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Sample records for intestinal polyps

  1. Intestinal Polyps (in Children)

    Science.gov (United States)

    ... these inherited conditions. What are the symptoms of polyps? Children with polyps usually pass blood in the stools. ... to have another colonoscopy. Children that have several polyps, or children whose families have special polyposis syndromes, may need ...

  2. Sonographic diagnosis of intestinal polyps in children.

    Science.gov (United States)

    Parra, Dimitri A; Navarro, Oscar M

    2008-06-01

    Although colonoscopy is the modality of choice for the diagnosis of intestinal polyps, sonography may be the first diagnostic modality in the evaluation of children with this pathology. Graded compression sonography of the small and large bowel may be useful in diagnosing intestinal polyps. A specific diagnosis is possible in many cases as most polyps have a characteristic appearance. Although sonography is not intended to replace endoscopy in the diagnostic work-up of intestinal polyps, it is important for radiologists to be aware of this appearance as they can be the first in making the diagnosis of intestinal polyps using sonography.

  3. The patient with multiple intestinal polyps.

    Science.gov (United States)

    Schulmann, Karsten; Pox, Christian; Tannapfel, Andrea; Schmiegel, Wolff

    2007-01-01

    The management of patients with multiple intestinal polyps may be difficult and greatly depends on the correct classification. Polyposis syndromes account for less than 1% of newly diagnosed colorectal cancers. In addition the risk for extracolonic cancer is increased in most syndromes. Here we report the case of a difficult patient with severe gastric polyposis and we present a review of polyposis syndromes such as classical and attenuated familial adenomatous polyposis (FAP), MYH-associated polyposis, Peutz-Jeghers syndrome, juvenile polyposis as well as rare polyposis syndromes. The most practical approach for the diagnostic workup in patients with newly diagnosed gastrointestinal polyposis is based on the histological typing of polyps. In addition, a detailed family history regarding cancer, polyps and congenital abnormalities should be obtained from every polyposis patient. Patients with multiple adenomas are most likely to suffer from FAP, AFAP or MAP. Of these, younger age and higher polyp count are most likely a diagnosis of typical FAP. Older age and fewer polyps favour a diagnosis of AFAP or MAP. Germline testing of the APC gene is suggested, and if negative, MYH gene testing should be done. In patients with hamartomas, extraintestinal features should be evaluated and reference histology should be initiated. In addition panintestinal imaging should be performed with EGD, colonoscopy and small bowel imaging (PE, CE, and MR) enteroclysis. For diagnostic and therapeutic problems a familial colorectal cancer center should be consulted. Using this algorithm, correct classification and adequate treatment should be possible for every polyposis patient.

  4. Colonic Polyps

    Science.gov (United States)

    ... Colonic polyps grow in the large intestine, or colon. Most polyps are not dangerous. However, some polyps ... member with polyps Have a family history of colon cancer Most colon polyps do not cause symptoms. ...

  5. [Treatment of polyps and villous tumors of the large intestine].

    Science.gov (United States)

    Nazarov, L U; Agavelian, A M; Kazarian, G A; Bagdasarian, A A; Martirosian, V S

    1987-07-01

    Polyps and villous tumors were found in 1525 of 10624 patients (14.3%) aged from 40 to 60. In 82% of the cases they were in combination with ulcer disease of the stomach and duodenum, with inflammatory diseases of the gastro-intestinal tract, diverticulitis, tumors of the colon. 1519 polypectomies and dissection of villous tumors both via the fibroscope, rectoscope and by transanal access were made. Complications were obtained in 5 patients, recurrent disease was noted in 3 patients (0.9%).

  6. [Application of metal hemoclip for endoscopic polypectomy in children with thick-pedunculated intestinal polyps].

    Science.gov (United States)

    Deng, Zhao-hui; Xu, Chun-di; Zhong, Jie; Chen, Shun-nian; Yao, Wei-jiong

    2004-03-01

    With the development of endoscopic therapy in children, endoscopic electrocoagulation polypectomy had gradually replaced surgery and became an important method to resect gastrointestinal polyps in children. Simple electrocoagulation polypectomy could often bring some complications of gastrointestinal bleeding and perforation because of incomplete electrocoagulation or mechanical incision, especially in gastrointestinal thick-pedunculated polyps which always have thick nutrient blood vessel. Hemoclips can successfully interdict arteriovenous blood because it can clamp tissue firmly without causing necrosis around the target area. Based on its good mechanical hemostasis, hemoclips are not only widely used in treating bleeding like from ulcer, tumor and variceal ligation but also used in removal of thick-pedunculated gastrointestinal polyps in adults. This paper describes the application of endoscopic electrocoagulation with metal hemoclips to remove thick-pedunculated intestinal polpys in children for the first time, sums up the experience and evaluates its efficacy and safety. Between October, 2001 and December, 2002, 5 cases with thick-pedunculated intestinal polpys were presented. The age of the patients ranged from 3 to 5 years. The clinical features were gastrointestinal bleeding or abdominal pain. The longest course of disease was 2 years. Enough preparations for alimentary tract were necessary for polypectomy. The procedures were performed under general anesthesia in order to avoid the risk of bleeding aspiration. Endoscopy was performed in the standard fashion. The apparatus included electronic colonic endoscope (XQ 200, Fuji Corp, Tokyo, Japan), snare (XQ200, Fuji Corp, Tokyo, Japan), impeller of the clip (HX-5QR-1) and hemoclip (MD850) which could be passed through the biopsy channel of endoscope. The clip was completely covered with a hood avoiding any injury to the mucous membrane. The pedicel with diameter of more than 1.0 cm underwent endoscopic

  7. Primary intestinal cryptococcosis mimicking adenomatous polyp in an HIV-negative patient.

    Science.gov (United States)

    Melato, M; Gorji, N

    1998-09-01

    Primary cryptococcal infection is thought to arise in the lungs, whereas secondary lesions may be found anywhere in the body. Because intestinal involvement is rare, especially in nonimmunocompromised patients, little is known about this localization. Nevertheless, the intestinal tract has long been suggested a possible portal of entry of Cryptococcus neoformans, although the hypothesis has never been sufficiently documented. We report an isolated cryptococcosis of the sigmoid colon mimicking an adenomatous polyp. The lesion has an endoscopic interest, being the first of its kind reported in the literature, and a more important pathogenic interest, as it highlights a further pathway of cryptococcal infection, one of major importance in immunocompromised patients.

  8. Loss of Apc heterozygosity and abnormal tissue building in nascent intestinal polyps in mice carrying a truncated Apc gene.

    Science.gov (United States)

    Oshima, M; Oshima, H; Kitagawa, K; Kobayashi, M; Itakura, C; Taketo, M

    1995-05-09

    Mutations in the APC (adenomatous polyposis coli) gene appear to be responsible for not only familial adenomatous polyposis but also many sporadic cases of gastrointestinal cancers. Using homologous recombination in mouse embryonic stem cells, we constructed mice that contained a mutant gene encoding a product truncated at a 716 (Apc delta 716). Mendelian transmission of the gene caused most homozygous mice to die in utero before day 8 of gestation. The heterozygotes developed multiple polyps throughout the intestinal tract, mostly in the small intestine. The earliest polyps arose multifocally during the third week after birth, and new polyps continued to appear thereafter. Surprisingly, every nascent polyp consisted of a microadenoma covered with a layer of the normal villous epithelium. These microadenomas originated from single crypts by forming abnormal outpockets into the inner (lacteal) side of the neighboring villi. We carefully dissected such microadenomas from nascent polyps by peeling off the normal epithelium and determined their genotype by PCR: all microadenomas had already lost the wild-type Apc allele, whereas the mutant allele remained unchanged. These results indicate that loss of heterozygosity followed by formation of intravillous microadenomas is responsible for polyposis in Apc delta 716 intestinal mucosa. It is therefore unlikely that the truncated product interacts directly with the wild-type protein and causes the microadenomas by a dominant negative mechanism.

  9. A metagenomic study of the preventive effect of Lactobacillus rhamnosus GG on intestinal polyp formation in ApcMin/+mice.

    Science.gov (United States)

    Ni, Y; Wong, V H Y; Tai, W C S; Li, J; Wong, W Y; Lee, M M L; Fong, F L Y; El-Nezami, H; Panagiotou, G

    2017-03-01

    To investigate the in vivo effects of Lactobacillus rhamnosus GG (LGG) on intestinal polyp development and the interaction between this single-organism probiotic and the gut microbiota therein. The Apc Min/+ mouse model was used to study the potential preventive effect of LGG on intestinal polyposis, while shotgun metagenomic sequencing was employed to characterize both taxonomic and functional changes within the gut microbial community. We found that the progression of intestinal polyps in the control group altered the community functional profile remarkably despite small variation in the taxonomic diversity. In comparison, the consumption of LGG helped maintain the overall functional potential and taxonomic profile in the resident microbes, thereby leading to a 25% decrease of total polyp counts. Furthermore, we found that LGG enriched those microbes or microbial activities related to short-chain fatty acid production (e.g. Roseburia and Coprococcus), as well as suppressed the ones that can lead to inflammation (e.g. Bilophila wadsworthia). Our study using shotgun metagenomics highlights how single probiotic LGG may exert its beneficial effects and decrease polyp formation in mice by maintaining gut microbial functionality. This probiotic intervention targeting microbiota may be used in conjugation with other dietary supplements or drugs as part of prevention strategies for early-stage colon cancer, after further clinical validations in human. © 2016 The Society for Applied Microbiology.

  10. THE ROLE OF COLORECTAL POLYPS IN THE ETIOLOGY OF LOWER GASTRO-INTESTINAL BLEEDING IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Claudia OLARU

    2015-12-01

    Full Text Available In children, colorectal polyps most commonly present with rectal bleeding. The aim of this study was to establish some correlations between clinical, endoscopic/histopathological aspects and therapeutic options in pediatric colorectal polyps. The experimental group included 253 children aged between 1 and 18 years, patients being included based on the presence of rectal bleeding associated with abdominal pain and/or constipation, established through colonoscopic examination. 39 polyps were identified: 37 with single lesions and 2 with multiple lesions. The solitary polyps, located mostly in the rectum and sigmoid, having sizes between 1 and 2.5 cm, were removed during the same colonoscopy. Pathology showed inflammatory aspects and two cases of hamartomatous polyps in a Peutz-Jeghers and a Bannayan-Ryley syndrome. Colonoscopy should routinely be recommended in children with suspected polyps; in multiple lesions, periodic surveillance by colonoscopy and histology is mandatory.

  11. THE ROLE OF COLORECTAL POLYPS IN THE ETIOLOGY OF LOWER GASTRO-INTESTINAL BLEEDING IN CHILDREN

    OpenAIRE

    Claudia OLARU; Marin BURLEA; Nicoleta GIMIGA; Smaranda DIACONESCU

    2015-01-01

    In children, colorectal polyps most commonly present with rectal bleeding. The aim of this study was to establish some correlations between clinical, endoscopic/histopathological aspects and therapeutic options in pediatric colorectal polyps. The experimental group included 253 children aged between 1 and 18 years, patients being included based on the presence of rectal bleeding associated with abdominal pain and/or constipation, established through colonoscopic examination. 39 polyps were id...

  12. A computer-aided diagnostic system for intestinal polyps identified by wireless capsule endoscopy.

    Science.gov (United States)

    Constantinescu, Adriana Florentina; Ionescu, Mihaela; Iovănescu, Vlad Florin; Ciurea, Marius Eugen; Ionescu, Alin Gabriel; Streba, Costin Teodor; Bunescu, Marius Gabriel; Rogoveanu, Ion; Vere, Cristin Constantin

    2016-01-01

    Small bowel polyps present in images acquired by wireless capsule endoscopy are more difficult to detect using computer-aided diagnostic (CAD) systems. We aimed to identify the optimum morphological characteristics that best describe a polyp and convert them into feature vectors used for automatic detection of polyps present in images acquired by wireless capsule endoscopy (WCE). We prospectively included 54 patients with clinical indications for WCE. Initially, physicians analyzed all images acquired, identifying the frames that contained small bowel polyps. Subsequently, all images were analyzed using an automated computer-aided diagnostic system designed and implemented to convert physical characteristics into vectors of numeric values. The data set was completed with texture and color information, and then analyzed by a feed forward back propagation artificial neural network (ANN) trained to identify the presence of polyps in WCE frames. Overall, the neural network had 93.75% sensitivity, 91.38% specificity, 85.71% positive predictive value (PPV) and 96.36% negative predictive value (NPV). In comparison, physicians' diagnosis indicated 94.79% sensitivity, 93.68% specificity, 89.22% PPV and 97.02% NPV, thus showing that ANN diagnosis was similar to that of human interpretation. Computer-aided diagnostic of small bowel polyps, based on morphological features detection methods, emulation and neural networks classification, seems efficient, fast and reliable for physicians.

  13. Polyps in Children

    OpenAIRE

    Adolph, Vincent R.; Bernabe, Kathryn

    2008-01-01

    Children with polyps usually present with bleeding or pain. Most pediatric intestinal polyps are sporadic and are not associated with malignancy. Polyposis syndromes are also well described in children. Peutz–Jeghers syndrome is the most common hamartomatous polyposis condition. Although the polyps are not thought to be premalignant in most patients, there is an increased risk of other cancers. Familial adenomatous polyposis is also seen in childhood and is associated with a very high risk of...

  14. Colonic polyps in children and adolescents

    OpenAIRE

    Durno, Carol A

    2007-01-01

    Colonic polyps most commonly present with rectal bleeding in children. The isolated juvenile polyp is the most frequent kind of polyp identified in children. ‘Juvenile’ refers to the histological type of polyp and not the age of onset of the polyp. Adolescents and adults with multiple juvenile polyps are at a significant risk of intestinal cancer. The challenge for adult and pediatric gastroenterologists is determining the precise risk of colorectal cancer in patients with juvenile polyposis ...

  15. Colorectal polyps in childhood.

    Science.gov (United States)

    Thakkar, Kalpesh; Fishman, Douglas S; Gilger, Mark A

    2012-10-01

    Colorectal polyps are a common cause of gastrointestinal bleeding in children. This review updates the information on colorectal polyps and summarizes the recent advances in genetics, diagnosis, and treatment of polyps in the large intestine. A review of recent literature regarding colorectal polyps demonstrates an estimated detected prevalence of 6.1% overall and 12.0% among those with lower gastrointestinal bleeding during pediatric colonoscopy. Non-Caucasian races (e.g., black and Hispanic) are at higher risk for colorectal polyps in childhood. Recent data show juvenile polyps may recur in approximately 45% of children with multiple polyps and 17% of children with solitary polyps. A clinical trial showed that celecoxib, a cyclooxygenase (COX)-2 inhibitor, significantly reduced the number of colorectal polyps in children with familial adenomatous polyposis (FAP). Ethical challenges related to genetic tests for FAP have been newly examined. The utility of novel endoscopic techniques (e.g., enteroscopy) in Peutz-Jeghers Syndrome to prevent intussusception have been newly described. Although colorectal polyps in children are generally benign and easily removed, careful clinical evaluation and ongoing research are needed to identify the small proportion of children at risk for cancer. The current paradigm of using the polyp number at presentation as a primary determinant of subsequent surveillance may be inadequate for many patients.

  16. Polyps in children.

    Science.gov (United States)

    Adolph, Vincent R; Bernabe, Kathryn

    2008-11-01

    Children with polyps usually present with bleeding or pain. Most pediatric intestinal polyps are sporadic and are not associated with malignancy. Polyposis syndromes are also well described in children. Peutz-Jeghers syndrome is the most common hamartomatous polyposis condition. Although the polyps are not thought to be premalignant in most patients, there is an increased risk of other cancers. Familial adenomatous polyposis is also seen in childhood and is associated with a very high risk of malignant transformation as well as extracolonic adenomas and malignancy. The diagnosis and management of sporadic juvenile polyps, Peutz-Jeghers syndrome, and familial adenomatous polyposis, as well as rarer conditions associated with intestinal polyps are reviewed in this article.

  17. Fibroid polyps of intestinal tract are inflammatory-reactive proliferations of CD34-positive perivascular cells.

    Science.gov (United States)

    Wille, P; Borchard, F

    1998-06-01

    Our aim was to determine the histogenesis of fibroid polyps (FP). These polyps are rare inflammatory-reactive, tumour-like lesions of unknown aetiology, arising in the submucosa or mucosa of the gastrointestinal tract. They are mainly due to a proliferation of characteristic spindle cells. Nine FP were investigated by light microscopy and immunohistochemistry with endothelial markers (Factor VIII, CD34, CD31), a neuronal marker (S100), muscular markers (desmin, alpha-smooth muscle actin) and histiocytic markers (PGMI, KP1, MAC387) using the highly sensitive avidin-biotin-peroxidase technique. We demonstrate, for the first time, a consistent positivity of the characteristic spindle cells of FP for CD34. The proposed endothelial, histiocytic or neuronal origin of FP could be completely ruled out. Because of the consistent positivity of the spindle cells of FP for CD34 we suggest an origin of these lesions from primitive perivascular or vascular cells. This origin and a probable relationship to gastrointestinal stromal tumours (GIST) is discussed.

  18. Enzymes in intestinal juice from patients with liver diseases and colon polyps: measurement of bilirubin, alkaline phosphatase, aspartate aminotransferase and lactate dehydrogenase.

    Science.gov (United States)

    Uno, Y; Saitoh, H; Ying, H; Tamai, Y; Ono, F; Yoshiike, M; Munakata, A; Yoshida, Y

    1996-02-01

    Since the amounts of hepatogenous enzymes discharged into the intestinal tract remain unknown, this study was initiated to evaluate the amounts of the enzymes in the intestinal tract. Whole gut lavage fluid (polyethyleneglycol electrolyte solution) was administered orally to 42 subjects, consisting of 5 patients with hepatoma, 10 with chronic hepatitis, 10 with colon polyps, and 17 control subjects without liver disease. Two hr after the large intestinal lavage, the digestive tract juice was aspirated by colonoscopy, and the bilirubin (Bil), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) in the aspirates were measured. A positive correlation between the AST and LDH values was found, and a significant difference in these values between the hepatic disorders and the normal controls was noticed. A significant positive correlation between the ALP and Bil values was found, and a statistical difference in these values between the group of colon polyps and the controls and other groups was observed. This lavage fluid technique enables to estimate the amounts of hepatic enzymes discharged into the intestinal tract, thereby opening a new avenue for future enzyme research.

  19. Stomach Polyps

    Science.gov (United States)

    ... pylori) bacteria are a common cause of the gastritis that contributes to hyperplastic polyps and adenomas. Familial adenomatous polyposis. This rare, inherited syndrome increases the risk of colon cancer and other conditions, including stomach polyps. Certain medications. ...

  20. Comparative study of mutations in SNP loci of K-RAS, hMLH1 and hMSH2 genes in neoplastic intestinal polyps and colorectal cancer.

    Science.gov (United States)

    Yan, Zhi-Hui; Cui, Li-Hong; Wang, Xiao-Hui; Li, Chao; He, Xing

    2014-12-28

    To clarify the molecular mechanism involved in pathogenesis of colorectal cancer as well as clinical significance of genetic analysis of histological samples. A total of 480 blood and tissue specimens were collected in our hospital from January 2011 to October 2012. In the observation group, there were 120 blood specimens and 120 intestinal tract tissue specimens collected from patients with neoplastic intestinal polyps. In the control group I there were 80 blood specimens and 80 intestinal tract tissue specimens collected from patients with colorectal cancer. In the control group II there were 40 blood specimens and 40 intestinal tract tissue specimens collected from healthy individuals. The gene segments were amplified using PCR and DNA gel electrophoresis along with DNA sequence analysis were employed for the detection of the following single nucleotide polymorphisms (SNPs): K-RAS codons 12 and 13; hMLH1 (human mutS homolog 1) gene missense mutation at Va1384Asp; hMSH2 (human mutS homolog 2) gene missense mutation at 2783C/A. The mutation rate of the SNP at Va1384Asp locus of the hMLH1 gene from blood and tissue specimens in the observation group showed no statistical difference from those in the control group I. The mutation rates of SNPs in codons 12 and 13 of K-RAS and at 2783C/A locus of the hMSH2 gene were significantly lower in the observation group than in the control group I (χ(2) = 15.476, 29.670, 10.811, 16.618, 33.538, 7.898, P polyps and colorectal cancer in terms of the mechanisms involved in the pathogenesis.

  1. Genetic diversity, phylogroup distribution and virulence gene profile of pks positive Escherichia coli colonizing human intestinal polyps.

    Science.gov (United States)

    Sarshar, Meysam; Scribano, Daniela; Marazzato, Massimiliano; Ambrosi, Cecilia; Aprea, Maria Rita; Aleandri, Marta; Pronio, Annamaria; Longhi, Catia; Nicoletti, Mauro; Zagaglia, Carlo; Palamara, Anna Teresa; Conte, Maria Pia

    2017-11-01

    Some Escherichia coli strains of phylogroup B2 harbor a (pks) pathogenicity island that encodes a polyketide-peptide genotoxin called colibactin. It causes DNA double-strand breaks and megalocytosis in eukaryotic cells and it may contribute to cancer development. Study of bacterial community that colonizes the adenomatous polyp lesion, defined as precancerous lesions, could be helpful to assess if such pathogenic bacteria possess a role in the polyp progression to cancer. In this cross-sectional study, a total of 1500 E. coli isolates were obtained from biopsies of patients presenting adenomatous colon polyps, the normal tissues adjacent to the polyp lesion and patients presenting normal mucosa. pks island frequency, phylogenetic grouping, fingerprint genotyping, and virulence gene features of pks positive (pks + ) E. coli isolates were performed. We found pks + E. coli strongly colonize two patients presenting polypoid lesions and none were identified in patients presenting normal mucosa. Predominant phylogroups among pks + E. coli isolates were B2, followed by D. Clustering based on fragment profiles of composite analysis, typed the pks + isolates into 5 major clusters (I-V) and 17 sub-clusters, demonstrating a high level of genetic diversity among them. The most prevalent virulence genes were fimH and fyuA (100%), followed by vat (92%), hra and papA (69%), ibeA (28%), and hlyA (25%). Our results revealed that pks + E. coli can colonize the precancerous lesions, with a high distribution in both the polyp lesions and in normal tissues adjacent to the lesion. The high differences in fingerprinting patterns obtained indicate that pks + E. coli strains were genetically diverse, possibly allowing them to more easily adapt to environmental variations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Loss of Apc heterozygosity and abnormal tissue building in nascent intestinal polyps in mice carrying a truncated Apc gene.

    OpenAIRE

    Oshima, M; Oshima, H; Kitagawa, K; Kobayashi, M; Itakura, C; Taketo, M

    1995-01-01

    Mutations in the APC (adenomatous polyposis coli) gene appear to be responsible for not only familial adenomatous polyposis but also many sporadic cases of gastrointestinal cancers. Using homologous recombination in mouse embryonic stem cells, we constructed mice that contained a mutant gene encoding a product truncated at a 716 (Apc delta 716). Mendelian transmission of the gene caused most homozygous mice to die in utero before day 8 of gestation. The heterozygotes developed multiple polyps...

  3. Colorectal polyps

    Science.gov (United States)

    ... tests at age 50. Those with a family history of colon cancer or colon polyps may need to be screened at an earlier age or more often. Taking aspirin, naproxen, ibuprofen, or similar medicines may help reduce ...

  4. Inflammatory polyps after necrotizing enterocolitis.

    Science.gov (United States)

    Iofel, E; Kahn, E; Lee, T K; Chawla, A

    2000-08-01

    Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in the neonatal period. NEC causes ulceration of the intestinal mucosa and may lead to perforation or a stricture. To the best of the authors' knowledge intestinal inflammatory polyps after NEC have not been described previously. The authors report on a 17-week-old boy with pseudopolyps at the site of a colonic stricture after NEC.

  5. Polyps of the Cervix

    Science.gov (United States)

    ... Epidural Additional Content Medical News Polyps of the Cervix By S. Gene McNeeley, MD, Clinical Professor, Michigan State ... the Vulva Noncancerous Ovarian Growths Polyps of the Cervix Skene Duct Cyst Cervical polyps are common fingerlike ...

  6. Genetic and epigenetic profiling of a solitary Peutz?Jeghers colon polyp

    OpenAIRE

    Linhart, Heinz; Bormann, Felix; Hutter, Barbara; Brors, Benedikt; Lyko, Frank

    2017-01-01

    Colon polyps represent precursor lesions of colon cancers and their malignant potential varies according to histological subtype. A rare subtype of colon polyps is the Peutz?Jeghers (PJ) polyp. PJ polyps mostly occur in the context of Peutz?Jeghers syndrome, which is characterized by the development of multiple polyps in the intestinal tract and hyperpigmentation of oral mucosa and lips. Peutz?Jeghers is an autosomal dominant disorder caused by pathogenic variants of the serine threonine kina...

  7. Gastrointestinal polyps in children.

    Science.gov (United States)

    Wang, Li-Chun; Lee, Hung-Chang; Yeung, Chun-Yan; Chan, Wai-Tao; Jiang, Chuen-Bin

    2009-10-01

    Gastrointestinal polyps are common in children. The purpose of this study was to review the clinical manifestations, diagnostic procedures, endoscopic findings, management, pathology, and recurrence of gastrointestinal polyps in children at Mackay Memorial Hospital. We retrospectively reviewed the charts of 50 children with a diagnosis of gastrointestinal polyps managed at Mackay Memorial Hospital between January 1984 and April 2007. Demographic data; clinical features; polyp size, number and location; endoscopic findings; management; pathology; and information on recurrences were extracted from the clinical records. The distribution of polyps in the 50 patients included gastric (4 patients), duodenal (2), ileocecal (4) and colorectal polyps (40). All patients with gastric polyps presented with vomiting, and three of the four patients with ileocecal polyps presented with intussusception. The mean age of the 40 patients with colorectal polyps was 6.8 years. The majority of those polyps were in the rectosigmoid colon; 36 patients presented with hematochezia. Solitary polyps were identified in 33 patients and multiple polyps were identified in seven patients. Most of the colorectal polyps were less than 2cm in diameter. Histologically, the most frequent type was juvenile polyp. Gastrointestinal polyps in children are usually benign. Pediatricians treating a child with a gastrointestinal polyp should pay attention to the immediate complications of the polyps, such as intussusception or bleeding, the extraintestinal manifestations and long-term risk for malignancy.

  8. Sonographic diagnosis of juvenile polyps in children.

    Science.gov (United States)

    Zhang, Yao; Li, Shi-Xing; Xie, Li-Mei; Shi, Bo; Ju, Hao; Bai, Yu-Zuo; Zhang, Shu-Cheng

    2012-09-01

    The aim of this study was to assess the diagnostic value of ultrasonography for juvenile polyps in children and their sonographic characteristics. A retrospective analysis was performed of the ultrasound findings in 27 children who were diagnosed preoperatively with juvenile polyp within the intestinal tract by ultrasonography and then confirmed by colonoscopy, laparotomy and histopathology. The ultrasonic finding common to all polyps was an isolated intraluminal nodular or massive protrusion, associated with multiple mesh-like fluid areas of different sizes. In 25 children, surrounding pedicle-like low echoes of varying lengths were seen connecting with the polyps to form "mushroom" sign. The color Doppler showed abundant blood flow signals within all polyps and pedicles in a shape of a branch or an umbrella. For seven children with an intussusception, the polyp shadow was detected in the cervical part or interior of the intussusception. Ultrasonography is, thus, considered to be a feasible method for diagnosing intestinal juvenile polyp. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  9. [Polyps (single or multiple) and juvenile polyposis].

    Science.gov (United States)

    Agnifili, A; Schietroma, M; Mattucci, S; Carloni, A; Caterino, G; Rossi, M; Pistoia, M A; Carlei, F

    2001-10-01

    The authors underline the important aspects of juvenile familial polyposis (JFP), a disease transmitted as an autosomal dominant trait. A case of JFP characterized by the presence of hundreds of polyps in the colo-rectal intestinal tract, is analyzed. The single juvenile polyp, multiple polyps (=/>5 polyps) and the sporadic form are examined. These are mucous hamartomas which can undergo neoplastic transformation (in carcinoma in 68% of untreated cases), a behaviour similar to that of adenomatous polyps. They differ from the later due to the following features: epidemiology (earlier appearance age), anatomopathology (stroma), clinical observation (self-recovery in some cases) and genetics (10q23.3-18q21, genetic mutations in a locus different those of adenomatous polyps). It is also necessary to determine its extension by means of colonoscopy, ileoscopy, gastroscopy and small bowel barium enema. Patients' screening through construction of the genealogical family tree is fundamental. Isolation of possible degenerative aspects of the polyps through biopsy is also fundamental. Single or multiple polyps are treated endoscopically, the juvenile polyposis is treated surgically (colectomy, total colectomy). A rigorous follow-up of the patients and their family members is recommended.

  10. Colonic Polyps in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Carol A Durno

    2007-01-01

    Full Text Available Colonic polyps most commonly present with rectal bleeding in children. The isolated juvenile polyp is the most frequent kind of polyp identified in children. ‘Juvenile’ refers to the histological type of polyp and not the age of onset of the polyp. Adolescents and adults with multiple juvenile polyps are at a significant risk of intestinal cancer. The challenge for adult and pediatric gastroenterologists is determining the precise risk of colorectal cancer in patients with juvenile polyposis syndrome. Attenuated familial adenamatous polyposis (AFAP can occur either by a mutation at the extreme ends of the adenomatous polyposis coli gene or by biallelic mutations in the mutY homologue (MYH gene. The identification of MYH-associated polyposis as an autosomal recessive condition has important implications for screening and management strategies. Adult and pediatric gastroenterologists need to be aware of the underlying inheritance patterns of polyposis syndromes so that patients and their families can be adequately evaluated and managed. Colonic polyps, including isolated juvenile polyps, juvenile polyposis syndrome, FAP, AFAP and MYH-associated polyposis, are discussed in the present review.

  11. Colonic polyps in children and adolescents.

    Science.gov (United States)

    Durno, C A

    2007-04-01

    Colonic polyps most commonly present with rectal bleeding in children. The isolated juvenile polyp is the most frequent kind of polyp identified in children. 'Juvenile' refers to the histological type of polyp and not the age of onset of the polyp. Adolescents and adults with multiple juvenile polyps are at a significant risk of intestinal cancer. The challenge for adult and pediatric gastroenterologists is determining the precise risk of colorectal cancer in patients with juvenile polyposis syndrome. Attenuated familial adenamatous polyposis (AFAP) can occur either by a mutation at the extreme ends of the adenomatous polyposis coli gene or by biallelic mutations in the mutY homologue (MYH) gene. The identification of MYH-associated polyposis as an autosomal recessive condition has important implications for screening and management strategies. Adult and pediatric gastroenterologists need to be aware of the underlying inheritance patterns of polyposis syndromes so that patients and their families can be adequately evaluated and managed. Colonic polyps, including isolated juvenile polyps, juvenile polyposis syndrome, FAP, AFAP and MYH-associated polyposis, are discussed in the present review.

  12. Gastrointestinal Polyps in Children

    OpenAIRE

    Li-Chun Wang; Hung-Chang Lee; Chun-Yan Yeung; Wai-Tao Chan; Chuen-Bin Jiang

    2009-01-01

    Gastrointestinal polyps are common in children. The purpose of this study was to review the clinical manifestations, diagnostic procedures, endoscopic findings, management, pathology, and recurrence of gastrointestinal polyps in children at Mackay Memorial Hospital. Methods: We retrospectively reviewed the charts of 50 children with a diagnosis of gastrointestinal polyps managed at Mackay Memorial Hospital between January 1984 and April 2007. Demographic data; clinical features; polyp size...

  13. Gastrointestinal Polyps in Children

    Directory of Open Access Journals (Sweden)

    Li-Chun Wang

    2009-10-01

    Conclusion: Gastrointestinal polyps in children are usually benign. Pediatricians treating a child with a gastrointestinal polyp should pay attention to the immediate complications of the polyps, such as intussusception or bleeding, the extraintestinal manifestations and long-term risk for malignancy.

  14. Small bowel obstruction due to inflammatory fibroid polyp.

    Science.gov (United States)

    Das, S; Mandal, T S; Sinhababu, A K; Chatterjee, T K; Khamrui, T K; Bhattacharya, H

    2012-01-01

    Inflammatory fibroid polyp is a benign and non-neoplastic condition of the intestinal tract, commonly affecting the gastric antrum, though it can affect any part of the gastro-intestinal tract. It is a submucosal, sessile, poypoid mass composed of myofibroblast like mesenchymal cells, numerous small blood vessels and marked inflammatory cell infiltrate mainly eosinophils. It commonly presents as intestinal obstruction or intussusception. A case of recurrent partial small intestinal obstruction due to intermittent intussusception associated with inflammatory fibroid polyp of jejunum is being reported.

  15. A child with colo-colonic intussusception due to a large colonic polyp

    African Journals Online (AJOL)

    Colo-colonic intussusception (CI) due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic ... We report a case of CI and review the literature, focusing on the diagnosis and treatment. Key words: Children, colo-colonic intussusception, colonic polyp, intestinal obstruction ...

  16. Heredity of nasal polyps.

    Science.gov (United States)

    Bohman, Anton; Oscarsson, Martin; Holmberg, Kenneth; Johansson, Leif; Millqvist, Eva; Nasic, Salmir; Torinsson-Naluai, Åsa; Bende, Mats

    2015-03-01

    Nasal polyps is a common disease but little is known about its` pathogenesis. Our hypothesis was that there are genetic factors involved in the development of this disease. The aim of this study was to examine close relatives of patients with nasal polyps and comparing them with a general population with regard to prevalence of polyps. Patients with nasal polyps who attended the clinic were recruited to the study and were asked whether they had any close adult relatives (siblings, parents or children). We intended to recruit two relatives per patient, one of each gender, for nasal endoscopy. The prevalence of nasal polyps in these relatives was compared with the prevalence of nasal polyps in a general population. During a 4-year period, 368 patients and 410 relatives were recruited to the study. Although we were unable to recruit two close relatives for every patient, we were able to calculate nasal polyp prevalence within families as being 19.2%. Compared with the prevalence of nasal polyps among individuals in a general Swedish population from the same geographical area, the relative risk for polyps among relatives was almost five times higher. This study strongly indicates that heredity is a factor of importance for development of nasal polyps.

  17. Effects of oral calcium supplementation on intestinal bile-acids and cytolytic activity of fecal water in patients with adenomatous polyps of the colon

    NARCIS (Netherlands)

    Welberg, J. W. M.; Kleibeuker, J. H.; van der Meer, R.; Kuipers, F.; Cats, A.; van Rijsbergen, H.; Termont, D. S. M. L.; Boersma-van Ek, W.; Vonk, R. J.; Mulder, N. H.; de Vries, E. G. E.

    Calcium has been proposed to prevent colon cancer in subjects at risk for this tumour. This effect is supposed to be due at least in part to binding the bile acids to calcium, making them insoluble and harmless. To evaluate the effects of oral calcium supplementation on intestinal bile acids, 19

  18. Juvenile polyps: recurrence in patients with multiple and solitary polyps.

    Science.gov (United States)

    Fox, Victor L; Perros, Stephen; Jiang, Hongyu; Goldsmith, Jeffrey D

    2010-09-01

    Juvenile polyps are benign hamartomas with neoplastic potential that are the most frequent gastrointestinal polyp of childhood. Most information about juvenile polyps in childhood comes from small published series that lack detailed outcome data. We sought to identify a large cohort of children with one or more polyps and analyze clinical characteristics, including polyp recurrence, which might contribute to the development of management guidelines. A retrospective chart review study of patients with juvenile polyps of the colon was performed. Cases were identified by searching a single hospital pathology database from 1990 to 2009 for the diagnosis of juvenile polyps. Recorded information included basic demographics, family history, genetic testing, and colonoscopy and pathology reports. A total of 257 children (median age, 5.6 y; 61.5% male) with juvenile polyps were identified. Among 192 patients who underwent complete colonoscopy at initial diagnosis, 117 (60.9%) had a single polyp, 75 (39.1%) had multiple polyps, 8 (4.2%) had polyps restricted to the right colon, and a total of 1653 polyps were found during 350 colonoscopy examinations. Polyps recurred in 21 of 47 (44.7%) patients after initial eradication, including 3 (16.7%) of 18 presenting with a single polyp. Neoplasia was found in 10 of 257 (3.9%) patients (right colon in 7 patients). Germline DNA abnormalities in mothers against decapentaplegic Drosophila (SMAD4), bone morphogenetic protein receptor 1A (BMPR1A), and phosphatase and tensin homolog (PTEN) were detected in 10 of 23 (43.5%) patients with multiple polyps. Recurrent polyp formation is common in children with juvenile polyps and occurs in patients with multiple and solitary polyps. Standardized protocols for detecting polyp recurrence, associated gene mutations, and neoplasia should be developed for children with juvenile polyps. Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

  19. [Fibro-inflammatory polyp with eosinophilic infiltration. Apropos of 3 cases of gastric polyps].

    Science.gov (United States)

    Battin-Bertho, R; Dauge, M C; Toublanc, M; Grossin, M; Marche, C; Bocquet, L

    1987-01-01

    We report three cases of inflammatory fibroid polyp of the stomach (Helwig's pseudo-tumour) and record 127 patients in the literature. The anatomo-clinical features of such a disease are analysed and the larger outline of eosinophilic infiltrations of the gastro intestinal tract are described. Most of the authors class the gastric nodular eosinophilic granuloma as the Helwig's pseudo-tumour, but they are not so unanimous for the exact relationship between inflammatory fibroid polyp and the eosinophilic gastroenteritis. For Helwig, they are two distinct conditions, but for others, they belong to the same anatomo-clinical entity, with a broad diversity of morphological features.

  20. Ureteral polyps: three case reports

    OpenAIRE

    禰宜田, 正志; 松田, 久雄; 片岡, 喜代徳; 上島, 成也; 今西, 正昭; 片山, 孔一; 植村, 匡志; 栗田, 孝

    1994-01-01

    We observed recently three cases of ureteral polyps including a case of multiple polyps. The first patient was a 33-year-old man with multiple polyps at the left upper ureter. The second patient was a 51-year-old man and the third 49-year-old man, and both cases were complicated with ureteral stones. We divided 88 ureteral polyps reported in Japan from 1970 to 1990 into polyps in children and those in adults. We further divided the individual polyps into single and multiple polyps and examine...

  1. Genetic and epigenetic profiling of a solitary Peutz-Jeghers colon polyp.

    Science.gov (United States)

    Linhart, Heinz; Bormann, Felix; Hutter, Barbara; Brors, Benedikt; Lyko, Frank

    2017-05-01

    Colon polyps represent precursor lesions of colon cancers and their malignant potential varies according to histological subtype. A rare subtype of colon polyps is the Peutz-Jeghers (PJ) polyp. PJ polyps mostly occur in the context of Peutz-Jeghers syndrome, which is characterized by the development of multiple polyps in the intestinal tract and hyperpigmentation of oral mucosa and lips. Peutz-Jeghers is an autosomal dominant disorder caused by pathogenic variants of the serine threonine kinase STK11. PJ polyps very rarely occur outside of the syndrome and are then referred to as solitary PJ polyps. Contrary to the situation in Peutz-Jeghers, the genetic basis and the malignant potential of solitary PJ polyps are currently unknown. Here we describe a detailed and comprehensive genetic profile of a solitary PJ polyp. Pathological examination revealed a high tissue homogeneity with >80% epithelial cells. Whole-genome sequencing failed to identify any clonal mutations but demonstrated a significant number of subclonal mutations. No somatic or germline mutations were found at the STK11 locus, suggesting that solitary PJ polyps are genetically distinct from Peutz-Jeghers polyps. In addition, methylome analysis revealed global hypomethylation and CpG island hypermethylation, two features that have been described as hallmarks of the colorectal cancer epigenome. These results provide an example of a premalignant lesion that is defined by epigenetic, rather than genetic changes. Furthermore, our findings support the notion that solitary PJ polyps constitute neoplastic tissue with malignant potential that should be removed for cancer prevention.

  2. Graded compression sonography of the colon in the diagnosis of polyps in pediatric patients.

    Science.gov (United States)

    Baldisserotto, Matteo; Spolidoro, José Vicente Noronha; Bahú, Maria da Graça Soares

    2002-07-01

    We report seven cases of juvenile polyps detected by graded compression gray-scale and color Doppler sonography in five children with nonspecific symptoms. Intestinal polyps can be detected by graded compression gray-scale and color Doppler sonography without colonic preparation. On gray-scale sonography, polyps appeared as spherical or ovoid hypoechoic nodules in the colon lumen. Small cysts were identified inside the nodules. Four polyps had fewer and smaller cysts, whereas three others contained many cysts. A hyperechoic layer surrounding the polyp corresponded to the submucosa. In two patients, the polyp was visualized in the transverse colon and caused a colocolic intussusception, which reduced spontaneously during sonography. Color Doppler sonography showed four hypovascularized and three hypervascularized polyps.

  3. Colonic polyps and polyposis syndromes in pediatric patients.

    Science.gov (United States)

    Kay, Marsha; Eng, Katharine; Wyllie, Robert

    2015-10-01

    Gastrointestinal polyps are commonly encountered during childhood and are one of the most common causes of rectal bleeding in this age group. Most polyps are benign and located in the colon, with the most frequent type being juvenile polyps. However, in older pediatric patients, if multiple polyps are present, in patients who have a positive family history, or if polyps are located outside of the colon, either adenomatous polyps or polyps associated with genetic abnormalities are more common. Imaging techniques such as ultrasound and computed tomographic colonoscopy have recently been utilized to identify simple juvenile colonic polyps in children with rectal bleeding in whom there is a high index of suspicion. Colonoscopy with polypectomy is still required for histologic evaluation and resection of the polyp. There have been significant advances in genetic testing and management of hereditary gastrointestinal cancer syndromes with onset in childhood or adolescence that may ultimately reduce long-term morbidity and mortality. In addition to enhanced gastrointestinal and extraintestinal malignancy screening for affected individuals, specific gene mutations within a given condition such as adenomatous polyposis coli may predict clinical course and timing of specific interventions such as colectomy. In other conditions such as phosphatase and tensin homolog hamartoma tumor syndrome, phenotype may not be predicted by genotype. Pediatricians, pediatric gastroenterologists, and adult gastroenterologists caring for children should understand how to differentiate benign polyps in the pediatric age group from those associated with a higher risk of complications including recurrence risk and risk of development of intestinal or extraintestinal malignancy. Recent advances in genetic testing, as well as development of consensus guidelines, are key in the identification, screening, and follow-up of children and adolescents with polyposis syndromes.

  4. Intestinal intussusception and occlusion caused by small bowel polyps in the Peutz-Jeghers syndrome. Management by combined intraoperative enteroscopy and resection through minimal enterostomy: case report Intussuscepção intestinal e oclusão intestinal causada por pólipos em intestino delgado na síndrome Peutz-Jeghers. Tratamento com ressecção por enterotomia associado a enteroscopia intra-operatória: relato de caso

    Directory of Open Access Journals (Sweden)

    Joaquim J. Gama-Rodrigues

    2000-12-01

    Full Text Available The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyps distributed along the small intestine. Enterotomy was performed to treat only the larger polyps, therefore limiting the intestinal resection to smaller segments. The postoperative follow-up was uneventful. CONCLUSION: We point out the importance of conservative treatment for patients with this syndrome, especially those who will undergo repeated surgical interventions because of clinical manifestation while they are still young.A síndrome de Peutz-Jeghers é uma doença de caráter hereditário que freqüentemente requer intervenções endoscópicas e cirúrgicas repetidas, levando a complicações secundárias como, por exemplo, a síndrome do intestino curto. RELATO DE CASO: Relatamos neste artigo o caso de paciente de 15 anos, masculino, com história familiar para a doença, que foi submetido ao procedimento cirúrgico para tratar oclusão devido a intussucepção de intestino delgado. DISCUSSÃO: Associou-se método fibroscópico intra-operatório com a finalidade de detecção e ressecção de numerosos pólipos distribuídos em todo o intestino delgado. Realizaram-se enterotomias para a retirada dos pólipos maiores, restringindo-se, portanto, a ressecção intestinal a segmentos menores. A evolução clínica foi boa. CONCLUSÃO: Ressalta-se a importância do manejo de forma conservadora dos pacientes portadores desta síndrome, principalmente naqueles cujas manifestações clínicas de importância cirúrgica aparecem precocemente.

  5. CLINICAL, EPIDEMIOLOGIC, AND ENDOSCOPIC PROFILE IN CHILDREN AND ADOLESCENTS WITH COLONIC POLYPS IN TWO REFERENCE CENTERS.

    Science.gov (United States)

    Andrade, Denise O; Ferreira, Alexandre Rodrigues; Bittencourt, Paulo Fernando S; Ribeiro, Daniela F P; Silva, Rodrigo Gomes da; Alberti, Luiz Ronaldo

    2015-12-01

    The main goal of this paper is to investigate the frequency, clinical profile, and endoscopic findings of children and teenagers submitted to colonoscopies. Patients of below 18 years of age, diagnosed with polyps by means of colonoscopies at two reference centers of pediatric endoscopy were followed-up between 2002 and 2012. The clinical variables evaluated in this study included: gender, recommendation of colonoscopy, associated signs and symptoms, age of onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of intestinal polyposis and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, histology, and distribution. Polyposis syndromes were also investigated. From the 233 patients submitted to colonoscopies, polyps were found in 74 (31.7%) patients, with a median age of 6.6 years, of which 61% were male. Juvenile polyps were identified in 55 (74%) patients, with 7 (9%) characterized within the criteria for juvenile polyposis. Patients with intestinal polyposis syndromes were diagnosed in 35% of the patients. The most frequent clinical presentation was hematochezia. Abdominal pain with acute episodes of intestinal partial obstruction or intussusception with emergency laparotomy was observed in the majority of Peutz-Jeghers syndrome patients leading to an increased morbidity. Even though juvenile colonic polyps are the most frequent type of diagnosed polyps, the present study identified a significant level of children with polyposis syndromes (35%), associated with a higher morbidity of these individuals.

  6. Hydrosonography in the evaluation of colorectal polyps.

    OpenAIRE

    Ling, U P; Chen, J Y; Hwang, C J; Lin, C K; Chang, M H

    1995-01-01

    Prewarmed saline enemas and transabdominal ultrasound (hydrosonography) were used to evaluate 17 consecutive children with rectal bleeding before colonoscopy. Twelve patients with polyps were identified (10 by ultrasound, 10 by endoscopy): these included multiple hyperplastic polyps (1), multiple polyps (1), solitary polyps (9), and pseudopolyps (1). Ultrasound identified 11 polyps in 10 patients, missing two patients with small polyps less than 0.5 cm in diameter. The polyps were hyperechoic...

  7. De Novo Development of Hamartomatous Duodenal Polyps in a Patient With Short Bowel Syndrome During Teduglutide Therapy: A Case Report.

    Science.gov (United States)

    Ukleja, Andrew; Alkhairi, Baker; Bejarano, Pablo; Podugu, Amareshwar

    2017-06-01

    Teduglutide (TG) is approved for the treatment of parenteral nutrition (PN)-dependent adult patients with short bowel syndrome (SBS). Its well-known adverse effect is expedited growth of colon polyps and potential formation of new polyps. Apart from animal studies, de novo development of duodenal polyps in a patient during TG therapy has not been reported in the literature. We report a case of a 71-year-old man with SBS on TG who developed multiple new duodenal polyps that were found incidentally during a diagnostic endoscopy. Furthermore, an accelerated growth of duodenal polyps was noted while on TG therapy, suggesting a potential trophic effect of TG on these polyps. There are no current recommendations for the surveillance of intestinal polyps in patients on TG therapy, but we recommend exercising caution and possible need for surveillance based on this case report.

  8. Genetic and epigenetic profiling of a solitary Peutz–Jeghers colon polyp

    Science.gov (United States)

    Linhart, Heinz; Bormann, Felix; Hutter, Barbara; Brors, Benedikt; Lyko, Frank

    2017-01-01

    Colon polyps represent precursor lesions of colon cancers and their malignant potential varies according to histological subtype. A rare subtype of colon polyps is the Peutz–Jeghers (PJ) polyp. PJ polyps mostly occur in the context of Peutz–Jeghers syndrome, which is characterized by the development of multiple polyps in the intestinal tract and hyperpigmentation of oral mucosa and lips. Peutz–Jeghers is an autosomal dominant disorder caused by pathogenic variants of the serine threonine kinase STK11. PJ polyps very rarely occur outside of the syndrome and are then referred to as solitary PJ polyps. Contrary to the situation in Peutz–Jeghers, the genetic basis and the malignant potential of solitary PJ polyps are currently unknown. Here we describe a detailed and comprehensive genetic profile of a solitary PJ polyp. Pathological examination revealed a high tissue homogeneity with >80% epithelial cells. Whole-genome sequencing failed to identify any clonal mutations but demonstrated a significant number of subclonal mutations. No somatic or germline mutations were found at the STK11 locus, suggesting that solitary PJ polyps are genetically distinct from Peutz–Jeghers polyps. In addition, methylome analysis revealed global hypomethylation and CpG island hypermethylation, two features that have been described as hallmarks of the colorectal cancer epigenome. These results provide an example of a premalignant lesion that is defined by epigenetic, rather than genetic changes. Furthermore, our findings support the notion that solitary PJ polyps constitute neoplastic tissue with malignant potential that should be removed for cancer prevention. PMID:28487883

  9. Gastric adenocarcinoma arising from fundic gland polyps in a patient with familial adenomatous polyposis syndrome.

    Science.gov (United States)

    Garrean, Sean; Hering, Justin; Saied, Abdul; Jani, Jigna; Espat, N Joseph

    2008-01-01

    Familial adenomatous polyposis (FAP) is a rare hereditary syndrome characterized by multiple colorectal polyps and early development of colorectal cancer. Although FAP uniformly involves the large bowel, it may also produce lesions in the stomach and upper intestinal tract. Fundic gland polyps are the most common gastric lesion in FAP. In the general population, these polyps are considered benign and have no malignant potential. However, in FAP patients, fundic gland polyps have been occasionally recognized as precursor lesions from which invasive cancer may develop. Herein, we present a case of gastric adenocarcinoma arising from fundic gland polyps in an FAP patient. We also review reported cases of gastric cancer in FAP and FAP variant patients in an effort to better understand the pathology, clinical course, and optimal screening and treatment strategies for this disease manifestation.

  10. Colorectal polyps: a frequently-missed cause of rectal bleeding in Egyptian children.

    Science.gov (United States)

    El-Shabrawi, M H F; El Din, Z E; Isa, M; Kamal, N; Hassanin, F; El-Koofy, N; El-Batran, G; El-Makarem, S A; El-Hennawy, A

    2011-01-01

    Colorectal polyps are important causes of rectal bleeding but they have been infrequently reported in Egyptian children. The prevalence and characteristics of colorectal polyps in a consecutive cohort of Egyptian children with rectal bleeding are presented. A total of 174 children aged 2-12 years [mean (SD) 6.4 (3.7)] with fresh rectal bleeding were enrolled prospectively. Rectal examination, laboratory investigations and fibre-optic colonoscopy were performed in all patients. The source of bleeding was diagnosed as colorectal polyps in 100 patients (57.4%) and was owing to other causes in 74. The interval between onset of symptoms and presentation ranged from 2 to 48 months [mean (SD) 18.3 (16)]. In patients with other causes, rectal bleeding was attributed to intestinal amoebiasis (42), diarrhoea/dysentery (18), severe constipation (2) and intestinal schistosomiasis (2). Polyps were solitary in 56 children (56%) and ranged from 2 to 5 in 34 (34%) and >5 in 10 (10%). Polyps were confined to the rectum in 68 children, were rectosigmoid in 20, in the descending colon in 8, and splenic flexure in 4. Polyps were juvenile in 84 children (84%), inflammatory in 10 (10%) and hyperplastic, schistosomal or adenomatous in 2 each (6%). Colonoscopic polypectomy was successful and arrested the bleeding in all cases. In Egyptian children, colorectal polyps are relatively common and an easily treatable cause of fresh rectal bleeding. They should be high on the list of differential diagnoses.

  11. Peutz-Jeghers Syndrome with Synchronous Adenocarcinoma Arising from Ileal Polyps

    OpenAIRE

    Sharma, Mohit; Singh, Rachhpal; Grover, Anumeet Singh

    2014-01-01

    Peutz-Jeghers syndrome is a rare inherited autosomal disease characterized by mucocutaneous pigmentation and multiple polyps in the gastrointestinal tract. The clinical picture is characterized by repeated episodes of polyp-induced intestinal obstruction, abdominal pain, and bleeding per rectum. Predisposition to both gastrointestinal and nongastrointestinal malignancies is increased in a patient with Peutz-Jeghers syndrome. This is a case report of a 29-year-old male with Peutz-Jeghers syndr...

  12. Superpixel Based Segmentation and Classification of Polyps in Wireless Capsule Endoscopy

    OpenAIRE

    Maghsoudi, Omid Haji

    2017-01-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology to record the entire GI trace, in vivo. The large amounts of frames captured during an examination cause difficulties for physicians to review all these frames. The need for reducing the reviewing time using some intelligent methods has been a challenge. Polyps are considered as growing tissues on the surface of intestinal tract not inside of an organ. Most polyps are not cancerous, but if one becomes larger than a centimeter, it...

  13. Hyperplastic Polyps and Gastroduodenal Pseudomelanosis

    Directory of Open Access Journals (Sweden)

    Akanksha Agrawal

    2017-01-01

    Full Text Available Pseudomelanosis is a rare endoscopic finding of the upper gastrointestinal tract characterized by hemosiderin deposits in histiocytes of lamina propria. We report a case of 72-year-old lady on chronic oral iron supplementation diagnosed with gastric hyperplastic polyps with background pseudomelanosis of stomach and duodenum. Concomitant occurrence of gastric pseudomelanosis, duodenal pseudomelanosis, and gastric hyperplastic polyps has never been reported. Its presence in the absence of gastritis raises question if pseudomelanosis could be associated with hyperplastic polyp. With limited literature on its etiology and prognosis, these patients should be prospectively followed and reported to study the natural history of the disease.

  14. Juvenile polyps and juvenile polyp syndromes in children: a clinical and endoscopic survey.

    Science.gov (United States)

    Hood, Brandy; Bigler, Steven; Bishop, Phyllis; Liu, Hua; Ahmad, Naveed; Renault, Macey; Nowicki, Michael

    2011-10-01

    In children, most colonic polyps are juvenile polyps with negligible risk for malignant transformation. The exception is juvenile polyposis syndrome (JPS) where there is a risk for developing colon cancer. The authors studied differences in clinical features and colonoscopic findings in children with solitary juvenile polyps (SJP), multiple juvenile polyps (MJP), and JPS. Children were identified as SJP (1 polyp), MJP (2-4 polyps), or JPS (>5 polyps). Demographic data, laboratory values, family history, and colonoscopic findings were recorded. Children having polypectomy had juvenile polyps (93%), adenomatous polyps (5%), and Peutz-Jegher syndrome (3%). Juvenile polyps were classified as SJP (67%), MJP (16%), and JPS (17%). Children with SJP were younger, were more likely to have polyps limited to the rectosigmoid colon, and had larger polyps than children with MJP and JPS. Anemia was more common in JPS than MJP and SJP. Clinical and endoscopic findings differ between SJP, MJP, and JPS.

  15. CLINICAL, EPIDEMIOLOGIC, AND ENDOSCOPIC PROFILE IN CHILDREN AND ADOLESCENTS WITH COLONIC POLYPS IN TWO REFERENCE CENTERS

    Directory of Open Access Journals (Sweden)

    Denise O ANDRADE

    2015-12-01

    Full Text Available Background - The main goal of this paper is to investigate the frequency, clinical profile, and endoscopic findings of children and teenagers submitted to colonoscopies. Methods - Patients of below 18 years of age, diagnosed with polyps by means of colonoscopies at two reference centers of pediatric endoscopy were followed-up between 2002 and 2012. The clinical variables evaluated in this study included: gender, recommendation of colonoscopy, associated signs and symptoms, age of onset of symptoms, age at identification of the polyp, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, and family history of intestinal polyposis and/or colorectal cancer. The characteristics of the polyps also included: number, morphological type, histology, and distribution. Polyposis syndromes were also investigated. Results - From the 233 patients submitted to colonoscopies, polyps were found in 74 (31.7% patients, with a median age of 6.6 years, of which 61% were male. Juvenile polyps were identified in 55 (74% patients, with 7 (9% characterized within the criteria for juvenile polyposis. Patients with intestinal polyposis syndromes were diagnosed in 35% of the patients. The most frequent clinical presentation was hematochezia. Abdominal pain with acute episodes of intestinal partial obstruction or intussusception with emergency laparotomy was observed in the majority of Peutz-Jeghers syndrome patients leading to an increased morbidity. Conclusions - Even though juvenile colonic polyps are the most frequent type of diagnosed polyps, the present study identified a significant level of children with polyposis syndromes (35%, associated with a higher morbidity of these individuals.

  16. Phenotype and polyp landscape in serrated polyposis syndrome: a series of 100 patients from genetics clinics.

    Science.gov (United States)

    Rosty, Christophe; Buchanan, Daniel D; Walsh, Michael D; Pearson, Sally-Ann; Pavluk, Erika; Walters, Rhiannon J; Clendenning, Mark; Spring, Kevin J; Jenkins, Mark A; Win, Aung K; Hopper, John L; Sweet, Kevin; Frankel, Wendy L; Aronson, Melyssa; Gallinger, Steve; Goldblatt, Jack; Woodall, Sonja; Arnold, Julie; Walker, Neal I; Jass, Jeremy R; Parry, Susan; Young, Joanne P

    2012-06-01

    Serrated polyposis syndrome (SPS), also known as hyperplastic polyposis, is a syndrome of unknown genetic basis defined by the occurrence of multiple serrated polyps in the large intestine and associated with an increased risk of colorectal cancer (CRC). There are a variety of SPS presentations, which may encompass a continuum of phenotypes modified by environmental and genetic factors. To explore the phenotype of SPS, we recorded the histologic and molecular characteristics of multiple colorectal polyps in patients with SPS recruited between 2000 and 2010 from genetics clinics in Australia, New Zealand, Canada, and the United States. Three specialist gastrointestinal pathologists reviewed the polyps, which they classified into conventional adenomas or serrated polyps, with various subtypes, according to the current World Health Organization criteria. Mutations in BRAF and KRAS and mismatch repair protein expression were determined in a subset of polyps. A total of 100 patients were selected for the study, of whom 58 were female and 42 were male. The total polyp count per patient ranged from 6 to 150 (median 30). The vast majority of patients (89%) had polyposis affecting the entire large intestine. From this cohort, 406 polyps were reviewed. Most of the polyps (83%) were serrated polyps: microvesicular hyperplastic polyps (HP) (n=156), goblet cell HP (n=25), sessile serrated adenoma/polyps (SSA/P) (n=110), SSA/P with cytologic dysplasia (n=28), and traditional serrated adenomas (n=18). A further 69 polyps were conventional adenomas. BRAF mutation was mainly detected in SSA/P with dysplasia (95%), SSA/P (85%), microvesicular HP (76%), and traditional serrated adenoma (54%), whereas KRAS mutation was present mainly in goblet cell HP (50%) and in tubulovillous adenoma (45%). Four of 6 SSA/Ps with high-grade dysplasia showed loss of MLH1/PMS2 expression. CRC was diagnosed in 39 patients who were more often found to have a conventional adenoma compared with patients

  17. Gastroduodenal and ileal polyps in patients treated surgically for familial polyposis coli with proctocolectomy and continent ileostomy.

    Science.gov (United States)

    Ojerskog, B; Myrvold, H E; Nilsson, L O; Philipson, B M; Ahrén, C

    1987-01-01

    Eighteen patients, who previously had been treated surgically for familial polyposis coli with proctocolectomy and a continent ileostomy were re-investigated with endoscopy and X-ray for gastric, duodenal and ileal polyps. Gastric and/or duodenal polyps were found in 6 patients and ileal polyps in 2. Altogether upper GI-polyps were found in 7 patients (39%). Most polyps were true adenomas. In one patient with large gastric adenomas, the severe dysplasia called for a gastric resection. It is obvious that familial polyposis may affect the whole gastro-intestinal tract, therefore necessitating regular surveillance of the upper GI-canal as well as the colon and rectum in patients with this hereditary affliction.

  18. Gallbladder Polyps: Epidemiology, Natural History and Management

    Directory of Open Access Journals (Sweden)

    Robert P Myers

    2002-01-01

    Full Text Available Polypoid lesions of the gallbladder affect approximately 5% of the adult population. Most affected individuals are asymptomatic, and their gallbladder polyps are detected during abdominal ultrasonography performed for unrelated conditions. Although the majority of gallbladder polyps are benign, most commonly cholesterol polyps, malignant transformation is a concern. The differentiation of benign from malignant lesions can be challenging. Several features, including patient age, polyp size and number, and rapid growth of polyps, are important discriminating features between benign and malignant polyps. Based on the evidence highlighted in this review, the authors recommend resection in symptomatic patients, as well as in asymptomatic individuals over 50 years of age, or those whose polyps are solitary, greater than 10 mm in diameter, or associated with gallstones or polyp growth on serial ultrasonography. Novel imaging techniques, including endoscopic ultrasonography and enhanced computed tomography, may aid in the differential diagnosis of these lesions and permit expectant management.

  19. CT diagnosis of ureteral fibroepithelial polyps

    Energy Technology Data Exchange (ETDEWEB)

    Bellin, Marie-France; Springer, Oliver; Mourey-Gerosa, Isabelle; Coumbaras, Jean; Beigelman, Catherine; Grenier, Philippe [Department of Radiology, Groupe Hospitalier Pitie-Salpetriere, Paris (France); Paris-6 Univ. (France). Groupe Hospitalier Paul Brousse; Chartier-Kastler, Emmanuel [Department of Urology, Groupe Hospitalier Pitie-Salpetriere, Paris (France); Paris-6 Univ., 75 (France); Delcourt, Annick [Department of Pathology, Groupe Hospitalier Pitie-Salpetriere, Paris (France)

    2002-01-01

    We report a case of fibroepithelial polyp of the ureter with serial CT examinations. Progressive growth of the fibroepithelial polyp was documented by CT within a period of 62 months. Excretory phase contrast-enhanced CT images accurately contributed to the diagnosis of ureteral fibroepithelial polyp and allowed limited surgical resection. Accurate imaging assessment of ureteral fibroepithelial polyps is essential for a conservative surgical approach and/or observation alone. (orig.)

  20. Colonic polyps: experience of 236 Indian children.

    Science.gov (United States)

    Poddar, U; Thapa, B R; Vaiphei, K; Singh, K

    1998-04-01

    We studied the clinical spectrum, histology, and malignant potential of colonic polyps in Indian children (children with colonic polyps were studied from January 1991 to October 1996. They were evaluated clinically and colonoscopic polypectomy was done. Children with five or more juvenile polyps were labeled as having juvenile polyposis and serial colonoscopic polypectomies were done every 3 wk. Colectomy was performed when there were intractable symptoms or clearing of the polyps by colonoscopy was not possible. Histological examination of the polyps was done. Follow-up colonoscopy was done in children with juvenile polyposis only. The mean age of these children was 6.12 +/- 2.7 yr, with a male preponderance (3.5:1). Rectal bleeding of a mean duration of 14 +/- 16 months was the presenting symptom in 98.7%. Solitary polyps were seen in 76%, multiple polyps in 16.5%, and juvenile polyposis in 7% (n = 17) of the children. A majority (93%) of the polyps were juvenile and 85% were rectosigmoid in location. Adenomatous changes, seen in 11%, were more common in juvenile polyposis (59%) than in juvenile polyps (5%). Among those with juvenile polyposis, colon clearance was achieved in eight, six required colectomy for intractable symptoms, and three were still on the polypectomy program. Polyps recurred in 5% of children with juvenile polyps and 37.5% of those with juvenile polyposis. Juvenile polyps remain the most common colonic polyps in children. A significant number of cases of polyps are multiple and proximally located, which emphasizes the need for total colonoscopy in all. Juvenile polyps should be removed even if asymptomatic because of their neoplastic potential. Colonoscopic polypectomy is effective even in juvenile polyposis. Surveillance colonoscopy is required in juvenile polyposis only.

  1. Laparoscopic management of large ureteral fibroepithelial polyp.

    Science.gov (United States)

    Kijvikai, Kittinut; Maynes, Lincoln J; Herrell, S Duke

    2007-08-01

    Fibroepithelial polyps of the ureter are rare benign mesothelial tumors. Most polyps are small; however, very rare large polyps have also been reported. Currently, most investigators encourage endoscopic management in these patients. Nevertheless, endoscopic resection can be difficult in patients with a long or large polypoid lesion. We describe our experience and laparoscopic technique for treatment of a symptomatic 42-year-old woman who presented with a 17-cm-long fibroepithelial polyp in the proximal ureter associated with ureteral obstruction. To our knowledge, this is the first reported case of laparoscopic management of a large ureteral fibroepithelial polyp.

  2. Gastric and duodenal polyps in familial adenomatous polyposis patients: Conventional endoscopyvsvirtual chromoendoscopy (fujinon intelligent color enhancement) in dysplasia evaluation.

    Science.gov (United States)

    Lami, Gabriele; Galli, Andrea; Macrì, Giuseppe; Dabizzi, Emanuele; Biagini, Maria Rosa; Tarocchi, Mirko; Messerini, Luca; Valanzano, Rosa; Milani, Stefano; Polvani, Simone

    2017-04-10

    To test the fujinon intelligent color enhancement (FICE) in identifying dysplastic or adenomatous polyps in familial adenomatous polyposis (FAP) patients. Seventy-six consecutive FAP patients, already treated by colectomy and members of sixty-five families, were enrolled. A FICE system for the upper gastro-intestinal tract with an electronic endoscope system and a standard duodenoscope (for side-viewing examination) were used by two expert examiners. Endoscopic resection was performed with diathermic loop for polyps ≥ 6 mm and with forceps for polyps polyps. Sixty-nine (90.8%) patients had gastric polyps (34 only in the corpus-fundus, 7 only in the antrum and 28 in the whole stomach) and 52 (68.4%) in duodenum (7 in the bulb, 35 in second/third duodenal portion, 10 both in the bulb and the second portion of duodenum). In the stomach fundus after FICE evaluation, 10 more polyps were removed from 10 patients for suspicious features of dysplasia or adenomas, but they were classified as cystic fundic gland after histology. In the antrum FICE identified more polyps than traditional endoscopy, showing a better tendency to identify adenomas and displastic areas. In the duodenum FICE added a significant advantage in identifying adenomas in the bulb and identified more polyps in the II/III portion. FICE significantly increases adenoma detection rate in FAP patients but does not change any Spigelman stage and thus does not modify patient's prognosis and treatment strategies.

  3. Hereditary intestinal polyposis syndromes.

    Science.gov (United States)

    Dean, P A

    1996-01-01

    Colorectal cancer is one of the most common cancers in the world, with overall mortality exceeding 40% even with treatment. Effective efforts for screening and prevention are most likely to succeed in patient groups identified as high risk for colorectal cancer, most notably the hereditary intestinal polyposis syndromes. In these syndromes, benign polyps develop throughout the intestinal tract prior to the development of colorectal cancer, marking the patient and associated family for precancer diagnosis followed by either close surveillance or preventive treatment. This review article was undertaken to discuss the most recent developments in the knowledge of hereditary intestinal polyposis syndromes, emphasizing the clinical approach to diagnosis and treatment relative to preventing the development of cancer. The most common of the hereditary polyposis syndromes is familial adenomatous polyposis (FAP), which is characterized by the development of hundreds to thousands of adenomatous polyps in the colon followed at an early age by colorectal cancer. Colorectal cancer can be prevented in this autosomal dominant condition by prophylactic colectomy, though a risk for other tumors, including periampullary cancers, remains throughout life. Variant of FAP associated with fewer and smaller polyps (hereditary flat adenoma syndrome), or even CNS tumors (Turcot's syndrome) also carry this high risk of colorectal cancer. Hereditary hamartomatous polyposis syndromes such as juvenile polyposis and Peutz-Jeghers syndrome (also autosomal dominant) are characterized by less frequent polyps. Though these are generally benign polyps, they are also associated with a significant risk of colorectal and other cancers. Other polyposis syndromes, including neurofibromatosis and Cowden's disease, do not carry this increased risk of colorectal cancer, and therefore affect different treatment strategies. Analysis of genetic factors responsible for these and other hereditary syndromes with

  4. Treatment of malignant polyps.

    Science.gov (United States)

    Spinelli, P; Pizzetti, P; Sala, P; Andreola, S; Bertario, L

    1995-01-01

    From 1975 to 1993, at the Division of Diagnostics and Endoscopic Surgery of the Istituto Nazionale Tumori in Milan, 191 malignant adenomas of colon-rectum have been endoscopically removed. On the basis of histopathologic criteria, endoscopic treatment has been judged adequate in 102 cases (53%), not adequate in 44 (23%), doubtfully adequate in 45 (24%). In 84 patients (44%) endoscopic polypectomy has been followed by surgical resection of the involved intestinal tract, 107 patients (56%) have been treated only by endoscopy. Results have been evaluated on the basis of surgical specimen, clinical follow-up and survival, showing that criteria we have adopted for the adequacy of the endoscopic treatment have a high negative predictive value (96%) and a low positive predictive value (32%). Actuarial survival of patients treated only endoscopically is 97% at 5 years and 95% at 10 years.

  5. Prevalence of colorectal polyps in pediatric colonoscopy.

    Science.gov (United States)

    Thakkar, Kalpesh; Alsarraj, Abeer; Fong, Emily; Holub, Jennifer L; Gilger, Mark A; El Serag, Hashem B

    2012-04-01

    The available data regarding the prevalence, types, and clinical determinants of colonic polyps in children is limited. We aimed to estimate the prevalence of colorectal polyps in a large cohort of children. We conducted a cross-sectional study to determine the presence, number, and location of colorectal polyps reported in all children (0-20 years) who underwent colonoscopy at 14 pediatric facilities between January 2000 and December 2007 recorded in Pediatric Endoscopy Database System Clinical Outcomes Research Initiative (PEDS-CORI). We compared procedures with and without polyps with respect to procedure indication, age, sex, and race. We also reviewed a sample of histopathologic reports from one participating center. We analyzed 13,115 colonoscopy procedures performed in 11,637 patients. Colorectal polyps were reported in 810 procedures (6.1%; 95% CI: 5.7-6.5%) performed in 705 patients, and in 12% of patients with lower GI bleeding. Children with colorectal polyps were significantly younger (8.9 years vs. 11.9 years; p children without polyps. In a sample of 122 patients with polyps from a single center, the histological types were solitary juvenile in 91 (70.5%), multiple juvenile in 20 (15.5%), adenoma in 14 (10.9%) and hyperplastic polyps in four patients (3.1%). Colorectal polyps are detected in 6.1% overall and in 12.0% among those with lower gastrointestinal bleeding during pediatric colonoscopy. Approximately 26% are multiple juvenile or adenoma.

  6. Hamartomatous Polyp of the Tonsil: A Case Report | Singh ...

    African Journals Online (AJOL)

    Hamartomatous Polyp of the Tonsil: A Case Report. M Singh, D.K. Mundi, I Kaur, A Kaur. Abstract. Hamartomatous polyps of the tonsil are rare. They have been described using various terms such as a lymphangiomatous polyp, lymphangiectatic fibrous polyp, lipomatous polyp, or pedunculated tonsil; hence, the actual ...

  7. [Inflammatory fibroid polyp: a report of three cases including an oesophageal tumor].

    Science.gov (United States)

    Pavageau, Aude-Hélène; Valo, Isabelle; Lavoine, Eric; Bourgois, Jean-Louis; Verrièle, Véronique

    2009-12-01

    We report three different cases in location with an original occurrence in the oesophagus. The gross appearance showed polypoid pedonculated masses with a whitish cut surface, arising from the submucosa. On microscopic examination, the tumor consisted of spindle cell dispersed in a loose fibromyxoid stroma containing numerous blood vessels and inflammatory cells with abundant eosinophils. At immunohistochemistry, the cells were strongly positive for CD34. Inflammatory fibroid polyp is a rare benign lesion of the gastro-intestinal tract. The pathogenesis of this lesion remains throat and unclear. Diagnosis on biopsy is difficult with various histologic pattern and because the inflammatory fibroid polyp share common pathologic features with digestive spindle cells tumor.

  8. Endoscopic treatment of a large colonic polyp as a cause of colocolonic intussusception in a child.

    Science.gov (United States)

    Suksamanapun, Nutnicha; Uiprasertkul, Mongkol; Ruangtrakool, Ravit; Akaraviputh, Thawatchai

    2010-07-16

    Colocolonic intussusception is an uncommon cause of intestinal obstruction in children. The most common type is idiopathic ileocolic intussusception. However, pathologic lead points occur approximately in 5% of cases. In pediatric patients, Meckel's diverticulum is the most common lead point, followed by polyps and duplication. We present a case of recurrent colocolonic intussusception which caused colonic obstruction in a 10-year-old boy. A barium enema revealed a large polypoid mass at the transverse colon. Colonoscopy showed a colonic polyp, 3.5 centimeters in diameter, which was successfully removed by endoscopic polypectomy.

  9. [Colonic polyps in children. Experience with polypectomy].

    Science.gov (United States)

    Güitrón, A; Adalid, R; Nares, J; Mena, G; Gutiérrez, J A

    1999-01-01

    Colonic polyp, the most common gastrointestinal tumor in children, is considered a cause of rectal bleeding in the pediatric population. Colonoscopy is the "gold standard" procedure in diagnosis and therapeutic. To know the incidence and symptomatology of colonic polyps in children to remark on the usefulness of the endoscopic examination. PATIENTS-METHODS AND RESULTS: Between 1985 and 1996, over 1,000 colonoscopies were performed on 50 children between 8 months and 14 years old. The patients had colonic polyps and lower gastrointestinal bleeding. In 40 cases polyps were solitary, 82% were located in rectum sigmoid, and 80% of polyps were found to be juvenile (retention). There were no complications associated with diagnostic and therapeutic endoscopy. The endoscopic method was shown to be very useful for diagnosis as well as treatment of the colonic polyps in children.

  10. Inappropriate colonoscopic surveillance of hyperplastic polyps.

    LENUS (Irish Health Repository)

    Keane, R A

    2011-11-15

    Colonoscopic surveillance of hyperplastic polyps alone is controversial and may be inappropriate. The colonoscopy surveillance register at a university teaching hospital was audited to determine the extent of such hyperplastic polyp surveillance. The surveillance endoscopy records were reviewed, those patients with hyperplastic polyps were identified, their clinical records were examined and contact was made with each patient. Of the 483 patients undergoing surveillance for colonic polyps 113 (23%) had hyperplastic polyps alone on last colonoscopy. 104 patients remained after exclusion of those under appropriate surveillance. 87 of the 104 patients (84%) were successfully contacted. 37 patients (8%) were under appropriate colonoscopic surveillance for a significant family history of colorectal carcinoma. 50 (10%) patients with hyperplastic polyps alone and no other clinical indication for colonoscopic surveillance were booked for follow up colonoscopy. This represents not only a budgetary but more importantly a clinical opportunity cost the removal of which could liberate valuable colonoscopy time for more appropriate indications.

  11. The Polyp Manager: a new tool for optimal polyp documentation during colonoscopy. A pilot study.

    OpenAIRE

    van de Meeberg, Maartje M.; Ouwendijk, Rob J. Th.; ter Borg, Pieter C. J.; van den Hazel, Sven J.; van de Meeberg, Paul C.

    2016-01-01

    Background and study aims: Conventional reporting of polyps is often incomplete. We tested the Polyp Manager (PM), a new software application permitting the endoscopist to document polyps in real time during colonoscopy. We studied completeness of polyp descriptions, user-friendliness and the potential time benefit. Patients and methods: In two Dutch hospitals colonoscopies were performed with PM (as a touchscreen endoscopist-operated device or nurse-operated desktop application). Completenes...

  12. Polyps in continent catheterizable bladder channels.

    Science.gov (United States)

    Groth, Travis W; Mitchell, Michael E; Balcom, Anthony H

    2013-02-01

    We describe our experience with polyps encountered in bladder continent catheterizable channels. An IRB-approved retrospective study was conducted on all patients at Children's Hospital of Wisconsin with continent catheterizable channels managed by a single physician over a 16-year time period. Fifty-five patients were identified with bladder channels. During a median follow-up of 7 years (range 3-16 years), 20% (11/55) of bladder channels developed polyps. The time to diagnosis of a polyp in bladder channels from initial surgery ranged from 3 months to 8 years (median of 29 months). Fifty-five percent (6/11) of patients who developed bladder polyps were symptomatic. All patients' symptoms resolved after treatment by endoscopic resection. Forty-five percent (5/11) of polyps recurred after resection. The time of recurrence ranged from 4 months to 7 years (median of 19 months). Polyps were universally benign inflammatory granulomatous tissue. This is the first series reporting the incidence of polyps in bladder catheterizable channels. Patients with continent catheterizable bladder channels can develop symptomatic polyps in their channels, of unknown long-term significance and risk. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  13. Confocal Endomicroscopy of Colorectal Polyps

    Directory of Open Access Journals (Sweden)

    Vivian M. Ussui

    2012-01-01

    Full Text Available Confocal laser endomicroscopy (CLE is one of several novel methods that provide real-time, high-resolution imaging at a micron scale via endoscopes. CLE has the potential to be a disruptive technology in that it can change the current algorithms that depend on biopsy to perform surveillance of high-risk conditions. Furthermore, it allows on-table decision making that has the potential to guide therapy in real time and reduce the need for repeated procedures. CLE and related technologies are often termed “virtual biopsy” as they simulate the images seen in traditional histology. However, the imaging of living tissue allows more than just pragmatic convenience; it also allows imaging of living tissue such as active capillary circulation, cellular death, and vascular and endothelial translocation, thus extending beyond what is capable in traditional biopsy. Immediate potential applications of CLE are to guide biopsy sampling in Barrett's esophagus and inflammatory bowel disease surveillance, evaluation of colorectal polyps, and intraductal imaging of the pancreas and bile duct. Data on these applications is rapidly emerging, and more is needed to clearly demonstrate the optimal applications of CLE. In this paper, we will focus on the role of CLE as applied to colorectal polyps detected during colonoscopy.

  14. A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review.

    Science.gov (United States)

    Takahashi, Toshiaki; Miyano, Go; Kayano, Hajime; Lane, Geoffrey J; Arakawa, Atsushi; Yamataka, Atsuyuki

    2014-01-01

    Colo-colonic intussusception (CI) due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR) and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment.

  15. A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Toshiaki Takahashi

    2014-01-01

    Full Text Available Colo-colonic intussusception (CI due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment.

  16. Colorectal polyps: an important cause of rectal bleeding.

    OpenAIRE

    Perisic, V N

    1987-01-01

    Seventy one children with rectal bleeding were examined by total fibreoptic colonoscopy. Large bowel polyps were found in 45; 27 (60%) had solitary rectal polyps. Altogether, 83% of resected polyps were juvenile. No complication of colonoscopic polypectomy occurred. New polyps reoccurred in four (9%) treated children.

  17. Screening and Management of Colon Polyp as Colorectal Cancer Prevention

    Directory of Open Access Journals (Sweden)

    Gratcia Ayundini

    2016-09-01

    Full Text Available Colon polyp is a term used for abnormality from bulging tissue above surrounding colonic mucosal layer. Adenoma polyp was the commonly found polyp that progress to colorectal cancer. Most of those patients was asymptomatic. Undetected and unmanaged polyp was a risk factors of colorectal cancer event.

  18. Symptomatic colonic polyps in childhood: not so benign.

    Science.gov (United States)

    Hoffenberg, E J; Sauaia, A; Maltzman, T; Knoll, K; Ahnen, D J

    1999-02-01

    The clinical spectrum of symptomatic polyps and the frequency of familial polyposis is not well defined in children. In the present study, a series of children with juvenile polyposis coli (JPC) and non-JPC polyps were studied. Children with symptomatic colonic polyps and negative family history of polyps were ascertained by review of endoscopic records. Juvenile polyposis coli was defined as 10 or more juvenile polyps or any juvenile polyp in a relative of an index case of JPC. Polyps were tested for Ki-ras mutations, p53 overexpression, and aneuploidy. Seventy-eight children (age range, 0.4-18 years) were identified, all evaluated for lower gastrointestinal bleeding. Nine (12%) had JPC, 66 (84%) had isolated juvenile polyps, and 3 (4%) had other types of polyps. The JPC and non-JPC groups were similar in age (p = 0.4) and symptom duration (p = 0.3). The JPC group had more polyps (p = 0.0001), and greater likelihood of anemia (p = 0.01), polyps with adenomatous change (p = 0.03), and right-colon polyps (p = 0.001). In three of eight JPC families, polyps were identified in asymptomatic first-degree relatives. No abnormalities in Ki-ras, p53, or aneuploidy were identified. Juvenile polyposis coli is common in children with symptomatic polyps, and is associated with anemia, right-colon polyps, and adenomas. The risk of polyps and of colorectal cancer in relatives of persons with JPC requires further study.

  19. [Bowel obstruction by hamartomatous polyp in a pediatric patient with tuberous sclerosis].

    Science.gov (United States)

    Scrigni, Adriana V; Bottero, Adriana; Bosaleh, Andrea; Aisenberg, Nuria; Paglia, Marcela; Manfrin, Lisandro; Luong, Tai C

    2017-06-01

    Tuberous sclerosis is an autosomal dominant disorder with a wide clinical spectrum of disease. It is characterized by development of benign tumors in multiple organs due to a disturbance in cellular growth and differentiation. It usually affects skin, brain, heart and kidney. Gastrointestinal involvement is rare and mainly restricted to adults and sigmoid colon and rectum. In children there are only two cases; our patient would be the third. We present a patient with tuberous sclerosis who began at the first month of life with repeated intestinal subocclusion. The videocolonoscopy showed a mass protruding into the lumen of the ascending colon. Right hemicolectomy was performed. The anatomopathological report corresponded to a hamartomatous polyp. The clinical and nutritional evolution in the postoperative period was very favorable. Although uncommon, the hamartomatous polyp should be considered in the differential diagnosis of intestinal occlusion in pediatrics. Sociedad Argentina de Pediatría.

  20. Nasal polyps in the pediatric population.

    Science.gov (United States)

    Segal, N; Gluk, O; Puterman, M

    2012-01-01

    Chronic sinusitis with nasal polyps is an uncommon pathology in the pediatric population and may be associated with systemic disease. In this study we aimed to characterize children who underwent nasal surgery at our medical center due to nasal polyps and review the current literature related to pediatric nasal polyps. We retrospectively reviewed all medical records of patients younger than 18 years who had sinus surgery from 2000 to 2010. We collected demographic and clinical data including age, sex, laterality, revision operations, and comorbidities including asthma, allergy, and cystic fibrosis (CF). Thirty-one patients age 8.8 to 18 years (mean 13.7) were treated surgically in our hospital. Thirteen had antrochoanal polyp, 16 had chronic sinusitis with nasal polyps, and 2 had mucocele. Among patients treated for nasal polyps, there were 6 boys and 10 girls, mean age was 14.2 years, and 14 (87.5%) had bilateral disease. Mean Lund McKay score was 15.8. Five (31.2%) had asthma, 15 (93.7%) had sleep breathing disorder, and none had known allergy. Three patients (18.7%) had more than one surgery, including one patient with CF. Nine healthy children were tested for CF; one was positive. Nasal polyps in children are more common in teenagers, are usually bilateral, and are commonly associated with bronchial asthma. There was no association with allergy. Meticulous anamnesis and a high index of suspicion are recommended to manage other comorbidities.

  1. Endoscopic treatment of a large colonic polyp as a cause of colocolonic intussusception in a child

    OpenAIRE

    Suksamanapun, Nutnicha; Uiprasertkul, Mongkol; Ruangtrakool, Ravit; Akaraviputh, Thawatchai

    2010-01-01

    Colocolonic intussusception is an uncommon cause of intestinal obstruction in children. The most common type is idiopathic ileocolic intussusception. However, pathologic lead points occur approximately in 5% of cases. In pediatric patients, Meckel’s diverticulum is the most common lead point, followed by polyps and duplication. We present a case of recurrent colocolonic intussusception which caused colonic obstruction in a 10-year-old boy. A barium enema revealed a large polypoid mass at the ...

  2. Giant fibroepithelial polyp of the vulva

    Directory of Open Access Journals (Sweden)

    Selma Korkmaz

    2014-12-01

    Full Text Available Fibroepithelial polyps are among common benign skin lesions. They are usually small and skin-colored lesions and are located frequently in the axilla and neck. They are rarely seen in the vulva. There is a small number of cases that reach the giant sizes in this area in the literature. A 20-year-old female patient presented with a pedunculated mass measuring 25 cm in diameter, localized to the right labium majus. The lesion was excised and the histopathological diagnosis was fibroepithelial polyp. We present this case because of it is the largest reported fibroepithelial polyp of the vulva in the literature.

  3. Determinants of polyp Size in patients undergoing screening colonoscopy

    Directory of Open Access Journals (Sweden)

    Maisonneuve Patrick

    2011-09-01

    Full Text Available Abstract Background Pre-existing polyps, especially large polyps, are known to be the major source for colorectal cancer, but there is limited available information about factors that are associated with polyp size and polyp growth. We aim to determine factors associated with polyp size in different age groups. Methods Colonoscopy data were prospectively collected from 67 adult gastrointestinal practice sites in the United States between 2002 and 2007 using a computer-generated endoscopic report form. Data were transmitted to and stored in a central data repository, where all asymptomatic white (n = 78352 and black (n = 4289 patients who had a polyp finding on screening colonoscopy were identified. Univariate and multivariate analysis of age, gender, performance site, race, polyp location, number of polyps, and family history as risk factors associated with the size of the largest polyp detected at colonoscopy. Results In both genders, size of the largest polyp increased progressively with age in all age groups (P P Conclusions In both genders there is a significant increase in polyp size detected during screening colonoscopy with increasing age. Important additional risk factors associated with increasing polyp size are gender, race, polyp location, and number of polyps, with polyp multiplicity being the strongest risk factor. Previous family history of bowel cancer was not a risk factor.

  4. [Serrated neoplasia of the gastro-intestinal tract].

    Science.gov (United States)

    Chatelain, Denis; Terris, Benoît; Fléjou, Jean-François

    2006-04-01

    Serrated neoplasia of the gastro-intestinal tract have peculiar microscopic and molecular features that are still incompletely described. Some serrated polyps seem to be involved in a new carcinogenic pathway in the colon: the serrated neoplasia pathway, with hypermethylation of the cytosine-guanine dinucleotides, located in the promoter of some genes such as h-MLH1, BRAF and MGMT. The natural history of the serrated polyps and their risk for progression to malignancy are still unclear. There is no official guideline for the management of serrated polyps. The aim of this article is to describe the epidemiological, morphological, immunohistochemical and molecular characteristics of the serrated neoplasia of the gastrointestinal tract: hyperplastic polyps, "traditional" serrated adenomas, mixed hyperplastic and adenomatous polyps, sessile serrated adenomas, hyperplastic polyposis and serrated adenocarcinomas.

  5. Wireless capsule endoscopy for evaluation of phenotypic expression of small-bowel polyps in patients with Peutz-Jeghers syndrome and in symptomatic first-degree relatives.

    Science.gov (United States)

    Soares, J; Lopes, L; Vilas Boas, G; Pinho, C

    2004-12-01

    Peutz-Jeghers syndrome (PJS) is an inherited gastrointestinal hamartomatous polyposis disorder. Small-bowel intussusception and bleeding are the most common complications, and malignancy may also occur. Survey of the gastrointestinal tract, particularly of the small bowel, is difficult and current recommendations for management syndrome are ambiguous. We evaluated the feasibility of capsule endoscopy for identifying phenotypic expression of small-bowel polyps in patients with full-blown PJS and a previous diagnosis of gastrointestinal polyposis, and in symptomatic kindred of PJS patients with no previous diagnosis of gastrointestinal polyposis. Two groups were studied: group A consisted of 14 patients with gastrointestinal polyposis, eight of whom had undergone previous small-intestine surgery; group B consisted of six symptomatic first-degree relatives of PJS patients; these patients had previous negative gastrointestinal endoscopic examinations. Numerous polyps were detected in all patients in group A. Most polyps were sessile, but the larger polyps tended to be pedunculated. Polyp density was highest in the jejunum (greater than in the ileum and duodenum). Seven patients had at least one large polyp (> 11 mm) and five of these patients subsequently underwent enteroscopy, which revealed that capsule endoscopy had correctly identified all the patients with large polyps, but had missed 20 % of the total number of large polyps in these patients. No polyps were detected by capsule endoscopy in group B patients, despite the excellent visualization of the small intestine. In all patients, the capsules were expelled within 24 hours, without complications, and the procedure was well tolerated. Capsule endoscopy is an effective and well-tolerated method for evaluating small-bowel pathology in patients with PJS.

  6. Association between colonic polyps and diverticular disease

    Science.gov (United States)

    Hirata, Tetsuo; Kawakami, Yuko; Kinjo, Nagisa; Arakaki, Susumu; Arakaki, Tetsu; Hokama, Akira; Kinjo, Fukunori; Fujita, Jiro

    2008-01-01

    AIM: To evaluate the association between colonic polyps and diverticular disease in Japan. METHODS: We retrospectively reviewed the medical records of 672 consecutive patients who underwent total colonoscopy between August 2006 and April 2007 at Nishinjo Hospital, Okinawa, Japan. Patients with a history of any of the following were excluded from the study: previous polypectomy, colonic resection, and inflammatory bowel diseases. The association between colonic polyps and diverticular disease was analyzed by logistic regression analysis, adjusted for age and sex. RESULTS: Prevalence of colonic polyps in all patients with diverticular disease was significantly higher than that in those without diverticular disease (adjusted odds ratio 1.7). CONCLUSION: Our data showed that patients with diverticular disease have a higher risk of colonic polyps compared to those without. PMID:18416471

  7. ETIOLOGICAL FACTORS FOR VOCAL FOLD POLYP FORMATION

    Directory of Open Access Journals (Sweden)

    DAŠA GLUVAJIĆ

    2016-05-01

    Full Text Available Background: Vocal fold polyp is one of the most common causes for hoarseness. Many different etiological factors contribute to vocal fold polyp formation. The aim of the study was to find out whether the etiological factors for polyp formation have changed in the last 30 years.Methods: Eighty-one patients with unilateral vocal fold polyp were included in the study. A control group was composed of 50 volunteers without voice problems who matched the patients by age and gender. The data about etiological factors and the findings of phoniatric examination were obtained from the patients' medical documentation and from the questionnaires for the control group. The incidence of etiological factors was compared between the two groups. The program SPSS, Version 18 was used for statistical analysis.Results: The most frequent etiological factors were occupational voice load, GER, allergy and smoking. In 79% of patients 2 – 6 contemporary acting risk factors were found. Occupational voice load (p=0,018 and GER (p=0,004 were significantly more frequent in the patients than in the controls. The other factors did not significantly influence the polyp formation.Conclusions: There are several factors involved simultaneously in the formation of vocal fold polyps both nowadays and 30 years ago. Some of the most common factors remain the same (voice load, smoking, others are new (GER, allergy, which is probably due to the different lifestyle and working conditions than 30 years ago. Occupational voice load and GER were significantly more frequently present in the patients with polyp than in the control group. Regarding the given results it is important to instruct workers with professional vocal load about etiological factors for vocal fold polyp formation.

  8. Posterior urethral polyps and review of literature

    Directory of Open Access Journals (Sweden)

    Prashant Jain

    2007-01-01

    Full Text Available Urethral polyp is a rare finding in young children. Fibroepithelial polyps of the urethra are usually diagnosed during the first decade of life. They present with obstruction, voiding dysfunction and hematuria. They can be associated with other congenital urinary tract anomalies. They are usually benign fibroepithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy.

  9. Differentiated thyroid carcinoma and intestinal polyposis syndromes.

    Science.gov (United States)

    Triggiani, Vincenzo; Angelo Giagulli, Vito; Tafaro, Angela; Resta, Francesco; Sabba, Carlo; Licchelli, Brunella; Guastamacchia, Edoardo

    2012-12-01

    Familial Adenomatous Polyposis, Cowden's Syndrome, and Peutz-Jeghers Syndrome are well known as Intestinal Polyposis Syndromes, inherited conditions characterized by the development of polyps of the gastro-intestinal tract in association with extra-intestinal manifestations, in particular malignant tumors at different sites. Thyroid carcinoma is sometimes a part of the clinical picture of these syndromes. The aim of this paper is to review the literature dealing with the association between differentiated thyroid carcinomas and Intestinal Polyposis Syndromes in order to point out peculiar aspects, providing suggestions for the screening and the management of thyroid tumors in these patients.

  10. Colonoscopic features of early intestinal tuberculosis

    African Journals Online (AJOL)

    1991-03-02

    Mar 2, 1991 ... resembled sessile polyps. They occurred ... the colonoscopic diagnosis of intestinal tuberculosis has, until recently ... Transverse colon. Ascending colon. Rectum. Caecum. Transverse colon. Caecum and ascending colon. Caecum and transverse colon*. Caecum, ascending and transverse colon*. Caecum ...

  11. Gastric polyps: Retrospective analysis of 41,253 upper endoscopies.

    Science.gov (United States)

    Argüello Viúdez, Lidia; Córdova, Henry; Uchima, Hugo; Sánchez-Montes, Cristina; Ginès, Àngels; Araujo, Isis; González-Suárez, Begoña; Sendino, Oriol; Llach, Josep; Fernández-Esparrach, Gloria

    2017-10-01

    Gastric polyps are usually asymptomatic lesions incidentally discovered during endoscopy. To study the frequency of different types of gastric polyps in our population and their possible association with other factors. Retrospective study of gastroscopies performed in a tertiary hospital over a ten-year period. Demographics, medical history, indication for gastroscopy and morphological and histological characteristics of polyps were collected. Gastric polyps were found in 827 out of 41253 (2%) reviewed gastroscopies, corresponding to 709 patients. Mean age was 65.6 years, and 62% were female. 53.9% of patients had multiple polyps. The most common location was the fundus and 83.3% were smaller than 1cm. Histopathology was obtained in 607 patients: hyperplastic polyps were the most common (42.8%), followed by fundic gland polyps (37.7%). Factors independently associated with hyperplastic polyps were age and single polyp, size ≥6mm and location other than fundus. In contrast, fundic gland polyps were associated with reflux and multiple polyps, size <6mm and located in fundus. Adenomas were independently associated with single polyp. Fundic gland and hyperplastic polyps are the most common in our population and have characteristic features that can guide histological diagnosis. With single polyps it is advisable to take biopsies to rule out adenoma. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  12. Chitinolytic activity in nasal polyps.

    Science.gov (United States)

    Park, Seong Kook; Heo, Kyung Wook; Hur, Dae Young; Yang, Young Il

    2011-01-01

    Chitin is a recognition element for tissue infiltration by innate cells implicated in allergy and immunity. This process can be negatively regulated by vertebrate chitinases. Both acidic mammalian chitinase (AMCase) and chitotriosidase (ChT) have chitinolytic activity. This study aimed to determine the activities of AMCase and ChT in nasal polyps (NPs), as well as their in situ localization in NP tissue. AMCase and ChT activities in NPs were compared with those in inferior turbinate tissue samples. Tissue samples were measured for AMCase and ChT activities at a range of pHs using the fluorogenic substrate 4-methylumbelliferyl-beta-d-N,N',N''-triacetyl-chitotriose. Double immunofluorescent staining for the localization of both AMCase and ChT was performed using NP cryosections. Both AMCase and ChT displayed markedly increased chitinolytic activity in all NPs, compared with inferior turbinate tissues. Double immunofluorescent staining revealed that CD68 highlighted monocytes in the submucosa of NP and these cells disclosed coexpression of AMCase and ChT. CD31 detected capillary endothelial cells, but did not express any AMCase and ChT. The increased chitinolytic activities of AMCase and ChT in NPs may be important in NP pathogenesis, suggesting that inhibition of chitinolytic activity may be a novel therapeutic strategy for the treatment of NPs.

  13. Active contours for localizing polyps in colonoscopic NBI image data

    Science.gov (United States)

    Breier, Matthias; Gross, Sebastian; Behrens, Alexander; Stehle, Thomas; Aach, Til

    2011-03-01

    Colon cancer is the third most common type of cancer in the United States of America. Every year about 140,000 people are newly diagnosed with colon cancer. Early detection is crucial for a successful therapy. The standard screening procedure is called colonoscopy. Using this endoscopic examination physicians can find colon polyps and remove them if necessary. Adenomatous colon polyps are deemed a preliminary stage of colon cancer. The removal of a polyp, though, can lead to complications like severe bleedings or colon perforation. Thus, only polyps diagnosed as adenomatous should be removed. To decide whether a polyp is adenomatous the polyp's surface structure including vascular patterns has to be inspected. Narrow-Band imaging (NBI) is a new tool to improve visibility of vascular patterns of the polyps. The first step for an automatic polyp classification system is the localization of the polyp. We investigate active contours for the localization of colon polyps in NBI image data. The shape of polyps, though roughly approximated by an elliptic form, is highly variable. Active contours offer the flexibility to adapt to polyp variation well. To avoid clustering of contour polygon points we propose the application of active rays. The quality of the results was evaluated based on manually segmented polyps as ground truth data. The results were compared to a template matching approach and to the Generalized Hough Transform. Active contours are superior to the Hough transform and perform equally well as the template matching approach.

  14. An Isolated Neurofibromal Polyp of the Colon

    Directory of Open Access Journals (Sweden)

    Pierre Hindy

    2012-01-01

    Full Text Available Solitary neurofibromal colonic polyps are a rare entity, particularly outside the setting of neurofibromatosis type 1. The clinical significance of such lesions has not yet been established. Though typically benign tumors, neurofibromas have been reported to undergo malignant transformation, with an increased risk of malignancy when associated with neurofibromatosis. In this case report, we present the rare case of a man found to have an isolated colonic neurofibroma without any personal/family history or clinical features of neurofibromatosis. A 59-year-old man with a history of dyslipidemia and degenerative joint disease presented for a routine screening colonoscopy. The colonoscopy revealed no abnormalities except a 3 mm transverse colon polyp and another 4 mm polyp in the descending colon. Biopsy results showed the descending colonic polyp to be a tubular adenoma; however, multiple levels of the 3 mm transverse colon polyp revealed interlacing bundles of spindle cells extending into the lamina propria with comma-shaped nuclei consistent with findings seen in neurofibroma. Isolated colonic neurofibromas are rare and understudied. While they are usually benign, they may undergo malignant transformation, especially when associated with neurofibromatosis. Thus, patients presenting with isolated neurofibromas should be followed for development of neurofibromatosis and malignancies.

  15. A Rare Complication of Hyperplastic Gastric Polyp

    Directory of Open Access Journals (Sweden)

    Suresh Kumar Nayudu

    2013-01-01

    Full Text Available Hyperplastic gastric polyps are incidentally diagnosed during upper gastrointestinal endoscopy. They are known to cause gastric outlet obstruction and chronic blood loss leading to iron deficiency anemia. However, hyperplastic gastric polyp presenting as acute severe upper gastrointestinal bleeding is very rare. To the best of our knowledge, there have been two cases of hyperplastic gastric polyps presenting as acute gastrointestinal bleeding in the medical literature. We present a case of a 56-year-old African American woman who was admitted to our hospital with symptomatic anemia and sepsis. The patient developed acute upper gastrointestinal bleeding during her hospital stay. She underwent emergent endoscopy, but bleeding could not be controlled. She underwent emergent laparotomy and wedge resection to control the bleeding. Biopsy of surgical specimen was reported as hyperplastic gastric polyp. We recommend that physicians should be aware of this rare serious complication of hyperplastic gastric polyps as endoscopic polypectomy has diagnostic and therapeutic benefits in preventing future complications including bleeding.

  16. Multiple metachronous fibroepithelial polyps in children.

    Science.gov (United States)

    Kojima, Yoshiyuki; Lambert, Sarah M; Steixner, Brian L; Laryngakis, Nicholas; Casale, Pasquale

    2011-03-01

    We present our experience with a new phenotype of fibroepithelial polyps recurring in the urinary tract in children after robotic or laparoscopic pyeloplasty, and discuss the most appropriate treatment for these multiple metachronous neoplasms. At our institution 14 children had fibroepithelial polyps as the cause of ureteropelvic junction obstruction at pyeloplasty. Of the patients 12 had at least 1 additional polyp in the ureter, necessitating concomitant ureteroscopy at either robotic or laparoscopic pyeloplasty. Of these 12 patients 9 had followup of at least 1 year. In 6 patients with at least 1 year of followup neoplasms were seen on retrograde pyelography and ureteroscopy that were not present on ureteroscopy at pyeloplasty. At 6 months after stent removal following the first recurrence 2 patients (33%) showed a second recurrence on imaging at a different location in the upper tract requiring laser ablation. One of these patients had a third recurrence that required further intervention before all were disease-free. No major intraoperative or preoperative complications developed. We should always consider the possibility of recurrent fibroepithelial polyps in children with ureteropelvic junction obstruction, and recommend routine retrograde pyelography and ureteroscopy at stent removal after laparoscopic or robotic pyeloplasty. Although ureteroscopic management seems to be the most appropriate modality in children with multiple metachronous fibroepithelial polyps, larger studies are needed. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Doxycycline or oral corticosteroids for nasal polyps.

    Science.gov (United States)

    Grammer, Leslie C

    2013-01-01

    The study by Van Zele et al reports positive results for a randomized, double-blind, placebo-controlled trial that used either 20 days of doxycycline (200 mg the first day, followed by 100 mg daily) or 20 days of a tapering schedule of methyl prednisolone (32 mg on days 1-5, 16 mg on days 6-10, and 8 mg on days 11-20) for the treatment of nasal polyps. The primary end point was reduction in nasal polyp score which was graded 0 to 4 on each side, resulting in a score range of 0 to 8; the score was determined at baseline and weeks 1, 2, 4, 8, and 12. Entry criteria required that the patient either have recurrent polyps after surgery or massive polyps (grade 3 or 4); the total polyp score in each of the 3 groups averaged approximately 6. The patient population in this study was therefore at the severe end of the spectrum; results may not be generalizable to patients with milder disease. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Elevation of WNT5A expression in polyp formation in Lkb1+/- mice and Peutz-Jeghers syndrome.

    Science.gov (United States)

    Lai, Cecilia; Robinson, James; Clark, Sue; Stamp, Gordon; Poulsom, Richard; Silver, Andrew

    2011-04-01

    Peutz-Jeghers syndrome (PJS) is a rare, inherited disease caused by germline mutation of the LKB1 gene. Patients with PJS develop characteristic polyps in the digestive tract and carry an elevated risk of cancers in multiple organs, including the intestinal tract. While LKB1 is capable of phosphorylating AMPK and regulates the mTOR pathway, it is also known to be a multitasking protein that can influence other cellular processes, including cell polarity. We hypothesized that there may be other biological pathways directly or indirectly affected by the loss of LKB1 in PJS and aimed to investigate this possibility through transcriptional profiling of polyps harvested from an Lkb1(+/-) mouse model of PJS and from PJS patients. We identified alterations in the mRNA level of a wide range of genes, including some that are involved in Wnt signalling (Wnt5a, Wif1, Dixdc1, Wnt11, Ccnd1, and Ccnd2), although we did not observe nuclear localization of β-catenin in over 93 human PJS intestinal polyps or in 24 gastric polyps from Lkb1(+/-) mice. Among these genes, WNT5A, a non-canonical and non-transforming Wnt, is consistently up-regulated in both Lkb1(+/-) mice and human PJS polyps at a high level. We performed in situ hybridization to further define the spatial expression pattern of WNT5A and observed a strong signal in the stroma of mouse and human polyps compared to no or very low expression in the mucosa. Our findings indicate that WNT5A plays an important role in PJS polyposis. Copyright © 2011 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  19. Gastrointestinal polyps and polyposis syndromes in children.

    Science.gov (United States)

    Erdman, Steven H; Barnard, John A

    2002-10-01

    Gastrointestinal polyps are common during childhood and most often present with painless rectal bleeding. Most polyps occur as isolated colonic lesions and are not harbingers of an underlying genetic disorder, nor do they bestow a risk of gastrointestinal cancer. The astute pediatrician must be aware, however, that occasionally polyps may occur in the context of a genetic polyposis disorder characterized by an increase in the life-time risk of cancer in the gastrointestinal tract and other organ systems. This review outlines the major polyposis syndromes affecting children and highlights associated findings that might clue the alert physician to an underlying diagnosis. Recent developments in the understanding of the genetics of each disorder are emphasized.

  20. Peutz--Jeghers syndrome with pseudoinvasion of hamartomatous polyps and multiple epithelial neoplasms.

    Science.gov (United States)

    Bolwell, J S; James, P D

    1979-01-01

    The risk of malignant change developing in the hamartomatous polyps in Peutz-Jeghers syndrome is widely held to be negligible. However an association with tumours of the upper gastro-intestinal tract, ovary and other diverse multiple neoplasms is now recognized. Previously reported cases of malignant change in Peutz--Jeghers polyps may represent 'pseudoinvasion' and we report such a case. This was associated with carcinomas of the bile ducts, left tonsil and a papillary adenoma of the pancreatic duct. It lends further support to the view that there may be a genetic predisposition to the development of neoplasms in this condition. Pathologists and clinicians must be aware of this entity of 'pseudoinvasion' in order to avoid unnecessarily radical surgery in Peutz-Jeghers syndrome.

  1. Appendiceal Adenocarcinoma Presenting as a Rectal Polyp

    Directory of Open Access Journals (Sweden)

    Erin Fitzgerald

    2016-02-01

    Full Text Available Appendiceal adenocarcinoma typically presents as an incidentally noted appendiceal mass, or with symptoms of right lower quadrant pain that can mimic appendicitis, but local involvement of adjacent organs is uncommon, particularly as the presenting sign. We report on a case of a primary appendiceal cancer initially diagnosed as a rectal polyp based on its appearance in the rectal lumen. The management of the patient was in keeping with standard practice for a rectal polyp, and the diagnosis of appendiceal adenocarcinoma was made intraoperatively. The operative strategy had to be adjusted due to this unexpected finding. Although there are published cases of appendiceal adenocarcinoma inducing intussusception and thus mimicking a cecal polyp, there are no reports in the literature describing invasion of the appendix through the rectal wall and thus mimicking a rectal polyp. The patient is a 75-year-old female who presented with spontaneous hematochezia and, on colonoscopy, was noted to have a rectal polyp that appeared to be located within a diverticulum. When endoscopic mucosal resection was not successful, she was referred to colorectal surgery for a low anterior resection. Preoperative imaging was notable for an enlarged appendix adjacent to the rectum. Intraoperatively, the appendix was found to be densely adherent to the right lateral rectal wall. An en bloc resection of the distal sigmoid colon, proximal rectum and appendix was performed, with pathology demonstrating appendiceal adenocarcinoma that invaded through the rectal wall. The prognosis in this type of malignancy weighs heavily on whether or not perforation and spread throughout the peritoneal cavity have occurred. In this unusual presentation, an en bloc resection is required for a complete resection and to minimize the risk of peritoneal spread. Unusual appearing polyps do not always originate from the bowel wall. Abnormal radiographic findings adjacent to an area of

  2. Is colonoscopy necessary in children suspected of having colonic polyps?

    Science.gov (United States)

    Lee, Hye Jin; Lee, Ji Hyuk; Lee, Jong Seung; Choe, Yon Ho

    2010-09-01

    The clinical spectrum, histology, and endoscopic features of colonic polyps in the pediatric age group were studied to evaluate the role of colonoscopy in children suspected of having colonic polyps. Seventy-six patients with colorectal polyps were studied. Investigations included barium enema (n=6), sigmoidoscopy (n=17), and colonoscopy (n=53) at the initial visit. Colonoscopy was also performed in 23 patients who received barium enema or sigmoidoscopy. Data related to age, gender, family history, signs, symptoms, size, location, polyp types, and associated diseases were collected and analyzed. Among the 76 patients, juvenile polyps were detected in 58 (76.3%), potentially premalignant polyposis in 17 (22.4%), familial adenomatous polyposis in 11 (14.5%), Peutz-Jegher syndrome in 4 (5.3%), and juvenile polyposis syndrome in 2 (2.6%). Twenty-two patients (28.9%) had polyps in the upper colon. All patients with potentially malignant polyps had polyps in both the upper colon and rectosigmoid colon. Although most of the children with colorectal polyps had juvenile polyps, a significant number of cases showed multiple premalignant and proximally located polyps. This finding emphasizes the need for a colonoscopy in such patients. Thus, the risk of malignant change, particularly in children with multiple polyps, makes surveillance colonoscopy necessary.

  3. Innovative video capsule endoscopy for detection of ubiquitously elongated small intestinal villi in Cronkhite-Canada syndrome

    OpenAIRE

    Heinzow, Hauke Sebastian; Domschke, Wolfram; Meister, Tobias

    2013-01-01

    Cronkhite-Canada syndrome (CCS) is a rare non-familial disorder with multiple gastrointestinal polyps and ectodermal changes. Adenomatous and carcinomatous changes have been reported. Video capsule endoscopy is a useful non-invasive tool to reveal polypoid lesions of the gastrointestinal tract suspicious for malignancy. We report a case of a patient with CCS with excessively elongated intestinal villi resembling dense sea grass under water as well as multiple polyps of the intestinal mucosa r...

  4. The Polyp Manager: a new tool for optimal polyp documentation during colonoscopy. A pilot study.

    Science.gov (United States)

    van de Meeberg, Maartje M; Ouwendijk, Rob J Th; Ter Borg, Pieter C J; van den Hazel, Sven J; van de Meeberg, Paul C

    2016-05-01

    Conventional reporting of polyps is often incomplete. We tested the Polyp Manager (PM), a new software application permitting the endoscopist to document polyps in real time during colonoscopy. We studied completeness of polyp descriptions, user-friendliness and the potential time benefit. In two Dutch hospitals colonoscopies were performed with PM (as a touchscreen endoscopist-operated device or nurse-operated desktop application). Completeness of polyp descriptions was compared to a historical group with conventional reporting (CRH). Prospectively, we compared user-friendliness (VAS-scores) and time benefit of the endoscopist-operated PM to conventional reporting (CR) in one hospital. Duration of colonoscopy and time needed to report polyps and provide a pathology request were measured. Provided that using PM does not prolong colonoscopy, the sum of the latter two was considered as a potential time-benefit if the PM were fully integrated into a digital reporting system. A total of 144 regular colonoscopies were included in the study. Both groups were comparable with regard to patient characteristics, duration of colonoscopy and number of polyps. Using the PM did reduce incomplete documentation of the following items in CRH-reports: location (96 % vs 82 %, P = 0.01), size (95 % vs 89 %, P = 0.03), aspect (71 % vs 36 %, P report was 01:27 ± 01:43 minutes (median + interquartile range) in the entire group (PM as CR), reflecting potential time benefit per colonoscopy. The PM is a user-friendly tool that seems to improve completeness of polyp reporting. Once integrated with digital reporting systems, it is probably time saving as well.

  5. Oculosporidial polyp infected secondarily by Enterobius vermicularis

    Science.gov (United States)

    Anuradha, S.; Bharathi, K.; Khalique, Abdul

    2014-01-01

    Oculosporidiosis caused by Rhinosporidium seeberi is a common infectious disease of south India. Here we are reporting a rare case of oculosporidial polyp containing another parasite Enterobius vermicularis as a co infection. This is the first report of its kind in literature. A nine year old school going girl from a rural area presented with a reddish polypoidal lesion from conjunctiva along with complaints of severe itching over it. On examination, the polyp measured 5 mm × 5 mm in size, reddish, granular with a tendency to bleed on touch. Her vision was normal. All the basic investigations were within normal limits. A differential diagnosis of conjunctival papilloma, foreign body granuloma and oculosporidiosis were considered clinically. The polyp was removed completely using electro cautery with healthy margins around the lesion. To our surprise histopathological examination of the swelling revealed the presence of two different parasites in the conjunctival polyp. Sections showed sporangia of Rhinosporidium seeberi, fragments of Enterobius vermicularis and its eggs. She was then treated with anti helminthic drugs. Two months of follow up till now showed no recurrence of the lesion. PMID:25337525

  6. [Colorectal polyps in children. A study of 34 patients].

    Science.gov (United States)

    Boukthir, Samir; Mazigh Mrad, Sonia; Oubich, Fayçal; Boussif, Ali; Debbabi, Ali; Barsaoui, Sihem

    2006-08-01

    To assess the frequency and the clinical features of polyps of the colon and rectum in children. A total of 34 patients (20 boys and 14 girls, mean age: 5.4 years) were enrolled in this 14-years retrospective study. Diagnosis was done for almost all patients by colonoscopy (n=8) or recto-sigmoidoscopy (n= 19). After endoscopic polypectomy, polyp's type is determined by histological examination. Minimal and relapsing rectal bleeding was the most frequent finding of polyps of the colon and rectum (85.3%) followed by spontaneous emission of polyp (n=3), rectal prolapses (n=2), chronic constipation (n=1) and abdominal pain (n=1). The polyp was unique in all cases and with a mean size of 12 mm. The majority of polyps were localized in the rectum or sigmoid (97%) and were pediculate (81.2%). Endoscopic polypectomies concerned 26 polyps while two small polyps were left. Most of the polyps corresponded histologically to juvenile polyps (96.2%). The immediate post-op course was uneventful for 26 children. Our study suggests that rectal bleeding is the most frequent finding of polyps of the colon and rectum in childhood. Outcome after endoscopic polypectomy is good.

  7. Juvenile polyp in Thai children--clinical and colonoscopic presentation.

    Science.gov (United States)

    Ukarapol, Nuthapong; Singhavejakul, Jesda; Lertprasertsuk, Nirush; Wongsawasdi, Lumduan

    2007-02-01

    The aim of this prospective study was to describe the clinical characteristics of colorectal polyp in Thai children. From December 2002 to February 2005, children under 15 years of age presenting with rectal bleeding were prospectively enrolled. Demographic, clinical, and laboratory information was recorded. Location, number, characteristics, and histopathology of the polyps were noted. There were 32 patients with a mean age of 6.5 years. The most common presenting symptom was hematochezia, followed by prolapsing rectal mass and diarrhea. In 20 patients there was a single polyp, 6 had 2-4 polyps, and 6 were diagnosed with polyposis coli. Most of the polyps were located exclusively at the rectum and sigmoid colon. In only 7 cases were the polyps proximal to the rectosigmoid region. This included 6 patients who had polyps beyond the splenic flexure. All were juvenile polyps without evidence of adenomatous changes. Compared to those with isolated polyps, the patients with polyposis coli had a statistically significant incidence of right-sided polyps (P polyps and the concern about malignant transformation, colonoscopy should be considered as the initial evaluation in children with rectal bleeding.

  8. Frequency of Thyroid Nodules among Patients with Colonic Polyps

    Directory of Open Access Journals (Sweden)

    Cevdet Duran

    2012-01-01

    Full Text Available Aim. Colonic polyps and thyroid nodules are common diseases and their frequency increases with age. In the literature, there is no study investigating the coexistence of colonic polyps and thyroid nodules. Therefore, this study was designed to investigate thyroid nodule prevalence in patients with colonic polyps. Material and Methods. Sixty-six patients with colonic polyps and 146 patients without colonic polyps enrolled into the study. Age and sex matched control group was composed from patients without colonic polyps. Colonoscopic examinations, thyroid ultrasonographies were performed in all patients, and TSH were measured. Results. Male/female ratio in polyp and control groups were 40/26 versus 68/78, respectively (P=0.058. Mean ages were similar in both groups (53.3±11.4 versus, 51.8±11.4, P=0.373. Thyroid nodule was detected in 44 (66.7% patients with polyps and in 61 (41.8% controls (P=0.001. Patients with adenomatous polyps had 5 or more thyroid nodules compared to patients with hyperplastic polyps (P=0.03. Thyroid nodules were more prevalent among patients aged 50 or older compared to 50 years or less (P=0.023. Conclusion. Thyroid nodules were detected more common in patients with colonic polyps. Further studies are needed to clarify this coexistence.

  9. Juvenile Polyps in Denmark From 1995 to 2014.

    Science.gov (United States)

    Jelsig, Anne Marie; Ousager, Lilian Bomme; Brusgaard, Klaus; Qvist, Niels

    2016-08-01

    Juvenile polyps in the large bowel are rare but the most common type of polyp in children. The prevalence and incidence are unknown, and few studies exist on the occurrence in adults. They are considered not to harbor any malignant potential unless they are part of the hereditary juvenile polyposis syndrome. We aimed to study the demographics of juvenile polyps in Denmark in a 20-year period from 1995 to 2015 in both adults and children. This is the first report on the occurrence, anatomic localization, and reoccurrence of these polyps in a whole population. Data from all of the patients who had been diagnosed with 1 or more juvenile polyp from January 1, 1995, until December 31, 2014, were obtained. The study was conducted based on patients registered in the nationwide pathological register in Denmark, the Danish Pathology Data Bank. We detected a total of 1772 patients who had 2108 juvenile polyps removed (male = 946; female = 826). We noted the sex, age, number, reoccurrence, and localization of polyps. Of the detected juvenile polyps ≈75% were detected in adults and ≈25% in children. Approximately 96% of the patients had a single juvenile polyp without reoccurrence, 1% fulfilled the diagnostic criteria for juvenile polyposis syndrome (more than 5 polyps), and 5% had multiple juvenile polyps (2-5 polyps). The incidence in the Danish population can be estimated to be between 1:45,000 and 1:65,000. Miscoding or misclassification in the register cannot be ruled out. We only have data for the 20-year period, limiting the evaluation of reoccurrence, and no data for the endoscopic removal procedures. We conclude that juvenile polyps are rare, with the majority found in adults, and most often found as a single juvenile polyp. A subgroup of patients have juvenile polyposis syndrome, which requires follow-up.

  10. [Diagnostic accuracy of double contrast examination in the detection of gastric polyps (author's transl)].

    Science.gov (United States)

    Montesi, A; De Nigris, E; Pesaresi, A; Graziani, L; Aguzzi, P; Cacciamani, G; Pucci, F

    1981-01-01

    Gastric polyps have been found in 2.9% of 4322 consecutive routine double contrast examination of upper gastro-intestinal tract. In 559 patients, endoscopically verified, sensitivity of radiological test was 96% and specificity 96.3%. An agreement index (K-index) was evaluated in a sample of 84 cases. The index value was 0.9 among 2 different radiologists with a similar, high experience and 0.8 among 2 radiologists with different degree of experience in double contrast examination. Our results demonstrate the validity of the double contrast study of the stomach as preliminary to endoscopy.

  11. [Colonorectal adenoma: relationships among histological structure, dimensions of the polyps, and age distribution].

    Science.gov (United States)

    Frimberger, E; Kühner, W; Seib, H J; Ottenjann, R

    1978-11-30

    Among 1258 polyps from the lower gastro-intestinal tract removed by rectoscopy or coloscopy and examined histologically there were 744 adenomas, 72% tubular, 27% papillary and 1% villous. 96.5% of all adenomas were extracted from patients aged over 40 years. Four fifths of the tumours were found in the rectum and sigmoid colon. Only 6% of the tubular adenomas were more than 15 mm in diameter, compared with 32% of papillary and 57% of villous adenomas. The special significance of the adenomas lies in their potential malignancy (adenoma-to-cancer sequence).

  12. Is epidermal growth factor involved in development of duodenal polyps in familial polyposis coli?

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1988-01-01

    Duodenal adenomas are a frequent extracolonic manifestation in patients with familial polyposis coli (FPC). Epidermal growth factor (EGF), a polypeptide that stimulates cellular growth and differentiation, is localized in Paneth cells in the small intestine. In two patients with FPC, we found EGF...... immunoreactivity in duodenal adenomas. Numerous EGF immunoreactive Paneth cells were localized, not as usually, in the bottom of the crypts, but scattered along the crypts alone or in clusters. We do not know whether EGF is involved in the development of duodenal polyps in FPC patients, or whether the present...

  13. Yellow nail syndrome, pincer nails, colon cancer and polyps in a 76 year-old-woman

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos Santos

    2015-11-01

    Full Text Available The yellow nail syndrome is a scarcely described condition characterized by dystrophic yellowish nails, respiratory disturbances and lymphedema; while the pincer nail deformity is characterized by thickening and excessive transverse curvature of the nail plate. The objective of this case study is to report a 76-year-old Japanese descent woman with yellow nail syndrome and pincer nails, intestinal polyps, and sigmoid colon adenocarcinoma. Both the yellow nail syndrome and pincer nails may develop in association with malignancies, either by chance or by some etiopathogenic mechanism not well-known.

  14. Use of a novel polyp "ruler snare" improves estimation of colon polyp size.

    Science.gov (United States)

    Kaz, Andrew M; Anwar, Asma; O'Neill, Darby Robinson; Dominitz, Jason A

    2016-04-01

    Prior studies have demonstrated that endoscopists' estimates of polyp size are imprecise. The aim of this study was to determine whether a modified polypectomy "ruler snare" improves the accuracy of assessment of polyp size in real time without the use of additional devices. Ten artificial polyps of predetermined sizes (4 to 25 mm) were affixed to the inside of a colon model. A standard polypectomy snare was modified by adding 5-mm graduated markings to the distal end of the plastic sheath. Study participants estimated the sizes of the artificial polyps during simulated colonoscopies, first using a standard snare and then with the modified ruler snare. Thirty-four private practice and academic gastroenterologists participated in the study. Endoscopists' ability to accurately classify polyps by size (diminutive, small, or large) improved from 48.5% to 60.3% with the ruler snare (P = .002). The greatest improvement in precision was seen among the large polyps, where accuracy increased from 35.9% to 58.2% with use of the ruler snare (P size by a mean of 3.6 mm (interquartile range, -5 to -2 mm) with the standard snare and 1.8 mm (interquartile range, -3 to 0 mm) with the ruler snare, which corresponded to a 44.2% improvement in accuracy with the ruler snare (P size assessment compared with a standard snare, particularly with large polyps. Overall, although size estimation continues to be imprecise, the addition of calibrated markings to a polypectomy snare is a simple and likely low-cost means to improve neoplasia surveillance recommendations. Copyright © 2016. Published by Elsevier Inc.

  15. Colonic polyps in children: frequently multiple and recurrent.

    Science.gov (United States)

    Pillai, R B; Tolia, V

    1998-04-01

    A retrospective chart review on 77 children and adolescents (45 males and 32 females) with colorectal polyps seen over a 15-year period (1980-1994) was undertaken. Their presenting symptoms, demographic data, methods of diagnosis, pathologic diagnosis, and outcome were assessed. The age at presentation varied from 6 months to 19 years (mean age 77 months), 66.2% presenting under 6 years of age. The presenting symptoms were rectal bleeding in 71 patients, mass per rectum in 12, abdominal pain in nine, diarrhea in nine, vomiting in two, and one patient was asymptomatic. Air contrast barium enema was confirmatory in 41/54 patients (76%). Polyps were palpable in 16 patients during the rectal examination. A single polyp was present in 50 patients, whereas two to five polyps were present in 20 patients, and more than five in seven patients. Successful endoscopic removal was accomplished in 71/73 patients (97.3%). In 83.1% of patients polyps were located in the rectosigmoid area and in 32.5% polyps occurred proximal to the sigmoid colon. However, multiple polyps in the same location or at other locations were also present simultaneously. Recurrence was observed in five of 63 patients (7.9%) with juvenile polyps, in one patient with infantile polyposis, and in one with solitary adenomatous polyp. We conclude that a full colonoscopic evaluation should be performed in all patients with suspected polyps if feasible, for multiple polyps occurred in 35% of children without polyposis syndromes in this series. Parents of patients with more than three polyps and/or a family history of juvenile polyposis should be warned regarding the possibility of an increased risk of malignancy in future if polyps continue to recur.

  16. Live imaging of cysteine-cathepsin activity reveals dynamics of focal inflammation, angiogenesis, and polyp growth.

    Directory of Open Access Journals (Sweden)

    Elias Gounaris

    2008-08-01

    Full Text Available It has been estimated that up to 30% of detectable polyps in patients regress spontaneously. One major challenge in the evaluation of effective therapy of cancer is the readout for tumor regression and favorable biological response to therapy. Inducible near infra-red (NIR fluorescent probes were utilized to visualize intestinal polyps of mice hemizygous for a novel truncation of the Adenomatous Polyposis coli (APC gene. Laser Scanning Confocal Microscopy in live mice allowed visualization of cathepsin activity in richly vascularized benign dysplastic lesions. Using biotinylated suicide inhibitors we quantified increased activities of the Cathepsin B & Z in the polyps. More than (3/4 of the probe signal was localized in CD11b(+Gr1(+ myeloid derived suppressor cells (MDSC and CD11b(+F4/80(+ macrophages infiltrating the lesions. Polyposis was attenuated through genetic ablation of cathepsin B, and suppressed by neutralization of TNFalpha in mice. In both cases, diminished probe signal was accounted for by loss of MDSC. Thus, in vivo NIR imaging of focal cathepsin activity reveals inflammatory reactions etiologically linked with cancer progression and is a suitable approach for monitoring response to therapy.

  17. Inverted Lymphoglandular Polyp in Descending Colon

    Directory of Open Access Journals (Sweden)

    Shengmei Zhou

    2015-01-01

    Full Text Available A 47-year-old male with a history of left colon cancer, status post left colon resection for 12 years, presented with rectal bleeding. Colonoscopic examination revealed an 8 mm sessile polyp in the proximal descending colon. Microscopic examination showed that the surface of this polyp was covered with a layer of normal colonic mucosa with focal surface erosion. In the submucosal layer, an intimate admixture of multiple cystically dilated glands and prominent lymphoid aggregates with germinal centers was seen. The glands were lined by columnar epithelium. Immunohistochemical staining showed the glands were positive for CK20 and CDX2 and negative for CK7, with a low proliferative index, mostly consistent with reactive colonic glands. The patient remained asymptomatic after one-year follow-up. A review of the literature shows very rare descriptions of similar lesions, but none fits exactly this pattern. We would designate this inverted lymphoglandular polyp and present this case to raise the awareness of recognizing this unusual histological entity.

  18. Microbiome analysis of stool samples from African Americans with colon polyps.

    Science.gov (United States)

    Brim, Hassan; Yooseph, Shibu; Zoetendal, Erwin G; Lee, Edward; Torralbo, Manolito; Laiyemo, Adeyinka O; Shokrani, Babak; Nelson, Karen; Ashktorab, Hassan

    2013-01-01

    Colonic polyps are common tumors occurring in ~50% of Western populations with ~10% risk of malignant progression. Dietary agents have been considered the primary environmental exposure to promote colorectal cancer (CRC) development. However, the colonic mucosa is permanently in contact with the microbiota and its metabolic products including toxins that also have the potential to trigger oncogenic transformation. To analyze fecal DNA for microbiota composition and functional potential in African Americans with pre-neoplastic lesions. We analyzed the bacterial composition of stool samples from 6 healthy individuals and 6 patients with colon polyps using 16S ribosomal RNA-based phylogenetic microarray; the Human intestinal Tract Chip (HITChip) and 16S rRNA gene barcoded 454 pyrosequencing. The functional potential was determined by sequence-based metagenomics using 454 pyrosequencing. Fecal microbiota profiling of samples from the healthy and polyp patients using both a phylogenetic microarraying (HITChip) and barcoded 454 pyrosequencing generated similar results. A distinction between both sets of samples was only obtained when the analysis was performed at the sub-genus level. Most of the species leading to the dissociation were from the Bacteroides group. The metagenomic analysis did not reveal major differences in bacterial gene prevalence/abundances between the two groups even when the analysis and comparisons were restricted to available Bacteroides genomes. This study reveals that at the pre-neoplastic stages, there is a trend showing microbiota changes between healthy and colon polyp patients at the sub-genus level. These differences were not reflected at the genome/functions levels. Bacteria and associated functions within the Bacteroides group need to be further analyzed and dissected to pinpoint potential actors in the early colon oncogenic transformation in a large sample size.

  19. Microbiome analysis of stool samples from African Americans with colon polyps.

    Directory of Open Access Journals (Sweden)

    Hassan Brim

    Full Text Available Colonic polyps are common tumors occurring in ~50% of Western populations with ~10% risk of malignant progression. Dietary agents have been considered the primary environmental exposure to promote colorectal cancer (CRC development. However, the colonic mucosa is permanently in contact with the microbiota and its metabolic products including toxins that also have the potential to trigger oncogenic transformation.To analyze fecal DNA for microbiota composition and functional potential in African Americans with pre-neoplastic lesions.We analyzed the bacterial composition of stool samples from 6 healthy individuals and 6 patients with colon polyps using 16S ribosomal RNA-based phylogenetic microarray; the Human intestinal Tract Chip (HITChip and 16S rRNA gene barcoded 454 pyrosequencing. The functional potential was determined by sequence-based metagenomics using 454 pyrosequencing.Fecal microbiota profiling of samples from the healthy and polyp patients using both a phylogenetic microarraying (HITChip and barcoded 454 pyrosequencing generated similar results. A distinction between both sets of samples was only obtained when the analysis was performed at the sub-genus level. Most of the species leading to the dissociation were from the Bacteroides group. The metagenomic analysis did not reveal major differences in bacterial gene prevalence/abundances between the two groups even when the analysis and comparisons were restricted to available Bacteroides genomes.This study reveals that at the pre-neoplastic stages, there is a trend showing microbiota changes between healthy and colon polyp patients at the sub-genus level. These differences were not reflected at the genome/functions levels. Bacteria and associated functions within the Bacteroides group need to be further analyzed and dissected to pinpoint potential actors in the early colon oncogenic transformation in a large sample size.

  20. Antral hyperplastic polyp: A rare cause of gastric outlet obstruction.

    Science.gov (United States)

    Aydin, Ibrahim; Ozer, Ender; Rakici, Halil; Sehitoglu, Ibrahim; Yucel, Ahmet Fikret; Pergel, Ahmet; Sahin, Dursun Ali

    2014-01-01

    Gastric polyps are usually found incidentally during upper gastrointestinal endoscopic examinations. These polyps are generally benign, with hyperplasia being the most common. While gastric polyps are often asymptomatic, they can cause gastric outlet obstruction. A 64 years-old female patient presented to our polyclinic with a history of approximately 2 months of weakness, occasional early nausea, vomiting after meals and epigastric pain. A polypoid lesion of approximately 25mm in diameter was detected in the antral area of the stomach, which prolapsed through the pylorus into the duodenal bulbus, and subsequently caused gastric outlet obstruction, as revealed by upper gastrointestinal endoscopy of the patient. The polyp was retrieved from the pyloric canal into the stomach with the aid of a tripod, and snare polypectomy was performed. Currently, widespread use of endoscopy has led to an increase in the frequency of detecting hyperplastic polyps. While most gastric polyps are asymptomatic, they can cause iron deficiency anemia, acute pancreatitis and more commonly, gastric outlet obstruction because of their antral location. Although there are no precise principles in the treatment of asymptomatic polyps, polyps >5mm should be removed due to the possibility of malignant transformation. According to the medical evidence, polypectomy is required for gastric hyperplastic polyps because of the risks of complication and malignancy. These cases can be successfully treated endoscopically. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Colonic chicken skin mucosa: association with juvenile polyps in children.

    Science.gov (United States)

    Nowicki, M J; Subramony, C; Bishop, P R; Parker, P H

    2001-03-01

    Chicken skin mucosa is a newly described endoscopic finding associated with colonic neoplasms in adults. Chicken skin mucosa was sought in children with juvenile polyps to determine the prevalence, endoscopic features, and location. An alternative theory is proposed for the pathogenic mechanism of this finding. Children having colonoscopy and polypectomy were prospectively evaluated for the presence of chicken skin mucosa. The location of the polyps was determined at colonoscopy; the size of removed polyps was measured during processing of samples in pathology. Biopsies from colonic chicken skin mucosa were stained with hematoxylin and eosin and mucicarmine. Over a 1-yr period, 27 juvenile polyps were removed from 15 children at colonoscopy. Eleven of 15 children (73%) were found to have polyps with chicken skin mucosa; overall, 43% of the polyps had associated chicken skin mucosa. Chicken skin mucosa-positive polyps were larger than chicken skin mucosa-negative polyps and were only found in the rectosigmoid colon. Lipid-laden macrophages were found in all samples of chicken skin mucosa tested. Chicken skin mucosa is a common finding in children with juvenile polyps. It probably is the result of local mucosal trauma, rather than a preneoplastic lesion.

  2. Effects of proton pump inhibitors on pediatric inflammatory esophagogastric polyps.

    Science.gov (United States)

    Choi, Kyong Eun; Kim, Mi Jin; Lee, Ji Hyuk; Lee, Jong Seung; Lee, Jee Hyun; Choe, Yon Ho

    2012-01-01

    The aim of this study was to investigate the effects of proton pump inhibitors on symptomatic inflammatory esophagogastric polyps (IEPs) in a pediatric cohort and to determine the optimal duration of treatment. The 11 patients with IEPs were managed with lansoprazole. Follow-up endoscopies were performed at 2 and 6 months after the start of medication. Medication was discontinued when the clinical symptoms completely resolved and the polyp size was reduced by more than 50% compared to the initial size. The initial polyp size was 13.7 ± 3.3 mm. After 2 months of medication, the polyp size was reduced to 8.0 ± 5.8 mm. At 6 months, the polyp size was 4.7 ± 2.2 mm. The mean duration of medication was 4.8 ± 2.1 months. The duration of medication and the change in the polyp size appeared to have a linear correlation (p polyp size, the optimal duration of treatment was more than 7 months for complete resolution of the polyps. Proton pump inhibitor was effective for the treatment of IEPs. About 5 months of lansoprazole was adequate to treat IEPs in children. The optimal duration for complete resolution of the polyp might be more than 7 months. Copyright © 2012 S. Karger AG, Basel.

  3. Diagnosis and management of gastrointestinal polyps: pediatric considerations.

    Science.gov (United States)

    Attard, Thomas M; Young, Rosemary J

    2006-01-01

    Painless, bright red, rectal bleeding with normal stool frequency and consistency is the hallmark presentation of colorectal polyps at any age. Most polyps in children are sporadic, usually isolated, colorectal juvenile polyps that do not require any further surveillance after they are removed. There is, however, increasing recognition of syndromes, including familial adenomatous polyposis, juvenile polyposis coli, Peutz-Jeghers syndrome, and infrequent conditions, such as PTEN hamartoma and hereditary mixed polyposis syndromes. The aim of this review is to allow the reader to correctly identify the patients who do not require follow-up and the smaller group of patients who do require follow-up because of syndromic polyp conditions.

  4. Photoacoustic imaging for differential diagnosis of benign polyps versus malignant polyps of the gallbladder: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Chae, Hee Dong; Lee, Jae Young; Han, Joon Koo [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul (Korea, Republic of); Jang, Jin Young; Kang, Mee Joo [Div. of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Chang, Jin Ho; Kang, Jeeun [Sogang University, Seoul (Korea, Republic of)

    2017-09-15

    To investigate the feasibility of ex vivo multispectral photoacoustic (PA) imaging in differentiating cholesterol versus neoplastic polyps, and benign versus malignant polyps, of the gallbladder. A total of 38 surgically confirmed gallbladder polyps (24 cholesterol polyps, 4 adenomas, and 10 adenocarcinomas) from 38 patients were prospectively included in this study. The surgical specimens were set on a gel pad immersed in a saline-filled container. The PA intensities of polyps were then measured, using two separate wavelength intervals (421–647 nm and 692–917 nm). Mann-Whitney U test was performed for the comparison of normalized PA intensities between the cholesterol and neoplastic polyps, and between the benign and malignant polyps. Kruskal-Wallis test was conducted for the comparison of normalized PA intensities among the cholesterol polyps, adenomas, and adenocarcinomas. A significant difference was observed in the normalized PA intensities between the cholesterol and neoplastic polyps at 459 nm (median, 1.00 vs. 0.73; p = 0.032). Comparing the benign and malignant polyps, there were significant differences in the normalized PA intensities at 765 nm (median, 0.67 vs. 0.78; p = 0.013), 787 nm (median, 0.65 vs. 0.77; p = 0.034), and 853 nm (median, 0.59 vs. 0.85; p = 0.028). The comparison of the normalized PA intensities among cholesterol polyps, adenomas, and adenocarcinomas demonstrated marginally significant differences at 765 nm (median, 0.67 vs. 0.66 vs. 0.78, respectively; p = 0.049). These preliminary results indicate that benign versus malignant gallbladder polyps might exhibit different spectral patterns on multispectral PA imaging.

  5. Vascular endothelial growth factor and children featuring nasal polyps.

    Science.gov (United States)

    Hu, Ko-Hsin; Lee, Fei-Peng; Cheng, Ya-Jian; Huang, Hung-Meng

    2007-01-01

    The aim of this study is to explore the expression of vascular endothelial growth factor within nasal polyps, and the implication of such expression as regards the development of nasal polyps amongst children. Sixty children suffering from chronic rhinosinusitis were enrolled in this study. Amongst them, 30 patients featured rhinosinusitis with associated nasal polyps. A biopsy specimen was taken from the stalk or the base of the nasal polyp for nasal-polyp sufferers, and the ethmoid sinus for study participants who featured no nasal polyps. The primary lesions biopsied were immunohistochemically stained with a specific endothelial-cell marker and also stained for the presence of vascular endothelial growth factor. The specific level of vascular endothelial growth factor and the mean number of blood vessels present in a visual microscopic (biopsied-specimen) field were calculated under light microscopy (x400). The number of vascular endothelial growth factor-expressing cells for the nasal-polyp group and for the sinusitis group was, respectively, 20.8+/-4.0 and 11.5+/-3.4 per visual field. Correspondingly, the mean intra-polyp blood-vessel density for the nasal-polyp group and that for the control group was, respectively, 10.5+/-2.6 and 5.0+/-1.9 per visual field. The mean intra-polyp blood-vessel density and the number of vascular endothelial growth factor-expressing cells proved to be significantly greater amongst individuals from the nasal-polyp group than was the case for their analogs from the sinusitis group (Ppolyp tissue. In addition, the level of vascular endothelial growth-factor expression and the mean blood-vessel count per field correlated significantly for nasal-polyp tissue (Ppolyps correlated significantly with the number of (intra-polyp) vascular endothelial-cell growth factor-expressing cells and the mean blood-vessel density (Ppolyps than within corresponding sinusitis mucosa. Clinically, the expression of both of these parameters correlated well

  6. Synthesis and in vivo evaluation of N-ethylamino-2-oxo-1,2-dihydro-quinoline-3-carboxamide for inhibition of intestinal tumorigenesis in APCMin/+ mice

    Science.gov (United States)

    Pathuri, Gopal; Li, Qian; Mohammed, Altaf; Gali, Hariprasad; Pento, J. Thomas; Rao, Chinthalapally V.

    2014-01-01

    A selective KGFR tyrosine kinase inhibitor, N-ethylamino-2-oxo-1,2-dihydro-quinoline-3-carboxamide, was synthesized and its possible inhibitory effects on the development of colon polyps and colorectal tumors was examined in APCMin/+ mice, a mouse model of human intestinal familial adenomatous polyposis. The present study shows for the first time that a dietary administration of a selective KGFR tyrosine kinase inhibitor lacks the overt-toxicities and significantly reduced the growth of small intestinal polyps in both male and female APCMin/+ mice. This inhibition of polyp growth appears to occur at a greater extent in female mice. PMID:24507628

  7. Small bowel intussusception in 2 adults caused by inflammatory polyps

    Directory of Open Access Journals (Sweden)

    André Carvalho, MD

    2017-12-01

    Full Text Available Inflammatory fibroid polyps are rare, benign pseudotumors of the gastrointestinal tract of unknown etiology, which may rarely present as bowel intussusception and obstruction. The authors describe the clinical, radiologic, and pathologic features of 2 patients with ileal inflammatory fibroid polyps presenting as small bowel intussusception.

  8. Minimal access surgical management of large juvenile polyps in children.

    Science.gov (United States)

    Wiseman, James; Emil, Sherif

    2009-09-01

    Juvenile polyps have a reported incidence of up to 2% in individuals younger than of 18 years. Most polyps are small, occur in the distal colon and rectum, and present with bleeding or prolapse. Giant juvenile polyps have been rarely reported. We encountered 2 unique presentations of very large juvenile polyps in children. A 9-year-old boy presented with recurrent rectal bleeding and anemia because of a single large polyp at the hepatic flexure. A 14-year-old boy presented with abdominal pain secondary to 2 large polyps in the cecum. The polyps were seen on colonoscopy as pedunculated masses larger than 5 cm and were not subjected to biopsy. Both patients underwent laparoscopic colon mobilizations with extracorporeal segmental resection in the first patient and colotomy and polypectomy in the second. Both patients had short hospital stays and excellent outcomes. Giant juvenile polyps are rare in children and may not be amenable to colonoscopic removal. They can be resected effectively with minimal access surgical techniques.

  9. Laparoscopic management of multiple ureteral polyps in children.

    Science.gov (United States)

    Bian, Zedong; Liu, Xing; Hua, Yi; Liu, Feng; Lin, Tao; He, Dawei

    2011-10-01

    We describe laparoscopic management of multiple ureteral polyps and our objective initial experience in children. We used laparoscopic polypectomy and pyeloureterostomy to treat 13 patients (15 ureters) diagnosed with hydronephrosis caused by multiple ureteral polyps between August 2006 and November 2010. Mean patient age was 11.4 years. The polyps were left sided in 9 patients, right sided in 2 and bilateral in 2. Hydronephrosis was mild in 9 cases, moderate in 4 and severe in 2. Postoperative followup consisted of ultrasound and excretory urography. A total of 12 patients were successfully treated with laparoscopy, while 1 patient with bilateral polyps required conversion to open surgery. Mean polyp length was 4.5 cm. Mean operative time in the unilateral cases was 121 minutes. The bilateral polyps were operated on simultaneously, with a surgical time of 185 minutes. Mean hospital stay was 3.5 days. Followup ranged from 6 to 26 months. In 1 patient obstruction of the temporary Double-J® stent developed 1 week postoperatively due to the deposition of urinary salts. No recurrent polyps were seen on followup B-mode ultrasound or excretory urography. Laparoscopic management of multiple ureteral polyps in children can be considered a safe and effective minimally invasive surgical option. However, further studies with larger cohorts are needed to confirm this finding. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Congenital urethral polyps: a report of two cases

    International Nuclear Information System (INIS)

    Cano, D.; Vivas, I.; Torres, E.; Garcia, L.; Fernandez-Villa, T.

    1999-01-01

    Congenital urethral polyps are uncommon lesions, very few cases of which have been previously reported in the literature. We present two cases of congenital urethral polyps in children, describing the clinical and radiological features and the diagnostic method employed, as well as reviewing the literature. (Author) 6 refs

  11. Polyp prevalence at colonoscopy among Nigerians: A prospective ...

    African Journals Online (AJOL)

    2014-05-20

    May 20, 2014 ... result of lower gastrointestinal bleeding, 14 (20.9%) for colorectal cancer (CRC) and 13 (19.4%) for routine screening. Thirty-nine (58.2%) patients had the polyps at the rectosigmoid region of the colon, 17 (25.4%) had the polyps located proximal to .... (rectum and sigmoid colon) and proximal colon (from.

  12. Dysphagia caused by a fibrovascular polyp: a case report.

    NARCIS (Netherlands)

    Blacha, M.M.; Sloots, C.E.J.; Munster, I.P. van; Wobbes, T.

    2008-01-01

    ABSTRACT: A 73-year old man presented with dysphagia for liquid and solid food. Barium contrast study of the esophagus and esophagoscopy demonstrated a fibrovascular polyp. This, almost 10 cm benign esophageal tumor, was removed surgically by a cervical esophagotomy. A fibrovascular polyp is a rare

  13. Clinical and pathological characteristics of colorectal polyps in ...

    African Journals Online (AJOL)

    Background & Aim: Colon polyps are important lesions and a concern because of the potential for colorectal cancer. Colorectal carcinoma is one of the most common causes of cancer-related deaths in Iranian population. The distribution of polyps in the colon may affect the efficacy of a screening modality. The aim of this ...

  14. Medical versus surgical treatment of nasal polyps

    International Nuclear Information System (INIS)

    Hassan, Z.U.; Majeed, A.

    2017-01-01

    To compare medical versus surgical treatment of nasal polyps in terms of frequency of success and recurrence. Study Design: Randomized controlled trial. Place and Duration of Study: This study was conducted at the department of ear nose throat (ENT), Combined Military Hospital (CMH) Peshawar over 2 years' period, from Jan 2000 to Dec 2002. Material and Methods: During this period, 80 patients were diagnosed of nasal polyps. These patients were randomly divided into two treatment groups. Patients in group-A received medical treatment in the form of intra-nasal steroids while patients in group-B received surgical treatment depending upon the extent of disease. Outcome variables were frequency of successful resolution of nasal polyps after 1 month of treatment and frequency of recurrence upon 1 year follow-up. Results: The age of the patients ranged from 15 years to 40 years with a mean of 26.13 +- 2.5 years. There were 49 (61.25%) male and 31 (38.75%) female patients in the study group giving a male to female ratio of 1.6:1. There was no significant difference between the two study groups in terms of gender (p=0.818) distribution. Bilateralintranasal polypectomy was the most frequently performed procedure (70.0%) followed by intranasal ethmoidectomy (12.5%), external ethmoidectomy (10.0%) and functional endoscopic sinus surgery (7.5%). The frequency of successful treatment was significantly higher with surgery (100% vs. 52.50%; p<0.001) as compared to intra-nasal steroids at 1 month follow-up. However, over the long-term follow-up, the frequency of recurrence was significantly lower with intra-nasal steroids (4.8% vs. 30.0%; p=0.022) as compared to surgery. There was no complication in the patients treated with intra-nasal steroids. While crusting (15.0%) followed by infection (10.0%) were among the few complications observed in the surgical group-B. Conclusion: Though associated with significantly lower frequency of successful treatment, intranasal steroids

  15. Intestinal Cancer

    Science.gov (United States)

    ... connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet ... increase your risk. Possible signs of small intestine cancer include Abdominal pain Weight loss for no reason ...

  16. Role of Bone Marrow-Derived Stem Cells in Polyps Development in Mice with ApcMin/+ Mutation

    Directory of Open Access Journals (Sweden)

    Michele Barone

    2015-01-01

    Full Text Available We explored the hypothesis that an altered microenvironment (intestinal adenomatous polyp could modify the differentiation program of bone marrow-derived stem cells (BMSCs, involving them in colon carcinogenesis. Sublethally irradiated 8-week-old female ApcMin/+ mice were transplanted with bone marrow (BM cells obtained from either male age-matched ApcMin/+ (Apc-Tx-Apc or wild type (WT (WT-Tx-Apc mice. At 4 and 7 weeks after transplantation, BM-derived colonocytes were recognized by colocalization of Y-chromosome and Cdx2 protein (specific colonocyte marker. Polyp number, volume, and grade of dysplasia were not influenced by irradiation/transplantation procedures since they were similar in both untreated female ApcMin/+ and Apc-Tx-Apc mice. At 4 and 7 weeks after transplantation, a progressive significant reduction of polyp number and volume was observed in WT-Tx-Apc mice. Moreover, the number of WT-Tx-Apc mice with a high-grade dysplastic polyps significantly decreased as compared to Apc-Tx-Apc mice. Finally, at 4 and 7 weeks after transplantation, WT-Tx-Apc mice showed a progressive significant increase of Y+/Cdx2+ cells in “normal” mucosa, whereas, in the adenomatous tissue, Y+/Cdx2+ cells remained substantially unvaried. Our findings demonstrate that WT BMSCs do not participate in polyp development but rather inhibit their growth. The substitution of genotypically altered colonocytes with Y+/Cdx2+ cells probably contributes to this process.

  17. Polyp Detection and Segmentation from Video Capsule Endoscopy: A Review

    Directory of Open Access Journals (Sweden)

    V. B. Surya Prasath

    2016-12-01

    Full Text Available Video capsule endoscopy (VCE is used widely nowadays for visualizing the gastrointestinal (GI tract. Capsule endoscopy exams are prescribed usually as an additional monitoring mechanism and can help in identifying polyps, bleeding, etc. To analyze the large scale video data produced by VCE exams, automatic image processing, computer vision, and learning algorithms are required. Recently, automatic polyp detection algorithms have been proposed with various degrees of success. Though polyp detection in colonoscopy and other traditional endoscopy procedure based images is becoming a mature field, due to its unique imaging characteristics, detecting polyps automatically in VCE is a hard problem. We review different polyp detection approaches for VCE imagery and provide systematic analysis with challenges faced by standard image processing and computer vision methods.

  18. Does painless rectal bleeding equate to a colonic polyp?

    Science.gov (United States)

    Campbell, Alison Morag; Sugarman, Ian

    2017-11-01

    It is often stated that if a patient presents with 'painless rectal bleeding' then a rectal polyp is the probable diagnosis. The aim of this study is to review our experience of children undergoing endoscopy to assess if the above statement is correct. The senior author keeps a prospective database of every child undergoing flexible sigmoidoscopy or colonoscopy. As part of this database, the symptoms and signs that the patient presents with, specifically abdominal pain, diarrhoea, mucous per rectum and rectal bleeding, are recorded. These results have been analysed specifically to assess whether the opening statement is correct. Between 2000 and 2014, a total of 401 children have undergone flexible sigmoidoscopy (21) or colonoscopy (380) to investigate rectal bleeding. Of these 401 patients, 42 (10.5%) had at least one polyp. Four polyps (9%) occurred in 159 patients with no rectal bleeding during the study period. The remaining 42 polyps (91%) were identified in patients with rectal bleeding. Of these 42 polyps, painless rectal bleeding was the only symptom in 24 (57%). However, 123 patients were endoscoped with painless rectal bleeding alone, giving a polyp rate of 19.5% for this symptom. The polyp pickup rate was increased to 28% if rectal bleeding and mucous per rectum were present; however, only 25 patients had this clinical history. We confirm that the most common symptom of rectal polyps is painless rectal bleeding. However, only one in five patients with this clinical history has a rectal polyp at endoscopy. The polyp pickup rate at endoscopy is greater (28%) when a history of both rectal bleeding and mucous per rectumispresent. This information can be used to counsel parents preoperatively. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Adult Intussusception Secondary to Inflammatory Polyps

    Directory of Open Access Journals (Sweden)

    M. Faisal Jabar

    2005-01-01

    Full Text Available Adult intussusception is a rare entity that may present in the acute and subacute setting principally related to the degree of bowel obstruction. Preoperative diagnosis of this condition may be difficult. The intussusception is usually due to a definable intraluminal lesion, most probably neoplasia, unlike intussusception in children. We present the cases of two adult male patients with intussusception. The first presented with acute small-bowel obstruction secondary to a retrograde ileojejunal intussusception with a pseudopolyp as the lead point. This was possibly due to a retrograde ball-valve effect. The intussuscepting segment was resected. The second patient presented with unexplained chronic diarrhoea and an intussusception occurring within the caecum, as demonstrated at colonoscopy, with a terminal ileal pedunculated fibroid polyp as the lead point. A limited right hemicolectomy was performed. Both patients recovered uneventfully and have remained well. A brief literature review of adult intussusception complements the case reports, with an emphasis on the pathogenesis of inflammatory polyps and recommended surgical management.

  20. Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

    Science.gov (United States)

    Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

    2015-06-01

    Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

  1. Low frequency of polyps in colonic regions with diverticulosis.

    Science.gov (United States)

    Levine, Irving; Rangnekar, Amol S; Tokayer, Aaron Z

    2017-11-01

    Conflicting evidence exists regarding any association between diverticulosis and adenomatous polyps. We evaluated the prevalence of polyps and cancer in colonic regions containing diverticula. Six hundred consecutive colonoscopy reports from a single endoscopist were reviewed to determine prevalence and location of diverticulosis and polyps. Additionally, pathology reports of 88 colon cancer resection specimens were reviewed for the presence of diverticulosis, and compared with expected prevalence of diverticulosis in that colonic region based on the collected colonoscopy data. Overall, rates of detected polyps were comparable between patients with and without diverticulosis. However, analyzing the data by colonic segment containing diverticulosis, the prevalence of adenomatous polyps was reduced in regions of diverticulosis compared to the same colonic segment unaffected by diverticulosis (7 vs. 17% for rectosigmoid (p = 0.005); 5 vs. 18% for descending (p diverticulosis was significantly reduced in the rectosigmoid and ascending colon, compared with expected rates of diverticulosis in those regions. (13 vs. 42% in rectosigmoid (p = 0.0006); 3 vs. 17% in ascending colon (p = 0.043)). Despite similar overall frequency of polyps in patients with and without diverticulosis, polyps were significantly less likely in the colonic segment affected by diverticulosis. Additionally, the frequency of diverticulosis in areas of cancer in the rectosigmoid and ascending colon was significantly lower than expected compared with the expected frequency of diverticulosis for those colonic regions. These observations suggest a true negative association between colonic neoplasia and diverticulosis.

  2. The utility of routine polyp histopathology after endoscopic sinus surgery.

    Science.gov (United States)

    Yeh, David H; Wong, Jay; Hoffbauer, Stephanie; Wehrli, Bret; Sommer, Doron; Rotenberg, Brian W

    2014-11-01

    Routine histopathological assessment is standard practice for nasal polyp specimens obtained during endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Retrospective studies suggest that routine histopathology of nasal polyps shows few unexpected diagnoses that alter patient management. Our objective was to study the use of routine pathological analysis, and its cost to the healthcare system, in a prospective manner. A multicenter prospective assessment was performed from data collected between 2007 and 2013. Only cases of patients undergoing ESS for bilateral CRS were included. We excluded unilateral disease cases, and cases in which diagnoses other than polyps were suspected either preoperatively or intraoperatively. We then compared the preoperative diagnosis with the final histopathology and identified the rate of unexpected pathologies. A cost analysis was performed. Only 4 of 866 pathological specimens were identified as having a clinically significant unexpected diagnosis. All unexpected pathologies in this series were benign. These 4 cases account for 0.46% of all specimens reviewed. This translates to a number needed to screen of 217 cases of bilateral CRS to discover 1 unexpected pathology. The associated cost for making an unexpected diagnosis was $19,192.73. Routine histopathology of nasal polyps in ESS for bilateral CRS with polyps yields few unexpected and management-altering diagnoses. It carries a significant cost to the healthcare system. In cases of bilateral CRS with no other concerning clinical features, clinicians should exercise judgment in submitting polyp specimens for pathology rather than routinely sending polyps for histopathologic analysis. © 2014 ARS-AAOA, LLC.

  3. Characteristics of Patients with Colonic Polyps Requiring Segmental Resection

    Directory of Open Access Journals (Sweden)

    Robert A. Mitchell

    2018-01-01

    Full Text Available Background. It is unclear if the availability of new techniques for removal of large colonic polyps has affected the use of segmental colon resection. We sought to evaluate the characteristics of polyps undergoing surgical resection, including involvement of therapeutic gastroenterologists (TG. Methods. 484 patients had a colonic resection; 165 (34% were identified from the pathology database with polyp, adenoma, or mass in the clinical history field; these charts were reviewed. Results. 128 patients (mean age 68 yrs, 72% male were included. The mean polyp size was 2.9 cm (0.4 cm–12.0 cm. Adenocarcinoma was diagnosed in 50 (39.1%. 97 (75.8% patients had a polyp that was felt to be unresectable by EMR, and 31 (24.2% underwent successful EMR followed by surgery for adenocarcinoma (n=29. The indication for surgery in those with unresectable polyps was variable and was not clearly documented in 51 (52.6%; only 17 of these patients (17.5% had a TG involved. Conclusion. A high proportion of polyps managed by segmental resection did not contain adenocarcinoma. This data suggests that even in a tertiary care center where advanced endoscopic techniques are easily available, they are not always utilized. Educational endeavors to ensure that ideal pathways of intervention are utilized require implementation.

  4. Gastric and duodenal polyps in familial adenomatous polyposis patients: Conventional endoscopy vs virtual chromoendoscopy (fujinon intelligent color enhancement) in dysplasia evaluation

    OpenAIRE

    Lami, Gabriele; Galli, Andrea; Macr?, Giuseppe; Dabizzi, Emanuele; Biagini, Maria Rosa; Tarocchi, Mirko; Messerini, Luca; Valanzano, Rosa; Milani, Stefano; Polvani, Simone

    2017-01-01

    AIM To test the fujinon intelligent color enhancement (FICE) in identifying dysplastic or adenomatous polyps in familial adenomatous polyposis (FAP) patients. METHODS Seventy-six consecutive FAP patients, already treated by colectomy and members of sixty-five families, were enrolled. A FICE system for the upper gastro-intestinal tract with an electronic endoscope system and a standard duodenoscope (for side-viewing examination) were used by two expert examiners. Endoscopic resection was perfo...

  5. Associations between dietary fiber and colorectal polyp risk differ by polyp type and smoking status.

    Science.gov (United States)

    Fu, Zhenming; Shrubsole, Martha J; Smalley, Walter E; Ness, Reid M; Zheng, Wei

    2014-05-01

    The association of dietary fiber intake with colorectal cancer risk is established. However, the association may differ between cigarette smokers and nonsmokers. We evaluated this hypothesis in a large colonoscopy-based case-control study. Dietary fiber intakes were estimated by self-administered food frequency questionnaire. Unconditional logistic regression analysis was used to estimate ORs and 95% CIs with adjustment for potential confounders. Analysis also was stratified by cigarette smoking and sex. High dietary fiber intake was associated with reduced risk of colorectal polyps (P-trend = 0.003). This association was found to be stronger among cigarette smokers (P-trend = 0.006) than nonsmokers (P-trend = 0.21), although the test for multiplicative interaction was not statistically significant (P = 0.11). This pattern of association was more evident for high-risk adenomatous polyps (ADs), defined as advanced or multiple ADs (P-interaction smoking and dietary fiber intake = 0.09). Among cigarette smokers who smoked ≥23 y, a 38% reduced risk of high-risk ADs was found to be associated with high intake of dietary fiber compared with those in the lowest quartile fiber intake group (P-trend = 0.004). No inverse association with dietary fiber intake was observed for low-risk ADs, defined as single nonadvanced ADs. Cigarette smoking may modify the association of dietary fiber intake with the risk of colorectal polyps, especially high-risk ADs, a well-established precursor of colorectal cancer.

  6. Improving Polyp Detection Algorithms for CT Colonography: Pareto Front Approach.

    Science.gov (United States)

    Huang, Adam; Li, Jiang; Summers, Ronald M; Petrick, Nicholas; Hara, Amy K

    2010-03-21

    We investigated a Pareto front approach to improving polyp detection algorithms for CT colonography (CTC). A dataset of 56 CTC colon surfaces with 87 proven positive detections of 53 polyps sized 4 to 60 mm was used to evaluate the performance of a one-step and a two-step curvature-based region growing algorithm. The algorithmic performance was statistically evaluated and compared based on the Pareto optimal solutions from 20 experiments by evolutionary algorithms. The false positive rate was lower (pPareto optimization process can effectively help in fine-tuning and redesigning polyp detection algorithms.

  7. Paediatric nasal polyps in cystic fibrosis.

    Science.gov (United States)

    Mohd Slim, Mohd Afiq; Dick, David; Trimble, Keith; McKee, Gary

    2016-06-21

    Patients with cystic fibrosis (CF) are at increased risk of nasal polyps. We present the case of a 17-month-old Caucasian patient with CF who presented with hypertelorism causing cycloplegic astigmatism, right-sided mucoid discharge, snoring and noisy breathing. Imaging suggested bilateral mucoceles in the ethmoid sinuses. Intraoperatively, bilateral soft tissue masses were noted, and both posterior choanae were patent. Polypectomy and bilateral mega-antrostomies were performed. Histological examination revealed inflammatory nasal polyposis typical of CF. The role of early functional endoscopic sinus surgery (FESS) in children with CF nasal polyposis remains questionable as the recurrence rate is higher, and no improvement in pulmonary function has been shown. Our case, however, clearly demonstrates the beneficial upper airway symptom relief and normalisation of facial appearance following FESS in a child with this condition. 2016 BMJ Publishing Group Ltd.

  8. Inhibition of intestinal adenoma formation in APC(Min/+ mice by Riccardin D, a natural product derived from liverwort plant Dumortiera hirsuta.

    Directory of Open Access Journals (Sweden)

    Hui-Ping Liu

    Full Text Available BACKGROUND: Mutation of tumor suppressor gene, adenomatous polyposis coli (APC, is the primary molecular event in the development of most intestinal carcinomas. Animal model with APC gene mutation is an effective tool for study of preventive approaches against intestinal carcinomas. We aimed to evaluate the effect of Riccardin D, a macrocyclic bisbibenzyl compound, as a chemopreventive agent against intestinal adenoma formation in APC(Min/+ mice. METHODS: APC(Min/+ mice were given Riccardin D by p.o. gavage for 7 weeks. Mice were sacrificed, and the number, size and histopathology of intestinal polyps were examined under a microscope. We performed immunohistochemical staining, western blotting, reverse transcriptase-polymerase chain reaction (RT-PCR and enzyme-linked immunosorbent assay (ELISA in intestinal polyps to investigate the mechanism of chemopreventive effect of Riccardin D. RESULTS: Riccardin D treatment resulted in a significant inhibition of intestinal adenoma formation, showing a reduction of polyp number by 41.7%, 31.1% and 44.4%, respectively, in proximal, middle and distal portions of small intestine. The activity of Riccardin D against polyp formation was more profound in colon, wherein Riccardin D decreased polyp number by 79.3%. Size distribution analysis revealed a significant reduction in large-size polyps (2-3 mm by 40.0%, 42.5% and 33.3%, respectively, in proximal, middle and distal portions of small intestine, and 77.8% in colon. Histopathological analysis of the intestinal polyps revealed mostly hyperplastic morphology without obvious dysplasia in Riccardin D-treated mice. Molecular analyses of the polyps suggested that the inhibitory effect of Riccardin D on intestinal adenoma formation was associated with its abilities of reduction in cell proliferation, induction of apoptosis, antiangiogenesis, inhibition of the Wnt signaling pathway and suppression of inflammatory mediators in polyps. CONCLUSIONS: Our results

  9. [Adenoma of the colon or rectum: relationship between histological structure, polyp size and site and age distribution (author's transl)].

    Science.gov (United States)

    Frimberger, E; Kühner, W; Seib, H J; Ottenjann, R

    1978-04-14

    Among 1258 polyps from the lower gastro-intestinal tract removed by rectoscopy or coloscopy and examined histologically there were 744 adenomas, 72% tubular, 27% papillary and 1% villous. 96.5% of all adenomas were extracted from patients aged over 40 years. Four fifths of the tumours were found in the rectum and sigmoid colon. Only 6% of the tubular adenomas were more than 15 mm in diameter, compared with 32% of papillary and 57% of villous adenomas. The special significance of the adenomas lies in their potential malignancy (adenoma-to-cancer sequence).

  10. Fibroepithelial polyps causing ureteropelvic junction obstruction in a child.

    Science.gov (United States)

    Li, Wei-Ming; Wu, Wen-Jeng; Ke, Hung-Lung; Chai, Chee-Yin; Chou, Yii-Her; Huang, Chun-Hsiung

    2005-06-01

    Fibroepithelial polyps of the ureter are benign tumors arising from mesodermal tissue in the ureter wall. They are extremely rare lesions that can cause ureteropelvic junction obstruction in children. In this report, we describe an 11-year-old boy with fibroepithelial polyps of the ureter that caused left ureteropelvic junction obstruction. He presented with a 6-month history of left abdominal and flank pain. He also had short stature. Intravenous pyelography showed hydronephrosis without filling defects at the left ureteropelvic junction. Exploration revealed several finger-like polyps obstructing the lumen. This area was resected segmentally and a dismembered pyeloplasty was performed. No complications occurred during the postoperative period. The boy caught up in growth after the operation. Fibroepithelial polyps were confirmed by histology.

  11. Fibroepithelial Polyps Causing Ureteropelvic Junction Obstruction in a Child

    Directory of Open Access Journals (Sweden)

    Wei-Ming Li

    2005-06-01

    Full Text Available Fibroepithelial polyps of the ureter are benign tumors arising from mesodermal tissue in the ureter wall. They are extremely rare lesions that can cause ureteropelvic junction obstruction in children. In this report, we describe an 11-year-old boy with fibroepithelial polyps of the ureter that caused left ureteropelvic junction obstruction. He presented with a 6-month history of left abdominal and flank pain. He also had short stature. Intravenous pyelography showed hydronephrosis without filling defects at the left ureteropelvic junction. Exploration revealed several finger-like polyps obstructing the lumen. This area was resected segmentally and a dismembered pyeloplasty was performed. No complications occurred during the postoperative period. The boy caught up in growth after the operation. Fibroepithelial polyps were confirmed by histology.

  12. Juvenile Polyps in Denmark From 1995 to 2014

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie; Ousager, Lilian Bomme; Brusgaard, Klaus

    2016-01-01

    BACKGROUND: Juvenile polyps in the large bowel are rare but the most common type of polyp in children. The prevalence and incidence are unknown, and few studies exist on the occurrence in adults. They are considered not to harbor any malignant potential unless they are part of the hereditary...... from all of the patients who had been diagnosed with 1 or more juvenile polyp from January 1, 1995, until December 31, 2014, were obtained. SETTINGS: The study was conducted based on patients registered in the nationwide pathological register in Denmark, the Danish Pathology Data Bank. PATIENTS: We......: Miscoding or misclassification in the register cannot be ruled out. We only have data for the 20-year period, limiting the evaluation of reoccurrence, and no data for the endoscopic removal procedures. CONCLUSIONS: We conclude that juvenile polyps are rare, with the majority found in adults, and most often...

  13. Drug Combo Decreases Colorectal Polyps in People with FAP

    Science.gov (United States)

    In people with familial adenomatous polyposis, or FAP, a combination treatment of erlotinib (Tarceva) and sulindac (Aflodac) decreased the number of precancerous colorectal polyps, according to recently published clinical trial results.

  14. Where are the polyps? Molecular identification, distribution and population differentiation of Aurelia aurita jellyfish polyps in the southern North Sea area

    OpenAIRE

    van Walraven, L.; Driessen, F.; van Bleijswijk, J.; Bol, A.; Luttikhuizen, P.C.; Coolen, J.; Bos, O.G.; Gittenberger, A.; Schrieken, N.; Langenberg, V.T.; van der Veer, H.W.

    2016-01-01

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates (settling plates, marina floats and wrecks) at ten inshore locations in the Netherlands, seven offshore locations in the North Sea and in the Gullmar Fjord in Sweden. Polyps were identified to spec...

  15. Where are the polyps? Molecular identification, distribution and population differentiation of Aurelia aurita jellyfish polyps in the southern North Sea area

    OpenAIRE

    Walraven, van, L.; Driessen, F.; Bleijswijk, van, J.; Bol, A.; Luttikhuizen, P.; Coolen, J.W.P.; Bos, Oscar; Gittenberger, A.; Schrieken, N.; Langenberg, V.T.; Veer, van der, H.W.

    2016-01-01

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates (settling plates, marina floats and wrecks) at ten inshore locations in the Netherlands, seven offshore locations in the North Sea and in the Gullmar Fjord in Sweden. Polyps were identified to spec...

  16. Ureteropelvic junction obstruction caused by Fibroepithelial polyps in children

    OpenAIRE

    Knoblich, Maria; Vital, Vanda; Cardoso, Dinorah; Alves, Fátima; Mota, Filipe; Casella, Paolo

    2017-01-01

    Fibroepithelial polyps are extremely rare benign tumors arising from mesodermal tissue in the ureteral wall in children, that can cause ureteropelvic junction obstruction. In this report, we present an 11‐year‐old boy complaining of left intermitent lumbar pain related with ipsilateral hydronephrosis. Surgical exploration revealed several endoluminal polyps located at the ureteropelvic junction, obstructing the lumen of the ureter. Standard treatment consists in resection of the affected uret...

  17. POLYPE ANTROChOANAL DE L'ENFANT

    African Journals Online (AJOL)

    7 mai 2012 ... INTRODUCTION. Le polype antrochoanal ou polype de killian est une pathologie bénigne, unilatérale qui prend naissance sur les parois du sinus maxillaire et fait issue dans la choane homolatérale après avoir traversé l'ostium principal ou accessoire du sinus. Il s'agit d'une affection du sujet jeune.

  18. Influence of Proton Pump Inhibitor Use in Gastrointestinal Polyps

    Directory of Open Access Journals (Sweden)

    Wen-Hung Hsu

    2010-02-01

    Full Text Available Proton pump inhibitors (PPIs are the most potent anti-acid agents and are extensively used worldwide. PPI-induced hypergastrinemia is one of the very few side effects associated with these drugs. However, because hypergastrinemia is related to the occurrence of colonic adenomatous polyps, the purpose of this study was to analyze the relationship between the occurrence of gastrointestinal polyps and hypergastrinemia induced by PPIs. This study included 259 patients who underwent colonoscopy and esophagogastroduodenoscopy between January and August 2007. Chart records, including medication history and fasting plasma gastrin level, were reviewed and analyzed. Any subtle polypoid lesions in the stomach and colon were sampled by biopsy for histological examination. Helicobacter pylori infection status was examined by a rapid urea test during esophagogastroduodenoscopy. All patients underwent endoscopy examinations. A total of 122 patients were receiving PPI treatment for either peptic ulcer disease or reflux esophagitis and were included as the study group. The remaining 137 patients were not treated with PPIs and served as the non-PPI group. The mean fasting gastrin level in PPI users versus non-PPI users was 121.8 ng/L versus 56.8 ng/L, respectively (p < 0.001. Although the prevalence of gastric gland polyps was higher in the PPI group (65.6% vs. 37.2%, p < 0.001, there was no difference in the prevalence of colonic adenomatous polyps observed (22.13% vs. 22.62%, p = 0.928. In conclusion, the prevalence of gastric polyps, particularly fundic gland polyps, was higher among PPI users. However, the prevalence of colonic polyps was not affected by PPI use, regardless of past history of colonic adenomatous polyps.

  19. Where are the polyps? Molecular identification, distribution and population differentiation of Aurelia aurita jellyfish polyps in the southern North Sea area

    NARCIS (Netherlands)

    Walraven, van L.; Driessen, F.; Bleijswijk, van J.; Bol, A.; Luttikhuizen, P.; Coolen, J.W.P.; Bos, Oscar; Gittenberger, A.; Schrieken, N.; Langenberg, V.T.; Veer, van der H.W.

    2016-01-01

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates

  20. Molecular features of colorectal hyperplastic polyps and sessile serrated adenoma/polyps from Korea.

    Science.gov (United States)

    Kim, Kyoung-Mee; Lee, Eui Jin; Ha, Sangyun; Kang, So Young; Jang, Kee-Taek; Park, Cheol Keun; Kim, Jin Yong; Kim, Young Ho; Chang, Dong Kyung; Odze, Robert Daniel

    2011-09-01

    Abundant recent data suggest that sessile serrated adenoma/polyp (SSA/P) is an early precursor lesion in the serrated pathway of carcinogenesis. It is believed that SSA/Ps develop cancer by an SSA/P-dysplasia-carcinoma sequence. Hyperplastic polyps (HPs) share some histologic and molecular characteristics with SSA/P, but it is unclear whether SSA/Ps are derived from HPs or whether they develop by a different pathogenetic pathway. Previous studies have shown that serrated polyps from Korean patients show different prevalence rates of certain molecular abnormalities compared with similar lesions from American patients, and this suggests that lifestyle and dietary factors may influence the serrated neoplasia pathway. The purpose of this study was to evaluate the molecular features of HPs and SSA/Ps, the latter both with and without dysplasia, from Korean patients and to compare the findings with similar lesions from American patients. One hundred and eleven serrated polyps, consisting of 45 HPs (30 microvesicular, 11 goblet cell, 4 mucin depleted) and 56 SSA/Ps (36 with dysplasia, 20 without dysplasia), were retrieved from the pathology files of a large medical center in Korea and 38 SSA/P from American patients were evaluated for BRAF and KRAS mutations, microsatellite instability, and hypermethylation of O6-methylguanine-DNA methyltransferase (MGMT), hMLH1, adenomatous polyposis coli (APC), p16, methylated in tumor-1 (MINT-1), MINT2, and MINT31. Methylation of hMLH1 was performed using 2 different sets of primers. Twenty-three conventional adenomas from Korean patients were included as controls. The data were compared between polyp subtypes and between polyps in the right versus the left colon. With regard to HP, KRAS mutations were present in 31.1% of polyps and BRAF mutations in 46.7% of polyps. KRAS mutations were significantly more common in goblet cell HP and BRAF in microvesicular HP (MVHP). Methylation of MGMT, hMLH1, APC, p16, MINT1, MINT2, and MINT31 were

  1. Endoscopic Management of Gastric Polyp with Outlet Obstruction without Polypectomy

    Directory of Open Access Journals (Sweden)

    Cheuk-Kay Sun

    2011-05-01

    Full Text Available Although gastric polyp is usually an incidental endoscopic finding, large-sized polyps can cause symptoms ranging from epigastralgia to bleeding from ulcerated polyps and gastric outlet obstruction. Although the gold standard of treatment is removal of the polyp either through endoscopic polypectomy or surgical excision, complications associated with these procedures cannot be ignored. The risk becomes a major concern for patients at high risk for surgery when complications arise. We describe a debilitated 74-year-old woman who presented with early satiety, intermittent postprandial nausea and vomiting for three months. Upper endoscopy revealed a 2.5 cm pedunculated polyp over the gastric antrum causing intermittent obstruction. Considering her high risk for polypectomy, detachable snaring was performed without polypectomy in an outpatient setting. The patient was complication-free with complete relief of obstructive symptoms one week after the procedure. Subsequent follow-ups showed satisfactory healing without signs of mucosal disruption or recurrence. The results suggest that detachable snaring without polypectomy may be a therapeutic option for high-risk patients with benign symptomatic gastric polyps.

  2. Fibroepithelial polyps causing ureteropelvic junction obstruction in children.

    Science.gov (United States)

    Adey, Gregory S; Vargas, Sara O; Retik, Alan B; Borer, Joseph G; Mandell, James; Hendren, W Hardy; Lebowitz, Robert L; Bauer, Stuart B

    2003-05-01

    Fibroepithelial polyps are benign mucosal projections that can be found throughout the urinary system. We review our experience with fibroepithelial polyps of the ureteropelvic junction in children to define more clearly this entity and its outcome following treatment. We reviewed the records of all children with fibroepithelial polyps causing ureteropelvic junction obstruction treated at our institution between December 1967 and February 2002. Nine patients 6 weeks to 9 years old had 11 ureteropelvic junction obstructions secondary to fibroepithelial polyps, representing a 0.5% incidence of all ureteropelvic junction obstructions seen during that period. The majority of the patients were male (89%) and had obstruction on the left side (78%). Only 22% of the patients had a diagnosis of obstructing polyps suggested preoperatively. All patients underwent dismembered pyeloplasty but 1 required subsequent nephrectomy due to progressive loss of renal function. All lesions were characterized microscopically by polypoid projections of fibrous tissue covered by epithelium and demonstrating varying degrees of inflammation. No recurrences were seen during a mean followup of 44 months. Fibroepithelial polyps are rare lesions that cause ureteropelvic junction obstruction in children, primarily in males and on the left side. Filling defects were diagnosed preoperatively in 22% of the patients in this series. Excision and dismembered pyeloplasty were curative, and recurrences were not observed. The etiology of this disease remains obscure.

  3. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report

    Directory of Open Access Journals (Sweden)

    Kurtkaya-Yapicier Ozlem

    2003-06-01

    Full Text Available Abstract Background Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. Case presentation A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for Helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor Helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. Conclusions Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.

  4. [Polyps esophageal cardio-conversion in children: causes, clinical picture, management and prognosis of tactics].

    Science.gov (United States)

    Sergeeva, T N

    2009-01-01

    105 children with polyps of esophago-gastric junction region, detected by gastroscopy, were under follow up during 1-9 years. 55 children with polyp size less than 5 mm were followed up without endoscopic polypectomy (EP) and 50 children with polyp size more than 5 mm and another indications underwent EP. Polyps were more frequently encountered in males aged 7-15 years without specific clinical symptoms; histologically, there were hyperplastic polyps. The majority of children (94.5%) treated conservatively were found to have absence of growth or polyp regression. Risk factors of reappearing of polyps after EP were progress of esophagitis and abnormal gastroesophageal flap valve. According to results of 24-hour pH monitoring of esophagus, alkaline gastroesophageal reflux was diagnosed only in patients with polyps in comparison with children without polyps with chronic diseases of upper floor of digestive tract (p = 0.04).

  5. Intestinal Obstruction

    Science.gov (United States)

    ... the obstruction along the intestines. Treatment Suction via nasogastric tube Fluids given by vein Surgery for strangulation Sometimes ... nose and placed in the stomach (called a nasogastric tube) or into the intestine. Suction is applied to ...

  6. Lesions of All Types Exist in Colon Polyps of All Sizes.

    Science.gov (United States)

    Turner, Kevin O; Genta, Robert M; Sonnenberg, Amnon

    2018-02-01

    Although large polyps are known to harbor more advanced neoplasia than small polyps, the extent of the relationship between size and type is not fully known. The study aim was to establish benchmarks for the prevalence of different histologic polyp types among varying size categories. The Miraca Life Sciences Database is an electronic repository of histopathologic patient records from private practices throughout the United States. We extracted the records of 483,998 unique patients who underwent colonoscopy with polypectomy between January 2008 and December 2014. A total of 550,811 polyps were stratified by their endoscopic size measurement. Polyps of each size were further stratified as hyperplastic polyp (HP), tubular adenoma (TA), tubulovillous adenoma (TVA), sessile serrated adenoma/polyp, and adenocarcinoma. Of all 550,811 polyps, 447,343 (81%) were 1-9 mm in size, and 103,517 (19%) were 10 mm or larger. A fraction of 18,591/550,811 polyps (3.4%) harbored histologic features of advanced adenoma, such as TVA, high-grade dysplasia, or cancer. Of these, 4,725/18,591 (25%) occurred in polyps 1-9 mm and 13,868/18,591 (75%) occurred in polyps 10 mm or larger. The fractions of advanced adenoma were 0.6% (0.5-0.6%) in 1-5 mm polyps and 2.1% (2.0-2.2%) in 6-9 mm polyps, as compared to 13.4% (13.2-13.6%) in polyps 10 mm or larger. The frequency of HP significantly decreased with increasing polyp size, whereas the frequency of TA remained largely unaffected by polyp size. While advanced histopathology was found more frequently in colorectal polyps of larger than smaller size, one quarter of all advanced histopathology existed in polyps of <10 mm.

  7. [Bleeding gastric inflammatory fibroid polyp (Vanek's tumor)].

    Science.gov (United States)

    Guţu, E; Ghidirim, Gh; Mişin, I; Iakovleva, Iraida; Vozian, M

    2010-01-01

    Inflammatory fibroid polyp's (IFP) or Vanek tumor of the gastrointestinal tract represents a relatively unusual entity. IFP is an extremely rare cause of upper gastrointestinal bleeding. We report herein a case of a 30-year-old woman who had a gastric IFP complicated by gastrointestinal bleeding and obstructive symptoms. The lesion was mistaken on endoscopic, radiologic examination and in the operating room for a gastrointestinal stromal tumor (GIST). Preoperative endoscopic examination revealed a protruding oval-shaped submucosal lesion (approximately 7 cm in size) of the gastric antrum, with ulceration of the mucosal surface. Multiple endoscopic biopsies were negative for neoplastic changes. Barium meal study disclosed a large tumor in the prepyloric area of the stomach. Presumptive preoperative diagnosis was GIST. Subtotal Bilroth II gastrectomy en bloc with the mass and lymphadenectomy was performed. Surprisingly, the final histological diagnosis was IFP. Postoperative course was uneventful and no recurrences were observed during 4 years follow-up. With reference to case report, the etiology, diagnosis and treatment strategy of IFP will be discussed. This case highlights an unusual presentation of IFP. Although bleeding may represent a rare complication due IFP, it should be considered in the differential diagnosis of upper gastrointestinal hemorrhage of uncertain etiology.

  8. Solitary juvenile polyps in children and colon cancer.

    Science.gov (United States)

    Kapetanakis, A M; Vini, D; Plitsis, G

    1996-01-01

    Solitary Juvenile Polyps (SJP) are quite common in preschool children, although they may occur at any age. It is not known whether the existence of a single juvenile polyp in a child predisposes to future development of new SJP or is related to colorectal neoplasia. The present study was designed to follow up young patients who had undergone polypectomy for SJP and their first degree relatives to elucidate the development of adenomatous polyps or colon cancer. From 31 children polypectomized for histologically proven SJP between 1983-1995, we were able to contact and gather information on 24. From our records and the information collected we studied age, gender, site of the polyp in the bowel, personal history, and family history. Mean time of follow up was 4.1 years (range 0.4-10, SD +/- 3.1) Mean age was 4.6 years (Range 3.5-9, SD +/- 1.2). There were 14 boys and 10 girls (ratio 1.4/1). Eighteen polyps were located at the rectosigmoid area, 5 in the lower descending colon, and one in the splenic flecture. From the 24 children, only one girl developed rectal bleeding at the age of 15 years, 8 years after polypectomy. However, subsequent evidence from the large bowel did not reveal any abnormality and the symptom was attributed to hemorrhoidal bleeding. Thorough investigation of the history of 146 first degree relatives (dead or alive) siblings, parents, and grandparents revealed that none of them were diagnosed with adenomatous polyps or colorectal cancer. SJP does not predispose to future development of new juvenile polyps and is not associated with a high risk of colorectal malignancy.

  9. Clinical characteristics of colorectal polyp in Thai children: a retrospective study.

    Science.gov (United States)

    Waitayakul, Satawan; Singhavejsakul, Jesda; Ukarapol, Nutthapong

    2004-01-01

    It was believed that more than 90 per cent of children with colorectal polyp had a single lesion, located in the rectosigmoid colon, therefore, sigmoidoscopy with polypectomy was the treatment of choice. After a wide use of pediatric colonoscopy, this concept has been changed. This study was aimed to describe clinical characteristics of colorectal polyp in Thai children. Medical records of children with colorectal polyp were retrospectively reviewed. Comparison between polyposis coli and children with less than 5 polyps were also analyzed. There were 93 patients, 43 females and 50 males. The average age was 5.1 years. Lower GI bleeding and prolapse of rectal polyp comprised the two most common presentations, 93.5 and 39.8 per cent, respectively. The mean duration of symptoms was 5.6 months. Only 50.6 per cent had rectal polyp noted by digital examination. Investigations included sigmoidoscopy (n = 77), colonoscopy (n = 16), and barium enema (n = 16). Eight per cent of the cases had more than 5 polyps. Location of the polyps was noted in the rectosigmoid colon (88.2%), descending colon (4.3%), right-sided colon (4.3%), and pancolonic (3.2%). Of all the patients, 11.8 per cent had the polyp above the rectosigmoid region, whereas 50 per cent of those who underwent colonoscopy (n = 16) had the polyps noted proximal to this region. Older age, lower hematocrit, and more frequent right-sided polyps were significantly associated with polyposis coli (p polyp (95%), inflammatory pseudopolyp (2.5%), and hyperplastic polyp (2.5%). Most of the children with colorectal polyp had juvenile polyp that is commonly found in the rectosigmoid colon. However, a significant number of patients had carrying polyps proximal to the rectosigmoid region, which would be easily missed by sigmoidoscopy. With the concern of malignancy change particularly in children with polyposis coli, routine colonoscopy should be considered as an initial investigation in children with colorectal polyp.

  10. Factors Influencing the Recurrence Potential of Benign Endometrial Polyps after Hysteroscopic Polypectomy.

    Directory of Open Access Journals (Sweden)

    Jehn-Hsiahn Yang

    Full Text Available An endometrial polyp is a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data.This case-series report included 168 premenopausal women who suffered from endometrial polyps and underwent hysteroscopic polypectomy. All of them were awaiting a future pregnancy. Office hysteroscopy was done before and after hysteroscopic polypectomy, in which preoperative hysteroscopy examined the number, type, and location of endometrial polyps, and postoperative hysteroscopy checked the polyp recurrence. Surgical indications, either infertility or the presentation of abnormal uterine bleeding, and follow-up duration were recorded.Seventy-three out of 168 (43% women had polyp recurrence after hysteroscopic polypectomy. Multivariate logistic regression analysis revealed that more endometrial polyps (P = 0.015 and longer duration of follow-up (P = 0.004 were significantly associated with an increased risk of postoperative polyp recurrence. The type of endometrial polyps was not correlated with polyp recurrence potential, whereas pedunculated type endometrial polyps were closely related to the presentation of abnormal uterine bleeding (P = 0.001.A higher number of endometrial polyps and longer follow-up duration are associated with a greater potential of polyp recurrence after hysteroscopic polypectomy.

  11. Nasoendotracheal tube obstruction by a nasal polyp in emergency oral surgery: a case report

    Directory of Open Access Journals (Sweden)

    Milic Morena

    2007-11-01

    Full Text Available Abstract Nasal polyps can make nasoendotracheal intubation difficult. We present a case of complete obstruction of a nasoendotracheal tube by a nasal polyp during a blind nasoendotracheal intubation in emergency oral surgery.

  12. Adenomatous Polyps in Adolescent Girl and Boy: A Report of Two Cases

    OpenAIRE

    Laleh Vahedi Larijani; Maryam Ghasemi; Hassan Karami

    2016-01-01

    A polyp is defined as a mass of the mucosal surface that protrudes into the lumen of the gastrointestinal tract. Neoplastic epithelial polyps are classified histologically as either benign adenoma or malignant carcinoma. The colonic polyps that most commonly present in children occur sporadically and individually and are of the juvenile type; they are most frequently associated with painless rectal hemorrhage (which is the most common symptom). Adenomatous polyps are similar to other nontumor...

  13. A Giant Pedunculated Urothelial Polyp Mimicking Bladder Mass in a Child: A Rare Case

    Directory of Open Access Journals (Sweden)

    Mehmet Kaba

    2014-01-01

    Full Text Available Ureteral fibroepithelial polyps are rarely seen benign tumors with mesodermal origin. These polyps can involve kidney, pelvis, ureter, bladder, and urethra. The most common symptoms are hematuria and flank pain. The choice of treatment is either endoscopic or surgical resection of polyp by sparing kidney. Here, we presented a pediatric case with giant, fibroepithelial polyp that mimics bladder tumor, originating from middle segment of the ureter.

  14. Nasal polyps. A clinical radiological histopathological and mycological study

    International Nuclear Information System (INIS)

    Babiker, Babiker Eltayeb

    1997-12-01

    Forty patients with nasal polyposis were studied. This study included clinical, haematological and mycological aspects. There were 24 females (60% of patients) and 16 males (40%). We found that all patients presented with nasal obstruction and nasal tone and the majority of them had allergic nasal symptoms such as sneezing and watery discharge. Thirty five percent of the patients were recurrent cases, being operated before for nasal polyps. Radiological investigations showed high of sinusitis and that 10% of the patients had complicated disease with orbital or intracranial extensions. Mycological studies revealed the presence of fungal infection in 4 patient (10%) and it was caused by Aspergillus flavus. Histological studies identified the allergic nature of the polyps in all patients. Surgical treatment was carried out in all patients and operations varied from simple intranasal polypectomy, intranasal ethmiodectomy, external ethmoidectomy to Caldwell-Luc operation for patients with antrochanal polyps.(Author)

  15. Aberrant Gene Expression Profile of Unaffected Colon Mucosa from Patients with Unifocal Colon Polyp

    Science.gov (United States)

    Lian, Jingjing; Ma, Lili; Yang, Jiayin; Xu, Lili

    2015-01-01

    Background The aim of this study was to evaluate gene expression profiles in unaffected colon mucosa and polyp tissue from patients with unifocal colon polyp to investigate the potential mucosa impairment in normal-appearing colon mucosa from these patients. Material/Methods Colon polyp patients were prospectively recruited. We obtained colon biopsies from the normal-appearing sites and polyp tissue through colonoscopy. Gene expression analysis was performed using microarrays. Gene ontology and clustering were evaluated by bioinformatics. Results We detected a total of 711 genes (274 up-regulated and 437 down-regulated) in polyp tissue and 256 genes (170 up-regulated and 86 down-regulated) in normal-appearing colon mucosa, with at least a 3-fold of change compared to healthy controls. Heatmapping of the gene expression showed similar gene alteration patterns between unaffected colon mucosa and polyp tissue. Gene ontology analyses confirmed the overlapped molecular functions and pathways of altered gene expression between unaffected colon mucosa and polyp tissue from patients with unifocal colon polyp. The most significantly altered genes in normal-appearing tissues in polyp patients include immune response, external side of plasma membrane, nucleus, and cellular response to zinc ion. Conclusions Significant gene expression alterations exist in unaffected colon mucosa from patients with unifocal colon polyp. Unaffected colon mucosa and polyp tissue share great similarity and overlapping of altered gene expression profiles, indicating the potential possibility of recurrence of colon polyps due to underlying molecular abnormalities of colon mucosa in these patients. PMID:26675397

  16. Where are the polyps? Molecular identification, distribution and population differentiation of

    NARCIS (Netherlands)

    van Walraven, L.; Driessen, F.; van Bleijswijk, J.; Bol, A.; Luttikhuizen, P.C.; Coolen, J.; Bos, O.G.; Gittenberger, A.; Schrieken, N.; Langenberg, V.T.; van der Veer, H.W.

    2016-01-01

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates

  17. Multiple hyperplastic polyps in the stomach: evidence for clonality and neoplastic potential

    NARCIS (Netherlands)

    Dijkhuizen, S. M.; Entius, M. M.; Clement, M. J.; Polak, M. M.; van den Berg, F. M.; Craanen, M. E.; Slebos, R. J.; Offerhaus, G. J.

    1997-01-01

    The origin and neoplastic potential of gastric epithelial polyps remains an area of great interest, and treatment choices are a topic of controversy. This report describes a patient diagnosed with three concurrent hyperplastic gastric polyps that were studied for genetic alterations. The polyps were

  18. Hamartomatous polyps - a clinical and molecular genetic study.

    Science.gov (United States)

    Jelsig, Anne Marie

    2016-08-01

    Hamartomatous polyps (HPs) in the gastrointestinal (GI) tract are rare compared to other types of GI polyps, yet they are the most common type of polyp in children. The symptoms are usually rectal bleeding, abdominal pain, obstipation, anaemia, and/or small bowel obstruction. The polyps are typically removed concurrently with endoscopy when located in the colon, rectum, or stomach, whereas polyps in the small bowel are removed during push-enteroscopy, device-assisted enteroscopy, or by surgery. HPs can be classified as juvenile polyps or Peutz-Jeghers polyps based on their histopathological appearance. Patients with one or a few juvenile polyps are usually not offered clinical follow-up as the polyp(s) are considered not to harbour any malignant potential. Nevertheless, it is important to note that juvenile polyps and HPs are also found in patients with hereditary hamartomatous polyposis syndromes (HPS). Patients with HPS have an increased risk of cancer, recurrences of polyps, and extraintestinal complications. The syndromes are important to diagnose, as patients should be offered surveillance from childhood or early adolescence. The syndromes include juvenile polyposis syndrome, Peutz-Jeghers syndrome, and the PTEN hamartoma tumour syndrome. Currently, the HPS diagnoses are based on clinical criteria and are often assisted with genetic testing as candidate genes have been described for each syndrome. This thesis is based on six scientific papers. The overall aim of the studies was to expand the knowledge on clinical course and molecular genetics in patients with HPs and HPS, and to investigate research participants' attitude towards the results of extensive genetic testing.   Paper I: In the first paper we investigated the occurrence, anatomic distribution, and other demographics of juvenile polyps in the colon and rectum in Denmark in 1995-2014. Based on the Danish Pathology Data Bank we found that 1772 patients had 2108 JPs examined in the period, and we

  19. Intestine transplantation

    Directory of Open Access Journals (Sweden)

    Tadeja Pintar

    2011-02-01

    Conclusion: Intestine transplantation is reserved for patients with irreversible intestinal failure due to short gut syndrome requiring total paranteral nutrition with no possibility of discontinuation and loss of venous access for patient maintenance. In these patients complications of underlying disease and long-term total parenteral nutrition are present.

  20. Inflammatory cloacogenic polyp: a rare kind of benign polyp to be cured with endoscopic and/or surgical removal

    Directory of Open Access Journals (Sweden)

    Şafak Meriç Özgenel

    2016-07-01

    Full Text Available Background: Inflammatory cloacogenic polyp is a very rare kind of benign polyp which occurs in the anal transitional zone and lower rectum. These polyps arise in association with various conditions (e.g., internal hemorrhoids, diverticulosis, colorectal tumors, and Crohn's disease in which mucosal injury is the underlying pathogenic mechanism. Case report: A 24-year-old male patient applied to emergency department with bloody defecation for a month. A polyp that is 1.5 cm in size had been observed at rectum and anal verge junction during colonoscopy, pathological diagnosis was inflammatory cloacogenic polyp. Thereupon, colonoscopic polypectomy was performed as the malignant transformation possibility. Conclusion: Polyps of the anorectal junction with inflammatory appearance might be inflammatory cloacogenic polyps with malignant transformation potential that must be treated by endoscopic removal or surgery and followed up routinely with colonoscopic surveillance. Resumo: Experiência: Pólipos cloacogênicos inflamatórios constituem um tipo muito raro de pólipo benigno, com ocorrência na zona de transição anal e reto baixo. Esses pólipos surgem em associação com diversos distúrbios (p. ex., hemorroidas internas, diverticulose, tumores colorretais, e doença de Crohn nos quais a lesão à mucosa é o mecanismo patogênico subjacente. Relato de caso: Paciente, gênero masculino, 24 anos, compareceu ao serviço de emergência com defecação sanguinolenta com duração de um mês. Durante a colonoscopia, foi observado um pólipo medindo 1,5 cm de diâmetro no reto e na junção da borda anal; foi estabelecido um diagnóstico patológico de pólipo cloacogênico inflamatório. Subsequentemente, foi realizada polipectomia colonoscópica, diante do potencial de transformação maligna. Conclusão: Pólipos da junção anorretal com aspecto inflamatório podem ser pólipos cloacogênicos inflamatórios com potencial para transforma

  1. Endoscopic Removal of a Giant Complicated Hyperplastic Gastric Polyp

    Directory of Open Access Journals (Sweden)

    Zaim Gashi

    2017-10-01

    Full Text Available The patient, a 40-year-old male, was referred to our clinic with intermittent nausea, vomiting and symptomatic anemia for 4 months. Notable hematological indices were low hemoglobin levels of 9.6 g/dl and hematocrit levels of 35.8%, while after receiving two units of concentrated red blood cells, at discharge; they achieved levels of 15.2 g/dl and 42.3%, respectively. Esophagogastroduodenoscopy revealed a 3 cm antral pedunculated polyp, prolapsing into pylorus thus causing intermittent pyloric obstruction and anemia. Histological examination revealed a hyperplastic polyp without evidences of malignancy. No atrophy, metaplasia, dysplastic changes or Helicobacter pylori infection were detected in samples taken from the antrum and the corpus; however, the examination provided evidence for gastritis. Follow-up endoscopy was provided after 12 weeks to see polypectomy site after a course of Pantoprazole administration, and to define symptom-free time after polypectomy. Endoscopic removal of complicated gastric polyps should be considered at the time of initial diagnostic endoscopy. Endoscopic resection of polyps enables to determine the exact histopathologic type as well as to effectively treat symptomatic gastric outlet obstruction and anemia.

  2. Colonoscopic polypectomy of colorectal polyps in children under general anesthesia.

    Science.gov (United States)

    Lin, Chien-Heng; Wu, Rick Sai-Chuen; Lin, Wei-Ching; Wu, Shu-Fen; Chen, An-Chyi

    2009-02-01

    In many countries, general anesthesia is not routinely used for colonoscopic polypectomy in children because of either feasibility or cost-effectiveness issues. However, we have been using general anesthesia for colonoscopic polypectomy in pediatric patients in our hospital for the past 5 years. The aim of this study was to evaluate the safety of the procedure and the degree of satisfaction that the patients' parents and endoscopists had with the use of general anesthesia. We retrospectively analyzed the results of colonoscopic polypectomies under general anesthesia in 18 patients performed between January 2001 and December 2005. The removed polyps were examined histologically and the patients were observed to assess complications during the first 24-hour postoperative period. The patients' parents' and endoscopists' satisfaction with the use of general anesthesia was surveyed after the procedure. In our patient group, there were 10 boys and eight girls. The mean age was 5.5 +/- 3.4 years (range, 2-15 years). Seventeen of the 18 patients had rectal bleeding (mean duration, 3.7 months) as the main symptom. There were 12 patients with juvenile polyps, four with hyperplastic polyps, one with juvenile polyposis and one with Peutz-Jeghers syndrome. The majority (70.6%) of the polyps were located in the rectosigmoid colon. No significant complications related to colonoscopic polypectomy or anesthesia were observed. Satisfaction among parents and endoscopists ranged from good to excellent. General anesthesia is recommended for pediatric patients undergoing colonoscopic polypectomy.

  3. Management of male urethral polyps in children: Experience with ...

    African Journals Online (AJOL)

    Congenital urethral polyps area rare anomaly of the male urethra that may present with features of voiding dysfunction or obstruction. Although the exact incidence is unknown, they are important in the differential diagnosis of lower urethral obstruction in male children. Their diagnosis requires a high index of suspicion ...

  4. Colonoscopic Polypectomy of Colorectal Polyps in Children Under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Chien-Heng Lin

    2009-02-01

    Full Text Available In many countries, general anesthesia is not routinely used for colonoscopic polypectomy in children because of either feasibility or cost-effectiveness issues. However, we have been using general anesthesia for colonoscopic polypectomy in pediatric patients in our hospital for the past 5 years. The aim of this study was to evaluate the safety of the procedure and the degree of satisfaction that the patients' parents and endoscopists had with the use of general anesthesia. We retrospectively analyzed the results of colonoscopic polypectomies under general anesthesia in 18 patients performed between January 2001 and December 2005. The removed polyps were examined histologically and the patients were observed to assess complications during the first 24-hour postoperative period. The patients' parents' and endoscopists' satisfaction with the use of general anesthesia was surveyed after the procedure. In our patient group, there were 10 boys and eight girls. The mean age was 5.5 ± 3.4 years (range, 2–15 years. Seventeen of the 18 patients had rectal bleeding (mean duration, 3.7 months as the main symptom. There were 12 patients with juvenile polyps, four with hyperplastic polyps, one with juvenile polyposis and one with Peutz-Jeghers syndrome. The majority (70.6% of the polyps were located in the rectosigmoid colon. No significant complications related to colonoscopic polypectomy or anesthesia were observed. Satisfaction among parents and endoscopists ranged from good to excellent. General anesthesia is recommended for pediatric patients undergoing colonoscopic polypectomy.

  5. European Position Paper on Rhinosinusitis and Nasal Polyps 2012.

    Science.gov (United States)

    Fokkens, Wytske J; Lund, Valerie J; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John

    2012-03-01

    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed.

  6. European Position Paper on Rhinosinusitis and Nasal Polyps 2012

    NARCIS (Netherlands)

    Fokkens, Wytske J.; Lund, Valerie J.; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John

    2012-01-01

    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of

  7. European position paper on rhinosinusitis and nasal polyps 2007

    NARCIS (Netherlands)

    Fokkens, Wytske; Lund, Valerie; Mullol, Joaquirn

    2007-01-01

    Rhinosinusitis is a significant and increasing health problem which results in a large financial burden on society. This evidence based position paper describes what is known about rhinosinusitis and nasal polyps, offers evidence based recommendations on diagnosis and treatment, and considers how we

  8. Original Article Nasal polyps - clinical profile and management in ...

    African Journals Online (AJOL)

    ETN

    may be presenting complaint of cystic fibrosis 7. In this study, most of the subjects (91%) with nasal polyps were between second and sixth decades of life with an average age of 34 years. Fifty –one percent were found to be between third and fourth decades of life A male predominance in this study is in consonance with ...

  9. Polyp-simulating mucosal prolapse syndrome in (pre-) diverticular disease

    NARCIS (Netherlands)

    Mathus-Vliegen, E. M.; Tytgat, G. N.

    1986-01-01

    Eight patients with anal blood loss were referred for endoscopic polyp removal (4) or because of problems with the differential diagnosis (4). These patients were referred because of an apparent discrepancy between the initial diagnosis (malignancy, ulcerative colitis and hemangioma) and the

  10. Prostatic-type polyp in the bladder. A case report

    DEFF Research Database (Denmark)

    Hansen, B J; Christensen, S W; Eldrup, J

    1989-01-01

    A case of prostatic-type polyp in the wall of the urinary bladder in a 73-year-old male is presented. The literature concerning ectopic prostatic tissue in the urinary tract is reviewed and it is concluded that the lesion is benign. However, recurrence has been reported in two cases. The etiology...

  11. Prolapsed submucous uterine fibroid polyp associated with urinary ...

    African Journals Online (AJOL)

    protruding down the vagina, irregular bleeding per vagina and offensive vaginal discharge. She had a preoperative diagnosis of infected proplased submucous uterine fibroid measuring 10cm by 10 cm with a stalk measuring 6cm. At laparotomy, the fibroid polyp was excised from its base in the posterior wall of the uterus.

  12. Aragonite precipitation by "proto-polyps" in coral cell cultures.

    Science.gov (United States)

    Mass, Tali; Drake, Jeana L; Haramaty, Liti; Rosenthal, Yair; Schofield, Oscar M E; Sherrell, Robert M; Falkowski, Paul G

    2012-01-01

    The mechanisms of coral calcification at the molecular, cellular and tissue levels are poorly understood. In this study, we examine calcium carbonate precipitation using novel coral tissue cultures that aggregate to form "proto-polyps". Our goal is to establish an experimental system in which calcification is facilitated at the cellular level, while simultaneously allowing in vitro manipulations of the calcifying fluid. This novel coral culturing technique enables us to study the mechanisms of biomineralization and their implications for geochemical proxies. Viable cell cultures of the hermatypic, zooxanthellate coral, Stylophora pistillata, have been maintained for 6 to 8 weeks. Using an enriched seawater medium with aragonite saturation state similar to open ocean surface waters (Ω(arag)~4), the primary cell cultures assemble into "proto-polyps" which form an extracellular organic matrix (ECM) and precipitate aragonite crystals. These extracellular aragonite crystals, about 10 µm in length, are formed on the external face of the proto-polyps and are identified by their distinctive elongated crystallography and X-ray diffraction pattern. The precipitation of aragonite is independent of photosynthesis by the zooxanthellae, and does not occur in control experiments lacking coral cells or when the coral cells are poisoned with sodium azide. Our results demonstrate that proto-polyps, aggregated from primary coral tissue culture, function (from a biomineralization perspective) similarly to whole corals. This approach provides a novel tool for investigating the biophysical mechanism of calcification in these organisms.

  13. Aragonite precipitation by "proto-polyps" in coral cell cultures.

    Directory of Open Access Journals (Sweden)

    Tali Mass

    Full Text Available The mechanisms of coral calcification at the molecular, cellular and tissue levels are poorly understood. In this study, we examine calcium carbonate precipitation using novel coral tissue cultures that aggregate to form "proto-polyps". Our goal is to establish an experimental system in which calcification is facilitated at the cellular level, while simultaneously allowing in vitro manipulations of the calcifying fluid. This novel coral culturing technique enables us to study the mechanisms of biomineralization and their implications for geochemical proxies. Viable cell cultures of the hermatypic, zooxanthellate coral, Stylophora pistillata, have been maintained for 6 to 8 weeks. Using an enriched seawater medium with aragonite saturation state similar to open ocean surface waters (Ω(arag~4, the primary cell cultures assemble into "proto-polyps" which form an extracellular organic matrix (ECM and precipitate aragonite crystals. These extracellular aragonite crystals, about 10 µm in length, are formed on the external face of the proto-polyps and are identified by their distinctive elongated crystallography and X-ray diffraction pattern. The precipitation of aragonite is independent of photosynthesis by the zooxanthellae, and does not occur in control experiments lacking coral cells or when the coral cells are poisoned with sodium azide. Our results demonstrate that proto-polyps, aggregated from primary coral tissue culture, function (from a biomineralization perspective similarly to whole corals. This approach provides a novel tool for investigating the biophysical mechanism of calcification in these organisms.

  14. Gallbladder Polyps: An Ambiguous Cause of Biliary Colic

    African Journals Online (AJOL)

    However, ultrasonography revealed multiple hyperechoic mass lesions protruding in the gallbladder lumen suggestive of gallbladder polyps [Figure 1], largest one measured 8.2 mm [Figure 2]. Subsequently, the patient underwent conventional 4-port laparoscopic cholecystectomy. Histopathology revealed the benign ...

  15. Thermal and Osmotic Tolerance of 'Irukandji' Polyps: Cubozoa; Carukia barnesi.

    Directory of Open Access Journals (Sweden)

    Robert Courtney

    Full Text Available This research explores the thermal and osmotic tolerance of the polyp stage of the Irukandji jellyfish Carukia barnesi, which provides new insights into potential polyp habitat suitability. The research also targets temperature, salinity, feeding frequency, and combinations thereof, as cues for synchronous medusae production. Primary findings revealed 100% survivorship in osmotic treatments between 19 and 46‰, with the highest proliferation at 26‰. As salinity levels of 26‰ do not occur within the waters of the Great Barrier Reef or Coral Sea, we conclude that the polyp stage of C. barnesi is probably found in estuarine environments, where these lower salinity conditions commonly occur, in comparison to the medusa stage, which is oceanic. Population stability was achieved at temperatures between 18 and 31°C, with an optimum temperature of 22.9°C. We surmise that C. barnesi polyps may be restricted to warmer estuarine areas where water temperatures do not drop below 18°C. Asexual reproduction was also positively correlated with feeding frequency. Temperature, salinity, feeding frequency, and combinations thereof did not induce medusae production, suggesting that this species may use a different cue, possibly photoperiod, to initiate medusae production.

  16. Computer Aided Detection of Polyps in CT Colonography

    NARCIS (Netherlands)

    Van Ravesteijn, V.F.

    2013-01-01

    CT colonography (CTC) is a minimally invasive method for detection of colorectal polyps and colon cancer. Limitations of CTC related to the efficiency as well as the sensitivity of radiologists. Additionally, the patient's preparation was considered burdensome and the X-ray radiation that is

  17. Nasal polyps - clinical profile and management in Ibadan, Nigeria ...

    African Journals Online (AJOL)

    Background: Nasal polyps are benign mucosal protrusions into the nasal cavity of multifactorial origin and are characterized by chronic mucosal inflammation. They result from the prolapsed lining of the ethmoid sinuses and block the nose to a variable degree depending on their sizes. This study aims to evaluate the clinical ...

  18. Association between Obesity, Serum Lipids, and Colorectal Polyps in Old Chinese People

    Directory of Open Access Journals (Sweden)

    Wen Yang

    2013-01-01

    Full Text Available Background. Colorectal cancer mostly arises from the polyps of colon. The aim of our study was to examine the association of body mass index (BMI and serum lipids with the colorectal polyps in old Chinese people. Methods. The risk of developing colorectal polyps was studied in 244 subjects (212 men and 32 women, 74.63 ± 11.63 years old who underwent colonoscopy for the first time from January 2008 to July 2012 at the Navy General Hospital, Beijing, China. According to the results of colonoscopy, all the subjects were divided into 112 normal control, 38 right colorectal polyps, 53 left colorectal polyps, and 41 both right and left colorectal polyps groups. The total plasma cholesterol, plasma triglyceride, plasma creatinine concentration, blood urinary nitrogen, and fasting glucose were determined using a multichannel analyzer. Results. There were significant differences among normal control, right colorectal polyps, left colorectal polyps, and both right and left polyps groups, which were the BMI, total cholesterol, triglycerides, creatinine, and urinary nitrogen. In binary logistic regression analysis, there were two risk factors associated with the occurrence of colorectal polyps, which included BMI and systolic blood pressure. Conclusions. Colorectal polyps were significantly associated with increased BMI, total cholesterol, and triglycerides levels.

  19. Juvenile polyps and their distribution in pediatric patients with gastrointestinal bleeding.

    Science.gov (United States)

    Lehmann, C U; Elitsur, Y

    1996-01-01

    Juvenile polyps (JPs) are the most common colonic tumor in childhood. The total number and anatomical distribution have changed significantly since the introduction of flexible colonoscopy. This article reviews our experiences treating 29 pediatric patients with JPs, and evaluates the 66 polyps we removed and their distribution in the colon. Thirteen patients (45%) had multiple polyps and 35% of all polyps were found proximal to the sigmoid colon. In the 14 patients who underwent a complete colonoscopy, eight had multiple polyps and 55% of these polyps were found proximal to the sigmoid colon. As a result, we conclude that there is a trend toward more polyps per patient and a more distal colonic distribution in children with JPs than previously reported. We recommend that a complete colonoscopy and possible polypectomy be performed on all children with unexplained rectal bleeding.

  20. Deep learning for polyp recognition in wireless capsule endoscopy images.

    Science.gov (United States)

    Yuan, Yixuan; Meng, Max Q-H

    2017-04-01

    Wireless capsule endoscopy (WCE) enables physicians to examine the digestive tract without any surgical operations, at the cost of a large volume of images to be analyzed. In the computer-aided diagnosis of WCE images, the main challenge arises from the difficulty of robust characterization of images. This study aims to provide discriminative description of WCE images and assist physicians to recognize polyp images automatically. We propose a novel deep feature learning method, named stacked sparse autoencoder with image manifold constraint (SSAEIM), to recognize polyps in the WCE images. Our SSAEIM differs from the traditional sparse autoencoder (SAE) by introducing an image manifold constraint, which is constructed by a nearest neighbor graph and represents intrinsic structures of images. The image manifold constraint enforces that images within the same category share similar learned features and images in different categories should be kept far away. Thus, the learned features preserve large intervariances and small intravariances among images. The average overall recognition accuracy (ORA) of our method for WCE images is 98.00%. The accuracies for polyps, bubbles, turbid images, and clear images are 98.00%, 99.50%, 99.00%, and 95.50%, respectively. Moreover, the comparison results show that our SSAEIM outperforms existing polyp recognition methods with relative higher ORA. The comprehensive results have demonstrated that the proposed SSAEIM can provide descriptive characterization for WCE images and recognize polyps in a WCE video accurately. This method could be further utilized in the clinical trials to help physicians from the tedious image reading work. © 2017 American Association of Physicists in Medicine.

  1. Intravenous contrast enhanced computed tomography colonoscopy in children with suspected colonic polyps.

    Science.gov (United States)

    Bhatia, Anmol; Saxena, Akshay K; Kalra, Naveen; Sodhi, Kushaljit S; Thapa, Babu R; Rao, Katragadda L N; Khandelwal, Niranjan

    2013-06-01

    The purpose of this study was to evaluate the diagnostic performance of intravenous contrast enhanced computed tomographic colonoscopy (IVCTC) in the diagnosis of clinically suspected colorectal polyps in children, using conventional colonoscopy (CC) as the gold standard. This was a prospective study conducted between July 2008 and June 2010. 30 pediatric patients with history of rectal bleeding and clinically suspected to have colorectal polyps were enrolled. All of the patients underwent IVCTC followed by CC. 30 IVCTC and 31 CC were performed in 30 patients. The findings of IVCTC were compared with those of CC. Statistical analysis was performed to obtain diagnostic performance values of IVCTC on per polyp (sensitivity and positive predictive value) and per patient (sensitivity, specificity, positive predictive value and negative predictive value) basis. By IVCTC, 63 polyps were detected in 28 patients of which 53 polyps were eligible for inclusion in the statistical analysis. 60 polyps were detected by CC in 28 patients of which 50 polyps were eligible for inclusion in the statistical analysis. The per polyp sensitivity and positive predictive values were 94% and 88.6% respectively. The per patient sensitivity, specificity, positive predictive value, and negative predictive values were 96.4, 50, 96.4, and 50% respectively. Twenty polyps, in 10 patients, were visualized only after intravenous contrast administration of which 5 polyps, in 5 patients, were likely to have been missed in the absence of the intravenous contrast injection as these polyps were submerged in fluid. Four patients would have had a false negative CTC examination if the intravenous contrast had not been injected; while in another patient, the number of polyps would have been underestimated. CTC is capable of serving as a safe and efficient non-invasive tool for evaluating children with clinically suspected colorectal polyps. Administration of intravenous contrast improves the sensitivity of

  2. Inflammatory myoglandular polyp of the cecum: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Papini Federica

    2010-01-01

    Full Text Available Abstract Background Inflammatory myoglandular polyp (IMGP is a rare non-neoplastic polyp of the large bowel, commonly with a distal localization (rectosigmoid, obscure in its pathogenesis. Up till now, 60 cases of IMGP have been described in the literature, but none located in the cecum. Case presentation We report a case of a 53-year-old man who was admitted to our hospital for further evaluation of positive fecal occult blood test associated to anemia. A colonoscopy identified a red, sessile, lobulated polyp of the cecum, 4.2 cm in diameter, partially ulcerated. The histological examination of the biopsy revealed the presence of inflammatory granulation tissue with lymphocytic and eosinophil infiltration associated to a fibrous stroma: it was diagnosed as inflammatory fibroid polyp. Considering the polyp's features (absence of a peduncle and size that could increase the risk of a polypectomy, a surgical resection was performed. Histological examination of the specimen revealed inflammatory granulation tissue in the lamina propria, hyperplastic glands with cystic dilatations, proliferation of smooth muscle and multiple erosions on the polyp surface: this polyp was finally diagnosed as IMGP. There was also another little polyp next to the ileocecal valve, not revealed at the colonoscopy, 0.8 cm in diameter, diagnosed as tubulovillous adenoma with low grade dysplasia. Conclusions This is the first case of IMGP of the cecum. It is a benign lesion of unknown pathogenesis and must be considered different from other non-neoplastic polyps of the large bowel such as inflammatory cap polyps (ICP, inflammatory cloacogenic polyps, juvenile polyps (JP, inflammatory fibroid polyps (IFP, polyps secondary to mucosal prolapse syndrome (MPS, polypoid prolapsing mucosal folds of diverticular disease. When symptomatic, IMGP should be removed endoscopically, whereas surgical resection is reserved only in selected patients as in our case.

  3. Intravenous contrast enhanced computed tomography colonoscopy in children with suspected colonic polyps

    International Nuclear Information System (INIS)

    Bhatia, Anmol; Saxena, Akshay K.; Kalra, Naveen; Sodhi, Kushaljit S.; Thapa, Babu R.; Rao, Katragadda L.N.; Khandelwal, Niranjan

    2013-01-01

    Objective: The purpose of this study was to evaluate the diagnostic performance of intravenous contrast enhanced computed tomographic colonoscopy (IVCTC) in the diagnosis of clinically suspected colorectal polyps in children, using conventional colonoscopy (CC) as the gold standard. Methods: This was a prospective study conducted between July 2008 and June 2010. 30 pediatric patients with history of rectal bleeding and clinically suspected to have colorectal polyps were enrolled. All of the patients underwent IVCTC followed by CC. 30 IVCTC and 31 CC were performed in 30 patients. The findings of IVCTC were compared with those of CC. Statistical analysis was performed to obtain diagnostic performance values of IVCTC on per polyp (sensitivity and positive predictive value) and per patient (sensitivity, specificity, positive predictive value and negative predictive value) basis. Results: By IVCTC, 63 polyps were detected in 28 patients of which 53 polyps were eligible for inclusion in the statistical analysis. 60 polyps were detected by CC in 28 patients of which 50 polyps were eligible for inclusion in the statistical analysis. The per polyp sensitivity and positive predictive values were 94% and 88.6% respectively. The per patient sensitivity, specificity, positive predictive value, and negative predictive values were 96.4, 50, 96.4, and 50% respectively. Twenty polyps, in 10 patients, were visualized only after intravenous contrast administration of which 5 polyps, in 5 patients, were likely to have been missed in the absence of the intravenous contrast injection as these polyps were submerged in fluid. Four patients would have had a false negative CTC examination if the intravenous contrast had not been injected; while in another patient, the number of polyps would have been underestimated. Conclusion: CTC is capable of serving as a safe and efficient non-invasive tool for evaluating children with clinically suspected colorectal polyps. Administration of

  4. Intestinal Ischemia

    Science.gov (United States)

    ... weight loss Intestinal ischemia Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  5. Intestinal Coccidia

    OpenAIRE

    MJ Ggaravi

    2007-01-01

    Intestinal Coccidia are a subclass of Apicomplexa phylum. Eucoccidida are facultative heteroxenous, but some of them are monoxenous. They have sexual and asexual life cycle. Some coccidia are human pathogens, for example: Cryptosporidium: Cryptosporidiums has many species that are mammalian intestinal parasites.C. Parvum specie is a human pathogenic protozoa. Cryptosporidum has circle or ellipse shapes and nearly 4-6 mm. It is transmitted in warm seasons. Oocyst is obtained insexual life cycl...

  6. SRC activates TAZ for intestinal tumorigenesis and regeneration.

    Science.gov (United States)

    Byun, Mi Ran; Hwang, Jun-Ha; Kim, A Rum; Kim, Kyung Min; Park, Jung Il; Oh, Ho Taek; Hwang, Eun Sook; Hong, Jeong-Ho

    2017-12-01

    Proto-oncogene tyrosine-protein kinase Src (cSRC) is involved in colorectal cancer (CRC) development and damage-induced intestinal regeneration, although the cellular mechanisms involved are poorly understood. Here, we report that transcriptional coactivator with PDZ binding domain (TAZ) is activated by cSRC, regulating CRC cell proliferation and tumor formation, where cSRC overexpression increases TAZ expression in CRC cells. In contrast, knockdown of cSRC decreases TAZ expression. Additionally, direct phosphorylation of TAZ at Tyr316 by cSRC stimulates nuclear localization and facilitates transcriptional enhancer factor TEF-3 (TEAD4)-mediated transcription. However, a TAZ phosphorylation mutant significantly decreased cell proliferation, wound healing, colony forming, and tumor formation. In a CRC mouse model, Apc Min/+ , activated SRC expression was associated with increased TAZ expression in polyps and TAZ depletion decreased polyp formation. Moreover, intestinal TAZ knockout mice had intestinal regeneration defects following γ-irradiation. Finally, significant correspondence between SRC activation and TAZ overexpression was observed in CRC patients. These results suggest that TAZ is a critical factor for SRC-mediated intestinal tumor formation and regeneration. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Effect of CADe on radiologists' performance in detection of "difficult" polyps in CT colonography

    Science.gov (United States)

    Suzuki, Kenji; Hori, Masatoshi; Iinuma, Gen; Dachman, Abraham H.

    2013-03-01

    To investigate the actual usefulness of computer-aided detection (CADe) of polyps as a second reader, we conducted a free-response observer performance study with radiologists in the detection of "difficult" polyps in CT colonography (CTC) from a multicenter clinical trial. The "difficult" polyps were defined as the ones that had been "missed" by radiologists in the clinical trial or rated "difficult" in our retrospective review. Our advanced CADe scheme utilizing massive-training artificial neural networks (MTANNs) technology was sensitive and specific to the "difficult" polyps. Four board-certified abdominal radiologists participated in this observer study. They were instructed, first without and then with our CADe, to indicate the location of polyps and their confidence level regarding the presence of polyps. Our database contains 20 patients with 23 polyps including 14 false-negative (FN) and 7 "difficult" polyps and 10 negative patients. With CADe, the average by-polyp sensitivity of radiologists was improved from 53 to 63% at a statistically significant level (P=0.037). Thus, our CADe scheme utilizing the MTANN technology improved the diagnostic performance of radiologists, including expert readers, in the detection of "difficult" polyps in CTC.

  8. Fate and ultra-structural features of chicken skin mucosa around juvenile polyps.

    Science.gov (United States)

    El-Hodhod, M A; Soliman, A A; Hamdy, A M; Abdel-Rahim, A A; Abdel-Hamid, F K

    2011-03-01

    Chicken skin mucosa (CSM) is a common finding around juvenile polyps in children. Its ultrastructural features and fate after polypectomy are not yet clear. The aim was to study ultra-structural features and outcome of this CSM compared to that of the polyps and distant endoscopically normal mucosa. From 240 children with juvenile polyps, 45 needed a second colonoscopy. Thirty six patients showing CSM represented the cohort of this study. One polyp only was studied in each patient. The histologic features of the CSM were compared to normal and polyp mucosa. The fate of CSM was evaluated in the second colonoscopy. The mean numbers of intraepithelial lymphocytes, as well as lamina propria inflammatory cellular infiltrates were significantly higher in polyp mucosa than in CSM. Goblet cells were significantly higher in CSM compared to normal mucosa with marked depletion in the polyp mucosa. The muscularis mucosae thickness was significantly higher in CSM compared to polyps (ppolyp showed the most intense mucosal inflammatory reaction. CSM with the unique thickening of muscularis mucosae especially around larger polyps almost disappeared after polypectomy. So these results suggest that CSM is a benign compensatory reaction induced by the mechanical effect of the polyp.

  9. [Expression of Foxa2 and its early alarm value of cancerous in gastric polyps].

    Science.gov (United States)

    Chai, Ning-li; Zhang, Wen-cheng; Wang, Yan-min; Zhou, Zhao-tao; Zhang, Yan-e; Liu, Hong-yan; Wan, Jun; Qin, Jin-hua; Wang, Shu-yong; Wang, Yun-fang; Pei, Xue-tao; Wu, Ben-yan

    2013-07-09

    To explore the expression of Foxa2 in different pathological types of gastric polyps and examine the correlation with cancerous risk. According to computerize random number, a total of 2000 patients were selected to receive endoscopic biopsy during November 2011 to October 2012. Tissues were harvested from 170 with gastric polyps and suspicious cancerous lesions and their histological types detected. There were hyperplastic polyps(n = 35), adenomatous polyps(n = 31), fundic gland polyps(n = 42), advanced gastric cancer tissues (n = 32)and normal gastric mucosa tissues (n = 30). ABC immunohistochemical staining and reverse transcription(RT)-PCR were employed to detect the expression of Foxa2 in these different types of tissues. Imagepro plus was used for quantitative and statistical analyses. A low-level expression of Foxa2 was 3.6% ± 1.3% in normal gastric mucosa group. And its expreesion gradually higher in proliferative inflammatory polyp group(33.1% ± 8.0%), adenomatous polyp group (71.4% ± 1.7%) and gastric cancer group(96.3% ± 0.9%, all P 0.05), it was markedly lower than the gastric cancer group (P 0.05). However, the size of polyps was correlated with Foxa2 (rs = 0.69, P Foxa2 in different types of gastric polyps may be used as a clinical predicator of polyps risk.

  10. Variation in polyp size estimation among endoscopists and impact on surveillance intervals.

    Science.gov (United States)

    Chaptini, Louis; Chaaya, Adib; Depalma, Fedele; Hunter, Krystal; Peikin, Steven; Laine, Loren

    2014-10-01

    Accurate estimation of polyp size is important because it is used to determine the surveillance interval after polypectomy. To evaluate the variation and accuracy in polyp size estimation among endoscopists and the impact on surveillance intervals after polypectomy. Web-based survey. A total of 873 members of the American Society for Gastrointestinal Endoscopy. Participants watched video recordings of 4 polypectomies and were asked to estimate the polyp sizes. Proportion of participants with polyp size estimates within 20% of the correct measurement and the frequency of incorrect surveillance intervals based on inaccurate size estimates. Polyp size estimates were within 20% of the correct value for 1362 (48%) of 2812 estimates (range 39%-59% for the 4 polyps). Polyp size was overestimated by >20% in 889 estimates (32%, range 15%-49%) and underestimated by >20% in 561 (20%, range 4%-46%) estimates. Incorrect surveillance intervals because of overestimation or underestimation occurred in 272 (10%) of the 2812 estimates (range 5%-14%). Participants in a private practice setting overestimated the size of 3 or of all 4 polyps by >20% more often than participants in an academic setting (difference = 7%; 95% confidence interval, 1%-11%). Survey design with the use of video clips. Substantial overestimation and underestimation of polyp size occurs with visual estimation leading to incorrect surveillance intervals in 10% of cases. Our findings support routine use of measurement tools to improve polyp size estimates. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  11. The presence of Helicobacter pylori in colorectal polyps detected by immunohistochemical methods in children.

    Science.gov (United States)

    Cheng, Haiying; Zhang, Ting; Gu, Weizhong; Shu, Xiaoli; Zhang, Yanyi; Zhang, Xuping; Wu, Xiuying; Chen, Jie; Jiang, Mizu

    2012-04-01

    Polyps are a common cause of hematochezia in children, but the pathogenesis of polyps is unclear. The aim of this study was to investigate the relationship between Helicobacter pylori (HP) infection and colorectal polyps in children. Thirty-five patients who had undergone polypectomy after the detection of polyps served as the case group. Twenty-seven patients with gastrointestinal symptoms and normal colonoscopy served as the control group. Hematoxylin and eosin (HE) stains obtained from paraffin blocks were evaluated and classified according to histopathologic type and degree of dysplasia. The other sections were used to detect HP organisms for immunohistochemistry (IHC). The seroprevalence of HP antibodies in children with colorectal polyps was detected by protein chip technology. HP infection was diagnosed if the serum urease antibody was positive. The HP-positive rate in children with colorectal polyps was 57.1% (20/35), which was higher than the rate of 22.2% (6/27) for colonic mucosa in the control group (P polyps and juvenile polyposis syndrome were not statistically significant. Age, gender, and the number, size, and locations of the colonic polyps were not significantly different between the patients with HP-positive and HP-negative polyps. The HP-antibody-positive rate was 65.0% (13/20) in the patients with HP-infection-positive colorectal polyps, which was higher than the rate of 26.7% (4/15) for the patients with HP-infection-negative colorectal polyps (P polyps in children in this study, indicating that HP infection is a risk factor for colorectal polyps in children.

  12. Esophageal polyps in pediatric patients undergoing routine diagnostic upper gastrointestinal endoscopy: a multicenter study.

    Science.gov (United States)

    Septer, S; Cuffari, C; Attard, T M

    2014-01-01

    Esophageal polyps are uncommon findings in pediatric patients, and reports have been limited to case reports. Esophageal polyps have been previously ascribed to esophagitis secondary to gastroesophageal reflux, medications, infections and recurrent vomiting. They have been associated with underlying conditions such as hiatal hernia, Barrett's esophagus, eosinophilic esophagitis and Crohn's disease. Presenting complaints of children with esophageal polyps have included vomiting, dysphagia, hematemesis and abdominal pain. The aim of this paper is to characterize the incidence, clinical presentation and progression, histologic subtypes and associated mucosal abnormalities in children with esophageal polyps. A retrospective multicenter study was performed at four institutions identifying diagnosis of esophageal polyps in pediatric patients (pediatric pathologists for all included cases. Esophageal polyps were identified in 13 patients (9 M) from 9438 esophagogastroduodenoscopies (0.14%). Mean age of subjects was 9.2 years. Vomiting was the most common indication for endoscopy. Polyp location was at the gastroesophageal junction in 7 of the 13 cases. Most polyps were inflammatory (n = 7). Esophagitis was noted in 69% of those with esophageal polyps. Repeat endoscopies in six patients at a mean interval of 8 months noted persistence of polyps in all six patients. This paper is the first to characterize esophageal polyps in pediatrics. These polyps are rare in children and often are associated with esophagitis. Presenting complaints seem to vary by age. Polyps did not consistently change with either time or acid suppression. The optimal management strategy has yet to be defined and likely depends on the underlying pathophysiologic process. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  13. Correlation of NOX1 and NOX2 expression in ulcerative colitis tissue with intestinal mucosal oxidative stress response and barrier function injury

    Directory of Open Access Journals (Sweden)

    Tao Ma

    2017-10-01

    Full Text Available Objective: To study the correlation of NOX1 and NOX2 expression in ulcerative colitis tissue with intestinal mucosal oxidative stress response and barrier function injury. Methods: A total of 69 patients who were diagnosed with ulcerative colitis in Yan’an People’s Hospital between May 2015 and March 2017 were selected as the UC group of the research, and 78 patients who were diagnosed with colon polyps were selected as the polyps group of the research. The ulcerative colitis lesion and polyp lesion were collected to detect the expression of NOX1 and NOX2, the generation of oxygen free radicals as well as the contents of apoptosis molecules and mucosal barrier molecules. Results: The mRNA expression and protein expression of NOX1 and NOX2 in the intestinal mucosa of UC group were significantly higher than those of polyps group; LPO, MDA, AOPP, NO, PDCD5 and Bax levels in intestinal mucosa of UC group were significantly higher than those of polyps group and positively correlated with the mRNA expression and protein expression of NOX1 and NOX2 while Bcl-2, Cdx1, Cdx2, galectin-1, galectin-3, OCLN, cingulin and ZO-1 levels were significantly lower than those of polyps group and negatively correlated with the mRNA expression and protein expression of NOX1 and NOX2. Conclusion: The high expression of NOX1 and NOX2 in ulcerative colitis tissue can activate the intestinal mucosal oxidative stress response and result in the intestinal mucosal barrier function injury.

  14. Small Intestine Disorders

    Science.gov (United States)

    ... disease Crohn's disease Infections Intestinal cancer Intestinal obstruction Irritable bowel syndrome Ulcers, such as peptic ulcer Treatment of disorders of the small intestine depends on the cause.

  15. [Bilateral ureteral polyps in children: a case report].

    Science.gov (United States)

    Sun, Peng-hao; Na, Wan-li; Nan, Yong-hao; Tian, Wen-jie; Liu, Ming

    2012-08-18

    Fibroepithelial polyp of the ureter is a benign tumor of mesodermal origin that rarely occurs in children. The most common presenting symptoms are hematuria and flank pain by obstruction of the urinary tract. The etiology of this tumor is still not clear. It occurs more frequently in boys and often arises in the proximal ureter and the ureteropelvic junction. The preoperative diagnosis is difficult. We present here the case of a 11-year-old boy who had fibroepithelial polyps as the cause of the left flank ureteropelvic junction obstruction at pyeloplasty, and had the same condition on the right flank 5 years ago. We used polypectomy and pyeloureterostomy to treat the boy. No major intraoperative or preoperative complications developed.

  16. Urethral polyp in a 1-month-old child

    International Nuclear Information System (INIS)

    Beluffi, Giampiero; Berton, Francesca; Gola, Giada; Chiari, Giorgio; Romano, Piero; Cassani, Ferdinando

    2005-01-01

    Urethral polyps are a rare finding in children, particularly in the very young. They are suspected by the presence of various clinical signs such as obstruction, voiding dysfunction and haematuria. There is an association with other urinary tract congenital anomalies. They are usually benign fibro-epithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy. We report a 1-month-old boy with an antenatally diagnosed left ectopic pelvic kidney, postnatal urinary tract infection and no clinical signs of obstruction. Voiding cystourethrography to exclude vesico-ureteric reflux showed a trabeculated bladder and a mobile filling defect in the posterior urethra. Owing to its large size, cystotomy was necessary to remove the polyp successfully. (orig.)

  17. Korean Guidelines for Colorectal Cancer Screening and Polyp Detection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bo In [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Hong, Sung Pil [Yensei University College of Medicine, Seoul (Korea, Republic of); Kim, Seong Eun [Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2012-04-15

    Colorectal cancer is currently the second most common cancer among Korean males and the fourth most common among females. Since the majority of colorectal cancer case present following the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are vital methods in its prevention. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish national guidelines for colorectal cancer screening and polyp detection. The proposed guidelines have been developed by the Korean Multi-Society Task Force using evidence-based methods. Systematic reviews and meta-analyses have been used to form the statements contained in the guidelines. This paper discusses the epidemiology of colorectal cancers and adenomas in Korea as well as optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.

  18. Urethral polyp in a 1-month-old child

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero [Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Section of Paediatric Radiology, Piazzale Golgi, 2, I-27100, Pavia PV (Italy); Berton, Francesca; Gola, Giada [University of Pavia, IRCCS Policlinico S. Matteo, Institute of Radiology, Pavia (Italy); Chiari, Giorgio; Romano, Piero; Cassani, Ferdinando [IRCCS Policlinico S. Matteo, Division of Paediatric Surgery, Pavia (Italy)

    2005-07-01

    Urethral polyps are a rare finding in children, particularly in the very young. They are suspected by the presence of various clinical signs such as obstruction, voiding dysfunction and haematuria. There is an association with other urinary tract congenital anomalies. They are usually benign fibro-epithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy. We report a 1-month-old boy with an antenatally diagnosed left ectopic pelvic kidney, postnatal urinary tract infection and no clinical signs of obstruction. Voiding cystourethrography to exclude vesico-ureteric reflux showed a trabeculated bladder and a mobile filling defect in the posterior urethra. Owing to its large size, cystotomy was necessary to remove the polyp successfully. (orig.)

  19. Hamartomatous polyps - a clinical and molecular genetic study

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie

    2016-01-01

    the knowledge on clinical course and molecular genetics in patients with HPs and HPS, and to investigate research participants' attitude towards the results of extensive genetic testing. Paper I: In the first paper we investigated the occurrence, anatomic distribution, and other demographics of juvenile polyps......-Jeghers syndrome, and the PTEN hamartoma tumour syndrome. Currently, the HPS diagnoses are based on clinical criteria and are often assisted with genetic testing as candidate genes have been described for each syndrome. This thesis is based on six scientific papers. The overall aim of the studies was to expand......% fulfilled to diagnostic criteria of JPS. The majority of patients had a single juvenile polyp. Paper II: In this paper we conducted a review of the HPS based on the current literature. Paper III: We investigated the hypothesis that patients with one or few HPs may have a HPS based on genetic screening. We...

  20. Hyperplastic Polyps Are Innocuous Lesions in Hereditary Nonpolyposis Colorectal Cancers

    Directory of Open Access Journals (Sweden)

    D. Speake

    2011-01-01

    Full Text Available Aims. To compare methylation profiles, protein expression, and microsatellite instability (MSI of sporadic, HNPCC, and familial hyperplastic polyps (HPs. Methods. Methylation-specific PCR (MSP and pyrosequencing assessed p16, MGMT, hMLH-1, MINT 1, and MINT 31 methylation. IHC (Immunohistochemistry assessed Ki67, CK20, hMLH-1, hMSH-2, and hMSH-6 protein expression. MSI analysis was performed on those polyps with adequate DNA remaining. Results. 124 HPs were identified 78 sporadic, 21 HNPCC, 25 familial, and the HNPCC group demonstrated no significant differences in overall methylation (P=.186 Chi2. The familial group demonstrated significantly less over all methylation levels (P=.004 Chi2. Conclusions. HPs that occur in HNPCC have no more worrying features at a molecular level than those patients with HPs in a sporadic setting.

  1. Prevalence and risk factors of the gallbladder polyps diagnosed by ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mi Hwa; Cho, Pyong Kon [Dept. of Radiological science, Catholic University of Daegu, Daegu (Korea, Republic of); Kwon, Duck Moon [Dept. of Diagnostic Radiology, Daegu Health College, Daegu (Korea, Republic of)

    2015-06-15

    This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. Although there are many studies reporting the prevalence and risk factors of GB polyp, the results varied among each report. The aims of this study were to evaluate the prevalence rate and risk factors of GB polyp, colon polyp and fatty liver in the population who underwent health screening. The study population consisted of 4,877 visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. The prevalence of GB polyp was evaluated along with age, gender, metabolic syndrom, body mass index (BMI), Fatty liver, Colon polyp. A showed of total 383 (7.9%) people were found to have GB polyps. The prevalence of sex among 256 (9.8%) patients men and 127 (5.6%) women which showed significantly higher in male than in female subjects(p=0.001). The mean size of the GB polyps 4.92 mm (1.6-17 mm). The sizes of most GB polyps (73.6%) were less than 10 mm in diameter. 122 subjects (31.28%) had multiple GB polyps which 2 or more polyps and 261 subjects (68.2%) had single polyp. Independent risk factors related with GB polyp were male gender (OR 0.551, p<0.001), overweight that BMI above 23 kg/m{sup 2} (OR 0.713, p=0.002) triglyceride (OR 0.571, p<0.001), metabolic syndrome (OR 0.049, p=0.033) and colon polyp (OR 1.409, p=0.002). In spite of the conclusion, the prevalence GB polyp was higher than previous Korea and other country reports. The GB polyp in a healthy population was results as 7.9%. The risk factors of GB polyps were found to be male, being overweight, triglyceride, metabolic syndrome and colon polyp. Not only the subject of a health examination is needed but, a further study of the general public when possible.

  2. Prevalence and risk factors of the gallbladder polyps diagnosed by ultrasound

    International Nuclear Information System (INIS)

    Lee, Mi Hwa; Cho, Pyong Kon; Kwon, Duck Moon

    2015-01-01

    This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. Although there are many studies reporting the prevalence and risk factors of GB polyp, the results varied among each report. The aims of this study were to evaluate the prevalence rate and risk factors of GB polyp, colon polyp and fatty liver in the population who underwent health screening. The study population consisted of 4,877 visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. The prevalence of GB polyp was evaluated along with age, gender, metabolic syndrom, body mass index (BMI), Fatty liver, Colon polyp. A showed of total 383 (7.9%) people were found to have GB polyps. The prevalence of sex among 256 (9.8%) patients men and 127 (5.6%) women which showed significantly higher in male than in female subjects(p=0.001). The mean size of the GB polyps 4.92 mm (1.6-17 mm). The sizes of most GB polyps (73.6%) were less than 10 mm in diameter. 122 subjects (31.28%) had multiple GB polyps which 2 or more polyps and 261 subjects (68.2%) had single polyp. Independent risk factors related with GB polyp were male gender (OR 0.551, p<0.001), overweight that BMI above 23 kg/m 2 (OR 0.713, p=0.002) triglyceride (OR 0.571, p<0.001), metabolic syndrome (OR 0.049, p=0.033) and colon polyp (OR 1.409, p=0.002). In spite of the conclusion, the prevalence GB polyp was higher than previous Korea and other country reports. The GB polyp in a healthy population was results as 7.9%. The risk factors of GB polyps were found to be male, being overweight, triglyceride, metabolic syndrome and colon polyp. Not only the subject of a health examination is needed but, a further study of the general public when possible

  3. Pregnancy does not influence colonic polyp multiplicity but may modulate upper gastrointestinal disease in patients with FAP.

    Science.gov (United States)

    Suraweera, Nirosha; Latchford, Andrew; McCart, Amy; Rogers, Pauline; Spain, Sarah; Sieber, Oliver; Phillips, Robin; Tomlinson, Ian; Silver, Andrew

    2007-08-01

    Reproductive factors have been shown by epidemiology studies to alter colorectal cancer risk in women. Familial adenomatous polyposis (FAP) patients carry a germline adenomatous polyposis coli (APC) mutation predisposing to multiple adenoma formation in the intestine. The Min mouse provides a good model of FAP, and we recently reported a significant increase in intestinal tumour multiplicity in a recombinant line of mice following pregnancy. We considered whether reproduction modulates intestinal tract disease in a large cohort of female patients with FAP (n = 180). Multiple regression analysis showed that the number of colonic polyps observed was not related to the person's pregnancy status nor the position of their APC germline mutation. The proportion of women attaining a high Spigelman stage (3 or 4) was unrelated to having a pregnancy prior to attaining the maximum Spigelman stage (p = 0.6). On the other hand, having a pregnancy significantly increased the proportion of women that attained the highest Spigelman stage when their APC germline mutation occurred within the mutation cluster region or at or after codon 1020 (50%, 6/12, p = 0.005 and 42%, 13/31, p = 0.006, respectively; multivariable logistic regression). Our data suggest that reproduction may influence disease severity in the upper gastrointestinal tract in patients with FAP.

  4. Severe dyspnea due to a giant antrochoanal polyp

    OpenAIRE

    Coloma-Milano M; Gil-Carcedo-Sañudo E; Gil-Carcedo-García LM.; Martín-Batista S; Madrigal-Revuelta M; Vallejo-Valdezate LA

    2012-01-01

    SummaryIntroduction: The antrochoanal polyp is a prevalent pathology in teenagers and young adults. It usually presents with nasal obstruction.Patient and method: Case report: An 80-year-old male with alcoholic encephalopathy, chronic bronchial disease of unknown etiology and polypoid chronic rhinosinusitis came to the emergency service with severe dyspnea without laryngeal features.Anterior rhinoscopy showed a polypoid mass in left nostril that prevented the visualization with nasal endoscop...

  5. Rectal inflammatory fibroid polyp in a Nigerian: case report & brief ...

    African Journals Online (AJOL)

    yp of the stomach. Endoscopy. 1990;22(5):203-7. DOI: 10.1055/s-2007-1012848. 2. Hirasaki S, Matsubara M, Ikeda F, Taniguchi H, Suzuki. S. Inflammatory fibroid polyp occurring in the transverse colon diagnosed by endoscopic biopsy. World J Gastroen- terol. 2007; 13(27): 3765-3766. DOI: 10.3748/wjg.v13. i27.3765. 3.

  6. Mast cells are an essential hematopoietic component for polyp development

    OpenAIRE

    Gounaris, Elias; Erdman, Susan E.; Restaino, Clifford; Gurish, Michael F.; Friend, Daniel S.; Gounari, Fotini; Lee, David M.; Zhang, Guoying; Glickman, Jonathan N.; Shin, Kichul; Rao, Varada P.; Poutahidis, Theofilos; Weissleder, Ralph; McNagny, Kelly M.; Khazaie, Khashayarsha

    2007-01-01

    It is generally agreed that most colon cancers develop from adenomatous polyps, and it is this fact on which screening strategies are based. Although there is overwhelming evidence to link intrinsic genetic lesions with the formation of these preneoplastic lesions, recent data suggest that the tumor stromal environment also plays an essential role in this disease. In particular, it has been suggested that CD34+ immature myeloid precursor cells are required for tumor development and invasion. ...

  7. Fully convolutional neural networks for polyp segmentation in colonoscopy

    OpenAIRE

    Rosa Brandao, P.; Mazomenos, E.; Ciuti, G.; Bianchi, F.; Menciassi, A.; Dario, P.; Koulaouzidis, A.; Arezzo, A.; Stoyanov, D.

    2017-01-01

    Colorectal cancer (CRC) is one of the most common and deadliest forms of cancer, accounting for nearly 10% of all forms of cancer in the world. Even though colonoscopy is considered the most effective method for screening and diagnosis, the success of the procedure is highly dependent on the operator skills and level of hand-eye coordination. In this work, we propose to adapt fully convolution neural networks (FCN), to identify and segment polyps in colonoscopy images. We converted three esta...

  8. Gastric Inflammatory Fibroid Polyp Treated by Endoscopic Submucosal Dissection

    Directory of Open Access Journals (Sweden)

    Y. Hattori

    2008-08-01

    Full Text Available The endoscopic examination of a 64-year-old male patient revealed a gastric submucosal tumor in the anterior wall of the gastric antrum. The lesion increased in diameter to 25 mm and was resected completely with endoscopic submucosal dissection (ESD. Histological examination of the submucosal tumor gave a diagnosis of an inflammatory fibroid polyp (IFP. It is suggested that ESD may be an effective and safe therapy for gastric submucosal tumors.

  9. Pathological findings of colorectal polyps analyzed in Curitiba – Brazil

    OpenAIRE

    Renato Nisihara; Francine Fudalli; Mariana Luísa Mafra Turra; Rhuanna Margareth Malanche; Soraia Heloise Benassi; Ana Paula Piai Pimenta; Danielle Giacometti Sakamoto

    2017-01-01

    Context: Colorectal cancer is the third leading cause of death from malignancy in the world and the fourth leading cause in Brazil's ranks. Adenomatous polyps are considered premalignant lesions, and its resection reduces both morbidity and mortality rates. Objectives: Investigate the prevalence of premalignant lesions and correlate it with age and gender, as well as with the lesion found profile: location, morphology, histology and grade dysplasia. Methods: This was a retrospective, observat...

  10. Adenomatous Polyps in Adolescent Girl and Boy: A Report of Two Cases.

    Science.gov (United States)

    Vahedi Larijani, Laleh; Ghasemi, Maryam; Karami, Hassan

    2016-01-01

    A polyp is defined as a mass of the mucosal surface that protrudes into the lumen of the gastrointestinal tract. Neoplastic epithelial polyps are classified histologically as either benign adenoma or malignant carcinoma. The colonic polyps that most commonly present in children occur sporadically and individually and are of the juvenile type; they are most frequently associated with painless rectal hemorrhage (which is the most common symptom). Adenomatous polyps are similar to other nontumoral polyps, and it is very rare for children to have symptoms other than rectal bleeding. This report describes two rare cases of polyps in pediatric patients. An 11-year-old girl presented with tubulovillous adenoma and a 13-year-old boy with tubular adenoma; both patients complained of rectal hemorrhage as well as anemia and abdominal pain. Epithelial adenoma is a tumor that is rarely found in adults or children. Colonoscopic perforation and biopsy are mandatory for establishing a definitive diagnosis and avoiding medical mismanagement.

  11. Endometrial polyps and associated factors in Danish women aged 36-74 years

    DEFF Research Database (Denmark)

    Dreisler, Eva; Sorensen, Soren Stampe; Lose, Gunnar

    2008-01-01

    OBJECTIVE: To identify factors associated with endometrial polyps. STUDY DESIGN: Case-control study of 140 women with endometrial polyps and 367 controls. Information on potentially associated factors was obtained by a validated questionnaire. RESULTS: In an age-adjusted logistic regression model......, the following was positively associated with endometrial polyps: current use of hormone therapy (odds ratio, 2.81; 95% CI, 1.29-6.13) and being overweight (body mass index > 25 kg/m(2)) (odds ratio, 2.06; 95% CI, 1.12-3.79) (postmenopausal women). Negatively associated was use of oral contraceptive pills (odds...... ratio, 0.20; 95% CI, 0.06-0.66). Histopathology diagnosed benign endometrial polyps (n = 137), polyp with premalignant disease (n = 3), and benign polyp with concomitant complex hyperplasia/endometrial cancer (n = 3). CONCLUSION: Being overweight and current use of hormone therapy in postmenopausal...

  12. Improving Polyp Detection Algorithms for CT Colonography: Pareto Front Approach

    Science.gov (United States)

    Huang, Adam; Li, Jiang; Summers, Ronald M.; Petrick, Nicholas; Hara, Amy K.

    2010-01-01

    We investigated a Pareto front approach to improving polyp detection algorithms for CT colonography (CTC). A dataset of 56 CTC colon surfaces with 87 proven positive detections of 53 polyps sized 4 to 60 mm was used to evaluate the performance of a one-step and a two-step curvature-based region growing algorithm. The algorithmic performance was statistically evaluated and compared based on the Pareto optimal solutions from 20 experiments by evolutionary algorithms. The false positive rate was lower (palgorithm than by the one-step for 63% of all possible operating points. While operating at a suitable sensitivity level such as 90.8% (79/87) or 88.5% (77/87), the false positive rate was reduced by 24.4% (95% confidence intervals 17.9–31.0%) or 45.8% (95% confidence intervals 40.1–51.0%) respectively. We demonstrated that, with a proper experimental design, the Pareto optimization process can effectively help in fine-tuning and redesigning polyp detection algorithms. PMID:20548966

  13. Surveillance of colonic polyps: Are we getting it right?

    Science.gov (United States)

    Bonnington, Stewart N; Rutter, Matthew D

    2016-02-14

    Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The identification of colonic polyps can reduce CRC mortality through earlier diagnosis of cancers and the removal of polyps: the precursor lesion of CRC. Following the finding and removal of colonic polyps at an initial colonoscopy, some patients are at an increased risk of developing CRC in the future. This is the rationale for post-polypectomy surveillance colonoscopy. However, not all individuals found to have colonic adenomas have a risk of CRC higher than that of the general population. This review examines the literature on post-polypectomy surveillance including current international clinical guidelines. The potential benefits of surveillance procedures must be weighed against the burden of colonoscopy: resource use, the potential for patient discomfort, and the risk of complications. Therefore surveillance colonoscopy is best utilised in a selected group of individuals at a high risk of developing cancer. Further study is needed into the specific factors conferring higher risk as well as the efficacy of surveillance in mitigating this risk. Such evidence will better inform clinicians and patients of the relative benefits of colonoscopic surveillance for the individual. In addition, the decision to continue with surveillance must be informed by the changing profile of risks and benefits of further procedures with the patient's advancing age.

  14. Giant fibrovascular polyp of the esophagus: report of a case.

    Science.gov (United States)

    Goenka, Ajit Harishkumar; Sharma, Sanjay; Ramachandran, Vijay; Chattopadhyay, Tushar K; Ray, Ruma

    2011-01-01

    A fibrovascular polyp is a peculiar nonepithelial tumor of the esophagus that invariably arises in the cervical esophagus at the level of the thoracic inlet and grows distally into a massive elongated, pedunculated, intraluminal lesion. Although it is a benign lesion that is eminently resectable, it is a dramatic entity owing to its tendency to cause bizarre complications such as asphyxia and sudden death when it regurgitates into the pharynx and causes laryngeal impaction. This report describes the multimodality imaging appearance of an archetypal case of a giant fibrovascular polyp in a patient with a seemingly innocuous presentation for the size of the lesion. The essential role of cross-sectional imaging in establishing a prompt diagnosis, defining the tissue elements of the mass, and delineation of the exact extent of the lesion in guiding the treatment approach is highlighted. The appearance of fibrovascular polyp in a single patient with a combination of barium swallow, multidetector computed tomography, and high-resolution contrast-enhanced magnetic resonance imaging has not been reported previously.

  15. Hyperspectral imaging of colonic polyps in vivo (Conference Presentation)

    Science.gov (United States)

    Clancy, Neil T.; Elson, Daniel S.; Teare, Julian

    2017-02-01

    Standard endoscopic tools restrict clinicians to making subjective visual assessments of lesions detected in the bowel, with classification results depending strongly on experience level and training. Histological examination of resected tissue remains the diagnostic gold standard, meaning that all detected lesions are routinely removed. This subjects the patient to risk of polypectomy-related injury, and places significant workload and economic burdens on the hospital. An objective endoscopic classification method would allow hyperplastic polyps, with no malignant potential, to be left in situ, or low grade adenomas to be resected and discarded without histology. A miniature multimodal flexible endoscope is proposed to obtain hyperspectral reflectance and dual excitation autofluorescence information from polyps in vivo. This is placed inside the working channel of a conventional colonoscope, with the external scanning and detection optics on a bedside trolley. A blue and violet laser diode pair excite endogenous fluorophores in the respiration chain, while the colonoscope's xenon light source provides broadband white light for diffuse reflectance measurements. A push-broom HSI scanner collects the hypercube. System characterisation experiments are presented, defining resolution limits as well as acquisition settings for optimal spectral, spatial and temporal performance. The first in vivo results in human subjects are presented, demonstrating the clinical utility of the device. The optical properties (reflectance and autofluorescence) of imaged polyps are quantified and compared to the histologically-confirmed tissue type as well as the clinician's visual assessment. Further clinical studies will allow construction of a full robust training dataset for development of classification schemes.

  16. Exploring Deep Learning and Transfer Learning for Colonic Polyp Classification

    Directory of Open Access Journals (Sweden)

    Eduardo Ribeiro

    2016-01-01

    Full Text Available Recently, Deep Learning, especially through Convolutional Neural Networks (CNNs has been widely used to enable the extraction of highly representative features. This is done among the network layers by filtering, selecting, and using these features in the last fully connected layers for pattern classification. However, CNN training for automated endoscopic image classification still provides a challenge due to the lack of large and publicly available annotated databases. In this work we explore Deep Learning for the automated classification of colonic polyps using different configurations for training CNNs from scratch (or full training and distinct architectures of pretrained CNNs tested on 8-HD-endoscopic image databases acquired using different modalities. We compare our results with some commonly used features for colonic polyp classification and the good results suggest that features learned by CNNs trained from scratch and the “off-the-shelf” CNNs features can be highly relevant for automated classification of colonic polyps. Moreover, we also show that the combination of classical features and “off-the-shelf” CNNs features can be a good approach to further improve the results.

  17. Deep learning of contrast-coated serrated polyps for computer-aided detection in CT colonography

    Science.gov (United States)

    Näppi, Janne J.; Pickhardt, Perry; Kim, David H.; Hironaka, Toru; Yoshida, Hiroyuki

    2017-03-01

    Serrated polyps were previously believed to be benign lesions with no cancer potential. However, recent studies have revealed a novel molecular pathway where also serrated polyps can develop into colorectal cancer. CT colonography (CTC) can detect serrated polyps using the radiomic biomarker of contrast coating, but this requires expertise from the reader and current computer-aided detection (CADe) systems have not been designed to detect the contrast coating. The purpose of this study was to develop a novel CADe method that makes use of deep learning to detect serrated polyps based on their contrast-coating biomarker in CTC. In the method, volumetric shape-based features are used to detect polyp sites over soft-tissue and fecal-tagging surfaces of the colon. The detected sites are imaged using multi-angular 2D image patches. A deep convolutional neural network (DCNN) is used to review the image patches for the presence of polyps. The DCNN-based polyp-likelihood estimates are merged into an aggregate likelihood index where highest values indicate the presence of a polyp. For pilot evaluation, the proposed DCNN-CADe method was evaluated with a 10-fold cross-validation scheme using 101 colonoscopy-confirmed cases with 144 biopsy-confirmed serrated polyps from a CTC screening program, where the patients had been prepared for CTC with saline laxative and fecal tagging by barium and iodine-based diatrizoate. The average per-polyp sensitivity for serrated polyps >=6 mm in size was 93+/-7% at 0:8+/-1:8 false positives per patient on average. The detection accuracy was substantially higher that of a conventional CADe system. Our results indicate that serrated polyps can be detected automatically at high accuracy in CTC.

  18. Utilizing ultrasonography in the diagnosis of pediatric fibroepithelial polyps causing ureteropelvic junction obstruction.

    Science.gov (United States)

    Wang, Xiao Man; Jia, Li Qun; Wang, Yu; Wang, Ning

    2012-09-01

    Fibroepithelial polyps are a rare cause of ureteropelvic junction (UPJ) obstruction in children. Preoperative US diagnosis of fibroepithelial polyps is infrequently reported, with intravenous pylogram and retrograde pyelography being most commonly used for diagnosis. To recommend the most accurate process for diagnosing this disease in children by assessing a modified ultrasonographic procedure for the diagnosis of fibroepithelial polyps. A retrospective review of US and IVP imaging studies performed in surgically and histologically confirmed cases of fibroepithelial polyps in children. Each child was asked to drink as much water as possible 30 min before the US testing. For US, the renal pelvis, UPJ and the proximal ureter were inspected for an echogenic mass resulting in hydronephrosis. For IVP studies, abdominal plain films were performed at 7, 15 and 30 min following contrast injection. Thirty-five children, 34 boys and 1 girl, had confirmed fibroepithelial polyps. The children ranged in age from 3 to 14 years (mean age 9 years). Clinical presentation included intermittent vague abdominal pain (100%) and/or hematuria (9.7%) for a period ranging from 1 month to 5 years. Of the 35 children (37 polyps), 21 (23 polyps) were correctly diagnosed preoperatively with US, establishing a 62.2% (23/37) US accuracy rate. Twenty polyps were seen on the left, three on the right and two children had bilateral polyps. The masses were all mildly echogenic with defined edges. Eight children (9 polyps) had an IVP consistent with fibroepithelial polyps giving IVP an accuracy rate of 24.3% (9/37). US is an effective screening tool for identifying fibroepithelial polyps causing UPJ obstruction in children.

  19. Computer-assisted polyp matching between optical colonoscopy and CT colonography: a phantom study

    Science.gov (United States)

    Roth, Holger R.; Hampshire, Thomas E.; Helbren, Emma; Hu, Mingxing; Vega, Roser; Halligan, Steve; Hawkes, David J.

    2014-03-01

    Potentially precancerous polyps detected with CT colonography (CTC) need to be removed subsequently, using an optical colonoscope (OC). Due to large colonic deformations induced by the colonoscope, even very experienced colonoscopists find it difficult to pinpoint the exact location of the colonoscope tip in relation to polyps reported on CTC. This can cause unduly prolonged OC examinations that are stressful for the patient, colonoscopist and supporting staff. We developed a method, based on monocular 3D reconstruction from OC images, that automatically matches polyps observed in OC with polyps reported on prior CTC. A matching cost is computed, using rigid point-based registration between surface point clouds extracted from both modalities. A 3D printed and painted phantom of a 25 cm long transverse colon segment was used to validate the method on two medium sized polyps. Results indicate that the matching cost is smaller at the correct corresponding polyp between OC and CTC: the value is 3.9 times higher at the incorrect polyp, comparing the correct match between polyps to the incorrect match. Furthermore, we evaluate the matching of the reconstructed polyp from OC with other colonic endoluminal surface structures such as haustral folds and show that there is a minimum at the correct polyp from CTC. Automated matching between polyps observed at OC and prior CTC would facilitate the biopsy or removal of true-positive pathology or exclusion of false-positive CTC findings, and would reduce colonoscopy false-negative (missed) polyps. Ultimately, such a method might reduce healthcare costs, patient inconvenience and discomfort.

  20. Colorectal polyps and diet: a case-control study in Marseilles.

    Science.gov (United States)

    Macquart-Moulin, G; Riboli, E; Cornée, J; Kaaks, R; Berthezène, P

    1987-08-15

    This study investigates the differences in usual past diet between 252 subjects with newly diagnosed adenomatous or villous polyps of the colon and rectum and a group of 238 hospital controls. Cases and controls were interviewed in hospital by 3 nutritionists using a dietary history questionnaire focused on the diet during the preceding year. Nutrient intake was estimated by means of ad hoc food tables adapted from French and British tables. Out of 16 food groups considered in the analyses, the cases reported lower consumption of oil and potatoes and higher consumption of sugar added to food and drink. Among nutrients, we found that cases had a lower consumption of carbohydrates (not taking into account added sugar), potassium, magnesium and vitamin B6. We found a slightly lower intake of fibre and a slightly higher intake of saturated fat among cases, though neither was statistically significant. Intake values for fibre and for carbohydrates were highly intercorrelated and, due to measurement errors, the effect of one may be masked by the other and vice versa. The hypothesis that some components of carbohydrates (starches, fibre and natural sugars but not added sugar) play a protective role in relation to the biology of tumours of the intestinal tract is considered in further multivariate analyses and in the "Discussion".

  1. Highly purified eicosapentaenoic acid as free fatty acids strongly suppresses polyps in Apc(Min/+) mice.

    Science.gov (United States)

    Fini, Lucia; Piazzi, Giulia; Ceccarelli, Claudio; Daoud, Yahya; Belluzzi, Andrea; Munarini, Alessandra; Graziani, Giulia; Fogliano, Vincenzo; Selgrad, Michael; Garcia, Melissa; Gasbarrini, Antonio; Genta, Robert M; Boland, C Richard; Ricciardiello, Luigi

    2010-12-01

    Although cyclooxygenase (COX)-2 inhibitors could represent the most effective chemopreventive tool against colorectal cancer (CRC), their use in clinical practice is hampered by cardiovascular side effects. Consumption of ω-3-polyunsaturated fatty acids (ω-3-PUFAs) is associated with a reduced risk of CRC. Therefore, in this study, we assessed the efficacy of a novel 99% pure preparation of ω-3-PUFA eicosapentaenoic acid as free fatty acids (EPA-FFA) on polyps in Apc(Min/+) mice. Apc(Min/+) and corresponding wild-type mice were fed control diet (Ctrl) or diets containing either EPA-FFA 2.5% or 5%, for 12 weeks while monitoring food intake and body weight. We found that both EPA-FFA diets protected from the cachexia observed among Apc(Min/+) animals fed Ctrl diet (P acid was replaced by EPA (P < 0.0001), leading to a significant reduction in COX-2 expression and β-catenin nuclear translocation. Moreover, in the EPA-FFA arms, we found a significant decrease in proliferation throughout the intestine together with an increase in apoptosis. Our data make 99% pure EPA-FFA an excellent candidate for CRC chemoprevention. ©2010 AACR.

  2. Directional wavelet based features for colonic polyp classification.

    Science.gov (United States)

    Wimmer, Georg; Tamaki, Toru; Tischendorf, J J W; Häfner, Michael; Yoshida, Shigeto; Tanaka, Shinji; Uhl, Andreas

    2016-07-01

    In this work, various wavelet based methods like the discrete wavelet transform, the dual-tree complex wavelet transform, the Gabor wavelet transform, curvelets, contourlets and shearlets are applied for the automated classification of colonic polyps. The methods are tested on 8 HD-endoscopic image databases, where each database is acquired using different imaging modalities (Pentax's i-Scan technology combined with or without staining the mucosa), 2 NBI high-magnification databases and one database with chromoscopy high-magnification images. To evaluate the suitability of the wavelet based methods with respect to the classification of colonic polyps, the classification performances of 3 wavelet transforms and the more recent curvelets, contourlets and shearlets are compared using a common framework. Wavelet transforms were already often and successfully applied to the classification of colonic polyps, whereas curvelets, contourlets and shearlets have not been used for this purpose so far. We apply different feature extraction techniques to extract the information of the subbands of the wavelet based methods. Most of the in total 25 approaches were already published in different texture classification contexts. Thus, the aim is also to assess and compare their classification performance using a common framework. Three of the 25 approaches are novel. These three approaches extract Weibull features from the subbands of curvelets, contourlets and shearlets. Additionally, 5 state-of-the-art non wavelet based methods are applied to our databases so that we can compare their results with those of the wavelet based methods. It turned out that extracting Weibull distribution parameters from the subband coefficients generally leads to high classification results, especially for the dual-tree complex wavelet transform, the Gabor wavelet transform and the Shearlet transform. These three wavelet based transforms in combination with Weibull features even outperform the state

  3. Colorectal polyps: a clinical, endoscopic and pathologic study in Iranian children.

    Science.gov (United States)

    Haghi Ashtiani, Mohammad Taghi; Monajemzadeh, Maryam; Motamed, Farzaneh; Moradi Tabriz, Hedieh; Mahjoub, Fatemeh; Karamian, Hamid; Najafi Sani, Mehri; Khatami, Gholam Reza; Khodadad, Ahmad; Farahmand, Fatemeh; Fallahi, Gholam Hossein

    2009-01-01

    To study the clinical presentation, histology and colonoscopic features of lower gastrointestinal polyps in Iranian children. Medical reports of children with colorectal polyps were retrospectively reviewed from 1996 to 2005 at the Children's Medical Center Hospital, Iran. A total of 563 cases were studied. Data related to age, sex, family history, signs and symptoms, the size, location, polyp types and associated lesions were collected and analyzed. The mean age of children was 5.66 +/- 2.88 years (range 2 months to 17 years), with a male-to-female ratio of 1.61:1.0. The highest incidence was between ages 2 and 10 years (85.1%). Rectal bleeding was the presenting symptom in 78.5% cases. The polyps were solitary in 94% of cases. A majority of polyps (86.3%) were juvenile and 86.7% located in the rectosigmoid area. Three percent of cases had a positive family history. One case of Turcot syndrome was also identified. Juvenile polyps remain the most common polyps in Iranian children. Although the presence of a solitary polyp in the rectosigmoid colon is more prevalent, in a significant number of cases they are multiple and located in proximal parts. Polyps must be removed even when asymptomatic because of their probable neoplastic potential. Copyright 2008 S. Karger AG, Basel.

  4. Complex rectal polyps: other treatment modalities required when offering a transanal endoscopic microsurgery service.

    LENUS (Irish Health Repository)

    Joyce, Myles R

    2011-09-01

    Complex rectal polyps may present a clinical challenge. The study aim was to assess different treatment modalities required in the management of patients referred for transanal endoscopic microsurgery.

  5. Endoscopic management of a rare granulation polyp in a colonic diverticulum.

    Science.gov (United States)

    Mori, Hirohito; Tsushimi, Takaaki; Kobara, Hideki; Nishiyama, Noriko; Fujihara, Shintaro; Matsunaga, Tae; Ayagi, Maki; Yachida, Tatsuo; Masaki, Tsutomu

    2013-12-28

    There are many case reports on colon diverticula that cause irritable bowel syndrome, constipation, bleeding, diverticulitis, stricture due to multiple recurrences of diverticulitis, and perforation. However, few articles have examined neoplasms that arise from a diverticulum, such as adenoma and adenocarcinoma, and there have been no reports of granulation polyps that arise from a colon diverticulum after recurrent diverticulitis. We observed a rare granulation polyp that arose from a diverticulum as a result of repeated episodes of local diverticulitis. Narrow band imaging magnified colonoscopy was very useful to diagnose the polyp as a granulation polyp because of the absence of a pit pattern on the surface of the polyp. We successfully resected the polyp using endoscopic mucosal resection. We inverted the diverticulum, and the resected stalk of the polyp was used to close the diverticulum with an over-the-scope clip. If a granulomatous polyp could arise from a diverticulum, differential diagnosis between a colon neoplasm and a granulomatous polyp would not only be difficult but also necessary for suitable endoscopic treatment.

  6. Diagnosis and management of ureteral fibroepithelial polyps in children: a new treatment algorithm.

    Science.gov (United States)

    Li, R; Lightfoot, M; Alsyouf, M; Nicolay, L; Baldwin, D D; Chamberlin, D A

    2015-02-01

    Fibroepithelial polyps are benign mesenchymal tumors arising from the urinary tract. With the advent of endoscopy in the pediatric population, more reports of endoscopic diagnosis and treatment have appeared. The present study reports experience with the diagnosis and treatment of fibroepithelial polyps of the upper urinary tract in the pediatric population. Incorporating past experience from literature, we propose an algorithm to guide the clinical diagnosis and treatment plan. Four pediatric patients undergoing pyeloplasty for ureteropelvic junction (UPJ) obstruction were diagnosed with ureteral polyps. Their demographics, radiologic, surgical and pathologic information were reviewed. In addition, a comprehensive literature search using the MEDLINE database yielded 37 reports containing 126 cases of ureteral polyps, including 5 series with 57 cases and 9 cases of synchronous bilateral ureteral polyps. Of 123 pediatric patients undergoing pyeloplasty from 2008 to 2013, four (3.3%) were found to have fibroepithelial polyps of the upper urinary tract. All patients were male and the mean age of presentation was 12 years. Ureteral polyps predominantly occurred unilaterally in the left ureter (75%) and one case of bilateral ureteral polyps was encountered. Along with three other recent case series [1-3], the combined incidence of ureteral polyps in patients undergoing evaluation for ureteral obstruction was 5.2%. Intraoperative retrograde pyelogram was used to identify filling defects in 4 of 5 affected ureters (see Figure). Ureterorenoscopy was performed in all three patients with filling defects for polyp mapping along the ureter and evaluation of the macroscopic polyp appearance. Based on ureteroscopic findings, Holmium laser polypectomy was performed in two patients with single, pedunculated polyps. Anderson-Hynes dismembered pyeloplasty was performed in three patients with broad based, multilobulated polyps too large for endoscopic treatment and in one patient for

  7. Where are the polyps? Molecular identification, distribution and population differentiation ofAurelia auritajellyfish polyps in the southern North Sea area.

    Science.gov (United States)

    van Walraven, Lodewijk; Driessen, Floor; van Bleijswijk, Judith; Bol, Anneke; Luttikhuizen, Pieternella C; Coolen, Joop W P; Bos, Oscar G; Gittenberger, Adriaan; Schrieken, Niels; Langenberg, Victor T; van der Veer, Henk W

    For many species of metagenic jellyfish the location of the benthic polyps is unknown. To gain insight in the distribution, species composition and population structure of scyphozoan jellyfish polyps in the southern North Sea area, polyp samples were collected from natural and artificial substrates (settling plates, marina floats and wrecks) at ten inshore locations in the Netherlands, seven offshore locations in the North Sea and in the Gullmar Fjord in Sweden. Polyps were identified to species level by sequencing both a fragment of 18S rDNA and a fragment of mitochondrial COI, and comparing these sequences to reference sequences available in GenBank and to newly obtained sequences from medusae collected in the area. All polyps sequenced did belong to Aurelia aurita . For this species, molecular diversity in mitochondrial COI was high, with 50 haplotypes among 183 polyps. Population differentiation was detected between the Dogger Bank and other-more coastal-locations, indicating extremely low connectivity. No significant differences were found between coastal samples. The location of polyps of Cyanea capillata , Cyanea lamarckii , Chrysaora hysoscella and Rhizostoma octopus in the study area remains unresolved.

  8. Cyclooxygenase-2 overexpression is common in serrated and non-serrated colorectal adenoma, but uncommon in hyperplastic polyp and sessile serrated polyp/adenoma

    Directory of Open Access Journals (Sweden)

    Kirkner Gregory J

    2008-01-01

    Full Text Available Abstract Background Cyclooxygenase-2 (COX-2, PTGS2 plays an important role in colorectal carcinogenesis. COX-2 overexpression in colorectal cancer is inversely associated with microsatellite instability (MSI and the CpG island methylator phenotype (CIMP. Evidence suggests that MSI/CIMP+ colorectal cancer may arise through the serrated tumorigenic pathway through various forms of serrated neoplasias. Therefore, we hypothesized that COX-2 may play a less important role in the serrated pathway. Methods By immunohistochemistry, we assessed COX-2 expression in 24 hyperplastic polyps, 7 sessile serrated polyp/adenomas (SSA, 5 mixed polyps with SSA and adenoma, 27 traditional serrated adenomas, 515 non-serrated adenomas (tubular adenoma, tubulovillous adenoma and villous adenoma, 33 adenomas with intramucosal carcinomas, 96 adenocarcinomas with serration (corkscrew gland and 111 adenocarcinomas without serration. Results Strong (2+ COX-2 overexpression was more common in non-serrated adenomas (28% = 143/515 than in hyperplastic polyps (4.2% = 1/24, p = 0.008 and serrated polyps (7 SSAs and 5 mixed polyps (0% = 0/12, p = 0.04. Furthermore, any (1+/2+ COX-2 overexpression was more frequent in non-serrated adenomas (60% = 307/515 than in hyperplastic polyps (13% = 3/24, p Conclusion COX-2 overexpression is infrequent in hyperplastic polyp, SSA and mixed polyp with SSA and adenoma, compared to non-serrated and serrated adenoma. COX-2 overexpression becomes more frequent as tumors progress to higher grade neoplasias. Our observations suggest that COX-2 may play a less significant role in the serrated pathway of tumorigenesis; however, COX-2 may still play a role in later stage of the serrated pathway.

  9. [A modified guaiac test for the early detection of tumors of the intestinal tract (author's transl)].

    Science.gov (United States)

    Warm, K; Blazek, Z; Weithofer, G; Bloch, R

    1977-03-04

    Of 1400 patients who were submitted to the Haemoccult test, 46 showed a postive result. Among other things there were 29 polyps, of which 3 already showed a focal carcinoma, and 5 carcinomata of the large intestine and 3 gastric carcinomata were also diagnosed. Over 70% of the tumor hosts had observed bleeding per anum at some time. In order to detect the number of false nagative results, patients were investigated in the same way even when the Haemoccult test had been negative three times. In this way 55 polyps were found as well as 7 partly advanced carcinomata of the large intestine. 35% of the Haemoccult-negative patients stated bleeding per anum in their history. The number of false negative findings must be considerably higher than previously estimated.

  10. Experience with juvenile polyps in North American children: the need for pancolonoscopy.

    Science.gov (United States)

    Gupta, S K; Fitzgerald, J F; Croffie, J M; Chong, S K; Pfefferkorn, M C; Davis, M M; Faught, P R

    2001-06-01

    We report a recent experience with juvenile polyps (JP) in a large cohort of North American children to determine if a pancolonoscopy (PC) is needed in all children with suspected polyps. We reviewed hospital charts of all patients with JP seen over a 9-yr period (January, 1990-October, 1998). A total of 331 JP were encountered during 195 procedures in 184 patients (64% males, 88% white, mean age 5.93 yr [range 0.42-15.5 yr], median age 4.84 yr). Painless rectal bleeding was the commonest symptom. PC was performed in 42% (82/195) of procedures, and 177 JP were encountered: 54% (97/177) were in the rectosigmoid colon, 14% (24/177) were in the descending colon, and 32% (56/177) were proximal to the splenic flexure (i.e., proximal polyps). Overall, proximal polyps were seen in 37% (31/82) of PC. Only proximal polyps were noted in 12% (10/82) of PC. Five patients were re-endoscoped after an initial limited examination because of continuing symptoms from proximal polyps. All but one of the polyps had typical features of a JP on histological examination. Though most JP are located in the left colon, a PC should be the initial procedure because: 1) 37% of PC revealed proximal polyps, 2) 32% of polyps were located proximal to splenic flexure, 3) persistence of symptoms from missed proximal polyp(s) necessitates a repeat study with attendant risks, and 4) there is a possibility of malignant transformation in an unidentified JP.

  11. Robot-Assisted Laparoscopic Excision of Ureteral and Ureteropelvic Junction Fibroepithelial Polyps in Children.

    Science.gov (United States)

    Osbun, Nathan; Ellison, Jonathan S; Lendvay, Thomas S

    2016-08-01

    Fibroepithelial polyps of the ureter are a rare cause of asymptomatic and symptomatic upper urinary tract obstruction in children. While these lesions can often be managed endoscopically, large or multifocal polyps may preclude such an approach. We aim to describe our institutional experience with robot-assisted laparoscopic treatment of ureteral polyps and show that a robotic approach is an effective alternative for large or multifocal polyps. Four children were identified with ureteral polyps over a 5-year period and underwent transperitoneal robot-assisted laparoscopic excision. Patients presented with flank pain and/or worsening hydronephrosis. All patients were evaluated preoperatively with ultrasound and Tc99m-mercaptoacetyltriglycine (MAG3) diuretic renogram or MR urogram. Retrograde pyelography corroborated the diagnosis of ureteral polyps. We reviewed the charts of these patients and compared the specific robotic approach for each patient, length of hospitalization, surgical complications, need for additional procedures, and resolution of symptoms and hydronephrosis. In one patient, more than 20 polyps were identified over a long ureteral segment and all were excised; for the remaining three patients, 1 to 2 polyps were found. Mean postoperative length of stay was 1.5 days. One patient developed a ureteral stricture requiring repeat ureteroureterostomy, and another patient required repeat retrograde pyelography for gross hematuria that occurred several months after surgery. No polyps or obstruction was observed on retrograde pyelography in these patients. Mean duration of follow-up was 29 months (9-62 months). Symptoms and degree of hydronephrosis have improved in the three patients who have been followed for at least 12 months. Robot-assisted laparoscopy is a safe and feasible alternative to endoscopic treatment of fibroepithelial ureteral polyps. The robotic platform may be preferred in cases of multifocal or large ureteral polyps, or in cases in which a

  12. Ureteral polyps: an etiological factor of hydronephrosis in children that should not be ignored.

    Science.gov (United States)

    Niu, Zhi Bin; Yang, Yi; Hou, Ying; Chen, Hui; Wang, Chang Lin

    2007-04-01

    To better define the demographics, urothelial distribution and typical gross anatomic and radiologic appearances of fibroepithelial polyps of the ureter in children. We reviewed 15 cases of fibroepithelial polyps of the ureter with hydronephrosis from the archives of our department. Data were collected from radiographic studies, gross anatomic pathology and pathology and radiology reports and categorized by age, sex, clinical presentation, lesion size and location. The mean patient age was 9.1 years, and 80% were male. All of them presented with hematuria and/or flank pain. The polyps were located in the upper ureter or ureteropelvic junction (UPJ) and pelvis. Of the polyps, 60% were multiple polyps or filiform, and 40% were single or bilobed and 1-6 cm in size. Only four cases showed typical filling defect on intravenous urography. In five cases, sonography showed a mildly echogenic structure extending into the ureter from the renal pelvis. Enhanced CT revealed soft tissue filling UPJ or/and proximal ureter in six cases, and hydroureter was found in one case by three-dimensional (3D) image. Fibroepithelial polyps were diagnosed in all cases by postoperative histological examination. Fibroepithelial polyps are the most common benign tumors of the ureter. Congenital factor may be associated with the origin of fibroepithelial polyps in children. The preoperative diagnosis of ureteral polyps is difficult. A history of flank pain, hematuria or both, other than abdominal mass, light-to-moderate hydronephrosis with soft-tissue in UPJ or upper ureter, shown by sonography and radiological examination, may help in the diagnosis of ureteral polyps in children. Ureteral polyps should be recognized as an important etiology for hydronephrosis in children.

  13. Identification of volumetric laser endomicroscopy features of colon polyps with histologic correlation.

    Science.gov (United States)

    Trindade, Arvind J; Rishi, Arvind; Hirten, Robert; Inamdar, Sumant; Sejpal, Divyesh V; Colombel, Jean-Frederic

    2018-02-23

    There are limited data on the use of volumetric laser endomicroscopy (VLE) for imaging colon polyps. Our aim was to identify VLE features of colon polyps. A total of 45 patients were included; 43 underwent endoscopic mucosal resection of colorectal polyps 2 cm or greater. These polyps were then scanned with VLE immediately after resection. Two patients who underwent partial colonic resection served as controls. Forty-three polyps were included with review of matching histology: 3 intramucosal cancer (IMCA), 5 tubular adenoma (TAs)/tubulovillous adenoma (TVA) with high-grade dysplasia (HGD), 9 TVA with only low-grade dysplasia (LGD), 5 serrated adenoma, and 21 TA with LGD. All TAs and TVAs were hyper-reflective compared with normal tissue. Effacement occurred in 82.4% (14/17) of the colonic polyps with advanced pathology (TVA with HGD/IMCA) compared with 11.6% (3/26) with non-advanced pathology (TA with LGD and serrated adenoma) (P VLE compared with none in the non-advanced pathology group (P = .0001). An irregular surface mainly occurred in polyps with high-grade pathology (HGD/IMCA) versus TAs. Eighty-eight percent of polyps with HGD/IMC had an irregular surface (7/8) versus 6% (2/35) of TAs (P VLE features of colon polyps that may help identify polyps or features of a higher-grade lesion. This may have implications for possible in vivo application to aid in dysplasia or polyp detection. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  14. Long-term risk of colorectal cancer in patients with sessile serrated adenomas, traditional serrated adenomas, and hyperplastic polyps

    DEFF Research Database (Denmark)

    Baron, John A; Erichsen, Rune; Hamilton-Dutoit, Stephen Jacques

    Long-term risk of colorectal cancer in patients with sessile serrated adenomas, traditional serrated adenomas, and hyperplastic polyps......Long-term risk of colorectal cancer in patients with sessile serrated adenomas, traditional serrated adenomas, and hyperplastic polyps...

  15. Adult Langerhans cell histiocytosis presenting as metachronous colonic polyps

    Directory of Open Access Journals (Sweden)

    Aloísio Felipe-Silva

    2013-03-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare disease characterized by proliferation of Langerhans-type cells that express CD1a, Langerin (CD207 and S100 protein. Birbeck granules are a hallmark by ultrastructural examination. LCH presents with a wide clinical spectrum, ranging from solitary lesions of a single site (usually bone or skin to multiple or disseminated multisystemic lesions, which can lead to severe organ dysfunction. Most cases occur in children. Gastrointestinal tract involvement is rare and has been associated with systemic illness and poor prognosis especially in children under the age of 2 years. Adult gastrointestinal LCH is very rare. We report a case of a previously healthy, nonsmoking 48-year-old male who was referred for routine screening colonoscopy. Two sessile, smooth, firm and yellowish LCH polyps measuring 0.2 cm and 0.3 cm were detected in the sigmoid colon. Fifteen months later a second colonoscopy found two histologically confirmed hyperplastic polyps at the sigmoid colon. No other LCH lesions were seen. A third colonoscopy after 28 months of follow-up found a submucosal 0.5 cm infiltrated and ulcerated LCH polyp in the cecum, close to the ostium of the appendix. The patient had been asymptomatic for all this period. Imaging investigation for systemic or multiorgan disease did not find any sign of extracolonic involvement. On histology all lesions showed typical LCH features and immunohistochemical analysis showed strong and diffuse staining for CD1a and CD207. This case illustrates two distinct clinicopathologic features not previously reported in this particular clinical setting: metachronous colonic involvement and positivity for CD207.

  16. Alcohol hyper-responsiveness in chronic rhinosinusitis with nasal polyps.

    Science.gov (United States)

    De Schryver, Els; Derycke, Lara; Campo, Paloma; Gabriels, Eline; Joos, Guy F; Van Zele, Thibaut; Bachert, Claus; Hellings, Peter W; Gevaert, Philippe

    2017-02-01

    An important percentage of subjects diagnosed with chronic upper airway disease report alcohol-induced worsening of their symptoms. The prevalence and characteristics of respiratory reactions provoked by alcohol-containing drinks have not been fully investigated yet. The aim of this study was to estimate the prevalence and characteristics of alcohol hyper-responsiveness in patients with chronic airway disease and healthy controls. Furthermore, nasal inflammation was evaluated in nasal polyp patients with and without hyper-responsiveness. We evaluated the prevalence and characteristics of alcohol-induced respiratory complaints in 1281 subjects. Chronic rhinosinusitis with nasal polyps (CRSwNP) patients with and without NSAID exacerbated respiratory disease (NERD), chronic rhinosinusitis patients without nasal polyps (CRSsNP), allergic rhinitis (AR) patients and healthy controls were approached by means of a questionnaire. Inflammatory markers (eosinophilic cationic protein (ECP), IL-5, IgE, SAE-specific IgE, IL-17, TNFα and IFNγ) in tissue were then compared between alcohol hyper-responsive and non-hyper-responsive CRSwNP patients. The highest prevalence of nasal and bronchial alcohol hyper-responsiveness was observed in patients with NERD, followed by CRSwNP, and less frequent in CRSsNP, AR and healthy controls. Alcohol hyper-responsiveness is significantly more prevalent in CRSwNP patients suffering from recurrent disease and in patients with severe symptomatology. In nasal tissue of the hyper-responsive CRSwNP group, we observed significantly higher nasal levels of the eosinophilic biomarker ECP. Nasal hyper-responsiveness to alcohol is significantly more prevalent in severe eosinophilic upper airway disease. © 2016 John Wiley & Sons Ltd.

  17. Pulp polyp - A periapical lesion: Radiographic observational study

    Directory of Open Access Journals (Sweden)

    Kandagal V Suresh

    2015-01-01

    Full Text Available Introduction: Pulp polyp (PP is a chronic hyperplastic condition resulting in formation of granulation tissue and proliferative mass. The radiographic appearance of PP has innumerable presentations. Diagnosing and treatment planning of periapical lesions, heavily relies on the radiographic changes surrounding the root structures. Objective: To evaluate different radiographic periapical changes in clinically detected PP patients. Materials and Methods: Patients reporting to Department of Oral Medicine and Radiology and who were clinically diagnosed with PP by an oral diagnostician were subjected to radiographic examination. Digital intraoral periapical radiographs of 50 patients with PP were taken. Various periapical changes in the digital radiographs were recorded by a skilled oral radiologist. The data obtained was subjected to statistical analysis using SPSS ver 17.0 and P-value was set at <0.05 as significant. Result: Periapical changes like periodontal space widening (PDLW, loss of lamina dura, periapical abscess, periapical granuloma, hypercementosis, condensing osteitis and root resorption were noted. Periodontal space widening was seen in all patients (100%, loss of lamina dura was noted in 72%, periapical rarefying osteitis in 56%, condensing osteitis in 8%, hypercementosis, periapical granuloma, and root resorption were seen in 4% of PP patients. Majority of PP were asymptomatic (66%. Pulp polyp was commonly seen in mandibular first molar followed by mandibular second molar and maxillary first molar. Statistically significant difference was noticed between periapical changes in PP patients (P value <0.0001. All PP patients showed definite periapical changes suggesting it to be a periapical lesion. Conclusion: Pulp polyp is confined to the pulpal portion of the tooth which, may or may not cause changes in periapical region. The results of the present study showed that majority of the PP patients were associated with definite periapical

  18. Colonic chicken-skin mucosa in children with polyps is not a preneoplastic lesion.

    Science.gov (United States)

    Nowicki, Michael J; Bishop, Phyllis R; Subramony, Charu; Wyatt-Ashmead, Josephine; May, Warren; Crawford, Maxine

    2005-11-01

    Colonic polyps are common both in adults and children; however, the malignant potential varies according to the type of polyp. Most childhood polyps are solitary juvenile polyps, which have negligible malignant potential. Chicken-skin mucosa (CSM) is an endoscopic finding initially described associated with adenomatous polyps and adenocarcinoma, suggesting a preneoplastic lesion. Subsequently, CSM was described in association with juvenile polyps, suggesting that this mucosal finding is not a precursor to dysplasia. To determine whether CSM represents a preneoplastic lesion, we studied endoscopic colonic mucosal biopsies for markers of cell replication (Ki-67) and malignant transformation (p53) in mucosal biopsies of CSM, normal colonic tissue, tubular adenomas, and adenocarcinomas. Samples were subjected to immunostaining for the presence of Ki-67 and p53. The degree of Ki-67-positive staining cells was similar for CSM and normal colonic tissue, whereas there was significantly increased staining for both tubular adenomas and adenocarcinomas. There was no evidence of p53 staining in CSM and normal colonic mucosa, whereas there was varying degrees of staining in tubular adenomas and adenocarcinomas. The association of CSM with benign juvenile polyps and the absence of histologic markers for increased replication and malignant transformation support the notion that this endoscopic finding is not preneoplastic. Rather, CSM arises in proximity to polyps of all histologic types because of local mucosal damage.

  19. Fibroepithelial polyps causing ureteropelvic junction obstruction in children--a case report and review article.

    Science.gov (United States)

    Cassar Delia, E; Joseph, V T; Sherwood, W

    2007-04-01

    Fibroepithelial polyps are extremely rare benign mesodermal tumours in children that can cause ureteropelvic junction (UPJ) obstruction. We report on a 10-year-old boy presenting with UPJ obstruction due to a fibroepithelial polyp, and review 28 similar published paediatric cases.

  20. Omalizumab is effective in allergic and nonallergic patients with nasal polyps and asthma

    NARCIS (Netherlands)

    Gevaert, Philippe; Calus, Lien; van Zele, Thibaut; Blomme, Katrien; de Ruyck, Natalie; Bauters, Wouter; Hellings, Peter; Brusselle, Guy; de Bacquer, Dirk; van Cauwenberge, Paul; Bachert, Claus

    2013-01-01

    Background: Adult patients with nasal polyps often have comorbid asthma, adding to the serious effect on the quality of life of these patients. Nasal polyps and asthma might represent a therapeutic challenge; inflammation in both diseases shares many features, such as airway eosinophilia, local IgE

  1. Two cases of benign polyps of the posterior urethra (ectopic prostatic tissue)

    OpenAIRE

    多田, 晃司; 山羽, 正義; 田村, 公一; 藤広, 茂; 河田, 幸道

    1990-01-01

    We report two cases of benign polyps of the posterior urethra. Their first symptoms were gross hematuria and urinary frequency. Both specimens obtained by transurethral resection were histologically identified as prostatic tissue. Discussion on benign polyps of the posterior urethra as ectopic prostatic tissue was done with review of literature.

  2. Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients

    Science.gov (United States)

    Lieberman, David; Holub, Jennifer; Moravec, Matthew; Eisen, Glenn; Peters, Dawn; Morris, Cynthia

    2013-01-01

    Context Compared to whites, Black men and women have a higher incidence and mortality from colorectal cancer and may develop cancer at a younger age. Colorectal cancer screening might be less effective in Blacks, if there are racial differences in the age-adjusted prevalence and location of cancer precursor lesions. Objectives To determine and compare the prevalence rates and location of polyp(s) >9mm in asymptomatic Blacks and whites who receive colonoscopy screening. Design, Setting, and Patients Colonoscopy data were prospectively collected from 67 practice sites in the United States using a computerized endoscopic report generator from 2004–2005. Data were transmitted to a central data repository, where all asymptomatic whites (n = 80,061) and Blacks (n = 5464) who received screening colonoscopy were identified. Main outcome measures Prevalence and location of polyp(s) >9mm, adjusted for age, gender, and family history of colorectal cancer in a multivariate analysis. Results Both Black men and women had a higher prevalence of polyp(s) >9mm (7.7 versus 6.2%; p 9mm (OR 1.133; 95% CI 0.93,1.38). However, in a sub-analysis of patients over age 60 years, proximal polyps >9mm were more likely in Black men (p = 0.026) and women (p9mm, and Black over age 60 years are more likely to proximal polyps >9mm. PMID:18812532

  3. Invasive adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp and synchronous transverse colon cancer.

    Science.gov (United States)

    Chen, Chuang-Wei; Hsiao, Koung-Hong; Yue, Chung-Tai; Wang, Chia-Chi

    2013-08-28

    An admixture of hyperplastic and adenomatous components within the same polyp is unusual. Adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp (MHAP) occurs even more rarely. We report the first case of a 59-year-old male who presented with invasive adenocarcinoma originating from a MHAP at a sigmoid colon and synchronous transverse colon cancer.

  4. Invasive adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp and synchronous transverse colon cancer

    OpenAIRE

    Chen, Chuang-Wei; Hsiao, Koung-Hong; Yue, Chung-Tai; Wang, Chia-Chi

    2013-01-01

    An admixture of hyperplastic and adenomatous components within the same polyp is unusual. Adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp (MHAP) occurs even more rarely. We report the first case of a 59-year-old male who presented with invasive adenocarcinoma originating from a MHAP at a sigmoid colon and synchronous transverse colon cancer.

  5. A large hymenal polyp in a 21-year-old virgin:

    OpenAIRE

    Borko, Elko; Došen, Marko; Kavalar, Rajko; Pivec, Gregor; Žebeljan, Ivan

    2009-01-01

    Pathological conditions of the hymen are rare in everyday medical practice. They are usually encountered in the pediatric patient population and are sometimes a matter of forensic interest. We report an interesting case of a large hymenal polyp in an adolescent virgin that presented only a cosmetic problem. The polyp was excised, the hymenal ring was preserved, and the sample was histologically verified.

  6. Cytogenetic comparisons of synchronous carcinomas and polyps in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Bardi, G; Parada, L A; Bomme, L

    1997-01-01

    Thirty tumorous lesions from seven patients with colorectal cancer were short-term cultured and cytogenetically analysed: 16 non-adenomatous polyps, six adenomas, seven carcinomas, including one in polyp, and one lymph node metastasis. Clonal chromosome aberrations were found in 20 samples in 100...

  7. Demographic And Histopathological Characteristics Of Colorectal Polyps: A Descriptive Study Based On Samples Obtained From Symptomatic Patients

    Directory of Open Access Journals (Sweden)

    Cekodhima Genta

    2016-06-01

    Full Text Available Colorectal polyps (CP are common among individuals older than 50 years. Some polyp types can precede colorectal cancer (CRC. This study aimed at describing histopathological characteristics of colorectal polyps in relation to age and gender among symptomatic patients referred for a colonoscopy examination during 2011-2014 in Tirana, Albania.

  8. Intermittent gastric outlet obstruction caused by a prolapsing antral gastric polyp

    Science.gov (United States)

    Parikh, Mehul; Kelley, Brian; Rendon, Gabriel; Abraham, Bincy

    2010-01-01

    Most gastric polyps have an asymptomatic presentation and are an incidental finding on upper endoscopy. Symptomatic presentations can range from an ulcerated polyp leading to anemia and occult bleed to complete gastric outlet obstruction. We report a case of an 89-year-old woman who presented with postprandial nausea and early satiety. Her upper endoscopy revealed a 2 cm pedunculated hyperplastic polyp arising from the antrum of the stomach which was seen prolapsing into the pylorus causing intermittent gastric outlet obstruction. In the present report, we statistically analyzed 39 prolapsing gastric polyps previously reported in the English literature and demonstrate the current utility of monopolar snare polypectomy in establishing a histological diagnosis while offering simultaneous treatment. Additionally, we review the literature for the management of all hyperplastic gastric polyps in relation to advancements in digestive endoscopy. PMID:21160624

  9. [Pathologies of lateral nasal wall in children with diagnosed antrochoanal polyps].

    Science.gov (United States)

    Zakrzewska, Anna; Piotrowska, Violetta; Zieliński, Rafał

    2011-01-01

    Antrochoanal polyps are more frequent in children than in adults. Patomechanism of their development is still unclear. New diagnostic methods allow precise examination of lateral nasal wall pathologies. Aim of the study is an evaluation of endoscopic examinations and CT scans of lateral walls in 15 children with chronic sinusitis and diagnosed antrochanal polyps. Both groups of children, those with chronic sinusitis and those with diagnosed antrochoanal polyps, were compared according to the results of the endocopies and CT scans. Unilateral pathologies of lateral nasal wall, like notable widening of natural ostium in 4 children and additional ostium in 7 children with antrochoanal polyps were noted. In children with chronic sinusitis pathologies were observed bilaterally, in none of them additional ostia were observed and pathologies of lateral nasal wall were typical for chronic inflammatory process or trauma. Diagnosed pathologies of lateral nasal wall in both children are different and need further studies, which may lead to explanation of antrochoanal polyps development.

  10. Comparison of polyp size and volume at CT colonography: implications for follow-up CT colonography.

    Science.gov (United States)

    Bethea, Emily; Nwawka, Ogonna K; Dachman, Abraham H

    2009-12-01

    The purpose of this study was to evaluate the reliability of polyp measurements at CT colonography and the factors that affect the measurements. Fifty colonoscopically proven cases of polyps 6 mm in diameter or larger were analyzed by two observers who measured each polyp in supine and prone views. Manual measurements of 2D volume by summation of areas, 2D maximum diameter, and 3D maximum diameter and automated measurements of 3D maximum diameter and volume were recorded for each observer and were repeated for one of the observers. Intraobserver and interobserver agreement was calculated. Analysis was performed to determine the measurement parameter that correlated most with summation-of-areas volume. Supine and prone measurements as a surrogate for tracking change in polyp size over time were analyzed to determine the measurement parameter with the least variation. Maximum diameter measured manually on 3D images had the highest correlation with summation-of-areas volume. Manual summation-of-areas volume was found to have the least variation between supine and prone measurements. Linear polyp measurement in the 3D endoluminal view appears to be the most reliable parameter for use in the decision to excise a polyp according to current guidelines. In our study, manual calculation of volume with summation of areas was found to be the most reliable measurement parameter for observing polyp growth over serial examinations. High reliability of polyp measurements is essential for adequate assessment of change in polyp size over serial examinations because many patients with intermediate-size polyps are expected to choose surveillance.

  11. Deep ensemble learning of virtual endoluminal views for polyp detection in CT colonography

    Science.gov (United States)

    Umehara, Kensuke; Näppi, Janne J.; Hironaka, Toru; Regge, Daniele; Ishida, Takayuki; Yoshida, Hiroyuki

    2017-03-01

    Robust training of a deep convolutional neural network (DCNN) requires a very large number of annotated datasets that are currently not available in CT colonography (CTC). We previously demonstrated that deep transfer learning provides an effective approach for robust application of a DCNN in CTC. However, at high detection accuracy, the differentiation of small polyps from non-polyps was still challenging. In this study, we developed and evaluated a deep ensemble learning (DEL) scheme for reviewing of virtual endoluminal images to improve the performance of computer-aided detection (CADe) of polyps in CTC. Nine different types of image renderings were generated from virtual endoluminal images of polyp candidates detected by a conventional CADe system. Eleven DCNNs that represented three types of publically available pre-trained DCNN models were re-trained by transfer learning to identify polyps from the virtual endoluminal images. A DEL scheme that determines the final detected polyps by a review of the nine types of VE images was developed by combining the DCNNs using a random forest classifier as a meta-classifier. For evaluation, we sampled 154 CTC cases from a large CTC screening trial and divided the cases randomly into a training dataset and a test dataset. At 3.9 falsepositive (FP) detections per patient on average, the detection sensitivities of the conventional CADe system, the highestperforming single DCNN, and the DEL scheme were 81.3%, 90.7%, and 93.5%, respectively, for polyps ≥6 mm in size. For small polyps, the DEL scheme reduced the number of false positives by up to 83% over that of using a single DCNN alone. These preliminary results indicate that the DEL scheme provides an effective approach for improving the polyp detection performance of CADe in CTC, especially for small polyps.

  12. Clinical, endoscopic, and pathologic characteristics of colorectal polyps in Indian children and adolescents.

    Science.gov (United States)

    Rathi, Chetan; Ingle, Meghraj; Pandav, Nilesh; Pipaliya, Nirav; Choksi, Dhaval; Sawant, Prabha

    2015-11-01

    Colorectal polyps are among the common causes for rectal bleeding in children. We studied the clinical, colonoscopic, and histopathological features of colorectal polyps and polyposis syndrome in Indian children and adolescents. Medical records of children and adolescents with colorectal polyps and polyposis syndrome were retrospectively reviewed from 2001 to 2014 at Department of Gastroenterology, in large tertiary care center of Mumbai. A total of 120 patients were found to have colonic polyps during study period. Mean age of presentation in children was 7.31 ± 4.05 years (range 2 to 19 years), with male-to-female ratio of 2.16:1. Rectal bleeding was presenting symptom in 95.8 % with mean duration of 12.6 ± 15 months. Majority of polyps (77.5 %) were juvenile, and 97.2 % were located in left colon. Solitary polyps were seen in 76.6 %, multiple polyps in 11.6 %, juvenile polyposis syndrome in 6.6 %, familial adenomatous polyposis in 4.2 %, and Peutz-Jeghers syndrome in 0.8 % of the children. The polyposis syndrome group had higher age at presentation (p = 0.00006), greater likelihood of anemia, abdominal pain, and diarrhea (p = 0.0001, 0.0002, and 0.0051, respectively). Likelihood of adenomatous change in polyps was higher in polyposis syndrome group (p = 0.0003). Left colonic polyps were more common in non-polyposis group, whereas pan-colonic polyps were more common in polyposis syndrome group (p < 0.00001). Presence of anemia, abdominal pain, diarrhea, higher age at presentation (more than 10 years), and history of polypectomy are clinical indicators of polyposis syndrome.

  13. Gastric polyps and nodules in children receiving long-term omeprazole therapy.

    Science.gov (United States)

    Pashankar, Dinesh S; Israel, David M

    2002-11-01

    Multiple gastric polyps have been reported to occur in adults receiving omeprazole therapy. There are little published data in children. We report our experience in monitoring the gross and histologic appearance of the stomach in children receiving long-term omeprazole therapy. This was a retrospective review of the charts of children who received omeprazole for more than 6 months for reflux esophagitis between 1989 and 1998. All patients had repeated endoscopic examinations until healing of the esophagitis was confirmed and then annually thereafter. At endoscopy, gastric mucosal swellings were classified as polyps or nodules based on histology. Thirty-one children had long-term endoscopic follow-up while receiving omeprazole. Seven of 31 children had gastric polyps and/or nodules, noted between 10 and 48 months (mean = 28 months) of omeprazole therapy. Four had nodules only, one had a sessile hyperplastic polyp, and two had both a polyp (one hyperplastic and one fundic gland polyp) and nodules. All lesions were found in the gastric body. Nodules in four of the six children disappeared spontaneously while the children continued to receive omeprazole. The polyps persisted. There were no dysplastic changes in the gastric mucosa or polyps in any of the patients. There were no significant differences between the 7 children with and the 24 without polyps/nodules with respect to age, gastrin concentrations, or dose and duration of omeprazole therapy. Gastric polyps and nodules may be found in children receiving long-term omeprazole therapy. The gastric changes in our patients were benign during the mean observation period of 31 months.

  14. Effect of visualization display colour on polyp conspicuity at virtual colonoscopy

    International Nuclear Information System (INIS)

    Burling, D.; Moore, A.; Gupta, A.; East, J.; Tam, E.; Pickhardt, P.J.; Marshall, M.; Taylor, S.A.

    2008-01-01

    Aim: To investigate the effect of different colour three-dimensional (3D) displays on polyp detection at virtual colonoscopy (VC). Methods: Five VC trained observers were shown 'brief flashes' (lasting 0.2 s) of 125 3D endoluminal image snap-shots, repeated for each of six display colours (750 images total). One hundred images contained a single polyp (diameter range 5-42 mm) and 25 contained no polyp ('normal'). Images were reviewed in random order over five reading sessions, readers recording either normality or presence and location of a polyp. Multilevel logistic regression was used to examine any influence of colour on polyp detection stratified according to polyp size (medium 5-9 mm/large ≥10 mm). The kappa statistic was used to assess effect of colour on observer agreement. Results: Individual reader polyp detection rates ranged between 75-94%. Compared to the default pink 'soft tissue' display, the odds of polyp detection were 0.65 (CI 0.41,1.01) for green, 0.82 (0.53,1.30) for blue, 1 (0.63,1.59) for red, 1.12 (0.7,1.79) for monochrome, and 1.15 for yellow (0.72,1.84). Overall, there was no significant difference between the displays (p = 0.11). Including normal cases, there was no overall difference in correct case classification between the six colours (p = 0.44). The odds of detecting large versus medium polyps was significantly greater for 3/5 observers; odds ratio (OR) 2.84-10.1, although unaffected by display colour (p = 0.3). Conclusion: The background colour display generally has a minimal effect on polyp detection at VC, although green should be avoided

  15. Hyperplastic polyps of the colon and rectum - reclassification, BRAF and KRAS status in index polyps and subsequent colorectal carcinoma

    DEFF Research Database (Denmark)

    Janjua, Huma Gul Rehana; Høgdall, Estrid; Linnemann, Dorte

    2015-01-01

    (THP), sessile serrated lesions (SSL), and other lesions. All patients were confirmed in the Danish National Pathology Database for the occurrence of metachronous polyps/adenomas, colorectal cancer (CRC), and other gastrointestinal malignancies. Molecular pathology of the CRC were characterized...... of patients with SSL subsequently developed a neoplastic lesion. Further studies are needed to clarify the cancer risk of SSL....... and correlated with the index lesion. In total, 591 HP biopsy specimens were obtained from 480 patients. The lesions were reclassified as: 358 THP, 109 SSL, 35 TA, 81 unspecified non-neoplastic lesions, four traditional serrated adenoma, and 4 SSL with cytological dysplasia. Seven patients developed CRC...

  16. Intussuscepção intestinal e oclusão intestinal causada por pólipos em intestino delgado na síndrome Peutz-Jeghers. Tratamento com ressecção por enterotomia associado a enteroscopia intra-operatória: relato de caso

    OpenAIRE

    Gama-Rodrigues, Joaquim J.; Silva, José Hyppolito da; Aisaka, Adilson A.; Jureidini, Ricardo; Falci Júnior, Renato; Maluf Filho, Fauze; Chong, A. Kim; Tsai, André Wan Wen; Bresciani, Cláudio

    2000-01-01

    The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyp...

  17. [Endoscopic Doppler ultrasonography in lower intestinal bleeding:vascular diagnosis and monitoring of therapy].

    Science.gov (United States)

    Jaspersen, D

    1992-05-30

    Endoscopic Doppler sonography is a relatively new method for evaluating the sources of intestinal bleeding. For the most part our experiences derived from cases of gastroduodenal ulcer bleedings, in which Doppler sonography permits the identification of arterial vessels relevant for recurrent ulcer bleedings as well as follow-up of therapy after sclerosing. In the lower intestinal tract endoscopic Doppler has, however, only rarely been used, e.g. for diagnosing vascular malformations. This method is of theoretical interest for evaluating colorectal sources of bleeding but is nonetheless of some practical importance, as our investigations of angiodysplasias, ulcers of the rectum and polyps demonstrate.

  18. [Mechanisms underlying glucocorticoid resistance in chronic rhinosinusitis with nasal polyps].

    Science.gov (United States)

    Zhang, Y Y; Lou, H F; Wang, C S; Zhang, L

    2018-02-07

    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease that occurs in the nasal and sinus mucosa, which is a common disease in otorhinolaryngology. At present, CRSwNP can be effectively treated by glucocorticoids (GC). GC binds to GC receptors in the nasal mucosa, affects the expression of inflammatory genes, inhibits the activation and action of eosinophils, T cell-associated inflammatory responses in nasal polyps, as well as tissue remodeling. However, there are some patients fall reponse to GC, so called GC resistance. The study suggests that the possible mechanism of CRSwNP GC resistance is mainly related to GC receptor abnormal, the role of cytokines and transcription factors, such as Th cells and IL-8. In addition, MAPK-related kinases and histone deacetylase in the GC signaling pathway also play important roles in the GC resistance process. This paper reviews the mechanism of GC treatment of CRSwNP, the mechanism of GC resistance and alternative treatment of GC.

  19. LEIBNIZ AND THE POLYP, OR THE METAPHYSICAL PUZZLE OF LIFE

    Directory of Open Access Journals (Sweden)

    Arthur Dony

    2017-06-01

    Full Text Available LEIBNIZ AND THE POLYP, OR THE METAPHYSICAL PUZZLE OF LIFE   In this paper, I propose to explore the link between experience and reason in the problem of the apprehension of life. My general claim is that philosophical issues are necessarily involved in a theory of living organisms, since identifying a certain entity as a living being is to go beyond its manifestations. In part I, I argue that the empirical approach of the natural sciences cannot fully account for the peculiarity of life, showing that the different criteria used to distinguish the living from the non‐living, as those proposed in biology, may turn out to be inadequate. In the second part, I elaborate on these issues by focusing on the Leibnizian theory of living beings. In particular, I will emphasize how Leibniz’s theory exemplifies the problematic relationship between the observable properties of organized matter and the inner (or metaphysical properties of the living as such. Finally, I will propose to consider the discovery of the polyp in the eighteenth century as a case of particular interest and a challenge to the classical conceptions of the living, insofar as it raises the crucial questions of unity and individuality, which are of utmost importance with regard to the ontological status of life. 

  20. X radiation up-regulates the occurrence and the multiplicity of invasive carcinomas in the intestinal tract of Apc(min/+) mice.

    Science.gov (United States)

    Nakayama, Toshiyuki; Yamazumi, Kazuyuki; Uemura, Takashi; Yoshizaki, Ayumi; Yakata, Yuichi; Matsuu-Matsuyama, Mutsumi; Shichijo, Kazuko; Sekine, Ichiro

    2007-10-01

    X rays are well known to cause genetic damage and to induce many types of carcinomas in humans. The Apc(min/+) mouse, an animal model for human familial adenomatous polyposis (FAP), contains a truncating mutation in the APC gene and spontaneously develops intestinal adenomas. To elucidate the role of X rays in the development of intestinal tumors, we examined the promotion of carcinogenesis in X-irradiated Apc(min/+) mice. Forty out of 77 (52%) X-irradiated Apc(min/+) mice developed adenocarcinomas that invaded the proprial muscle layer of the small intestine; 24 of 44 (55%) were in males, and 16 of 33 (49%) were in females. In contrast, invasive carcinomas were detected in the small intestines of only 13 of 64 (20%) nonirradiated Apc(min/+) mice; nine of 32 (28%) were in males and four of 32 (13%) were in females. These differences between X-irradiated and nonirradiated Apc(min/+) mice in the occurrence of invasive intestinal carcinomas were statistically significant (P polyps in the large intestine with or without X irradiation; there was no difference in the number of polyps between the two groups. Also, invasive carcinomas were not detected in the large intestine with or without irradiation. The occurrence of mammary tumors, which was observed in Apc(min/+) mice, was found to be increased in irradiated Apc(min/+) mice (P polyps in the small and large intestines with or without X irradiation. X-irradiated Apc(min/+) mice had highly invasive carcinomas in the small intestine with multiplicities associated with invasiveness. Our results suggest that X radiation may promote the invasive activity of intestinal tumors in Apc(min/+) mice.

  1. Intestinal pseudo-obstruction

    Science.gov (United States)

    Primary intestinal pseudo-obstruction; Acute colonic ileus; Colonic pseudo-obstruction; Idiopathic intestinal pseudo-obstruction; Ogilvie syndrome; Chronic intestinal pseudo-obstruction; Paralytic ileus - pseudo-obstruction

  2. A20 restricts wnt signaling in intestinal epithelial cells and suppresses colon carcinogenesis.

    Directory of Open Access Journals (Sweden)

    Ling Shao

    Full Text Available Colon carcinogenesis consists of a multistep process during which a series of genetic and epigenetic adaptations occur that lead to malignant transformation. Here, we have studied the role of A20 (also known as TNFAIP3, a ubiquitin-editing enzyme that restricts NFκB and cell death signaling, in intestinal homeostasis and tumorigenesis. We have found that A20 expression is consistently reduced in human colonic adenomas than in normal colonic tissues. To further investigate A20's potential roles in regulating colon carcinogenesis, we have generated mice lacking A20 specifically in intestinal epithelial cells and interbred these with mice harboring a mutation in the adenomatous polyposis coli gene (APC(min. While A20(FL/FL villin-Cre mice exhibit uninflamed intestines without polyps, A20(FL/FL villin-Cre APC(min/+ mice contain far greater numbers and larger colonic polyps than control APC(min mice. We find that A20 binds to the β-catenin destruction complex and restricts canonical wnt signaling by supporting ubiquitination and degradation of β-catenin in intestinal epithelial cells. Moreover, acute deletion of A20 from intestinal epithelial cells in vivo leads to enhanced expression of the β-catenin dependent genes cyclinD1 and c-myc, known promoters of colon cancer. Taken together, these findings demonstrate new roles for A20 in restricting β-catenin signaling and preventing colon tumorigenesis.

  3. Identification of the modifier of Min 2 (Mom2) locus, a new mutation that influences Apc-induced intestinal neoplasia.

    Science.gov (United States)

    Silverman, Karen A; Koratkar, Revati; Siracusa, Linda D; Buchberg, Arthur M

    2002-01-01

    Min (Multiple intestinal neoplasia) mice carry a dominant mutation in the adenomatous polyposis coli (Apc) gene and develop multiple adenomas throughout their intestinal tract (Moser et al. 1990; Su et al 1992). Polyp multiplicity in Min mice is greatly influenced by genetic background. A modifier locus, Mom1 (Modifier of Min 1), was identified and localized to distal mouse chromosome 4 (Moser et al. 1992; Dietrich et al. 1993), and accounts for some of the genetic variance in polyp multiplicity. Mom1 is a semidominant modifier of polyp size and multiplicity in Min mice (Gould and Dove 1997), and encodes the secretory type II nonpancreatic phospholipase A2 (Pla2g2a) gene (MacPhee et al. 1995; Cornier et al. 1997, 2000). We now report the identification of a second Modifier of Min 2 (Mom2) locus that is the result of a spontaneous mutation. One resistant Mom2 allele can suppress 88%-95% of polyps detected in Apc(Min)/+ mice, indicating that Mom2 acts in a dominant fashion. Linkage analysis has localized Mom2 to distal mouse chromosome 18. The effects of the Mom2 locus on reducing polyp multiplicity are stronger than the effects of the Mom1 locus, in both the small and large intestines. Some Apc(Min)/+ mice that carried one resistant Mom2 allele were tumor-free at 21 weeks of age, even in the absence of a resistant Mom1 allele. Thus, the resistant Mom2 allele can, in some cases, completely suppress the penetrance of the Apc(Min) mutation.

  4. Intestinal myiasis

    Directory of Open Access Journals (Sweden)

    U S Udgaonkar

    2012-01-01

    Full Text Available Purpose: Intestinal myiasis is a condition when the fly larvae inhabit the gastrointestinal tract and are passed out in faeces. This type of infestation results when eggs or larvae of the fly, deposited on food are inadvertently taken by man. They survive the unfavourable conditions within the gastrointestinal tract and produce disturbances, which may vary from mild to severe. The condition is not uncommon and is often misdiagnosed as pinworm infestation. Correct diagnosis by the clinical microbiologist is important to avoid unnecessary treatment. Materials and Methods: We had 7 cases of intestinal myiasis. In 2 cases the larvae were reared to adult fly in modified meat and sand medium (developed by Udgaonkar. This medium is simple and can be easily prepared in the laboratory. Results: Of the 7 larvae, 5 were Sarcophaga haemorrhoidalis, 1 Megaselia species and 1 was identified as Muscina stabulans. Conclusions: S. haemorrhoidalis was the commonest maggot involved. A high index of suspicion is required for clinical diagnosis when the patient complains of passing wriggling worms in faeces for a long period without any response to antihelminthics. The reason for long duration of illness and recurrence of infestation is baffling. The nearest to cure was colonic wash. We feel prevention is of utmost importance, which is to avoid eating food articles with easy access to flies.

  5. Respiratory response to temperature of three populations of Aurelia aurita polyps in northern Europe.

    Directory of Open Access Journals (Sweden)

    Danja P Höhn

    Full Text Available The benthic life stage (polyp or scyphistoma of the bloom-forming jellyfish, Aurelia aurita (Linnaeus, 1759, also known as the moon jellyfish, contributes to the seasonal occurrence and abundance of medusa blooms via asexual reproduction. A. aurita is widely distributed in coastal areas in northern Europe, and one of the most studied jellyfish species. While the physiology of the visible medusa is largely understood, understanding of the physiology of the perennial benthic life-stage is scarce. To measure the physiological tolerance of A. aurita, the scyphistoma's temperature sensitivity across its distributional range was investigated. Respiration rates of polyps from three northern European locations exposed to 11 temperatures between 2 and 22°C were measured. There was a significant difference in respiration rate among the three polyp populations, which may reflect on differences in their thermal tolerance window. A critical temperature was reached at 14°C with the metabolic rate decreasing below and above that temperature. This pattern was less pronounced in the Norwegian population but polyps were able to survive, at least temporarily, those temperatures exceeding their natural range. While polyps collected from northern Norway, with a narrow environmental thermal window, displayed a low baseline metabolism with a Q10 value of 1.2, polyps from southern England and Scotland had Q10 values of 1.6 and 2.5, respectively. Differences in polyps' respiration rates across their distributional range suggest that populations have evolved adaptations to local environmental thermal conditions.

  6. Inflammatory Myoglandular Polyps: A Case Series of Four Patients and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shoji Hirasaki

    2010-01-01

    Full Text Available Background. Inflammatory myoglandular polyp (IMGP is a nonneoplastic colorectal polyp. Only a small number of cases have been reported, and the pathogenesis remains unclear. Methods. We analyzed colonoscopy and histologic findings in 4 patients with IMGP. Histologic confirmation of the inflammatory granulation tissue in the lamina propria, proliferation of smooth muscle, and hyperplastic glands with variable cystic changes formed the criteria for the selection of patients. Results. We treated four cases of IMGP and reviewed the literature on this disease. Three cases were located in the sigmoid colon or descending colon. All 4 polyps were identified as red, pedunculated lesions. All 4 cases had no symptoms. In two cases, endoscopic findings of polyps were necessary to be differentiated from juvenile polyps. Conclusions. Pedunculated lesions are the main pattern of IMGP. An analysis of endoscopic and histologic features in IMGP of the colorectum revealed that colonic IMGPs resembled juvenile polyps. On colonoscopy, IMGP should generally be taken into consideration as a differential diagnosis of peduncular polyp.

  7. Inflammatory Myoglandular Polyps: A Case Series of Four Patients and Review of the Literature

    Science.gov (United States)

    Hirasaki, Shoji; Kanzaki, Hiromitsu; Matsubara, Minoru; Suzuki, Seiyuu

    2010-01-01

    Background. Inflammatory myoglandular polyp (IMGP) is a nonneoplastic colorectal polyp. Only a small number of cases have been reported, and the pathogenesis remains unclear. Methods. We analyzed colonoscopy and histologic findings in 4 patients with IMGP. Histologic confirmation of the inflammatory granulation tissue in the lamina propria, proliferation of smooth muscle, and hyperplastic glands with variable cystic changes formed the criteria for the selection of patients. Results. We treated four cases of IMGP and reviewed the literature on this disease. Three cases were located in the sigmoid colon or descending colon. All 4 polyps were identified as red, pedunculated lesions. All 4 cases had no symptoms. In two cases, endoscopic findings of polyps were necessary to be differentiated from juvenile polyps. Conclusions. Pedunculated lesions are the main pattern of IMGP. An analysis of endoscopic and histologic features in IMGP of the colorectum revealed that colonic IMGPs resembled juvenile polyps. On colonoscopy, IMGP should generally be taken into consideration as a differential diagnosis of peduncular polyp. PMID:20396388

  8. Utility of Routine Colonic Biopsies in Pediatric Colonoscopic Polypectomy for Benign Juvenile Hamartomatous Polyps.

    Science.gov (United States)

    Malandra, Michael; Kaur, Sunpreet; Chogle, Ashish

    2017-04-01

    Benign juvenile hamartomatous polyps are common in pediatric gastrointestinal practice. We hypothesize that in the absence of gross mucosal abnormalities, the likelihood of histologic abnormalities from routine random colonic biopsies is low. We performed a retrospective chart review identifying patients ages 1 to 18 years who underwent complete colonoscopy and polypectomy for suspected colorectal polyps from January 1, 2004 to July 1, 2014. Indication, age, number of polyps, gross and histologic findings, and any management changes resulting from endoscopy were recorded. Exclusion criteria included history of polyposis syndrome, >5 polyps on colonoscopy, inflammatory bowel disease, and incomplete documentation. Practice patterns were assessed by online survey distributed via Pediatric Gastroenterology listserv. A total of 141 patients underwent colonoscopy with anticipated polypectomy. Seventy-two (63% male) were included. Mean age was 6.5 years. Indication was hematochezia in 71. Findings other than polyps were found in 7 (10%). Juvenile hamartomatous polyps were documented by histologic examination in 68 patients (94%). Routine colonic biopsies were performed in 55 patients (76%). In 8 (15%), histologic abnormalities were seen that did not result in management changes. Seventy-three providers responded to the online survey; 56% reported not taking ileocolonic biopsies in the absence of other mucosal abnormalities; 45% routinely biopsied from the terminal ileum and/or colon. None would biopsy the terminal ileum only. In children with benign juvenile hamartomatous polyps, routine colonic biopsies are not required in the absence of mucosal abnormalities. Overuse of pathology services, increased procedural time, risk, and cost can be avoided.

  9. Incidence and evolution of nasal polyps in children and adolescents with cystic fibrosis.

    Science.gov (United States)

    Weber, Silke Anna Thereza; Ferrari, Giesela Fleischer

    2008-01-01

    Nasal polyps are a clinical sign of alert for investigating Cystic Fibrosis (CF). To study the incidence of nasal polyps in children and adolescents with cystic fibrosis, its possible association with age, gender, clinical manifestations, genotype and sweat chlorine level, and its evolution with topical steroid therapy. Clinical symptoms, sweat chlorine level and genotype were studied in 23 cystic fibrosis patients. Nasal polyps were diagnosed by nasal endoscopy and treated with topical steroids during 6 months, followed by a second nasal endoscopy. Fisher test was used for statistical analysis. Nasal polyps were found in 39.1% of the patients (five bilateral, four unilateral), all older than six years, recurrent pneumonia in 82.6%, pancreatic insufficiency in 87% and malnutrition in 74%. No association was seen between nasal polyps and sweat chlorine level, genotype, clinical sings of severity and nasal symptoms. Seven patients improved in their nasal polyps with topical steroids, six showed complete resolution. The study showed a high incidence of nasal polyps in older children, who span the entire range of clinical severity, even in the absence of clinical nasal symptoms. Topical steroid therapy showed good results. An interaction among pediatricians and otolaryngologists is necessary for diagnosis and follow-up.

  10. Congenital urethral polyps in children: report of 18 patients and review of literature.

    Science.gov (United States)

    Akbarzadeh, Aram; Khorramirouz, Reza; Kajbafzadeh, Abdol-Mohammad

    2014-05-01

    To evaluate the presentation, diagnosis and management of congenital urethral polyps (CUP) in children and to report the results of the endoscopic resection of polyp with long-term follow-up. Between April 1995 to March 2010, 18 children (14 boys, 4 girls) with CUP were treated. The most common presentation was urinary outflow obstruction/retention, hematuria or protruding polyp from the urethra meatus in girls. Six patients presented with vesicoureteral reflux (VUR). All children (except one) underwent a transurethral resection of the CUP. Following the endoscopic resection of the polyps, there was no polyp recurrence, and all patients became symptom-free. The children exhibited no reflux, urinary retention, hematuria or urinary tract infection (UTI) following endoscopic management. Abnormal uroflowmetry patterns returned to normal following the resection of the polyp for one year after the operation. Urethral polyps must be considered in every child with history of triad of recurrent intermittent urinary retention, hematuria and lower urinary tract symptoms. The cure can be achieved in all cases by an endoscopic approach. This type of tumor is always benign and very rarely recurs, unless the pedicle stalk is not resected. The endoscopic management of reflux is unnecessary in this group of patients due to their natural history of secondary reflux. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. A novel colonic polyp volume segmentation method for computer tomographic colonography

    Science.gov (United States)

    Wang, Huafeng; Li, Lihong C.; Han, Hao; Song, Bowen; Peng, Hao; Wang, Yunhong; Wang, Lihua; Liang, Zhengrong

    2014-03-01

    Colorectal cancer is the third most common type of cancer. However, this disease can be prevented by detection and removal of precursor adenomatous polyps after the diagnosis given by experts on computer tomographic colonography (CTC). During CTC diagnosis, the radiologist looks for colon polyps and measures not only the size but also the malignancy. It is a common sense that to segment polyp volumes from their complicated growing environment is of much significance for accomplishing the CTC based early diagnosis task. Previously, the polyp volumes are mainly given from the manually or semi-automatically drawing by the radiologists. As a result, some deviations cannot be avoided since the polyps are usually small (6~9mm) and the radiologists' experience and knowledge are varying from one to another. In order to achieve automatic polyp segmentation carried out by the machine, we proposed a new method based on the colon decomposition strategy. We evaluated our algorithm on both phantom and patient data. Experimental results demonstrate our approach is capable of segment the small polyps from their complicated growing background.

  12. Localization by immunoperoxidase and estimation by radioimmunoassay of carcinoembryonic antigen on colonic polyp

    International Nuclear Information System (INIS)

    Sharkey, R.M.; Hagihara, P.F.; Goldenberg, D.M.

    1977-01-01

    A 3-layer immunoperoxidase technique was used to demonstrate carcinoembryonic antigen (CEA) in colonic polyps from patients with or without previous or concurrent malignancy. CEA was demonstrated in a higher percentage of the polyps received as fresh specimens that were rapidly frozen and fixed in ethanol, than in formalin-fixed, paraffin-embedded sections. Tissue CEA content of both colonic carcinomas and polyps was determined by radioimmunoassay, and it was found that benign colonic tumours had levels of tissue CEA comparable to colonic cancer, indicating that CEA concentration in a tumour does not reflect its grade of malignancy. In fact, in one case in which both colonic cancer and polyps were removed, the polyps has the higher quantities of tissue CEA. Further, tissue CEA concentration of a polyp was not dependent on its size or location. Studying the titres of circulating CEA in these patients revealed an elevation of plasma CEA in one-third of the patients with only colonic polyps, whilst the patients with cancer all had increased titres. (author)

  13. Automatic Polyp Detection in Pillcam Colon 2 Capsule Images and Videos: Preliminary Feasibility Report

    Directory of Open Access Journals (Sweden)

    Pedro N. Figueiredo

    2011-01-01

    Full Text Available Background. The aim of this work is to present an automatic colorectal polyp detection scheme for capsule endoscopy. Methods. PillCam COLON2 capsule-based images and videos were used in our study. The database consists of full exam videos from five patients. The algorithm is based on the assumption that the polyps show up as a protrusion in the captured images and is expressed by means of a P-value, defined by geometrical features. Results. Seventeen PillCam COLON2 capsule videos are included, containing frames with polyps, flat lesions, diverticula, bubbles, and trash liquids. Polyps larger than 1 cm express a P-value higher than 2000, and 80% of the polyps show a P-value higher than 500. Diverticula, bubbles, trash liquids, and flat lesions were correctly interpreted by the algorithm as nonprotruding images. Conclusions. These preliminary results suggest that the proposed geometry-based polyp detection scheme works well, not only by allowing the detection of polyps but also by differentiating them from nonprotruding images found in the films.

  14. Measurement of smaller colon polyp in CT colonography images using morphological image processing.

    Science.gov (United States)

    Manjunath, K N; Siddalingaswamy, P C; Prabhu, G K

    2017-11-01

    Automated measurement of the size and shape of colon polyps is one of the challenges in Computed tomography colonography (CTC). The objective of this retrospective study was to improve the sensitivity and specificity of smaller polyp measurement in CTC using image processing techniques. A domain knowledge-based method has been implemented with hybrid method of colon segmentation, morphological image processing operators for detecting the colonic structures, and the decision-making system for delineating the smaller polyp-based on a priori knowledge. The method was applied on 45 CTC dataset. The key finding was that the smaller polyps were accurately measured. In addition to 6-9 mm range, polyps of even <5 mm were also detected. The results were validated qualitatively and quantitatively using both 2D MPR and 3D view. Implementation was done on a high-performance computer with parallel processing. It takes [Formula: see text] min for measuring the smaller polyp in a dataset of 500 CTC images. With this method, [Formula: see text] and [Formula: see text] were achieved. The domain-based approach with morphological image processing has given good results. The smaller polyps were measured accurately which helps in making right clinical decisions. Qualitatively and quantitatively the results were acceptable when compared to the ground truth at [Formula: see text].

  15. DMLLE: a large-scale dimensionality reduction method for detection of polyps in CT colonography

    Science.gov (United States)

    Wang, Shijun; Yao, Jianhua; Summers, Ronald M.

    2008-03-01

    Computer-aided diagnosis systems have been shown to be feasible for polyp detection on computed tomography (CT) scans. After 3-D image segmentation and feature extraction, the dataset of colonic polyp candidates has large-scale and high dimension characteristics. In this paper, we propose a large-scale dimensionality reduction method based on Diffusion Map and Locally Linear Embedding for detection of polyps in CT colonography. By selecting partial data as landmarks, we first map the landmarks into a low dimensional embedding space using Diffusion Map. Then by using Locally Linear Embedding algorithm, non-landmark samples are embedded into the same low dimensional space according to their nearest landmark samples. The local geometry of samples is preserved in both the original space and the embedding space. We applied the proposed method called DMLLE to a colonic polyp dataset which contains 58336 candidates (including 85 6-9mm true polyps) with 155 features. Visual inspection shows that true polyps with similar shapes are mapped to close vicinity in the low dimensional space. FROC analysis shows that SVM with DMLLE achieves higher sensitivity with lower false positives per patient than that of SVM using all features. At the false positives of 8 per patient, SVM with DMLLE improves the average sensitivity from 64% to 75% for polyps whose sizes are in the range from 6 mm to 9 mm (p < 0.05). This higher sensitivity is comparable to unaided readings by trained radiologists.

  16. Automated polyp measurement based on colon structure decomposition for CT colonography

    Science.gov (United States)

    Wang, Huafeng; Li, Lihong C.; Han, Hao; Peng, Hao; Song, Bowen; Wei, Xinzhou; Liang, Zhengrong

    2014-03-01

    Accurate assessment of colorectal polyp size is of great significance for early diagnosis and management of colorectal cancers. Due to the complexity of colon structure, polyps with diverse geometric characteristics grow from different landform surfaces. In this paper, we present a new colon decomposition approach for polyp measurement. We first apply an efficient maximum a posteriori expectation-maximization (MAP-EM) partial volume segmentation algorithm to achieve an effective electronic cleansing on colon. The global colon structure is then decomposed into different kinds of morphological shapes, e.g. haustral folds or haustral wall. Meanwhile, the polyp location is identified by an automatic computer aided detection algorithm. By integrating the colon structure decomposition with the computer aided detection system, a patch volume of colon polyps is extracted. Thus, polyp size assessment can be achieved by finding abnormal protrusion on a relative uniform morphological surface from the decomposed colon landform. We evaluated our method via physical phantom and clinical datasets. Experiment results demonstrate the feasibility of our method in consistently quantifying the size of polyp volume and, therefore, facilitating characterizing for clinical management.

  17. Jejunojejunal Intussusception Induced by Lipomatous Polyp of Jejunum

    Directory of Open Access Journals (Sweden)

    Jayant Kumar Biswal

    2017-10-01

    Full Text Available Adult intussusception is rare unlike childhood variety where it is the leading cause of intestinal obstruction. Preoperative diagnosis is often difficult as the symptoms are nonspecific and so high index of suspicion is needed for early diagnosis by appropriate investigations. This is a case of 65-year-old man presented with acute intestinal obstruction whose laparotomy revealed a jejunojejunal intussusception secondary to a lipomatous lesion which was successfully treated with resection and primary anastomosis. When dealing with a case of chronic intermittent intestinal obstruction, intussusception must be kept in mind as one of the differential diagnosis.

  18. The Homeodomain Transcription Factor Cdx1 Does Not Behave as an Oncogene in Normal Mouse Intestine

    Directory of Open Access Journals (Sweden)

    Mary Ann S. Crissey

    2008-01-01

    Full Text Available The Caudal-related homeobox genes Cdx1 and Cdx2 are intestine-specific transcription factors that regulate differentiation of intestinal cell types. Previously, we have shown Cdx1 to be antiproliferative and to promote cell differentiation. However, other studies have suggested that Cdx1 may be an oncogene. To test for oncogenic behavior, we used the murine villin promoter to ectopically express Cdx1 in the small intestinal villi and colonic surface epithelium. No changes in intestinal architecture, cell differentiation, or lineage selection were observed with expression of the transgene. Classic oncogenes enhance proliferation and induce tumors when ectopically expressed. However, the Cdx1 transgene neither altered intestinal proliferation nor induced spontaneous intestinal tumors. In a murine model for colitis-associated cancer, the Cdx1 transgene decreased, rather than increased, the number of adenomas that developed. In the polyps, the expression of the endogenous and the transgenic Cdx1 proteins was largely absent, whereas endogenous Villin expression was retained. This suggests that transgene silencing was specific and not due to a general Villin inactivation. In conclusion, neither the ectopic expression of Cdx1 was associated with changes in intestinal cell proliferation or differentiation nor was there increased intestinal cancer susceptibility. Our results therefore suggest that Cdx1 is not an oncogene in normal intestinal epithelium.

  19. Detection of colonic polyp candidates with level set-based thickness mapping over the colon wall

    Science.gov (United States)

    Han, Hao; Li, Lihong; Duan, Chaijie; Zhao, Yang; Wang, Huafeng; Liang, Zhengrong

    2015-03-01

    Further improvement of computer-aided detection (CADe) of colonic polyps is vital to advance computed tomographic colonography (CTC) toward a screening modality, where the detection of flat polyps is especially challenging because limited image features can be extracted from flat polyps, and the traditional geometric features-based CADe methods usually fail to detect such polyps. In this paper, we present a novel pipeline to automatically detect initial polyp candidates (IPCs), especially flat polyps, from CTC images. First, the colon wall mucosa was extracted via a partial volume segmentation approach as a volumetric layer, where the inner border of colon wall can be obtained by shrinking the volumetric layer using level set based adaptive convolution. Then the outer border of colon wall (or the colon wall serosa) was segmented via a combined implementation of geodesic active contour and Mumford-Shah functional in a coarse-to-fine manner. Finally, the wall thickness was estimated along a unique path between the segmented inner and outer borders with consideration of the volumetric layers and was mapped onto a patient-specific three-dimensional (3D) colon wall model. The IPC detection results can usually be better visualized in a 2D image flattened from the 3D model, where abnormalities were detected by Z-score transformation of the thickness values. The proposed IPC detection approach was validated on 11 patients with 22 CTC scans, and each scan has at least one flat poly annotation. The above presented novel pipeline was effective to detect some flat polyps that were missed by our CADe system while keeping false detections in a relative low level. This preliminary study indicates that the presented pipeline can be incorporated into an existing CADe system to enhance the polyp detection power, especially for flat polyps.

  20. Magnifying endoscopy with indigo carmine contrast for differential diagnosis of neoplastic and nonneoplastic colonic polyps.

    Science.gov (United States)

    Su, Ming-Yao; Ho, Yu-Pin; Chen, Pang-Chi; Chiu, Cheng-Tang; Wu, Cheng-Shyong; Hsu, Chen-Ming; Tung, Shui-Yi

    2004-08-01

    This study describes the feasibility of magnifying colonoscopy with indigo carmine dye contrast to distinguish neoplastic and nonneoplastic colonic polyps. This study sampled consecutive patients undergoing colonoscopy using an Olympus CF240ZI from January to October 2000 at Chang-Gung Memorial Hospital, Lin-Kou Medical Center. This study analyzed a total of 270 polyps. Indigo carmine (0.2%) was sprayed directly on the mucosa surface before observing the crypts using a magnifying colonoscope (1.5x-100x). The pit patterns were described using the classification proposed by Kudo. Finally, polypectomy or biopsy was performed for histological diagnosis. The study identified 155 adenomas, 99 hyperplastic polyps, 9 adenocarcinomas, and 7 other nonneoplastic lesions (harmatoma, inflammatory polyps, and mucosal tag). The pit pattern was analyzed for all lesions. Further classification into neoplastic (adenoma and adenocarcinoma) and nonneoplastic (hyperplastic and others) polyps revealed 156 neoplastic and 14 nonneoplastic polyps among the type III to type V pits and 92 nonneoplastic and 8 neoplastic polyps among the type I and II pits. The sensitivity of type III to type V pits in detecting neoplastic polyps was 95.1%, with a specificity of 86.8% and diagnostic accuracy of 91.9%. The positive likelihood ratio was 7.3, and the negative likelihood ratio was 0.06. Magnifying colonoscopy with indigo carmine dye contrast provides morphological detail that correlates well with polyp histology. Small flat lesions with typical type II pit pattern should have minimal neoplastic risk, thus endoscopic resection is not necessary.

  1. Intestinal Failure (Short Bowel Syndrome)

    Science.gov (United States)

    Intestinal Failure (Short Bowel Syndrome) What is intestinal failure? Intestinal failure occurs when a significant portion of the small ... intestine does. Who is at risk for intestinal failure? N Babies (usually premature) who have had surgery ...

  2. Fibroepithelial ureteral polyps as a cause of ureteropelvic junction obstruction in children: A case report

    Directory of Open Access Journals (Sweden)

    Ilse Van Horebeek

    2016-09-01

    Full Text Available We present a ten-year-old boy with episodic left flank pain, vomiting and microscopic hematuria. Imaging showed hydronephrosis characteristic for ureteropelvic junction (UPJ obstruction. Pyeloplasty revealed a ureteral polyp, histopathologic examination confirmed the diagnosis of a fibroepithelial polyp. Fibroepithelial polyps of the ureter are a rare cause of UPJ obstruction in children. The most common presentation is episodic flank pain and/or hematuria. Imaging can be guiding, but pre-operative diagnosis is difficult. After surgical resection recurrence is rare.

  3. The Fibroepithelial Polyp of the Urethra: A Rare Cause of Urinary Terention In Children

    Directory of Open Access Journals (Sweden)

    Nihat Uluocak

    2012-10-01

    Full Text Available Benign fibroepithelial polyp of the prostatic urethra is a rare congenital lesion. It is most commonly diagnosed in the pediatric population and causes various urinary symptoms. In this case report, we presented a thirteen months old boy with a posterior urethral polyp who admitted to our clinic with complaints of obstructive urinary symptoms. An obstructing mass extending from bladder neck to prostatic urethra was seen in endoscopy. The lesion was completely removed by transure-thral resection. Pathological evaluation of the specimen revealed fibroepithelial polyp of the urethra. At postoperative follow up periods no complications of mic-turition at control examinations.

  4. Giant Ureteral Fibroepithelial Polyp with Intermittent Prolapse Reaching the Urethral Meatus: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohamad El-Haress

    2017-07-01

    Full Text Available Ureteral fibroepithelial polyps (UFPs are rare non-epithelial benign tumors of the urinary tract. Treatment of such cases ranges from conservative management to surgical resection of the polyp. Hereby, we present a rare case of a 37-year-old female patient with giant 14 cm UFP of the distal left ureter, successfully resected by ureteroscopic electrocauterization. Several cases of UFPs have been previously reported in world literature describing polyps extending into the bladder; yet, our case is the first to present a giant UFP that extends beyond the bladder cavity protruding outside the urethral meatus as a red fleshy mass.

  5. Study design and patient recruitment for the Japan Polyp Study

    Directory of Open Access Journals (Sweden)

    Sano Y

    2014-05-01

    , Japan Background: The Japan Polyp Study (JPS Workgroup was established in 2000 to evaluate colonoscopic follow-up surveillance strategies. The JPS was a multicenter randomized controlled trial designed to evaluate follow-up surveillance strategies in patients who had undergone two complete colonoscopies for control of colorectal cancer, with removal of all detected polyps. The aim of the present analysis was to assess the patient recruitment and whether the clinical characteristics were adequate for enrollment at the participating centers. Materials and methods: Among referrals for colonoscopy at the eleven participating centers, all patients who were 40–69 years old, without a family or personal history of familial polyposis, Lynch syndrome, inflammatory bowel disease, or a personal history of polypectomy with unknown histology, and had no invasive colorectal cancer or colectomy, were considered for inclusion from February 2003. Results: Among 4,752 referrals, a total of 3,926 patients with a mean age of 57.3 (range 40–69 years, including 2,440 (62% males, were included in the JPS. The participation rate was 83%. Among them, a total of 2,757 patients who had undergone two complete colonoscopies with removal of all detected polyps were eligible, giving an eligibility rate of 70% (2,757 of 3,926. Among the eligible patients, 2,166 were assigned to randomized groups, and 591 patients to a nonrandomized group. The last steps of data lock, analysis, and complete histopathological assessment based on a pathology review are ongoing. Conclusion: Eligible patients recruited for the JPS were successfully assigned on the basis of the expected sample-size calculation. Keywords: colonoscopy, follow-up surveillance strategies, Japan Polyp Study (JPS, study design, multicenter randomized controlled trial

  6. [Morphological features of juvenile colon polyps in children].

    Science.gov (United States)

    Tertychnyĭ, A S; Konovalov, D M; Talalaev, A G

    2004-01-01

    Histological, histochemical and immunohistochemical studies of 50 solitary juvenile polyps (JP) and 50 JP from children with juvenile polyposis syndrome (JPS) were performed. Observations of the focal complex glandular structures with high mitotic rate were more frequent in JP from patients with JPS (n = 29, 58%) than in solitary JP (n = 17, 34%) (p < 0.03). The immunohistochemical study demonstrated p53 overexpression in individual cells and more than 50% of Ki-67-positive cells in 5 (10%) solitary JP and in 17(34%) JP from patients with JPS (p < 0.007). The finding of microglandular pattern is more typical for JP from patients with JPS. Pathological data, expression of p53 and Ki-67 by immunohistochemistry could help to pick out the group of JP with dysplastic changes.

  7. POLYP: an automatic device for drawing sequential samples of gas

    International Nuclear Information System (INIS)

    Gaglione, P.; Koechler, C.; Stanchi, L.

    1974-12-01

    POLYP is an automatic device consisting of an electronic equipment which drives sequentially 8 small pumps for drawing samples of gas. The electronic circuit is driven by a quartz oscillator and allows for the preselection of a waiting time in such a manner that a set of similar instruments placed in suitable position in the open country will start simultaneously. At the same time the first pump of each instrument will inflate a plastic bag for a preset time. Thereafter the other seven pumps will inflate sequentially the other bag. The instrument is powered by rechargeable batteries and realized with C-MOS integrated circuits for a nearly negligible consumption. As it is foreseen for field operation it is waterproof

  8. [Serrated polyps and their association with synchronous advanced colorectal neoplasia].

    Science.gov (United States)

    Urman, Jesús; Gomez, Marta; Basterra, Marta; Mercado, María Del Rosario; Montes, Marta; Gómez Dorronsoro, Marisa; Garaigorta, Maitane; Fraile, María; Rubio, Eva; Aisa, Gregorio; Galbete, Arkaitz

    2016-11-01

    Large serrated polyps (SP), proximal SP, SP with dysplasia and the presence of multiple sessile serrated adenomas/polyps (SSA/P), which we refer to as SP with increased risk of metachronous lesions (SPIRML), have been associated with an increased risk of advanced colon lesions on follow-up. It is unclear, however, whether SPIRML are also associated with an increased risk of synchronous advanced colorectal neoplasia (ACN). The aim of this study was to estimate the prevalence of SPIRML and to evaluate the association between SPIRML and synchronous ACN. A cross-sectional population-based study in all patients (1,538) with histological diagnosis of SP obtained from colonoscopies, sigmoidoscopies and colonic surgery performed in Navarra Health Service hospitals (Spain) in 2011. Demographic parameters and synchronous colonic lesions (adenomas, advanced adenomas [AA] and ACN) were analyzed. One fourth of the sample (384 patients) presented SPIRML. These were older patients, with a slight predominance of women, and with no differences in body mass index (BMI) compared to patients without SPIRML. In the univariate analysis, patients with SPIRML showed an increased risk of adenoma, AA and ACN. In the multivariate analysis, the SPIRML group had a higher risk of synchronous AA and ACN (odds ratio [OR]: 2.38 [1.77-3.21] and OR: 2.29 [1.72-3.05], respectively); in the case of ACN, this risk was statistically significant in both locations (proximal or distal), with OR slightly higher for the proximal location. Different subtypes of SPIRML had a higher risk of AA and synchronous NA. SPIRML were common in patients with SP, and their presence was associated with an increased risk of synchronous ACN. Copyright © 2016 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  9. Characteristics of antrochoanal polyps in the pediatric age group

    International Nuclear Information System (INIS)

    AlMazrou, Khalid A; Bukhari, Manal; AlFayez, Abdurhman I

    2009-01-01

    To evaluate and compare the clinical and the pathological characteristics of antrochoanal polyps (ACPS) in adults and children. Medical records of 35 patients (19 children, 16 adults) operated upon for ACPS between 1995 and 2005 at an academic tertiary center were reviewed retrospectively. Demographic characteristics, clinical presentation, surgical management, histological findings and recurrence rate were compared. Of the 35 patients, 19 (54%) were children (mean age, 12.6 years) and 16 (46%) were adults (mean age, 31.4 years). Nasal obstruction was the most common presenting symptom in both groups. The incidence of snoring and/or obstructive sleep apnea was statistically significant, more common among the pediatric age group as compared to the adult group ( P =.001). Epistaxis was also found to be more common among the pediatric age group ( P =.027), while sinusitis was noted to be significantly more common among the adult group ( P =.019).Transnasal endoscopic removal of ACPS was performed in 12 (63.1%) children and 11 (68.7%) adults. A combined open/endoscopic approach was required in 36.9% of children and 31.3% of adults. On histologic examination, allergic ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant eosinophils) was more common than inflammatory ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant neutrophils) in children (2.8:1) as compared to adults (0.8:1) ( P =.045). All of our patients were followed with endoscopic examination for a period ranging from 9 to 42 months (mean, 24 months). Recurrence of ACPS was identified in 2 children and 1 adult. Antrochoanal polyps are a rare clinical entity. Children have unique clinical and pathological features as compared to adults. Endoscopic excision is safe and effective in the pediatric age group and has the capability to ensure complete removal and lower recurrence rate. (author)

  10. Gene Signature in Sessile Serrated Polyps Identifies Colon Cancer Subtype

    Science.gov (United States)

    Kanth, Priyanka; Bronner, Mary P.; Boucher, Kenneth M.; Burt, Randall W.; Neklason, Deborah W.; Hagedorn, Curt H.; Delker, Don A.

    2016-01-01

    Sessile serrated colon adenoma/polyps (SSA/Ps) are found during routine screening colonoscopy and may account for 20–30% of colon cancers. However, differentiating SSA/Ps from hyperplastic polyps (HP) with little risk of cancer is challenging and complementary molecular markers are needed. Additionally, the molecular mechanisms of colon cancer development from SSA/Ps are poorly understood. RNA sequencing was performed on 21 SSA/Ps, 10 HPs, 10 adenomas, 21 uninvolved colon and 20 control colon specimens. Differential expression and leave-one-out cross validation methods were used to define a unique gene signature of SSA/Ps. Our SSA/P gene signature was evaluated in colon cancer RNA-Seq data from The Cancer Genome Atlas (TCGA) to identify a subtype of colon cancers that may develop from SSA/Ps. A total of 1422 differentially expressed genes were found in SSA/Ps relative to controls. Serrated polyposis syndrome (n=12) and sporadic SSA/Ps (n=9) exhibited almost complete (96%) gene overlap. A 51-gene panel in SSA/P showed similar expression in a subset of TCGA colon cancers with high microsatellite instability (MSI-H). A smaller seven-gene panel showed high sensitivity and specificity in identifying BRAF mutant, CpG island methylator phenotype high (CIMP-H) and MLH1 silenced colon cancers. We describe a unique gene signature in SSA/Ps that identifies a subset of colon cancers likely to develop through the serrated pathway. These gene panels may be utilized for improved differentiation of SSA/Ps from HPs and provide insights into novel molecular pathways altered in colon cancer arising from the serrated pathway. PMID:27026680

  11. Characteristics of antrochoanal polyps in the pediatric age group

    Directory of Open Access Journals (Sweden)

    Al-Mazrou Khalid

    2009-01-01

    Full Text Available Objectives: To evaluate and compare the clinical and the pathological characteristics of antrochoanal polyps (ACPS in adults and children. Materials and methods: Medical records of 35 patients (19 children, 16 adults operated upon for ACPS between 1995 and 2005 at an academic tertiary center were reviewed retrospectively. Demographic characteristics, clinical presentation, surgical management, histological findings and recurrence rate were compared. Results: Of the 35 patients, 19 (54% were children (mean age, 12.6 years and 16 (46% were adults (mean age, 31.4 years. Nasal obstruction was the most common presenting symptom in both groups. The incidence of snoring and/or obstructive sleep apnea was statistically significant, more common among the pediatric age group as compared to the adult group ( P =.001. Epistaxis was also found to be more common among the pediatric age group ( P =.027, while sinusitis was noted to be significantly more common among the adult group ( P =.019.Transnasal endoscopic removal of ACPS was performed in 12 (63.1% children and 11 (68.7% adults. A combined open/endoscopic approach was required in 36.9% of children and 31.3% of adults. On histologic examination, allergic ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant eosinophils was more common than inflammatory ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant neutrophils in children (2.8:1 as compared to adults (0.8:1 ( P =.045. All of our patients were followed with endoscopic examination for a period ranging from 9 to 42 months (mean, 24 months. Recurrence of ACPS was identified in 2 children and 1 adult. Conclusion: Antrochoanal polyps are a rare clinical entity. Children have unique clinical and pathological features as compared to adults. Endoscopic excision is safe and effective in the pediatric age group and has the capability to ensure complete removal and lower recurrence rate.

  12. Recurrent small intestine intussusception in a patient with Peutz-Jeghers syndrome Invaginación recurrente del intestino delgado en un paciente con síndrome de Pentz-Jeghers

    OpenAIRE

    Orestis Ioannidis; Styliani Papaemmanouil; George Paraskevas; Anastasios Kotronis; Stavros Chatzopoulos; Athina Konstantara; Nikolaos Papadimitriou; Apostolos Makrantonakis; Emmanouil Kakoutis

    2012-01-01

    Peutz-Jeghers syndrome is a rare hereditary autosomal dominant disease caused by a mutation of the tumor suppressor gene serine/threonine kinase 11 located in chromosome 19p13.3. It is characterized by the presence of extensive mucocutaneous pigmentation, especially of the lips and the occurrence of hamartomatous polyps throughout the gastrointestinal tract. Gastrointestinal hamartomas occur predominantly in the small intestine and can become symptomatic leading usually to intestinal obstruct...

  13. Detection of colonic polyps in the elderly: Optimization of the single-contrast barium enema examination

    International Nuclear Information System (INIS)

    Gelfand, D.W.; Chen, Y.M.; Ott, D.J.; Munitz, H.A.

    1986-01-01

    Single-contrast studies account for 75% of barium enema examinations and are often performed in the elderly. By optimizing all factors, the following results were obtained: for polyps of less than 1 cm, 40 of 57 were detected (sensitivity, 70.2%); for polyps of 1 cm or larger, 33 of 35 were detected (sensitivity, 94%). Overall, 73 of 92 polyps were detected (sensitivity, 79.3%). These sensitivities result from meticulous preparation and the use of compression filming, low-density barium, moderate kilovoltages, high-resolution screens, remote control apparatus, and high-bandpass TV fluoroscopy. The authors conclude that an optimal single-contrast barium enema examination detects colonic polyps with a sensitivity approaching that of the double-contrast study and may be employed in elderly patients who cannot undergo the double-contrast study

  14. Gastrojejunostomy stomal polyp presenting as stomal obstruction and its endoscopic management

    Directory of Open Access Journals (Sweden)

    Mohd Talha Noor

    2013-01-01

    Full Text Available We report the case of a 42-year-old male who presented with postprandial, non bilious, non projectile vomiting for 4 months. Patient underwent gastrojejunostomy 10 years back for post corrosive gastric outlet obstruction. General physical and systemic examinations were within normal limits. Routine laboratory investigations including complete blood count, liver and renal function tests were also within normal limits. Upper gastrointestinal endoscopy revealed solitary pedunculated polyp at the gastrojejunostomy site almost completely obstructing the lumen at the gastrrojejunostomy site. Endoscopic snare polypectomy of the gastrojejunostomy site polyp was done. Histopathological examination of the polyp was suggestive of hyperplastic polyp. After snare polypectomy patient became asymptomatic and is doing well at 6 months of follow up.

  15. Simple colonoscopy reporting system checking the detection rate of colon polyps.

    Science.gov (United States)

    Kim, Jae Hyun; Choi, Youn Jung; Kwon, Hye Jung; Park, Seun Ja; Park, Moo In; Moon, Won; Kim, Sung Eun

    2015-08-21

    To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps. A simple colonoscopy reporting system Kosin Gastroenterology (KG quality reporting system) was developed. The polyp detection rate (PDR), adenoma detection rate (ADR), serrated polyp detection rate (SDR), and advanced adenoma detection rate (AADR) are easily calculated to use this system. In our gastroenterology center, the PDR, ADR, SDR, and AADR test results from each gastroenterologist were updated, every month. Between June 2014, when the program was started, and December 2014, the overall PDR and ADR in our center were 62.5% and 41.4%, respectively. And the overall SDR and AADR were 7.5% and 12.1%, respectively. We envision that KG quality reporting system can be applied to develop a comprehensive system to check colon polyp detection rates in other gastroenterology centers.

  16. Significant difference of neutrophil-lymphocyte ratio between colorectal cancer, adenomatous polyp and healthy people.

    Science.gov (United States)

    Zhou, W-W; Chu, Y-P; An, G-Y

    2017-12-01

    Tumor was reported to correlate with inflammation and the host's inflammatory response to tumor has been shown to independently predict the outcome. Many measures of the systemic inflammatory response have been studied in recent years. In the present study the full blood count (leukocyte, neutrophil, lymphocyte) of colorectal cancers (CRCs) adenomatous polyps, and healthy people were collected, and the difference of ratios was studied. A total of 752 individuals (242 colorectal cancers, 248 adenomatous polyps, and 262 healthy people) were randomized enrolled in the present study. The full blood counts (leukocyte, neutrophil, and lymphocyte) of each individual were collected and the NLRs were calculated. The leukocyte count, neutrophil ratio and neutrophil-lymphocyte ratio were the highest in colorectal cancer group, the second in adenomatous polyp group, and the lowest in healthy control (p ratio was in the reverse order (p ratio and NLR may provide available information in the differential diagnosis of CRC, adenomatous polyp and healthy people.

  17. Analysis of mtDNA sequence variants in colorectal adenomatous polyps

    Directory of Open Access Journals (Sweden)

    Grizzle William

    2010-10-01

    Full Text Available Abstract Colorectal tumors mostly arise from sporadic adenomatous polyps. Polyps are defined as a mass of cells that protrudes into the lumen of the colon. Adenomatous polyps are benign neoplasms that, by definition display some characteristics of dysplasia. It has been shown that polyps were benign tumors which may undergo malignant transformation. Adenomatous polyps have been classified into three histologic types; tubular, tubulovillous, and villous with increasing malignant potential. The ability to differentially diagnose these colorectal adenomatous polyps is important for therapeutic intervention. To date, little efforts have been directed to identifying genetic changes involved in adenomatous polyps. This study was designed to examine the relevance of mitochondrial genome alterations in the three adenomatous polyps. Using high resolution restriction endonucleases and PCR-based sequencing, fifty-seven primary fresh frozen tissues of adenomatous polyps (37 tumors and 20 matched surrounding normal tissues obtained from the southern regional Cooperative Human Tissue Network (CHTN and Grady Memorial Hospital at Atlanta were screened with three mtDNA regional primer pairs that spanned 5.9 kbp. Results from our data analyses revealed the presence of forty-four variants in some of these mitochondrial genes that the primers spanned; COX I, II, III, ATP 6, 8, CYT b, ND 5, 6 and tRNAs. Based on the MITODAT database as a sequence reference, 25 of the 44 (57% variants observed were unreported. Notably, a heteroplasmic variant C8515G/T in the MT-ATP 8 gene and a germline variant 8327delA in the tRNAlys was observed in all the tissue samples of the three adenomatous polyps in comparison to the referenced database sequence. A germline variant G9055A in the MT-ATP 6 gene had a frequency of 100% (17/17 in tubular and 57% (13/23 in villous adenomas; no corresponding variant was in tubulovillous adenomas. Furthermore, A9006G variant at MT-ATP 6 gene was

  18. "Melanosis" in the small and large intestine.

    Science.gov (United States)

    Freeman, Hugh-James

    2008-07-21

    Deposition of pigment in the intestinal mucosa is commonly observed by the endoscopist, especially within the colon, and particularly during investigations for constipation. Pigment may also be detected in the small intestine. Although labeled as melanosis, electron microscopy and X-ray analytical methods have provided evidence that this pigment is not melanin at all, but lipofuscin. Often, herbal remedies or anthracene containing laxatives are often historically implicated, and experimental studies in both humans and animal models have also confirmed the intimate relationship with these pharmacological or pseudo-pharmacological remedies. The appearance of melanosis coli during colonoscopy is largely due to pigment granule deposition in macrophages located in the colonic mucosa. The pigment intensity is not uniform, being more intense in the cecum and proximal colon compared to the distal colon. Possibly, this reflects higher luminal concentrations of an offending agent in the proximal compared to distal colon, differential absorption along the length of the colon, or finally, differences in macrophage distribution within the colon. Mucosal lymphoid aggregates normally display a distinct absence of pigment producing a "starry sky" appearance, especially in the rectosigmoid region. Interestingly, some focal, usually sessile, colonic mucosal neoplastic lesions, rather than submucosal lesions, may be better appreciated as pigment deposition may be absent or limited. If detected, removal and further histopathologic analysis of the polyp may be facilitated.

  19. Management of male urethral polyps in children: experience with four cases.

    Science.gov (United States)

    Eziyi, Amogu K; Helmy, Tamer E; Sarhan, Osama M; Eissa, Waleed M; Ghaly, Magdy A

    2009-01-01

    Congenital urethral polyps area rare anomaly of the male urethra that may present with features of voiding dysfunction or obstruction. Although the exact incidence is unknown, they are important in the differential diagnosis of lower urethral obstruction in male children. Their diagnosis requires a high index of suspicion because of the variability of presentation. We present our experience with four cases of male urethral polyps in boys with discussion on the related literature.

  20. Management of male urethral polyps in children: Experience with four cases

    Directory of Open Access Journals (Sweden)

    Eziyi Amogu

    2009-01-01

    Full Text Available Congenital urethral polyps area rare anomaly of the male urethra that may present with features of voiding dysfunction or obstruction. Although the exact incidence is unknown, they are important in the differential diagnosis of lower urethral obstruction in male children. Their diagnosis requires a high index of suspicion because of the variability of presentation. We present our experience with four cases of male urethral polyps in boys with discussion on the related literature.

  1. Selective suppression of in situ proliferation of scyphozoan polyps by biofouling.

    Science.gov (United States)

    Feng, Song; Wang, Shi-Wei; Zhang, Guang-Tao; Sun, Song; Zhang, Fang

    2017-01-30

    An increase in marine artificial constructions has been proposed as a major cause of jellyfish blooms, because these constructions provide additional substrates for organisms at the benthic stage (polyps), which proliferate asexually and release a large amount of free-swimming medusae. These hard surfaces are normally covered by fouling communities, the components of which have the potential to impede the proliferation of polyps. In this study, we report an in situ experiment of polyp survival of four large scyphozoan species found in East Asian marginal seas that were exposed to biofouling, a universal phenomenon occurring on marine artificial constructions. Our results showed that the polyps of three species (Nemopilema nomurai, Cyanea nozaki, and Rhopilema esculentum) attached to the artificial surfaces were completely eliminated by biofouling within 7-8months, and only those of moon jellyfish (Aurelia sp.1) in the upper layers could multiply on both artificial materials and other organisms (e.g., ascidians and bryozoans). Fouling-associated competition and predation and suppressed asexual reproduction of podocysts were observed to contribute to the loss of polyps. This study shows that the natural distribution of polyps is defined by the biofouling community that colonizes the surfaces of artificial constructions. Consequently, the contribution of marine constructions to jellyfish bloom is limited only to the ability of the jellyfish species to reproduce asexually through budding and inhabit solid surfaces of fouling organisms in addition to inhabiting original artificial materials. We anticipate that fragile polyps will colonize and proliferate in harsh environments that are deleterious to biofouling, and we propose special attention to polyps in antifouling practices for excluding the possibility that they occupy the available ecological space. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Jellyfish life histories: role of polyps in forming and maintaining scyphomedusa populations.

    Science.gov (United States)

    Lucas, Cathy H; Graham, William M; Widmer, Chad

    2012-01-01

    Large population fluctuations of jellyfish occur over a variety of temporal scales, from weekly to seasonal, inter-annual and even decadal, with some regions of the world reported to be experiencing persistent seasonal bloom events. Recent jellyfish research has focussed on understanding the causes and consequences of these population changes, with the vast majority of studies considering the effect of changing environmental variables only on the pelagic medusa. But many of the bloom-forming species are members of the Scyphozoa with complex metagenic life cycles consisting of a sexually reproducing pelagic medusa and asexually reproducing benthic polyp. Recruitment success during the juvenile (planula, polyp and ephyrae) stages of the life cycle can have a major effect on the abundance of the adult (medusa) population, but until very recently, little was known about the ecology of the polyp or scyphistoma phase of the scyphozoan life cycle. The aim of this review is to synthesise the current state of knowledge of polyp ecology by examining (1) the recruitment and metamorphosis of planulae larvae into polyps, (2) survival and longevity of polyps, (3) expansion of polyp populations via asexual propagation and (4) strobilation and recruitment of ephyrae (juvenile medusae). Where possible, comparisons are made with the life histories of other bentho-pelagic marine invertebrates so that further inferences can be made. Differences between tropical and temperate species are highlighted and related to climate change, and populations of the same species (in particular Aurelia aurita) inhabiting different habitats within its geographic range are compared. The roles that polyps play in ensuring the long-term survival of jellyfish populations as well as in the formation of bloom populations are considered, and recommendations for future research are presented. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. The development of nasal polyp disease involves early nasal mucosal inflammation and remodelling.

    Directory of Open Access Journals (Sweden)

    Juan Meng

    Full Text Available Chronic rhinosinusitis with nasal polyps (CRSwNP is characterized by both a chronic inflammation and tissue remodelling; as indicated by extracellular matrix protein deposition, basement membrane thickening, goblet cell hyperplasia and subepithelial edema, with reduced vessels and glands. Although remodelling is generally considered to be consequence of persistent inflammation, the chronological order and relationship between inflammation and remodelling in polyp development is still not clear. The aim of our study was therefore to investigate the pathological features prevalent in the development of nasal polyps and to elucidate the chronological order and relationship between inflammation and remodelling, by comparing specific markers of inflammation and remodelling in early stage nasal polyps confined to the middle turbinate (refer to as middle turbinate CRSwNP obtained from 5 CRSwNP patients with bilateral polyposis, mature ethmoidal polyps from 6 CRSwNP patients, and normal nasal mucosal tissue from 6 control subjects. Middle turbinate CRSwNP demonstrated significantly more severe epithelial loss compared to mature ethmoidal polyps and normal nasal mucosa. The epithelial cell junction molecules E-cadherin, ZO-1 and occludin were also expressed in significantly lower amounts in mature ethmoidal polyps compared to healthy mucosa. Middle turbinate CRSwNP were further characterized by significantly increased numbers of subepithelial eosinophils and M2 type macrophages, with a distinct lack of collagen and deposition of fibronectin in polyp part. In contrast, the turbinate area of the middle turbinate CRSwNP was characterized by an increase in TGF-β activated myofibroblasts expressing α-SMA and vimentin, an increase in the number of pSmad2 positive cells, as well as increased deposition of collagen. These findings suggest a complex network of processes in the formation of CRSwNP; including gross epithelial damage and repair reactions

  4. Colonic polyp detection method from 3D abdominal CT images based on local intensity analysis

    International Nuclear Information System (INIS)

    Oda, M.; Nakada, Y.; Kitasaka, T.; Mori, K.; Suenaga, Y.; Takayama, T.; Takabatake, H.; Mori, M.; Natori, H.; Nawano, S.

    2007-01-01

    This paper presents a detection method of colonic polyps from 3D abdominal CT images based on local intensity analysis. Recently, virtual colonoscopy (VC) has widely received attention as a new colon diagnostic method. VC is considered as a less-invasive inspection method which reduces patient load. However, since the colon has many haustra and its shape is long and convoluted, a physician has to change the viewpoint and the viewing direction of the virtual camera of VC many times while diagnosis. Additionally, there is a risk to overlook lesions existing in blinded areas caused by haustra. This paper proposes an automated colonic polyp detection method from 3D abdominal CT images. Colonic polyps are located on the colonic wall. Their CT values are higher than those of colonic lumen regions and lower than those of fecal materials tagged by an X-ray opaque contrast agent. CT values inside polyps which exist outside the tagged fecal materials tend to gradually increase from outward to inward (blob-like structure). CT values inside polyps that exist inside the tagged fecal materials tend to gradually decrease from outward to inward (inv-blob-like structure). We employ the blob and the inv-blob structure enhancement filters based on the eigenvalues of the Hessian matrix to detect polyps using intensity characteristic of polyps. Connected components with low output values of the enhancement filter are eliminated in false positive reduction process. Small connected components are also eliminated. We applied the proposed method to 44 cases of abdominal CT images. Sensitivity for polyps of 6 mm or larger was 80% with 4.7 false positives per case. (orig.)

  5. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies

    OpenAIRE

    Morais, Drausio Jefferson; Yamanaka, Ademar; Zeitune, José Murilo Robilotta; Andreollo, Nelson Adami

    2007-01-01

    BACKGROUND: Gastric polyps are small gastric lesions, asymptomatic in most cases and are generally discovered inadvertently during upper digestive endoscopy. AIM: To retrospectively review the characteristics and frequency of gastric polyps, derived from the gastric mucosal epithelium in a large series of endoscopies. METHODS: One hundred and fifty three patients in a series of 26,000 consecutive upper digestive endoscopies done over a 5-year period, being that each patient had only one exami...

  6. A comprehensive study of nondysplastic and dysplastic serrated polyps of the vermiform appendix.

    Science.gov (United States)

    Yantiss, Rhonda K; Panczykowski, Andrea; Misdraji, Joseph; Hahn, Hejin P; Odze, Robert D; Rennert, Hanna; Chen, Yao-Tseng

    2007-11-01

    Serrated colorectal polyps often show DNA hypermethylation and/or BRAF mutations and have been implicated in the "serrated neoplastic pathway." Although similar lesions occur in the appendix, they have never been systematically investigated. We evaluated a study group of 56 serrated polyps, a control group of 17 mucinous cystadenomas, and 4 adenocarcinomas with adjacent serrated polyps of the appendix to better understand their pathogenesis. The study cases were classified as nondysplastic or dysplastic serrated polyps and evaluated for MLH-1, MSH-2, MGMT, beta-catenin, p53, and Ki-67 expression, BRAF and KRAS mutations, and microsatellite instability. Serrated polyps usually occurred in older adults with no sex predilection. Most (59%) lacked dysplasia, but all showed similar molecular features, regardless of the degree of dysplasia present. Decreased MLH-1 (50%, P<0.001) and/or MGMT (59%, P<0.001) expression and BRAF (29%, P=0.007) mutations were significantly more common in serrated polyps, but BRAF mutations were detected in a minority of the extracted DNA in 15/16 cases. Of the 28 cases with decreased MLH-1 expression, none showed high-frequency microsatellite instability. Loss of MLH-1 (25%) or MGMT (50%) expression and BRAF or KRAS mutations (50%) were inconsistently present in adenocarcinomas and were not identified in combination in any cases. We conclude that molecular features of the "serrated neoplastic pathway" are present with similar frequencies among dysplastic and nondysplastic serrated appendiceal polyps and are not highly prevalent in adjacent carcinomas. These features, including BRAF mutations, may be more closely related to a serrated morphology in appendiceal polyps rather than biologically important changes.

  7. Intestinal microbiota: a potential diet-responsive prevention target in ApcMin mice.

    Science.gov (United States)

    Mai, Volker; Colbert, Lisa H; Perkins, Susan N; Schatzkin, Arthur; Hursting, Stephen D

    2007-01-01

    We previously reported that two dietary regimens, calorie restriction (CR) and a high olive oil-containing diet supplemented with a freeze-dried fruit and vegetable extract (OFV), reduced the development of intestinal adenomas in Apc(Min) mice by 57% and 33%, respectively, compared to control mice fed a defined diet ad libitum. The OFV diet was designed to have a strong effect on the composition of the intestinal microbiota through its high content of fiber, which represents a major source of fermentable substrate for the gut bacteria. We hypothesized that some of the observed effects of diet on intestinal carcinogenesis might be mediated by diet-related changes in the bacterial species that thrive in the gut. Therefore, we determined by fluorescent in situ hybridization (FISH) and denaturing gradient gel electrophoresis (DGGE) how the dietary interventions affected the composition of the intestinal microbiota, and we characterized specific microbiota changes that were associated with diet and reduced intestinal carcinogenesis. The OFV diet changed the overall composition of the intestinal microbiota, smaller changes were observed for the CR diet. Furthermore, we detected a 16S rDNA fragment associated with mice that did not develop polyps. Sequence analysis suggested that hitherto unidentified bacteria belonging to the family Lachnospiraceae (order Clostridiales) were its source. Thus, these bacteria may be an indicator of intestinal conditions associated with reduced intestinal carcinogenesis in Apc(Min) mice. Copyright 2006 Wiley-Liss, Inc.

  8. Adenomatous Polyps in Adolescent Girl and Boy: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Laleh Vahedi Larijani

    2016-01-01

    Full Text Available A polyp is defined as a mass of the mucosal surface that protrudes into the lumen of the gastrointestinal tract. Neoplastic epithelial polyps are classified histologically as either benign adenoma or malignant carcinoma. The colonic polyps that most commonly present in children occur sporadically and individually and are of the juvenile type; they are most frequently associated with painless rectal hemorrhage (which is the most common symptom. Adenomatous polyps are similar to other nontumoral polyps, and it is very rare for children to have symptoms other than rectal bleeding. This report describes two rare cases of polyps in pediatric patients. An 11-year-old girl presented with tubulovillous adenoma and a 13-year-old boy with tubular adenoma; both patients complained of rectal hemorrhage as well as anemia and abdominal pain. Epithelial adenoma is a tumor that is rarely found in adults or children. Colonoscopic perforation and biopsy are mandatory for establishing a definitive diagnosis and avoiding medical mismanagement.

  9. Value of Fecal Calprotectin as a Biomarker for Juvenile Polyps in Children Investigated With Colonoscopy.

    Science.gov (United States)

    Olafsdottir, Ingunn; Nemeth, Artur; Lörinc, Ester; Toth, Ervin; Agardh, Daniel

    2016-01-01

    The clinical presentation of colonic juvenile polyps with abdominal discomfort and occult rectal bleedings make them difficult to recognize. The aim of this study was to report the clinical features of colonic juvenile polyps in children referred to colonoscopy and evaluate fecal calprotectin (FCP) as a screening biomarker for their diagnosis. The study included a total of 266 children (range 3.1-19.0 years, median age 15.8 years) investigated with ileocolonoscopy; of whom, 239 (89%) were investigated for inflammatory bowel disease (IBD). FCPs were analyzed as a marker of colonic inflammation, and levels polyps were detected in 12 (4.5%) children; the remaining 67 (25.2%) had Crohn disease, 57 (21.4%) ulcerative colitis, 5 (1.9%) unclassified IBD, 4 (1.5%) allergic colitis, bleeding source was localized in 6 (2.3%), and 115 (43.2%) had unspecific or normal findings. FCP was available in 203 (76.3%) children before colonoscopy; levels of FCP were higher in children with juvenile polyps (range 28-2287 mg/kg, median 844 mg/kg) compared with those with normal colonoscopies (range children after polypectomy, of whom all had their FCP levels significantly reduced (range 0-281 mg/kg, median 49 mg/kg, P Colonic juvenile polyps are frequently found in pediatric patients presenting with hematochezia and elevated FCP levels. Colonic juvenile polyps are difficult to differentiate from pediatric IBD without a colonoscopy.

  10. Paediatric traffic accident and obstructive sleep apnoea by antrochoanal polyps: case report and literature review.

    Science.gov (United States)

    Weder, S; Landis, B N; Banz, Y; Caversaccio, M; Dubach, P

    2011-11-01

    Antrochoanal polyps are hyperplasias of the nasal mucosa, which have their origin in the maxillary sinus and extend through the nasal cavity and the choanae into the naso- and oropharynx. In children antrochoanal polyps represent one of the more frequent manifestations of paediatric nasal polyposis. Most studies on antrochoanal polyps in children report only on nasal obstruction, hyponasal speech and snoring, which are also encountered in the most common cause of obstructive sleep apnoea syndrome; i.e. adenoid or tonsillar hyperplasia. Only very few studies report on additional health hazards by antrochoanal polyps ranging from obstructive sleep apnoea syndrome to swallowing disorders and cachexia. We present the case of an 8 year old girl with a bicycle accident caused by excessive daytime sleepiness and obstructive sleep apnoea syndrome due to an extensive antrochoanal polyp. After a transnasal polypectomy and meatotomy type II the obstructive sleep apnoea and day time sleepiness resolved completely. Awareness of this additional health hazard is important and correct evaluation and timely diagnosis of a potential antrochoanal polyp is mandatory because minimally invasive rhinosurgery is highly curative in preventing further impending problems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Seasonality in polyps of a tropical cubozoan: A latina nr mordens.

    Directory of Open Access Journals (Sweden)

    Robert Courtney

    Full Text Available A latina nr mordens have been located in large predictable spawning aggregations near Osprey Reef in the Coral Sea eight to ten days after a full moon; however, polyps have never been located in-situ. The polyp stage contributes to the abundance of medusae through asexual reproduction and metamorphosis, and may influence the periodicity of medusae by metamorphosis of the polyp. To elucidate the relationship between medusae periodicity and polyp ecology, polyps were exposed to thermal and osmotic treatments in order to determine the theoretical environmental limits to their distribution. Maximum fecundity occurred in thermal treatments of 21 to 25ºC and the theoretical minimum thermal requirement for population stability was approximately 17ºC. Polyps were also exposed to five feeding regimes and fecundity was found to be positively correlated with feeding frequency. Thermal and osmotic variations did not induce metamorphosis in this species, however, reduced food did. The implications of asexual reproduction and cues for metamorphosis in relation to population dynamics of this species are discussed.

  12. Nasal polyps: a predisposing factor for cutaneous leishmaniasis of the lips?

    Science.gov (United States)

    Veraldi, Stefano; D'Agostino, Antonio; Pontini, Paolo; Guanziroli, Elena; Gatt, Paul

    2016-04-01

    Cutaneous leishmaniasis (CL) of the lips is rare. This study was conducted to investigate findings in patients with this condition. From 2007 to date, we observed 10 patients (nine males and one female), with a median age of 45.2 years (range: 8-77 years), with CL of the lips. Six of the 10 patients suffered from nasal polyps, three from bronchial asthma, and one from chronic obstructive pulmonary disease (COPD). Three of the patients with nasal polyps also had asthma. Three patients had none of nasal polyps, asthma, or COPD. In all patients with nasal polyps, diagnosis was confirmed by anterior rhinoscopy and nasal endoscopy. It is possible that, in patients with nasal polyps, asthma, and COPD, the need to breathe through the mouth rather than the nose facilitates the sting by sandflies. Subjects with nasal polyps living in areas endemic for CL should be warned about the risk for being stung by sandflies on the lips, in addition to other uncovered areas. © 2015 The International Society of Dermatology.

  13. The role of PGE2 in intestinal inflammation and tumorigenesis.

    Science.gov (United States)

    Montrose, David C; Nakanishi, Masako; Murphy, Robert C; Zarini, Simona; McAleer, Jeremy P; Vella, Anthony T; Rosenberg, Daniel W

    2015-01-01

    Release of the free fatty acid arachidonic acid (AA) by cytoplasmic phospholipase A2 (cPLA2) and its subsequent metabolism by the cyclooxygenase and lipoxygenase enzymes produces a broad panel of eicosanoids including prostaglandins (PGs). This study sought to investigate the roles of these mediators in experimental models of inflammation and inflammation-associated intestinal tumorigenesis. Using the dextran sodium sulfate (DSS) model of experimental colitis, we first investigated how a global reduction in eicosanoid production would impact intestinal injury by utilizing cPLA2 knockout mice. cPLA2 deletion enhanced colonic injury, reflected by increased mucosal ulceration and pro-inflammatory cytokine expression. Increased disease severity was associated with a significant reduction in the levels of several eicosanoid metabolites, including PGE2. We further assessed the precise role of PGE2 synthesis on mucosal injury and repair by utilizing mice with a genetic deletion of microsomal PGE synthase-1 (mPGES-1), the terminal synthase in the formation of inducible PGE2. DSS exposure caused more extensive acute injury as well as impaired recovery in knockout mice compared to wild-type littermates. Increased intestinal damage was associated with both reduced PGE2 levels as well as altered levels of other eicosanoids including PGD2. To determine whether this metabolic redirection impacted inflammation-associated intestinal tumorigenesis, Apc(Min/+) and Apc(Min/+):mPGES-1(-/-) mice were exposed to DSS. DSS administration caused a reduction in the number of intestinal polyps only in Apc(Min/+):mPGES-1(-/-) mice. These results demonstrate the importance of the balance of prostaglandins produced in the intestinal tract for maintaining intestinal homeostasis and impacting tumor development. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. The prevalence of high dysplastic colonic adenomatous polyps in a 3 year endoscopic retrospective study from a single clinical center

    Directory of Open Access Journals (Sweden)

    Alexandru C. Septimiu

    2017-04-01

    Full Text Available Introduction: Many colon neoplastic tumors come from the malignancy of adenomatous polyps (70%-90% that were not timely diagnosed in order to be resected. Materials and Methods: We conducted a retrospective study regarding the incidence of adenomatous polyps during 1.000 consecutive colonoscopies performed in our Upper and Lower Digestive Endoscopy Laboratory during a three-year period. Results: During these colonoscopies, some targeted polyps were biopsied or completely removed and the samples had been sent to a complete anatomopathological examination. Taking into consideration the results, the polyps were classified after the histological type and the form of dysplasia, in order to determine the polyp forms that present a high risk of malignancy. Conclusion: Given the rather high frequency of malignant polyps discovered during our study, we highly recommend colonoscopy as a method of choice for routine monitoring of selected cases.

  15. THE PREVALENCE OF COLONIC POLYPS IN PATIENTS WITH ACROMEGALY: A CASE-CONTROL, NESTED IN A COHORT COLONOSCOPIC STUDY.

    Science.gov (United States)

    Gonzalez, Baldomero; Vargas, Guadalupe; Mendoza, Victoria; Nava, Mariana; Rojas, Moisés; Mercado, Moisés

    2017-05-01

    Acromegaly is associated with an increased risk of colonic polyps. The magnitude of such risk is controversial, and the characteristics that distinguish patients who develop polyps from those who do not are not well established. This study was performed to determine the prevalence of colonic polyps upon the diagnosis of acromegaly and to compare the clinical and biochemical features of patients with and without polyps. Out of 165 patients who underwent a full colonoscopy upon diagnosis of acromegaly, 53 were found to harbor colonic lesions (cases), whereas the remaining 112 were used as controls. Demographic, clinical, and biochemical characteristics were compared between the 2 groups. The prevalence of colonic polyps was 32%, with an estimated relative risk of 6.21 (95% confidence interval [CI] 4.08-9.48). Adenomatous and nonadenomatous polyps were found in 22 and 31 patients, respectively. The most common location was the descending colon. Compared to patients without polyps, subjects with polyps were somewhat older and had significantly higher insulin-like growth factor-1 (IGF-1) levels and a higher prevalence of diabetes. Upon multivariate analysis, only IGF-1 level at diagnosis remained significantly associated with colonic polyps in general and with hyperplastic polyps in particular. Acromegaly is associated with an elevated risk of developing colonic polyps, particularly, distally located hyperplastic lesions. Except for a higher IGF-1 level at diagnosis, no distinctive clinical or biochemical features can be found among those who develop polyps compared to those who do not. CI = confidence interval GH = growth hormone IGF-1 = insulin-like growth factor 1 IQR = inter-quartile range RR = relative risk ULN = upper limit of normal.

  16. Usefulness of a novel calibrated hood to determine indications for colon polypectomy: visual estimation of polyp size is not accurate.

    Science.gov (United States)

    Watanabe, Tatsuyuki; Kume, Keiichiro; Yoshikawa, Ichiro; Harada, Masaru

    2015-07-01

    Accurate measurement of polyp size during colonoscopy is important because the size is a surrogate marker of cancer, but a standardized measurement technique to measure polyp size has yet to be determined. We have developed a new device "a novel calibrated hood." We assessed polyp size by visual estimation and measurement using the calibrated hood. Patients who underwent polypectomy from November 2012 to September 2013 and who had received screening colonoscopy within 6 months prior to the polypectomy were included in this study. Polypectomy was performed attaching the calibrated hood. The endoscopist measured the polyp size using the calibrated hood. Polyp size was compared between visual estimation and measurement using the calibrated hood. Seventy-five patients with 157 polyps were included. Seventy-seven polyps fulfilled the selection criteria. Mean polyp size by visual estimation was 6.57 ± 2.15, and by using calibrated hood was 5.94 ± 1.73 (p = 0.005). There was a significant difference between measurements using the calibrated hood vs. visual estimation by inexperienced trainees; however, there was no difference in case of well-experienced endoscopists. By visual estimation, 11 of 19 polyps were decided for ≥5 mm despite being less than 5 mm, and 5 of 58 polyps were decided for estimation of polyp size is not accurate. It is important to measure the size by an objective way, and the calibrated hood is useful in measuring polyp size, from the standpoint of accurately determining indication for polypectomy.

  17. Colorectal polyps in children: a retrospective study of clinical features and the value of ultrasonography in their diagnosis.

    Science.gov (United States)

    Wei, Chen; Dayong, Wang; Liqun, Jia; Xiaoman, Wang; Yu, Wang; Xiaohong, Qiu

    2012-10-01

    Colorectal polyps are common in children. The purpose of this report was to describe a clinical experience with colorectal polyps at the Beijing Children's Hospital and to evaluate the diagnostic value of ultrasonography in screening colorectal polyps in children. This was a retrospective medical record review of 487 children with colorectal polyps managed at the Beijing Children's Hospital between August 2003 and April 2010. The mean age at presentation was 4.7 ± 2.5 years, with a male predominance (M/F ratio, 1.9:1). Most children (n = 458, 94%) presented with hematochezia associated with other symptoms, such as recurrent abdominal pain (n = 42, 8.6%), prolapse of the polyp from the anus (n = 43, 8.8%), and diarrhea (n = 10, 2.1%). Anemia was observed in 33 (6.8%) children, 4 of whom required a blood transfusion before the colonoscopy. Among the 487 patients, 352 (72.3%) patients underwent ultrasonography before the colonoscopy. Polyps were detected on 345 of 352 ultrasonographic examinations in which patients subsequently underwent colonoscopy and were found to have colonic polyps. The most common polyp locations were the sigmoid colon (n = 212, 46.1%) and the rectum (n = 174, 37.8%). Solitary polyps were identified in 421 patients (88.4%), and multiple polyps were identified in 55 (11.6%) patients. Colonoscopy complications were rare, with colonic perforation observed in 2 patients and postcolonoscopy hemorrhage observed in 1 patient. The available pathology records showed that the most frequent histological type was juvenile polyps (n = 435, 91.8%), followed by Peutz-Jeghers polyps (n = 17, 3.6%), juvenile polyposis (n = 14, 3.0%), hamartomas (n = 6, 1.3%), familial adenomatous polyposis (n = 1, 0.2%), and inflammatory polyps (n = 1, 0.2%). Ultrasonic examination is a valid, accurate, and safe technique for screening colorectal polyps in children; and a full colonoscopy should be performed to remove the polyp(s) as soon as possible. Copyright © 2012 Elsevier

  18. Nasal polyp chitinolytic activity associated with smoking or allergy.

    Science.gov (United States)

    Heo, Kyung Wook; Kim, Tae Yong; Park, Seong Kook; Park, Ga Bin; Hur, Dae Young; Bae, Woo Yong

    2014-05-01

    Cells of the innate immune system that are implicated in allergy and immunity bind to chitin during tissue infiltration in a process negatively regulated by vertebrate chitinases. Both acidic mammalian chitinase (AMCase) and chitotriosidase (ChT) exert chitinolytic activity. The levels of activities of these enzymes in nasal polyps (NPs) of subjects who smoke or who suffer from allergies are unknown. In the present work, we measured the activities of AMCase and ChT in NPs of smokers and allergic subjects. We report a prospective cohort study in a tertiary care facility. AMCase and ChT activities of NPs were measured in buffers of several pH values using the fluorogenic substrate 4-methylumbelliferyl-β-d-N,N',N″-triacetyl-chitotriose. The activities of AMCase and ChT in NPs did not differ significantly among smokers, nonsmokers, and ex-smokers. AMCase and ChT activities were significantly higher in NPs of allergic subjects than in NPs of those who did not suffer from allergy. Increased levels of chitinolytic activities in NPs were associated with the allergic rhinitis. We suggest that control of such rhinitis may help to prevent the development and growth of NPs. © 2014 ARS-AAOA, LLC.

  19. Colonic inflammation found at diagnosis of juvenile retention polyps in pediatric patients.

    Science.gov (United States)

    Kader, H A; Wenner, W J; Baldassano, R N; Ruchelli, E; Carpentieri, D F; Verma, R; Mascarenhas, M R

    2000-08-01

    The finding of colonic inflammation concurrently with a juvenile retention polyp (JRP) may have prognostic value. However, the significance of abnormal mucosal histology with JRP has not been evaluated. We evaluated the significance of mucosal histology at the time of JRP removal with respect to future development of inflammatory bowel disease (IBD) and polyp recurrence. The medical records of patients who had an endoscopic polypectomy performed at the Children's Hospital of Philadelphia (CHOP) from 1/1/87 through 4/30/98 were retrospectively reviewed. JRP was histologically identified in 96 patients. A total of 54 patients had colonic mucosal biopsies: 30 (55.6%) had normal histology and 24 (44.4%) had colitis. Of the 24 patients with colitis, 14 patients (58.3%) had inflammation at the polyp site. Twelve of these patients had additional inflammation elsewhere in the colon. Nine (37.5%) had inflammation elsewhere in the colon; however, biopsies around the polyp site were not obtained. One patient with inflammation did not have the location of the polyp documented. Four patients (16.7%) had IBD at the time of polypectomy; two were diagnosed prior and two coincident with JRP. None have subsequently been diagnosed with IBD. There was no difference in polyp recurrence between those with or without inflammation (16.7% [4/24] vs 10.0% [3/30]). The mean follow-up period was 72.4 months (range, 5-142 months). In our experience, histological mucosal inflammation is a common finding with JRP. This inflammation may be a precursor for the development of JRP but has no predictive value for polyp recurrence. This colitis does not seem to be associated with IBD.

  20. Relative quantification of AXIN2 mRNA expression in different pathological types of colorectal polyps

    Directory of Open Access Journals (Sweden)

    Mina Golmohammadi

    2017-08-01

    Methods: In the present analytical-descriptive study, the investigated population was chosen from the cases with colonic polyps that referred to the Gastroenterology and Liver Diseases Research Center, Taleghani Hospital, Tehran, Iran, from October 2014 to April 2015. Forty four biopsy polyp samples and 10 normal tissue samples were collected, as well as the demographic and clinical properties of the patients and the expression level of AXIN2 gene was quantified by Real-time PCR. The outcomes were analyzed by the ABI Prism 7500 Sequence Detection System (SDS software, version 2.1.0 (Applied Biosystems Inc., Foster City, CA, USA and GraphPad Prism, version 3 (GraphPad Software Inc., La Jolla, CA, USA Also, the expression changes of the intended gene in target groups were compared with the normal tissues using the 2-ΔΔCt equation. Results: The data showed enhanced level of the expression of AXIN2 gene in the colonic polyps in comparison to the normal tissues (RQ>2, which was significantly upper in adenoma polyps compared to the hyperplastic group (P=0.015. Also, unlike the rectum, the AXIN2 gene activity in colon area was higher than normal tissue. Conclusion: The results of the current study show that the expression pattern of AXIN2 gene, was markedly changed during the transformation of the normal tissue to polyp. The increased expression level of this gene could be applied as a diagnostic marker in dissociation of the adenoma polyps from hyperplastic ones. On the other hand, the location of the polyps modulates the AXIN2 gene function. Taking together, evaluating the changes of AXIN2, has a precise diagnostic value in the CRC related studies.

  1. Feature extraction and pattern classification of colorectal polyps in colonoscopic imaging.

    Science.gov (United States)

    Fu, Jachih J C; Yu, Ya-Wen; Lin, Hong-Mau; Chai, Jyh-Wen; Chen, Clayton Chi-Chang

    2014-06-01

    A computer-aided diagnostic system for colonoscopic imaging has been developed to classify colorectal polyps by type. The modules of the proposed system include image enhancement, feature extraction, feature selection and polyp classification. Three hundred sixty-five images (214 with hyperplastic polyps and 151 with adenomatous polyps) were collected from a branch of a medical center in central Taiwan. The raw images were enhanced by the principal component transform (PCT). The features of texture analysis, spatial domain and spectral domain were extracted from the first component of the PCT. Sequential forward selection (SFS) and sequential floating forward selection (SFFS) were used to select the input feature vectors for classification. Support vector machines (SVMs) were employed to classify the colorectal polyps by type. The classification performance was measured by the Az values of the Receiver Operating Characteristic curve. For all 180 features used as input vectors, the test data set yielded Az values of 88.7%. The Az value was increased by 2.6% (from 88.7% to 91.3%) and 4.4% (from 88.7% to 93.1%) for the features selected by the SFS and the SFFS, respectively. The SFS and the SFFS reduced the dimension of the input vector by 57.2% and 73.8%, respectively. The SFFS outperformed the SFS in both the reduction of the dimension of the feature vector and the classification performance. When the colonoscopic images were visually inspected by experienced physicians, the accuracy of detecting polyps by types was around 85%. The accuracy of the SFFS with the SVM classifier reached 96%. The classification performance of the proposed system outperformed the conventional visual inspection approach. Therefore, the proposed computer-aided system could be used to improve the quality of colorectal polyp diagnosis. Copyright © 2014. Published by Elsevier Ltd.

  2. Intestinal microbiome landscaping

    NARCIS (Netherlands)

    Shetty, Sudarshan A.; Hugenholtz, Floor; Lahti, Leo; Smidt, Hauke; Vos, de Willem M.

    2017-01-01

    High individuality, large complexity and limited understanding of the mechanisms underlying human intestinal microbiome function remain the major challenges for designing beneficial modulation strategies. Exemplified by the analysis of intestinal bacteria in a thousand Western adults, we discuss

  3. Roles of sonography and hysteroscopy in the detection of premalignant and malignant polyps in women presenting with postmenopausal bleeding and thickened endometrium.

    Science.gov (United States)

    Cavkaytar, Sabri; Kokanali, Mahmut Kuntay; Ceran, Ufuk; Topcu, Hasan Onur; Sirvan, Levent; Doganay, Melike

    2014-01-01

    To assess the role of sonographic endometrial thickness and hysteroscopic polyp size in predicting premalignant and malignant polyps in postmenopausal women. A total of 328 postmenopausal women with abnormal uterine bleeding and thickened endometrium underwent operative hysteroscopy due to detection of endometrial polyps were included in this retrospective study. Preoperative endometrial thickness measured by transvaginal ultrasonography and polyp size on hysteroscopy were noted. Hysteroscopic resection with histology was performed for endometrial polyps. Endometrial thickness and polyp size were evaluated on the basis of final diagnosis established by histologic examination. Receiver operator characteristic curves were calculated to assess the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of endometrial thickness and polyp size for detecting premalignant and malignant polyps. Premalignant and malignant polyps were identified in 26 (7.9%) of cases. Sonographic measurement showed a greater endometrial thickness in cases of premalignant and malignant polyps when compared to benign polyps. On surgical hysteroscopy, premalignant and malignant polyps were also larger. Endometrial thickness demonstrated a sensitivity of 53.8%, specificity of 85.8%, PPV of 24.6% and NPV of 95.6% at a cut-off limit of 11.5 mm with diagnostic accuracy of 83.2%. Polyp size has a diagnostic accuracy of 94.8% with a sensitivity of 92.3%, specificity of 95.0%, PPV of 61.5% and NPV of 99.3% at a cut-off point of 19.5mm. Endometrial thickness measured by transvaginal ultrasonography is not sufficient in predicting premalignant and malignant endometrial polyps in postmenopausal women with abnormal uterine bleeding and thickened endometrium. Polyp size on hysteroscopy is a more accurate parameter, because of better sensitivity and specificity. However, while polyp size ≥ 19.5mm seems to have a great accuracy for predicting premalignancy and

  4. Neural influences on human intestinal epithelium in vitro.

    Science.gov (United States)

    Krueger, Dagmar; Michel, Klaus; Zeller, Florian; Demir, Ihsan E; Ceyhan, Güralp O; Slotta-Huspenina, Julia; Schemann, Michael

    2016-01-15

    We present the first systematic and, up to now, most comprehensive evaluation of the basic features of epithelial functions, such as basal and nerve-evoked secretion, as well as tissue resistance, in over 2200 surgical specimens of human small and large intestine. We found no evidence for impaired nerve-evoked epithelial secretion or tissue resistance with age or disease pathologies (stomach, pancreas or colon cancer, polyps, diverticulitis, stoma reversal). This indicates the validity of future studies on epithelial secretion or resistance that are based on data from a variety of surgical specimens. ACh mainly mediated nerve-evoked and basal secretion in the small intestine, whereas vasoactive intestinal peptide and nitric oxide were the primary pro-secretory transmitters in the large intestine. The results of the present study revealed novel insights into regional differences in nerve-mediated secretion in the human intestine and comprise the basis by which to more specifically target impaired epithelial functions in the diseased gut. Knowledge on basic features of epithelial functions in the human intestine is scarce. We used Ussing chamber techniques to record basal tissue resistance (R-basal) and short circuit currents (ISC; secretion) under basal conditions (ISC-basal) and after electrical field stimulation (ISC-EFS) of nerves in 2221 resectates from 435 patients. ISC-EFS was TTX-sensitive and of comparable magnitude in the small and large intestine. ISC-EFS or R-basal were not influenced by the patients' age, sex or disease pathologies (cancer, polyps, diverticulitis). Ion substitution, bumetanide or adenylate cyclase inhibition studies suggested that ISC-EFS depended on epithelial cAMP-driven chloride and bicarbonate secretion but not on amiloride-sensitive sodium absorption. Although atropine-sensitive cholinergic components prevailed for ISC-EFS of the duodenum, jejunum and ileum, PG97-269-sensitive [vasoactive intestinal peptide (VIP) receptor 1

  5. Small Intestine Cancer Treatment

    Science.gov (United States)

    ... all of an organ that contains cancer. The resection may include the small intestine and nearby organs (if the cancer has spread). The doctor may remove the section of the small intestine that contains cancer and perform an anastomosis (joining the cut ends of the intestine together). ...

  6. Linked color imaging improves the visibility of various featured colorectal polyps in an endoscopist's visibility and color difference value.

    Science.gov (United States)

    Yoshida, Naohisa; Naito, Yuji; Yasuda, Ritsu; Murakami, Takaaki; Hirose, Ryohei; Ogiso, Kiyoshi; Inada, Yutaka; Dohi, Osamu; Kamada, Kazuhiro; Uchiyama, Kazuhiko; Handa, Osamu; Konishi, Hideyuki; Rani, Rafiz Abdul; Kishimoto, Mitsuo; Konishi, Eiichi; Itoh, Yoshito

    2017-09-01

    Linked color imaging (LCI) by laser endoscopy is a novel narrow band light observation. In this study, we analyzed the efficacy of LCI for improving the various featured colorectal polyp's visibility utilizing a subjective endoscopist's visibility scoring and objective color difference (CD) value. We retrospectively reviewed two pictures both with white light (WL) and LCI for 54 consecutive neoplastic polyps 2-20 mm in size. All pictures were evaluated by four endoscopists according to a published polyp visibility score from four (excellent visibility) to one (poor visibility). Additionally, we calculated CD value between each polyp and surrounding mucosa in LCI and WL using an original software. The mean polyp visibility scores of LCI (3.11 ± 1.05) were significantly higher than those of WL (2.50 ± 1.09, P visibility (polyp visibility scores 1 and 2) was significantly lower in LCI (27.9%) than WL (55.6%, P analysis, the CD value of LCI was significantly higher than that of WL (33.3 ± 13.9 vs. 20.7 ± 13.6, P analysis, the polyp visibility scores and CD values of LCI about 24 diminutive polyps (≤5 mm) were higher than those of WL (3.29 ± 0.99 vs. 2.12 ± 0.99, P visibility scores and CD values of LCI for polyps with any location, size, histology, and morphology were significantly higher than those of WL. LCI improved the various featured polyp's visibility compared to WL in both polyp visibility scores and CD value.

  7. Metastatic Carcinoma Occurring in a Gastric Hyperplastic Polyp Mimicking Primary Gastric Cancer: The First Reported Case

    Directory of Open Access Journals (Sweden)

    Gabriel M. Groisman

    2014-01-01

    Full Text Available Hyperplastic polyps of the stomach are regarded as benign. However, in rare cases they may contain incipient primary carcinomas. To our knowledge, breast carcinoma metastatic to a gastric hyperplastic polyp has not yet been reported. We describe the case of a 69-year-old woman to whom a gastric polyp was endoscopically excised. The patient had previously undergone a right mastectomy for mixed, invasive ductal and lobular carcinoma 5 years earlier. Histological sections from the gastric lesion showed typical features of hyperplastic polyp with foci of poorly differentiated adenocarcinoma including signet ring cells infiltrating the lamina propria. The histologic findings were consistent with a primary gastric cancer. However, the carcinoma cells were immunopositive for estrogen and progesterone receptors and GATA3 and negative for CDX2, Hep Par 1, and MUC5AC. E-cadherin showed membranous reactivity in some of the carcinoma cells while in others it was negative. Accordingly, metastatic mixed, lobular and ductal breast carcinoma was diagnosed. We conclude that metastatic adenocarcinoma mimicking primary gastric cancer can be rarely encountered in hyperplastic gastric polyps.

  8. Foods and food groups associated with the incidence of colorectal polyps: the Adventist Health Study.

    Science.gov (United States)

    Tantamango, Yessenia M; Knutsen, Synnove F; Beeson, W Lawrence; Fraser, Gary; Sabate, Joan

    2011-01-01

    Colorectal cancer (CRC) is a leading cause of cancer death in the United States. The majority of CRC arise in adenomatous polyps and 25-35% of colon adenoma risk could be avoidable by modifying diet and lifestyle habits. We assessed the association between diet and the risk of self-reported physician-diagnosed colorectal polyps among 2,818 subjects who had undergone colonoscopy. Subjects participated in 2 cohort studies: the AHS-1 in 1976 and the AHS-2 from 2002-2005. Multivariate logistic regression analysis was used to estimate the period risk of incident cases of polyps; 441 cases of colorectal polyps were identified. Multivariate analysis adjusted by age, sex, body mass index, and education showed a protective association with higher frequency of consumption of cooked green vegetables (OR 1 time/d vs. Consumption of legumes at least 3 times/wk reduced the risk by 33% after adjusting for meat intake. Consumption of brown rice at least 1 time/wk reduced the risk by 40%. These associations showed a dose-response effect. High frequency of consumption of cooked green vegetables, dried fruit, legumes, and brown rice was associated with a decreased risk of colorectal polyps.

  9. The CIMP Phenotype in BRAF Mutant Serrated Polyps from a Prospective Colonoscopy Patient Cohort

    Directory of Open Access Journals (Sweden)

    Winnie C. Fernando

    2014-01-01

    Full Text Available Colorectal cancers arising via the serrated pathway are often associated with BRAF V600E mutation, CpG island methylator phenotype (CIMP, and microsatellite instability. Previous studies have shown a strong association between BRAF V600E mutation and serrated polyps. This study aims to evaluate CIMP status of all the serrated polyp subtypes and its association with functionally important genes such as MLH1, p16, and IGFBP7. CIMP status and methylation were evaluated using the real-time based MethyLight assay in 154 serrated polyps and 63 conventional adenomas. Results showed that CIMP-high serrated polyps were strongly associated with BRAF mutation and proximal colon. CIMP-high was uncommon in conventional adenomas (1.59%, occurred in 8.25% of hyperplastic polyps (HPs, and became common in sessile serrated adenomas (SSAs (51.43%. MLH1 methylation was mainly observed in the proximal colon and was significantly associated with BRAF mutation and CIMP-high. The number of samples methylated for p16 and IGFBP7 was the highest in SSAs. The methylation panel we used to detect CIMP is highly specific for CIMP-high cancers. With this panel, we demonstrate that CIMP-high is much more common in SSAs than HPs. This suggests that CIMP-high correlates with increased risk of malignant transformation which was also observed in methylation of functionally important genes.

  10. Integrating Online and Offline Three-Dimensional Deep Learning for Automated Polyp Detection in Colonoscopy Videos.

    Science.gov (United States)

    Lequan Yu; Hao Chen; Qi Dou; Jing Qin; Pheng Ann Heng

    2017-01-01

    Automated polyp detection in colonoscopy videos has been demonstrated to be a promising way for colorectal cancer prevention and diagnosis. Traditional manual screening is time consuming, operator dependent, and error prone; hence, automated detection approach is highly demanded in clinical practice. However, automated polyp detection is very challenging due to high intraclass variations in polyp size, color, shape, and texture, and low interclass variations between polyps and hard mimics. In this paper, we propose a novel offline and online three-dimensional (3-D) deep learning integration framework by leveraging the 3-D fully convolutional network (3D-FCN) to tackle this challenging problem. Compared with the previous methods employing hand-crafted features or 2-D convolutional neural network, the 3D-FCN is capable of learning more representative spatio-temporal features from colonoscopy videos, and hence has more powerful discrimination capability. More importantly, we propose a novel online learning scheme to deal with the problem of limited training data by harnessing the specific information of an input video in the learning process. We integrate offline and online learning to effectively reduce the number of false positives generated by the offline network and further improve the detection performance. Extensive experiments on the dataset of MICCAI 2015 Challenge on Polyp Detection demonstrated the better performance of our method when compared with other competitors.

  11. CT colonography: Diagnostic role of contrast enhancement of benign polyps and colorectal carcinoma

    International Nuclear Information System (INIS)

    Stoinova, V.; Nedevska, M.

    2006-01-01

    Full text: The aim of this study was to compare pre- and postcontrast CT attenuation values of benign colorectal polyps and carcinoma lesions detected by CT colonography, and to investigate whether contrast enhancement of these lesions can be potentially used for differentiation from residual fluid and feces. We retrospectively reviewed CT colonographic dataset of 120 patients. 35 benign polyps and 22 colorectal carcinomas were included in our study. All lesions were confirmed by colonoscopic biopsy or surgery. The difference in attenuation value between precontrast and postcontrast studies of polyps was statistically significant; the same was true for colorectal cancers. In the precontrast phase no statistically significant difference was observed between stool, polyps and cancers. The mean attenuation value of solid fecal residuals was 37 HU before and after contrast enhancement. Residual fluid do not take up contrast and the density does not change in the contrast-enhanced phase. The difference between postcontrast density of polyps and cancers with respect to density of stools and residual fluid was significant. The use of contrast medium could be helpful in CT colonography for discriminating polypoid benign lesions and colorectal cancer from fecal and fluid residuals

  12. Evaluation value of intestinal flora detection for intestinal mucosal inflammation and immune response in patients with ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Yan Zou

    2017-09-01

    Full Text Available Objective: To study the evaluation value of intestinal flora detection for intestinal mucosal inflammatory response and immune response in patients with ulcerative colitis. Methods: The patients who were diagnosed with ulcerative colitis in Zigong Fifth People’s Hospital between March 2015 and February 2017 were selected as the UC group, and those who were diagnosed with colonic polyps were selected as the control group. Fresh excreta were collected to detect the number of intestinal flora, and the diseased intestinal mucosa tissue was collected to detect the expression of inflammatory response molecules and immune cell transcription factors. Results: enterococcus contents in intestinal tract and TLR4, NF-kB, TNF-α, HMGB-1, T-bet and RORC mRNA expression levels in intestinal mucosa of UC group were significantly higher than those of control group while bifidobacteria contents in intestinal tract and SOCS2, SOCS3, Foxp3 and GATA-3 mRNA expression levels were significantly lower than those of control group; TLR4, NF-kB, TNF-α, HMGB-1, T-bet and RORC mRNA expression levels in intestinal mucosa of UC patients with grade II and grade III flora disturbance were significantly higher than those of UC patients with normal flora and grade I flora disturbance while SOCS2, SOCS3, Foxp3 and GATA-3 mRNA expression levels were significantly lower than those of UC patients with normal flora and grade I flora disturbance; TLR4, NF-kB, TNF-α, HMGB-1, T-bet and RORC mRNA expression levels in intestinal mucosa of UC patients with grade III flora disturbance were significantly higher than those of UC patients with grade II flora disturbance while SOCS2, SOCS3, Foxp3 and GATA-3 mRNA expression levels were significantly lower than those of UC patients with grade II flora disturbance. Conclusion: The intestinal flora disturbance in patients with ulcerative colitis can result in inflammatory response activation and immune response disorder.

  13. Management of duodenal-jejunal polyps in children with peutz-jeghers syndrome with single-balloon enteroscopy.

    Science.gov (United States)

    Bizzarri, Barbara; Borrelli, Osvaldo; de'Angelis, Nicola; Ghiselli, Alessia; Nervi, Giorgio; Manfredi, Marco; de'Angelis, Gian Luigi

    2014-07-01

    Children with Peutz-Jeghers syndrome (PJS) have increased risk of polyp-related complications and emergency laparotomies. The aim of the present study was to assess the efficacy and the safety of endoscopic therapy of small bowel polyps using single-balloon enteroscopy (SBE) in children affected by PJS. Between January 2010 and December 2011, prospectively consecutive PJS children with polyps >15 mm or polyps actively bleeding previously identified using video capsule endoscopy and magnetic resonance imaging underwent therapeutic SBE. The main outcome measurements were the feasibility, the technical performance, and the safety. A total of 10 children (6 boys; median age 13.7 years, range 5.6-15.6) underwent 23 SBE procedures. Four patients had a history of abdominal surgery. A total of 53 polyps were removed, and 23 of them were >15 mm. The majority of polyps were found in jejunum (85%). The mean insertion depths for antegrade and retrograde approach were 200 ± 80 and 100 ± 50 cm beyond the ileal valve, respectively. The mean procedure time was 75 ± 25 minutes. Mild abdominal pain was reported after 3 procedures. In 1 patient a postpolypectomy perforation occurred. In conclusion, SBE is an effective endoscopic tool for treating small bowel polyps in children with PJS, and well-timed polypectomy may optimize patients' care, preventing polyp-related complications and emergency laparotomy. Further larger multicenter studies are warranted to accurately determine the safety of therapeutic SBE in children.

  14. An Automatic Gastrointestinal Polyp Detection System in Video Endoscopy Using Fusion of Color Wavelet and Convolutional Neural Network Features

    Directory of Open Access Journals (Sweden)

    Mustain Billah

    2017-01-01

    Full Text Available Gastrointestinal polyps are considered to be the precursors of cancer development in most of the cases. Therefore, early detection and removal of polyps can reduce the possibility of cancer. Video endoscopy is the most used diagnostic modality for gastrointestinal polyps. But, because it is an operator dependent procedure, several human factors can lead to misdetection of polyps. Computer aided polyp detection can reduce polyp miss detection rate and assists doctors in finding the most important regions to pay attention to. In this paper, an automatic system has been proposed as a support to gastrointestinal polyp detection. This system captures the video streams from endoscopic video and, in the output, it shows the identified polyps. Color wavelet (CW features and convolutional neural network (CNN features of video frames are extracted and combined together which are used to train a linear support vector machine (SVM. Evaluations on standard public databases show that the proposed system outperforms the state-of-the-art methods, gaining accuracy of 98.65%, sensitivity of 98.79%, and specificity of 98.52%.

  15. Importance of X-ray diagnosis of colorectal polyps as compared to the endoscopic method

    International Nuclear Information System (INIS)

    Lass, B.

    1980-01-01

    The importance of X-ray diagnosis of colorectal polyps as compared with endoscopy is assessed on the basis of the literature and the authoress's own investigations. These make clean that the double contrast method attains a degree of accuracy approaching that of endoscopy. Some investigations by the authoress in 98 patients show that the procedure permits to recognize 72% of polyps under 1 cm of length and 81% above if the patients are well prepared. 4 out of 129 polyps were not detected by endoscopy. Coloscopy is not an infallible method. Both methods should not be viewed as rivalling but as complementary ones. Knowledge of the limitations and methods, and contant endeavour to combine all methods will entail the best diagnostic results. (orig.) [de

  16. Urothelial polyps from anterior urethra in a prepubertal female child: a rare entity.

    Science.gov (United States)

    Goel, Prabudh; Manchanda, Vivek; Mohta, Anup; Gupta, Chhabi Ranu; Das, Prasenjit; Srivastav, Sarika

    2012-12-01

    Urothelial polyps arising from the anterior urethra are rarely encountered in the pediatric age group and are even rarer in the females. Scarcely reported in English literature, their exact incidence is not known. They may be asymptomatic for years or present with features of urinary obstruction, mass or "vaginal" bleeding. They are important in the differential diagnosis of interlabial masses in female children. Anterior urethral polyps are benign fibroepithelial lesions. Surgery is indicated for relief of symptoms and differentiation from malignant lesions such as a sarcoma or a papilloma. No recurrences have been reported. We report a case of solitary anterior urethral polyp in an 8-year old girl managed successfully at our centre. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Computer-aided polyp detection on CT colonography: Comparison of three systems in a high-risk human population

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Sun [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Se Hyung, E-mail: shkim@radcom.snu.ac.k [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Kim, Jong Hyo [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of); Interdisciplinary Program in Radiation Applied Life Science, Seoul National University College of Medicine (Korea, Republic of); Lee, June-Goo [Interdisciplinary Program in Radiation Applied Life Science, Seoul National University College of Medicine (Korea, Republic of); Kim, Sang Gyun [Department of Internal Medicine, Seoul National University Hospital (Korea, Republic of); Lee, Jeong Min; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn [Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Hospital (Korea, Republic of)

    2010-08-15

    Purpose: To compare the detection performances of two commercial and one academic computer-aided diagnosis (CAD) systems for polyp detection on CT colonography (CTC) in a high-risk human population and to assess their detection characteristics. Materials and methods: This retrospective study had institutional review board approval, but informed consent was waived. Sixty-eight patients who were suspected of having colonic polyps and scheduled for colonoscopic polyp removal were included. After CTC was performed using a 64-row MDCT, two commercial (PEV, CAR) and one academic (Hessian matrix-based) CAD systems were applied to each CTC dataset. Colonoscopy using the segmental unblinded technique was performed as a standard of reference. Per-polyp and per-patient sensitivities were calculated and compared for each CAD system. The mean number of false-positives (FPs) and false-negatives (FNs) was computed and the causes of all FPs and FNs were analyzed. Results: A total of 151 polyps in 61 patients were detected (77 polyps <6 mm, 48 6-9.9 mm, 26 {>=} 10 mm). Per-polyp sensitivity for PEV, CAR, and Hessian matrix-based CAD were: 71.6%, 78.4%, and 83.8% for polyps {>=}6 mm, and 88.5%, 96.2%, and 96.2% for polyps {>=}10 mm. Per-patient sensitivity for polyps {>=}6 mm was 80.4%, 89.1%, and 93.5%, and 87%, 95.7%, and 95.7% for polyps {>=}10 mm, respectively. Per-polyp and per-patient sensitivities were not significantly different among the three CAD systems regardless of size threshold. Mean number of FPs was 6.9 for PEV, 7.3 for CAR, and 14 for Hessian matrix-based CAD. The most common cause of FPs were feces, followed by extracolonic findings, prominent folds and ileocecal valve, and rectal tube. The distribution of the causes of FPs was significantly different among the three systems. Conclusion: Sensitivity of the three CAD systems for polyp detection was comparable regardless of the polyp size threshold; however, the number of FPs was higher in the Hessian matrix

  18. Computer-aided polyp detection on CT colonography: Comparison of three systems in a high-risk human population

    International Nuclear Information System (INIS)

    Park, Hee Sun; Kim, Se Hyung; Kim, Jong Hyo; Lee, June-Goo; Kim, Sang Gyun; Lee, Jeong Min; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn

    2010-01-01

    Purpose: To compare the detection performances of two commercial and one academic computer-aided diagnosis (CAD) systems for polyp detection on CT colonography (CTC) in a high-risk human population and to assess their detection characteristics. Materials and methods: This retrospective study had institutional review board approval, but informed consent was waived. Sixty-eight patients who were suspected of having colonic polyps and scheduled for colonoscopic polyp removal were included. After CTC was performed using a 64-row MDCT, two commercial (PEV, CAR) and one academic (Hessian matrix-based) CAD systems were applied to each CTC dataset. Colonoscopy using the segmental unblinded technique was performed as a standard of reference. Per-polyp and per-patient sensitivities were calculated and compared for each CAD system. The mean number of false-positives (FPs) and false-negatives (FNs) was computed and the causes of all FPs and FNs were analyzed. Results: A total of 151 polyps in 61 patients were detected (77 polyps <6 mm, 48 6-9.9 mm, 26 ≥ 10 mm). Per-polyp sensitivity for PEV, CAR, and Hessian matrix-based CAD were: 71.6%, 78.4%, and 83.8% for polyps ≥6 mm, and 88.5%, 96.2%, and 96.2% for polyps ≥10 mm. Per-patient sensitivity for polyps ≥6 mm was 80.4%, 89.1%, and 93.5%, and 87%, 95.7%, and 95.7% for polyps ≥10 mm, respectively. Per-polyp and per-patient sensitivities were not significantly different among the three CAD systems regardless of size threshold. Mean number of FPs was 6.9 for PEV, 7.3 for CAR, and 14 for Hessian matrix-based CAD. The most common cause of FPs were feces, followed by extracolonic findings, prominent folds and ileocecal valve, and rectal tube. The distribution of the causes of FPs was significantly different among the three systems. Conclusion: Sensitivity of the three CAD systems for polyp detection was comparable regardless of the polyp size threshold; however, the number of FPs was higher in the Hessian matrix-based CAD

  19. Nuclear accumulation of beta-catenin occurs commonly in the epithelial cells of juvenile polyps.

    Science.gov (United States)

    Iwamoto, Michiko; Hoffenberg, Edward J; Carethers, John M; Doctolero, Ryan; Tajima, Akihiro; Sugano, Kentaro; Franklin, Wilbur A; Ahnen, Dennis J

    2005-01-01

    In the two conditions juvenile polyps (JPs) and juvenile polyposis coli (JPC), colonic polyps may have overlapping histologic and phenotypic appearance, but JPC confers a significant risk for colon adenocarcinoma. Although not thought to contain adenomatous polyposis coli (APC) mutations, the status of beta-catenin and full-length APC protein expression in JPs is not known. We evaluated beta-catenin and full-length APC protein expression in JPs from children with JPs and JPC. Cases were identified through endoscopic procedure records. Immunohistochemistry was performed for beta-catenin and full-length APC protein. Loss of heterozygosity at the APC gene locus on chromosome 5 was assessed using two APC-linked microsatellite markers. Polyp and normal colonic tissue were analyzed from 36 children with JPs and 9 with JPC. Both APC and beta-catenin immunoreactivity were present in epithelial cells from all samples but in different patterns. In all normal colon and polyp samples, APC expression was cytoplasmic with maximal immunoreactivity in the goblet cells. In contrast, beta-catenin immunoreactivity in epithelial cells was limited to the plasma membrane in normal colon but was both cytoplasmic and nuclear in all 45 JPs. No evidence of APC gene loss of heterozygosity was found. In polyps from children with JPs and JPC, nuclear beta-catenin accumulation is a consistent feature, and it is not due to APC gene mutation or loss of full-length APC protein expression. Thus, beta-catenin accumulation may be intrinsic to the formation of juvenile-type polyps through an as-yet-undefined mechanism.

  20. Prevalence of colorectal adenomatous polyps in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Chun EM

    2015-05-01

    Full Text Available Eun Mi Chun, Seo Woo Kim, So Yeon Lim Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea Background: Colorectal adenomatous polyps are precancerous lesions of colorectal cancer. The aim of this study was to assess the prevalence of colorectal adenomatous polyps in chronic obstructive pulmonary disease (COPD patients and determine whether COPD is associated with colorectal malignant potential.Methods: Subjects who had undergone post-bronchodilator spirometry and colonoscopy and were 40 years or older were selected from the hospital database. COPD was defined as a spirometry in which the ratio of forced expiratory volume in 1 second (FEV1 and forced vital capacity (FVC is <0.7 in post-bronchodilator spirometry. The non-COPD group was matched for both age and sex, and were defined as having an FEV1, FVC, and FEV1/FVC ≥0.7 in spirometry. Finally, 333 patients were retrospectively reviewed; of this group, 82 patients had COPD.Results: Among the subjects, 201 patients (60% were nonsmokers, while 78 (23% were current smokers. The prevalence of colorectal adenomatous polyps was 39% (98/251 in the non-COPD group and 66% (54/82 in the COPD group. Among 54 patients with adenomatous polyps in the COPD group, 47 had tubular adenoma and seven had villous adenoma. Multiple logistic regression analyses revealed that only COPD patients whom matched to the criteria of COPD by pulmonary function test (odds ratio 2.1, 95% confidence interval: 1.1–3.8; P=0.019 were independently associated with colorectal malignant potential.Conclusion: The risk of colorectal malignant potential in the COPD group was higher than in the non-COPD group. We may suggest that COPD patients should consider regular colonoscopic evaluation to screen for premalignant colon polyps regardless of smoking. Keywords: COPD, colorectal adenomatous polyp, smoking, chronic obstructive pulmonary

  1. Recurrent small intestine intussusception in a patient with Peutz-Jeghers syndrome Invaginación recurrente del intestino delgado en un paciente con síndrome de Pentz-Jeghers

    Directory of Open Access Journals (Sweden)

    Orestis Ioannidis

    2012-01-01

    Full Text Available Peutz-Jeghers syndrome is a rare hereditary autosomal dominant disease caused by a mutation of the tumor suppressor gene serine/threonine kinase 11 located in chromosome 19p13.3. It is characterized by the presence of extensive mucocutaneous pigmentation, especially of the lips and the occurrence of hamartomatous polyps throughout the gastrointestinal tract. Gastrointestinal hamartomas occur predominantly in the small intestine and can become symptomatic leading usually to intestinal obstruction and abdominal pain. We present a case of recurrent intestinal obstruction caused by small bowel intussusception treated by reduction, enterotomy and polypectomy and followed by intraoperative enteroscopy and endoscopic polypectomy.

  2. A case of giant fibrovascular polyp of the esophagus. MR findings

    International Nuclear Information System (INIS)

    Kanamoto, Takaaki; Matsuki, Mitsuru; Kani, Hiroyuki; Tanikake, Masato; Narabayashi, Isamu; Egashira, Yutaro; Shibayama, Yuro

    2005-01-01

    We report a case of giant fibrovascular polyp of the esophagus. The patient was a 69-year-old man who complained of hematemesis. Barium swallowing revealed a long, expansile lesion within the esophagus. Endoscopy demonstrated a pedunculated lesion covered with normal esophageal epithelium. On MRI, the sagittal image showed the characteristic sausage-like shape of the lesion. On T2-weighted images, the lesion demonstrated predominantly low signal intensity, which reflected a fibrous tumor. Opposed-phase imaging showed the area of decreased intensity within the mass, which reflected adipose tissue. MRI was useful for the differential diagnosis of fibrovascular polyp. (author)

  3. Improved classifier for computer-aided polyp detection in CT Colonography by nonlinear dimensionality reduction

    Science.gov (United States)

    Wang, Shijun; Yao, Jianhua; Summers, Ronald M.

    2008-01-01

    Computer-aided detection (CAD) has been shown to be feasible for polyp detection on computed tomography (CT) scans. After initial detection, the dataset of colonic polyp candidates has large-scale and high dimensional characteristics. In this article, we propose a nonlinear dimensionality reduction method based on diffusion map and locally linear embedding (DMLLE) for large-scale datasets. By selecting partial data as landmarks, we first map these points into a low dimensional embedding space using the diffusion map. The embedded landmarks can be viewed as a skeleton of whole data in the low dimensional space. Then by using the locally linear embedding algorithm, nonlandmark samples are mapped into the same low dimensional space according to their nearest landmark samples. The local geometry is preserved in both the original high dimensional space and the embedding space. In addition, DMLLE provides a faithful representation of the original high dimensional data at coarse and fine scales. Thus, it can capture the intrinsic distance relationship between samples and reduce the influence of noisy features, two aspects that are crucial to achieving high classifier performance. We applied the proposed DMLLE method to a colonic polyp dataset of 175 269 polyp candidates with 155 features. Visual inspection shows that true polyps with similar shapes are mapped to close vicinity in the low dimensional space. We compared the performance of a support vector machine (SVM) classifier in the low dimensional embedding space with that in the original high dimensional space, SVM with principal component analysis dimensionality reduction and SVM committee using feature selection technology. Free-response receiver operating characteristic analysis shows that by using our DMLLE dimensionality reduction method, SVM achieves higher sensitivity with a lower false positive rate compared with other methods. For 6–9mm polyps (193 true polyps contained in test set), when the number of

  4. Improved classifier for computer-aided polyp detection in CT colonography by nonlinear dimensionality reduction.

    Science.gov (United States)

    Wang, Shijun; Yao, Jianhua; Summers, Ronald M

    2008-04-01

    Computer-aided detection (CAD) has been shown to be feasible for polyp detection on computed tomography (CT) scans. After initial detection, the dataset of colonic polyp candidates has large-scale and high dimensional characteristics. In this article, we propose a nonlinear dimensionality reduction method based on diffusion map and locally linear embedding (DMLLE) for large-scale datasets. By selecting partial data as landmarks, we first map these points into a low dimensional embedding space using the diffusion map. The embedded landmarks can be viewed as a skeleton of whole data in the low dimensional space. Then by using the locally linear embedding algorithm, nonlandmark samples are mapped into the same low dimensional space according to their nearest landmark samples. The local geometry is preserved in both the original high dimensional space and the embedding space. In addition, DMLLE provides a faithful representation of the original high dimensional data at coarse and fine scales. Thus, it can capture the intrinsic distance relationship between samples and reduce the influence of noisy features, two aspects that are crucial to achieving high classifier performance. We applied the proposed DMLLE method to a colonic polyp dataset of 175 269 polyp candidates with 155 features. Visual inspection shows that true polyps with similar shapes are mapped to close vicinity in the low dimensional space. We compared the performance of a support vector machine (SVM) classifier in the low dimensional embedding space with that in the original high dimensional space, SVM with principal component analysis dimensionality reduction and SVM committee using feature selection technology. Free-response receiver operating characteristic analysis shows that by using our DMLLE dimensionality reduction method, SVM achieves higher sensitivity with a lower false positive rate compared with other methods. For 6-9 mm polyps (193 true polyps contained in test set), when the number of false

  5. Adult ileocolic intussusception secondary to ileocaecal valve polyp.

    LENUS (Irish Health Repository)

    Chugthai, Saqib Zeeshan

    2012-01-31

    Intussusception is relatively common in children, but it is a rare cause of abdominal pain and intestinal obstruction in adults. The aetiology, clinical presentation and management of this condition differs in adults and children. Preoperative clinical diagnosis is usually difficult due to the non-specific and intermittent nature of the symptoms. Ultrasound and computed tomography can be helpful in establishing the diagnosis. We present a case of adult ileocolic intussusception with classical radiological signs and operative findings. In adults the diagnosis of intussusception should be considered in a case of intermittent abdominal pain, especially with clinical signs of intermittent bowel obstruction.

  6. Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management

    Directory of Open Access Journals (Sweden)

    Emanuele Neri

    2010-12-01

    , improving overall diagnostic accuracy and potentially speeding up the clinical workflow of CTC image interpretation.Keywords: colonic polyps, colorectal cancer, colonoscopy, double contrast barium enema, computed tomography colonography

  7. [Dermatology and polyposis of the gastro-intestinal tract (author's transl)].

    Science.gov (United States)

    Bazex, A; Bazex, J

    1978-10-01

    The authors study three rare syndromes which are characterized by the association of cutaneous manifestations with an intestinal polyposis: Gardner's syndrome, Peutz-Jeghers-Touraine's syndrome, Cronkhite-Canada's syndrome. The Gardner's syndrome is transmitted with an autosomal prevalence, and its vital prognosis remains very porr. It is characterized by the association of various cutaneous manifestations such as fibromas, freckles, etc. with osteomas, neuro-fibromas and polyps of the large bowel. Its severity is related to the very early malignant degeneration of digestive polyps. The Peutz-Jeghers-Touraine's syndrome is transmitted in an autosomal prevalence and its vital prognosis is benign. The cutaneous manifestations are the very early occurrence of lentigines on the face, around the hiatus, and on the lips. The polyps are situated on the small bowel, and are the source of important functional phenomenons; their malignant change is rare. The Cronkhite-Canada's syndrome is rare. Its etiology is unknown and its prognosis is very poor. Its manifestation is the association of more or less wide-spread cutaneous pigmentations, alopecia, and onyxis with a digestive syndrome secondary to a pseudo-polyposis which is the origin for afecal and serous diarrhea, a cause for very severe denutrition. The diagnosis and the treatment of these three syndromes are discussed.

  8. Intestinal tumorigenesis is not affected by progesterone signaling in rodent models.

    Directory of Open Access Journals (Sweden)

    Jarom Heijmans

    Full Text Available Clinical data suggest that progestins have chemopreventive properties in the development of colorectal cancer. We set out to examine a potential protective effect of progestins and progesterone signaling on colon cancer development. In normal and neoplastic intestinal tissue, we found that the progesterone receptor (PR is not expressed. Expression was confined to sporadic mesenchymal cells. To analyze the influence of systemic progesterone receptor signaling, we crossed mice that lacked the progesterone receptor (PRKO to the Apc(Min/+ mouse, a model for spontaneous intestinal polyposis. PRKO-Apc(Min/+ mice exhibited no change in polyp number, size or localization compared to Apc(Min/+. To examine effects of progestins on the intestinal epithelium that are independent of the PR, we treated mice with MPA. We found no effects of either progesterone or MPA on gross intestinal morphology or epithelial proliferation. Also, in rats treated with MPA, injection with the carcinogen azoxymethane did not result in a difference in the number or size of aberrant crypt foci, a surrogate end-point for adenoma development. We conclude that expression of the progesterone receptor is limited to cells in the intestinal mesenchyme. We did not observe any effect of progesterone receptor signaling or of progestin treatment in rodent models of intestinal tumorigenesis.

  9. Gastric and intestinal surgery.

    Science.gov (United States)

    Fossum, Theresa W; Hedlund, Cheryl S

    2003-09-01

    Gastric surgery is commonly performed to remove foreign bodies and correct gastric dilatation-volvulus and is less commonly performed to treat gastric ulceration or erosion, neoplasia, and benign gastric outflow obstruction. Intestinal surgery, although commonly performed by veterinarians, should never be considered routine. The most common procedures of the small intestinal tract performed in dogs and cats include enterotomy and resection/anastomosis. Surgery of the large intestine is indicated for lesions causing obstruction, perforations, colonic inertia, or chronic inflammation.

  10. Intestinal parasites and tuberculosis

    Directory of Open Access Journals (Sweden)

    Anuar Alonso Cedeño-Burbano

    2017-10-01

    Conclusions: The available evidence was insufficient to affirm that intestinal parasites predispose to developing tuberculous. The studies carried out so far have found statistically insignificant results.

  11. Microbiome Analysis of Stool Samples from African Americans with Colon Polyps

    NARCIS (Netherlands)

    Brim, H.; Yooseph, S.; Zoetendal, E.G.; Lee, E.; Torralbo, M.; Laiyemo, A.O.; Shokrani, B.; Nelson, K.; Ashktorab, H.

    2013-01-01

    Background: Colonic polyps are common tumors occurring in similar to 50% of Western populations with similar to 10% risk of malignant progression. Dietary agents have been considered the primary environmental exposure to promote colorectal cancer (CRC) development. However, the colonic mucosa is

  12. Computer-aided detection of polyps in CT colonography by means of AdaBoost

    Science.gov (United States)

    Xu, Jian-Wu; Suzuki, Kenji

    2012-03-01

    Computer-aided detection (CADe) has been investigated for assisting radiologists in detecting polyps in CT colonography (CTC). One of the major challenges in current CADe of polyps in CTC is to improve the specificity without sacrificing the sensitivity. We have developed several CADe schemes based on a massive-training framework with different nonlinear regression models such as neural network regression, support vector regression, and Gaussian process regression. Individual CADe schemes based on different nonlinear regression models, however, achieved comparable results. In this paper, we propose to use the AdaBoost algorithm to combine different regression models in CADe schemes for improving the specificity without sacrificing the sensitivity. To test the performance of the proposed approach, we compared it with individual regression models in the distinction between polyps and various types of false positives (FPs). Our CTC database consisted of 246 CTC datasets obtained from 123 patients in the supine and prone positions. The testing set contained 93 patients including 19 polyps in seven patients and 86 negative patients with 474 FPs produced by an original CADe scheme. The AdaBoost algorithm combining multiple massive-training regression models achieved a performance that was higher than each individual regression model, yielding a 94.7% (18/19) bypolyp sensitivity at an FP rate of 2.0 (188/93) per patient in a leave-one-lesion-out cross validation test.

  13. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists.

    Science.gov (United States)

    Fokkens, Wytske J; Lund, Valerie J; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John

    2012-03-01

    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

  14. Unusual Endoscopic Findings in Children: Esophageal and Gastric Polyps: Three Cases Report.

    Science.gov (United States)

    Diaconescu, Smaranda; Miron, Ingrith; Gimiga, Nicoleta; Olaru, Claudia; Ioniuc, Ileana; Ciongradi, Iulia; Sarbu, Ioan; Stefanescu, Gabriela

    2016-01-01

    Isolated polyps of the upper digestive tract are rarely diagnosed in children, being usually an incidental finding during endoscopic exploration.The diagnostic, therapy, and outcome of these lesions are based on endoscopy and pathology.In a 5-year period, clinical features, topography, size, pathology, therapeutics, and progression of esophagogastric polyps founded in children addressed to our pediatric gastroenterology unit were studied.The authors encountered 3 lesions in teenagers aged 13 to 17 years two males (2M), from a total number of 2140 upper digestive endoscopies (0.14%). All patients presented with pirosis, epigastric pain, and vomits; one of the children had end-stage renal disease and Kabuki syndrome. Endoscopic and pathologic findings were 2 esophageal polyps, an inflammatory one, and another containing goblet cells and a double-headed hyperplastic gastric polyp. Two patients received proton pump inhibitors without any improvement in subsequent endoscopic evaluations.The difficulties related to age group, underlying conditions, debatable response to acid suppression, and limited experience in pediatric therapeutic endoscopy selected significantly the effectiveness of treatment.The rarity of these lesions requires an individualized management, the endoscopic diagnostic, and therapeutic gesture depending on the symptoms, type, location, comorbidities, and team experience.

  15. Incidentally detected ureteral fibroepithelial polyps in children: is endoscopic treatment of them really necessary?

    Science.gov (United States)

    Kara, Cengiz; Reşorlu, Berkan; Oğuz, Ural; Unsal, Ali

    2010-03-01

    Fibroepithelial polyps (FEPs) are the most common benign lesions of the ureter. However, FEPs of the ureter accompanied by calculi are rare. In this study, we reviewed our experiences with five children having FEP associated with ureteral calculi to define more clearly this entity and its outcome following observation. We identified five children who were intraoperatively found to have FEP associated with ureteral calculi during the period 2000-2008. The patients included four males and one female, and the average age of these patients was 6.4 years (range 4-9). The main symptoms were flank pain (five patients), hematuria (four patients), and dysuria (two patients). Radiographically, all patients showed complete ureteral obstruction due to distal ureter stone and hydronephrosis. Fibroepithelial polyps and stones were located left distal ureter in all children. These polyps were 1-2 cm, with a mean size of 1.5 cm. Stone sizes ranged from 5 to 13 mm (mean 8.8 mm). The stones were smashed into smaller fragments using a pneumatic lithotriptor, and the pieces were removed with forceps. After the lithotripsy, the polyps were grasped with biopsy forceps and punch biopsies were done. FEPs were diagnosed in all cases by postoperative histological examination. During the follow-up period of these patients, none of the FEPs displayed any growth or symptom. Due to the potential complications during the ureteroscopic resection, our opinion is to observe the small FEPs without joint symptoms and hydronephrosis.

  16. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists

    NARCIS (Netherlands)

    Fokkens, Wytske J.; Lund, Valerie J.; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John

    2012-01-01

    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also propose definitions for 'difficult to treat' rhinosinusitis, control

  17. Polype antrochoanal de l'enfant | Amor | Journal Tunisien d'ORL et ...

    African Journals Online (AJOL)

    origine est le sinus maxillaire et qui touche avec prédilection l'enfant et l'adulte jeune. Objectif : Le but de ce travail est de préciser les caractéristiques du polype de killian chez l'enfant et d'évaluer les résultats du traitement endoscopique.

  18. Lack of association between the 677 C to T polymorphism and colorectal hyperplastic polyps

    NARCIS (Netherlands)

    Ulrich, C.M.; Kampman, E.; Bigler, J.; Schwartz, S.M.; Chen, C.; Bostick, R.; Fosdick, L.

    2000-01-01

    Colorectal hyperplastic polyps are benign lesions that share many risk factors with colorectal adenomas and cancers. Low folate intakes are associated with an increased risk of colon cancer. The enzyme 5,10-methylene-tetrahydrofolate reductase (MTHFR) may be linked to DNA methylation and nucleotide

  19. Gastric Polyp: A rare cause of Chronic Volvulus in an Adult ...

    African Journals Online (AJOL)

    Gastric Polyp: A rare cause of Chronic Volvulus in an Adult. ME Mohammed, I Elawad. Abstract. Gastric volvulus is a rare but potentially life-threatening cause of upper gastrointestinal obstruction. It presents clinically with epigastric pain radiating to the back and or left thoracic area or left abdominal quadrant and retching.

  20. Detection and Segmentation of Colonic Polyps on Implicit Isosurfaces by Second Principal Curvature Flow

    NARCIS (Netherlands)

    Van Wijk, C.; Van Ravesteijn, V.F.; Vos, F.M.; Van Vliet, L.J.

    2010-01-01

    Today’s computer aided detection systems for computed tomography colonography (CTC) enable automated detection and segmentation of colorectal polyps.We present a paradigm shift by proposing a method that measures the amount of protrudedness of a candidate object in a scale adaptive fashion. One of

  1. Detection and segmentation of colonic polyps on implicit isosurfaces by second principal curvature flow

    NARCIS (Netherlands)

    van Wijk, Cees; van Ravesteijn, Vincent F.; Vos, Frans M.; van Vliet, Lucas J.

    2010-01-01

    Today's computer aided detection systems for computed tomography colonography (CTC) enable automated detection and segmentation of colorectal polyps. We present a paradigm shift by proposing a method that measures the amount of protrudedness of a candidate object in a scale adaptive fashion. One of

  2. Fibroepithelial polyps of the urethra in infants: A report of three cases

    African Journals Online (AJOL)

    A. Ksia

    Fibroepithelial polyps of the urethra (FEPU) are rare benign epithe- lial tumors, more frequently encountered in males and in the posterior urethra. In this paper, we report our experience with three patients having FEPU (between January 2006 and December 2012) and discuss the etiology, clinical presentations, diagnosis, ...

  3. Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth.

    Science.gov (United States)

    Mori, Hirohito; Kobara, Hideki; Tsushimi, Takaaki; Fujihara, Shintaro; Nishiyama, Noriko; Matsunaga, Tae; Ayaki, Maki; Yachida, Tatsuo; Masaki, Tsutomu

    2014-05-21

    Gastric hamartomatous inverted polyps (GHIP) are difficult to diagnose accurately because of inversion into the submucosal layer. GHIP are diagnosed using the pathological characteristics of the tumor, including the fibroblast cells, smooth muscle, nerve components, glandular hyperplasia, and cystic gland dilatation. Although Peutz-Jeghers syndrome, juvenile polyposis, and Cowden disease are hereditary, it is rare to encounter 2 cases of monostotic and asymptomatic gastric hamartomas. The pathogeneses of hamartomatous inverted polyps and inverted hyperplastic polyps remain controversial because of the paucity of reported cases. There are 3 hypotheses regarding the pathogenesis of complete gastric inverted polyps. Based on our experience with 2 successive, rare GHIP cases, we affirm the hypothesis that after a hamartomatous change occurs in the submucosal layer, some of these components are exposed to the gastric mucosa and, consequently, form a hypertrophic lesion. In Case 1, our hypothesis explains why a tiny hypertrophic change was first detected on the top of the submucosal tumor using a detailed narrow band imaging-magnified endoscopy. There was no confirmation that the milky white mucous and calcification structures were exuding directly from the biopsy site like Case 1, and in Case 2 the presence of this mucous was indirectly confirmed during an endoscopic submucosal dissection (ESD). Regarding the pathogenesis of GHIP, a submucosal hamartomatous change may occur prior to the growth of hypertrophic portions. An en bloc resection using ESD is recommended for treatment.

  4. Application of a conversion factor to estimate the adenoma detection rate from the polyp detection rate.

    LENUS (Irish Health Repository)

    Francis, Dawn L

    2011-03-01

    The adenoma detection rate (ADR) is a quality benchmark for colonoscopy. Many practices find it difficult to determine the ADR because it requires a combination of endoscopic and histologic findings. It may be possible to apply a conversion factor to estimate the ADR from the polyp detection rate (PDR).

  5. Asthma in ear, nose, and throat primary care patients with chronic rhinosinusitis with nasal polyps

    DEFF Research Database (Denmark)

    Frendø, Martin; Håkansson, Kåre; Schwer, Susanne

    2016-01-01

    BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder associated with asthma. This association is well described in patients with CRSwNP undergoing endoscopic sinus surgery (ESS); however, some patients are never referred for surgery, and the frequency of...

  6. Sigmoid colon translocation of an intrauterine device misdiagnosed as a colonic polyp: A case report.

    Science.gov (United States)

    Zhou, Xin-Xin; Yu, Mo-Sang; Gu, Meng-Li; Zhong, Wei-Xiang; Wu, Hong-Ru; Ji, Feng; Pan, Hang-Hai

    2018-02-01

    Intrauterine contraceptive devices (IUDs) are recommended as a means of contraception. Translocation of IUD is a rare and serious complication. Colonic inflammatory mass caused by translocated IUD initially misdiagnosed as a colonic polyp is extremely rare and has not been reported yet. This report presents a case of sigmoid colon translocation of intrauterine device on a 37-year-old female patient. Colonoscopy was performed due to her complain of repeated blood in stools and subsequently the patient was misdiagnosed as a sigmoid colon polyp. Nonetheless, the "polyp" was not able to be removed endoscopically. Sigmoid colon translocation of an intrauterine device. To further clarify the diagnosis, computed tomography (CT) scan was performed and the "polyp" was confirmed to be caused by a translocated IUD. The translocated IUD was removed easily by surgery, and the patient recovered soon after the operation. The present case indicates that an annual gynaecologic examination is necessary to determine the position of the IUD, and a CT examination may help confirm an ectopic IUD.

  7. [Determination of bile acids in stools of patients with colonic neoplasms and adenomatous polyps].

    Science.gov (United States)

    Paniagua Estévez, M; Roque Lozano, J; Cerdán Cordoví, A; Rodríguez Miranda, A

    1994-01-01

    Since several years ago, the biliar acids have been incriminated in the etiopathogeny of colon cancer and adenomatous polyps, above all the secondary ones, involved by its aggressive action over the colonic epithelium in these mechanisms. The dietetical habits of developed countries have the high responsibility for this situation, their food pattern being a high animal fat diet, high in refined carbohydrates, animal proteins and low in dietetic fiber (diet type "occidental") unlike to developing countries that have a high natural fiber diet, having a much lower incidence in colon cancer and adenomatous polyps. Dietetic fiber has been studied considering it with a protector effect over the aggressive action of biliar acids on the colon mucous. We have studied 60 patients, 20 of them with colon cancer, 20 with adenomatous and 20 case controls without colonic pathology. All of them had total high biliar acids in stools, a dietetical screening was carried out to determine the intake of animal fat and dietetic fibre during a week. There was a significant correlation in cases of cancer, polyps and biliar acids high in stools. There was also a significant correlation between the undue dietetic habits in colon cancer patients and high bilar acids. In those cases of adenomatous polyps, there was not a significant relation to dietetic habits.

  8. Computer-Aided Detection of Polyps in CT Colonography Using Logistic Regression

    NARCIS (Netherlands)

    Van Ravesteijn, V.F.; Van Wijk, C.; Vos, F.M.; Truyen, R.; Peters, J.F.; Stoker, J.; Van Vliet, L.J.

    2010-01-01

    We present a computer-aided detection (CAD) system for computed tomography colonography that orders the polyps according to clinical relevance. TheCADsystem consists of two steps: candidate detection and supervised classification. The characteristics of the detection step lead to specific choices

  9. Computer-aided detection of polyps in CT colonography using logistic regression

    NARCIS (Netherlands)

    van Ravesteijn, Vincent F.; van Wijk, Cees; Vos, Frans M.; Truyen, Roel; Peters, Joost F.; Stoker, Jaap; van Vliet, Lucas J.

    2010-01-01

    We present a computer-aided detection (CAD) system for computed tomography colonography that orders the polyps according to clinical relevance. The CAD system consists of two steps: candidate detection and supervised classification. The characteristics of the detection step lead to specific choices

  10. Follow up of patients with colorectal polyps: are the BSG guidelines being adhered to?

    Science.gov (United States)

    Pickard, M; Dewar, E P; Kapadia, R C; Khan, R B N; Hutchinson, I F; Nejim, A

    2007-03-01

    The publication of the BSG guidelines in 2002 provided a framework for the follow up of patients with colorectal polyps. The aim of the present study was to determine whether they had, or were being correctly adhered to in a moderately sized District General Hospital. A total of 598 patients were on the waiting list for colonoscopy at Airedale General Hospital (AGH) in February 2005. Of these, 203 were being followed up as a result of the previous finding of a polyp. Only 14.8% of patients had been or were being followed up according to the BSG guidelines. The majority of the 85.2% of patients who did not comply with follow up did so as a result of over investigation. Seventy-eight per cent of the low-risk group and 55% of the intermediate-risk group had been colonoscoped, or were waiting to have colonoscopy, too soon or too frequently according to the BSG guidelines. Twenty-four patients with hyperplastic polyps were being followed up incorrectly, as were 17 patients discovered to have a polyp pathology on flexible sigmoidoscopy. It was established that 131 extra colonoscopies had been, or were planned to be performed unnecessarily. These data have major implications with regard to patient safety, service provision and cost to the NHS.

  11. Polyps revealed on a virtual colon voyage : Three-dimensional colonoscopy reduces discomfort

    NARCIS (Netherlands)

    Bruens, A.; Battjes, J.A.; Winterwerp, H.; Mols, B.

    2003-01-01

    In the western world, colon cancer is the second-largest cause of death from cancer. Since there is a considerable risk that polyps five millimetres and more in diameter may develop into malicious tumours, it is important that they can be detected at an early stage. Until now, this is done by means

  12. Reduction of false positives by extracting fuzzy rules from data for polyp detection in CTC scans

    Science.gov (United States)

    Siddique, Musib M.; Zheng, Yalin; Yang, Xiaoyun; Beddoe, Gareth

    2008-03-01

    This paper presents an adaptive neural network based Fuzzy Inference System (ANFIS) to reduce the false positive (FP) rate of detected colonic polyps in Computed Tomography Colonography (CTC) scans. Extracted fuzzy rules establish linguistically interpretable relationships in the data that are easy to understand, validate, and extend. The system takes several features identified from regions extracted by a segmentation algorithm and decides whether the regions are true polyps. In the training phase, subtractive clustering is used to down-sample the negative regions in order to get balanced data. The rule extraction method is based on estimating clusters in the data using the subtractive clustering algorithm; each cluster obtained corresponds to a fuzzy rule that maps a region in the input space to an output class. After the number of rules and initial rule parameters are obtained by cluster estimation, the rule parameters are optimized using a hybrid learning algorithm which is a combination of least-squares estimation with back propagation. The evolved Sugeno-type FIS has been tested on a total of 129 scans with 99 polyps of sizes 5-15 mm by experienced radiologists. The results indicate that for 93% detection sensitivity (on polyps), the evolved FIS method is able to remove 88% of FPs generated by the segmentation algorithm leaving 7.5 FP per scan. The high sensitivity rate of our results show the promise of neuro-fuzzy classifiers as an aid for interpreting CTC examinations.

  13. Ectopic lymphoid tissues support local immunoglobulin production in patients with chronic rhinosinusitis with nasal polyps.

    Science.gov (United States)

    Song, Jia; Wang, Hai; Zhang, Ya-Na; Cao, Ping-Ping; Liao, Bo; Wang, Zhe-Zheng; Shi, Li-Li; Yao, Yin; Zhai, Guan-Ting; Wang, Zhi-Chao; Liu, Li-Meng; Zeng, Ming; Lu, Xiang; Wang, Heng; Yang, Xiang-Ping; Yu, Di; Bachert, Claus; Liu, Zheng

    2018-03-01

    The contribution of ectopic lymphoid tissues (eLTs) to local immunoglobulin hyperproduction in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) is unclear. We sought to explore the cellular basis, formation mechanisms, and function of eLTs in patients with CRSwNP. We graded lymphoid aggregations in sinonasal mucosa and histologically studied their structures. The expression of lymphorganogenic factors and molecules required for immunoglobulin production was measured by using real-time PCR, and their localization was analyzed by means of immunohistochemistry and immunofluorescence. The phenotype of follicular helper T cells was analyzed by performing flow cytometry. Immunoglobulin levels were quantified by using the Bio-Plex assay or ImmunoCAP system. Nasal tissue explants were challenged ex vivo with Dermatophagoides pteronyssinus group 1 (Der p 1), and the expression of Iε-Cμ and Iε-Cγ circle transcripts was detected by using seminested PCR. Increased formation of eLTs with germinal center-like structures was discovered in patients with eosinophilic (20.69%) and noneosinophilic (17.31%) CRSwNP compared with that in patients with chronic rhinosinusitis without nasal polyps (5.66%) and control subjects (3.70%). The presence of eLTs was associated with increased expression of lymphorganogenic and inflammatory chemokines and cytokines, as well as their receptors. The expression of molecules required for immunoglobulin production, generation of follicular helper T cells, and production of IgE in eosinophilic polyps and IgG and IgA in both eosinophilic and noneosinophilic polyps were predominantly upregulated in patients with eLTs. After Der p 1 challenge ex vivo, Iε-Cμ transcript was detected only in eosinophilic polyps with eLTs but not in polyps without eLTs and noneosinophilic polyps. eLTs might support local immunoglobulin production and therefore significantly contribute to the development of CRSwNP. Copyright © 2017 American Academy of

  14. Hyoscine for polyp detection during colonoscopy: A meta-analysis and systematic review.

    Science.gov (United States)

    Ashraf, Imran; Ashraf, Sohail; Siddique, Sameer; Nguyen, Douglas L; Choudhary, Abhishek; Bechtold, Matthew L

    2014-11-16

    To assess the role of hyoscine for polyp detection during colonoscopy. Studies (randomized controlled trials or RCTs) that compared the use of hyoscine vs no hyoscine or placebo for polyp detection during colonoscopy were included in our analysis. A search on multiple databases was performed in September 2013 with search terms being "hyoscine and colonoscopy", "hyoscine and polyp", "hyoscine and adenoma", "antispasmotic and colonoscopy", "antispasmotic and adenoma", and "antispasmotic and polyp". Jadad scoring was used to assess the quality of studies. The efficacy of hyoscine was analyzed using Mantel-Haenszel model for polyp and adenoma detection with odds ratio (OR). The I (2) measure of inconsistency was used to assess heterogeneity (P 50%). Statistical analysis was performed by RevMan 5.1. Funnel plots was used to assess publication bias. The search of the electronic databases identified 283 articles. Of these articles, eight published RCTs performed at various locations in Europe, Asia, and Australia were included in our meta-analysis, seven published as manuscripts and one published as an abstract (n = 2307). All the studies included patients with a hyoscine and a no hyoscine/placebo group and were of adequate quality (Jadad score ≥ 2). Eight RCTs assessed the polyp detection rate (PDR) (n = 2307). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for PDR (OR = 1.06; 95%CI: 0.89-1.25; P = 0.51). Five RCTs assessed the adenoma detection rate (ADR) (n = 2015). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for ADR (OR = 1.12; 95%CI: 0.92-1.37; P = 0.25). Furthermore, the timing of hyoscine administration (given at cecal intubation or pre-procedure) demonstrated no differences in PDR compared to no hyoscine or placebo. Publication bias or heterogeneity was not observed for any of the outcomes. Hyoscine use in patients undergoing

  15. Investigation of the Roles of Cyclooxygenase-2 and Galectin-3 Expression in the Pathogenesis of Premenopausal Endometrial Polyps

    Directory of Open Access Journals (Sweden)

    Esin Kasap

    2016-05-01

    Full Text Available Background: The pathogenesis and etiology of endometrial polyps has not been elucidated. In this study, we aimed to examine the pathogenic mechanisms of endometrial polyp development using immunohistochemistry. We evaluated the expression of galectin-3 and cyclooxgenase-2 (COX-2 during the menstrual cycle in premenopausal women with endometrial polyps or normal endometrium. Methods Thirty-one patients with endometrial polyps and 50 healthy control patients were included in this study. The levels of expression of COX-2 and galectin-3 were studied by immunohistochemistry. Results: The percentage of COX-2–positive cells and the intensity of COX-2 staining in the endometrium did not vary during the menstrual cycle either in the control group or in patients with endometrial polyps. However, expression of galectin-3 was significantly lower in endometrial polyps and during the proliferative phase of the endometrium compared with the secretory phase. Conclusions: Our data suggests that the pathogenesis of endometrial polyps does not involve expression of COX-2 or galectin-3.

  16. The differentiation and prognostic implication of the solitary colonic polyp and the polyposis syndromes: A radiologic, histologic, and pathologic approach

    International Nuclear Information System (INIS)

    Olmsted, W.W.; Lichtenstein, J.E.

    1987-01-01

    The differential diagnosis of the solitary colonic polyp and the implications and prognostic significance of the solitary colonic polyp and the polyposis syndromes are frequently confusing because of imprecise and overlapping terminology. Such confusion may lead to misdiagnosis or overdiagnosis and improper patient treatment and surveillance. In the first part of this course, basic terms are defined to acquaint all participants with current common ground. The most frequently occurring solitary polyps (e.g., the colonic adenoma, hyperplastic polyp, Peutz-Jeghers hamartoma, juvenile hamartoma, and inflammatory polyp) are illustrated in detail with radiologic-histologic-pathologic correlation. The prognostic significance of each type of lesion and a scheme for proper colonic surveillance is discussed. In the second part of the session, there is a thorough discussion of multiple colonic polyps and the polyposis syndromes. Radiologic-pathologic correlation are used to illustrate these entities, and therapeutic and diagnostic implications are thoroughly covered. The differential diagnosis of the polyposis syndromes, including lymphoid abnormalities, pneumatosis intestinalis, and colitis cystica profunda, are mentioned. The participant should expect to gain a full understanding of the solitary and multiple colonic polyp states and algorithms for prognosis and treatment

  17. A randomised controlled trial of Outpatient versus inpatient Polyp Treatment (OPT) for abnormal uterine bleeding.

    Science.gov (United States)

    Clark, T Justin; Middleton, Lee J; Cooper, Natalie Am; Diwakar, Lavanya; Denny, Elaine; Smith, Paul; Gennard, Laura; Stobert, Lynda; Roberts, Tracy E; Cheed, Versha; Bingham, Tracey; Jowett, Sue; Brettell, Elizabeth; Connor, Mary; Jones, Sian E; Daniels, Jane P

    2015-07-01

    Uterine polyps cause abnormal bleeding in women and conventional practice is to remove them in hospital under general anaesthetic. Advances in technology make it possible to perform polypectomy in an outpatient setting, yet evidence of effectiveness is limited. To test the hypothesis that in women with abnormal uterine bleeding (AUB) associated with benign uterine polyp(s), outpatient polyp treatment achieved as good, or no more than 25% worse, alleviation of bleeding symptoms at 6 months compared with standard inpatient treatment. The hypothesis that response to uterine polyp treatment differed according to the pattern of AUB, menopausal status and longer-term follow-up was tested. The cost-effectiveness and acceptability of outpatient polypectomy was examined. A multicentre, non-inferiority, randomised controlled trial, incorporating a cost-effectiveness analysis and supplemented by a parallel patient preference study. Patient acceptability was evaluated by interview in a qualitative study. Outpatient hysteroscopy clinics and inpatient gynaecology departments within UK NHS hospitals. Women with AUB - defined as heavy menstrual bleeding (formerly known as menorrhagia) (HMB), intermenstrual bleeding or postmenopausal bleeding - and hysteroscopically diagnosed uterine polyps. We randomly assigned 507 women, using a minimisation algorithm, to outpatient polypectomy compared with conventional inpatient polypectomy as a day case in hospital under general anaesthesia. The primary outcome was successful treatment at 6 months, determined by the woman's assessment of her bleeding. Secondary outcomes included quality of life, procedure feasibility, acceptability and cost per quality-adjusted life-year (QALY) gained. At 6 months, 73% (166/228) of women who underwent outpatient polypectomy were successfully treated compared with 80% (168/211) following inpatient polypectomy [relative risk (RR) 0.91, 95% confidence interval (CI) 0.82 to 1.02]. The lower end of the CIs showed

  18. Colonoscopy yields fewer polyps as the day progresses despite using social influence theory to reverse the trend.

    Science.gov (United States)

    Kaneshiro, Marc; Ho, Andrew; Chan, Michael; Cohen, Hartley; Spiegel, Brennan M R

    2010-12-01

    We previously reported that fewer polyps are detected by colonoscopy as the day progresses, a phenomenon that could be modified with "social influence theory" by using auditing and feedback. To measure the impact of a social influence informational poster on the relationship between time of day and colonoscopy yield. Controlled before-and-after study comparing the polyp yield and time of day relationship in a historical cohort versus a 3-month intervention period. University-based Veterans Affairs medical center. Patients undergoing outpatient screening, surveillance, or diagnostic colonoscopies. Placement of informational posters in endoscopy rooms within view of operators and nurses. The poster depicted a bar graph of the previously documented hour-by-hour decreases in polyp yield coupled with prominent text: "What Time Is It Now?" Polyp yield, including secondary end point limited to adenoma detection. We performed regression to measure the effect of start time on polyp yield. There were 477 and 301 patients in the control and intervention periods, respectively. There was a negative relationship between start time and polyp yield, including adenoma detection, for both periods (P = .001). Start time remained negatively predictive of polyp and adenoma yield after adjusting for poster exposure and confounders (P = .01). Nonrandomized study design. An informational poster did not alter the relationship between colonoscopy start time and polyp yield. This strengthens the previous finding that start time may affect polyp yield and suggests that passive use of social influence theory is inadequate to modify this effect. Shortening endoscopy shifts and active auditing with feedback may be necessary. Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  19. Development and validation of a highly sensitive urine-based test to identify patients with colonic adenomatous polyps.

    Science.gov (United States)

    Wang, Haili; Tso, Victor; Wong, Clarence; Sadowski, Dan; Fedorak, Richard N

    2014-03-20

    Adenomatous polyps are precursors of colorectal cancer; their detection and removal is the goal of colon cancer screening programs. However, fecal-based methods identify patients with adenomatous polyps with low levels of sensitivity. The aim or this study was to develop a highly accurate, prototypic, proof-of-concept, spot urine-based diagnostic test using metabolomic technology to distinguish persons with adenomatous polyps from those without polyps. Prospective urine and stool samples were collected from 876 participants undergoing colonoscopy examination in a colon cancer screening program, from April 2008 to October 2009 at the University of Alberta. Colonoscopy reference standard identified 633 participants with no colonic polyps and 243 with colonic adenomatous polyps. One-dimensional nuclear magnetic resonance spectra of urine metabolites were analyzed to define a diagnostic metabolomic profile for colonic adenomas. A urine metabolomic diagnostic test for colonic adenomatous polyps was established using 67% of the samples (un-blinded training set) and validated using the other 33% of the samples (blinded testing set). The urine metabolomic diagnostic test's specificity and sensitivity were compared with those of fecal-based tests. Using a two-component, orthogonal, partial least-squares model of the metabolomic profile, the un-blinded training set identified patients with colonic adenomatous polyps with 88.9% sensitivity and 50.2% specificity. Validation using the blinded testing set confirmed sensitivity and specificity values of 82.7% and 51.2%, respectively. Sensitivities of fecal-based tests to identify colonic adenomas ranged from 2.5 to 11.9%. We describe a proof-of-concept spot urine-based metabolomic diagnostic test that identifies patients with colonic adenomatous polyps with a greater level of sensitivity (83%) than fecal-based tests.

  20. Adherence to colorectal polyp surveillance guidelines: is there a 'scope' to increase the opportunities for screening?

    LENUS (Irish Health Repository)

    O'Connor, Anthony

    2012-02-01

    Colorectal polyps are usually asymptomatic and are found opportunistically. Individuals with adenomata are at increased risk for cancer and therefore guidelines exist for surveillance of these lesions including those of the British Society of Gastroenterology (BSG). Deviation from these guidelines is common and increases the workload of endoscopy. We examined those individuals waiting for endoscopy for polyp surveillance to see whether strict adherence to BSG guidelines could facilitate opportunities for screening. A total of 413 patients with earlier colonic polyps were examined, of whom 50 patients were excluded based on having alternative indications for surveillance, 179 (49.3%) were appropriately scheduled for surveillance and 184 patients (55.9%) were scheduled incorrectly. Seventy-nine patients (30%) could have been discharged; of these, 59 had hyperplastic polyps. Of the remaining 105 inappropriate triages under surveillance at the wrong interval, seven patients were scheduled for too infrequent surveillance and 98 were too frequent. A total of 284 patients with adenomatous polyps were under surveillance of whom 11 patients (3.8%) were in the high-risk category and all were appropriately scheduled, and 75 patients (26.4%) were in the intermediate-risk category, of whom 48 were appropriately scheduled, 20 were incorrectly triaged as high risk and seven were triaged as low risk. A total of 198 (69.7%) patients were in the low-risk category, 117 of these were correctly triaged, 15 were incorrectly triaged as high risk and 66 were classified as intermediate risk. Over a five-year period, 318 unnecessary colonoscopies are being performed. On the basis of the data obtained from a population-based colorectal screening programme using immunohistochemical-faecal occult blood testing in our department another 1516 patients could be screened annually without requiring any additional endoscopy resources, if strict adherence to guidelines was assured.

  1. Fibroepithelial polyp of the glans penis in two children, a rare cause of penile mass: A case report

    Directory of Open Access Journals (Sweden)

    Patil Prashant S

    2016-07-01

    Full Text Available Fibroepithelial polyps of glans penis are rare in children. We present two male children with polyp over glans penis. The lesion was excised completely in both cases. Histopathological examination revealed fibroepithelial polyp in both patients. All of the reported cases published previously, except two are described in adults and all of them have been associated with the history of long-term condom catheter use. Only two cases have been reported in English literature in pediatric patients. We add two more cases to this rare entity in children.

  2. adhesive intestinal obstruction

    African Journals Online (AJOL)

    2006-06-01

    Jun 1, 2006 ... ABSTRACT. Background: Adhesions after abdominal and pelvic surgery are a major cause of intestinal obstruction in the western world and the pathology is steadily gaining prominence in our practice. Objective: To determine the magnitude of adhesive intestinal obstruction; to determine the types.

  3. Intestinal Barrier and Behavior.

    Science.gov (United States)

    Julio-Pieper, M; Bravo, J A

    2016-01-01

    The intestinal barrier function contributes to gut homeostasis by modulating absorption of water, electrolytes, and nutrients from the lumen into the circulation while restricting the passage of noxious luminal substances and microorganisms. Chronic conditions such as rheumatoid arthritis, inflammatory bowel disease, and celiac disease are associated to intestinal barrier dysfunction. Here, the hypothesis is that a leaky intestinal wall allowing for indiscriminate passage of intraluminal compounds to the vascular compartment could in turn lead to systemic inflammation. An increasing number of studies are now investigating the association between gut permeability and CNS disorders, under the premise that translocation of intestinal luminal contents could affect CNS function, either directly or indirectly. Still, it is unknown whether disruption of intestinal barrier is a causative agent or a consequence in these situations. Here, we discuss the latest evidence pointing to an association between increased gut permeability and disrupted behavioral responses. © 2016 Elsevier Inc. All rights reserved.

  4. Nodular lymphoid hyperplasia of the intestinal tract in infancy and childhood.

    Science.gov (United States)

    Atwell, J D; Burge, D; Wright, D

    1985-02-01

    Over an 18-year period we have diagnosed nodular lymphoid polyposis of the intestinal tract in 6 patients. The site of the polyposis, which was due to prominent lymphoid hyperplasia, was ileal (3), colonic (2), and rectal (1). The diagnosis was made following complications arising from the polyps, which included recurrent intussusception (2), rectal prolapse (1), intestinal or pseudointestinal obstruction (2), and rectal bleeding (1). Immunoglobulin staining was performed on all the bowel specimens and in every case secretory IgA was present on the mucosal surfaces and IgG and IgA were seen in the lamina propria, thus excluding immunodeficiency in these patients. Viral studies were performed in 3 patients and all were positive. In one patient Echovirus II was seen in tissue homogenate from a mesenteric lymph node and in another, adenovirus type II was cultured from lymphoid polyps of the rectum. A further patient had positive serological tests for adenovirus. Thus it appears that nodular lymphoid hyperplasia is part of the generalized lymphoid hyperplasia associated with viral infections in infancy and childhood. Immunodeficiency states as a cause of the lymphoid hyperplasia should always be excluded by estimation of serum immunoglobulins.

  5. Mycotoxins and the intestine

    Directory of Open Access Journals (Sweden)

    Leon Broom

    2015-12-01

    Full Text Available Fungal biochemical pathways can yield various compounds that are not considered to be necessary for their growth and are thus referred to as secondary metabolites. These compounds have been found to have wide ranging biological effects and include potent poisons (mycotoxins. Mycotoxins invariably contaminate crops and (thus animal feeds. The intestine is the key link between ingested mycotoxins and their detrimental effects on the animal. Effects on the intestine, or intestinal environment, and immune system have been reported with various mycotoxins. These effects are almost certainly occurring across species. Most, if not all, of the reported effects of mycotoxins are negative in terms of intestinal health, for example, decreased intestinal cell viability, reductions in short chain fatty acid (SCFA concentrations and elimination of beneficial bacteria, increased expression of genes involved in promoting inflammation and counteracting oxidative stress. This challenge to intestinal health will predispose the animal to intestinal (and systemic infections and impair efficient digestion and absorption of nutrients, with the associated effect on animal productivity.

  6. Time of day variation in polyp detection rate for colonoscopies performed on a 3-hour shift schedule.

    LENUS (Irish Health Repository)

    Munson, Gregory W

    2011-03-01

    Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue.

  7. Comparison of hand-craft feature based SVM and CNN based deep learning framework for automatic polyp classification.

    Science.gov (United States)

    Younghak Shin; Balasingham, Ilangko

    2017-07-01

    Colonoscopy is a standard method for screening polyps by highly trained physicians. Miss-detected polyps in colonoscopy are potential risk factor for colorectal cancer. In this study, we investigate an automatic polyp classification framework. We aim to compare two different approaches named hand-craft feature method and convolutional neural network (CNN) based deep learning method. Combined shape and color features are used for hand craft feature extraction and support vector machine (SVM) method is adopted for classification. For CNN approach, three convolution and pooling based deep learning framework is used for classification purpose. The proposed framework is evaluated using three public polyp databases. From the experimental results, we have shown that the CNN based deep learning framework shows better classification performance than the hand-craft feature based methods. It achieves over 90% of classification accuracy, sensitivity, specificity and precision.

  8. Solitary Peutz-Jeghers type hamartomatous polyps in the duodenum are not always associated with a low risk of cancer: two case reports

    Directory of Open Access Journals (Sweden)

    Koide Tomoko

    2011-06-01

    Full Text Available Abstract Introduction A hamartomatous polyp without associated mucocutaneous pigmentation or a family history of Peutz-Jeghers Syndrome is diagnosed as a solitary Peutz-Jeghers type hamartomatous polyp. As compared with Peutz-Jeghers Syndrome, Peutz-Jeghers type hamartomatous polyps are diagnosed with a lower risk of cancer and are regarded as a different disorder. Case presentation In case one, we describe an 84-year-old Japanese man with a 14 mm duodenal polyp. Endoscopic mucosal resection was performed and histological examination showed findings suggestive of a hamartomatous polyp with a focus of well-differentiated adenocarcinoma. In case two, we describe a 76-year-old Japanese man who had been treated for prostate, rectal and lung cancer. Upper gastrointestinal endoscopy revealed a duodenal polyp measuring 15 mm in diameter. Endoscopic mucosal resection was performed, and histological examination showed findings suggestive of a hamartomatous polyp. Liver and thyroid cancers were found after the endoscopic treatment. Conclusion Although duodenal solitary hamartomatous polyps are associated with a lower risk of cancer, four patients, including our cases, have been diagnosed with cancerous polyps. Patients with duodenal solitary hamartomatous polyps should be treated by endoscopic or surgical resection and need whole-body screening.

  9. Intestinal solute carriers

    DEFF Research Database (Denmark)

    Steffansen, Bente; Nielsen, Carsten Uhd; Brodin, Birger

    2004-01-01

    A large amount of absorptive intestinal membrane transporters play an important part in absorption and distribution of several nutrients, drugs and prodrugs. The present paper gives a general overview on intestinal solute carriers as well as on trends and strategies for targeting drugs and...... membrane transporters in the small intestine in order to increase oral bioavailabilities of drug or prodrug, the major influence on in vivo pharmacokinetics is suggested to be dose-dependent increase in bioavailability as well as prolonged blood circulation due to large capacity facilitated absorption...

  10. Intestinal solute carriers

    DEFF Research Database (Denmark)

    Steffansen, Bente; Nielsen, Carsten Uhd; Brodin, Birger

    2004-01-01

    membrane transporters in the small intestine in order to increase oral bioavailabilities of drug or prodrug, the major influence on in vivo pharmacokinetics is suggested to be dose-dependent increase in bioavailability as well as prolonged blood circulation due to large capacity facilitated absorption......A large amount of absorptive intestinal membrane transporters play an important part in absorption and distribution of several nutrients, drugs and prodrugs. The present paper gives a general overview on intestinal solute carriers as well as on trends and strategies for targeting drugs and...

  11. Risk factors for colorectal cancer in patients with multiple serrated polyps: a cross-sectional case series from genetics clinics.

    Directory of Open Access Journals (Sweden)

    Daniel D Buchanan

    2010-07-01

    Full Text Available Patients with multiple serrated polyps are at an increased risk for developing colorectal cancer (CRC. Recent reports have linked cigarette smoking with the subset of CRC that develops from serrated polyps. The aim of this work therefore was to investigate the association between smoking and the risk of CRC in high-risk genetics clinic patients presenting with multiple serrated polyps.We identified 151 Caucasian individuals with multiple serrated polyps including at least 5 outside the rectum, and classified patients into non-smokers, current or former smokers at the time of initial diagnosis of polyposis. Cases were individuals with multiple serrated polyps who presented with CRC. Controls were individuals with multiple serrated polyps and no CRC. Multivariate logistic regression was performed to estimate associations between smoking and CRC with adjustment for age at first presentation, sex and co-existing traditional adenomas, a feature that has been consistently linked with CRC risk in patients with multiple serrated polyps. CRC was present in 56 (37% individuals at presentation. Patients with at least one adenoma were 4 times more likely to present with CRC compared with patients without adenomas (OR = 4.09; 95%CI 1.27 to 13.14; P = 0.02. For females, the odds of CRC decreased by 90% in current smokers as compared to never smokers (OR = 0.10; 95%CI 0.02 to 0.47; P = 0.004 after adjusting for age and adenomas. For males, there was no relationship between current smoking and CRC. There was no statistical evidence of an association between former smoking and CRC for both sexes.A decreased odds for CRC was identified in females with multiple serrated polyps who currently smoke, independent of age and the presence of a traditional adenoma. Investigations into the biological basis for these observations could lead to non-smoking-related therapies being developed to decrease the risk of CRC and colectomy in these patients.

  12. Benign Fibroepithelial Polyp of Renal Pelvis in a Patient with Familial Adenomatous Polyposis: A Successful Percutaneous Nephroscopic Management Strategy

    Directory of Open Access Journals (Sweden)

    Nikhil Vasdev

    2009-01-01

    Full Text Available We present a rare case of a benign fibroepithelial polyp of the renal pelvis in a patient with familial adenomatous polyposis. In our paper we describe a new minimally invasive technique developed in our unit using an amplatz goose neck snare via a percutaneous nephroscope sheath in the management of the benign fibroepithelial polyp of the renal pelvis and present a current review of management strategies in literature.

  13. Expression of BMP2, TLR3, TLR4 and COX2 in colorectal polyps, adenoma and adenocarcinoma.

    Science.gov (United States)

    Xiang, Li; Wang, Shiqi; Jin, Xianqing; Duan, Wenjuan; Ding, Xionghui; Zheng, Chang

    2012-11-01

    The initiation and development of colorectal cancer is closely associated with the malignant transformation of colorectal polyps. The aim of this study was to analyze the expression of the bone morphogenetic protein-2 (BMP2), toll-like receptor 3 (TLR3), TLR4 and cyclooxygenase-2 (COX2) proteins in colorectal polyps, adenoma and adenocarcinoma. An immunohistochemical streptavidin-peroxidase (SP) method was used to examine the expression of MBP2, TLR4, TLR3 and COX2 in 20 colorectal juvenile polyps and 15 colorectal polyps of hamartomatous polyposis obtained from children, and 20 colorectal adenomas and 20 colorectal adenocarcinomas obtained from adults. A comparison of the expression levels of TLR3 among the groups revealed a gradual downward trend from the colorectal juvenile polyp group to the colorectal hamartomatous polyposis, adenoma and adenocarcinoma groups, respectively. The expression level of TLR3 was significantly lower in the colorectal adenocarcinoma group (ppolyp, hamartomatous polyposis, adenoma and adenocarcinoma groups. These three protein molecules may be significant in the development and malignant transformation of colorectal polyps.

  14. Analysis of risk factors and morphological ultrasound image for gallbladder polyp in adults living in Busan and Gyeongnam provinces

    Energy Technology Data Exchange (ETDEWEB)

    An, Hyeon [Dept. of Radiology, Inje University Busan Paik Hospital, Busan (Korea, Republic of); Hwang, Chul Hwan [Dept. of Radiation Oncology, Pusan National University Hospital, Busan (Korea, Republic of); Kim, Chang Soo; Ko, Sung Jin [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2016-09-15

    This study were to evaluate risk factors of GB polpy in Busan and Gyeongnam area. This study was performed with patients by abdominal ultrasonography among the patients who came to the P hospital from January to May 2016. Among them, risk factors were analyzed on 399 people at the same time when abdominal ultrasonography and hematological test. The statistical analysis of risk factors related to the GB ployp was performed by independent t-test and chi-square test. In consider of difference verification result for calculations odds ratio about independent variables, multiple logistic regression analysis to conduct verify adequacy by calculating forecasting model from variable. As a result, GB polyp risk factors have relevance to male, HBsAg positive, triglyceride. GB polyp risk factors confirmed to male, HBsAg positive, triglyceride were calculated forecasting model and forecasting probability value. Forecasting probability sensitivity 61.0%, specificity 76.8%, ROC area under curve 0.735 showed, it confirmed validity of forecasting model. When analyzing the GB polyps morphologically, among the GB polyp types observed from abdominal ultrasonography, the hyperechoic and homogeneous pattern with neck was the largest as shown from 27.5% and two GB polyps were shown most from 38%, sizes were shown most by maximum diameter, 5 to 10mm from 53%. As a disease accompany with GB polyp showed mild fatty liver(23%), diffuse hepatopathy(21%)

  15. The Heidelberg POLYP - a flexible and fault-tolerant poly-processor

    International Nuclear Information System (INIS)

    Maenner, R.; Deluigi, B.

    1981-01-01

    The Heidelberg poly-processor system POLYP is described. It is intended to be used in nuclear physics for reprocessing of experimental data, in high energy physics as second-stage trigger processor, and generally in other applications requiring high-computing power. The POLYP system consists of any number of I/O-processors, processor modules (eventually of different types), global memory segments, and a host processor. All modules (up to several hundred) are connected by a multiple common-data-bus system; all processors, additionally, by a multiple sync bus system for processor/task-scheduling. All hard- and software is designed to be decentralized and free of bottle-necks. Most hardware-faults like single-bit errors in memory or multi-bit errors during transfers are automatically corrected. Defective modules, buses, etc., can be removed with only a graceful degradation of the system-throughput. (orig.)

  16. Airway Inflammation in Chronic Rhinosinusitis with Nasal Polyps and Asthma: The United Airways Concept Further Supported

    DEFF Research Database (Denmark)

    Håkansson, Kåre; Bachert, Claus; Konge, Lars

    2015-01-01

    Background It has been established that patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have co-existing asthma. Objective We aimed to test two hypotheses: (i) upper and lower airway inflammation in CRSwNP is uniform in agreement with the united airways concept; and (ii......) bronchial inflammation exists in all CRSwNP patients irrespective of clinical asthma status. Methods We collected biopsies from nasal polyps, inferior turbinates and bronchi of 27 CRSwNP patients and 6 controls. All participants were evaluated for lower airway disease according to international guidelines...... cytokines measured, IL-13 was significantly increased in bronchial biopsies from CRSwNP patients with, but not without asthma. Conclusion Our findings support the united airways concept; however, we did not find evidence for subclinical bronchial inflammation in CRSwNP patients without asthma. Finally...

  17. The effects of food and photoperiod on strobilation of Aurelia aurita polyps

    Directory of Open Access Journals (Sweden)

    João Chambel

    2014-06-01

    After 30 days of experiment results showed 100 % survival independently of the treatment. In presence of food the strobilation increased (52.08 ± 4.11 % comparatively with the strobilation in polyps without food (33.33 ± 4.35% (pAurelia aurita. However face the necessity of the optimization of the culture jellyfish conditions for ornamental trade and as source of MNPs, more studies are necessary to turned profitable the mass production of this specie.

  18. Is prevalence of colorectal polyps higher in patients with family history of colorectal cancer?

    OpenAIRE

    Murad-Regadas, Sthela Maria; Bezerra, Carla Camila Rocha; Peixoto, Ana Ligia Rocha; Regadas, Francisco Sérgio Pinheiro; Rodrigues, Lusmar Veras; Siebra, José Airton Gonçalves; da Silva Fernandes, Graziela Olivia; Vasconcelos, Rafael Aragão

    2015-01-01

    ABSTRACTObjectives:To assess the prevalence of polyps in patients with a family history of colorectal cancer, in comparison to asymptomatic individuals with indication for screening.Methods:A prospective study in a group of patients who underwent colonoscopy between 2012 and 2014. Patients were divided into two groups: Group I: no family history of colorectal cancer, and Group II: with a family history in first-degree relatives. Demographic characteristics, findings on colonoscopy...

  19. CLINICAL, EPIDEMIOLOGIC, AND ENDOSCOPIC PROFILE IN CHILDREN AND ADOLESCENTS WITH COLONIC POLYPS IN TWO REFERENCE CENTERS

    OpenAIRE

    ANDRADE,Denise O; FERREIRA,Alexandre Rodrigues; BITTENCOURT,Paulo Fernando S; RIBEIRO,Daniela F P; SILVA,Rodrigo Gomes da; ALBERTI,Luiz Ronaldo

    2015-01-01

    Background - The main goal of this paper is to investigate the frequency, clinical profile, and endoscopic findings of children and teenagers submitted to colonoscopies. Methods - Patients of below 18 years of age, diagnosed with polyps by means of colonoscopies at two reference centers of pediatric endoscopy were followed-up between 2002 and 2012. The clinical variables evaluated in this study included: gender, recommendation of colonoscopy, associated signs and symptoms, age of onset of sy...

  20. Long-term evaluation after endoscopic sinus surgery for chronic pediatric sinusitis with polyps.

    Science.gov (United States)

    Tsukidate, Toshiharu; Haruna, Shinichi; Fukami, Satoshi; Nakajima, Itsuo; Konno, Wataru; Moriyama, Hiroshi

    2012-12-01

    Long-term retrospective evaluation was performed of computed tomography (CT) images and endoscopic findings after endoscopic sinus surgery for 88 cases of chronic pediatric sinusitis with nasal polyps. The objective was to determine the appropriate duration of such postoperative evaluation for children. Fifty-one patients had both sinusitis and nasal polyps (BSP group), and the surgical procedure was decided in consideration of each patient's age (for less than 10 years of age, polypectomy (n=12); for 10-13 years old, anterior ethmoidectomy plus opening of the fontanelle and nasofrontal duct (n=20); and for serious cases older than 13 years, total sinusectomy (n=19)). On the other hand, for cases of unilateral sinusitis with antrochoanal polyps (USP group), anterior ethmoidectomy plus opening of the fontanelle was performed regardless of the patient's age (n=37, 5-15 years old). The postoperative endoscopic findings indicated that the polyps had been eliminated in approximately 91% of total patients. Good postoperative findings of CT images in most patients of USP group are observed at one year after the operation like the same of the postoperative course of adult chronic sinusitis. On the other hand CT images in BSP group evaluated one year after the operation were rated as unchanged or worsened in approximately half of the patients. However, at 4 years after the operation nearly all the patients were rated as improved or better. In addition, comparison of the age at final observation and the postoperative course found a striking decrease in the proportion of unchanged and worsened patients aged 12 and above. Accordingly, it was concluded that there is difference of healing process after the operation between USP and BSP group. Postoperative evaluation of BSP group should be performed for 4 years and up to an age of at least 12 years although post-ESS following of USP group is similar to that of adult sinusitis. Copyright © 2012 Elsevier Ireland Ltd. All rights

  1. Safety of mometasone furoate nasal spray in the treatment of nasal polyps in children.

    Science.gov (United States)

    Chur, Victor; Small, Catherine B; Stryszak, Paul; Teper, Ariel

    2013-02-01

    Mometasone furoate nasal spray (MFNS) improves nasal symptoms and reduces polyp size in adults with nasal polyposis. This 4-month, multinational, randomized, double-blind study was conducted to assess the safety of MFNS in pediatric subjects aged 6-17 yr. Subjects aged 6-11 yr with bilateral nasal polyps received MFNS 100 μg once or twice daily or placebo; those aged 12-17 yr received MFNS 200 μg once or twice daily or placebo. End-points included change in 24-h urinary free cortisol (primary), change in 24-h urinary free cortisol corrected for creatinine (key secondary), and adverse events. Efficacy parameters included polyp size, nasal symptoms, and investigator-evaluated therapeutic response, although the study was not powered for statistical analysis of efficacy. Least squares baseline mean urinary free cortisol level (nmol/24 h) for both age groups combined (N = 127) was 49.5 in the MFNS once-daily group, 39.6 in the MFNS twice-daily group, and 49.8 in the placebo group. Change in 24-h urinary free cortisol did not significantly differ among MFNS- and placebo-treated subjects. Least squares mean 24-h urinary free cortisol levels corrected for creatinine also showed no significant differences among MFNS- and placebo-treated subjects. No safety issues emerged. Results of this study confirm the safety profile of MFNS in pediatric patients with bilateral nasal polyps over 4 months, even at double the recommended pediatric dosage for allergic rhinitis. © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  2. Age-related prevalence of chronic rhinosinusitis and nasal polyps and their relationships with asthma onset.

    Science.gov (United States)

    Won, Ha-Kyeong; Kim, Young-Chan; Kang, Min-Gyu; Park, Han-Ki; Lee, Seung-Eun; Kim, Min-Hye; Yang, Min-Suk; Chang, Yoon-Seok; Cho, Sang-Heon; Song, Woo-Jung

    2018-02-09

    Chronic rhinosinusitis (CRS) is a major disease condition with high morbidity, and may influence lower airway disease status in adults. However, its associations with adult asthma onset and activity have not been examined in detail in a general adult population. To investigate the relationships between CRS with nasal polyps and asthma characteristics. A cross-sectional dataset from 17,506 adult participants (age≥18 years) in the Korean National Health and Nutrition Examination Survey 2010-2012 was analyzed. CRS was defined using structured questionnaires according to the international guideline, and presence of nasal polyps was objectively assessed using nasal endoscope. Presence of asthma and its onset and current activity were asked using structured questionnaires. CRS was significantly related with asthma, but the relationships were distinct by CRS and asthma status. CRS with nasal polyps (CRSwNP) was significantly associated with adult-onset asthma (onset after 18 years) or late-onset asthma (onset after 40 years), whereas CRS without nasal polyps (CRSsNP) were related to childhood-onset asthma (onset before 18 years) or early-onset asthma (onset before 40 years) in adults. Both CRS subgroups showed significant associations with current asthma but not with past asthma. However, comorbid asthma rate was less than 10% among subjects with CRS. This study found distinct age-related patterns of CRSwNP and asthma and demonstrated their significant associations in a general population. However, low prevalence of asthma in CRSwNP is in sharp contrast to the findings in Western populations, which warrants further investigation for ethnic or regional difference in CRSwNP-asthma relationships. Copyright © 2018. Published by Elsevier Inc.

  3. Mixed T helper cell signatures in chronic rhinosinusitis with and without polyps.

    Directory of Open Access Journals (Sweden)

    Lara Derycke

    Full Text Available In chronic rhinosinusitis (CRS different phenotypes have been reported based on cytokine profile and inflammatory cell patterns. The aim of this study was to characterize the intracytoplasmatic cytokines of T cells infiltrating the inflamed sinonasal mucosa.Infiltrated T cells and tissue homogenates from sinonasal mucosal samples of 7 healthy subjects, 9 patients with CRS without nasal polyp (CRSsNP, 15 with CRS with nasal polyps (CRSwNP and 5 cystic fibrosis patients (CF-NP were analyzed for cytokine expression using flow cytometry and multiplex analysis respectively. Intracytoplasmic cytokinesin T cells were analyzed after stimulation of nasal polyps with Staphylococcus aureus enterotoxin B for 24 hours.The number of T cells per total living cells was significantly higher in patients with CRSwNP vs. CRSsNP and controls. 85% of the CD4(+ T cells showed to be memory T cells. The effector T cells present in all tissues have a predominant Th1 phenotype. Only in CRSwNP, a significant fraction of T cells produced the Th2 cytokines IL-4 and IL-5, while nasal polyps from CF patients were characterized by a higher CD4/CD8 T cell ratio and an increased number of Th17 cells. 24 h stimulation with SEB resulted in a significant induction of CD4(+ T cells producing IL-10 (Tr1 cells.T cell cytokine patterns in healthy and inflamed sinonasal mucosa revealed that Th2 cells (IL-4 and IL-5 producing cells are significantly increased in CRSwNP mucosal inflammation. Exposure to SEB stimulates Tr1 cells that may contribute to the Th2 bias in CRSwNP.

  4. Aural-pharyngeal polyps associated with Cryptosporidium infection in three iguanas (Iguana iguana).

    Science.gov (United States)

    Uhl, E W; Jacobson, E; Bartick, T E; Micinilio, J; Schimdt, R

    2001-03-01

    Cryptosporidium spp. infection was associated with aural-pharyngeal polyps in three iguanas (Iguana iguana). All iguanas were presented for masses protruding from the ear canal, and the disease was characterized by a chronic clinical course. The masses consisted of nests of cystic glands surrounded by abundant fibrous connective tissue and lined by hyperplastic cuboidal to pseudostratified columnar epithelium that was moderately to heavily colonized by cryptosporidial organisms. Electron microscopy revealed that the majority of organisms were trophozoites.

  5. Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

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    Đorđević Biljana

    2008-01-01

    Full Text Available Background/Aim. The prevalence of endometrial polyps (EPs in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma, patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204 and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7. Results. In 211 (21.94% patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94% EPs, 29 (13.74% EPs with hyperplasia without atypia, 5 (2.37% EPs with atypical hyperplasia, and 2 (0.95% EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A, patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B were older (p < 0.05, and more commonly postmenopausal (p < 0.05 and with hypertension (p < 0.05, all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

  6. A Rare Clinical Presentation of Giant Bilateral Labial Fibroepithelial Stromal Polyps in Patient with Psoriasis Disease

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    Ayse Filiz Avsar

    2016-01-01

    Full Text Available Fibroepithelial polyps (FEPs are rarely seen lesions of the lower female genital tract with polypoid proliferations of stroma. These tumors usually present in the vulvovaginal region of the reproductive aged women. In this presentation, we report a case of a psoriatic woman who developed unusual multiple polypoid lesions approximately 15 cm in size arising from both left and right labia minora and unique connection of FEPs with psoriasis disease.

  7. Infantile donovanosis presenting as external auditory canal polyps: a diagnostic trap.

    Science.gov (United States)

    Ramdial, Pratistadevi K; Sing, Yetish; Ramburan, Amsha; Naidu, Tesuven K; Samuel, Elizabeth Y; Bagratee, Jayanthilall S; Calonje, Eduardo

    2012-12-01

    Two infants, 6 months and 4 months of age, presented with bilateral or unilateral external auditory canal polyps and otorrhea, respectively. Additional findings on examination included otitis media and mastoiditis. Tympanic membrane perforation was noted in one patient and a postauricular abscess in the other. Incisional biopsies of the polyps and abscess were reported as nonspecific mixed inflammation and abscess wall, respectively. There was a limited response to an empirical 5-day course of trimethoprim sulfamethoxazole. The children were referred to the academic hospital, and excision of the polyps and biopsies of the middle ear, mastoid, and postauricular abscess was undertaken. All the biopsies demonstrated donovanosis. Reappraisal of the initial incisional biopsies also confirmed donovanosis. Trimethoprim sulfamethoxazole was administered to both patients for 3 weeks, with resolution of the lesions. Subsequent investigations confirmed genital tract donovanosis, human immunodeficiency virus seropositivity, acquired immunodeficiency syndrome, and pulmonary tuberculosis in both mothers. Heightened awareness of the occurrence of donovanosis at unusual sites and improved recognition of the histomorphological features of the disease, especially in small and superficial biopsies, are pivotal not only for its correct diagnosis in extragenital cutaneous and extracutaneous locations but also for timely and adequate therapy and an improved infant and maternal outcome.

  8. Polyps and masses of the pediatric urinary bladder: a 21-year pathology review.

    Science.gov (United States)

    Huppmann, Alison R; Pawel, Bruce R

    2011-01-01

    Although not uncommon in adults, bladder tumors are rare in children. In addition, the histologic types of tumors seen in the pediatric population differ from those seen in adults. Although rhabdomyosarcoma is the most common pediatric bladder tumor, many other benign, malignant, and reactive lesions can be encountered. All may present clinically as a mass or polyp in the bladder. This study was designed to describe the pathology and patient demographics of pediatric bladder masses, because there are few studies describing these entities. Retrospectively reviewing our experience over a 21-year period, we identified 98 specimens from 65 patients with polyps or masses in the urinary bladder. As expected, the most frequent diagnosis was rhabdomyosarcoma. This was followed by fibroepithelial polyp and a variety of additional nonurothelial tumors. Only 7 urothelial tumors were identified, including 1 low-grade papillary urothelial carcinoma. Inflammatory lesions, such as cystitis cystica and nephrogenic adenoma, were invariably associated with an irritating factor when a history was provided. Our findings emphasize that diagnoses made in the pediatric urinary bladder are distinct from those in adults, although a wide variety of lesions may still be seen.

  9. Three-Dimensional Flow Separation Induced by a Model Vocal Fold Polyp

    Science.gov (United States)

    Stewart, Kelley C.; Erath, Byron D.; Plesniak, Michael W.

    2012-11-01

    The fluid-structure energy exchange process for normal speech has been studied extensively, but it is not well understood for pathological conditions. Polyps and nodules, which are geometric abnormalities that form on the medial surface of the vocal folds, can disrupt vocal fold dynamics and thus can have devastating consequences on a patient's ability to communicate. A recent in-vitro investigation of a model polyp in a driven vocal fold apparatus demonstrated that such a geometric abnormality considerably disrupts the glottal jet behavior and that this flow field adjustment was a likely reason for the severe degradation of the vocal quality in patients. Understanding of the formation and propagation of vortical structures from a geometric protuberance, and their subsequent impact on the aerodynamic loadings that drive vocal fold dynamic, is a critical component in advancing the treatment of this pathological condition. The present investigation concerns the three-dimensional flow separation induced by a wall-mounted prolate hemispheroid with a 2:1 aspect ratio in cross flow, i.e. a model vocal fold polyp. Unsteady three-dimensional flow separation and its impact of the wall pressure loading are examined using skin friction line visualization and wall pressure measurements. Supported by the National Science Foundation, Grant No. CBET-1236351 and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  10. Oncogene Mutations in Colorectal Polyps Identified in the Norwegian Colorectal Cancer Prevention (NORCCAP Screening Study

    Directory of Open Access Journals (Sweden)

    Jon A. Lorentzen

    2016-01-01

    Full Text Available Data are limited on oncogene mutation frequencies in polyps from principally asymptomatic participants of population-based colorectal cancer screening studies. In this study, DNA from 204 polyps, 5 mm or larger, were collected from 176 participants of the NORCCAP screening study and analyzed for mutations in KRAS, BRAF , and PIK3CA including the rarely studied KRAS exons 3 and 4 mutations. KRAS mutations were identified in 23.0% of the lesions and were significantly associated with tubulovillous adenomas and large size. A significantly higher frequency of KRAS mutations in females was associated with mutations in codon 12. The KRAS exon 3 and 4 mutations constituted 23.4% of the KRAS positive lesions, which is a larger proportion compared to previous observations in colorectal cancer. BRAF mutations were identified in 11.3% and were associated with serrated polyps. None of the individuals were diagnosed with de novo or recurrent colorectal cancer during the follow-up time (median 11.2 years. Revealing differences in mutation-spectra according to gender and stages in tumorigenesis might be important for optimal use of oncogenes as therapeutic targets and biomarkers.

  11. Diagnostic Accuracy of Transvaginal Sonography in Infertile Patients with Endometrial Polyps

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    Maryam Niknejadi

    2010-01-01

    Full Text Available Background: To evaluate the diagnostic accuracy of transvaginal sonography (TVS in infertilepatients and compare its results with hysteroscopy, as the gold standard.Materials and Methods: A total of 679 infertile women who underwent both TVS and diagnostichysteroscopy were retrospectively investigated. TVS was performed in the mid-follicular phase(days 5-8 of their cycles. Sensitivity, specificity, and positive and negative predictive valueswere calculated for TVS.Results: Hysteroscopy diagnosed endometrial polyps in 197 out of 679 cases (24.5%. TVSconfirmed the hysteroscopy findings in 174 of 197 (88.3% cases. The sensitivity, specificity,and positive and negative predictive values of TVS compared to hysteroscopy in the detection ofendometrial polyps were 88.3%, 91.9%, 81.6% and 90.8%, respectively.Conclusion: TVS is both a cost-effective and non-invasive method for the diagnosis of intrauterinelesions such as polyps. When used in conjunction with a saline infusion, it can be a properalternative for diagnostic hysteroscopy that saves time and enables the surgeon to perform theoperative hystroscopy procedure with greater accuracy.

  12. Effects of dexamethasone or methotrexate on chitinolytic activity in nasal polyps.

    Science.gov (United States)

    Park, Seong Kook; Hur, Dae Young; Urm, Sang-Hwa

    2012-01-01

    Chitin is a recognition element for tissue infiltration by innate cells implicated in allergy and immunity. This process can be negatively regulated by vertebrate chitinases. Chitinolytic activity is significantly increased in nasal polyps (NPs) compared with that in normal turbinate mucosa. Dexamethasone (DEX) or methotrexate (MTX) is an effective treatment for chronic inflammatory diseases. The aim of this study was to investigate the effects of DEX or MTX on chitinolytic activity in organ-cultured NPs. NP tissues were cultured using an air-liquid interface culture model. Cultures were maintained for 24 hours in the absence or presence of DEX (10 or 100 micromolar) or MTX (10 or 100 micromolar). Acidic mammalian chitinase (AMCase) and chitotriosidase (ChT) activities in tissue samples were measured at a range of pH values by using the fluorogenic substrate 4-methylumbelliferyl-beta-(D)-N,N',N″-triacetyl-chitotriose. AMCase and ChT chitinolytic activities were significantly lower in NPs treated with 100 micromolar DEX or 100 micromolar MTX than that in fresh or untreated NPs. AMCase chitinolytic activity tended to be lower in DEX-treated polyps than in MTX-treated polyps, although the difference was not statistically significant. DEX or MTX reduced chitinolytic activity in NPs. We suggest that DEX or MTX may inhibit the growth of NPs via local regulation of NP chitinolytic activity.

  13. Osteomeatal complex obstruction is not associated with adjacent sinus disease in chronic rhinosinusitis with polyps.

    Science.gov (United States)

    Leung, Randy M; Kern, Robert C; Conley, David B; Tan, Bruce K; Chandra, Rakesh K

    2011-01-01

    It is universally accepted that osteomeatal complex (OMC) disease is linked to the subsequent development of chronic rhinosinusitis without nasal polyps (CRSsNPs) via postobstructive mechanisms. The role of OMC obstruction in the pathogenesis of CRSwNPs is less clear. This study was designed to identify if there is an association between OMC obstruction and inflammation of the adjacent sinuses, when patients are stratified by polyp status. This is a follow-up and expanded series of a previous pilot study from our group. CT scans of 144 patients with CRSsNPs and 123 patients with CRS with nasal polyps (CRSwNPs) were evaluated for each sinus and OMC. Patients had no previous surgeries for NPs. CT scans were obtained after a trial of maximal medical therapy. Increasing OMC involvement was associated with increasing Lund-Mackay score for both CRSsNPs and CRSwNPs. In CRSsNP patients, OMC status significantly correlated with adjacent sinus status (p OMC status does not correlate with adjacent sinus status (p = 0.328). OMC obstruction in the setting of CRSwNP may be a barometer of the overall disease process, but in this scenario, paranasal sinus inflammation can not be classified as a postobstructive phenomenon. These findings question the role of minimally invasive procedures in the management of CRSwNPs.

  14. Impact of feedback and monitoring on colonoscopy withdrawal times and polyp detection rates

    Science.gov (United States)

    Nielsen, Amalie Bach; Hendel, Jakob

    2017-01-01

    Background Previous studies have shown colonoscopy withdrawal time (WT) to be a reliable surrogate indicator for polyp detection rate (PDR) and adenoma detection rate (ADR) in colonoscopy. Our aim was to assess the impact of feedback and monitoring of WT on PDR in routine colonoscopies with long-term follow-up. Materials and methods A total of 307 colonoscopies were performed in three separate clinical scenarios. First, PDR and WT were recorded without the staff being aware of the specific objective of the study. Before the second scenario, the staff was given interventional information and feedback on WTs and PDRs from the first scenario and was encouraged to aim for a minimum WT of 8 min. Retention of knowledge gained was reassessed in the third scenario 1 year later. Results The PDR in the first two scenarios differed significantly (p0.05). The increase in PDR between the first and second scenarios was retained in the third follow-up scenario 1 year later where the WT of both polyp-positive and polyp-negative colonoscopies was found to be longer. Conclusions PDR almost doubled from the first to the second scenario of a real-life colonoscopy setting, indicating that awareness of WT is crucial. The knowledge gained from this intervention in routine practice was even retained after a year. PMID:28761691

  15. Colonic polyp detection in CT colonography with fuzzy rule based 3D template matching.

    Science.gov (United States)

    Kilic, Niyazi; Ucan, Osman N; Osman, Onur

    2009-02-01

    In this paper, we introduced a computer aided detection (CAD) system to facilitate colonic polyp detection in computer tomography (CT) data using cellular neural network, genetic algorithm and three dimensional (3D) template matching with fuzzy rule based tresholding. The CAD system extracts colon region from CT images using cellular neural network (CNN) having A, B and I templates that are optimized by genetic algorithm in order to improve the segmentation performance. Then, the system performs a 3D template matching within four layers with three different cell of 8 x 8, 12 x 12 and 20 x 20 to detect polyps. The CAD system is evaluated with 1043 CT colonography images from 16 patients containing 15 marked polyps. All colon regions are segmented properly. The overall sensitivity of proposed CAD system is 100% with the level of 0.53 false positives (FPs) per slice and 11.75 FPs per patient for the 8 x 8 cell template. For the 12 x 12 cell templates, detection sensitivity is 100% at 0.494 FPs per slice and 8.75 FPs per patient and for the 20 x 20 cell templates, detection sensitivity is 86.66% with the level of 0.452 FPs per slice and 6.25 FPs per patient.

  16. Retroperitoneal laparoscopy management for ureteral fibroepithelial polyps causing hydronephrosis in children: a report of five cases.

    Science.gov (United States)

    Dai, L N; Chen, C D; Lin, X K; Wang, Y B; Xia, L G; Liu, P; Chen, X M; Li, Z R

    2015-10-01

    Hydronephrosis is a common disease in children and may be caused by ureteral fibroepithelial polyps (UFP). Ureteral fibroepithelial polyps are rare in children and are difficult to precisely diagnose before surgery. Surgical treatment for symptomatic UFP is recommended. At the present institution, retroperitoneal laparoscopy has been used to treat five boys with UFP since 2006. To highlight the significance of UFP as an etiological factor of hydronephrosis in children and evaluate the applicative value of retroperitoneal laparoscopy in the treatment of children with UFP. Between 2006 and 2013 five boys underwent retroperitoneal laparoscopy at the present institution. They were identified with UFP by review of the clinical database. Detailed data were collected, including: radiographic studies, gross anatomical pathology, and pathology and radiology reports. All boys had been followed up at least every 6 months. All of the boys were aged between 7 and 16 years (mean 9.8 years). The main symptoms were flank pain (all five) and hematuria (three). Radiographic examination showed that all of the boys presented with incomplete ureteral obstruction and hydronephrosis. The ureteral fibroepithelial polyps were located near the left UPJ or the left proximal ureter. All of the boys had the UFP removed: three underwent retroperitoneal laparoscopic dismembered Anderson-Hynes pyeloplasty and polypectomy, and two had retroperitoneal laparoscopic ureteral anastomosis. These polyps were all on the left side and between 15 and 35 mm in length (mean 22 mm) (Figure). All of the boys recovered well and were discharged from hospital. The postoperative histological report confirmed that the specimens were UFP. Hydronephrosis was periodically assessed by ultrasonography (using the same method as pre-surgical ultrasonography) after surgery. Mean follow-up was 33 months (range 6-58 months) and no complications were found afterwards. Ureteral fibroepithelial polyps are rare but rather

  17. Is prevalence of colorectal polyps higher in patients with family history of colorectal cancer?

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    Sthela Maria Murad-Regadas

    2015-07-01

    Full Text Available Objectives: To assess the prevalence of polyps in patients with a family history of colorectal cancer, in comparison to asymptomatic individuals with indication for screening. Methods: A prospective study in a group of patients who underwent colonoscopy between 2012 and 2014. Patients were divided into two groups: Group I: no family history of colorectal cancer, and Group II: with a family history in first-degree relatives. Demographic characteristics, findings on colonoscopy, presence, location and histological type of polyps were evaluated, comparing the two groups. Results: 214 patients were evaluated: 162 in Group I and 52 in Group II. The distribution of patients with polyps was similar in relation to gender: polyps were evidenced in Group I in 33 (20% female patients vs. 10 (6% male patients (p = 1.00; in Group II, the presence of polyps was evidenced in 9 (17% female patients vs. 2 (4% male patients (p = 1.00. Polypoid lesions were found in 54 patients (25%, with 43 (26% in Group I and 11 (21% in Group II. The prevalence of adenomas was similar in both groups (Group I = 18/37% vs. Group II = 10/50% (p = 0.83. Conclusion: In this preliminary study, no correlation was found between prevalence of polyps and a family history of colorectal cancer. Resumo: Objetivos: Avaliar a prevalência de pólipos em pacientes com história familiar de câncer colorretal comparando com indivíduos assintomáticos com indicação para rastreamento. Métodos: Estudo prospectivo realizado em um grupo de indivíduos submetidos à colonoscopia entre 2012 e 2014. Os pacientes foram distribuídos em dois grupos: Grupo I: sem história familiar de câncer colorretal e Grupo II: com história familiar em parentes de primeiro grau. Avaliaram-se características demográficas, achados na colonoscopia, presença, localização e tipo histológico dos pólipos, comparando os dois grupos. Resultados: Foram avaliados 214 pacientes, 162 incluídas no grupo I e 52

  18. Risk of colorectal polyps and of malignancies in asymptomatic carriers of mutations in the main DNA mismatch repair genes.

    Science.gov (United States)

    Ponz de Leon, Maurizio; Pedroni, Monica; Pezzi, Annalisa; Sulce, Blerta; Roncucci, Luca; Domati, Federica; Rossi, Giuseppina; Reggiani Bonetti, Luca

    2018-01-01

    Mutation carriers (Mut+) in DNA mismatch repair genes are predisposed to cancer of various organs and to adenomatous polyps; however, they may remain asymptomatic and cancer or polyp-free for several years. We purposed to analyse the clinical follow-up of individuals carrying constitutional mutations in the MLH1, MSH2 or MSH6 genes who were unaffected by benign polyps or malignant tumours at diagnosis. Mut + subjects (n.81) were members of Lynch syndromes in whom mutations were detected between 1993 and 2015; all were asymptomatic at diagnosis. They were informed of the cancer risk and surveillance was suggested. As controls, 113 nongene carriers (Mut-) in the same Lynch families were identified. About one-fourth of the mutation carriers developed polyps, mostly adenomas; polyps were less (12%, p < .05) in Mut - subjects, and hyperplastic lesions were the prevalent histology. More polyps were detected in MLH1 vs. MSH2 mutation carriers. In Mut+, 21 malignant tumours developed in 14 carriers vs. 4 tumours in 3 patients among Mut- (p < .001). Tumours were mostly of the Lynch spectrum; however, three glioblastomas were developed, together with neoplasms of various organs (duodenum, thyroid, skin, lung and cervix). Mean age of tumour occurrence was 43.0 years in Mut + vs. 53.0 among Mut-. Cancer developed more often in Mut+, with no consistent difference between MLH1 and MSH2 carriers. More polyps (mostly adenomas) were detected in MLH1 carriers. The majority (13 of 21) of malignant tumours occurred in organs for which there is no recommended surveillance, and were lethal in three patients.

  19. Clinical validation of a novel urine-based metabolomic test for the detection of colonic polyps on Chinese population.

    Science.gov (United States)

    Deng, Lu; Fang, Hong; Tso, Victor K; Sun, Yuanyuan; Foshaug, Rae R; Krahn, Spencer C; Zhang, Fen; Yan, Yujie; Xu, Huilin; Chang, David; Zhang, Yong; Fedorak, Richard N

    2017-05-01

    Colorectal cancer is the fifth leading cause of cancer-related deaths in China. When detected early, with the removal of adenomatous polyps, precursors of colorectal cancer, it is preventable. The aim of this study was to evaluate a novel urine-based metabolomic diagnostic test for the detection of adenomatous polyps, PolypDx™, that was originally developed and validated using 1000 samples from Canadian Cohort, on Chinese population. Prospective urine samples were collected from 1000 participants undergoing colonoscopy examination, from March 2013 to July 2014 at Minhang District, Shanghai Centre for Disease Control and Prevention. One-dimensional nuclear magnetic resonance spectra of urine metabolites were analyzed to determine the concentrations of three key metabolites used in PolypDx™. The predicted results were then compared to the gold standard for colorectal cancer diagnostic, colonoscopy. Area under curve (AUC) was calculated specifically for the Chinese population and compared with the Canadian dataset. Sensitivity and specificity of this urine-based metabolomic diagnostic test were also compared with three commercially available fecal-based tests. An AUC of 0.717 for PolypDx™ was calculated on Chinese dataset which is slightly lower than the AUC on the Canadian dataset. A sensitivity of 82.6% and a specificity of 42.4% were achieved on Chinese dataset. Here, we validated a novel urine-based metabolomic diagnostic test for the detection of adenomatous polyps, PolypDx™, on Chinese population through a sample size of 1000 participants with a greater level of sensitivity than fecal-based tests.

  20. A prospective analysis evaluating tissue biopsy location and its clinical relevance in chronic rhinosinusitis with nasal polyps.

    Science.gov (United States)

    Weibman, Ava R; Huang, Julia He; Stevens, Whitney W; Suh, Lydia A; Price, Caroline P E; Lidder, Alcina K; Conley, David B; Welch, Kevin C; Shintani-Smith, Stephanie; Peters, Anju T; Grammer, Leslie C; Kato, Atsushi; Kern, Robert C; Schleimer, Robert P; Tan, Bruce K

    2017-11-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) has a high propensity for recurrence. Studies suggest that eosinophilia influences disease severity and surgical outcomes, but the selection of sinonasal site for measuring eosinophilia has not been examined. The aim of this study was to investigate how region-specific tissue eosinophilia affects radiographic severity, comorbidity prevalence, and polyp recurrence risk following sinus surgery. Eosinophil cationic protein (ECP) levels in uncinate tissue (UT) and nasal polyp (NP) homogenates from 116 CRSwNP patients were measured using enzyme-linked immunosorbent assay (ELISA). Clinical history, radiographic severity, and time to polyp recurrence were obtained from electronic health records. The correlations between baseline Lund-Mackay scores and comorbidities were compared between UT and NP ECP levels. Cox regression and Kaplan-Meier analysis were then performed to assess whether UT or NP ECP better predicted recurrence. Censoring occurred at 4 years or at last follow-up if there was no endoscopic diagnosis of recurrent polyps. Lund-Mackay scores were significantly correlated with UT and NP ECP (r = 0.46 and 0.26 respectively, p < 0.05). UT but not NP ECP was significantly higher in patients with asthma (p < 0.01) and aspirin-exacerbated respiratory disease (AERD) (p < 0.05). Polyp recurrence risk was only significantly higher for patients with eosinophilic UT tissue (hazard ratio [HR] = 2.84, p = 0.025). When measured in NP, eosinophilia did not predict recurrence. Although ECP in NP was higher than in UT tissue, eosinophilia in UT tissue was a more clinically coherent biomarker of baseline radiographic severity, comorbid asthma and AERD, and prospective polyp recurrence risk than NP eosinophilia. © 2017 ARS-AAOA, LLC.

  1. Comparison of the diagnostic ability of blue laser imaging magnification versus pit pattern analysis for colorectal polyps.

    Science.gov (United States)

    Nakano, Arihiro; Hirooka, Yoshiki; Yamamura, Takeshi; Watanabe, Osamu; Nakamura, Masanao; Funasaka, Kohei; Ohno, Eizaburo; Kawashima, Hiroki; Miyahara, Ryoji; Goto, Hidemi

    2017-04-01

    Background and study aims  There have been few evaluations of the diagnostic ability of new narrow band light observation blue laser imaging (BLI). The present prospective study compared the diagnostic ability of BLI magnification and pit pattern analysis for colorectal polyps. Patients and methods  We collected lesions prospectively, and the analysis of images was made by two endoscopists, retrospectively. A total of 799 colorectal polyps were examined by BLI magnification and pit pattern analysis at Nagoya University Hospital. The Hiroshima narrow-band imaging classification was used for BLI. Differentiation of neoplastic from non-neoplastic lesions and diagnosis of deeply invasive submucosal cancer (dSM) were compared between BLI magnification and pit pattern analysis. Type C2 in the Hiroshima classification was evaluated separately, because application of this category as an index of the depth of cancer invasion was considered difficult. Results  We analyzed 748 colorectal polyps, excluding 51 polyps that were inflammatory polyps, sessile serrated adenoma/polyps, serrated adenomas, advanced colorectal cancers, or other lesions. The accuracy of differential diagnosis between neoplastic and non-neoplastic lesions was 98.4 % using BLI magnification and 98.7 % with pit pattern analysis. In addition, the diagnostic accuracy of BLI magnification and pit pattern analysis for dSM for cancer was 89.5 % and 92.1 %, respectively. When type C2 lesions were excluded, the diagnostic accuracy of BLI for dSM was 95.9 %. The 18 type C2 lesions comprised 1 adenoma, 9 intramucosal or slightly invasive submucosal cancers, and 8 dSM. Pit pattern analysis allowed accurate diagnosis of the depth of invasion in 13 lesions (72.2 %). Conclusions  Most colorectal polyps could be diagnosed accurately by BLI magnification without pit pattern analysis, but we should add pit pattern analysis for type C2 lesions in the Hiroshima classification.

  2. The association between recreational physical activity, sedentary time, and colorectal polyps in a population screened for colorectal cancer.

    Science.gov (United States)

    Brenner, Darren R; Shaw, Eileen; Yannitsos, Demetra H; Warkentin, Matthew T; Brockton, Nigel T; McGregor, S Elizabeth; Town, Susanna; Hilsden, Robert J

    2018-04-01

    Regular recreational moderate to vigorous physical activity (rMVPA) has been previously associated with a reduced risk of colorectal cancer (CRC), however, few studies have examined the association of rMVPA with colorectal polyps, the pre-malignant precursor lesions. The objective of this study was to examine the associations between physical activity and sitting time and polyps at the time of screening. We conducted a cross-sectional study of 2496 individuals undergoing screening-related colonoscopy in Calgary, Alberta, Canada. Physical activity and sitting time were characterized using hours of rMVPA, meeting physical activity recommendations and hours of sitting time using self-reported data obtained from the International Physical Activity Questionnaire. Logistic regression models were used to estimate the crude and adjusted odds ratios (OR) for presence of polyps associated with rMVPA and sitting time. Meeting physical activity guidelines of ≥150 min/week was non-significantly associated with a modest decrease in odds of having ≥1 polyp at screening (OR adj  = 0.95, 95% CI: 0.80-1.14). In males, threshold effects for sitting time were observed for up to 20 h/week (OR adj per hour sitting = 1.07, 95% CI: 1.01-1.13). In stratified analysis, larger inverse associations were observed between physical activity and the presence of polyps in females, obese individuals, and ever smokers, compared to pooled findings. In this large CRC screening population, there was a suggestive association between increased rMVPA and reduced prevalence of polyps at screening, particularly among females. Even low amounts of regular sitting time (0-20 h/day) were associated with the presence of polyps, particularly among males. Further research on rMVPA and sitting time is necessary to better inform strategies to reduce the frequency of pre-malignant colorectal lesions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps

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    Tescher Paul

    2010-04-01

    Full Text Available Abstract Background Familial adenomatous polyposis (FAP is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE may provide a useful adjunct in screening for polyposis in the small bowel in FAP patients. This study aims to evaluate the effectiveness of CE in the assessment of patients with FAP, compared to other imaging modalities for the detection of small bowel polyps. Method 20 consecutive patients with previously diagnosed FAP and duodenal polyps, presenting for routine surveillance of polyps at The Royal Melbourne Hospital were recruited. Each fasted patient initially underwent a magnetic resonance image (MRI of the abdomen, and a barium small bowel follow-through study. Capsule Endoscopy was performed four weeks later on the fasted patient. An upper gastrointestinal side-viewing endoscopy was done one (1 to two (2 weeks after this. Endoscopists and investigators were blinded to results of other investigations and patient history. Results Within the stomach, upper gastrointestinal endoscopy found more polyps than other forms of imaging. SBFT and MRI generally performed poorly, identifying fewer polyps than both upper gastrointestinal and capsule endoscopy. CE was the only form of imaging that identified polyps in all segments of the small bowel as well as the only form of imaging able to provide multiple findings outside the stomach/duodenum. Conclusion CE provides important information on possible polyp development distal to the duodenum, which may lead to surgical intervention. The place of CE as an adjunct in surveillance of FAP for a specific subset needs consideration and confirmation in replication studies. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12608000616370

  4. Intravenous, contrast-enhanced MR colonography using air as endoluminal contrast agent: Impact on colorectal polyp detection.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2010-12-03

    PURPOSE: To compare diagnostic accuracy and patient tolerance of MR colonography with intravenous contrast and luminal air (MRC) to conventional colonoscopy (CC). MATERIALS AND METHODS: IRB approval and written informed consent were obtained. Forty-six patients, both screening and symptomatic, underwent MRC followed by CC. The MRC technique employed 3D T1W spoiled gradient echo sequences performed after the administration of gadopenetate dimeglumine, with parallel imaging. The diagnostic accuracy and tolerance of patients for MRC was compared to CC. RESULTS: Twenty-four polyps were detected in eighteen patients with CC (5 polyps ≥10mm, 4 polyps 6-9mm, 15 polyps ≤5mm). MRC was 66.7% (12\\/18) sensitive and 96.4% (27\\/28) specific for polyp detection on a per-patient basis. When analyzed by polyp size, sensitivity and specificity of MRC was 100% (5\\/5) and 100% (19\\/19), respectively, for lesions greater than 10mm, 100% (4\\/4) and 100% (20\\/20) for lesions 6-9mm, and sensitivity of 20% (3\\/15) lesions less than 5mm. The sensitivity and specificity of MRC for detecting significant lesions (>6mm) was 100% (9\\/9) and 100% (15\\/15), respectively. Regarding tolerance of the exams, there were no significant differences between MRC and CC. Thirty-five percent (n=16) of patients preferred MRC as a future screening test compared to 33% (n=15) for CC. CONCLUSION: MRC using air as an intraluminal contrast agent is a feasible and well-tolerated technique for detecting colonic polyps ≥6mm in size. Further studies are warranted.

  5. Intravenous, contrast-enhanced MR colonography using air as endoluminal contrast agent: Impact on colorectal polyp detection.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2012-02-01

    PURPOSE: To compare diagnostic accuracy and patient tolerance of MR colonography with intravenous contrast and luminal air (MRC) to conventional colonoscopy (CC). MATERIALS AND METHODS: IRB approval and written informed consent were obtained. Forty-six patients, both screening and symptomatic, underwent MRC followed by CC. The MRC technique employed 3D T1W spoiled gradient echo sequences performed after the administration of gadopenetate dimeglumine, with parallel imaging. The diagnostic accuracy and tolerance of patients for MRC was compared to CC. RESULTS: Twenty-four polyps were detected in eighteen patients with CC (5 polyps >\\/=10mm, 4 polyps 6-9mm, 15 polyps <\\/=5mm). MRC was 66.7% (12\\/18) sensitive and 96.4% (27\\/28) specific for polyp detection on a per-patient basis. When analyzed by polyp size, sensitivity and specificity of MRC was 100% (5\\/5) and 100% (19\\/19), respectively, for lesions greater than 10mm, 100% (4\\/4) and 100% (20\\/20) for lesions 6-9mm, and sensitivity of 20% (3\\/15) lesions less than 5mm. The sensitivity and specificity of MRC for detecting significant lesions (>6mm) was 100% (9\\/9) and 100% (15\\/15), respectively. Regarding tolerance of the exams, there were no significant differences between MRC and CC. Thirty-five percent (n=16) of patients preferred MRC as a future screening test compared to 33% (n=15) for CC. CONCLUSION: MRC using air as an intraluminal contrast agent is a feasible and well-tolerated technique for detecting colonic polyps >\\/=6mm in size. Further studies are warranted.

  6. Intravenous, contrast-enhanced MR colonography using air as endoluminal contrast agent: Impact on colorectal polyp detection

    International Nuclear Information System (INIS)

    Keeling, Aoife N.; Morrin, Martina M.; McKenzie, Charles; Farrell, Richard J.; Sheth, Sunil G.; Ngo, Long; Bloch, B. Nicolas; Pedrosa, Ivan; Rofsky, Neil M.

    2012-01-01

    Purpose: To compare diagnostic accuracy and patient tolerance of MR colonography with intravenous contrast and luminal air (MRC) to conventional colonoscopy (CC). Materials and methods: IRB approval and written informed consent were obtained. Forty-six patients, both screening and symptomatic, underwent MRC followed by CC. The MRC technique employed 3D T1W spoiled gradient echo sequences performed after the administration of gadopenetate dimeglumine, with parallel imaging. The diagnostic accuracy and tolerance of patients for MRC was compared to CC. Results: Twenty-four polyps were detected in eighteen patients with CC (5 polyps ≥10 mm, 4 polyps 6–9 mm, 15 polyps ≤5 mm). MRC was 66.7% (12/18) sensitive and 96.4% (27/28) specific for polyp detection on a per-patient basis. When analyzed by polyp size, sensitivity and specificity of MRC was 100% (5/5) and 100% (19/19), respectively, for lesions greater than 10 mm, 100% (4/4) and 100% (20/20) for lesions 6–9 mm, and sensitivity of 20% (3/15) lesions less than 5 mm. The sensitivity and specificity of MRC for detecting significant lesions (>6 mm) was 100% (9/9) and 100% (15/15), respectively. Regarding tolerance of the exams, there were no significant differences between MRC and CC. Thirty-five percent (n = 16) of patients preferred MRC as a future screening test compared to 33% (n = 15) for CC. Conclusion: MRC using air as an intraluminal contrast agent is a feasible and well-tolerated technique for detecting colonic polyps ≥6 mm in size. Further studies are warranted.

  7. Diagnosis of intestinal and extra intestinal amoebiasis

    International Nuclear Information System (INIS)

    Lopez, Myriam Consuelo; Quiroz, Damian Arnoldo; Pinilla, Analida Elizabeth

    2007-01-01

    The objective is to carry out a review of the national and international literature as of the XXth century in order to update the advances for the diagnosis of complex odd Entamoeba histolytic / Entamoeba dispar and that of intestinal and extra intestinal amoebiasis that may be of use to the scientific community. As well as to unify the diagnostic criteria of this parasitosis known as a public health problem, and as a consequence of that, optimize the quality of population care. Data source: there was a systematic search for the scientific literature Publisher in Spanish and English since 1960 until today, this selection started on the first semester of 2006 until 2007, in the development of the line on intestinal and extra-intestinal amoebiasis of the Medical School of the National University of Colombia. A retrospective search process was carried out, systematically reviewing the most relevant articles as well as the products of this research line. In deciding how to make this article, there was a continuous search in different data bases such as Medline, SciELO and other bases in the library of the National University of Colombia, as well as other classical books related to the subject. For that purpose the terms amoebiasis, odd Entamoeba histolytic, Entamoeba, diagnosis, epidemiology, dysentery, amoebic liver abscess, were used. Studies selection: titles and abstracts were reviewed to select the original publications and the most representative ones related to this article's subject. Data extraction: the articles were classified according to the subject, the chronology and the authors according to the scientific contribution to solve the problem. Synthesis of the data: in the fi rst instance, a chronological critical analysis was carried out to order and synthesize the progress made in the diagnosis until confirmation of the experts' agreements in the field of amoebiasis was obtained throughout the world. Conclusion: this article summarizes what has taken place

  8. Intestinal anisakidosis (anisakiosis).

    Science.gov (United States)

    Takei, Hidehiro; Powell, Suzanne Z

    2007-10-01

    A case of intestinal anisakidosis in a 42-year-old man in Japan is presented. His chief complaint was an acute onset of severe abdominal pain. Approximately 12 hours before the onset of this symptom, he had eaten sliced raw mackerel ("sashimi"). Upper endoscopy was unremarkable. At exploratory laparotomy, an edematous, diffusely thickened segment of jejunum was observed, which was resected. The postoperative course was uneventful. The segment of small intestine showed a granular indurated area on the mucosal surface, and microscopically, a helminthic larva penetrating the intestinal wall, which was surrounded by a cuff of numerous neutrophils and eosinophils, as well as diffuse acute serositis. A cross section of the larva revealed the internal structures, pathognomonic of Anisakis simplex. Although anisakidosis is rare in the United States, with the increasing popularity of Japanese cuisine, the incidence is expected to increase, and pathologists should be familiar with this disease.

  9. Intestinal failure: a review

    Science.gov (United States)

    Allan, Philip; Lal, Simon

    2018-01-01

    Intestinal failure (IF) is the inability of the gut to absorb necessary water, macronutrients (carbohydrate, protein, and fat), micronutrients, and electrolytes sufficient to sustain life and requiring intravenous supplementation or replacement. Acute IF (types 1 and 2) is the initial phase of the illness and may last for weeks to a few months, and chronic IF (type 3) from months to years. The challenge of caring for patients with IF is not merely the management of the underlying condition leading to IF or the correct provision of appropriate nutrition or both but also the prevention of complications, whether thromboembolic phenomenon (for example, venous occlusion), central venous catheter-related bloodstream infection, IF-associated liver disease, or metabolic bone disease. This review looks at recent questions regarding chronic IF (type 3), its diagnosis and management, the role of the multidisciplinary team, and novel therapies, including hormonal treatment for short bowel syndrome but also surgical options for intestinal lengthening and intestinal transplant. PMID:29399329

  10. Small intestine diverticuli

    International Nuclear Information System (INIS)

    Pomakov, P.; Risov, A.

    1991-01-01

    The routine method of contrast matter passage applied to 850 patients with different gastrointestinal diseases proved inefficient to detect any small-intestinal diverticuli. The following modiffications of the method have been tested in order to improve the diagnostic possibilities of the X-ray: study at short intervals, assisted passage, enteroclysm, pharmacodynamic impact, retrograde filling of the ileum by irrigoscopy. Twelve diverticuli of the small-intestinal loops were identified: 5 Meckel's diverticuli, 2 solitary of which one of the therminal ileum, 2 double diverticuli and 1 multiple diverticulosis of the jejunum. The results show that the short interval X-ray examination of the small intestines is the method of choice for identifying local changes in them. The solitary diverticuli are not casuistic scarcity, its occurrence is about 0.5% at purposeful X-ray investigation. The assisted passage method is proposed as a method of choice for detection of the Meckel's diverticulum. 5 figs., 3 tabs. 18 refs

  11. Chronic intestinal pseudoobstruction syndrome

    International Nuclear Information System (INIS)

    Yeon, Kyung Mo; Seo, Jeong Kee; Lee, Yong Seok

    1992-01-01

    Chronic intestinal pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel, and may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distension and deflection difficulty. Five had urinary bladder distension. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepses within one year. All had gaseous distension of small and large bowel on abdominal films. In small bowel series, consistent findings were variable degree of dilatation, decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome

  12. Small Intestinal Infections.

    Science.gov (United States)

    Munot, Khushboo; Kotler, Donald P

    2016-06-01

    Small intestinal infections are extremely common worldwide. They may be bacterial, viral, or parasitic in etiology. Most are foodborne or waterborne, with specific etiologies differing by region and with diverse pathophysiologies. Very young, very old, and immune-deficient individuals are the most vulnerable to morbidity or mortality from small intestinal infections. There have been significant advances in diagnostic sophistication with the development and early application of molecular diagnostic assays, though these tests have not become mainstream. The lack of rapid diagnoses combined with the self-limited nature of small intestinal infections has hampered the development of specific and effective treatments other than oral rehydration. Antibiotics are not indicated in the absence of an etiologic diagnosis, and not at all in the case of some infections.

  13. The intestinal calcistat

    Directory of Open Access Journals (Sweden)

    M K Garg

    2013-01-01

    Full Text Available The main physiological function of vitamin D is maintenance of calcium homeostasis by its effect on calcium absorption, and bone health in association with parathyroid gland. Vitamin D deficiency (VDD is defined as serum 25-hydroxy vitamin D (25OHD levels <20 ng/ml. Do all subjects with VDD have clinical disease according to this definition? We hypothesize that there exist an intestinal calcistat, which controls the calcium absorption independent of PTH levels. It consists of calcium sensing receptor (CaSR on intestinal brush border, which senses calcium in intestinal cells and vitamin D system in intestinal cells. CaSR dampens the generation of active vitamin D metabolite in intestinal cells and decrease active transcellular calcium transport. It also facilitates passive paracellular diffusion of calcium in intestine. This local adaptation adjusts the fractional calcium absorption according the body requirement. Failure of local adaptation due to decreased calcium intake, decreased supply of 25OHD, mutation in CaSR or vitamin D system decreases systemic calcium levels and systemic adaptations comes into the play. Systemic adaptations consist of rise in PTH and increase in active vitamin D metabolites. These adaptations lead to bone resorption and maintenance of calcium homeostasis. Not all subjects with varying levels of VDD manifest with secondary hyperparathyroidism and decreased in bone mineral density. We suggest that rise in PTH is first indicator of VDD along with decrease in BMD depending on duration of VDD. Hence, subjects with any degree of VDD with normal PTH and BMD should not be labeled as vitamin D deficient. These subjects can be called subclinical VDD, and further studies are required to assess beneficial effect of vitamin D supplementation in this subset of population.

  14. Computer-assisted detection of colonic polyps with CT colonography using neural networks and binary classification trees

    International Nuclear Information System (INIS)

    Jerebko, Anna K.; Summers, Ronald M.; Malley, James D.; Franaszek, Marek; Johnson, C. Daniel

    2003-01-01

    Detection of colonic polyps in CT colonography is problematic due to complexities of polyp shape and the surface of the normal colon. Published results indicate the feasibility of computer-aided detection of polyps but better classifiers are needed to improve specificity. In this paper we compare the classification results of two approaches: neural networks and recursive binary trees. As our starting point we collect surface geometry information from three-dimensional reconstruction of the colon, followed by a filter based on selected variables such as region density, Gaussian and average curvature and sphericity. The filter returns sites that are candidate polyps, based on earlier work using detection thresholds, to which the neural nets or the binary trees are applied. A data set of 39 polyps from 3 to 25 mm in size was used in our investigation. For both neural net and binary trees we use tenfold cross-validation to better estimate the true error rates. The backpropagation neural net with one hidden layer trained with Levenberg-Marquardt algorithm achieved the best results: sensitivity 90% and specificity 95% with 16 false positives per study

  15. Increased BAFF expression in nasal polyps is associated with local IgE production, Th2 response and concomitant asthma.

    Science.gov (United States)

    Dilidaer; Zheng, Yan; Liu, Zhuofu; Hu, Xianting; Zhang, Jia; Hu, Li; Han, Miaomiao; Wang, Dehui; Li, Huabin

    2017-04-01

    B-cell activating factor of the TNF family is critical for the survival and maturation of B cells and play a role in the pathophysiology of chronic rhinosinusitis with nasal polyps (CRSwNP). In this study, nasal tissues were enrolled from 25 CRSwNP patients (asthmatic, 16; non-asthmatic, 9), 12 CRSsNP patients and ten control subjects, respectively. The immunoreactivity of BAFF, CD20 and CD138 were examined using immunohistochemistry staining. The mRNA expression of BAFF, CD20, εGLT, AID, GATA3 and CRTH2 were examined using real-time RT-PCR. The protein levels of BAFF, IL-5 and IgE were measured using ELISA assays and the Unicap system, respectively. We found the numbers of BAFF+ cells, CD20+ cells (B cells) and CD138+ cells (plasma cells) were significantly increased in polyp tissues compared with control groups. The concentrations of BAFF, IgE and IL-5 in tissue homogenates were also significantly increased in polyp tissues compared with control groups, and the BAFF protein level in the polyp homogenates was significantly associated with the IgE and IL-5 levels and with concomitant asthma in CRSwNP patients. Our findings indicate that BAFF expression is significantly increased in CRSwNP patients and may orchestrate inflammatory load in polyp tissues by regulating T and B cell-mediated response.

  16. Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy?

    Science.gov (United States)

    van Dijk, Myrthe M; van Hanegem, Nehalennia; de Lange, Maria E; Timmermans, Anne

    2015-01-01

    We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and the patient satisfaction with each technique. No previously reported studies have compared TCRP and LNG-IUD as treatment for HMB in premenopausal women with an endometrial polyp. Likewise, no studies are available on LNG-IUD as a treatment for HMB in the presence of an endometrial polyp. Several studies have found the LNG-IUD to be an effective treatment option for HMB, with high patient satisfaction rates. Evidence of the effectiveness of TCRP as treatment of HMB is scarce. Patient satisfaction is reported relatively good, although persistent or recurrent symptoms appear to be frequent. We conclude that no evidence is available on LNG-IUD as treatment for HMB in women with an endometrial polyp. We hypothesize that LNG-IUD could be a good alternative to TCRP for treating HMB in premenopausal women with a polyp; however, further evidence is needed, and a randomized controlled trial should be performed. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  17. Effects of seawater pH on growth and skeletal U/Ca ratios of Acropora digitifera coral polyps

    Science.gov (United States)

    Inoue, Mayuri; Suwa, Ryota; Suzuki, Atsushi; Sakai, Kazuhiko; Kawahata, Hodaka

    2011-06-01

    The impact of ocean acidification caused by the increasing atmospheric CO2 has been studied in marine calcifiers, including hermatypic corals. However, the effect of elevated pCO2 on the early developmental life-cycle stage of corals has been little studied. In this study, we reared polyps of Acropora digitifera in seawater at pHT 6.55, 7.31, 7.64, 7.77, and 8.03, controlled by CO2 bubbling. We measured the dry weights of polyp skeletons after the 40-d experiment to investigate the relationship between the seawater aragonite saturation state and polyp growth. In addition, we measured skeletal U/Ca ratio to estimate their pH dependence. Skeletal weights of coral polyps increased with the aragonite saturation state and reached an apparent saturation plateau above pH 7.77. U/Ca ratios had a strong inverse relationship with pH and a negligible relationship with skeletal growth rate (polyp weight), suggesting that skeletal U/Ca could be useful for reconstructing paleo-pH.

  18. Intestinal microbiota and ulcerative colitis.

    Science.gov (United States)

    Ohkusa, Toshifumi; Koido, Shigeo

    2015-11-01

    There is a close relationship between the human host and the intestinal microbiota, which is an assortment of microorganisms, protecting the intestine against colonization by exogenous pathogens. Moreover, the intestinal microbiota play a critical role in providing nutrition and the modulation of host immune homeostasis. Recent reports indicate that some strains of intestinal bacteria are responsible for intestinal ulceration and chronic inflammation in inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). Understanding the interaction of the intestinal microbiota with pathogens and the human host might provide new strategies treating patients with IBD. This review focuses on the important role that the intestinal microbiota plays in maintaining innate immunity in the pathogenesis and etiology of UC and discusses new antibiotic therapies targeting the intestinal microbiota. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Small intestine aspirate and culture

    Science.gov (United States)

    ... ency/article/003731.htm Small intestine aspirate and culture To use the sharing features on this page, please enable JavaScript. Small intestine aspirate and culture is a lab test to check for infection ...

  20. Intestinal adenocarcinoma in an augmented ileocystoplasty

    OpenAIRE

    Lopes, Filipe Alpoim; Rolim, Nidia; Rodrigues, Tiago; Canhoto, Artur

    2013-01-01

    We present a case of a 67-year-old patient with a history of augmentation ileocystoplasty 31 years ago following genitourinary tuberculosis. Radiological investigations performed due to asymptomatic microscopic haematuria revealed three contrast-enhancing polyps within the neobladder. The patient had enterocystoprostatectomy and histopathological examination of the neobladder revealed mucinous adenocarcinoma in all three polyps, together with a prostatic adenocarcinoma Gleason 7 (3+4). After ...

  1. Stages of Small Intestine Cancer

    Science.gov (United States)

    ... all of an organ that contains cancer. The resection may include the small intestine and nearby organs (if the cancer has spread). The doctor may remove the section of the small intestine that contains cancer and perform an anastomosis (joining the cut ends of the intestine together). ...

  2. Intestinal inflammatory myofibroblastic tumour

    African Journals Online (AJOL)

    abdominal X-ray of patients 1, 3 and 4 demonstrated dilated small bowel loops with fluid levels in keeping with intestinal ... myxoid/vascular pattern characterised by a variable admixture of capillary-calibre blood vessels, .... in the present study had a past history of abdominal trauma or surgery. Ancillary histopathological ...

  3. Small intestine and microbiota.

    Science.gov (United States)

    Cotter, Paul D

    2011-03-01

    To highlight the recent studies which have enhanced our appreciation of the composition of the microbiota in the human small intestine and its relevance to the health of the host. In the past number of years, the composition of the microorganisms present in our small intestines has been the subject of greater scrutiny than ever before. These investigations have been possible as a consequence of the development and utilization of new molecular tools which have revolutionized the field of microbial ecology and have focused predominantly on the small intestinal microbiota associated with pediatric celiac disease, inflammatory bowel disease, irritable bowel syndrome and pouchitis. The impact of invasive procedures, such as small bowel transplant, ileostomy and ileal pouch anal anastomosis, on the ileal microbiota has also been investigated. The ever greater appreciation of the link between the small intestinal microbiota and the health status of the host has the potential to lead to the development of new strategies to alter this microbiota in a targeted way to prevent or treat specific disorders.

  4. Intestinal obstruction repair

    Science.gov (United States)

    ... Ileostomy and your diet Ileostomy - caring for your stoma Ileostomy - changing your pouch Ileostomy - discharge Ileostomy - what to ask your doctor Intestinal or bowel obstruction - discharge Low-fiber diet Surgical wound care - open Types of ileostomy When you have nausea ...

  5. adhesive intestinal obstruction

    African Journals Online (AJOL)

    2006-06-01

    Jun 1, 2006 ... obstruction. Brit. I. Surg. 1998; 85: 1071-1074. The acute abdomen: Intestinal obstruction. In: Primary surgery, Vol. 1. Edited by Maurice King et al. Oxford. Med. PubL, Oxford. 1990; 142-169. Fluids and electrolyte management. In: Essentials of pediatric surgery. Edited by Marc Rowe et al. Mosby,. St. Louis ...

  6. Intestinal Complications of IBD

    Science.gov (United States)

    ... localized pocket of pus caused by infection from bacteria. More common in Crohn’s than in colitis, an abscess may form in the intestinal wall—sometimes causing it to bulge out. Visible abscesses, such as those around the anus, look like boils and treatment often involves lancing. Symptoms of ...

  7. Intestinal failure in childhood

    African Journals Online (AJOL)

    Short bowel syndrome (SBS) was one of the first recognised conditions of protracted IF. With the increasing and successful use of long-term PN during the last three decades, several other causes of IF have emerged. Long-term PN and home-PN are the mainstay of therapy, independent of the nature of “Intestinal failure” ...

  8. An economic evaluation of outpatient versus inpatient polyp treatment for abnormal uterine bleeding.

    Science.gov (United States)

    Diwakar, L; Roberts, T E; Cooper, N A M; Middleton, L; Jowett, S; Daniels, J; Smith, P; Clark, T J

    2016-03-01

    To undertake a cost-effectiveness analysis of outpatient uterine polypectomy compared with standard inpatient treatment under general anaesthesia. Economic evaluation carried out alongside the multi-centre, pragmatic, non-inferiority, randomised controlled Outpatient Polyp Treatment (OPT) trial. The UK National Health Service (NHS) perspective was used in the estimation of costs and the interpretation of results. Thirty-one secondary care UK NHS hospitals between April 2008 and July 2011. Five hundred and seven women with abnormal uterine bleeding and hysteroscopically diagnosed endometrial polyps. Outpatient uterine polypectomy versus standard inpatient treatment. Clinicians were free to choose the technique for polypectomy within the allocated setting. Patient-reported effectiveness of the procedure determined by the women's self-assessment of bleeding at 6 months, and QALY gains at 6 and 12 months. Inpatient treatment was slightly more effective but more expensive than outpatient treatment, resulting in relatively high incremental cost-effectiveness ratios. Intention-to-treat analysis of the base case at 6 months revealed that it cost an additional £9421 per successfully treated patient in the inpatient group and £ 1,099,167 per additional QALY gained, when compared with outpatient treatment. At 12 months, these costs were £22,293 per additional effectively treated patient and £445,867 per additional QALY gained, respectively. Outpatient treatment of uterine polyps associated with abnormal uterine bleeding appears to be more cost-effective than inpatient treatment at willingness-to-pay thresholds acceptable to the NHS. HTA-funded OPT trial concluded that outpatient uterine polypectomy is cost-effective compared with inpatient polypectomy. © 2015 Royal College of Obstetricians and Gynaecologists.

  9. Evidence-based investigation of the influence of computer-aided detection of polyps on screening of colon cancer with CT colonography

    International Nuclear Information System (INIS)

    Yoshida, Hiroyuki

    2008-01-01

    Computed tomographic colonography (CTC), also known as virtual colonoscopy, is a CT examination of the colon for colorectal neoplasms. Recent large-scale clinical trials have demonstrated that CTC yields sensitivity comparable to optical colonoscopy in the detection of clinically significant polyps in a screening population, making CTC a promising technique for screening of colon cancer. For CTC to be a clinically practical means of screening, it must reliably and consistently detect polyps with high accuracy. However, high-level expertise is required to interpret the resulting CT images to find polyps, resulting in variable diagnostic accuracy among radiologists in the detection of polyps. A key technology to overcome this problem and to bring CTC to prime time for screening of colorectal cancer is computer-aided detection (CAD) of polyps. CAD automatically detects the locations of suspicious polyps in CTC images and presents them to radiologists. CAD has the potential to increase diagnostic performance in the detection of polyps as well as to reduce variability of the diagnostic accuracy among radiologists. This paper presents an evidence-based investigation of the influence of CAD on screening of colon cancer with CTC by describing the benefits of using CAD in the diagnosis of CTC, the fundamental CAD scheme for the detection of polyps in CTC, its detection performance, the effect on the improvement of detection performance, as well as the current and future challenges in CAD. (author)

  10. Partial unilateral lentiginous and colon polyp in a young male patient

    Directory of Open Access Journals (Sweden)

    Gulhan Gurel

    2018-03-01

    Full Text Available Partial unilateral lentiginosis is an unusual pigmentary disorder characterized by numerous lentigines grouped within an area of normal skin. Pigmented macules are usually localized in one half of the body. Associations with café-au-lait spots, cutis marmorata, acanthosis nigricans, nevus depigmentosus, vitiligo, blue nevus, segmental neurofibromatosis, central nervous system diseases, celiac disease, and sickle cell anemia have been reported. We describe a 17-year-old male patient with a partial unilateral lentiginous lesion on the left side of the body and left upper back and incidental polyp in the descending colon.

  11. Benign Fibroepithelial Polyps: A Rare Cause of Ureteropelvic Junction Obstruction in Children

    Directory of Open Access Journals (Sweden)

    Anitha Ezekiel

    2015-07-01

    Full Text Available FEPs are rare, benign mucosal growths that may cause urinary tract obstruction in both adults and children. We present the case of a ten year old Hispanic male with recurring urinary tract infections and hydronephrosis diagnosed with fibroepithelial polyps (FEPs. Despite multiple radiographic procedures, we were unable to accurately preoperatively diagnose FEPs. Here we demonstrate the difficulties in preoperative diagnosis and suggest that perhaps a combination of US and MRI in the setting of persistent urinary tract infections and flank pain may be the best approach for early diagnosis and conservative management, including less invasive treatment protocols.

  12. Metformin efficacy and safety for colorectal polyps: a double-blind randomized controlled trial

    International Nuclear Information System (INIS)

    Higurashi, Takuma; Fujisawa, Nobutaka; Uchiyama, Shiori; Ezuka, Akiko; Nagase, Hajime; Kessoku, Takaomi; Matsuhashi, Nobuyuki; Yamanaka, Shoji; Inayama, Yoshiaki; Morita, Satoshi; Nakajima, Atsushi; Takahashi, Hirokazu; Endo, Hiroki; Hosono, Kunihiro; Yamada, Eiji; Ohkubo, Hidenori; Sakai, Eiji; Uchiyama, Takashi; Hata, Yasuo

    2012-01-01

    Colorectal cancer is one of the major neoplasms and a leading cause of cancer death worldwide, and new preventive strategies are needed to lower the burden of this disease. Metformin, a biguanide, which is widely used for treating diabetes mellitus, has recently been suggestive to have a suppressive effect on tumorigenesis and cancer cell growth. In a previous study conducted in non-diabetic subjects, we showed that oral short-term low-dose metformin suppressed the development of colorectal aberrant crypt foci (ACF). ACF have been considered as a useful surrogate biomarker of CRC, although the biological significance of these lesions remains controversial. We devised a prospective randomized controlled trial to evaluate the chemopreventive effect of metformin against metachronous colorectal polyps and the safety of this drug in non-diabetic post-polypectomy patients. This study is a multi-center, double-blind, placebo-controlled, randomized controlled trial to be conducted in non-diabetic patients with a recent history of undergoing colorectal polypectomy. All adult patients visiting the Yokohama City University hospital or affiliated hospitals for polypectomy shall be recruited for the study. Eligible patients will then be allocated randomly into either one of two groups: the metformin group and the placebo group. Patients in the metformin group shall receive oral metformin at 250 mg per day, and those in the placebo group shall receive an oral placebo tablet. At the end of 1 year of administration of metformin/placebo, colonoscopy will be performed to evaluate the polyp formation. This is the first study proposed to explore the effect of metformin against colorectal polyp formation. Metformin activates AMPK, which inhibits the mammalian target of rapamycin (mTOR) pathway. The mTOR pathway plays an important role in the cellular protein translational machinery and cell proliferation. Patients with type 2 diabetes taking under treatment with metformin have been

  13. Metformin efficacy and safety for colorectal polyps: a double-blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Higurashi Takuma

    2012-03-01

    Full Text Available Abstract Background Colorectal cancer is one of the major neoplasms and a leading cause of cancer death worldwide, and new preventive strategies are needed to lower the burden of this disease. Metformin, a biguanide, which is widely used for treating diabetes mellitus, has recently been suggestive to have a suppressive effect on tumorigenesis and cancer cell growth. In a previous study conducted in non-diabetic subjects, we showed that oral short-term low-dose metformin suppressed the development of colorectal aberrant crypt foci (ACF. ACF have been considered as a useful surrogate biomarker of CRC, although the biological significance of these lesions remains controversial. We devised a prospective randomized controlled trial to evaluate the chemopreventive effect of metformin against metachronous colorectal polyps and the safety of this drug in non-diabetic post-polypectomy patients. Methods/Design This study is a multi-center, double-blind, placebo-controlled, randomized controlled trial to be conducted in non-diabetic patients with a recent history of undergoing colorectal polypectomy. All adult patients visiting the Yokohama City University hospital or affiliated hospitals for polypectomy shall be recruited for the study. Eligible patients will then be allocated randomly into either one of two groups: the metformin group and the placebo group. Patients in the metformin group shall receive oral metformin at 250 mg per day, and those in the placebo group shall receive an oral placebo tablet. At the end of 1 year of administration of metformin/placebo, colonoscopy will be performed to evaluate the polyp formation. Discussion This is the first study proposed to explore the effect of metformin against colorectal polyp formation. Metformin activates AMPK, which inhibits the mammalian target of rapamycin (mTOR pathway. The mTOR pathway plays an important role in the cellular protein translational machinery and cell proliferation. Patients with

  14. Lack of efficacy of blueberry in nutritional prevention of azoxymethane-initiated cancers of rat small intestine and colon

    Directory of Open Access Journals (Sweden)

    Wu Xianli

    2009-09-01

    Full Text Available Abstract Background Blueberries may lower relative risk for cancers of the gastrointestinal tract. Previous work indicated an inhibitory effect of consumed blueberry (BB on formation of aberrant crypt foci (ACF in colons of male Fisher F344 rats (inbred strain. However, effects of BB on colon tumors and in both genders are unknown. Methods We examined efficacy of BB in inhibition of azoxymethane (AOM-induced colon ACF and intestine tumors in male and female Sprague-Dawley rats (outbred strain. Pregnant rats were fed a diet with or without 10% BB powder; progeny were weaned to the same diet as their dam and received AOM as young adults. Results Male and female rats on control diet had similar numbers of ACF at 6 weeks after AOM administration. BB increased (P P P > 0.05 to reduce overall gastrointestinal tract tumor incidence in males, however, tumor incidence in females was unaffected (P > 0.1 by BB. There was a tendency (0.1 > P > 0.05 for fewer adenocarcinomas (relative to total of adenomatous polyps plus adenocarcinomas in colons of female than male tumor-bearing rats; in small intestine, this gender difference was significant (P P Conclusion Results did not indicate robust cancer-preventive effects of BB. Blueberry influenced ACF occurrence in distal colon and tumor progression in duodenum, in gender-specific fashion. Data indicate the potential for slowing tumor progression (adenomatous polyp to adenocarcinoma by BB.

  15. Causative Role of Ureaplasma Urealyticum and other Sexually Transmitted Infections in the Urethral Meatus Polyp Development in Women

    Directory of Open Access Journals (Sweden)

    Tatyana S. Taranina

    2013-09-01

    Full Text Available The objective of this study was the investigation of the influence of ureaplasmal infection on the development of urethral meatus polyps in women. The article presents the results of the examination of women with chronic cystitis and urethritis over a 0.5- to 5-year duration, complicated by the presence of urethral meatus polyps and associated with concomitant Ureaplasma urealyticum and other sexually transmitted infections (STI. This was based on the culture analysis of the cervical and urethral content, and PCR-diagnostics of STI, as well as a complex pathomorphologic study of the resected polyps, including electron microscopy. In this study, 98 women between 45 and 60 years (52.5±4.9 years were examined, who had undergone radiowave resection of the polyps: 52 women were infected by STI, including Ureaplasma urealyticum, Mycoplasma genitalium, Mycoplasma hominis, Chlamydia trachomatis and Trichomonas vaginalis, while the remaining 46 women had been diagnosed as not having STI. According to the culture results in the women with STI, U. urealyticum was identified as a monoinfection in 69% of cases, while in the remaining 31% of cases it was evident in the form of mixed infections, mainly in association with Mycoplasma hominis (17.5% and Trichomonas vaginalis (13.5%. Pathomorphological examination of the urethral meatus polyps of the women with U. urealyticum and other STI demonstrated the proliferative character of the remodeling of the surface epithelium with hyperplasia, acanthosis, and keratinization of the stratified squamous epithelium and synchronous changes in the underlying connective tissue - impaired microcirculation and the diffuse inflammatory cell infiltrates with transepithelial leukopedesis. Using electron microscopy in the fibroblasts and plasma cells of the resected polyps the markers of U. urealyticum were detected in patients with negative results of the bacteriological diagnostic methods.

  16. Automated image-based colon cleansing for laxative-free CT colonography computer-aided polyp detection

    International Nuclear Information System (INIS)

    Linguraru, Marius George; Panjwani, Neil; Fletcher, Joel G.; Summer, Ronald M.

    2011-01-01

    Purpose: To evaluate the performance of a computer-aided detection (CAD) system for detecting colonic polyps at noncathartic computed tomography colonography (CTC) in conjunction with an automated image-based colon cleansing algorithm. Methods: An automated colon cleansing algorithm was designed to detect and subtract tagged-stool, accounting for heterogeneity and poor tagging, to be used in conjunction with a colon CAD system. The method is locally adaptive and combines intensity, shape, and texture analysis with probabilistic optimization. CTC data from cathartic-free bowel preparation were acquired for testing and training the parameters. Patients underwent various colonic preparations with barium or Gastroview in divided doses over 48 h before scanning. No laxatives were administered and no dietary modifications were required. Cases were selected from a polyp-enriched cohort and included scans in which at least 90% of the solid stool was visually estimated to be tagged and each colonic segment was distended in either the prone or supine view. The CAD system was run comparatively with and without the stool subtraction algorithm. Results: The dataset comprised 38 CTC scans from prone and/or supine scans of 19 patients containing 44 polyps larger than 10 mm (22 unique polyps, if matched between prone and supine scans). The results are robust on fine details around folds, thin-stool linings on the colonic wall, near polyps and in large fluid/stool pools. The sensitivity of the CAD system is 70.5% per polyp at a rate of 5.75 false positives/scan without using the stool subtraction module. This detection improved significantly (p = 0.009) after automated colon cleansing on cathartic-free data to 86.4% true positive rate at 5.75 false positives/scan. Conclusions: An automated image-based colon cleansing algorithm designed to overcome the challenges of the noncathartic colon significantly improves the sensitivity of colon CAD by approximately 15%.

  17. Invaginación intestinal por pólipo fibroide inflamatorio del íleon: Presentación de 1 caso

    Directory of Open Access Journals (Sweden)

    Isnerio Valerio Arzuaga Anderson

    2001-03-01

    Full Text Available Los pólipos fibroides inflamatorios del tractus gastrointestinal son lesiones raras. Se reporta el caso de una mujer de 86 años de edad que fue operada de urgencia en el Hospital Clinicoquirúrgico Docente «Joaquín Albarrán» de Ciudad de La Habana, con diagnóstico preoperatorio de oclusión intestinal por bridas. La laparotomía exploradora detectó un tumor invaginado en el íleon a 20 cm de la válvula ileocecal. El diagnóstico anatomopatológico fue de pólipo fibroide inflamatorio. Se documentan los aspectos clínicos y patológicos de este casoInflammatory fibroid polyps of the gastro-intestinal tract are rare lesions. The case of a 86-year-old woman with preoperative diagnosis of intestinal occlusion due to bridle that underwent emergency surgery at the "Joaquín Albarrán" Clinical and Surgical Teaching Hospital of Havana City is reported. An invaginated tumor in the ileum, 20 cm from the ileocaecal valve, was detected by explorative laparotomy. The anatomopathological diagnosis was inflammatory fibroid polyp. The clinical and pathological aspects of this case were documented

  18. Demographic and Clinical Features of Endometrial Polyps in Patients with Endometriosis

    Directory of Open Access Journals (Sweden)

    Ningning Wang

    2016-01-01

    Full Text Available Aims. To compare the clinical features of endometrial polyps (EPs between patients with endometriosis (EM (EM group and without EM (non-EM group. Methods and Results. Seventy-six cases in the EM group and 133 cases in the non-EM group underwent laparotomy or hysteroscopy and laparoscopy; later, it was confirmed that the results by pathology from July 2002 to April 2008 in the Department of Gynecology and Obstetrics at the First Affiliated Hospital of Sun Yat-sen University. The recurrence of EPs was followed up after the surgery until 2013. The following parameters were assessed: age, gravidity, parity, infertility, and menstrual cycle changes, as well as polyps diameters, locations, number, association with the revised American Fertility Society (r-AFS classification, and their recurrence. On review, 76 EPs cases of EM group histologically resembled EPs but the majority of EPs with EM occurred in primary infertility cases and in fewer pregnancy rate women who had stable and smaller EPs without association with the AFS stage. The recurrence rate of EPs in EM group was higher than that in non-EM group. Conclusion. It is important to identify whether infertile patients with EM are also having EPs. Removing any coexisting EPs via hysteroscopy would be clinically helpful in treating endometriosis-related infertility in these patients.

  19. Blood Eosinophil and Basophil Values Before and After Surgery for Eosinophilic-type Sinonasal Polyps.

    Science.gov (United States)

    Brescia, Giuseppe; Parrino, Daniela; Zanotti, Claudia; Tealdo, Giulia; Barion, Umberto; Sfriso, Paolo; Marioni, Gino

    2018-01-01

    Background Blood eosinophil and basophil levels have recently been considered for the purpose of endotyping chronic rhinosinusitis with nasal polyps (CRSwNP). Histologically, eosinophilic-type CRSwNPs have been associated with high recurrence rates after treatment. Objective The present study was the first to compare blood eosinophil and basophil counts in eosinophilic-type CRSwNP patients before and after endoscopic sinus surgery. Methods The study concerned 79 consecutive patients with histologically confirmed eosinophilic-type CRSwNP treated with endoscopic sinus surgery. Results A significant drop in mean blood eosinophil counts and percentages occurred from before to after endoscopic sinus surgery in the cohort as a whole. Mean blood eosinophil counts and percentages were also reduced after surgery in the subcohorts of CRSwNP patients with (i) asthma, (ii) aspirin-exacerbated respiratory disease (AERD), and (iii) no allergy. Although blood eosinophil and basophil counts correlated directly before and after surgery, a statistical reduction in blood basophil counts and percentages after surgery emerged only in the subcohort of nonallergic CRSwNP patients. Conclusion Endoscopic sinus surgery can clear polyps, remove inflammatory tissue, and reduce inflammatory cytokine levels. Consistently with the biological mechanism described, endoscopic sinus surgery could coincide with a reduction in blood eosinophils in eosinophilic-type CRSwNP.

  20. Hyper-Methylated Loci Persisting from Sessile Serrated Polyps to Serrated Cancers.

    Science.gov (United States)

    Andrew, Angeline S; Baron, John A; Butterly, Lynn F; Suriawinata, Arief A; Tsongalis, Gregory J; Robinson, Christina M; Amos, Christopher I

    2017-03-02

    Although serrated polyps were historically considered to pose little risk, it is now understood that progression down the serrated pathway could account for as many as 15%-35% of colorectal cancers. The sessile serrated adenoma/polyp (SSA/P) is the most prevalent pre-invasive serrated lesion. Our objective was to identify the CpG loci that are persistently hyper-methylated during serrated carcinogenesis, from the early SSA/P lesion through the later cancer phases of neoplasia development. We queried the loci hyper-methylated in serrated cancers within our rightsided SSA/Ps from the New Hampshire Colonoscopy Registry, using the Illumina Infinium Human Methylation 450 k panel to comprehensively assess the DNA methylation status. We identified CpG loci and regions consistently hyper-methylated throughout the serrated carcinogenesis spectrum, in both our SSA/P specimens and in serrated cancers. Hyper-methylated CpG loci included the known the tumor suppressor gene RET (p = 5.72 x 10-10), as well as loci in differentially methylated regions for GSG1L, MIR4493, NTNG1, MCIDAS, ZNF568, and RERG. The hyper-methylated loci that we identified help characterize the biology of SSA/P development, and could be useful as therapeutic targets, or for future identification of patients who may benefit from shorter surveillance intervals.

  1. Endoscopic resection using the Clutch Cutter and a detachable snare for large pedunculated colonic polyps.

    Science.gov (United States)

    Akahoshi, Kazuya; Kubokawa, Masaru; Gibo, Junya; Osada, Shigeki; Tokumaru, Kayo; Shiratsuchi, Yuki; Oya, Masafumi; Ihara, Eikichi; Nakamura, Kazuhiko

    2017-01-01

    Background and study aims  Endoscopic snare polypectomy with prophylactic detachable snare of large pedunculated colonic polyps (PCPs) is technically demanding. To facilitate removal of such polyps, we developed endoscopic resection using the Clutch Cutter and a detachable snare (ERCCDS). This study aimed to evaluate the efficacy and safety of the procedure. Patients and methods  From April 2010 to July 2015, 14 consecutive patients who had PCPs with head > 10 mm, stalk width > 5 mm, and stalk length > 10 mm were enrolled in this single-center prospective uncontrolled study. They were treated using ERCCDS by a single endoscopist. The efficacy and safety were assessed using a database prospectively formatted from the medical records. Results  The Clutch Cutter was able to cut the distal side of the stalk an adequate distance from the detachable snare under good visual control. R0 resections were obtained in all lesions. There were no immediate or delayed complications. Conclusions  ERCCDS appears to be a safe, easy, and technically efficient method for large PCPs, although larger studies are needed to compare ERCCDS and standard resection. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Motion - Computerized Tomographic Colography is a Better Method for Screening for Polyps: Arguments Against the Motion

    Directory of Open Access Journals (Sweden)

    Jerome B Simon

    2003-01-01

    Full Text Available Computerized tomographic (CT colography is an exciting technique whereby images of the colonic wall and lumen can be obtained without colonoscopy. It is not as good as conventional colonoscopy, however, because of both inherent and performance limitations. Among the former is the inability to visualize subtle mucosal lesions, such as alterations in colour or pliability. More importantly, CT colography is strictly a diagnostic technique, and does not allow biopsy or removal of polyps. The vigorous bowel preparation required for this procedure can be very unpleasant for the patient, and includes purgatives followed by distension of the colon with air. Unlike with colonoscopy, adherent stool can be difficult to distinguish radiologically from polyps or cancers; as a result, many patients require colonoscopy anyway. The major performance limitations of CT colography are poor sensitivity and specificity compared with conventional colonoscopy. Rectal lesions, flat adenomas and diminutive adenomas are especially difficult to detect, and false-positive results are also common. In addition, the procedure is expensive and less cost effective than colonoscopy. CT colography takes relatively little patient time, but a substantial amount of time is needed for the radiologist to interpret the images. Interobserver variability is high. For all of these reasons, CT colography cannot be recommended as a screening test for colorectal neoplasia.

  3. Emerging Role of Proteases in the Pathogenesis of Chronic Rhinosinusitis with Nasal Polyps

    Directory of Open Access Journals (Sweden)

    Dawei Wu

    2018-01-01

    Full Text Available Chronic rhinosinusitis with nasal polyps (CRSwNP is a heterogeneous upper airway disease with multiple etiologies. Clinically, CRSwNP can be classified into either eosinophilic or non-eosinophilic subtypes. The eosinophilic phenotype of CRSwNP is widely thought to be highly associated with recurrence of nasal polyps or surgical failure. Epithelial cells have a crucial role in the development of Th2-biased airway diseases. Recent studies have shown that a wide range of external stimuli such as allergens and microorganisms can elicit the release of epithelial-derived Th2-driving cytokines and chemokines. Protease activity is a feature common to these multiple environmental insults and there is growing evidence for the concept that an imbalance of proteases and protease inhibitors in the epithelial barrier leads to both the initiation and maintenance of chronic eosinophilic airway inflammation. In this review, we analyze recent work on the role of proteases in the development of the sinonasal mucosal type 2 immune response with an emphasis on the molecular pathways promoting adaptive Th2 cell immunity.

  4. Imaging for Polyps and Leiomyomas in Women With Abnormal Uterine Bleeding: A Systematic Review.

    Science.gov (United States)

    Maheux-Lacroix, Sarah; Li, Fiona; Laberge, Philippe Y; Abbott, Jason

    2016-12-01

    To evaluate the accuracy of saline infusion sonohysterography in comparison with transvaginal ultrasonography for diagnosing polyps and submucosal leiomyomas in women with abnormal uterine bleeding. We searched the databases MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov as well as citations and reference lists to the end of November 2015. Two authors screened 5,347 citations for eligibility. We included randomized controlled trials or prospective cohort studies published in English, assessing the accuracy of saline infusion sonohysterography and transvaginal ultrasonography for diagnosing polyps and submucosal leiomyomas in women with abnormal uterine bleeding. We considered studies using histopathologic specimens obtained at either hysteroscopy or hysterectomy as criterion standard. Twenty-five studies were eligible. Two authors extracted data and assessed the quality of included studies. Bivariate random-effects models were used to compare the different tests and evaluate sources of heterogeneity. Saline infusion sonohysterography was superior to transvaginal ultrasonography with pooled sensitivity and specificity of 0.92 and 0.89 compared with 0.64 and 0.90, respectively (Pabnormal uterine bleeding. Although less specific than hysteroscopy, saline infusion sonohysterography offers a similar detection rate and permits concomitant visualization of the ovaries and myometrium. Cost, convenience, and tolerability of different imaging techniques require further evaluation. PROSPERO International prospective register of systematic reviews, http://www.crd.york.ac.uk/PROSPERO, CRD42016034005.

  5. Antrochoanal Polyps: Clinical Presentation and the Role of Powered Endoscopic Polypectomy

    Directory of Open Access Journals (Sweden)

    Balwant Singh Gendeh

    2004-01-01

    Full Text Available Antrochoanal polyps are a rare clinical entity. In this review of patients treated between January 1996 and September 2002, there were 18 cases of antrochoanal polyps. The mean age of patients was 20 years. Nasal obstruction was the most common symptom (17 cases, 94%, followed by rhinorrhoea (44%, epistaxis (33%, postnasal drip (28%, and snoring (22%. Chronic sinusitis was the most common associated rhinological finding (50%. Various surgical approaches were used: endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%, powered endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%, endoscopic polypectomy and inferior meatal antrostomy in three patients (16.7% and Caldwell-Luc surgery in one patient (5.6%. No complications were noted in patients treated with powered instrumentation, including the three patients in whom combined transcanine approaches were used. We concluded that powered endoscopic polypectomy was safe and effective. It allowed a more complete dissection and may diminish the chance of recurrence.

  6. Small intestinal transplantation.

    LENUS (Irish Health Repository)

    Quigley, E M

    2012-02-03

    The past few years have witnessed a considerable shift in the clinical status of intestinal transplantation. A great deal of experience has been gained at the most active centers, and results comparable with those reported at a similar stage in the development of other solid-organ graft programs are now being achieved by these highly proficient transplant teams. Rejection and its inevitable associate, sepsis, remain ubiquitous, and new immunosuppressant regimes are urgently needed; some may already be on the near horizon. The recent success of isolated intestinal grafts, together with the mortality and morbidity attendant upon the development of advanced liver disease related to total parenteral nutrition, has prompted the bold proposal that patients at risk for this complication should be identified and should receive isolated small bowel grafts before the onset of end-stage hepatic failure. The very fact that such a suggestion has begun to emerge reflects real progress in this challenging field.

  7. A report of unusual diffuse nodular lesions in intestines of lambs with coccidiosis

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    a.r Taghavi Razavizadeh

    2016-11-01

    Full Text Available Ovine and caprine coccidiosis has always been regarded as one of the important diseases with high morbidity and economic losses such as weight loss, death and costs of treatment and control. In a sheep farm, 4 sick newborn lambs (out of 10 lambs with the age of 1 to 2 months died with clinical signs of weight loss, loss of appetite, yellowish diarrhea, fever, ruffled wool, contamination of tail and perineal area to diarrheic stool and abdominal pain at the touch of abdomen. At necropsy on one lamb, multiple and diffuse nodular hyperplastic lesions yellowish-white in color were seen in the mucosal surface of jejunum. Microscopically, in addition to hyperplasia of the small intestinal villi, various developmental stages of Eimeria were observed. Based on morphological characteristics and presence of numerous polyp like formations in small intestine, the involved protozoan species was determined as Eimeria bakuensis. The relatively high case fatality rate in this flock could be related to sever nodular lesions in the small intestines, age and immune status of the affected animals.

  8. Small intestinal cytochromes P450.

    Science.gov (United States)

    Kaminsky, L S; Fasco, M J

    1991-01-01

    Small intestinal cytochromes P450 (P450) provide the principal, initial source of biotransformation of ingested xenobiotics. The consequences of such biotransformation are detoxification by facilitating excretion, or toxification by bioactivation. P450s occur at highest concentrations in the duodenum, near the pylorus, and at decreasing concentrations distally--being lowest in the ileum. Highest concentrations occur from midvillus to villous tip, with little or none occurring in the crypts of Lieberkuehn. Microsomal P4503A, 2C8-10, and 2D6 forms have been identified in human small intestine, and P450s 2B1, possibly 2B2, 2A1, and 3A1/2 were located in endoplasmic reticulum of rodent small intestine, while P4502B4 has been purified to electrophoretic homogeneity from rabbit intestine. Some evidence indicates a differential distribution of P450 forms along the length of the small intestine and even along the villus. Rat intestinal P450s are inducible by xenobiotics--with phenobarbital (PB) inducing P4502B1, 3-methylcholanthrene (3-MC) inducing P4501A1, and dexamethasone inducing two forms of P4503A. Induction is most effectively achieved by oral administration of the agents, and is rapid--aryl hydrocarbon hydroxylase (AHH) was increased within 1 h of administration of, for example, 3-MC. AHH, 7-ethoxycoumarin O-deethylase (ECOD), and 7-ethoxyresorufin O-deethylase (EROD) have been used most frequently as substrates to characterize intestinal P450s. Dietary factors affect intestinal P450s markedly--iron restriction rapidly decreased intestinal P450 to beneath detectable values; selenium deficiency acted similarly but was less effective; Brussels sprouts increased intestinal AHH activity 9.8-fold, ECOD activity 3.2-fold, and P450 1.9-fold; fried meat and dietary fat significantly increased intestinal EROD activity; a vitamin A-deficient diet increased, and a vitamin A-rich diet decreased intestinal P450 activities; and excess cholesterol in the diet increased intestinal

  9. Qualities of sessile serrated adenoma/polyp/lesion and its borderline variant in the context of synchronous colorectal carcinoma

    DEFF Research Database (Denmark)

    Mohammadi, Mahin; Kristensen, Michael Holmsgaard; Nielsen, Hans Jørgen

    2012-01-01

    Although much data have accumulated on sessile serrated adenoma/polyp/lesion (SSA/P/L) in general, its characteristics in specified contexts are less well elucidated. This lack of knowledge is even more conspicuous concerning its borderline counterpart, referred to as BSSA/P/L. The previous...

  10. Use of Proton Pump Inhibitors and Risks of Fundic Gland Polyps and Gastric Cancer : Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Tran-Duy, An; Spaetgens, Bart; Hoes, Arno W|info:eu-repo/dai/nl/101111762; de Wit, Niek J|info:eu-repo/dai/nl/100525393; Stehouwer, Coen D A

    2016-01-01

    BACKGROUND & AIMS: There have been increasing numbers of case reports and observational studies of adverse events in patients receiving long-term therapy with proton pump inhibitors (PPIs). The effects of PPI therapy on risks of fundic gland polyps (FGPs) and gastric cancer have received

  11. Early onset of dysplasia in polyps in children with familial adenomatous polyposis: case report and literature review.

    Science.gov (United States)

    Boskovic, Aleksandra; Djuricic, Slavisa; Grujic, Blagoje; Stankovic, Ivica

    2014-06-01

    Familial adenomatous polyposis (FAP) is one of the most common hereditary syndromes associated with an increased risk of colorectal cancer. Onset of polyp formation and cancer in childhood is very unusual but has recently been associated with a specific mutation at codon 1309 in exon 15 where a more severe phenotype is sometimes observed .We report a 12-year-old girl who presented with haematochezia. The girl's mother and aunt had died of colon cancer which developed from untreated FAP. The other two aunts also had FAP and underwent colectomy. Endoscopy showed extensive polyps presented on the luminal surface of the entire colon. Histomorphology confirmed a low grade of intraepithelial neoplasia (IEN) in three polyps and the patient underwent colectomy. We present a review of the literature focussed on early onset of IEN in polyps in children with FAP. Clinicians should take note of the family history and be prepared to consider much earlier intervention if symptoms occur in a child with a family history of FAP. Copyright © 2014. Published by Elsevier Ltd.

  12. Long-term results of functional endoscopic sinus surgery in children with chronic rhinosinusitis with nasal polyps

    NARCIS (Netherlands)

    Cornet, M. E.; Georgalas, C.; Reinartz, S. M.; Fokkens, W. J.

    2013-01-01

    Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is rare in children and has a major impact on Quality of Life (QoL). Functional endoscopic sinus surgery (FESS) has proven to be an effective treatment, but it is still unclear what long-term outcomes are in children with CRSwNP.The

  13. Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

    NARCIS (Netherlands)

    Tutein Nolthenius, Charlotte J.; Boellaard, Thierry N.; de Haan, Margriet C.; Nio, C. Yung; Thomeer, Maarten G. J.; Bipat, Shandra; Montauban van Swijndregt, Alexander D.; Essink-Bot, Marie-Louise; Kuipers, Ernst J.; Dekker, Evelien; Stoker, Jaap

    2016-01-01

    We assessed the burden of waiting for surveillance CT colonography (CTC) performed in patients having 6-9 mm colorectal polyps on primary screening CTC. Additionally, we compared the burden of primary and surveillance CTC. In an invitational population-based CTC screening trial, 101 persons were

  14. Germline variants in Hamartomatous Polyposis Syndrome-associated genes from patients with one or few hamartomatous polyps

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie; Brusgaard, Klaus; Hansen, Tine Plato

    2016-01-01

    Sequencing, DNA samples from 77 patients with 84 hamartomatous polyps were sequenced. The detected germline variants were classified into pathogenicity classes. RESULTS: We detected several germline variants, among them three in ENG, two in BMPR1A, one in PTEN, and one in SMAD4. Although some of the detected...

  15. Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy?

    NARCIS (Netherlands)

    van Dijk, Myrthe M.; van Hanegem, Nehalennia; de Lange, Maria E.; Timmermans, Anne

    2015-01-01

    We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing

  16. Does hyoscine butylbromide really improve polyp detection during colonoscopy? A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Cui, Pei-Jing; Yao, Jing; Han, Hua-Zhong; Zhao, Yi-Jun; Yang, Jun

    2014-06-14

    To investigate the benefits of hyoscine butylbromide in polyp detection during colonoscopy by a meta-analysis of available randomized controlled trials (RCTs). Databases, including PubMed, EMBASE, the Cochrane Library, and the Science Citation Index up to September 2013, were searched. The primary outcome was polyp detection rate, and the secondary outcome was adenoma detection rate. The meta-analysis was performed using the free software Review Manager. Differences observed between the treated and the control groups were expressed as odds ratio (OR) with a 95% confidence interval (CI). A fixed-effects model was used to pool data when statistical heterogeneity was absent. If statistical heterogeneity was present (P analysis. Of the five studies, all described a comparison of baseline patient characteristics and showed that there was no statistically significant difference between the two groups. Among the 1998 patients, 1006 received hyoscine butylbromide and 992 were allocated to the control group, and the polyp detection rate was reported. There were no significant differences between the treated and the control group (OR = 1.09, 95%CI: 0.91-1.31, P = 0.33). Four RCTs included 1882 patients, of whom 948 received hyoscine butylbromide, and the adenoma detection rate was reported. There were no significant differences between the treated and the control group (OR = 1.13, 95%CI: 0.92-1.38, P = 0.24). The use of hyoscine butylbromide did not significantly improve the polyp detection rate during colonoscopy.

  17. A comparative study of standard vs. high definition colonoscopy for adenoma and hyperplastic polyp detection with optimized withdrawal technique.

    Science.gov (United States)

    East, J E; Stavrindis, M; Thomas-Gibson, S; Guenther, T; Tekkis, P P; Saunders, B P

    2008-09-15

    Colonoscopy has a known miss rate for polyps and adenomas. High definition (HD) colonoscopes may allow detection of subtle mucosal change, potentially aiding detection of adenomas and hyperplastic polyps. To compare detection rates between HD and standard definition (SD) colonoscopy. Prospective, cohort study with optimized withdrawal technique (withdrawal time >6 min, antispasmodic, position changes, re-examining flexures and folds). One hundred and thirty patients attending for routine colonoscopy were examined with either SD (n = 72) or HD (n = 58) colonoscopes. Groups were well matched. Sixty per cent of patients had at least one adenoma detected with SD vs. 71% with HD, P = 0.20, relative risk (benefit) 1.32 (95% CI 0.85-2.04). Eighty-eight adenomas (mean +/- standard deviation 1.2 +/- 1.4) were detected using SD vs. 93 (1.6 +/- 1.5) with HD, P = 0.12; however more nonflat, diminutive (9 mm) hyperplastic polyps was 7% (0.09 +/- 0.36). High definition did not lead to a significant increase in adenoma or hyperplastic polyp detection, but may help where comprehensive lesion detection is paramount. High detection rates appear possible with either SD or HD, when using an optimized withdrawal technique.

  18. Cold versus hot endoscopic mucosal resection for nonpedunculated colorectal polyps sized 6-10 mm: a randomized trial.

    Science.gov (United States)

    Papastergiou, Vasilios; Paraskeva, Konstantina D; Fragaki, Maria; Dimas, Ioannis; Vardas, Emmanouil; Theodoropoulou, Angeliki; Mathou, Nicoletta; Giannakopoulos, Athanasios; Karmiris, Konstantinos; Mpitouli, Afroditi; Apessou, Dimitra; Giannikaki, Linda; Karagiannis, John A; Chlouverakis, Grigorios; Paspatis, Gregorios A

    2018-04-01

     Cold snare polypectomy is an established method for the resection of small colorectal polyps; however, significant incomplete resection rates still leave room for improvement. We aimed to assess the efficacy of cold snare endoscopic mucosal resection (CS-EMR), compared with hot snare endoscopic mucosal resection (HS-EMR), for nonpedunculated polyps sized 6 - 10 mm.  This study was a dual-center, randomized, noninferiority trial. Consecutive adult patients with at least one nonpedunculated polyp sized 6 - 10 mm were enrolled. Eligible polyps were randomized (1:1) to be treated with either CS-EMR or HS-EMR. Both methods involved submucosal injection of a methylene blue-tinted normal saline solution. The primary noninferiority end point was histological eradication evaluated by postpolypectomy biopsies (noninferiority margin - 10 %). Secondary outcomes included occurrence of intraprocedural bleeding, clinically significant postprocedural bleeding, and perforation.  Among 689 patients screened, 155 patients with 164 eligible polyps were included (CS-EMR n = 83, HS-EMR n = 81). The overall rate of histological complete resection was 92.8 % in the CS-EMR group and 96.3 % in the HS-EMR group (difference 3.5 %; 95 % confidence interval [CI] - 4.15 to 11.56), showing noninferiority of CS-EMR compared with HS-EMR. CS-EMR was shown to be noninferior both for polyps measuring 6 - 7 mm (CS-EMR 93.3 %; HS-EMR 100 %; 95 %CI - 7.95 to 21.3) and those of 8 - 10 mm (92.5 % vs. 94.7 %, respectively; 95 %CI - 7.91 to 13.16). Rates of intraprocedural bleeding were similar between the two groups (CS-EMR 3.6 %, HS-EMR 1.2 %; P  = 0.30). No clinically significant postprocedural bleeding or perforation occurred in either group.  CS-EMR appears to be a valuable modification of the standard cold snare technique, obviating the need to use diathermy for nonpedunculated colorectal polyps sized 6 - 10

  19. Helicobacter Pylori Associated Gastritis Increases Risk of Colorectal Polyps: a Hospital Based-Cross-Sectional Study in Nakhon Ratchasima Province, Northeastern Thailand.

    Science.gov (United States)

    Tongtawee, Taweesak; Kaewpitoon, Soraya; Kaewpitoon, Natthawut; Dechsukhum, Chavaboon; Leeanansaksiri, Wilairat; Loyd, Ryan A; Matrakool, Likit; Panpimanmas, Sukij

    2016-01-01

    Colorectal polyps are common in Thailand, particularly in the northeastern region. The present study aimed to determine any correlation between Helicobacter pylori-associated gastritis and colorectal polyps in the Thai population. A total of 303 patients undergoing esophagogastroduodenoscopy with colonoscopy for investigation of chronic abdominal pain participated in this study from November 2014 to October 2015. A diagnosis of Helicobacter pylori associated gastritis was made if the bacteria were seen on histopathological examination and a rapid urease test was positive. Colorectal polyps were confirmed by histological examination of colorectal biopsies. Patient demographic data were analyzed for correlations. The prevalence of colorectal polyps was 77 (25.4%), lesions being found more frequently in Helicobacter pylori infected patients than non-infected subjects [38.4% vs. 12.5%; Odds Ratio (OR) (95% CI): 2.26 (1.32 - 3.86), p gastritis were at high risk of having adenomas featuring dysplasia [OR (95% CI): 1.15 (1.16 - 7.99); P = 0.02]. There was no varaition in location of polyps, age group, sex and gastric lesions with respect to Helicobacter pylori status. This study showed that Helicobacter pylori associated gastritis is associated with an increased risk of colorectal polyps, especially adenomas with dysplasia in the Thai population. Patients with Helicobacter pylori-associated gastritis may benefit from concurrent colonoscopy for diagnosis of colorectal polyps as a preventive and early treatment for colorectal cancer.

  20. Lipo sarcoma in small intestine

    International Nuclear Information System (INIS)

    Rodriguez Iglesias, J.; Pineyro Gutierrez, A.; Taroco Medeiros, L.; Fein Kolodny, C.; Navarrete Pedocchi, H.

    1987-01-01

    A case is presented by primitive liposarcoma in small intestine , an extensive bibliographical review foreigner and national in this case. It detach the exceptional of the intestinal topography of the liposarcomas; and making stress in the relative value of the computerized tomography and ultrasonography in the diagnose of the small intestine tumors . As well as in the sarcomas of another topography, chemo and radiotherapy associated to the exeresis surgery, it can be of benefit [es