are suspected to be risk factors for gastric cancer in subjects with H. pylori infection. Dietary factors, especially vitamin C, and patterns of precancerous lesions also seem to influence the relationship between H. pylori and gastric cancer. H. pylori seems to reduce the risk for esophageal and for some gastric cardia adenocarcinomas. This finding, as

  2. CARDIOVASCULAR RISK FACTORS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    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

  3. 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

  4. A Rare Case of Gastric Variceal Hemorrhage Secondary to Infiltrative B-Cell Lymphoma

    Directory of Open Access Journals (Sweden)

    Adrienne Lenhart

    2016-10-01

    Full Text Available Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena. On admission to hospital, he was found to have a hemoglobin level of 3.4 g/l. Emergent esophagogastroduodenoscopy showed isolated bleeding gastric varices (IGV1 by Sarin classification in the fundus and cardia with subsequent argon plasma coagulation injection. He was transferred to our tertiary center where work-up revealed normal liver function tests, and abdominal ultrasound showed patent hepatic/portal vasculature without cirrhosis. MRI demonstrated a large heterogeneously enhancing mass in the pancreatic tail, with invasion into the spleen and associated splenic vein thrombosis. Surgery consultation was obtained, but urgent splenectomy was not recommended. The patient instead underwent splenic artery embolization to prevent future bleeding from his known gastric varices. Pathology from a CT-guided biopsy was consistent with diffuse large B-cell lymphoma. PET imaging showed uptake in the splenic hilum/pancreatic tail region with no additional metastatic involvement. He was evaluated by the Hematology Department to initiate R-CHOP chemotherapy. During his outpatient follow-up, he reported no further episodes of melena or hematemesis. To the best of our knowledge, there have only been two published case reports of large B-cell lymphoma causing upper gastrointestinal bleeding from isolated gastric varices. These cases were treated with splenectomy or

  5. [Transgastric laparo-endoscopic approach for difficult access lesions. Experimental mode].

    Science.gov (United States)

    Tapia-Vega, Marcel Adalid; Morales-Chávez, Carlos Ernesto; Aguirre-Olmedo, Itzé; Cuendis-Velázquez, Adolfo; Rojano-Rodríguez, Martín Edgardo; Cárdenas-Lailson, Luis Eduardo

    2014-01-01

    Antecedentes: las neoplasias gástricas pueden tratarse de forma segura y eficaz mediante laparoscopia. Debido a su localización algunas lesiones son inaccesibles mediante cirugía laparoscópica, como alternativa se propone el abordaje transgástrico. Objetivo: exponer los resultados con la aplicación de una técnica laparo-endoscópica en un modelo animal que mantenga funcional la anatomía, para resecar neoplasias gástricas de la pared posterior del estómago, próximas al cardias y a la región pre-pilórica. Material y métodos: el estudio se efectuó entre los meses de mayo a diciembre de 2011en el Hospital General Gea González y consistió en experimentar en 12 cerdos la técnica laparo-endoscópica para resección de neoplasias gástricas de la pared posterior. La inserción de los trócares intragástricos se realizó mediante endoscopia. Se efectuaron tres gastrotomías en la pared anterior y con visión endoscópica los trócares se introdujeron con el auxilio laparoscópico. El estómago se insufló con CO2. La lesión se resecó manteniendo un margen circunferencial de 20 mm, se suturaron las gastrotomías, se utilizaron la prueba de t de Student y la prueba exacta de Fisher para el análisis estadístico. Resultados: todas las resecciones fueron exitosas y se efectuaron en un tiempo promedio de 102.33 minutos (± 4.50), hubo dos complicaciones y ninguna defunción transoperatoria. Conclusiones: el abordaje laparoscópico transgástrico es factible y seguro para resecar neoplasias de la pared posterior del estómago, próximas a la unión esófago-gástrica y área prepilórica.

  6. Esophagogastric pathology in morbid obese patient: preoperative diagnosis and influence in the selection of surgical technique

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

  8. 上消化道不同部位黏膜下肿瘤的临床病理学特征%Clinicopathological features of submucosal tumors in different upper gastrointestinal locations

    Institute of Scientific and Technical Information of China (English)

    齐志鹏; 钟芸诗; 周平红; 徐美东; 时强; 蔡世伦; 姚礼庆

    2016-01-01

    Objective To analyze the clinicopathological characteristics of upper gastrointestinal submucosal tumors ( SMTs ) . Methods Clinicopathological data of 1 743 patients with 1 775 upper gastrointestinal SMTs in our department from January 2008 to December 2012 were retrospectively analyzed. Results The first finding was that in 702 esophagus cases,leiomyoma(92�59%,650/702) was the most common type of esophageal SMTs. Second, in 1 045 gastric cases, there were 405 lesions at gastric fundus, the most common type of SMTs were 249 ( 61�48%) GISTs and 144 ( 35�56%) leiomyoma. In 307 lesions located at body,the most common type of SMTs were 143( 46�58%) GISTs and 90( 29�32%) leiomyoma. In 191 lesions located at antrum, the most common type of SMTs were 83( 43�46%) heterotopia pancreas and 45(23�56%) hamartoma, followed by 28(14�66%) lipoma and 20(10�47%) GISTs. In 142 lesions located at cardia, the most common type of SMTs was 110 ( 77�46%) leiomyoma. Third, in 28 duodenum cases, there were 19 lesions at duodenal bulb, the most common type of SMTs was 10 heterotopia pancreas, 4 Brunner gland adenoma and 3 GISTs. In 9 lesions located at descending duodenum,the most common type of SMTs was 4 lipomyoma, followed by 2 ectopic pancreas,1 GISTs and 2 others. Conclusion Leiomyoma is the most common type of esophageal SMTs. In gastric fundus and body, the most common type of SMTs are GISTs and leiomyoma. In antrum, the most common type of SMTs are heterotopia pancreas and hamartoma, but in cardia, that is leiomyoma.In duodenal bulb, the most common type of SMTs are heterotopia pancreas, Brunner gland adenoma and GISTs,and in descending duodenum, is lipomyoma.%目的:探讨不同部位上消化道黏膜下肿瘤( SMTs)的临床病理学特征。方法2008年1月至2012年12月,在复旦大学附属中山医院内镜中心行胃镜下诊疗,经病理确诊为上消化道SMTs,且资料记录完整的1743例患者(1775例次诊

  9. Splenic autotransplantation plus lower esophagus transaction for the treatment of portal hypertension%自体脾移植联合食管横断吻合术治疗肝硬化门静脉高压症

    Institute of Scientific and Technical Information of China (English)

    陈汝福; 霍景山; 陈积圣; 周泉波

    2008-01-01

    目的 本研究比较自体脾移植联合食管横断吻合术与脾切除联合食管横断吻合术治疗门静脉高压症(PHT)的疗效.方法 将30例研究对象平均分为两组.研究组行脾次全切除加自体脾腹膜后移植及食管横断吻合术;对照组行脾切除加食管横断吻合术.于术前1周及术后6个月通过三维动态增强磁共振血管成像(3D DCE MRA)检测其门静脉主干(MPV)管腔横截面积、血流量、血流速度等门静脉系统血流动力学参数及食管胃底曲张静脉的变化,并观察自体移植脾在腹膜后的侧支血管形成与血流方向的改变.并同步检查血清肝纤维化指标及肝功能的重要指标. 结果术后两组MPV的管腔横截面积、MPV的平均流速和MPV的平均流量均比术前明显减小(P<0.05).且术后研究组MPV的平均流速和平均流量均少于对照组(P<0.05).两组手术后胃底曲张静脉、食管曲张静脉均消失或明显改善;两组手术前后肝功能的重要指标均差异无统计学意义(P>0.05).研究组血清透明质酸水平在术后显著下降(P<0.05),研究组移植脾成活良好,并建立了广泛的侧支循环. 结论自体脾移植联合食管横断吻合术是一种优于脾切除加断流术治疗肝硬化PHT的方法,且未对肝功能造成负面影响.%Objective To evaluate the efficacy of splenic autotransplantation plus lower esophagus transaction for the treatment of portal hypertension(PTH).Methods Thirty patients were divided into study group(15 cases)and control group(15 cases).Patients in study group Underwent splenic autotransplantation after splenectomy and cardia-esophageal devascularization plus lower esophagus transaction,and those in control group had all except splenic autotransplantation.The cross section area,blood velocity,blood flow of MPV(main portal vein)and changes of cardia-esophageal varices were evaluated by 3D DCE MRA at 1 week before operation and 6 months after,and blood

  10. 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

  11. 胃上部癌根治术保留胰脾功能性清除脾门和脾动脉干淋巴结的临床意义%Radical resection of gastric carcinoma with pancreas and spleen preservation and functional cleaning of lymph nodes

    Institute of Scientific and Technical Information of China (English)

    秦环龙; 林超鸿

    2002-01-01

    目的观察胃癌手术保留胰脾清除脾门和脾动脉干淋巴结(即No 10、11)合理性和可行性.方法分析439例手术切除的胃贲门、体部和全胃癌侵入胰脾情况;对54例胃癌患者在术中从贲门和体部浆膜下注入亚甲兰观察胃的淋巴流向;63例胃癌采用保留胰脾功能性清除No 10、11 淋巴结方法,与同期保胰法和胰脾切除法比较,分析No 10、11淋巴结转移率,观察术后并发症发生率和生存率.结果 439例胃贲门、体部和全胃癌侵入胰脾机会不多,分别为5.7%(25/439)和2.3%910/439);5 4例胃的美兰淋巴引流不进入脾脏和胰腺内.保留胰脾法、保胰法和脾胰切除法3组No 10、1 1淋巴结转移率分别为17.5%(11/63),19.1%(12/63);20.8%(45/216),25%(54/216);20%( 6/30),23%(7/30),差异无显著意义.63例保留胰脾法术后并发症发生率和病死率均较保留胰法和胰脾联合切除法低,而生存期较高,5年、10年生存率分别为57.5%、52%,57.4%、47 .4%和37.3%、30%.Ⅱ、Ⅲa期患者保留胰脾手术的5年、10年生存率明显改善.结论保胰脾法是一个安全、切实可行的保留脏器功能的胃癌根治手术,术后并发症低、生存率高 .尤对Ⅱ、Ⅲa期患者应行保留胰脾手术.%Objective To study the clinical value of radical resection of gastric carcinoma with pancr eas and spleen preservation (PSP) and functional cleaning of lymph nodes (LNs) o f the spleen hillus and along the splenic artery.Methods Pancreas and spleen involvement was retrospectively reviewed among 439 cases of resectable carcinoma of the gastric cardia,gastric corpus and total stomach. Du ring gastric surgery, 2 ml of methylene blue was injected into the subserosal sp ace of the gastric cardia or corpus to observe the spread of lymphatic flow in 5 4 cases of gastric carcinoma. The metastatic rate of LNs in splenic hillus and along the trunk of the splenic artery (No10, No11), postoperative complications and survival rates

  12. 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

  13. 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

  14. Clinical significance of combined detection of serum levels of multiterm tumor markers in patients with upper gastrointestinal cancer%上消化道恶性肿瘤患者血清多项肿瘤标志物联合检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    刘兴君; 韩存芝; 马晋峰; 张羽捷

    2009-01-01

    Objective To evaluate clinical significance of the CEA, CA19-9, CA242, AFP, CA724,SCC, TPA, TPS combined detection for the clinical diagnosis of gastrointestial cancer. Methods 373 cases of upper digestive tract malignant tumor patient and 50 cases of healthy serum sample were detected for eight markers, evaluating the relationship between the level of markers and illness. Results 8 marker diagnostic positive rates were: CEA 26.80 %, CA19-9 27.34 %, CA242 34.14 %, AFP 2.84 %, SCC 19.72 %, CA724 12.13 %, TPA 34.15 %, TPS 30.89 %. The total positive rate of joint detection of 8 markers was 89.05 %.Preoperative CEA, CA242, SCC-positive patients had a shorter survival time. CA242 and CA19-9 levels with upper gastrointestinal malignancies were positively correlated. Conclusion The combined detection of a number of markers in different pathological type and clinical staging is statistically significant, and the positive rate is much higher than any single marker test results. CA19-9 and CA242 may be the best combination of monitoring the disease. CA724, CA242 and SCC can be as adverse prognostic indicators for cardia, stomach,esophageal malignant tumors, respectively.%目的 评价痛胚抗原(CEA)、唾液酸化岩藻戊糖(CA19-9)、胃肠道癌抗原(CA242)、甲胎蛋白(AFP)、胃癌及卵巢癌抗原(CA724)、鳞状上皮细胞癌抗原(SCC)、组织多肽抗原(TPA)、细胞角蛋白(TPS)8项标志物联合检测,对上消化道恶性肿瘤的临床诊断、评价疗效及预后等方面的临床意义.方法 对373例上消化道恶性肿瘤患者及50名健康体检者血清标本进行8项标志物检测,评价标志物水平与病情的关系.结果 8项标志物诊断阳性率分别为:CEA 26.80%,CA19-9 27.34%,CA24234.14%,AFP 2.84%,SCC 19.72%,CA724 12.13%,TPA 34.15%,TPS;30.89%.8项标志物联合检查的总阳性率为89.05%.术前CEA、CA242、SCC阳性患者的生存时间较短.上消化道恶性肿瘤患者血清CA242和CA19-9水平

  15. Effects of microtubule stabilizer on connexin 43 of isolated cardiac myocytes under hypoxia injury%微管稳定剂Taxol对缺氧心肌细胞Cx43蛋白的影响

    Institute of Scientific and Technical Information of China (English)

    王德国; 王新; 刘玉; 王星; 邢文; 李祥东; 杨胜; 王安才; 孙贤林

    2012-01-01

    Aim To observe the effects of mierotu-bule stabilizer ( Taxol) on eonnexin43 ( Cx43 ) expression and distribution of eardiae myoeyles and investi-gate its new value as an anti-arrhylhmie agent. Methods Cardiae myoevles isolated from aduk rats were exposed to hypoxia for 120 min with or without taxol ( a kind of mierotubule stabilizer ) in different. eoneentra-tions. Cellular survival was assayed by trypan blue dye-exelusion. Cx43 expression was determined by western blots. Cx43 distribution was deteeted by immu-nofluoreseenee staining and observed under laser sean-ning eonfoeal mieroseope. Results The cell viability under hypoxie eondition was redueed signifieantly whieh showed only few numbers of rod-shaped eells. Taxol promoted cell survival in a dose-dependent man- ner at the range of0. 1~10 nmol · L-1 . At the range of 100 nmol o L-1~ 10 μmol · L~1 , taxol lead toredueed cell survival. Taxol in a dose-dependent manner improved Cx43 expression even although exeessive taxol also suppressed Cx43. Cx43 was loeat ed in both ends of intaet eardiae myoeyles ( interealated disk ) and redistributed in both sides of the cell under hypoxie eonditions. Taxol dose-dependently inhibited lateraliza-tion of Cx43 in lower eoneentration and further de-ereased Cx43 in the interealated disk. Conclusions Cx43 redistribution indueed by hypoxie is proteeted by low dosage of taxol. Mierotubule stabilizer may be ae-ted as a new anti-arrhythmie agent.%目的 观察微管稳定剂Taxol对缺氧心肌细胞Cx43表达和分布的影响,探讨其作为新的抗心律失常药物的潜在价值.方法 酶解法分离的大鼠心肌细胞缺氧120 min,并以不同浓度的Taxol干预;台盼蓝排斥实验测定细胞存活率;免疫印迹检测Cx43的蛋白表达,免疫荧光染色后激光共聚焦显微镜观察分析Cx43的分布.结果 Taxol在0.1~10 nmol·L-1浓度下成剂量依赖性地提高杆状细胞数,促进细胞存活,而100 nmol·L-1~10 μmol·L-1浓度下杆状细胞数

  16. Gastric Large Cell Neuroendocrine Carcinoma

    Science.gov (United States)

    Rustagi, Tarun; Alekshun, Todd J.

    2010-01-01

    Case: A 63-year-old male presented with unintentional weight loss of 20 pounds over a 4-month duration. He reported loss of appetite, intermittent post-prandial nausea, bloating and early satiety. He also complained of dyspepsia and had been treated for reflux during the previous 2 years. He denied vomiting, dysphagia, odynophagia, abdominal pain, melena, hematochezia, or alterations in bowel habits. Additionally, he denied fevers, night sweats, cough, or dyspnea. He quit smoking 25 years ago, and denied alcohol use. His past medical history was significant for basal cell carcinoma treated with local curative therapy and he was without recurrence on surveillance. Pertinent family history included a paternal uncle with lung cancer at the age of 74. Physical examination was unremarkable except for occult heme-positive stools. Laboratory evaluation revealed elevated liver enzymes (ALT-112, AST-81, AlkPhos-364). CT scan of the chest, abdomen and pelvis showed diffuse heterogeneous liver with extensive nodularity, raising the concern for metastases. Serum tumor-markers: PSA, CEA, CA 19-9, and AFP were all within normal limits. Screening colonoscopy was normal, but esophagogastroduodenoscopy revealed a malignant-appearing ulcerative lesion involving the gastro-esophageal junction and gastric cardia. Pathology confirmed an invasive gastric large cell neuroendocrine carcinoma. Ultrasound-guided fine needle aspiration of a hepatic lesion revealed malignant cells with cytologic features consistent with large-cell type carcinoma and positive immunostaining for synaptophysin favoring neuroendocrine differentiation. A PET-CT demonstrated intense diffuse FDG uptake of the liver, suggesting diffuse hepatic parenchymal infiltration by tumor. There were multiple foci of intense osseous FDG uptake with corresponding osteolytic lesions seen on CT scan. The remaining intra-abdominal and intra-thoracic structures were unremarkable. The patient will receive palliative systemic therapy

  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. EXPRESSION AND CLINICAL SIGNIFICANCE OF CD44 IN THE PERIPHERAL BLOOD OF PATIENTS WITH CASTRIC CANCER

    Institute of Scientific and Technical Information of China (English)

    XU; Shen-hua

    2001-01-01

    of Chinese subjects [J]. Cancer 1995; 75:1065.[13]Mao WM, Zheng S, Gao YL. Expression and clinical significance of P53, P21, nm23, CD44 cardia carcinoma [J]. Chin J Dig 1999; 19:1329.[14]Pan X, Chen GR, Zhao J, et al. The expression of CD44 in biopsy tissue by endoscopy [J]. China J Endoscopy l996; 2:36.[15]Zhao Jun, Pan Xue, Yin Geping. A clinical research of CD44 molecule in gastrointestinal neoplasm [J]. Chin J Clin Oncol Rehabilitation 1998; 5:24.

  19. 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

  20. EARLY DIAGNOSIS OF CONGENITAL HEART DISEASE%新生儿先天性心脏病早期诊断

    Institute of Scientific and Technical Information of China (English)

    冉建瑜

    2011-01-01

    [Objective] To improve the diagnosis rate, reduce mortality and morbidity of congenital heart disease, summarize the early diagnosis of congenital neart disease characteristics. [Methods] From January 2008 -December 2010, 61 neonatal children with congenital heart disease admitted to our hospital were diagnosed by color Doppler ultrasound, retrospectively analyzed to the clinical features of children with congenital heart disease performance and auxiliary examination. [ Re-Sults] The qolor Doppler ultrasound investigation showed that newborns with congenital heart disease mainly were found with ventricular septal defect, followed by atri^l septal defect. CR film showed expansion of the heart shadow in 20 cases (32.7%) , lung field congestion in 16 patients (26.2%), lung field ischemia in 9 patients (14.8%) . ECG showed right ventricular hypertrophy in 20 cases (32.7%), ECG left side in 9 cases (14.8%), arrhythmia in 8 patients (13.1%) , supraventricular brady-cardia in 3 patients (4.9%), sT-segment depression in 1 case (1.6%). [Conclusion] Neonatal congenital heart disease is deficiency in clinical manifestations, shortness of breath is common, and the majority pathological type is ventricular septal defect. Color Doppler ultrasound examination is with a unique advantage.%[目的]为提高临床诊断率,降低先心病病死率及致残率,总结新生儿先天性心脏病患者早期诊断特点.[方法]选择2008年1月-2010年12月住院新生儿科的先心病患儿共61例,所有患儿均经过彩色多普勒超声明确诊断,回顾分析心儿先天性心脏病临床特征性表现及各辅助检查结果.[结果]彩超查显示,新生儿先天性心脏病中以室间隔缺损居多,其次为房间隔缺损.CR拍片显示心影扩大者20例(32.7%),肺野淤血者16例(26.2%),肺野缺血者9例(14.8%).心电图检查显示右室肥厚者20例(32.7%),心电左偏者9例(14.8%),心率不整者8例(13.1%),室上性心动过缓者3例(4.9%),s-T段压低者1

  1. 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

  2. 经左胸腹全胸腔镜食管胃交界区腺癌外科治疗(附17例报告)%The treatment of adenocarcinoma of the esophagogastric junction (AEG) by endoscopic radical oesophagectomy (report of 17 cases)

    Institute of Scientific and Technical Information of China (English)

    宿学家; 张志勇; 朱斌; 谭鑫; 范波

    2014-01-01

    目的:研究探讨胸腔镜下食管胃交界部腺癌(adenocarcinoma of the esophagogastric junction AEG)的手术体位、入路和手术方法的可行性及安全性。方法2011年11月至2014年03月对17例A E G行右侧卧位经左胸腹完全腔镜下根治术:右侧卧位经左胸行腔镜下下段食管的游离及清扫纵隔淋巴结,开膈肌,第七肋间肋弓下、腹直肌外缘做5cm长切口,腔镜辅助下游离贲门、胃及清扫胃左动脉、网膜淋巴结,普通消化道吻合器行食管胃吻合。结果无中转开胸。总手术时间:110-190m i n,平均146m i n。术中无大出血,总出血量30-150m l,平均110m l。共清扫纵隔淋巴结104枚,平均每例6.1枚;清扫腹腔淋巴结133枚,平均每例7.8例。术后住院9-14d,平均11d。住院期间病人无死亡。术后并发症:肺部感染2例,无吻合口漏。结论右侧卧位经左胸腹全腔镜下AEG的外科治疗是可行安全的,近期效果良好,并发症少,达到左侧开胸手术效果。但其长期疗效需要进一步研究、随访。%Objective To study the feasibility and safety of thoracoscopic surgery posturals and methods of the adenocarcinoma of the esophagogastric junction(AEG).Methods A total of 17 patients with AEG were operated with the right lateral endoscopic radical oesophagectomy from November 2011 to March 2014 : freeing the lower esophagus and clean mediastinal lymph nodes using thoracoscopy under the right side of the supine line, then opening the diaphragm and cuting 5cm long incision under the left seventh rib and the outer rectus abdominis, next by endoscopic-assisting freeing cardia, stomach and sweeping left gastric artery and omental lymph nodes, last esophagogastrostomy using a common gastrointestinal stapling. Results No transit thoracotomy. The total operation time :110-190min, average 146min. No massive hemorrhage, bleeding volume 30-150ml, average 110ml. Sweeping a total of 104

  3. 全胃切除消化道重建术对胃癌合并Ⅱ型糖尿病血糖的影响%Total gastrectomy reconstruction procedures on blood sugar of gastric cancer concomitance T2DM

    Institute of Scientific and Technical Information of China (English)

    汪启斌; 董荣坤; 张笃; 马芷琴

    2012-01-01

    目的 研究全胃切除加消化道重建术对胃癌合并Ⅱ型糖尿病(T2DM)术后血糖的影响.方法 将胃底贲门癌合并T2DM患者25例行全胃切除加Roux-Y吻合术(A组);选取同期的远端胃癌合并T2DM患者25例行毕Ⅱ式手术(B组)作为对照组;比较两组术后第一个月及丰年的血糖、C肽、糖化血红蛋白变化,采用t检验.结果 ①A组手术前后血糖、糖化血红蛋白及C肽改善无显著性差异(P>0.05),B组手术前后血糖、糖化血红蛋白及C肽的变化有显著性差异(P<0.05).②两组间术后对比差异有显著性(P<0.05).结论 ①全胃切除加Roux-Y吻合术对术后近期血糖无明星影响.②毕Ⅱ式术后近期血糖有明显改善,该术式对糖尿病有治疗作用.③胃与术后糖尿病改善有密切关系.④迷走神经肝支可能影响肠-胰岛轴.%Objective To explore the effect of total gastrectomy adding reconstruction procedures on blood sugar of gastric cancer concomitance T2DM. Methods 25 cases were operated total gastrectomy and Roux-Y on gastric bottom and cardia cancer consolidation type 2 diabetes mellitus (A group),at the same time,25 cases gastric sinuses cancer were performed Billioth 1KB group) ,to be collating group. To compare preoperative and postoperative the blood sugar. HbAlc and C peptide among A and B, using t test to analyze. Results 1. The difference was no significant that A group preoperative and postoperative the biood sugar, HbAlc and C peptide. The difference was significant that B group preoperative and postoperative the blood sugar, HbAlc and C peptide. 2. The postoperative difference was significant among A group and B. Conclusion The operation total gastrectomy adding Roux-Y don't evidently produce an effect on postoperative blood sugar in the near future. The operation Billroth II do evidently affect on postoperative blood sugar in the near future, it show that the operation can treat T2DM. 3. The relation of stomach and

  4. RETROSPECTIVE INVESTIGATION ON THE MORTALITY OF MALIGNANT TUMORS AND ITS DISEASE BURDEN AMONG RESIDENTS IN YUHUATAI DlSTRICT%雨花台区2007年居民恶性肿瘤死因及疾病负担回顾性调查

    Institute of Scientific and Technical Information of China (English)

    徐翠林; 蒋宁卫; 包磊; 周守君

    2011-01-01

    [目的]了解雨花台区居民恶性肿瘤死亡状况和疾病负担情况,为预防和控制恶性肿瘤的发生提供科学依据.[方法]采用回顾性调查方式,收集2007年全部恶性肿瘤(包括良性脑部肿瘤)死亡病例计361例,按照2:1比例随机抽取180例组成样本,进行入户问卷调查.[结果]收回有效问卷151(83.9%)份,死亡年龄1~86周岁,平均66.41周岁,较平均期望寿命低11.67岁(2007年雨花台区平均期望寿命为78岁).按系统分析死亡原因主要为消化系统肿瘤,计85(56.3%)例,恶性肿瘤的前10位死因顺位分别是肺癌、胃癌、肝癌、食管癌、贲门癌、直肠癌、胰腺癌、肾癌、胆囊癌、乳腺癌.患者确诊后在平均生存时间18.4个月,潜在寿命损失均数11.57年/例.[结论]恶性肿瘤对患者的生命健康和生存质量和经济情况造成了重大损失,肺癌和消化系统肿瘤是引起肿瘤死亡的主要原因.%[Objective] To design to describe the mortality of malignant tumors and its disease burden among residents in Yuhuatai District in Nanjing in Jiangsu Province, and to provide a scientific basis for the control and protection of the development of malignant tumors. [Methods] With the retrospective investigation method, all 361 death cases caused by malignant (including the innocence brain tumor) tumor in Yuhuatai District in 2007 were collected, 180 samples of them were randomly chosen with 1 : 2 ratio for door questionnaires research. [Results] 151 questionnaires (83.9%) were taken back, the death age was from 1 to 86, and the average age was 66.41, shorter than the expected age 78.08. A total of 85 deaths were caused by the digestive system tumors, the top ten malignant tumors causing death were pulmonary cancer, stomach cancer, hepatic cancer, esophageal cancer, carcinoma of gastric cardia, rectal cancer, pancreatic cancer, renal cancer, gallbladder cancer and mammary adenocarcinoma. The medium survival time after diagnosis was 18

  5. 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

  6. 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

  7. Clinical application of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of medi-astinal lesions and mediastinal lymphadenopathy%支气管内超声引导针吸活检术在纵隔肿物及纵隔肿大淋巴结诊断中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李明; 谭旭艳; 张治; 胡静雯; 夏红香; 成静; 许林

    2014-01-01

    of cardia cancer, 2 cases of nasopharyngeal cancer and 3 cases of lymphoma. Twenty⁃three patients showed negative EBUS⁃TBNA,and 5 patients was diagnosed as metastatic node.The sensitivity,specificity,and accuracy of EBUS⁃TBNA in defining malignant lymph nodes were 96�8%, 100%, 97%, respectively. No patients presented with complications. Conclusions EBUS⁃TBNA is a safe and effective method for evaluating mediastinal lesions.

  8. 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

  9. 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

  10. Comportamiento del cáncer gástrico en pacientes de la EPS-s provincia de García Rovira (Santander, en el periodo 2007-2014 / Gastric Cancer Behavior in EPS-s (Health Insurance Company in The Province of García Rovira (Santander, during the 2007 – 2014 Period / Comportamento do câncer gástrico nos pacientes da EPS-s da província de Garcia Rovira (Santander no periodo de 2007-2014

    Directory of Open Access Journals (Sweden)

    Diana Mireya Cuadros- Picón, MD.

    2015-03-01

    Full Text Available Introducción: El cáncer gástrico es en Colombia y Santander, la primera causa de muerte por tumores malignos, a pesar de no ser la primera neoplasia en frecuencia. Objetivo: Teniendo en cuenta lo anterior, el cáncer gástrico es un problema de salud pública y en nuestro medio no existen estudios analíticos que permitan caracterizar esta población; lo que se propone es una investigación en la cual se caracterice el comportamiento en la población con cáncer gástrico en la provincia de García Rovira, Santander, en el periodo 2007-2014. Metodología: Estudio analítico con 57 historias clínicas revisadas de pacientes de una empresa promotora de salud del régimen subsidiado (EPS-s con diagnóstico de cáncer gástrico confirmado por histopatología. Las variables consideradas fueron: sexo, edad, estadio, patología, localización, tratamiento y sobrevida, se realizó análisis univariado teniendo en cuenta la variable edad categorizada por rangos (hasta 50 años, 51 a 60 años, 61 a 70 años, y más de 70 años; variables cualitativas descritas en tabla de frecuencias, porcentajes e intervalos de confianza; el análisis bivariado se realizó buscando el valor P del test de Fisher, los datos fueron analizados en el paquete estadístico Stata. Resultados y conclusiones: Los resultados mostraron que los hombres representan un 77.2% de los casos de cáncer gástrico estudiados; el 68.4% del total de los pacientes tenía más de 60 años. Se encontraron diferencias significativas en la localización del tumor por sexo, ya que en las mujeres el cáncer se localizó en el antro pilórico mientras que en los hombres fue predominantemente en el cardias y el cuerpo del estómago (p<0.05; por su parte, las variables estadio clínico y tratamiento recibido se encontraron asociados de manera estadística a mortalidad (p<0.05. [Cuadros-Picón DM, Reyes-Soto Y. Comportamiento del cáncer gástrico en pacientes de la EPS-s provincia de García Rovira

  11. 南昌地区消化性溃疡的临床特点和季节变化规律%Clinical characteristics and the regularity of seasonal changes of peptic ulcer in Nanchang area

    Institute of Scientific and Technical Information of China (English)

    舒徐; 李国华; 吕农华; 朱萱; 陈幼祥; 王崇文

    2008-01-01

    Objectives To investigate the clinical characteristics and the regularity of seasonal changes that influence peptic ulcer (PU) in Nanehang area and to provide a theoretical basis for the treatment and prevention of PU.Methods Data collected from patients with PU diagnosed by clinic and gastroendoseopy between October 2003 to May 2008 were retrospectively analyzed.The PU was further divided into gastric ulcer,duodenal ulcer and complex ulcer.The lesion of gastric ulcer was calculated by five locations that were antral,angular,corporal,pyloric canal,fundic and cardia.The lesion of duodenal ulcer was calculated by five locations that were anterior wall of bulb,posterior wall,lesser curvature, greater curvature and postbulbar.The climate changes that influnced the incidence of PU disease were also observed.The detective rates of different types of PU were analyzed and its association with gender,age, lesion locations,seasons,Helicobacter pylori (Hp) infection and complications were also investigated. Results Among 83 888 patients who underwent endoscopy,PU was found in 21 308 patients (25.4%) including 66.33% duodenal ulcer,24.88% gastric ulcer and 8.79% complex ulcer.The male and femal ratio was 2.44 : 1 in PU,2.53 : 1 in duodenal ulcer,2.26 : 1 in gastric ulcer,and 2.33 : 1 in complex ulcer.The average age of patients with gastric ulcer was 48.0 years that was about 6.7 years higher than that of patients with duodenal ulcer.The prevalence of duodenal ulcer and gastric ulcer peaked in the 30- 39 years and 50-59 years,respectively.PU was more common from December to February (30.17%) and less common from June to August (22.54%) (P<0.01) .The 57.43% of duodenal ulcer was found on anterior wall of bulb,18.26% on greater curvature,13.21% on lesser curvature,7.34% on posterior wall and 3.76% on postbulbar.The 45.69% of gastric ulcer was found on antral,20.54% on angular, 15.54% on corporal,9.36% on pyloric canal,and 8.87% on fundic and cardia.The 91.83% (12 318/ 13 414

  12. Correlation between hypertension and clinical probable Parkinson disease: Cohort analysis of 4 335 people in Linxian County with nutritional intervention%高血压与临床很可能帕金森病的关联性:林县营养干预4 335人队列人群资料分析

    Institute of Scientific and Technical Information of China (English)

    范金虎; 张亚黎; 刘颖; 孙秀娣; 乔友林

    2006-01-01

    BACKGROUND: Linxian County of China is one of the areas with the highest incidence of esophageal cancer and gastric cardia cancer in the world, and nutrition-deficiency is widely existing in local people. In recent years, many researches around the world revealed that the cause of Parkinson disease (PD) is related to factors of gene, age, environment, diet, nutrition and smoking. More and more studies confirmed that primary hypertension may be in relation to vascular Parkinsonism (VP) and long-term hypertension was apt to VP.OBJECTIVE: To investigate the relationship between hypertension and clinical probable Parkinson disease (PPD) in nutrition-deficient population of Linxian County and provide a theoretical basis for early prevention and treatment of PD.DESIGN: Cross-sectional study.PARTICIPANTS: A total of 4 335 subjects aged over 55 years were selected. These subjects have taken part in the nutritional intervention study of Linxian County and first entered in the cohort study in 1985. They were enrolled in the nutritional intervention study in Linxian County in 1985.METHODS: A prospective cohort study was conducted. ①Case screening: PD questionnaire (used in American Gebai County) combined with general neurological examination were adopted. ②The diagnosis of PD: Clinical diagnostic criteria of UK Parkinson Disease Society Brain Bank were taken as the criteria for screening PD. Further evaluations were undertaken for clinical PPD and clinical possible PD on subjects who had PD symptoms.The diagnostic criteria of clinical PPD: Subjects were diagnosed as having clinical PPD if they presented any two of the following two cardinal features (resting tremor, hypermyotonia, bradykinesia and impairment of postural reflexes) or presented any one of the following features (resting tremor, hypermyotonia and bradykinesia). Diagnostic criteria of clinical possible PD: Subjects were diagnosed as having clinical possible PD when presented any one of the following four

  13. 胃癌17号染色体异倍体改变及TP53和拓扑异构酶Ⅱα蛋白过表达与病理诊断的相关性%Correlation between aneuploidy of chromosome 17,over-expression of TP53 and TOP Ⅱα,and the clinicopathoiogical features and diagnosis of gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    鲁海珍; 吴玉鹏; 罗巍; 韩亚玲; 蔡岩; 徐昕; 梁晶; 刘尚梅; 王明荣

    2009-01-01

    Objective The purpose of this study was to investigate the markers which can be used in auxiliary diagnosis of gastric adenocarcinoma (GAC),and their correlation with their clinicopathological features.Methods 122 surgical specimens including 99 gastric adenocarcinoma (GAC),18 adjacent mucosa and 5 distal normal mucosa were collected,and analyzed by in situ hybridization (FISH).The centromere probe cen17,specific for chromosome 17,which was reported to be frequently amplified in GAC,was selected for the FISH analysis.The clinicopathological features of the 99 GAC cases were reviewed,and the level of TP53 and TOP Ⅱα gene expression,located in chromosome 17,was detected using tissue microarray (TMA),compared with that of corresponding adjacent normal mucosa.Data were analyzed with SPSS 11.5 for Windows.Results The statistical results of FISH and TMA showed that 58.6% of cen17 in tumor tissues were aneuploid,and 45.5% of TP53 and 84.7% of TOP Ⅱα were over-expressed in GAC samples,significantly higher than those in non-tumor gastric mucosa (0,12.1% and 14.1%,respectively) (P =0.000).58 GAC tissues were aneuploid of cen 17,including 26 cases TP53-positive and 49 cases TOP Ⅱα-positive.The expression of TP53 in non-tumor gastric mucosa with dysplasia was significantly higher than that in the mucosa without dysplasia (P=0.009).Aneuploidy of cen17 was more frequent in grade 1 or 2 than in grade 3 GAC(P<0.05).Higher frequency of aneuploidy of cen17 was also observed in the gastric cardia than in pylorus (P<0.05),while no correlation was found between aneuploidy of cen17 and age,sex of patients,lymph node metastasis,and clinical stage of tumors.Over-expression of TP53 protein was associated with the size of tumors (P<0.05).In addition,a negative correlation was observed between over-expression of TOP Ⅱα and lymph node metastasis (LNM) as well as TNM classification (P<0.05).Conclusion Detection of aneuploidy of cen17 as well as over-expression of TP53 and

  14. 伊伐布雷定治疗窦性心动过速的 Meta 分析%A Meta-analysis of ivabradine in treatment of inappropriate sinus tachycardia

    Institute of Scientific and Technical Information of China (English)

    邱爽; 杨波; 平海芹; 王慧

    2015-01-01

    Objective To systemic evaluate clinical curative effect of ivabradine in treatment of sinus tachycardia. Methods Through the retrieval of Wanfang database, VIP database, China journal full text database, PubMed, EMBASE database, database SCI/SSCI/A&HCI, science direct database, Springer electronic journals and electronic books, the Co-chrane Database, all evaluation of Ivabradine for treatment of sinus tachycardia random or non-randomized control trials ( re-trieval time from state of the database to January 2015), the included studies were evaluated by Jadad quality score, resting heart rate, average heart rate, maximum heart rate, minimal heart rate, daytime heart rate, maximum exercise heart rate were weighted the mean difference (WMD) as the therapeutic index, and the results were analyzed by Rev man 5.2 software.Re-sults A total of 8 studies were included, all were English literature, and the total number of cases was 231, the treatment group with 116 cases, and the control group with 115 cases.Meta-analysis shows that for sinus tachycardia patients, Ivabra-dine can effectively reduce the resting heart rate (WMD=-29.55, 95%CI -32.69 to -26.41, P <0.01), average heart rate (WMD=-23.41, 95%CI -24.81 to -22.00, P <0.01), the maximum heart rate (WMD=-28.69, 95% CI -32.03 to -25.34, P <0.01), the minimal heart rate (WMD=-11.42, 95%CI -13.86 to -8.98, P <0.01), the day-time heart rate (WMD=-23.90, 95%CI -25.91 to -21.89, P <0.01), and the maximum exercise heart rate (WMD=-25.20, 95%CI -34.40 to -15.99, P <0.01).Conclusion Ivabradine showed certain curative effect for sinus tachy-cardia, while its long-term efficacy and safety needed to be confirmed by high quality randomized controlled trials and evidence based medicine.%目的:系统评价伊伐布雷定治疗窦性心动过速的临床疗效。方法通过检索万方数据库、维普数据库、中国期刊全文数据库、PubMed数据库、Embase数据库、SCI/SSCI/A&HCI数据库、Science Direct数

  15. 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

  16. 三维标测系统指导下复杂心律失常的经导管射频消融治疗%Three-dimensional mapping for radiofrequency catheter ablation of complex cardiac arrhythmias

    Institute of Scientific and Technical Information of China (English)

    洪浪; 王洪; 赖珩莉; 尹秋林; 陈章强; 陆林祥; 邱赞; 肖承伟

    2009-01-01

    目的:探讨在三维标测系统指导下,经导管复杂心律失常射频消融治疗的有效性与安全性. 方法:选择2006年2月至2008年9月住院患者98例,其中阵发性房颤50例、持续性或永久性房颤6例、心房扑动9例、房性心动过速(房速)9例、室性心动过速(室速)或频发室性早搏24例.在EnSite NavX或Array系统(72例)或CARTO系统(26例)指导下进行射频消融手术. 结果:84例一次手术成功(85.71%),7例再次导管消融成功,成功率合计92.86%.50例房颤一次手术成功,5例再次消融后3例成功.9例心房扑动患者中7例一次手术成功,1例复发再次消融成功.9例房速中7例一次手术成功,1例复发再次消融成功.24例室速、室早患者中20例一次消融成功,4例行再次消融2例成功.共有并发症6例:心包填塞4例,左前降支远端栓塞1例、术后肺栓塞1例. 结论:三维标测系统可清晰地显示心脏三维立体结构,对复杂疑难心律失常的射频消融治疗具有较好的指导作用,提高消融的成功率并增加手术安全性.%Objective:To explore the validity and safety of radiofrequeney catheter ablation of complex cardiac arrhythmias guided by a three-dimensional mapping system. Methods.. A cohort of 98 consecutive inpatients were registered from February 2006 to September 2008, of which 68 cases were male and 30 cases were female, with an average age of (50.2 ± 19. 7) years ranging from 9 to 88 years of age. These patients suffered from various arrhythmias including paroxysmal atrial fibrillation (50 cases), persistent or permanent atrial fibrillation (6 cases), atrial flutter (9 cases), atrial tachy-cardia (9 cases), ventricular tachycardia or frequent episode ventricular premature beat (24 cases). A total of 72 cases underwent radiofrequency catheter ablation of arrhythmias guided by an En-Site3000/NavX or Array mapping system, and 26 cases guided by a CARTO mapping system. Re-suits:Successful ablation of

  17. Predictive risk factors for delayed sternal closure in the patients under the age of three months old with congenital cardiac disease%3个月内复杂先天性心脏病患儿术后延迟关胸的因素分析

    Institute of Scientific and Technical Information of China (English)

    张惠锋; 贾兵; 陈张根; 李炘; 叶明; 陶麒麟; 陈刚

    2008-01-01

    Objective To analyze the risk factors related with delayed sternal closure(DSC)in the patients under three months old with complex cardiac disease.Methods One hundred and nineteen patients underwent median sternotomy and cardiopulmonary bypass(CPB)between Jan 2000 to Oct 2006.The age ranged from 1 to 90 days(mean 44±26 days)and the weight ranged from 2.2 kg to 7.1 kg(mean 3.9±0.89 kg).SPSS v 11.5 software was used to analyze the factors including the age,gender,weight,preoperative conditions,diagnose,prematurity,requirement for preoperative mechanic ventilation,preoperative SPO2,cardia-thoracic area ratio,left ventricular faction,CPB duration,clamping time,total circulatory arrest with profound hypothermia.Results Forty-seven patients had DSC.The rate of DSC iS over 75% for IAA or TAPVD(infracardiac)or TGA/VSD.The risk factors including age(P=0.032),pre-operative mechanic ventilation(P=0.001),CPB duration(P=0.000),total circulatory arrest with profound hypothermia(P=0.001).They were statistically significant(multivariate logistic regression).Conclusions DSC is a simple,safe and efficient procedure for the complex cardiac diseases.DSC iS related to IAA or TAPVD(infracardiac)or TGA/VSD.Age,pre-operative mechanic ventilation,CPB duration,total circulatory arrest with profound hypothermia are the risk factors for DSC.Understanding the factors iS helpful in the clinical decision making process.%目的 探讨3个月内的复杂先天性心脏病患儿术后行延迟关胸的危险因素.方法 2000年1月~2006年10月收治119例胸骨正中切口并进行体外循环的患儿,男97例,女22例,年~龄1~90 d,平均(44±26)d,体重2.2~7.1 kg,平均(3.9±0.9)kg,分析年龄、性别、体重、术前胸围、诊断、是否为早产儿、术前是否机械通气、SpO2、胸片测得的心胸比例、心超测得的左心射血分数、体外循环时间、主动脉阻断时间、深低温停循环等因素与延迟关胸的相关性.结果 延迟关胸47

  18. 两种龟消化道黏膜上皮的扫描电镜观察%Observations on the mucosa of digestive tract in two turtles by SEM

    Institute of Scientific and Technical Information of China (English)

    李贵生; 唐福星

    2014-01-01

    利用扫描电镜对黄喉拟水龟和乌龟的消化道黏膜上皮进行了观察。结果显示,黄喉拟水龟胃黏膜上皮有发达的沟、回结构,在胃的贲门区可见指状突起的黏膜上皮细胞。胃体部的黏膜上皮细胞较大,柱状,表面多数呈五边形或六边形。在一些黏膜上皮细胞中,可见明显的分泌孔。在胃的幽门区,可见突起的微脊。在十二指肠中,可见横行的主皱襞和次皱襞,表面分布着形态不规则的细胞,可见沟、回结构;表面有很多杯状细胞,大多呈圆形。在回肠,可见纵行皱襞,吸收细胞表面不规则,有很多肠腺开口。大肠的黏膜皱襞较浅,可见杯状细胞分布于其中。乌龟胃黏膜上皮表面结构与黄喉拟水龟相似。可见两种不同形状的黏膜上皮细胞,一种为中央凹陷,排列紧密,呈鳞状;另一种为中央稍突起,呈不规则型。胃底部可见很多分泌细胞,在这些细胞中可见乳头状突起,在一些乳头状突起的中央可见分泌孔。小肠上皮细胞结构与黄喉拟水龟相似。大肠黏膜上皮细胞中可见簇状排列的黏液分泌细胞。在两种龟的胃黏膜上皮细胞中均可见胃小凹结构,但未见微绒毛结构,也无杯状细胞。%The mucosa of digestive tract in Mauremys mutica and Chinemys reevesii were studied by scanning electron microscope.The results showed that,in Mauremys mutica,there are developed channel and promontory in stomach.There are fingerlike protuberant mucosa epithilia in the cardia section of stom-ach.The mucosa epithilia is larger,stylolitic,pentagon or hexagon on stomach body surface.In some mucosa epithilia,there are obvious secretory hole.In the pyloric section of stomach,the protuberant tiny ridge is seen.In duodenum,there are transverse main plica and petit plica.There are irregular cells in the surface of duodenum,and the channel and promontory are seen.There are many circular

  19. 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.

  20. 上海市与肥胖相关的恶性肿瘤发病趋势分析%Trend Analysis on Obesity-Associated Cancer Incidences in Shanghai

    Institute of Scientific and Technical Information of China (English)

    周峰; 吴春晓; 柯居中; 郑莹; 鲍萍萍; 彭鹏; 龚杨明; 向詠梅; 黄哲宙

    2013-01-01

    To describe the incidence trends of obesity-associated cancers,and to provide basis for cancercontrol-related policy making and prevention program evaluation in Shanghai.[Methods] Incidence rate data from Shanghai cancer registry system were coded by ICD-10 and ICD-O-3 and analyzed.Average annual percentage change (AAPC) and annual percentage change (APC) based on log linear model was adopted to describe the incidence trend.Population attributable risk percent (PARP) was employed to estimate the obesity-associated incidence cases.[Results] Whether over the long-term (1973-2008) or short-term (2002-2008) period,the breast cancer incidence rate of females at age of 50 years old and above was increasing continually and significantly with an AAPC of 2.34% in urban areas during 1973-2008 and an APC of 4.00% in suburb areas during 2002-2008.The incidence rates of endometrial cancer of all females and of the 50 years old and above did not present significant trends of variation.The colorectum cancer presented significant ascending trends,except among the suburb females,for the urban with an AAPC of 2.33% during 1973-2008 and the suburb with an APC of 2.51% during 2002-2008.The kidney cancer showed significant ascending trends for the urban residents with an AAPC of 5.20% during 1973-2008 and the suburb residents with an APC of 7.57% during 2002-2008.During 2002-2008,the esophagus and gastric cardia adenocarcinoma presented significant descending trends,except among the suburb males,for the urban residents with an APC of 10.49% and the suburb residents with an APC of 2.94%.In 2009,the obesity-associated incidence number of the above 5 cancers was 1431,accounting for 11.37% of the total incidence count of the above 5 cancers.The endometrial cancer had the largest proportion of the obesity-associated cancers and covered 23.41% of its total incidence cases.[Conclusion] Multiple strategies including obesity control and screening for high risk populations

  1. 42例早期胃癌临床病理特点%The clinical pathology characteristic of 42 example early time stomach cancer

    Institute of Scientific and Technical Information of China (English)

    彭文新

    2010-01-01

    目的 观察早期胃癌胃镜、临床病理特点,探讨其病理诊断.方法 将收集42例早期胃癌临床、胃镜及组织病理特点进行观察,采用免疫组化S-P法检查C-erbB-2、P53、Ki-67的表达.结果 早期胃癌临床表现无特异性,主要为腹痛腹胀不适,部分消瘦食欲减退,呕血便血等,胃镜主要表现为糜烂平坦型23例(54.8%)隆起型17例(40.5%),病变部位胃窦最多29例、胃角5例、胃体6例,胃底贲门部2例.组织类型:管状腺癌24例,黏液腺癌2例,印戒细胞癌7例,低分化腺癌9例,伴有肠上皮化生15例,不典型增生14例.黏膜内癌26例,黏膜下层16例,伴有淋巴结转移6例.C-erbB-2阳性表达占16.7%(7/42),Ki-67阳性表达占38.1%(16/42)、P53阳性表达占30.9%(13/42).结论 早期胃癌临床表现隐匿,无特异性,不足以引起患者和临床医生的重视.对胃癌高危患者积极开展定期胃镜检查是提高早期胃癌检出率的关键,是早期胃癌确诊的的最佳方法,C-erbB-2阳性表达与淋巴结转移有关.早期胃癌是一种多因素,多基因,多步骤共同作用复杂过程.%Objective To observe early gastric endoscopy, clinical and pathological features of the pathological diagnosis. Methods 42 cases of early gastric cancer of clinical, endoscopic and pathological features was observed, C-erbB2, P53, Ki-67 expression were detected by immunohistochemical sp method. Results The results of early gastric cancer had no specific, mainly abdominal pain and bloating discomfort, some weight loss loss of appetite, vomiting blood in the stool, etc. , endoscopy showed erosive flat major, 23 cases (54. 8% )protruded in 17 cases (40. 5% ), lesions up to 29 cases of gastric area, gastric angle in 5 cases, 6 cases of gastric body and gastric cardia in 2 patients. Organization type: tubular adenocarcinoma, 24 cases,2 cases of mucinous adenocarcinoma, signet ring cell carcinoma in 7 cases, 9 cases of poorly differentiated adenocarcinoma, 15 cases

  2. Characteristics of the lymph node metastases and influencing factors and their value in target region delineation in postoperative radiotherapy for thoracic esophageal carcinoma%胸段食管癌的淋巴结转移规律及其对确定术后放射治疗靶区范围的价值

    Institute of Scientific and Technical Information of China (English)

    李幼梅; 祝淑钗; 刘志坤; 宋长亮; 王玉祥; 王士杰

    2010-01-01

    Objective To explore the distribution of lymph node metastases, to analyze the cliniopathologic factors of thoracic esophageal carcinoma after curative resection, and to provide the criteria of irradiated region delineation in radiotherapy for esophageal carcinoma. Methods The clinicopathological data of 763 patients who underwent esophagecotomy from Jun 2002 to Jun 2006 were retrospectively analyzed. The regularity of lymph node metastases of thoracic esophageal cancer and clinicopathological factors were stratified and analyzed with SPSS13.0 software. Results Of the 763 patients, a total of 5846 lymph nodes were dissected with an average of 7.7 lymph nodes in each case. Metastatic lymph nodes were 711, the ratio of metastatic lymph node was 12.2% , and 297 patients had lymph node involved, the lymph node metastasis rate was 38.9%. The metastatic lymph nodes of upper-thoracic esophagus were mainly observed in the supraclavicular and paratracheal regions (P<0.05), the metastatic lymph nodes of middlethird thoracic esophagus were bidirectional, and those of the lower-third thoracic esophagus mainly metastasized to the regions adjacent to the esophagus, gastric cardia and gastric artery (P< 0.05 ). Both the metastasis ratio and rate of lymph nodes adjacent to the gastric artery in the lower-thoracic esophageal cancer were significantly higher than those in the middle-third and upper-third thoracic esophageal cancers ( P =0.007, P = 0.001). The multiple factors logistic regression analysis showed that tumor length, depth of tumor invasion, vascular tumor emboli and distant metastasis were major factors for lymphatic metastasis (P<0.01). For the whole group of patients the lymph node metastatic rate was 28.5% in upper-thoracic esophageal cancer, significantly lower than 38.8% of the lower-thoracic esophageal cancer (P =0.039) and 43.4% in the middle-thoracic esophageal cancer (P=0.010). However, the lymph node metastatic rates were 37.0% , 37.9% and 41.4% in the upper

  3. 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.

  4. 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)

  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. 门静脉高压症巨脾切除+贲门周围血管离断术后发热的原因分析及处理%Analysis and Treatment of Postoperative Fever in Portal Hypertension Splenectomy+Ben Peripheral Vascular Transection

    Institute of Scientific and Technical Information of China (English)

    丁建忠; 李强; 王锦华

    2013-01-01

    Objective: To investigate patients with portal hypertension underwent splenectomy pericardial blood vessel broken postoperative persistent fever risk factors and treatment methods that clinical guidance. Methods:Collect hospital in January 2005~2012 5 treated patients with portal hypertension splenectomy the+cardia surrounding blood vessels from the off surgery in patients treated 236 cases of clinical data, screening of patients with postoperative persistent fever, a comparative analysis of persistent postoperative fever of risk factors, and summarizes the approach. Results:Of the 236 cases of patients with persistent fever after 35 cases, mainly due to the infection in 22 cases, five cases of splenic vein thrombosis, unexplained eight cases. After symptomatic treatment, 32 cases recovered, 3 cases of death, cause of death was infection with liver and kidney function failure in 1 case, 1 cases of severe pneumonia, splenic vein thrombosis cases. Univariate analysis, display emergency surgery, classification of poor liver function, operative time>4h after surgery is not for total parenteral nutrition, postoperative platelet significantly higher in the major risk factors that cause patients with persistent fever (P<0.05). fever was no significant relationship with the patient sex and age. Conclusion: Splenectomy+pericardial blood vessel transection of postoperative persistent fever because complex clinical risk factors should be based on the heat, a rigorous screening can be surgery, perioperative anti-infection effective to enhance the nutritional status of patients, as far as possible to shorten the operation time to effectively reduce the persistent postoperative fever.%  目的:探讨肝硬化门静脉高压患者行脾切除+贲门周围血管离断术后持续发热的危险因素及处理方法,以为临床提供指导。方法:收集本院2005年1月~2012年5收治肝硬化门静脉高压行脾切除+贲门周围血管离断术治疗的患者236例

  7. 多西紫杉醇对可切除的淋巴结阳性乳腺癌的疗效分析%The effect of adjuvant docetaxel for operable node - positive breast cancer

    Institute of Scientific and Technical Information of China (English)

    郭立伟; 黄自明; 王蓉; 薛明兴; 魏刚

    2014-01-01

    To compare docetaxel plus epirubicin and cyclophosphamide(TEC)with fluorouracil plus epirubicin and cyclophosphamide(FEC)as adjuvant chemotherapy for operable node - positive breast cancer. Meth-ods:From July 2005 to July 2007,we randomly assigned 62 women with axillary node - positive breast cancer to six cycles of treatment with either trial group(TEC)or control group(FEC)as adjuvant chemotherapy after modified rad-ical mastectomy to analyse 5 - year disease - free survival,overall survival and adverse effect. Results:The rate of five- year disease - free was 70. 0%(21 / 30)in the TEC group significantly higher than that[40. 6%(13 / 32)]in the FEC group(P = 0. 020). The rate of five - year overall survival was 50. 0%(16 / 32)in the FEC group significantly lower than that[76. 7%(23 / 30)]in the TEC group(P = 0. 030). The incidence of grade 3 or 4 neutropenia was 53 . 1 %( 17 / 32 )in the FEC group and 63. 3%(19 / 30)in the TEC group(P = 0. 416). Rates of febrile neutro-penia were 6. 3%(2 / 32)and 10. 0%(3 / 30),respectively(P = 0. 587). The damages to liver,kindey and cardia were not significantly different in the two groups(P ﹥ 0. 05). Quality of life scores decreased during chemotherapy but returned to baseline levels after therapy,but scores in the FEC group were significantly lower than those in the TEC group on the 24th month after completing the sixth chemotherapy(P = 0. 032). Conclusion:Adjuvant chemotherapy with TEC as compared with FEC significantly improves the rates of five - year disease - free and overall survival among women with operable node -positive breast cancer,and its adverse effects such as myelosuppression are not unacceptable.%目的:比较含多西紫杉醇的化疗方案(TEC)与 FEC 方案对可切除的淋巴结阳性乳腺癌的疗效。方法:2005年7月至2007年7月,将我科62例行乳腺癌改良根治术后的腋窝淋巴结阳性病人随机分为 TEC 组(试验组)和 FEC 组(对照组),并行6

  8. 胸内食管吻合口隐匿瘘的诊断与治疗%Diagnosis and Management of Concealed Intrathoracic Anastomotic Leak of Esophagus

    Institute of Scientific and Technical Information of China (English)

    刘奎; 杨秀芝; 王明钊; 王栋; 王滋宗; 沈毅; 魏煜程

    2012-01-01

    Objective To investigate diagnosis and treatment of concealed intrathoracic anastomotic leak of the esophagus. Methods We retrospectively analyzed the clinical data of 32 patients who presented with unexplained sepsis (temperature > 38 ℃ and elevated white blood cell count) after esophagectomy and intrathoracic anastomosis for esophageal carcinoma or gastric cardia carcinoma in Affiliated Hospital, Medical College of Qingdao University from January 2006 to December 2010. All the patients underwent oral water-soluble contrast esophagogram and oral water-soluble contrast computerized tomography of the chest. None of the patients had any sign of contrast leak in these diagnostic examinations, but their chest computerized tomography all showed peri-anastomotic bubble and encapsulated effusion. Fifteen patients were treated as concealed intrathoracic anastomotic leak of the esophagus, including fasting, broad spectrum antibiotic treatment, -. prolonged gastrointestinal decompression and enteral nutrition via naso-intestinal feeding tube. The other 17 patients were not treated as anastomotic leak of the esophagus and only received broad spectrum antibiotic treatment. Results None of the 15 patients who were treated as concealed intrathoracic anastomotic leak finally developed anastomotic leak proved by oral water-soluble contrast esophagogram and computerized tomography of the chest (0%, 0/15). Among the 17 patients who were not treated as anastomotic leak, fourteen patients developed anastomotic leak later (82. 4%, 14/17), 2 patients died of aorto-esophageal fistula and 3 patients died of multiple organ dysfunction syndrome. Conclusion Peri-anastomotic bubble and irregular encapsulated effusion in oral water-soluble contrast esophagogram and computerized tomography of the chest should be considered as specific signs of concealed intrathoracic anastomotic leak of esophagus after esophagectomy and intrathoracic anastomosis. Patients with such signs should be treated

  9. Analysis on Clinical Value of Spiral CT in Diagnosis of Thoracic Segment Esophageal Cancer Lymph Node Metastasis%胸段食管癌淋巴结转移的螺旋CT诊断价值

    Institute of Scientific and Technical Information of China (English)

    顾勤

    2015-01-01

    statistically significant when compared to results of pathological examination (p<0.05). The number of top mediastinal juxta-groups and paratracheal juxta--groups in the upper thoracic portion was the most, hitting 42.9%and 33.3% respectively, and the number of mediastinum groups, paratracheal juxta-groups and submental juxta-groups in the mid-thoracic portion was the most, hitting 22.9%, 37.5% and 25.0% respectively, and the number of cardia juxta-group and left gastric arteries in the lower thoracic portion was the most, hitting 54.5%and 27.2%respectively. Conclusions Spiral enhanced CT delivers important clinical value in the diagnosis of thoracic segment esophageal cancer lymph node metastasis, its images possess certain characteristics, and it can improve the diagnostic accuracy, clearly show the metastasis availability of lymph nodes, and provide important diagnostic basis for clinical treatment, being worth of wide application and promotion in clinical practices.

  10. Interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery%介入治疗股浅动脉硬化闭塞19例分析

    Institute of Scientific and Technical Information of China (English)

    祝慧鹏; 周艺琳; 冯翔; 李鸣; 包俊敏; 景在平

    2009-01-01

    Objective To explore the methods and mid-term results of interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery(SFA).Methods From January 2005 to August 2008,Nineteen cases with 22 diseased lower limbs were admitted.According to Fontaine stage system,there were 6 stage Ⅱb limbs(moderate to severe intermittent claudication),8 stage Ⅲ limbs(rest pain),and 8 stage Ⅳ limbs(6 with ulcer and 2 with gangrene).The mean lesion length was 8.8 cm(5~13 cm).On the basis of the TransAtlantic Inter-Society Consensus(TASC)femoropopliteal classification,the lesions were classified as type B in 4 limbs,type C in 17,and D in 1.Follow up examinations with color duplex ultrasound and/or arteriography were carried out to determine the patency.The improvement of clinical symptoms after operation was analyzed.Results 17 limbs were revascularization successfully,2 limbs were turned to bypass operation,3 limbs were judged untreatable.The technical success rate is 77.3%,and the clinical improvement of symptoms was achieved in 100% of the 17 limbs on which the procedure was successful.The 17 limbs were followed up for a mean of 12.5 months(range 3-33 months).One patient died of cardia infarction one month postoperatively.SFA occlusion happened in 4 limbs.At one year postoperatively,the patency rate was 75%(13/17)after primary operation.Conclusions Primary endovascular treatment of SFA occlusion diseases is a safe,minimally invasive,and effective method.%目的 探讨股浅动脉硬化闭塞介入治疗的方法和疗效.方法 回顾性分析2005年1月至2008年8月介入治疗的19例(22条下肢)股浅动脉硬化闭塞症患者的临床资料.其中Fontaine Ⅱb期(中、重度间歇跛行)6条,Ⅲ期(静息痛)8条,Ⅳ期(组织缺损)8条(其中足部溃疡6条,足趾坏疽2条).股浅动脉病变的平均长度8.8 cm(5.0~13 cm).病变TASC分型B型4条,C型17条,D型1条.通过彩色血管超声和(或)动脉造影观察病变段动脉

  11. ارتباط حضور ژن cagA در عفونت هليكوباكتر پيلوري با بيماريهای گاستريت و زخمهای دئودنال و آدنوکارسينومای Correlation of cagA positive Helicobacter pylori Infection with clinical outcomes in Alzahra hospital, Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Hajieh Ghasemian Safaei

    2008-08-01

    اد که بين ژنوتيپ cagA و سن، ميزان تحصيلات، محل سکونت و مثبت بودن تست اوره­آز سريع، رابطه معنی داری وجود نداشت(pvalue>0.05. ولی بين سن و بيماری آدنوکارسينوما ارتباط معنی داری وجود داشت.  (pvalue>0.05

    • BACKGROUND: Helicobacter pylori causes chronic active gastritis, peptic ulcer, non-cardia gastric cancer and mucosal– associated lymphoid tissue (MALT lymphoma. Different genotypes of  Helicobacter pylori are confirmed from disease geographical areas. Its association with clinical disease remained controversial. The aim of the present study was to investigate the relationship of the cagA genotype of Helicobacter pylori isolates with clinical manifestations and its relation to age and sex of patients.
    • METHODS: A total of 100 patients (60 male and 40 female biopsy specimens were obtained from 3 groups of patients (40 chronic active gastritis, 40 duodenal ulcers and 20 non-gastric gastric cancers. Biopsies were cultured on specific medium and after growth colonies were confirmed as Helicobacter pylori. DNA extraction and polymerase chain reaction (PCR were used to detect the presence or absence of cagA gene.
    • RESULTS: From a total of 100

    • Neoplasias do trato alimentar superior de bovinos associadas ao consumo espontâneo de samambaia (Pteridium aquilinum Neoplasms of the upper digestive tract of cattle associated with spontaneous ingestion of bracken fern (Pteridium aquilinum

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      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.

    • 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