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Sample records for multiple adenomatous polyps

  1. Glycoprotein expression by adenomatous polyps of the colon

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    Roney, Celeste A.; Xie, Jianwu; Xu, Biying; Jabour, Paul; Griffiths, Gary; Summers, Ronald M.

    2008-03-01

    Colon cancer is the second leading cause of cancer related deaths in the United States. Specificity in diagnostic imaging for detecting colorectal adenomas, which have a propensity towards malignancy, is desired. Adenomatous polyp specimens of the colon were obtained from the mouse model of colorectal cancer called adenomatous polyposis coli-multiple intestinal neoplasia (APC Min). Histological evaluation, by the legume protein Ulex europaeus agglutinin I (UEA-1), determined expression of the glycoprotein α-L-fucose. FITC-labelled UEA-1 confirmed overexpression of the glycoprotein by the polyps on fluorescence microscopy in 17/17 cases, of which 13/17 included paraffin-fixed mouse polyp specimens. In addition, FITC-UEA-1 ex vivo multispectral optical imaging of 4/17 colonic specimens displayed over-expression of the glycoprotein by the polyps, as compared to non-neoplastic mucosa. Here, we report the surface expression of α-L-fucosyl terminal residues by neoplastic mucosal cells of APC specimens of the mouse. Glycoprotein expression was validated by the carbohydrate binding protein UEA-1. Future applications of this method are the development of agents used to diagnose cancers by biomedical imaging modalities, including computed tomographic colonography (CTC). UEA-1 targeting to colonic adenomas may provide a new avenue for the diagnosis of colorectal carcinoma by CT imaging.

  2. Prevalence of colorectal adenomatous polyps in patients with chronic obstructive pulmonary disease

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    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

  3. Colorectal polyps

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    Intestinal polyps; Polyps - colorectal; Adenomatous polyps; Hyperplastic polyps; Villous adenomas; Serrated polyp; Serrated adenoma; Precancerous polyps; Colon cancer - polyps; Bleeding - colorectal polyps

  4. Shifts in the Fecal Microbiota Associated with Adenomatous Polyps.

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    Hale, Vanessa L; Chen, Jun; Johnson, Stephen; Harrington, Sean C; Yab, Tracy C; Smyrk, Thomas C; Nelson, Heidi; Boardman, Lisa A; Druliner, Brooke R; Levin, Theodore R; Rex, Douglas K; Ahnen, Dennis J; Lance, Peter; Ahlquist, David A; Chia, Nicholas

    2017-01-01

    Adenomatous polyps are the most common precursor to colorectal cancer, the second leading cause of cancer-related death in the United States. We sought to learn more about early events of carcinogenesis by investigating shifts in the gut microbiota of patients with adenomas. We analyzed 16S rRNA gene sequences from the fecal microbiota of patients with adenomas (n = 233) and without (n = 547). Multiple taxa were significantly more abundant in patients with adenomas, including Bilophila, Desulfovibrio, proinflammatory bacteria in the genus Mogibacterium, and multiple Bacteroidetes species. Patients without adenomas had greater abundances of Veillonella, Firmicutes (Order Clostridia), and Actinobacteria (family Bifidobacteriales). Our findings were consistent with previously reported shifts in the gut microbiota of colorectal cancer patients. Importantly, the altered adenoma profile is predicted to increase primary and secondary bile acid production, as well as starch, sucrose, lipid, and phenylpropanoid metabolism. These data hint that increased sugar, protein, and lipid metabolism along with increased bile acid production could promote a colonic environment that supports the growth of bile-tolerant microbes such as Bilophilia and Desulfovibrio In turn, these microbes may produce genotoxic or inflammatory metabolites such as H 2 S and secondary bile acids, which could play a role in catalyzing adenoma development and eventually colorectal cancer. This study suggests a plausible biological mechanism to explain the links between shifts in the microbiota and colorectal cancer. This represents a first step toward resolving the complex interactions that shape the adenoma-carcinoma sequence of colorectal cancer and may facilitate personalized therapeutics focused on the microbiota. Cancer Epidemiol Biomarkers Prev; 26(1); 85-94. ©2016 AACR. ©2016 American Association for Cancer Research.

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

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    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.

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

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    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.

  7. Analysis of mtDNA sequence variants in colorectal adenomatous polyps

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    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

  8. The patient with multiple intestinal polyps.

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    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.

  9. Relation between obesity and adenomatous polyps of the large bowel.

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    Sato, Yumi; Nozaki, Ryoichi; Yamada, Kazutaka; Takano, Masahiro; Haruma, Ken

    2009-07-01

    We compared the prevalence of colorectal adenoma (polyps) in men and women and examined the role of body mass index (BMI) on polyp risk according to patient age and gender. The risk of developing colorectal polyps was studied in 15 380 subjects (7155 men and 8225 women) who underwent colonoscopy for the first time from April 1998 to March 2006 at our 'Human Dry Dock', which is the check-up service provided in Japan. Eligible subjects were 20-86 years old (mean age +/- SD, 47.3 +/- 8.5) and were free of invasive cancer, hyperplastic polyps and familial polyposis. Polyps were found in 1590 subjects (1062 men and 528 women). The odds ratio (OR) of detection of polyps in relation to obesity was determined in all cases by multivariate logistic regression analysis after making an adjustment for gender and age. The OR of polyp detection in obese subjects (BMI >or= 25) versus non-obese subjects (BMI women. As the BMI increased in increments of one, the OR in men increased significantly to 1.01 (P women was unchanged at 1.00 (P = 0.23), which was without significance. We conclude that obesity in men is a risk factor for the development of polyps. These results must be confirmed by additional epidemiological studies.

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

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    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.

  11. Rh-I-UEA-1 Polymerized Liposomes Target and Image Adenomatous Polyps in the APCMin/+ Mouse Using Optical Colonography

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    Celeste A. Roney

    2011-07-01

    Full Text Available Mutated adenomatous polyposis coli (APC genes predispose transformations to neoplasia, progressing to colorectal carcinoma. Early detection facilitates clinical management and therapy. Novel lectin-mediated polymerized targeted liposomes (Rh-I-UEA-1, with polyp specificity and incorporated imaging agents were fabricated to locate and image adenomatous polyps in APCMin/+ mice. The biomarker α-l-fucose covalently joins the liposomal conjugated lectin Ulex europaeus agglutinin (UEA-1, via glycosidic linkage to the polyp mucin layer. Multispectral optical imaging (MSI corroborated a global perspective of specific binding (rhodamine B 532 nm emission, 590–620 nm excitation of targeted Rh-I-UEA-1 polymerized liposomes to polyps with 1.4-fold labeling efficiency. High-resolution coregistered optical coherence tomography (OCT and fluorescence molecular imaging (FMI reveal the spatial correlation of contrast distribution and tissue morphology. Freshly excised APCMin bowels were incubated with targeted liposomes (UEA-1 lectin, control liposomes (no lectin, or iohexol (Omnipaque and imaged by the three techniques. Computed tomographic quantitative analyses did not confirm that targeted liposomes more strongly bound polyps than nontargeted liposomes or iohexol (Omnipaque alone. OCT, with anatomic depth capabilities, along with the coregistered FMI, substantiated Rh-I-UEA-1 liposome binding along the mucinous polyp surface. UEA-1 lectin denotes α-l-fucose biomarker carbohydrate expression at the mucin glycoprotein layer; Rh-I-UEA-1 polymerized liposomes target and image adenomatous polyps in APCMin mice.

  12. Predictive gene signatures: molecular markers distinguishing colon adenomatous polyp and carcinoma.

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    Janice E Drew

    Full Text Available Cancers exhibit abnormal molecular signatures associated with disease initiation and progression. Molecular signatures could improve cancer screening, detection, drug development and selection of appropriate drug therapies for individual patients. Typically only very small amounts of tissue are available from patients for analysis and biopsy samples exhibit broad heterogeneity that cannot be captured using a single marker. This report details application of an in-house custom designed GenomeLab System multiplex gene expression assay, the hCellMarkerPlex, to assess predictive gene signatures of normal, adenomatous polyp and carcinoma colon tissue using archived tissue bank material. The hCellMarkerPlex incorporates twenty-one gene markers: epithelial (EZR, KRT18, NOX1, SLC9A2, proliferation (PCNA, CCND1, MS4A12, differentiation (B4GANLT2, CDX1, CDX2, apoptotic (CASP3, NOX1, NTN1, fibroblast (FSP1, COL1A1, structural (ACTG2, CNN1, DES, gene transcription (HDAC1, stem cell (LGR5, endothelial (VWF and mucin production (MUC2. Gene signatures distinguished normal, adenomatous polyp and carcinoma. Individual gene targets significantly contributing to molecular tissue types, classifier genes, were further characterised using real-time PCR, in-situ hybridisation and immunohistochemistry revealing aberrant epithelial expression of MS4A12, LGR5 CDX2, NOX1 and SLC9A2 prior to development of carcinoma. Identified gene signatures identify aberrant epithelial expression of genes prior to cancer development using in-house custom designed gene expression multiplex assays. This approach may be used to assist in objective classification of disease initiation, staging, progression and therapeutic responses using biopsy material.

  13. Stomach Polyps

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    ... 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. ...

  14. Ursodeoxycholic acid counteracts celecoxib in reduction of duodenal polyps in patients with familial adenomatous polyposis: a multicentre, randomized controlled trial

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    2013-01-01

    Background Due to prophylactic colectomy, mortality in patients with familial adenomatous polyposis (FAP) has changed, with duodenal cancer currently being the main cause of death. Although celecoxib reduces duodenal polyp density in patients with FAP, its long-term use may increase the risk of cardiovascular events and alternatives need to be explored. Preclinical studies suggest that the combination of celecoxib with ursodeoxycholic acid (UDCA) is a potentially effective strategy. We performed a randomized, double-blind, placebo-controlled trial to investigate the effect of celecoxib and UDCA co-treatment on duodenal adenomatosis in patients with FAP. Methods Patients with FAP received celecoxib (400 mg twice daily) and UDCA (1000-2000 mg daily, ~20-30 mg/kg/day, n=19) or celecoxib and placebo (n=18) orally for 6 months. Primary outcome was drug efficacy, assessed by comparing duodenal polyp density at pre- and post-intervention by blinded review of endoscopic recordings. As secondary outcomes, cell proliferation, apoptosis, and COX-2 levels in normal duodenal mucosa were assessed by immunohistochemistry or real-time quantitative polymerase chain reaction. Results In intention-to-treat analysis, deceased polyp density was observed after celecoxib/placebo treatment (p=0.029), whereas increased polyp density was observed after celecoxib/UDCA treatment (p=0.014). The difference in change in duodenal polyp density was statistically significant between the groups (p=0.011). No changes in secondary outcomes were observed. Thirty patients (81%) reported one or more adverse events, 16 patients (84%, Common Toxicity Criteria for Adverse Events version 3.0 (CTCAE) grade 1–3) treated with celecoxib/UDCA and 14 patients (78%, CTCAE grade 1–2) treated with celecoxib/placebo. Nine patients (24%) discontinued intervention prematurely, 5 patients (26%) treated with celecoxib/UDCA and 4 patients (22%) treated with celecoxib/placebo. Conclusions Celecoxib reduces duodenal

  15. A healthy lifestyle index is associated with reduced risk of colorectal adenomatous polyps among non-users of non-steroidal anti-inflammatory drugs.

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    Tabung, Fred K; Steck, Susan E; Burch, James B; Chen, Chin-Fu; Zhang, Hongmei; Hurley, Thomas G; Cavicchia, Philip; Alexander, Melannie; Shivappa, Nitin; Creek, Kim E; Lloyd, Stephen C; Hebert, James R

    2015-02-01

    In a Columbia, South Carolina-based case-control study, we developed a healthy lifestyle index from five modifiable lifestyle factors (smoking, alcohol intake, physical activity, diet, and body mass index), and examined the association between this lifestyle index and the risk of colorectal adenomatous polyps (adenoma). Participants were recruited from a local endoscopy center and completed questionnaires related to lifestyle behaviors prior to colonoscopy. We scored responses on each of five lifestyle factors as unhealthy (0 point) or healthy (1 point) based on current evidence and recommendations. We added the five scores to produce a combined lifestyle index for each participant ranging from 0 (least healthy) to 5 (healthiest), which was dichotomized into unhealthy (0-2) and healthy (3-5) lifestyle scores. We used logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) for adenoma with adjustment for multiple covariates. We identified 47 adenoma cases and 91 controls. In the main analyses, there was a statistically nonsignificant inverse association between the dichotomous (OR 0.54; 95% CI 0.22, 1.29) and continuous (OR 0.75; 95% CI 0.51, 1.10) lifestyle index and adenoma. Odds of adenoma were significantly modified by the use of non-steroidal anti-inflammatory drugs (NSAIDs) (p(interaction) = 0.04). For participants who reported no use of NSAIDs, those in the healthy lifestyle category had a 72% lower odds of adenoma as compared to those in the unhealthy category (OR 0.28; 95% CI 0.08, 0.98), whereas a one-unit increase in the index significantly reduced odds of adenoma by 53% (OR 0.47; 95% CI 0.26, 0.88). Although these findings should be interpreted cautiously given our small sample size, our results suggest that higher scores from this index are associated with reduced odds of adenomas, especially in non-users of NSAIDs. Lifestyle interventions are required to test this approach as a strategy to prevent colorectal adenomatous

  16. Freqüência de pólipos em doentes operados de câncer colorretal Frequency of adenomatous polyps after surgical resection of colorectal cancer

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    Beatriz Pinho ROCHA

    2000-01-01

    Full Text Available Introdução - Estudos epidemiológicos e gênicos mostram que os pólipos colônicos do tipo adenoma são lesões pré-neoplásicas. O seguimento de um paciente com câncer colorretal visa principalmente o diagnóstico e retirada de pólipos adenomatosos. Objetivo - Estudar a freqüência do aparecimento de pólipos adenomatosos em doentes com câncer colorretal em acompanhamento clínico após ressecção tumoral. Casuística e Métodos - Foi estudada, retrospectivamente, a freqüência de pólipos do tipo adenoma em 68 pacientes com idade média de 59 anos, submetidos a cirurgia curativa para tratamento de câncer colorretal e a colonoscopia de controle. Resultados - A incidência de pólipos adenomatosos foi de 18%, sendo maior acima de 45 anos (20% e no cólon esquerdo (38%. Em relação ao tipo histológico, 61% eram tubulares, 22% vilosos e 17% túbulo-vilosos. Discussão - Assim como em outros relatos da literatura, a incidência de pólipos foi superior em indivíduos com mais de 45 anos, sendo em mais da metade do tipo tubular. A freqüência de pólipos foi maior nos dois primeiros anos de acompanhamento.Introduction - Epidemiologic and molecular biologic studies have already demonstrated that adenomatous colonic polyps are precancerous diseases. The main indication of the colonoscopy in the surveillance of colorectal cancer treated patients is the diagnosis and resection of adenomatous polyps. Aim - To study the frequency of adenomatous polyps after surgically resection of colorectal cancer. Material and Methods - Sixty eight patients, mean age 59 years old, with total resection of colorectal cancer, submitted to various colonoscopies during the follow up were studied retrospectively. The histological type and the characteristics of the polyp were described. Results - The frequency of polyps was 18%, being higher in the patients with more than 45 years (20%. The site of the polyps was in the left colon in 38% of the patients with

  17. Case-control study of candidate gene methylation and adenomatous polyp formation.

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    Alexander, M; Burch, J B; Steck, S E; Chen, C-F; Hurley, T G; Cavicchia, P; Shivappa, N; Guess, J; Zhang, H; Youngstedt, S D; Creek, K E; Lloyd, S; Jones, K; Hébert, J R

    2017-02-01

    Colorectal cancer (CRC) is one of the most common and preventable forms of cancer but remains the second leading cause of cancer-related death. Colorectal adenomas are precursor lesions that develop in 70-90 % of CRC cases. Identification of peripheral biomarkers for adenomas would help to enhance screening efforts. This exploratory study examined the methylation status of 20 candidate markers in peripheral blood leukocytes and their association with adenoma formation. Patients recruited from a local endoscopy clinic provided informed consent and completed an interview to ascertain demographic, lifestyle, and adenoma risk factors. Cases were individuals with a histopathologically confirmed adenoma, and controls included patients with a normal colonoscopy or those with histopathological findings not requiring heightened surveillance (normal biopsy, hyperplastic polyp). Methylation-specific polymerase chain reaction was used to characterize candidate gene promoter methylation. Odds ratios (ORs) and 95 % confidence intervals (95% CIs) were calculated using unconditional multivariable logistic regression to test the hypothesis that candidate gene methylation differed between cases and controls, after adjustment for confounders. Complete data were available for 107 participants; 36 % had adenomas (men 40 %, women 31 %). Hypomethylation of the MINT1 locus (OR 5.3, 95% CI 1.0-28.2) and the PER1 (OR 2.9, 95% CI 1.1-7.7) and PER3 (OR 11.6, 95% CI 1.6-78.5) clock gene promoters was more common among adenoma cases. While specificity was moderate to high for the three markers (71-97 %), sensitivity was relatively low (18-45 %). Follow-up of these epigenetic markers is suggested to further evaluate their utility for adenoma screening or surveillance.

  18. Eviendep® reduces number and size of duodenal polyps in familial adenomatous polyposis patients with ileal pouch-anal anastomosis.

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    Calabrese, Carlo; Praticò, Chiara; Calafiore, Andrea; Coscia, Maurizio; Gentilini, Lorenzo; Poggioli, Gilberto; Gionchetti, Paolo; Campieri, Massimo; Rizzello, Fernando

    2013-09-14

    To evaluate if 3 mo oral supplementation with Eviendep® was able to reduce the number of duodenal polyps in familial adenomatous polyposis (FAP) patients with ileal pouch-anal anastomosis (IPAA). Eleven FAP patients with IPAA and duodenal polyps were enrolled. They underwent upper gastrointestinal (GI) endoscopy at the baseline and after 3 mo of treatment. Each patient received 5 mg Eviendep twice a day, at breakfast and dinner time, for 3 mo. Two endoscopists evaluated in a blinded manner the number and size of duodenal polyps. Upper GI endoscopies with biopsies were performed at the baseline (T0) with the assessment of the Spigelman score. Polyps > 10 mm were removed during endoscopy and at the end of the procedure a new Spigelman score was determined (T1). The procedure was repeated 3 mo after the baseline (T2). Four photograms were examined for each patient, at T1 and T2. The examined area was divided into 3 segments: duodenal bulb, second and third portion duodenum. Biopsy specimens were taken from all polyps > 10 mm and from all suspicious ones, defined by the presence of a central depression, irregular surface, or irregular vascular pattern. Histology was classified according to the updated Vienna criteria. At baseline the mean number of duodenal detected polyps was 27.7 and mean sizes were 15.8 mm; the mean Spigelman score was 7.1. After polypectomy the mean number of duodenal detected polyps was 25.7 and mean sizes were 7.6 mm; the mean Spigelman score was 6.4. After 3 mo of Eviendep bid, all patients showed a reduction of number and size of duodenal polyps. The mean number of duodenal polyps was 8 (P = 0.021) and mean size was 4.4 mm; the mean Spigelman score was 6.6. Interrater agreement was measured. Lesions > 1 cm found a very good degree of concordance (kappa 0.851) and a good concordance was as well encountered for smaller lesions (kappa 0.641). Our study demonstrated that short-term (90 d) supplementation with Eviendep® in FAP patients with IPAA

  19. Multiple desmoid tumors in a patient with familial adenomatous polyposis caused by the novel W421X mutation Tumor desmoide múltiple en un paciente con poliposis adenomatosa familiar originada por la nueva mutación W421X

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    Orestis Ioannidis

    2012-03-01

    Full Text Available Familial adenomatous polyposis (FAP is a rare syndrome characterized by the presence of hundreds to thousands of colorectal adenomas and is responsible for less than 1% of all colorectal cancers. The syndrome is also characterized by extra-colorectal features including amongst others upper gastrointestinal tract polyps and desmoid tumors. The syndrome is inherited by an autosomal dominant gene, the adenomatous polyposis coli (APC gene. We present the physical history, clinical presentation, diagnosis and treatment of a patient with a novel germline APC mutation, the W421X mutation, which resulted in FAP presenting with about a hundred colorectal polyps, gastric hyperplastic polyps and multiple aggressive intra-abdominal and extra-abdominal desmoid tumors.

  20. Familial adenomatous polyposis

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    Rozen Paul

    2009-10-01

    Full Text Available Abstract Familial adenomatous polyposis (FAP is characterized by the development of many tens to thousands of adenomas in the rectum and colon during the second decade of life. FAP has an incidence at birth of about 1/8,300, it manifests equally in both sexes, and accounts for less than 1% of colorectal cancer (CRC cases. In the European Union, prevalence has been estimated at 1/11,300-37,600. Most patients are asymptomatic for years until the adenomas are large and numerous, and cause rectal bleeding or even anemia, or cancer develops. Generally, cancers start to develop a decade after the appearance of the polyps. Nonspecific symptoms may include constipation or diarrhea, abdominal pain, palpable abdominal masses and weight loss. FAP may present with some extraintestinal manifestations such as osteomas, dental abnormalities (unerupted teeth, congenital absence of one or more teeth, supernumerary teeth, dentigerous cysts and odontomas, congenital hypertrophy of the retinal pigment epithelium (CHRPE, desmoid tumors, and extracolonic cancers (thyroid, liver, bile ducts and central nervous system. A less aggressive variant of FAP, attenuated FAP (AFAP, is characterized by fewer colorectal adenomatous polyps (usually 10 to 100, later age of adenoma appearance and a lower cancer risk. Some lesions (skull and mandible osteomas, dental abnormalities, and fibromas on the scalp, shoulders, arms and back are indicative of the Gardner variant of FAP. Classic FAP is inherited in an autosomal dominant manner and results from a germline mutation in the adenomatous polyposis (APC gene. Most patients (~70% have a family history of colorectal polyps and cancer. In a subset of individuals, a MUTYH mutation causes a recessively inherited polyposis condition, MUTYH-associated polyposis (MAP, which is characterized by a slightly increased risk of developing CRC and polyps/adenomas in both the upper and lower gastrointestinal tract. Diagnosis is based on a

  1. [Rare indication of cephalic duodenopancreatectomy with total gastrectomy--periampullary carcinoma in moderate form of familial adenomatous polyposis].

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    Stănciulea, Oana; Preda, Carmen; Herlea, V; Popa, Monica; Ulmeanu, D; Vasilescu, C

    2007-01-01

    We present the case of a 52 years old man, with significant familial history, diagnosed with familial adenomatous polyposis-attenuated form, with no clinical and endoscopic surveillance until 2001 when he was admitted for an upper gastrointestinal haemorrhage episode. Upper gastrointestinal scopy revealed duodenal adenomatous polyps and gastric hyperplastic polyps. The patient underwent duodenopancreatectomy with total gastrectomy. The histopathological exam revealed duodenal G2 adenocarcinoma pT3N0, and gastric hyperplastic polyps with no signs of dysplasia. The surgical procedure was followed by chemotherapy. In 2002 the patient was admitted for rectal bleeding and colonoscopy showed 2 sigmoid polyps, appropriate for endoscopic removal and a poly-lobate polyp in the transverse colon. The patient underwent transverse colectomy (the histopathological exam--in situ carcinoma). March 2003--the patient underwent endoscopic removal for a rectal polyp (histopathological exam: moderate dysplasia). In 2005 was noted a pulmonary nodule, located in the postero-apical segment of upper left lobe, for which left superior lobe resection was performed (the histopathological exam: metastatic adenocarcinoma). In May 2006 was performed an exploratory laparotomy. Intraoperatively were noted: peritoneal carcinomatosis and multiple liver metastasis. The surgical procedure recommended in patients with attenuated form of familial adenomatous polyposis and suspect periampullary lesions is duodenopancreatectomy. The particularity of the case is the association of total gastrectomy for gastric hyperplastic polyps.

  2. Evaluation of patients with gastric polyps.

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    Olmez, Sehmus; Sayar, Suleyman; Saritas, Bunyamin; Savas, Ayla Yildiz; Avcioglu, Ufuk; Tenlik, Ilyas; Ozaslan, Ersan; Koseoglu, Hasan Tankut; Altiparmak, Emin

    2018-01-01

    The incidence of gastric polyps (GPs) greatly differs according to study populations and was found to be 0.33%-6.7% in various studies. The majority of GPs are composed of hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Although APs have a high risk of malignant potential, sporadic FGPs have no malignant potential. Conversely, HPs have a low risk of malignant potential. It is not sufficient to perform a biopsy to identify the polyp type and the presence of dysplasia; thus, some polyps may require multiple biopsies or total excision. This retrospective study included patients with GPs or polypoid lesions found on esophagogastroscopy with polyp or malignant histology on biopsy at Ankara Numune Training and Research Hospital Endoscopy Unit between 2005 and 2011. In a series of 56.300 upper endoscopies, 192 patients (0.34%) were found to have GPs. Among the patients, 51 (26.6%) were men and 151 (73.4%) were women. The average age of the patients was 61.9±13.3 (14-90) years. The frequency of HPs, APs, and FGPs were 88%, 2.6%, and 1.6%, respectively. The size of the polyps was ≤1 cm in 137 (70%) patients. One polyp was determined in 141 (73.4%) patients. The most common localizations of polyps were the antrum and corpus. Endoscopic snare polypectomy was performed in 64 patients. One bleeding episode was observed, which required endoscopic treatment after ESP. In our study, the GP frequency was low (0.34%), whereas the frequency of HP maybe high due to the high frequency of Helicobacter pylori (HPy) infection in our country. The frequency of FGP is probably low due to the high frequency of HPy infection and the short-term use of proton-pump inhibitors.

  3. Broad phenotypic spectrum in familial adenomatous polyposis; from early onset and severe phenotypes to late onset of attenuated polyposis with the first manifestation at age 72

    DEFF Research Database (Denmark)

    Nilbert, Mef; Kristoffersson, Ulf; Ericsson, Mats

    2008-01-01

    ABSTRACT: Background Familial adenomatous polyposis (FAP) is typically characterized by multiple colonic polyps and frequent extracolonic features. Whereas the number of colonic polyps has been linked to the APC gene mutation, possible genotype-phenotype correlations largely remain to be defined...... of extracolonic manifestations was identified in most of these individuals. Two sisters with an insertion in codon 528 (c.1582_1583insGC) both showed severe phenotypes with classical polyposis, upper gastrointestinal polyps and thyroid cancer. A woman with a 3'APC mutation (c.5030_5031insAA) developed colon...

  4. 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.

  5. Sporadic colorectal polyps and mismatch repair proteins

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    Mahsa Molaei

    2011-01-01

    Full Text Available Background: Colorectal cancers often arise from benign polyps. Adenomatous polyps and serrated polyps progress step by step to adenocarcinoma and change into malignant cancers. Genetic and epigenetic changes have correlation with specific stages of polyp-adenocarcinoma progression and colorectal cancer histopathological changes. Aims: In this study we used immunohistochemistry (IHC staining in sporadic colorectal polyps to assay functional status of MLH1, MSH2, MSH6, and PMS2 proteins, to track genetic/epigenetic roles of this issue in our patients. Materials and Methods: In this cross-sectional study we assessed all patients who were admitted with sporadic colorectal polyps and underwent polypectomy in endoscopy department during 2004-2008. Result: IHC results were abnormal in 6.8% cases for MLH1, in 4.5% cases for MSH2, in 3% for MSH6, and in 4.8% for PMS2. In all cases with abnormal PMS2, MLH1 was also reported as abnormal. Same results were reported for abnormal MSH2, which is accompanied with abnormal MSH6 in all cases (P values < 0.001. There is no significant difference between IHC staining results, gender, dysplasia grade, adenomatous type, and invasion. On the other hand, there was significant difference between IHC staining results, polyp location, and mean age of patients. The same significant difference was between adenomatous polyps and serrated adenoma polyps by MLH1 and PMS2 (P values < 0.05. Conclusion: According to our findings, maybe MMR dysfunction is the cause of sporadic colorectal polyps in younger age and its increasing risk of dysplasia progression and malignancy progression is only in serrated adenoma. Sporadic polyps in left colon had a higher risk to progress to malignancies, and abnormal IHC staining for MLH1 and PMS2 in serrated polyps is much more than in other adenomatous polyps.

  6. Broad phenotypic spectrum in familial adenomatous polyposis; from early onset and severe phenotypes to late onset of attenuated polyposis with the first manifestation at age 72

    DEFF Research Database (Denmark)

    Nilbert, Mef; Kristoffersson, Ulf; Ericsson, Mats

    2008-01-01

    ABSTRACT: Background Familial adenomatous polyposis (FAP) is typically characterized by multiple colonic polyps and frequent extracolonic features. Whereas the number of colonic polyps has been linked to the APC gene mutation, possible genotype-phenotype correlations largely remain to be defined...... cancer at age 72 as the first manifestation of attenuated FAP. Conclusion With an increasing number of FAP families diagnosed, a broad and variable tumor spectrum and a high frequency of extracolonic manifestations are gradually recognized. We report novel APC mutations and present two FAP cases...

  7. 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.

  8. 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.

  9. Decision analysis in the management of duodenal adenomatosis in familial adenomatous polyposis

    NARCIS (Netherlands)

    Vasen, H. F.; Bülow, S.; Myrhøj, T.; Mathus-Vliegen, L.; Griffioen, G.; Buskens, E.; Taal, B. G.; Nagengast, F.; Slors, J. F.; de Ruiter, P.

    1997-01-01

    Patients with familial adenomatous polyposis are not only at high risk of developing adenomas in the colorectum but a substantial number of patients also develop polyps in the duodenum. Because treatment of duodenal polyps is extremely difficult and it is unknown how many patients ultimately develop

  10. The adenomatous polyposis coli protein.

    OpenAIRE

    Näthke, I S

    1999-01-01

    Mutations in the adenomatous polyposis coli (APC) gene are associated with most colorectal cancers. The APC protein has been implicated in many aspects of tumour development. This article will discuss recent data suggesting that APC may have multiple functions in the cell. First, APC is a component of the Wnt signalling pathway; second, APC may have a role in cell migration; finally, APC may regulate proliferation and apoptosis.

  11. A case series of intestinal adenomatous polyposis of unidentified etiology; a late effect of irradiation?

    International Nuclear Information System (INIS)

    Rigter, Lisanne Sara; Kallenberg, Frank G. J.; Bastiaansen, Barbara; Os, Theo A. M. van; Leeuwen, Floor E. van; Leerdam, Monique Esther van; Dekker, Evelien

    2016-01-01

    In a large number of patients with multiple gastrointestinal adenomatous polyps, no causal germline mutation can be found. Non-genetic factors may contribute to the development of adenomatous polyps in these unexplained polyposis patients. In the development of gastrointestinal cancer, prior exposure to abdominal radiotherapy has been identified as such a factor, as it increases the gastrointestinal cancer risk in cancer survivors. A relationship of radiotherapy with intestinal polyposis, however, has not yet been described. Despite the increased cancer risk, these cancer survivors do not receive gastrointestinal screening recommendations. This case series describes three patients with adenomatous polyposis after abdominal radiotherapy. Patient 1 was diagnosed with testicular cancer at the age of 31 and was treated with hemicastration, radiotherapy and chemotherapy. Thirty-nine years later, he was diagnosed with more than 30 colonic adenomas. Additionally, gastroduodenoscopy revealed a well-differentiated adenocarcinoma in the antrum of the stomach. Patient 2 was diagnosed with a nephroblastoma at the age of 10, which was resected and treated with radiotherapy and chemotherapy. At age 36, a rectal adenocarcinoma was diagnosed and treated by radiotherapy and a total mesorectal excision. During 11 years of surveillance endoscopies, 21 colonic adenomas and three duodenal adenomas were detected. Patient 3 was diagnosed with Hodgkin lymphoma at the age of 20 and treated with radiotherapy, followed by chemotherapy for a recurrence 3 years later. At age 62, a subtotal colectomy was performed because of colonic polyposis: 36 adenomas were detected. During screening gastro-duodenoscopy, three duodenal adenomas were detected. In all three patients, germline analysis did not reveal a mutation in the APC and MYH genes. The gastric and rectal cancer were both microsatellite stable. This report describes three patients with adenomatous polyposis, of which two developed a

  12. Colorectal Adenomatous Polyposis: Heterogeneity of Susceptibility Gene Mutations and Phenotypes in a Cohort of Italian Patients.

    Science.gov (United States)

    Marabelli, Monica; Molinaro, Valeria; Abou Khouzam, Raefa; Berrino, Enrico; Panero, Mara; Balsamo, Antonella; Venesio, Tiziana; Ranzani, Guglielmina Nadia

    2016-12-01

    Colorectal adenomatous polyposis entailing cancer predisposition is caused by constitutional mutations in different genes. APC is associated with the familial adenomatous polyposis (FAP/AFAP) and MUTYH with the MUTYH-associated polyposis (MAP), while POLE and POLD1 mutations cause the polymerase proofreading-associated polyposis (PPAP). We screened for mutations in patients with multiple adenomas/FAP: 121 patients were analyzed for APC and MUTYH mutations, and 36 patients were also evaluated for POLE and POLD1 gene mutations. We found 20 FAP/AFAP, 15 MAP, and no PPAP subjects: pathogenic mutations proved to be heterogeneous, and included 5 APC and 1 MUTYH novel mutations. The mutation detection rate was significantly different between patients with 5-100 polyps and those with >100 polyps (p = 8.154 × 10 -7 ), with APC mutations being associated with an aggressive phenotype (p = 1.279 × 10 -9 ). Mean age at diagnosis was lower in FAP/AFAP compared to MAP (p = 3.055 × 10 -4 ). Mutation-negative probands showed a mean age at diagnosis that was significantly higher than FAP/AFAP (p = 3.46986 × 10 -7 ) and included 45.3% of patients with <30 polyps and 70.9% of patients with no family history. This study enlarges the APC and MUTYH mutational spectra, and also evaluated variants of uncertain significance, including the MUTYH p.Gln338His mutation. Moreover this study underscores the phenotypic heterogeneity and genotype-phenotype correlations in a cohort of Italian patients.

  13. Familial adenomatous polyposis. Report of a case

    International Nuclear Information System (INIS)

    Barroso Marquez, Lisset; Tusen Toledo, Yunia; Chao Gonzalez, Lissette; Alonso Soto, Jordi

    2009-01-01

    Familial adenomatous polyposis is an inherited disease characterized by the appearance of multiple colorectal adenomas by the teenagers and with an incidence of colorectal cancer approaching 100%. We present herein a 39-years-old man with an atypical form of the disease, an attenuated variant, and we comment the importance of management guidelines for surveillance of the patients and their families

  14. 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...

  15. Dento-osseous anomalies associated to familial adenomatous polyposis mimicking florid cemento-osseous dysplasia.

    Science.gov (United States)

    Almeida, Fabiana Tolentino; Leite, André Ferreira; de Souza Figueiredo, Paulo Tadeu; Melo, Nilce Santos; Sousa, João Batista; Almeida, Rômulo; Acevedo, Ana Carolina; Silva Guerra, Eliete Neves

    2012-12-01

    Familial adenomatous polyposis (FAP) is a colorectal cancer syndrome characterized by the development of multiple polyps of the colon and rectum with high risk of malignant transformation. The extraintestinal manifestations such as dento-osseous changes are associated with FAP. This is a case report of a 36-year-old female patient who was referred for dental treatment with the initial diagnosis of florid cemento-osseous dysplasia (FCOD). However, the association of the imaging dento-osseous findings with the medical history confirmed the diagnosis of FAP. The paper illustrates the clinical characteristics and imaging findings associated with FAP, and also discusses misdiagnosis based exclusively on imaging features. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Synchronous cecal adenocarcinoma and multiple colonic in situ carcinomas in hamartomatous polyps in a case of isolated Peutz–Jeghers syndrome

    Directory of Open Access Journals (Sweden)

    Yahia Z Gad

    2011-03-01

    Full Text Available Yahia Z Gad1, Doaa H Bakr1, Mohammad G El-Ebeidy21Department of Internal Medicine, 2Department of Surgery, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, EgyptBackground: Peutz–Jeghers syndrome (PJS is a rare autosomal dominant disease characterized by mucocutaneous pigmentation and hamartomatous polyps of the entire gastrointestinal tract. A Peutz–Jeghers polyp (PJP in a patient without pigmentation or a family history of the disease is called an isolated or solitary PJP. Individuals with PJS carry a very high risk of developing gastrointestinal (GI as well as extra-GI malignancies. This case report documents lesion multiplicity and their malignant potential in a young patient with PJS presenting in a serious condition for the first time.Case report: An 18-year-old female Egyptian patient was admitted with hematochezia and remarkable anemia. After appropriate resuscitation and consent, colonoscopic evaluation revealed seven pedunculated colonic polyps at the ascending and the transverse colon, and numerous variable-sized sessile polyps were scattered all over the colon. To establish hemostasis, endoscopic polypectomy for pedunculated polyps and argon plasma photocoagulation for the bleeding sessile polyps were performed. Histopathological examination revealed cecal adenocarcinoma in one specimen and two simultaneous in situ carcinoma at the transverse and the sigmoid colon in the mucosae of the excised histologically proven hamartomatous polyps. Additionally, one focal in situ carcinoma in the resected colon was detected.Conclusions: When considering the family history, serious GI neoplastic lesions may be unmasked in young patients with PJS who present with hematochezia, even in the absence of its characteristic mucocutaneous pigmented lesions. GI endoscopic surveillance programs should be adopted for diagnosed cases of PJS and their families. Genetic prenatal screening for early detection is the best option for

  17. Wireless capsule endoscopy in adolescents with familial adenomatous polyposis.

    Science.gov (United States)

    Cavallo, Debora; Ballardini, Giovanni; Ferrari, Andrea; Delconte, Gabriele; Signoroni, Stefano; Sala, Paola; Chiaravalli, Stefano; Massimino, Maura; Bertario, Lucio; Vitellaro, Marco

    2016-01-01

    Guidelines for surveillance in patients with familial adenomatous polyposis (FAP) recommend mutation carriers to undergo periodic colorectal examination starting in the early teens. Performing colonoscopy in children may lead to complications. Wireless capsule endoscopy (WCE) has been introduced recently to evaluate both the upper and lower gastrointestinal tract, and seems suitable as a first screening examination for adolescents. The aim of this study was to evaluate the pros and cons of WCE. This was a retrospective review of a single institution database of adolescent patients with FAP identified through the Hereditary Colorectal Tumor Registry between 2007 and 2013. The main outcomes were identification of upper and lower gastrointestinal tract polyps, tolerance of the examination, and number and size of polyps. Of 46 adolescent patients with FAP, 14 (30.4%) patients carrying adenomatous polyposis coli gene (APC) mutation, 6 male and 8 female, age (median, range) 12 (10-17) years, body mass index 19 (13-24), underwent WCE as first screening examination. The examination was completed in 13 patients (93.3%). Wireless capsule endoscopy identified the duodenal papilla in 4 patients and colonic and rectal polyps in all 13 patients. In 7 patients, fewer than 25 polyps were identified. No complications were recorded related to the use of the video capsule. Wireless capsule endoscopy is feasible and well-tolerated as a first screening examination in adolescent patients. It cannot be used as alternative to the colonoscopy, but could improve compliance with colonoscopy, and increase early adherence to a surveillance program.

  18. Nasal polyps

    Science.gov (United States)

    ... shrink polyps, and can reduce swelling and nasal congestion. The effect lasts a few months in most ... this procedure, your doctor uses a thin, lighted tube with instruments at the end. The tube is ...

  19. 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.

  20. A proposed staging system and stage-specific interventions for familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Lynch, Patrick M; Morris, Jeffrey S; Wen, Sijin

    2016-01-01

    BACKGROUND: It is not possible to accurately count adenomas in many patients with familial adenomatous polyposis (FAP). Nevertheless, polyp counts are critical in evaluating each patient's response to interventions. However, the U.S. Food and Drug Administration no longer recognizes the decrease ...

  1. Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps

    Directory of Open Access Journals (Sweden)

    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

  2. Familial adenomatous polyposis.

    OpenAIRE

    Burn, J; Chapman, P D; Eastham, E J

    1994-01-01

    Abstract Familial adenomatous polyposis (FAP) is characterized by the development of many tens to thousands of adenomas in the rectum and colon during the second decade of life. FAP has an incidence at birth of about 1/8,300, it manifests equally in both sexes, and accounts for less than 1% of colorectal cancer (CRC) cases. In the European Union, prevalence has been estimated at 1/11,300-37,600. Most patients are asymptomatic for years until the adenomas are large and numerous, and cause rect...

  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. Broad phenotypic spectrum in familial adenomatous polyposis; from early onset and severe phenotypes to late onset of attenuated polyposis with the first manifestation at age 72

    Directory of Open Access Journals (Sweden)

    Johannsson Oskar

    2008-11-01

    Full Text Available Abstract Background Familial adenomatous polyposis (FAP is typically characterized by multiple colonic polyps and frequent extracolonic features. Whereas the number of colonic polyps has been linked to the APC gene mutation, possible genotype-phenotype correlations largely remain to be defined for the extracolonic manifestations. Methods Full genomic sequencing combined with multiplex ligation-dependent probe amplification was used to identify APC gene mutations, which were correlated to the clinical presentations. Results 10 novel APC gene mutations were identified in 11 families. A broad spectrum of extracolonic manifestations was identified in most of these individuals. Two sisters with an insertion in codon 528 (c.1582_1583insGC both showed severe phenotypes with classical polyposis, upper gastrointestinal polyps and thyroid cancer. A woman with a 3'APC mutation (c.5030_5031insAA developed colon cancer at age 72 as the first manifestation of attenuated FAP. Conclusion With an increasing number of FAP families diagnosed, a broad and variable tumor spectrum and a high frequency of extracolonic manifestations are gradually recognized. We report novel APC mutations and present two FAP cases that suggest familial aggregation of thyroid cancer and demonstrate the need to consider attenuated FAP also among elderly patients with colon cancer.

  5. Multidetector-row CT duodenography in familial adenomatous polyposis: a pilot study

    International Nuclear Information System (INIS)

    Taylor, S.A.; Halligan, S.; Moore, L.; Saunders, B.P.; Gallagher, M.; Phillips, R.K.S.; Bartram, C.I.

    2004-01-01

    AIM: To investigate the feasibility of using multidetector-row computed tomography (CT) duodenography to stage duodenal polyposis in patients with familial adenomatous polyposis. MATERIALS AND METHODS: Six patients underwent multidetector-row CT duodenography before upper gastrointestinal endoscopy. A single-blinded radiologist used a surface shaded three-dimensional endoluminal fly though and two-dimensional axial and multiplanar reformats to assign a score for maximum polyp size and number based on the Spigelman classification. Comparison was made with the corresponding Spigelman scores obtained from subsequent endoscopy. RESULTS: CT duodenography was technically successful in five of six patients. The CT derived Spigelman score based on maximum polyp size was accurate in all five patients. The CT derived Spigelman score based on polyp number was accurate in only two cases: Polyp number was overestimated in one patient and underestimated in a further two. In retrospect, fine carpeting of tiny duodenal polyps was poorly visualized with CT. CONCLUSIONS: CT duodenography is technically feasible and accurately predicts maximum polyp size but CT estimates of polyp number are relatively inaccurate. CT duodenography potentially has a useful role for duodenal surveillance in those patients intolerant of conventional endoscopy

  6. Somatic APC mosaicism and oligogenic inheritance in genetically unsolved colorectal adenomatous polyposis patients.

    Science.gov (United States)

    Ciavarella, Michele; Miccoli, Sara; Prossomariti, Anna; Pippucci, Tommaso; Bonora, Elena; Buscherini, Francesco; Palombo, Flavia; Zuntini, Roberta; Balbi, Tiziana; Ceccarelli, Claudio; Bazzoli, Franco; Ricciardiello, Luigi; Turchetti, Daniela; Piazzi, Giulia

    2018-03-01

    Germline variants in the APC gene cause familial adenomatous polyposis. Inherited variants in MutYH, POLE, POLD1, NTHL1, and MSH3 genes and somatic APC mosaicism have been reported as alternative causes of polyposis. However, ~30-50% of cases of polyposis remain genetically unsolved. Thus, the aim of this study was to investigate the genetic causes of unexplained adenomatous polyposis. Eight sporadic cases with >20 adenomatous polyps by 35 years of age or >50 adenomatous polyps by 55 years of age, and no causative germline variants in APC and/or MutYH, were enrolled from a cohort of 56 subjects with adenomatous colorectal polyposis. APC gene mosaicism was investigated on DNA from colonic adenomas by Sanger sequencing or Whole Exome Sequencing (WES). Mosaicism extension to other tissues (peripheral blood, saliva, hair follicles) was evaluated using Sanger sequencing and/or digital PCR. APC second hit was investigated in adenomas from mosaic patients. WES was performed on DNA from peripheral blood to identify additional polyposis candidate variants. We identified APC mosaicism in 50% of patients. In three cases mosaicism was restricted to the colon, while in one it also extended to the duodenum and saliva. One patient without APC mosaicism, carrying an APC in-frame deletion of uncertain significance, was found to harbor rare germline variants in OGG1, POLQ, and EXO1 genes. In conclusion, our restrictive selection criteria improved the detection of mosaic APC patients. In addition, we showed for the first time that an oligogenic inheritance of rare variants might have a cooperative role in sporadic colorectal polyposis onset.

  7. The role of high-resolution endoscopy and narrow-band imaging in the evaluation of upper GI neoplasia in familial adenomatous polyposis

    NARCIS (Netherlands)

    Lopez-Ceron, Maria; van den Broek, Frank J. C.; Mathus-Vliegen, Elisabeth M.; Boparai, Karam S.; van Eeden, Susanne; Fockens, Paul; Dekker, Evelien

    2013-01-01

    The Spigelman classification stratifies cancer risk in familial adenomatous polyposis (FAP) patients with duodenal adenomatosis. High-resolution endoscopy (HRE) and narrow-band imaging (NBI) may identify lesions at high risk. To compare HRE and NBI for the detection of duodenal and gastric polyps

  8. Oestrogen receptor beta isoform expression in sporadic colorectal cancer, familial adenomatous polyposis and progressive stages of colorectal cancer

    DEFF Research Database (Denmark)

    Stevanato Filho, Paulo Roberto; Aguiar Júnior, Samuel; Begnami, Maria Dirlei

    2017-01-01

    BACKGROUND: Among the sex hormones, oestrogen may play a role in colorectal cancer, particularly in conjunction with oestrogen receptor-β (ERβ). The expression of ERβ isoform variants and their correlations with familial adenomatous polyposis (FAP) syndrome and sporadic colorectal carcinomas...... was identified in sporadic polyps and in sporadic colorectal cancer as well as in polyps from FAP syndrome patients compared with normal tissues (p expression in polyps (p ..., no differences were observed when sporadic colorectal carcinomas were compared to normal mucosa tissues. These findings suggest an association of the ERβ isoform variants in individuals affected by germline mutations of the APC gene. Progressively decreased expression of ERβ was found in polyps at early stages...

  9. Natural history of diminutive colorectal polyps: long-term prospective observation by colonoscopy.

    Science.gov (United States)

    Mizuno, Ken-Ichi; Suzuki, Yutaka; Takeuchi, Manabu; Kobayashi, Masaaki; Aoyagi, Yutaka

    2014-04-01

    Endoscopic removal of colorectal adenomatous polyps effectively prevents cancer. However, the treatment strategy for diminutive polyps (diameter ≤ 5 mm) remains controversial. Understanding the natural history of diminutive polyps is a prerequisite to their effective management. We prospectively examined the natural history of diminutive polyps by long-term surveillance colonoscopy. A total of 207 polyps detected in 112 patients from December 1991 through March 2002 were studied. To avoid potential effects on size and morphological characteristics, all polyps were selected randomly and were followed without biopsy. Polyp size was estimated by comparing the lesion with the diameter of a biopsy forceps. Mean follow up was 7.8 years (SD, 4.8; range, 1.0-18.6; median, 7.5; interquartile range 3.4-11.2). Twenty-four polyps were resected endoscopically, and the histopathological diagnosis was mucosal high-grade neoplasia (Category 4) for one polyp, and mucosal low-grade neoplasia (Category 3) for 23 polyps. Mean linear size of the polyps was 3.2 mm (SD, 1.0; range, 1.3-5.0) at initial colonoscopy and 3.8 mm (SD 1.6; range 1.3-10.0) at final colonoscopy (Ppit pattern was associated with a lower growth rate than a type IIIL1 pattern. We clarified the natural history of diminutive polyps by long-term follow-up colonoscopy. The benign course of diminutive polyps should be considered in the design of treatment strategies. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  10. 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.

  11. Double-contrast gastrography and gastroscopy in the diagnosis of gastric polyps. Personal experience

    Energy Technology Data Exchange (ETDEWEB)

    Biscarini, R; Giorgi, G; Lazzari, G and others

    1986-01-01

    Gastric polyps are benign tumors which have been less uncommonly detected in recent years, due to the refinement of both radiologic and endoscopic investigations. From 1981 through 1985 gastric polyps were detected in 102 patients (1,9%) out of 5368 radiologic examination. In the same period, 98 cases (3,3%) were detected out of 2942 endoscopic examination. The comparison of data in these two series shows a superimposition. Despite an increased percentage of endoscopic findings (to some extent due to previous radiologic reports), the authors assert the diagnostic efficacy of double contrast radiologic investigation as a first approach to benign polypous lesions of the stomach. As far as histology is concerned, a clear prevalence is shown of hyperplastic versus adenomatous polyps (90 and 8 cases repectively).

  12. Oestrogen receptor beta isoform expression in sporadic colorectal cancer, familial adenomatous polyposis and progressive stages of colorectal cancer.

    Science.gov (United States)

    Stevanato Filho, Paulo Roberto; Aguiar Júnior, Samuel; Begnami, Maria Dirlei; Kuasne, Hellen; Spencer, Ranyell Matheus; Nakagawa, Wilson Toshihiko; Bezerra, Tiago Santoro; Kupper, Bruna Catin; Takahashi, Renata Maymi; Barros Filho, Mateus; Rogatto, Silvia Regina; Lopes, Ademar

    2017-11-13

    Among the sex hormones, oestrogen may play a role in colorectal cancer, particularly in conjunction with oestrogen receptor-β (ERβ). The expression of ERβ isoform variants and their correlations with familial adenomatous polyposis (FAP) syndrome and sporadic colorectal carcinomas are poorly described. This study aimed to investigate the expression levels of the ERβ1, ERβ2, ERβ4 and ERβ5 isoform variants using quantitative RT-PCR (921 analyses) in FAP, normal mucosa, adenomatous polyps and sporadic colorectal carcinomas. Decreased expression of ERβ isoforms was identified in sporadic polyps and in sporadic colorectal cancer as well as in polyps from FAP syndrome patients compared with normal tissues (p colorectal carcinomas were compared to normal mucosa tissues. These findings suggest an association of the ERβ isoform variants in individuals affected by germline mutations of the APC gene. Progressively decreased expression of ERβ was found in polyps at early stages of low-grade dysplasia, followed by T1-T2 and T3-T4 tumours (p colorectal cancer, the loss of expression was an independent predictor of recurrence, and ERβ1 and ERβ5 expression levels were associated with better disease-free survival (p = 0.002). These findings may provide a better understanding of oestrogens and their potential preventive and therapeutic effects on sporadic colorectal cancer and cancers associated with FAP syndrome.

  13. Risk and protective factors for development of colorectal polyps and cancer (Bulgarian experience).

    Science.gov (United States)

    Kotzev, I; Mirchev, M; Manevska, B; Ivanova, I; Kaneva, M

    2008-01-01

    Colorectal cancer takes third place among all malignancies in the Varna region. The present study aims to determine the typical and distinguishing risk and protective factors for colorectal polyps and cancer formation. 166 patients with large bowel polyps and 107 patients with colorectal cancer were questioned, examined endoscopically and histologically. Logistic regression analysis was used to find a possible correlation between alimentary habits, way of life, and risk for colorectal polyps and cancer formation. The latter have been used to define a strategy for their prevention. Our results showed that fried, preserved, and grilled meat, consumption of animal fats, sugar, and being overweight are positively associated with colorectal polyps. In contrast, consumption of fruit, vegetables, rye- and brown bread, green tea, vegetable food, yoghourt, vegetarian food, fish, lamb, hare, garlic, boiled food, and mineral water, have strong protective effect against large bowel polyps. We have confirmed the role of the well-known risk factors for colorectal cancer, and discovered an association between H. pylori infection, age, villous component in the adenomatous polyps, and family history for any neoplasia and large bowel carcinoma. We suggest the following protective factors for CRC: vegetarian food, plant oil, rural life, aspirin intake, legumes, fish, fruit and vegetable consumption. We observe a similarity between the risk factors for colorectal polyps and cancer formation. They act simultaneously and depend on genetic predisposition. A combination of endoscopic treatment and correction of the alimentary factors could be used as a means of cancer prevention.

  14. Assessing barriers to a rational chemoprevention trial design in young patients with familial adenomatous polyposis.

    Science.gov (United States)

    Wood, Joanna P; Howells, Lynne M; Brown, Karen; Thomas, Anne L

    2017-07-01

    Familial adenomatous polyposis coli (FAP) is an autosomal dominant condition caused by a germline mutation in the adenomatous polyposis coli gene. Colonic adenomas form and almost all patients will develop colorectal cancer if they are not managed at an early stage. The safest preventive strategy is surgical resection of the colon, most commonly performed in late teenage years. There is a paucity of trials investigating the use of primary chemoprevention to delay polyp formation in paediatric FAP. There are extensive preclinical and early clinical data demonstrating that curcumin may be a safe and effective chemotherapeutic agent in reducing the polyp burden in this disease. We ultimately proposed to design and conduct a clinical study to assess whether curcumin treatment delays the need for surgery and/or prevents cancer in young patients with FAP. Research into clinical trial protocols has demonstrated that assessing patients' perceptions at the initial stage leads to better outcomes. We therefore conducted a questionnaire study of patients and parents of children affected by FAP to gain information to aid the protocol design. Results demonstrated that there are some FAP patients for whom this study is relevant and desirable. Those with a personal history of curcumin use reported that it was well tolerated. However, the response rate was poor (25%), indicating that there are potential difficulties ensuring adequate recruitment to the proposed trial. This report draws on lessons learnt from prior trials and the findings from the questionnaire to outline the challenges faced in designing such a study.

  15. SPHENOCHOANAL POLYP: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Gaurav

    2015-09-01

    Full Text Available Sphenochoanal polyp is a rare clinical occurrence as compared to the much common antro - choanal polyp. It originates from the sphenoid sinus and extends into the choana via the sphenoid ostium. We present a case of spheno - choanal polyp and its clinical features and surgical management is discussed. Our aim in this case was to properly d elineate the origin of the polyp and differentiate it from other lesions such as the antro - choanal polyp and meningocele, followed by meticulous endoscopic excision of the polyp

  16. 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.

  17. 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

  18. 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.

  19. A randomized placebo-controlled prevention trial of aspirin and/or resistant starch in young people with familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Burn, John; Bishop, D Timothy; Chapman, Pamela D

    2011-01-01

    Evidence supporting aspirin and resistant starch (RS) for colorectal cancer prevention comes from epidemiologic and laboratory studies (aspirin and RS) and randomized controlled clinical trials (aspirin). Familial adenomatous polyposis (FAP) strikes young people and, untreated, confers virtually...... and sigmoid colon (at the end of intervention), and the major secondary endpoint was size of the largest polyp. A total of 206 randomized FAP patients commenced intervention, of whom 133 had at least one follow-up endoscopy and were therefore included in the primary analysis. Neither intervention...... significantly reduced polyp count in the rectum and sigmoid colon: aspirin relative risk = 0.77 (95% CI, 0.54-1.10; versus nonaspirin arms); RS relative risk = 1.05 (95% CI, 0.73-1.49; versus non-RS arms). There was a trend toward a smaller size of largest polyp in patients treated with aspirin versus...

  20. Increased polyp detection using narrow band imaging compared with high resolution endoscopy in patients with hyperplastic polyposis syndrome

    NARCIS (Netherlands)

    Boparai, K. S.; van den Broek, F. J. C.; van Eeden, S.; Fockens, P.; Dekker, E.

    2011-01-01

    Hyperplastic polyposis syndrome (HPS) is associated with colorectal cancer and is characterized by multiple hyperplastic polyps, sessile serrated adenomas (SSAs) and adenomas. Narrow band imaging (NBI) may improve the detection of polyps in HPS. We aimed to compare polyp miss rates with NBI with

  1. Giant fibrovascular polyp of esophagus

    Directory of Open Access Journals (Sweden)

    Ramakanth Sannidi

    2016-01-01

    Full Text Available Benign tumors of esophagus are uncommon and account for only 3% of all esophageal neoplasms. Fibrovascular polyps (FVP are rare intraluminal tumors of esophagus. They are composed of fibrous tissue, vascular structures and covered with normal Squamous epithelium. Here we present a case of a 45 yr old gentleman with progressive dysphagia since 3 months. UGI endoscopy showed a long, linear, compressible mass extending from cricoid area to gastro-esophageal junction (GEJ. Patient was operated, through cervical incision esophgectomy done and polyp of size 16 × 7 cm was removed. Histopathology of polyp was suggestive of fibrovascular polyp. Post surgery patient was asymptomatic and doing well.

  2. Causes of death in familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Galle, T S; Juel, K; Bülow, S

    1999-01-01

    The prognosis in familial adenomatous polyposis (FAP) has improved over the past decades owing to a reduction in the prevalence of colorectal cancer, resulting from effective early screening. During the same period several polyposis registers have recorded an increasing number of deaths due to du...... to duodenal/periampullary cancer and desmoid tumours. The aim of this study was to examine the causes of death with special emphasis on duodenal/periampullary cancer.......The prognosis in familial adenomatous polyposis (FAP) has improved over the past decades owing to a reduction in the prevalence of colorectal cancer, resulting from effective early screening. During the same period several polyposis registers have recorded an increasing number of deaths due...

  3. Familial adenomatous polyposis: from bedside to benchside.

    LENUS (Irish Health Repository)

    O'Sullivan, M J

    2012-02-03

    Familial adenomatous polyposis (FAP) is a dominantly inherited cancer-predisposition syndrome with an incidence of between 1:17,000 and 1:5,000. The condition has been causally linked to mutation of the adenomatous polyposis coli (APC) gene located at 5q21. Virtually all mutations in the APC gene are truncating mutations, resulting in loss of function of the APC protein. Spontaneous germline mutation of this gene occurs frequently and accounts for the high incidence of FAP. The gene is somatically mutated at an early point in the colorectal adenoma-carcinoma progression. Somatic mutations of the APC gene are also frequently observed in a variety of other human carcinomas. Isolation of the APC gene has led to the recognition of genotype-phenotype correlations and, together with protein studies, has helped to elucidate the structure and function of the APC protein. This report aims to take the reader from a clinical appreciation to a molecular understanding of FAP.

  4. 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.

  5. APC promoter 1B deletion in seven American families with familial adenomatous polyposis.

    Science.gov (United States)

    Snow, A K; Tuohy, T M F; Sargent, N R; Smith, L J; Burt, R W; Neklason, D W

    2015-10-01

    Familial adenomatous polyposis (FAP) is a colorectal cancer predisposition syndrome caused by mutations in the adenomatous polyposis coli (APC) gene. Clinical genetic testing fails to identify disease causing mutations in up to 20% of clinically apparent FAP cases. Following the inclusion of multiplex ligation-dependent probe amplification (MLPA) probes specific for APC promoter 1B, seven probands were identified with a deletion of promoter 1B. Using haplotype analysis spanning the APC locus, the seven families appear to be identical by descent from a common founder. The clinical phenotype of 19 mutation carriers is classical FAP with colectomy at an average age of 24. The majority of cases had a large number of duodenal and gastric polyps. Measurements of allele-specific expression of APC mRNA using TaqMan assay confirmed that relative expression in the allele containing the promoter 1B deletion was reduced 42-98%, depending on tissue type. This study confirms the importance of APC promoter deletions as a cause of FAP and identifies a founder mutation in FAP patients from the United States. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Epidemiology of goblet cell and microvesicular hyperplastic polyps.

    Science.gov (United States)

    Qazi, Taha M; O'Brien, Michael J; Farraye, Francis A; Gould, Ryan W; Chen, Clara A; Schroy, Paul C

    2014-12-01

    Serrated polyps compromise both typical hyperplastic polyps as well as sessile serrated adenomas and dysplastic serrated polyps. Hyperplastic polyps exhibit two histological patterns: microvesicular hyperplastic polyps (MVHPs) and goblet cell hyperplastic polyps (GCHPs). MVHPs and GCHPs differ in their molecular signature. MVHPs have been frequently found to have the BRAF(V600E) mutation as well as aberrant methylation. In contrast, GCHPs have been associated with the KRAS mutation (KRAS-mut), which are infrequently seen in dysplastic serrated sessile adenomas. The particular risk factors that are associated with development of the types of hyperplastic polyps have not been previously studied. The purpose of this study is to characterize the associations between particular risk factors and the development of goblet cell or microvesicular hyperplastic polyps. We conducted a cross-sectional analysis of 3,543 asymptomatic, mostly average risk patients 50 and 79 years of age undergoing open-access screening colonoscopy between March 2005 and January 2012. Each patient was given a survey regarding 25 reputed risk factors for colorectal neoplasia and the responses were correlated with findings at colonoscopy. Associations between putative risk factors for colorectal neoplasia and MVHPs and GSHPs were examined using multiple logistic regression. MVHPS and GCHPs were identified in 5.3% and 8.7% of patients, respectively. The results of the statistical analysis indicate that a history of smoking greater than 20 years is associated with an increased risk of MVHPs (P30 kg/m(2) was also associated with the presence of MVHP at colonoscopy (PGCHP at colonoscopy in blacks. The study suggests that the development of the distinct histological types of hyperplastic polyps are associated with distinct modifiable and non-modifiable lifestyle factors.

  7. Concentration of folate in colorectal tissue biopsies predicts prevalence of adenomatous polyps

    Science.gov (United States)

    Background and aims: Folate has been implicated as a potential aetiological factor for colorectal cancer. Previous research has not adequately exploited concentrations of folate in normal colonic mucosal biopsies to examine the issue. Methods: Logistic regression models were used to estimate ORs ...

  8. Methylation diet and methyl group genetics in risk for adenomatous polyp occurrence

    Directory of Open Access Journals (Sweden)

    Mark Lucock

    2015-06-01

    Conclusion: A methylation diet influences methyl group synthesis in the regulation of blood homocysteine level, and is modulated by genetic interactions. Methylation-related nutrients also interact with key genes to modify risk of AP, a precursor of colorectal cancer. Independent of diet, two methylation-related genes (A2756G-MS and A66G-MSR were directly associated with AP occurrence.

  9. [Rectocolonic polyps in Senegal. Results of 1500 lower endoscopies carried out at the Dakar General Hospital].

    Science.gov (United States)

    Peghini, M; Barabe, P; Seurat, P; Philippon, G; Morcillo, R; Diallo, A; Gueye, P M

    1987-01-01

    57 polyps were discovered during 1,500 low endoscopies, and 24 of them were adenoma. In the same period of time, 26 proctocolitic adenocarcinomas were found. Adenomatous polyps appear to be 5 times less frequent in Senegal than in industrialized countries and frequency of colitic cancer should be of the same frequency, that is far less negligible. Even if proctocolitic cancer does not set up any Public Health problems one could envisage systematic screening of polyadenoma in every patient aged more than 40. Proctosigmoid being the seat of most adenoma, fibrosigmoidoscopy appears well adapted to this kind of screening because it does not require any preparation, it is easy to perform and well accepted.

  10. 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.

  11. APC gene mutations and extraintestinal phenotype of familial adenomatous polyposis

    NARCIS (Netherlands)

    Giardiello, F. M.; Petersen, G. M.; Piantadosi, S.; Gruber, S. B.; Traboulsi, E. I.; Offerhaus, G. J.; Muro, K.; Krush, A. J.; Booker, S. V.; Luce, M. C.; Laken, S. J.; Kinzler, K. W.; Vogelstein, B.; Hamilton, S. R.

    1997-01-01

    Familial adenomatous polyposis (FAP) is caused by germline mutation of the adenomatous polyposis coli (APC) gene on chromosome 5q. This study assessed genotype-phenotype correlations for extraintestinal lesions in FAP. Mutations of the APC gene were compared with the occurrence of seven

  12. Angiomatous nasal polyp: Clinical diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Sunder Goyal

    2015-03-01

    Full Text Available Angiomatous polyp (Angiectatic nasal polyps is rare and its incidence is 4-5% of all nasal polyps. As it occurs with variable clinical features and there is no confirmatory preoperative investigation, clinical diagnosis can be a dilemma. Clinical picture of angiofibroma, simple antrochoanal polyp and inverted papilloma may resemble with each other. As polyps invade surrounding bone, these should be distinguished from a malignant mass. We present an interesting case of an infarcted angiectatic nasal polyp with extensive surrounding bony destruction. Correct preoperative radiological diagnosis is important to avoid unnecessary extensive surgery. Histopathological evaluation of polyps is mandatory since they require different treatment due to difference in the prognosis.

  13. Computer-Aided Diagnosis Based on Convolutional Neural Network System for Colorectal Polyp Classification: Preliminary Experience.

    Science.gov (United States)

    Komeda, Yoriaki; Handa, Hisashi; Watanabe, Tomohiro; Nomura, Takanobu; Kitahashi, Misaki; Sakurai, Toshiharu; Okamoto, Ayana; Minami, Tomohiro; Kono, Masashi; Arizumi, Tadaaki; Takenaka, Mamoru; Hagiwara, Satoru; Matsui, Shigenaga; Nishida, Naoshi; Kashida, Hiroshi; Kudo, Masatoshi

    2017-01-01

    Computer-aided diagnosis (CAD) is becoming a next-generation tool for the diagnosis of human disease. CAD for colon polyps has been suggested as a particularly useful tool for trainee colonoscopists, as the use of a CAD system avoids the complications associated with endoscopic resections. In addition to conventional CAD, a convolutional neural network (CNN) system utilizing artificial intelligence (AI) has been developing rapidly over the past 5 years. We attempted to generate a unique CNN-CAD system with an AI function that studied endoscopic images extracted from movies obtained with colonoscopes used in routine examinations. Here, we report our preliminary results of this novel CNN-CAD system for the diagnosis of colon polyps. A total of 1,200 images from cases of colonoscopy performed between January 2010 and December 2016 at Kindai University Hospital were used. These images were extracted from the video of actual endoscopic examinations. Additional video images from 10 cases of unlearned processes were retrospectively assessed in a pilot study. They were simply diagnosed as either an adenomatous or nonadenomatous polyp. The number of images used by AI to learn to distinguish adenomatous from nonadenomatous was 1,200:600. These images were extracted from the videos of actual endoscopic examinations. The size of each image was adjusted to 256 × 256 pixels. A 10-hold cross-validation was carried out. The accuracy of the 10-hold cross-validation is 0.751, where the accuracy is the ratio of the number of correct answers over the number of all the answers produced by the CNN. The decisions by the CNN were correct in 7 of 10 cases. A CNN-CAD system using routine colonoscopy might be useful for the rapid diagnosis of colorectal polyp classification. Further prospective studies in an in vivo setting are required to confirm the effectiveness of a CNN-CAD system in routine colonoscopy. © 2017 S. Karger AG, Basel.

  14. 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.

  15. Polyp Detection, Characterization, and Management Using Narrow-Band Imaging with/without Magnification

    Directory of Open Access Journals (Sweden)

    Takahiro Utsumi

    2015-11-01

    Full Text Available Narrow-band imaging (NBI is a new imaging technology that was developed in 2006 and has since spread worldwide. Because of its convenience, NBI has been replacing the role of chromoendoscopy. Here we review the efficacy of NBI with/without magnification for detection, characterization, and management of colorectal polyps, and future perspectives for the technology, including education. Recent studies have shown that the next-generation NBI system can detect significantly more colonic polyps than white light imaging, suggesting that NBI may become the modality of choice from the beginning of screening. The capillary pattern revealed by NBI, and the NBI International Colorectal Endoscopic classification are helpful for prediction of histology and for estimating the depth of invasion of colorectal cancer. However, NBI with magnifying colonoscopy is not superior to magnifying chromoendoscopy for estimation of invasion depth. Currently, therefore, chromoendoscopy should also be performed additionally if deep submucosal invasive cancer is suspected. If endoscopists become able to accurately estimate colorectal polyp pathology using NBI, this will allow adenomatous polyps to be resected and discarded; thus, reducing both the risk of polypectomy and costs. In order to achieve this goal, a suitable system for education and training in in vivo diagnostics will be necessary.

  16. 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.

  17. 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

  18. Didactic training vs. computer-based self-learning in the prediction of diminutive colon polyp histology by trainees: a randomized controlled study.

    Science.gov (United States)

    Khan, Taimur; Cinnor, Birtukan; Gupta, Neil; Hosford, Lindsay; Bansal, Ajay; Olyaee, Mojtaba S; Wani, Sachin; Rastogi, Amit

    2017-12-01

    Background and study aim  Experts can accurately predict diminutive polyp histology, but the ideal method to train nonexperts is not known. The aim of the study was to compare accuracy in diminutive polyp histology characterization using narrow-band imaging (NBI) between participants undergoing classroom didactic training vs. computer-based self-learning. Participants and methods  Trainees at two institutions were randomized to classroom didactic training or computer-based self-learning. In didactic training, experienced endoscopists reviewed a presentation on NBI patterns for adenomatous and hyperplastic polyps and 40 NBI videos, along with interactive discussion. The self-learning group reviewed the same presentation of 40 teaching videos independently, without interactive discussion. A total of 40 testing videos of diminutive polyps under NBI were then evaluated by both groups. Performance characteristics were calculated by comparing predicted and actual histology. Fisher's exact test was used and P  didactic training and 9 self-learning). A larger proportion of polyps were diagnosed with high confidence in the classroom group (66.5 % vs. 50.8 %; P  didactic training for predicting diminutive polyp histology. This approach can help in widespread training and clinical implementation of real-time polyp histology characterization. © Georg Thieme Verlag KG Stuttgart · New York.

  19. The genetic basis of colonic adenomatous polyposis syndromes.

    Science.gov (United States)

    Talseth-Palmer, Bente A

    2017-01-01

    Colorectal cancer (CRC) is one of the most common forms of cancer worldwide and familial adenomatous polyposis (FAP) accounts for approximately 1% of all CRCs. Adenomatous polyposis syndromes can be divided into; familial adenomatous polyposis (FAP) - classic FAP and attenuated familial adenomatous polyposis (AFAP), MUTYH-associated polyposis (MAP), NTHL1-associated polyposis (NAP) and polymerase proofreading-associated polyposis (PPAP). The polyposis syndromes genetics and clinical manifestation of disease varies and cases with clinical diagnosis of FAP might molecularly show a different diagnosis. This review examines different aspects of the adenomatous polyposis syndromes genetics and clinical manifestation of disease; in addition the genotype-phenotype and modifier alleles of FAP will be discussed. New technology has made it possible to diagnose some of the APC mutation negative patients into their respective syndromes. There still remain many molecularly undiagnosed adenomatous polyposis patients indicating that there remain causative genes to be discovered and with today's technology these are expected to be identified in the near future. The knowledge about the role of modifier alleles in FAP will contribute to improved pre-symptomatic diagnosis and treatment. New novel mutations will continually be discovered in genes already associated with disease and new genes will be discovered that are associated with adenomatous polyposis. The search for modifier alleles in FAP should be made a priority.

  20. [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

    electrocoagulation polypectomy with hemoclips. The clip contacted polyps in upright direction. One or more hemoclips were selected to clamp the proximal basement of the pedicel in terms of the pedicel diameter. Turning of the red colour of polyps to purple suggested that hemoclip interdicted arteriovenous blood effectively. The clip was then shut off and electrocoagulation polypectomy was followed. Six polyps were observed and removed. Six polyps including 2 transverse colon polyps and 4 descending colon polyps were resected. Pathological results showed that 3 were juvenile polyps and the other 3 adenomatous polyps. All the polyps were completely resected. The diameter of pedicel were 1.2 - 2.2 cm. The head and pedicel of the biggest polyp was about 5 cm x 5 cm and 2.2 cm, respectively, and five clips were used in order to remove it. No complications of bleeding and perforation were observed in these children. All hemoclips were expelled from intestines within one week. The symptoms of these patients disappeared. Mechanical hemostasis with hemoclips successfully interdicted arteriovenous blood of thick-pedunculated polyps. Hemoclips can successfully prevent the complications of bleeding and perforation. The clipping brings about a new method in endoscopic therapy. Endoscopic electrocoagulation polypectomy with hemoclips is a simple, safe and effective method to treat thick-pedunculated gastrointestinal polyps in children and it is a valuable tool in polypectomy for children.

  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. 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 ...

  3. [Fibroepithelial polyp of the ureter. Report of one case].

    Science.gov (United States)

    Morales, Raúl; Manrique, Eduardo; Casanova, Rubén; Molina, Pedro; Falcón, Ramón

    2004-05-01

    To report the rare case of a patient with a ureteral polyp. We describe the case of a 55-year-old female patient receiving care at the Celia Sanchez Manduley University Hospital in Manzanillo, Cuba, who was fortuitously diagnosed of a fibroepithelial polyp of the right ureter during the work up and treatment of an ovarian tumor. This case is the first of its kind in this hospital after 22 years, which confirms the rarity of ureteral tumors, specifically those of benign etiology. The absence of symptoms, specifically hematuria and pain, does not correspond to the reviewed articles. The chosen treatment was exeresis of the polyp at its base and frozen biopsy, followed by re-establishment of the urinary passage, as various authors recommend. Currently the endoscopical approach is recommended for its multiple advantages. We conclude that this disease is very rare, may have a symptomatic course and the treatment of choice is surgery with very good results.

  4. 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.

  5. Immunopurification of adenomatous polyposis coli (APC) proteins

    Science.gov (United States)

    2013-01-01

    Background The adenomatous polyposis coli (APC) tumour suppressor gene encodes a 2843 residue (310 kDa) protein. APC is a multifunctional protein involved in the regulation of β-catenin/Wnt signalling, cytoskeletal dynamics and cell adhesion. APC mutations occur in most colorectal cancers and typically result in truncation of the C-terminal half of the protein. Results In order to investigate the biophysical properties of APC, we have generated a set of monoclonal antibodies which enable purification of recombinant forms of APC. Here we describe the characterisation of these anti-APC monoclonal antibodies (APC-NT) that specifically recognise endogenous APC both in solution and in fixed cells. Full-length APC(1–2843) and cancer-associated, truncated APC proteins, APC(1–1638) and APC(1–1311) were produced in Sf9 insect cells. Conclusions Recombinant APC proteins were purified using a two-step affinity approach using our APC-NT antibodies. The purification of APC proteins provides the basis for detailed structure/function analyses of full-length, cancer-truncated and endogenous forms of the protein. PMID:24156781

  6. 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.

  7. Current status of prophylactic surgical treatment for familial adenomatous polyposis in Japan.

    Science.gov (United States)

    Yamadera, Masato; Ueno, Hideki; Kobayashi, Hirotoshi; Konishi, Tsuyoshi; Ishida, Fumio; Yamaguchi, Tatsuro; Hinoi, Takao; Inoue, Yasuhiro; Kanemitsu, Yukihide; Tomita, Naohiro; Ishida, Hideyuki; Sugihara, Kenichi

    2017-06-01

    We conducted this study to clarify the current clinical practice of prophylactic colectomy for patients with familial adenomatous polyposis (FAP) in Japan. This retrospective multi-center cohort study involved 23 specialized institutions for colorectal disease in Japan. We analyzed the records of 147 patients who underwent prophylactic surgical treatment between 2000 and 2012. Patients were divided into Group 1 (2000-2006) and Group 2 (2007-2012) based on their date of surgery. Age at the time of prophylactic surgery was 27 and 31 years in Groups 1 and 2, respectively. The proportion of attenuated FAP was significantly lower in Group 2 than in Group 1 (1.0 vs. 13 %, respectively). Pathological examination revealed an increased incidence of malignant polyps in the resected specimens from Group 2 patients (10 vs. 23 %, respectively; P = 0.034). Laparoscopic surgery was more frequent in Group 2 than in Group 1 (61 vs. 40 %, respectively). There was no surgical mortality in either group. Prophylactic surgery for FAP results in good short-term surgical outcomes in Japan. The current surgical approach is characterized by limited surgical indications for patients with attenuated FAP, delayed timing of colectomy, and the increasing standardization of laparoscopic surgery.

  8. Telomerase activity and telomere length in the colorectal polyp-carcinoma sequence Actividad de la telomerasa y longitud del telómero en la secuencia pólipo-carcinoma colorrectal

    OpenAIRE

    C. Valls Bautista; C. Piñol Felis; J. M. Reñe Espinet; J. Buenestado García; J. Viñas Salas

    2009-01-01

    Objective: the role of telomerase activity and telomere length in the adenoma-carcinoma sequence of colon carcinogenesis has not been well established. The objective of this study was to determine telomerase activity and telomere length patterns in patients with adenomatous polyps either associated or not with colorectal cancer, as well as the role of telomeric instability in the adenoma-carcinoma sequence. Patients and methods: we included in the study 14 patients who underwent surgery for c...

  9. Dental anomalies in pediatric patients with familial adenomatous polyposis.

    Science.gov (United States)

    Septer, Seth; Bohaty, Brenda; Onikul, Robin; Kumar, Vandana; Williams, Karen B; Attard, Thomas M; Friesen, Craig A; Friesen, Lynn Roosa

    2018-04-01

    Familial adenomatous polyposis patients often present with non-malignant extra-intestinal manifestations which include dental anomalies that may be evident prior to the appearance of the colonic adenomas. The aims of this study were to describe the prevalence and type of dental anomalies and the relationships between gene mutations and dental anomalies in these patients. Twenty-two pediatric familial adenomatous polyposis patients and 46 controls, who were age and gender matched participated. Familial adenomatous polyposis patient's had a dental examination with panoramic radiograph and medical record review for age at diagnosis, the presence of the adenomatous polyposis coli gene mutation, and determination of other extra-intestinal manifestations on the body. The control group was identified from a retrospective chart review and selected if there was a current panoramic radiograph. The only significant difference between familial adenomatous polyposis patients and controls were the presence of jaw osteomas and sclerosis (p = .0001). Patients with a mutation in, or upstream of codon 1309 had a higher frequency of osteomas (77.8%) and jaw-bone sclerosis (44.4%), and 77% of these had at least one dental anomaly. This preliminary study showed an association between a genetic variant at, or upstream of codon 1309, and radiographic dental anomalies.

  10. Tubercular thyroiditis with multinodular goitre with adenomatous hyperplasia: a rare coexistence.

    Science.gov (United States)

    Chaurasia, Jai Kumar; Garg, Cheena; Agarwal, Arjun; Naim, Mohammed

    2013-09-25

    A 32-year-old Indian woman presented with swelling in the anterior part of the neck for the last 3 years. Clinical and radiological examination and fine needle aspiration cytology suggested the diagnosis of multinodular goitre. A subtotal thyroidectomy was performed by the surgeon and the specimen was submitted for the final diagnosis. Histological examination of the specimen revealed multiple caseating tubercular granulomas coexistent with multinodular goitre and adenomatous hyperplasia. The sections demonstrated acid-fast tubercle bacteria, confirming the diagnosis of tubercular thyroiditis. This case emphasises that tubercular thyroiditis should always be considered in patients with thyroid swelling or nodule, in countries where the prevalence of tuberculosis is high.

  11. 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.

  12. Recurrent giant fibrovascular polyp of the esophagus

    OpenAIRE

    Lee, Ser Yee; Chan, Weng Hoong; Sivanandan, Ranjiv; Lim, Dennis Teck Hock; Wong, Wai Keong

    2009-01-01

    Giant fibrovascular polyps of the esophagus and hypopharynx are rare benign esophageal tumors. They arise most commonly in the upper esophagus and may, rarely, originate in the hypopharynx. They can vary significantly in size. Even though they are benign, they may be lethal due to either bleeding or, rarely, asphyxiation if a large polyp is regurgitated. Patients commonly present with dysphagia or hematemesis. The polyps may not be well visualized on endoscopy and imaging plays a vital role i...

  13. Mutation analysis of the adenomatous polyposis coli (APC) gene in Danish patients with familial adenomatous polyposis (FAP)

    DEFF Research Database (Denmark)

    Bisgaard, Marie Luise; Ripa, Rasmus S; Bülow, Steffen

    2004-01-01

    Development of one hundred or more adenomas in the colon and rectum is diagnostic for the dominantly inherited, autosomal disease Familial Adenomatous Polyposis (FAP). It is possible to identify a mutation in the Adenomatous Polyposis Coli (APC) gene in approximately 80% of the patients, and almost...... 1,000 different pathogenic mutations have been identified in the APC gene up till now. We report 12 novel and 24' previously described germline APC mutations from 48 unrelated Danish families. Four families with the mutation localized in the 3' region of the gene showed great variance in phenotypic...

  14. Inflammatory fibroid polyp of sigmoid colon.

    Science.gov (United States)

    Lifschitz, O; Lew, S; Witz, M; Reiss, R; Griffel, B

    1979-01-01

    A case of inflammatory fibroid polyp of the sigmoid colon is presented. This is the eight case of this type of polyp in the colon and, to the best of our knowledge, the first one involving the sigmoid and producing intussusception. Symptomatology of the inflamed fibroid polyp in this part of the gut closely simulates gastrointestinal malignancy. The treatment is surgical excision of the polyp, or colonoscopic resection when it is possible. Intraoperative colonoscopy helps the surgeon to localize the lesion and to role out the existence of other lesions.

  15. Fecal blood loss in patients with colonic polyps: a comparison of measurements with 51chromium-labeled erythrocytes and with the Haemoccult test

    International Nuclear Information System (INIS)

    Herzog, P.; Holtermueller, K.H.; Preiss, J.; Fischer, J.; Ewe, K.; Schreiber, H.J.; Berres, M.

    1982-01-01

    The quantitative determinations of fecal daily blood loss after intravenous administration of 51 Cr-labeled erythrocytes in 44 patients with colonic polyps and in 11 controls were compared with the results of the daily performed Haemoccult test without dietary restrictions. A total of 642 stool specimens was analyzed for 51 Cr loss and the Haemoccult test. The mean fecal daily blood loss in the 34 patients with adenomatous polyps of the descending colon and rectosigmoid was 1.36 +/- 0.14 ml/day (mean +/- SEM), in the 10 patients with polyps of the ascending and transverse colon it was 1.28 +/- 0.31 ml/day, and in the 11 controls 0.62 +/- 0.07 ml/day. There was no positive Haemoccult test in the controls. In fecal specimens from patients with polyps in the descending colon and rectosigmoid containing 2.0-3.99 ml blood/day, the Haemoccult-test was positive in 86%. Fecal specimens from patients with polyps in the ascending colon and transverse colon containing equal blood loss yielded a positive Haemoccult test result in 26%. Thus, the positivity of the Haemoccult test is determined by the fecal daily blood loss and the anatomic location of colonic bleeding sites

  16. Feasibility and diagnostic utility of video capsule endoscopy for the detection of small bowel polyps in patients with hereditary polyposis syndromes.

    Science.gov (United States)

    Schulmann, Karsten; Hollerbach, Stephan; Kraus, Katja; Willert, Jörg; Vogel, Tilman; Möslein, Gabriela; Pox, Christian; Reiser, Markus; Reinacher-Schick, Anke; Schmiegel, Wolff

    2005-01-01

    At present, surveillance of premalignant small bowel polyps in hereditary polyposis syndromes has a number of limitations. Capsule endoscopy (CE) is a promising new method to endoscopically assess the entire length of the small bowel. We prospectively examined 40 patients with hereditary polyposis syndromes (29 familial adenomatous polyposis (FAP), 11 Peutz-Jeghers syndrome (PJS)). Results were compared with push-enteroscopy (PE) results in FAP and with esophagogastroduodenoscopy, PE, (MR)-enteroclysis, and surgical specimen in PJS patients. A total of 76% of the patients with FAP with duodenal adenomas (n = 21) had additional adenomas in the proximal jejunum that could be detected by CE and PE. Moreover, 24% of these FAP patients had further polyps in the distal jejunum or ileum that could only be detected by CE. In contrast, in FAP patients without duodenal polyps (n = 8), jejunal or ileal polyps occurred rarely (12%). CE detected polyps in 10 of 11 patients with PJS, a rate superior to all other reference procedures employed. Importantly, the findings of CE had immediate impact on further clinical management in all PJS patients. Our results suggest that CE may be of clinical value in selected patients with FAP, whereas in PJS, CE could be used as first line surveillance procedure.

  17. Small bowel endoscopy in familial adenomatous polyposis and Lynch syndrome

    NARCIS (Netherlands)

    Koornstra, Jan Jacob

    Patients with familial adenomatous polyposis (FAP) and patients with Lynch syndrome have an increased risk of developing small intestinal neoplasia. In both conditions, the lifetime risk to develop small bowel cancer is estimated to be around 5%. In FAP, this risk is associated with the degree of

  18. Inflammatory myoglandular polyp--a rare but distinct type of colorectal polyps.

    Science.gov (United States)

    Becheanu, Gabriel; Stamm, Bernhard

    2003-01-01

    The aim of this paper was to report another example of a rare type of colorectal polyps, the inflammatory myoglandular polyp, and to reaffirm this type of polyp as a distinct entity. This solitary pedunculated polyp was detected after a single episode of rectal bleeding. It was situated in the sigmoid colon, measured 2.5 cm in greatest diameter, and was composed almost exclusively of smooth muscles and hyperplastic glands. The patient had neither chronic colitis nor diverticula. Clinical presentation, localization, and histology give this type of polyp a unique appearance and justify its designation as a separate entity.

  19. Diffuse benign gastric inflammatory hyperplastic polyps presenting ...

    African Journals Online (AJOL)

    Benign gastric inflammatory hyperplasic polyps are benign lesions that rarely occur in young age. We report a case of diffuse benign gastric inflammatory hyperplastic polyps in a 19 year old boy who presented with cough, nausea, and hematamesis. In the presented case symptoms such as nausea and vomiting are non ...

  20. Prevalence of adenomas and hyperplastic polyps in mismatch repair mutation carriers among CAPP2 participants: report by the colorectal adenoma/carcinoma prevention programme 2

    DEFF Research Database (Denmark)

    Liljegren, Annelie; Barker, Gail; Elliott, Faye

    2008-01-01

    PURPOSE: To determine the prevalence of adenomatous and hyperplastic polyps in a large cohort of individuals with a germline mutation in a mismatch repair (MMR) gene, the major genetic determinant of hereditary nonpolyposis colorectal cancer (HNPCC). These prevalences have been estimated previously...... in smaller studies, and the results have been found to be variable. PATIENTS AND METHODS: Colorectal Adenoma/Carcinoma Prevention Programme 2 trial is a chemoprevention trial in people classified as having HNPCC. The 695 patients with a proven germline MMR mutation and documented screening history before...

  1. A shift from distal to proximal neoplasia in the colon: a decade of polyps and CRC in Italy

    Directory of Open Access Journals (Sweden)

    Panzone Sergio

    2010-11-01

    Full Text Available Abstract Background In the last years a trend towards proximalization of colorectal carcinomas (CRC has been reported. This study aims to evaluate the distribution of CRC and adenomatous polyps (ADP to establish the presence of proximalization and to assess the potential predictors. Methods We retrieved histology reports of colonic specimens excised during colonoscopy, considering the exams performed between 1997 and 2006 at Cuneo Hospital, Italy. We compared the proportion of proximal lesions in the period 1997-2001 and in the period 2002-2006. Results Neoplastic lesions were detected in 3087 people. Proximal CRC moved from 25.9% (1997-2001 to 30.0% (2002-2006. Adjusting for sex and age, the difference was not significant (OR 1.23; 95% CI: 0,95-1,58. The proximal ADP proportion increased from 19.2% (1997-2001 to 26.0% (2002-2006 (OR: 1.43; 95% CI: 1.17-1.89. The corresponding figures for advanced proximal ADP were 6.6% and 9.5% (OR: 1.48; 95% CI: 1.02-2.17. Adjusting for gender, age, diagnostic period, symptoms and number of polyps the prevalence of proximal advanced ADP was increased among people ≥ 70 years compared to those aged 55-69 years (OR 1.49; 95% CI: 1.032.16. The main predictor of proximal advanced neoplasia was the number of polyps detected per exam (> 1 polyp versus 1 polyp: considering all ADP: OR 2.16; 95% CI: 1.59-2.93; considering advanced ADP OR 1.63; 95% CI: 1.08-2.46. Adjusting for these factors, the difference between the two periods was no longer significant. Conclusions CRC do not proximalize while a trend towards a proximal shift in adenomas was observed among people ≥ 70 years.

  2. Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan.

    Science.gov (United States)

    Takeuchi, Chihiro; Yamamichi, Nobutake; Shimamoto, Takeshi; Takahashi, Yu; Mitsushima, Toru; Koike, Kazuhiko

    2017-03-01

    Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) is a method broadly used for gastric cancer screening in Japan. Gastric polyp is one of the most frequent findings detected by UGI-XR, but how to handle it remains controversial. Gastric polyps of the 17,264 generally healthy subjects in Japan who underwent UGI-XR or upper gastrointestinal endoscopy (UGI-ES) in 2010 were analyzed. Of the 6,433 UGI-XR examinees (3,405 men and 3,028 women, 47.4 ± 9.0 years old), gastric polyps were detected in 464 men (13.6 %) and 733 women (24.2 %) and were predominantly developed on the non-atrophic gastric mucosa (p gastric polyps has significant association with lower value of serum anti-Helicobacter pylori IgG titer, female gender, lighter smoking habit, older age, and normal range of body mass index (≥18.5 and gastric cancer occurred in 7 subjects (0.11 %), but none of them had gastric polyps at the beginning of the follow-up period. Of the 2,722 subjects with gastric polyps among the 10,831 UGI-ES examinees in the same period, 2,446 (89.9 %) had fundic, 267 (9.8 %) had hyperplastic, and 9 (0.3 %) had adenomatous/cancerous polyps. Gastric polyps diagnosed by UGI-XR predominantly arise on the Helicobacter pylori-negative gastric mucosa with a low risk of gastric cancer in Japan. In the prospective observation, none of the UGI-XR examinees with gastric polyps developed gastric cancer for at least 3 years subsequently.

  3. 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.

  4. Contribution of APC and MUTYH mutations to familial adenomatous polyposis susceptibility in Hungary.

    Science.gov (United States)

    Papp, Janos; Kovacs, Marietta Eva; Matrai, Zoltan; Orosz, Enikő; Kásler, Miklós; Børresen-Dale, Anne-Lise; Olah, Edith

    2016-01-01

    Familial adenomatous polyposis (FAP) is a colorectal cancer predisposition syndrome with considerable genetic and phenotypic heterogeneity, defined by the development of multiple adenomas throughout the colorectum. FAP is caused either by monoallelic mutations in the adenomatous polyposis coli gene APC, or by biallelic germline mutations of MUTYH, this latter usually presenting with milder phenotype. The aim of the present study was to characterize the genotype and phenotype of Hungarian FAP patients. Mutation screening of 87 unrelated probands from FAP families (21 of them presented as the attenuated variant of the disease, showing APC were identified in 65 patients (75 %), including nine cases (37.5 %) with large genomic alterations. Twelve of the point mutations were novel. In addition, APC-negative samples were also tested for MUTYH mutations and we were able to identify biallelic pathogenic mutations in 23 % of these cases (5/22). Correlations between the localization of APC mutations and the clinical manifestations of the disease were observed, cases with a mutation in the codon 1200-1400 region showing earlier age of disease onset (p APC- and MUTYH-associated FAP in our cohort: the age at onset of polyposis was significantly delayed for biallelic MUTYH mutation carriers as compared to patients with an APC mutation. Our data represent the first comprehensive study delineating the mutation spectra of both APC and MUTYH in Hungarian FAP families, and underscore the overlap between the clinical characteristics of APC- and MUTYH-associated phenotypes, necessitating a more appropriate clinical characterization of FAP families.

  5. Low 25-Hydroxyvitamin D and Myofascial Pain: Association of Cancer, Colon Polyps, and Tendon Rupture.

    Science.gov (United States)

    Hightower, Jane M; Dalessandri, Kathie M; Pope, Karl; Hernández, Germán T

    2017-08-01

    Myofascial pain that has been associated with cancer and increased risk of morbidity and mortality in cancer patients is intrinsically associated with low magnesium and low 25-hydroxyvitamin D (25(OH)D). Therefore, this physical finding was used as a clinical diagnostic proxy. The objective of this study was to assess the association and prevalence of disease in individuals with myofascial pain and low 25(OH)D in a county with low magnesium in the drinking water. This is a retrospective cross-sectional study of a chart review of 269 subjects to assess subjects presenting with myofascial pain (assessed by tender trigger points) and 25(OH)D concentrations below 30 ng/mL or a history of 25(OH)D deficiency compared to those without these exposures. The association between the exposure of low 25(OH)D levels and myofascial pain was compared to all cancers, colon polyps, and tendon ruptures. The odds of having cancer with the combined exposures was 10.14 times the odds of not having either exposure (95% confidence interval [CI], 5.08, 20.25, p D less than 30 ng/mL, 74 were tested for red blood cell (RBC) magnesium. Half of those subjects had RBC magnesium concentrations D deficiency showed a significant association with cancer, adenomatous colon polyps, and tendon rupture. Further studies to verify these results are needed, especially in areas where there is low magnesium in the drinking water.

  6. Automatic Polyp Detection via A Novel Unified Bottom-up and Top-down Saliency Approach.

    Science.gov (United States)

    Yuan, Yixuan; Li, Dengwang; Meng, Max Q-H

    2017-07-31

    In this paper, we propose a novel automatic computer-aided method to detect polyps for colonoscopy videos. To find the perceptually and semantically meaningful salient polyp regions, we first segment images into multilevel superpixels. Each level corresponds to different sizes of superpixels. Rather than adopting hand-designed features to describe these superpixels in images, we employ sparse autoencoder (SAE) to learn discriminative features in an unsupervised way. Then a novel unified bottom-up and top-down saliency method is proposed to detect polyps. In the first stage, we propose a weak bottom-up (WBU) saliency map by fusing the contrast based saliency and object-center based saliency together. The contrast based saliency map highlights image parts that show different appearances compared with surrounding areas while the object-center based saliency map emphasizes the center of the salient object. In the second stage, a strong classifier with Multiple Kernel Boosting (MKB) is learned to calculate the strong top-down (STD) saliency map based on samples directly from the obtained multi-level WBU saliency maps. We finally integrate these two stage saliency maps from all levels together to highlight polyps. Experiment results achieve 0.818 recall for saliency calculation, validating the effectiveness of our method. Extensive experiments on public polyp datasets demonstrate that the proposed saliency algorithm performs favorably against state-of-the-art saliency methods to detect polyps.

  7. Guidelines for the clinical management of familial adenomatous polyposis (FAP)

    DEFF Research Database (Denmark)

    Vasen, H.F.; Moslein, G.; Alonso, A.

    2008-01-01

    BACKGROUND: Familial adenomatous polyposis (FAP) is a well-described inherited syndrome, which is responsible for cancer (CRC) cases. The syndrome is characterised by the development of hundreds to thousands of adenomas in the colorectum. Almost all patients will develop CRC...... if they are not identified and treated at an early stage. The syndrome is inherited as an autosomal dominant trait and caused by mutations in the APC gene. Recently, a second gene has been identified that also gives rise to colonic adenomatous polyposis, although the phenotype is less severe than typical FAP. The gene...... is the MUTYH gene and the inheritance is autosomal recessive. In April 2006 and February 2007, a workshop was organised in Mallorca by European experts on hereditary gastrointestinal cancer aiming to establish guidelines for the clinical management of FAP and to initiate collaborative studies. Thirty...

  8. Automatic polyp detection in colonoscopy videos

    Science.gov (United States)

    Yuan, Zijie; IzadyYazdanabadi, Mohammadhassan; Mokkapati, Divya; Panvalkar, Rujuta; Shin, Jae Y.; Tajbakhsh, Nima; Gurudu, Suryakanth; Liang, Jianming

    2017-02-01

    Colon cancer is the second cancer killer in the US [1]. Colonoscopy is the primary method for screening and prevention of colon cancer, but during colonoscopy, a significant number (25% [2]) of polyps (precancerous abnormal growths inside of the colon) are missed; therefore, the goal of our research is to reduce the polyp miss-rate of colonoscopy. This paper presents a method to detect polyp automatically in a colonoscopy video. Our system has two stages: Candidate generation and candidate classification. In candidate generation (stage 1), we chose 3,463 frames (including 1,718 with-polyp frames) from real-time colonoscopy video database. We first applied processing procedures, namely intensity adjustment, edge detection and morphology operations, as pre-preparation. We extracted each connected component (edge contour) as one candidate patch from the pre-processed image. With the help of ground truth (GT) images, 2 constraints were implemented on each candidate patch, dividing and saving them into polyp group and non-polyp group. In candidate classification (stage 2), we trained and tested convolutional neural networks (CNNs) with AlexNet architecture [3] to classify each candidate into with-polyp or non-polyp class. Each with-polyp patch was processed by rotation, translation and scaling for invariant to get a much robust CNNs system. We applied leave-2-patients-out cross-validation on this model (4 of 6 cases were chosen as training set and the rest 2 were as testing set). The system accuracy and sensitivity are 91.47% and 91.76%, respectively.

  9. 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.

  10. Hyoscine butylbromide for colorectal polyp detection: prospective, randomized, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Oliveira dos Santos

    Full Text Available OBJECTIVES: The removal of pre-malignant colorectal lesions prevents cancer. Hyoscine has been proposed as a means of improving diagnosis by reducing colonic movements. The aim of this study was to analyze whether this anti-spasmodic enhances the detection of pre-malignant colorectal lesions. METHODS: In a randomized, double-blinded fashion patients received hyoscine or a saline solution in all consecutive colonoscopies in which the cecum was reached. Lesions were analysed with respect to number, size, location, histology and capillary pattern. RESULTS: A total of 440 colonoscopies were randomized. The overall polyp detection rate (PDR and the adenoma detection rate (ADR were 65.2% and 49.3%, respectively. In the hyoscine group, non-polypoid lesions were detected significantly more often (p=0.01. In the placebo group 281 lesions were diagnosed (202 adenomas and in the hyoscine group 282 lesions were detected (189 adenomas (p=0.23. The PDR and ADR were similar between the placebo and hyoscine groups (64% vs 66% and 50% vs 47%, respectively. No differences were observed between the two groups in the advanced-ADR or advanced neoplasia detection rate, as well the mean numbers of polyps, adenomas, advanced adenomas and advanced neoplasias detected per patient. The administration of hyoscine also did not improve the diagnostic accuracy of digital chromoendoscopy. The presence of adenomatous polyps in the right colon was detected significantly more frequently in the hyoscine group (OR 5.41 95% CI 2.7 - 11; p<0.01 vs OR 2.3 95% CI 1.1 - 4.6; p=0.02. CONCLUSION: The use of hyoscine before beginning the withdrawal of the colonoscope does not seem to enhance the PDR and the ADR.

  11. 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

  12. Environmental control of asexual reproduction and somatic growth of Aurelia spp. (Cnidaria, Scyphozoa) polyps from the Adriatic Sea

    OpenAIRE

    Hubot, Nathan; Lucas, Cathy H.; Piraino, Stefano

    2017-01-01

    Polyps of two moon jellyfish species, Aurelia coerulea and A.relicta, from two Adriatic Sea coastal habitats were incubated under multiple combinations of temperature (14, 21 °C), salinity (24, 37 ppt) and food regime (9.3, 18.6, 27.9 μg C ind‾¹ week‾¹) to comparatively assess how these factors may influence major asexual reproduction processes in the two species. Both species exhibited a shared pattern of budding mode (Directly Budded Polyps: DBP; Stolonal Budded Polyps: SBP), with DBP favo...

  13. Association between colonic polyps and diverticular disease

    Institute of Scientific and Technical Information of China (English)

    Tetsuo Hirata; Yuko Kawakami; Nagisa Kinjo; Susumu Arakald; Tetsu Arakaki; Akira Hokama; Fukunori Kinjo; Jim Fujita

    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 ahistory 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.

  14. 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

  15. 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.

  16. An umbilical polyp in an infant.

    Science.gov (United States)

    Swanson, David L; Pakzad, Betty

    2005-10-01

    The persistence at birth of the omphalomesenteric (vitelline) duct may result in life-threatening consequences. Early identification of this congenital anomaly is essential for prompt surgical treatment to eliminate the risk of prolapse and herniation. A neonatal umbilical polyp may indicate the presence of an omphalomesenteric duct remnant. We describe the diagnosis and surgical treatment of an infant with an umbilical polyp. We also present an overview of the diagnosis and treatment of vitelline duct remnants and their associated anomalies.

  17. ETIOLOGICAL FACTORS FOR VOCAL FOLD POLYP FORMATION

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    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.

  18. Combining heterogeneous features for colonic polyp detection in CTC based on semi-definite programming

    Science.gov (United States)

    Wang, Shijun; Yao, Jianhua; Petrick, Nicholas A.; Summers, Ronald M.

    2009-02-01

    Colon cancer is the second leading cause of cancer-related deaths in the United States. Computed tomographic colonography (CTC) combined with a computer aided detection system provides a feasible combination for improving colonic polyps detection and increasing the use of CTC for colon cancer screening. To distinguish true polyps from false positives, various features extracted from polyp candidates have been proposed. Most of these features try to capture the shape information of polyp candidates or neighborhood knowledge about the surrounding structures (fold, colon wall, etc.). In this paper, we propose a new set of shape descriptors for polyp candidates based on statistical curvature information. These features, called histogram of curvature features, are rotation, translation and scale invariant and can be treated as complementing our existing feature set. Then in order to make full use of the traditional features (defined as group A) and the new features (group B) which are highly heterogeneous, we employed a multiple kernel learning method based on semi-definite programming to identify an optimized classification kernel based on the combined set of features. We did leave-one-patient-out test on a CTC dataset which contained scans from 50 patients (with 90 6-9mm polyp detections). Experimental results show that a support vector machine (SVM) based on the combined feature set and the semi-definite optimization kernel achieved higher FROC performance compared to SVMs using the two groups of features separately. At a false positive per patient rate of 7, the sensitivity on 6-9mm polyps using the combined features improved from 0.78 (Group A) and 0.73 (Group B) to 0.82 (p<=0.01).

  19. Familiær adenomatøs polypose

    DEFF Research Database (Denmark)

    Bülow, Steffen

    2013-01-01

    Familial adenomatous polyposis (FAP) is an autosomally dominant disease characterized by early development of up to thousands of colorectal adenomas and colorectal carcinoma in untreated patients. Extra-colonic manifestations include duodenal adenomatosis and desmoid development. Due...... to identification of gene carriers by DNA analysis or endoscopy the prognosis is good after early colectomy, but life-long surveillance of the rectum and the duodenum is necessary. The Danish Polyposis Register coordinates prophylactic examination and treatment in the families, and serves as basis for research....

  20. Adenomas of the common bile duct in familial adenomatous polyposis

    Science.gov (United States)

    Yan, Mao-Lin; Pan, Jun-Yong; Bai, Yan-Nan; Lai, Zhi-De; Chen, Zhong; Wang, Yao-Dong

    2015-01-01

    Familial adenomatous polyposis (FAP) or Gardner’s syndrome is often accompanied by adenomas of the stomach and duodenum. We experienced a case of adenomas of the common bile duct in a 40-year-old woman with FAP presenting with acute cholangitis. Only 8 cases of adenomas or adenocarcinoma of the common bile duct have been reported in the literature in patients with FAP or Gardner’s syndrome. Those patients presented with acute cholangitis or pancreatitis. Local excision or Whipple procedure may be the reasonable surgical option. PMID:25780319

  1. 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.

  2. CT findings of the angiomatous polyp in the nasal cavity and paranasal sinus

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Young Sim; Youm, Dong Ho; Lee, Myeong Sub; Kang, In Goo; Lee, Jun Ha; Sung, Ki Joon; Cho, Mee Yon; Yang, Suk Woo [Yonsei Univ. College of Medicine, Wonju (Korea, Republic of)

    1999-06-01

    To assess the characteristic CT findings of the angiomatous polyp. Five cases of pathologically-proven angiomatous polyp were retrospectively evaluated. All underwent CT scanning, but in only four cases were postcontrast CT scans obtained. In analysing CT findings we focused on adjacent bony change, and the extent and enhancement pattern of the mass. All but one case involved the maxillary sinus, showing thickening of the posterolateral wall and erosion or destruction of the medial wall. As for involvement of the anterior wall of this sinus, bony destruction was seen in one case, and thickening in three. In four cases the tumor involved the maxillary sinus and nasal cavity, and two cases showed nasopharyngeal extension. No case involved the pterygopalatine fossa, however. On contrast enhanced CT scans(n=4), all cases showed enhancement as strong as blood vessels, and a multiple focal punctate or tubular pattern. Angiomatous polyp tends to show bone thickening rather than bone destruction, not to involve the pterygopalatine fossa, and to reveal a strong punctate or tubular enhancement pattern. These findings may be helpful in the differential diagnosis of angiomatous polyp from other tumors such as maxillary cancer, angiofibroma and nasal polyp.

  3. [Surgical aspects of indications and techniques for adenomatous polyposis variants].

    Science.gov (United States)

    Möslein, Gabriela

    2016-08-01

    Due to the advances in molecular genetic diagnostics of adenomatous polyposis variants, identification of patients with a genetic predisposition and their at risk relatives is becoming increasingly important in clinical practice. Precise knowledge of the specific risk profile is gaining significance especially for surgeons and requires a clinically differentiated approach in order to correctly identify the indications for prophylactic surgery. In this article reference will be made to the technical details of the pouch operation rather than the decision-making process per se, since this has become common knowledge for specialized colorectal surgeons. Besides the more commonly known polyposis syndromes, such as familial adenomatous polyposis (FAP), surgeons should nowadays at least be able to clinically distinguish between attenuated and classical variants of FAP, be aware of MUTYH-associated polyposis (MAP) and also the new polyposis syndrome polymerase proofreading-associated polyposis (PPAP). Surgeons should be familiar with the specific indications and extent of surgery for prophylactic organ removal in the lower gastrointestinal tract in order to be able to competently advise patients.

  4. Lymphangiomatous Polyp of Tonsil: A Case Report.

    Science.gov (United States)

    Sayar, Hamide; Sayar, Çağdaş; Adamhasan, Fulya; Uğuz, Aysun

    2016-01-01

    Lymphangiomatous polyps of the palatine tonsils are uncommon hamartomatous proliferations that could be clinically misdiagnosed as malignant neoplasms. These polyps consist of dilated lymphatic vessels located inside fibrous and/or adipose tissue. In this paper, a 27-year-old man who presented to the outpatient clinic with a complaint of dysphagia is presented. On physical examination, the patient had a smooth, polypoid mass extending from the posterior section of the right palatine tonsil into the oropharynx. The patient underwent right tonsillectomy. Histopathological examination of the specimen showed typical features of a lymphangiomatous polyp of the tonsil. The case is reported with the accompanying literature to avoid the possibility of misdiagnosing it as a malignant lesion clinically.

  5. 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

  6. Fibroepithelial ureteral polyps presenting as ureteropelvic obstruction

    Science.gov (United States)

    Cusano, Antonio; Abarzua-Cabezas, Fernando; Kesler, Stuart

    2014-01-01

    A 57-year-old woman presented with bilateral abdominal pain and flank discomfort. Imaging studies, consisting of CT scan, diethylene triamine pentaacetic acid renal scan with Lasix and a retrograde pyelogram, indicated an obstruction at the uteropelvic junction (UPJ), possibly due to fibroepithelial polyps within the ureter. A robotic pyeloplasty revealed a ureteral diverticulum and a thin, still-attached fibroepithelial polyp of approximately 2 cm in length. The patient tolerated the procedure well and was discharged one day postpyeloplasty with no reported complications. This rare clinical scenario should be considered when formulating a diagnosis for a UPJ obstruction. PMID:24759168

  7. Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management

    Directory of Open Access Journals (Sweden)

    Emanuele Neri

    2010-12-01

    Full Text Available Emanuele Neri, Lorenzo Faggioni, Lorenzo Cini, Carlo BartolozziDiagnostic and Interventional Radiology, University of Pisa, Pisa, ItalyAbstract: Colorectal cancer (CRC is the third-ranked neoplasm in order of incidence and mortality, worldwide, and the second cause of cancer death in industrialized countries. One of the most important environmental risk factors for CRC is a Western-type diet, which is characterized by a low-fiber and high-fat content. Up to 25% of patients with CRC have a family history for CRC, and a fraction of these patients are affected by hereditary syndromes, such as familial adenomatous polyposis, Gardner or Turcot syndromes, or hereditary nonpolyposis colorectal cancer. The onset of CRC is triggered by a well-defined combination of genetic alterations, which form the bases of the adenoma-carcinoma sequence hypothesis and justify the set-up of CRC screening techniques. Several screening and diagnostic tests for CRC are illustrated, including rectosigmoidoscopy, optical colonoscopy (OC, double contrast barium enema (DCBE, and computed tomography colonography (CTC. The strengths and weaknesses of each technique are discussed. Particular attention is paid to CTC, which has evolved from an experimental technique to an accurate and mature diagnostic approach, and gained wide acceptance and clinical validation for CRC screening. This success of CTC is due mainly to its ability to provide cross-sectional analytical images of the entire colon and secondarily detect extracolonic findings, with minimal invasiveness and lower cost than OC, and with greater detail and diagnostic accuracy than DCBE. Moreover, especially with the advent and widespread availability of modern multidetector CT scanners, excellent quality 2D and 3D reconstructions of the large bowel can be obtained routinely with a relatively low radiation dose. Computer-aided detection systems have also been developed to assist radiologists in reading CTC examinations

  8. The use of high definition colonoscopy versus standard definition: does it affect polyp detection rate?

    Science.gov (United States)

    Richardson, John; Thaventhiran, Anthony; Mackenzie, Hugh; Stubbs, Benjamin

    2017-11-03

    Polyp detection rate (PDR) during lower gastrointestinal endoscopy (LGIE) is of clinical importance. Detecting adenomatous polyps early in the adenoma-carcinoma sequence can halt disease progression, enabling treatment at a favourable stage. High definition colonoscopy (HDC) has been used in our hospital alongside standard definition equipment since 2011. We aim to determine what affect the use of HDC has on PDR. Post-hoc analysis of a prospectively maintained database on all patients undergoing LGIE was performed (01/01/2012-31/12/2015), n = 15,448. Analysis tested the primary outcome of HD's effect on PDR across LGIE and secondary outcome stratified this by endoscopist group (Physician (PE), Surgeon (SE) and Nurse Endoscopist (NE)). Of 15,448 patients, 1353 underwent HDC. Unmatched analysis showed PDR increased by 5.3% in this group (p < 0.001). Matched analysis considered 2288 patients from the total cohort (1144 HDC) and showed an increase of 1% in PDR with HDC (p = 0.578). Further unmatched analysis stratified by endoscopist groups showed a PDR increase of 1.8% (p = 0.375), 5.4% (p = 0.008) and 4.6% (p = 0.021) by PE, SE and NE respectively. Matched analysis demonstrated an increase of 1% (p = 0.734) and 1.5% (p = 0.701) amongst PE and NE, with a decrease of 0.6% (p = 0.883) by SE. The introduction of HDC increased PDR across all LGIE in our hospital, though this was not clinically significant. This marginal benefit was present across all endoscopist groups with no group benefiting over another in matched analysis.

  9. Association of meat intake and meat-derived mutagen exposure with the risk of colorectal polyps by histologic type

    Science.gov (United States)

    Fu, Zhenming; Shrubsole, Martha J.; Smalley, Walter E.; Wu, Huiyun; Chen, Zhi; Shyr, Yu; Ness, Reid M.; Zheng, Wei

    2011-01-01

    Background The association of meat intake and meat-derived mutagens with colorectal tumor risk remains unclear. We evaluated this hypothesis in a large colonoscopy-based case-control study. Methods Included in the study were 2,543 polyp patients [(1,881 with adenomas, and 622 with hyperplastic polyp (HPP)] and 3,764 polyp-free controls. Surveys obtained information about meat intake by cooking methods and doneness levels plus other suspected or known risk factors for colorectal tumors. Unconditional logistic regression was used to derive odds ratios (ORs) after adjusting for potential confounders. Results High intake of red meat and processed meat (P-trend meat cooked using high-temperature cooking methods (P-trend ≤ 0.01), was associated with an elevated risk for colorectal polyps. A significant positive association between exposures to meat-derived heterocyclic amines and risk of polyps was found for both adenomas and hyperplastic polyps. Furthermore, the positive association with red-meat intake and heterocyclic amine exposure was stronger for multiple adenomas than single adenoma and serrated than non-serrated adenomas. Conclusion This study supports a role for red meat and meat-derived mutagen exposure in the development of colorectal tumor. PMID:21803984

  10. 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%)

  11. Familial Adenomatous Polyposis (FAP and Other Polyposis Syndromes

    Directory of Open Access Journals (Sweden)

    Scott Rodney J

    2003-12-01

    Full Text Available Abstract There have been significant advances in our knowledge about the molecular changes that precede and accompany the development of inherited predispositions to colorectal cancer. In this review the clinical relationship to the molecular changes associated with the polyposis syndromes is presented. The aim is to put into context the diverse findings that have been shown to be associated with the development of colorectal cancer in persons who harbor a predisposition to develop disease at unusually early ages. The main focus will be on familial adenomatous polyposis as it serves as a model disease and is the most extensively studied of all of the polyposis syndromes. In addition some information is provided that explains the relationship between a germline change in one gene and what consequences that can have for a particular cell and the development of disease.

  12. A case of bilateral vocal fold mucosal bridges, bilateral trans-vocal fold type III sulci vocales, and an intracordal polyp.

    Science.gov (United States)

    Tan, Melin; Pitman, Michael J

    2011-07-01

    We present a patient with a novel finding of bilateral mucosal bridges, bilateral type III trans-vocal fold sulci vocales, and a vocal fold polyp. Although sulci and mucosal bridges occur in the vocal folds, it is rare to find multiples of these lesions in a single patient, and it is even more uncommon when they occur in conjunction with a vocal fold polyp. To our knowledge, this is the first description of a vocal fold polyp in combination with multiple vocal fold bridges and multiple type III sulci vocales in a single patient. To describe and visually present the diagnosis and treatment of a patient with an intracordal polyp, bilateral mucosal bridges, as well as bilateral type III trans-vocal fold sulci vocales. Presentation of a set of high definition intraoperative photos displaying the extent of the vocal fold lesions and the resection of the intracordal polyp. This patient presented with only 6 months of significant dysphonia. It was felt that the recent change in voice was because of the polyp and not the bridges or sulci vocales. Considering the patient's presentation and the possible morbidity of resection of mucosal bridges and sulci, only the polyp was excised. Postoperatively, the patient's voice returned to his acceptable mild baseline dysphonia, and the benefit has persisted 6 months postoperatively. The combination of bilateral mucosal bridges, bilateral type III sulcus vocalis, and an intracordal polyp in one patient is rare if not novel. Treatment of the polyp alone returned the patient's voice to his lifelong baseline of mild dysphonia. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  13. Evaluation of management of desmoid tumours associated with familial adenomatous polyposis in Dutch patients

    NARCIS (Netherlands)

    Nieuwenhuis, M. H.; Mathus-Vliegen, E. M.; Baeten, C. G.; Nagengast, F. M.; van der Bijl, J.; van Dalsen, A. D.; Kleibeuker, J. H.; Dekker, E.; Langers, A. M.; Vecht, J.; Peters, F. T.; van Dam, R.; van Gemert, W. G.; Stuifbergen, W. N.; Schouten, W. R.; Gelderblom, H.; Vasen, H. F. A.

    2011-01-01

    BACKGROUND: The optimal treatment of desmoid tumours is controversial. We evaluated desmoid management in Dutch familial adenomatous polyposis (FAP) patients. METHODS: Seventy-eight FAP patients with desmoids were identified from the Dutch Polyposis Registry. Data on desmoid morphology, management,

  14. Homozygous PMS2 deletion causes a severe colorectal cancer and multiple adenoma phenotype without extraintestinal cancer.

    Science.gov (United States)

    Will, Olivia; Carvajal-Carmona, Luis G; Gorman, Patricia; Howarth, Kimberley M; Jones, Angela M; Polanco-Echeverry, Guadalupe M; Chinaleong, Jo-Anne; Günther, Thomas; Silver, Andrew; Clark, Susan K; Tomlinson, Ian

    2007-02-01

    We report a patient of Indian descent with parental consanguinity, who developed 10 carcinomas and 35 adenomatous polyps at age 23 and duodenal adenocarcinoma at age 25. He also had dysmorphic features, mental retardation, and café-au-lait spots but no brain tumor. We aimed to establish his molecular diagnosis. Germ-line screening for APC and MYH/MUTYH mutations was normal as was immunohistochemistry for MLH1 and MSH2 proteins. Investigation by array-comparative genomic hybridization revealed deletion of a small region on chromosome 7. Using polymerase chain reaction, this region was refined to a 400-kilobase deletion, which included exons 9-15 of the PMS2 gene, and all coding regions of oncomodulin, TRIAD3, and FSCN1. The deletion was confirmed as homozygous, and both parents were carriers. Immunohistochemistry showed absent PMS2 expression in all tumors and normal tissue. Most tumors showed microsatellite instability, more marked at dinucleotide than mononucleotide repeats. The tumors harbored no somatic mutations in APC, BRAF, AXIN2, or beta-catenin, but KRAS2 and TGFBR2 mutations were found. Our patient represents a novel phenotype for homozygous PMS2 mutation and perhaps the most severe colorectal cancer phenotype-in terms of numbers of malignancies at an early age-described to date. PMS2 mutations-and perhaps other homozygous mismatch repair mutations-should be considered in any patient presenting with multiple gastrointestinal tumors, since our patient could not be distinguished clinically from cases with attenuated familial adenomatous polyposis or MUTYH-associated polyposis.

  15. Nilotinib Induced Recurrent Gastric Polyps: Case Report and Review of Literature.

    Science.gov (United States)

    Kassem, Nancy; Ismail, Omar M; Elomri, Halima; Yassin, Mohamad A

    2017-07-14

    BACKGROUND Tyrosine kinase inhibitors (TKIs) are currently an important targeted drug class in the treatment of chronic myeloid leukemia (CML). Imatinib was the first approved TKI for CML in 2001. Nilotinib is a second-generation TKI, approved in 2007; it inhibits BCR-ABL, PDGFR, and c-KIT, and is 30 times more potent than imatinib. Tyrosine kinase enzymes are expressed in multiple tissues and are involved in several signaling pathways; they have been shown to have several off-target side effects. CASE REPORT We report a case of an elderly male with CML and no history of gastrointestinal diseases, treated with nilotinib, and developed recurrent gastric polyps after three years of treatment. We excluded common causes of gastric polyps and therefore considered nilotinib as a probable cause of recurrent gastric polyps. CONCLUSIONS Recurrent gastric polyps could be a potential side effect of nilotinib treatment. Careful long-term monitoring of patients on TKI therapy is necessary and further long-term studies of TKI side effects are needed.

  16. Giant fibrovascular esophageal polyp misdiagnosed as achalasia.

    Science.gov (United States)

    Cordoş, I; Istrate, A; Codreşi, M; Bolca, C

    2012-01-01

    A 59 years old woman was admitted in our unit accusing longtime dysphagia and regurgitation. On admission, the patient was wearing a 3 month old definitive feeding gastrostomy tube. The contrast swallow, endoscopy and esophageal manometry established the diagnostic--achalasia. We removed the gastrostomy tube and we performed an open Heller myotomy. The postoperative period was uneventful and the patient was discharged one week later with affirmatively unimpaired deglutition. One month later, the patient was admitted via emergency with a giant fibrous tumor arising from her mouth after an episode of strong coughing and vomiting. The repeated endoscopy showed a giant esophageal polyp that was missed by the previous investigations, originating from pharingoesophageal junction. The esophageal polyp was resected by cervical approach with good postoperative outcome. The polyp's particular extreme dimensions (27 cm) prevented the acute asphyxia by blockage at the laryngeal level, possibly provoked by smaller tumors. As postoperative one month barium swallow showed a normal esophageal aspect, a final question remains--was achalasia real or an erroneous diagnosis was established the second time too?

  17. Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

    Science.gov (United States)

    Kinoshita, Yuichi; Harada, Hiroshi; Kobayashi, Tadao K.; Yoshizawa, Katsuhiko; Yuri, Takashi; Takasu, Kosho; Tsubura, Airo; Shikata, Nobuaki

    2014-01-01

    Multifocal adenomatous oncocytic hyperplasia (MAOH) is a non-neoplastic lesion that is classified as oncocytosis. MAOH is a rare entity of the parotid gland and accounts for approximately 0.1% of salivary gland lesions. Here, we report a case of MAOH of the parotid gland. The patient was a 71-year-old woman who presented with discomfort at the left side of her neck. Fine-needle aspiration cytology of the parotid gland revealed a loose sheet-like cluster of round to polygonal cells with granular cytoplasm against a hemorrhagic background. The cells had round to oval, centrally located nuclei with granular chromatin and without distinct nucleoli. Histologically, the lesion was formed of many variable-sized nodules, comprising oncocyte-like cells with small round nuclei and eosinophilic granular cytoplasm that was positive for mitochondrial antibodies. The diagnosis of MAOH is difficult to make by cytology alone, because the findings overlap with those of other oncocytic lesions. In particular, the cytological findings of MAOH have not been sufficiently reported to date. A correlation of cytology and histology was expected. PMID:25580104

  18. Multifocal Adenomatous Oncocytic Hyperplasia of the Parotid Gland

    Directory of Open Access Journals (Sweden)

    Yuichi Kinoshita

    2014-12-01

    Full Text Available Multifocal adenomatous oncocytic hyperplasia (MAOH is a non-neoplastic lesion that is classified as oncocytosis. MAOH is a rare entity of the parotid gland and accounts for approximately 0.1% of salivary gland lesions. Here, we report a case of MAOH of the parotid gland. The patient was a 71-year-old woman who presented with discomfort at the left side of her neck. Fine-needle aspiration cytology of the parotid gland revealed a loose sheet-like cluster of round to polygonal cells with granular cytoplasm against a hemorrhagic background. The cells had round to oval, centrally located nuclei with granular chromatin and without distinct nucleoli. Histologically, the lesion was formed of many variable-sized nodules, comprising oncocyte-like cells with small round nuclei and eosinophilic granular cytoplasm that was positive for mitochondrial antibodies. The diagnosis of MAOH is difficult to make by cytology alone, because the findings overlap with those of other oncocytic lesions. In particular, the cytological findings of MAOH have not been sufficiently reported to date. A correlation of cytology and histology was expected.

  19. 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.

    2016-01-01

    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). 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. Results: 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 < 0.001) and completeness of removal (61 % vs 37 %, P < 0.001). In the prospective study 23 PM-colonoscopies where compared to 28 CR-colonoscopies. VAS-scores were significantly higher in the endoscopist-operated PM group. Time to report was 01:27 ± 01:43 minutes (median + interquartile range) in the entire group (PM as CR), reflecting potential time benefit per colonoscopy. Conclusions: 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

  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. Role of quantitative chemical shift magnetic resonance imaging and chemical shift subtraction technique in discriminating adenomatous from non adenomatous adrenal solid lesions

    Directory of Open Access Journals (Sweden)

    Ahmed H. Afifi

    2017-03-01

    Conclusion: The signal intensity index and adrenal to spleen ratio are the most reliable quantitative chemical shift MRI methods in differentiation of adrenal adenomas from other non-adenomatous adrenal solid lesions. Chemical shift subtraction MRI is a recent technique that gives highly confident discrimination between two categories of pathology without using of any reference organ.

  2. 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.)

  3. 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.

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

    International Nuclear Information System (INIS)

    Chae, Hee Dong; Lee, Jae Young; Han, Joon Koo; Jang, Jin Young; Kang, Mee Joo; Chang, Jin Ho; Kang, Jeeun

    2017-01-01

    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. A Rare Clinical Presentation of Giant Bilateral Labial Fibroepithelial Stromal Polyps in Patient with Psoriasis Disease

    Directory of Open Access Journals (Sweden)

    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.

  6. [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.

  7. 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

  8. 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

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

    International Nuclear Information System (INIS)

    Ryoo, Jae Wook; Kim, Jeung Sook; Lee, Kyung Soo; Lim, Jae Hoon; Shim, Young Mog; Han, Joung Ho

    1995-01-01

    Fibrovascular polyp of the esophagus is a rare and benign pedunculated intraluminal tumor. The tumor consists of varying amount of vascular fibrous and adipose tissue that arises in the submucosa and is covered by squamous epithelium. We report the typical radiographic, CT and MR findings of a case of giant fibrovascular polyp of the esophagus

  10. 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 ...

  11. Chondroitin sulfate iron colloid as MR contrast agent in differentiation between hepatocellular carcinoma and adenomatous hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Y. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)); Kato, T. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)); Matsuo, T. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)); Kamba, M. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)); Shimatani, Y. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)); Ohuchi, Y. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)); Nakamura, K. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)); Ohta, Y. (Department of Radiology, Tottori Univ. School of Medicine, Yonago (Japan))

    1993-05-01

    Using a 1.5 T MR imaging unit, T1- and T2-weighted images were obtained before and after i.v. administration of chondroitin sulfate iron colloid (CSIC) in order to differentiate hepatocellular carcinoma (n=20) from adenomatous hyperplasia without atypia (n=16). Differentiation was made from the tumor-liver contrast to noise ratio (CNR) and visual evaluation of the nodule, with reference to signal intensity relative to that of the surrounding liver. The CNR of adenomatous hyperplasia was on T1-weighted images significantly decreased after CSIC administration (p<0.01). On T2-weighted images, there was no significant difference in CNR after CSIC administration. On the other hand, the CNR of hepatocellular carcinoma was significantly increased after CSIC administration on both T1- and T2-weighted images (p<0.01). CSIC reflects intratumor reticuloendothelial cellular functions, and is therefore useful in differentiating hepatocellular carcinoma from adenomatous hyperplasia without atypia. (orig.).

  12. Family history, surgery, and APC mutation are risk factors for desmoid tumors in familial adenomatous polyposis: an international cohort study

    DEFF Research Database (Denmark)

    Nieuwenhuis, Marry H; Lefevre, Jérémie H; Bülow, Steffen

    2011-01-01

    Ability to identify patients with familial adenomatous polyposis who have a high risk of developing desmoid tumors may affect decisions in clinical practice.......Ability to identify patients with familial adenomatous polyposis who have a high risk of developing desmoid tumors may affect decisions in clinical practice....

  13. 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.

  14. 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...... 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......-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...

  15. Spontaneous resolution of hemorrhagic polyps of the true vocal fold.

    Science.gov (United States)

    Klein, Adam M; Lehmann, Marcus; Hapner, Edie R; Johns, Michael M

    2009-01-01

    Hemorrhagic polyps are the most common benign lesions surgically removed from the vocal folds. Although this modality does offer satisfactory results in most of the cases, there is a subset of polyps that seems to resolve with conservative therapy. This study was performed to examine this subset of polyps. Thirty-four consecutive subjects diagnosed with hemorrhagic polyps of the true vocal fold were retrospectively reviewed to determine the incidence of spontaneous resolution of the lesions with nonsurgical therapy. Sixteen subjects began conservative therapy, consisting of voice therapy and proper vocal hygiene, often while awaiting an optimal personal time for surgical intervention. Of these subjects, nine (56.3%) experienced a resolution of their lesion and symptoms without undergoing surgical therapy. Surgical removal of hemorrhagic polyps is often considered the standard of treatment for these benign lesions. However, these observations support a regimen of voice therapy and observation in select cases.

  16. Gender and plasma iron biomarkers, but not HFE gene mutations, increase the risk of colorectal cancer and polyps.

    Science.gov (United States)

    Castiella, Agustin; Múgica, Fernando; Zapata, Eva; Zubiaurre, Leire; Iribarren, Arantxa; de Juan, M Dolores; Alzate, Luis; Gil, Ines; Urdapilleta, Gregorio; Otazua, Pedro; Emparanza, José Ignacio

    2015-09-01

    A cohort study of patients included in the Basque Country colorectal cancer (CRC) screening programme was carried out to assess the risk of adenomatous polyps and CRC (P-CRC) associated with HFE gene mutations, with gender and with iron biomarkers (serum ferritin (SF), iron (Fe) and transferrin saturation index (TSI)). Among 432 included patients (mean age 59.8 years), 263 were men (60.9 %) and 169 women (39.1 %). P-CRC were identified in 221 patients (51.2 %) and no polyps (NP) in 211 patients (48.8 %). HFE mutations were identified in 43.8 % of the patients. C282Y/wt genotypic frequency was 6.8 % in the P-CRC group and 1.4 % in the NP group (p < 0.05). The allelic frequency was 3.8 versus 1.2 % (p < 0.05). For laboratory, all three iron biomarkers showed a statistically significant difference: mean Fe, 91.29 ± 34 for P-CRC and 80.81 ± 30.59 for NP group. Mean TSI for P-CRC was 24.95 ± 8.90 and 22.74 ± 8.79 for NP group. Mean SF 308.09 ± 536.32 for P-CRC and 177.55 ± 159.95 for NP group. In a multivariate logistic regression analysis, only male gender (odds ratio (OR) = 2.04, 1.29-3.22), SF (OR = 1.001, 1.0004-1.003) and Fe (OR = 1.01, 1.004-1.02) were related with the presence of CRC and adenoma. Men gender and raised serum iron biomarkers increase the risk of P-CRC.

  17. Celecoxib use and circulating oxylipins in a colon polyp prevention trial.

    Directory of Open Access Journals (Sweden)

    Jessica A Martinez

    Full Text Available Drugs that inhibit cyclooxygenase (COX-2 and the metabolism of arachidonic acid (ARA to prostaglandin E2 are potent anti-inflammatory agents used widely in the treatment of joint and muscle pain. Despite their benefits, daily use of these drugs has been associated with hypertension, cardiovascular and gastrointestinal toxicities. It is now recognized that ARA is metabolized to a number of bioactive oxygenated lipids (oxylipins by cyclooxygenase (COX, lipoxygenase (LOX, and cytochrome P450 (CYP450 enzymes. Currently, the contribution of individual variability in ARA metabolism in response to the COX-2 inhibitors and potential adverse effects remains poorly understood. Using patient samples from the randomized, placebo-controlled phase III selenium/celecoxib (Sel/Cel trial for the prevention of colorectal adenomatous polyps, we analyzed plasma concentrations of 74 oxylipins in a subset of participants who received celecoxib (n = 90 or placebo (n = 95. We assessed the effect of celecoxib (with and without low dose aspirin on circulating oxylipins and systolic blood pressure (SBP. Individual CYP450- and LOX- but not COX-derived metabolites were higher with celecoxib than placebo (P<0.05 and differences were greater among non-aspirin users. LOX derived 5- and 8-HETE were elevated with celecoxib and positively associated with systolic blood pressure (P = 0.011 and P = 0.019 respectively. 20-HETE, a prohypertensive androgen-sensitive CYP450 metabolite was higher with celecoxib absent aspirin and was positively associated with SBP in men (P = 0.040 but not women. Independent of celecoxib or aspirin, LOX derived metabolites from ARA were strongly associated with SBP including 5- and 8-HETE. These findings support oxylipins, particularly the ARA LOX-derived, in blood pressure control and indicate that pharmacologic inhibition of COX-2 has effects on LOX and CYP450 ARA metabolism that contribute to hypertension in some patients.

  18. 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.

  19. Transanal endoscopic microsurgery for giant polyps of the rectum

    DEFF Research Database (Denmark)

    Levic, K; Bulut, O; Hesselfeldt, P

    2014-01-01

    in the rectum. We present our results with TEM in the removal of giant polyps equal or greater than 4 cm in diameter. METHODS: In the period between 1998 and 2012, TEM was performed in 39 patients with rectal polyps measuring at least 4 cm in diameter. Transrectal ultrasound and/or magnetic resonance imaging......, these recurrences were treated with endoscopic removal or re-TEM. The remaining 5 underwent total mesorectal excision and/or chemotherapy. CONCLUSIONS: Full-thickness TEM provides a safe and efficient treatment for excision of giant polyps. In case of unexpected cancer, TEM can be curative. Local recurrence can...

  20. The outcome of familial adenomatous polyposis in the absence of a ...

    African Journals Online (AJOL)

    S Afr Med J 1995; 85: 272-276. Familial adenomatous polyposis (FAP) almost always leads to large-bowel cancer unless prophylactic surgery is performed. The results of treating large numbers of patients with FAP are usually reported from polyposis registries. Such registries have two main functions. Firstly they identify,.

  1. Attitudes toward genetic testing in childhood and reproductive decision-making for familial adenomatous polyposis

    NARCIS (Netherlands)

    Douma, K.F.L.; Aaronson, N.K.; Vasen, H.F.A.; Verhoef, S.; Gundy, C.M.; Bleiker, E.M.A.

    2010-01-01

    Childhood DNA testing, prenatal diagnosis (PND) and preimplantation genetic diagnosis (PGD) are available for familial adenomatous polyposis (FAP). However, the use of PND and PGD is controversial. The purpose of this study was to investigate attitudes toward, and experiences with, childhood DNA

  2. Desmoid tumors in a dutch cohort of patients with familial adenomatous polyposis

    NARCIS (Netherlands)

    Nieuwenhuis, Marry H.; de Vos Tot Nederveen Cappel, Wouter; Botma, Akke; Nagengast, Fokko M.; Kleibeuker, Jan H.; Mathus-Vliegen, Elisabeth M. H.; Dekker, Evelien; Dees, Jan; Wijnen, Juul; Vasen, Hans F. A.

    2008-01-01

    BACKGROUND & AIMS: Desmoid tumors are a severe extracolonic manifestation in familial adenomatous polyposis (FAP). Identification of risk factors might be helpful in the management of FAP patients with such tumors. The aim of this study was to assess potential risk factors for the development of

  3. Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis.

    Science.gov (United States)

    Prouty, Megan; Patrawala, Samit; Vogt, Adam; Kelleher, Michael; Lee, Michael; Parker, Douglas C

    2016-03-01

    There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease (IBD). However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented. We report a case of a 51-year-old female with a history of colonic adenocarcinoma who presented with pruritic, erythematous, scaly plaques on the right lower abdomen, present since reversal of her ileostomy in 2007. Skin biopsy revealed benign foci of colonic epithelium with no evidence of adenomatous change. Benign intraepidermal colonic mucosa was diagnosed based on histopathologic findings and immunohistochemistry. To our knowledge, this is the first case of intraepidermal benign colonic metaplasia forming in a patient following ostomy reversal. The case emphasizes the importance of patient education and physical examination of the stoma or stoma remnants for detection of unusual or changing lesions due to the risk for malignant transformation. It also demonstrates that benign colonic mucosa should be considered in the differential diagnosis when evaluating lesions near ileostomy sites, regardless of whether the patient has a history of familial adenomatous polyposis or IBD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Genotype predicting phenotype in familial adenomatous polyposis: a practical application to the choice of surgery

    DEFF Research Database (Denmark)

    Nieuwenhuis, Marry H; Bülow, Steffen; Björk, Jan

    2009-01-01

    PURPOSE: Genetic information may help preoperatively select patients with familial adenomatous polyposis for either colectomy with ileorectal anastomosis or proctocolectomy with ileal pouch-anal anastomosis. Although complicated, the latter procedure has a low long-term risk of rectal cancer. MET...

  5. Tumour Suppressor Adenomatous Polyposis Coli (APC) localisation is regulated by both Kinesin-1 and Kinesin-2

    NARCIS (Netherlands)

    Ruane, Peter T; Gumy, Laura F; Bola, Becky; Anderson, Beverley; Wozniak, Marcin J; Hoogenraad, Casper C; Allan, Victoria J

    2016-01-01

    Microtubules and their associated proteins (MAPs) underpin the polarity of specialised cells. Adenomatous polyposis coli (APC) is one such MAP with a multifunctional agenda that requires precise intracellular localisations. Although APC has been found to associate with kinesin-2 subfamily members,

  6. Culture of primary epithelial adenoma cells from familial adenomatous polyposis patients

    Czech Academy of Sciences Publication Activity Database

    Fostira, F.; Apessos, A.; Oikonomou, E.; Kouklis, P.; Baratsis, S.; Manifikos, G.; Anděra, Ladislav; Yannoukakos, D.; Pintzas, A.; Nasioulas, G.

    2008-01-01

    Roč. 28, 2A (2008), s. 843-846 ISSN 0250-7005 Institutional research plan: CEZ:AV0Z50520514 Keywords : colorectal neoplasia * adenomatous polyposis coli * epithelial cells Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.390, year: 2008

  7. Evaluation of 28 years of surgical treatment of children and young adults with familial adenomatous polyposis

    NARCIS (Netherlands)

    Booij, Klaske A. C.; Mathus-Vliegen, Elisabeth M. H.; Taminiau, Jan A. J. M.; ten Kate, Fibo J. W.; Slors, J. Frederick M.; Tabbers, Merit M.; Aronson, Daniel C.

    2010-01-01

    Background: In this retrospective study, 28 years of surgical treatment of children and young adults with familial adenomatous polyposis (FAP) was analyzed. Methods: Forty-three patients were operated on before the age of 26 years. Endoscopic aspects, operative data, and complications were analyzed,

  8. Evaluation of 28 years of surgical treatment of children and young adults with familial adenomatous polyposis.

    NARCIS (Netherlands)

    Booij, K.A.; Mathus-Vliegen, E.M.H.; Taminiau, J.A.; Kate, F.J. ten; Slors, J.F.M.; Tabbers, M.M.; Aronson, D.C.

    2010-01-01

    BACKGROUND: In this retrospective study, 28 years of surgical treatment of children and young adults with familial adenomatous polyposis (FAP) was analyzed. METHODS: Forty-three patients were operated on before the age of 26 years. Endoscopic aspects, operative data, and complications were analyzed,

  9. Desmoid tumors in a dutch cohort of patients with familial adenomatous polyposis

    NARCIS (Netherlands)

    Nieuwenhuis, M.H.; Vos to Nederveen Cappel, de W.; Botma, A.; Nagengast, F.M.; Kleibeuker, J.H.; Mathus-Vliegen, E.M.; Dekker, E.; Dees, J.; Wijnen, J.; Vasen, H.F.

    2008-01-01

    Background & Aims: Desmoid tumors are a severe extracolonic manifestation in familial adenomatous polyposis (FAP). Identification of risk factors might be helpful in the management of FAP patients with such tumors. The aim of this study was to assess potential risk factors for the development of

  10. Sulfate-reducing bacteria colonize pouches formed for ulcerative colitis but not for familial adenomatous polyposis.

    LENUS (Irish Health Repository)

    Duffy, M

    2012-02-03

    PURPOSE: Ileal pouch-anal anastomosis remains the "gold standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. Pouchitis occurs mainly in patients with a background of ulcerative colitis, although the reasons for this are unknown. The aim of this study was to characterize differences in pouch bacterial populations between ulcerative colitis and familial adenomatous pouches. METHODS: After ethical approval was obtained, fresh stool samples were collected from patients with ulcerative colitis pouches (n = 10), familial adenomatous polyposis (n = 7) pouches, and ulcerative colitis ileostomies (n = 8). Quantitative measurements of aerobic and anaerobic bacteria were performed. RESULTS: Sulfate-reducing bacteria were isolated from 80 percent (n = 8) of ulcerative colitis pouches. Sulfate-reducing bacteria were absent from familial adenomatous polyposis pouches and also from ulcerative colitis ileostomy effluent. Pouch Lactobacilli, Bifidobacterium, Bacteroides sp, and Clostridium perfringens counts were increased relative to ileostomy counts in patients with ulcerative colitis. Total pouch enterococci and coliform counts were also increased relative to ileostomy levels. There were no significant quantitative or qualitative differences between pouch types when these bacteria were evaluated. CONCLUSIONS: Sulfate-reducing bacteria are exclusive to patients with a background of ulcerative colitis. Not all ulcerative colitis pouches harbor sulfate-reducing bacteria because two ulcerative colitis pouches in this study were free of the latter. They are not present in familial adenomatous polyposis pouches or in ileostomy effluent collected from patients with ulcerative colitis. Total bacterial counts increase in ulcerative colitis pouches after stoma closure. Levels of Lactobacilli, Bifidobacterium, Bacteroides sp, Clostridium perfringens, enterococci, and coliforms were similar in both pouch groups. Because sulfate-reducing bacteria are

  11. The Colonoscopist's Expertise Affects the Characteristics of Detected Polyps

    Directory of Open Access Journals (Sweden)

    Da Kyoung Jung

    2016-01-01

    Full Text Available Background/Aims: The influence of the endoscopist on the polyp detection rate (PDR is underappreciated in clinical practice. Moreover, flat lesions or lesions of the proximal colon are more difficult to detect. Here, we evaluated the differences in the PDR and the characteristics of detected polyps according to the experience of the colonoscopist. Methods: We collected data on 2,549 patients who underwent screening colonoscopy performed by three fellows. The PDR was calculated according to the percentage of patients who had at least one polyp (method A and according to the percentage of detected lesions (method B. The primary outcome included the change in the PDR, and the secondary outcome included the change in the characteristics of the detected polyps with increasing experience of the colonoscopist. Results: No proportional correlation was found between the PDR and increasing experience in colonoscopy with method A; however, with method B, the PDR increased after 400 colonoscopies (p=0.0209. With method B, the detection rates of small polyps (<5 mm (p=0.0015 and polyps in proximal sites (p=0.0050 increased after 300 colonoscopies. Conclusions: Our study demonstrated that the quality of a colonoscopy, measured by using the PDR, may increase when performed by experienced fellows.

  12. Endoscopic resection of large colorectal polyps Resección endoscópica de pólipos difíciles de colon

    Directory of Open Access Journals (Sweden)

    F. Pérez Roldán

    2004-01-01

    Full Text Available Backgrounds: endoscopic polypectomy is a common technique, but there are discrepancies over which treatment -surgical or endoscopic- to follow in case of polyps of 2 cm or larger. Objectives: to analyse the efficacy and complications of colonoscopic polypectomy of large colorectal polyps. Patients and methods: 147 polypectomies were performed on 142 patients over an eight-year period. The technique used was that of submucosal adrenaline 1:10000 or saline injection at the base of the polyp, followed by resection of the polyp using a diathermic snare in the smallest number of fragments. Remnant adenomatous tissue was fulgurated with an argon plasma coagulator. Lately, prophylactic hemoclips have been used for thick-pedicle polyps. Complete removal was defined as when a polyp was completely resected in one or more polypectomy sessions. Polypectomy failure was defined as when a polyp could not be completely resected or contained an invasive carcinoma. Results: the mean patient age was 67.9 years (range, 4-90 years, with 68 men and 79 women. There were 74 sessile polyps, and the most common location was the sigmoid colon. The most frequent histology was tubulovillous. Most of the polyps (96.6%, were resected and cured. This was not achieved in four cases of invasive carcinoma, and a villous polyp of the cecum. All pedunculated polyps were resected in one session, whereas the average number of colonoscopies for sessile polyps was 1.35 ± 0.6 (range, 1-4. The polypectomy was curative in all of the in situ carcinomata except one. As for complications, 2 colonic perforations (requiring surgery and 8 hemorrhages appeared, which were controlled via endoscopy. There was no associated mortality. Conclusions: endoscopic polypectomy of large polyps (≥ 2 cm is a safe, effective treatment, though it is not free from complications. Complete resection is achieved in a high percentage, and there are few relapses. It should be considered a technique of choice for

  13. Endometrial Intraepithelial Neoplasia (EIN In An Endometrial Polyp

    Directory of Open Access Journals (Sweden)

    Devic Ana

    2015-12-01

    Full Text Available Endometrial intraepithelial neoplasia (EIN is a monoclonal neoplastic cell proliferation of the endometrium associated with a significantly increased risk of endometrioid endometrial adenocarcinoma. We herein present the case of a 58-year-old female patient who underwent a hysterectomy with bilateral salpingo-oophorectomy because of the existence of endometrial intraepithelial neoplasia in an endometrial polyp. The patient had irregular uterine bleeding, which lasted 10 days. An endometrial polyp was diagnosed by ultrasound examination. The polyp was located in the isthmus of the uterus, on the back wall, and measured 32 mm × 25 mm. The patient underwent fractional dilation and curettage, and the specimens were subjected to a histopathological examination. The histopathological findings were EIN, endometrioid type, a focus of which was found within the endometrial polyps, as well as the endometrial polyp and proliferative endometrium. The endocervical tissue was normal. Given the age of the patient and the histopathological findings, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The final histopathological findings were EIN, endometrioid type with a focus found within the endometrial polyp; endometrial polyp; simple hyperplasia; chronic inflammation of the uterine cervix; hyperkeratosis of the cervical squamous epithelium; and cervicitis chronica. There was also hydrosalpinx of the left fallopian tube, and cystic follicles in the left ovary. There was no significant morphological change in the right ovary or fallopian tube. The surgical and postoperative course were normal. The patient was sent home on the fifth postoperative day in good general condition. A check-up performed one month after surgery showed normal findings.

  14. Constitutional mismatch repair-deficiency syndrome presenting as colonic adenomatous polyposis: clues from the skin.

    Science.gov (United States)

    Jasperson, K W; Samowitz, W S; Burt, R W

    2011-10-01

    Constitutional mismatch repair-deficiency (CMMR-D) syndrome is an autosomal recessive condition characterized by hematologic malignancies, brain tumors, Lynch syndrome-associated cancers and skin manifestations reminiscent of neurofibromatosis type 1 (NF1). In contrast to Lynch syndrome, CMMR-D syndrome is exceptionally rare, onset typically occurs in infancy or early childhood and, as described in this report, may also present with colonic polyposis suggestive of attenuated familial adenomatous polyposis (AFAP) or MUTYH associated polyposis (MAP). Here we describe two sisters with CMMR-D syndrome due to germline bi-allelic MSH6 mutations. Both sisters are without cancer, are older than typical for this condition, have NF1 associated features and a colonic phenotype suspicious for an attenuated polyposis syndrome. This report highlights the role of skin examinations in leading to an underlying genetic diagnosis in individuals with colonic adenomatous polyposis, but without mutations associated with AFAP or MAP. © 2010 John Wiley & Sons A/S.

  15. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient

    DEFF Research Database (Denmark)

    Klarskov, Louise; Mogensen, Anne Mellon; Jespersen, Niels

    2011-01-01

    Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma in the i......Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma...... during the adenoma carcinoma sequence included the acquisition of CK7 expression in the malignant portion. Gastric mucin may play a role in the initial step of the neoplastic evolution and CK7 may denote neoplastic progression. This case confirms the notion of a widely variegated morphology of precursor...

  16. Familial adenomatous polyposis patients without an identified APC germline mutation have a severe phenotype

    DEFF Research Database (Denmark)

    Bisgaard, M L; Ripa, R; Knudsen, Anne Louise

    2004-01-01

    BACKGROUND: Development of more than 100 colorectal adenomas is diagnostic of the dominantly inherited autosomal disease familial adenomatous polyposis (FAP). Germline mutations can be identified in the adenomatous polyposis coli (APC) gene in approximately 80% of patients. The APC protein...... comprises several regions and domains for interaction with other proteins, and specific clinical manifestations are associated with the mutation assignment to one of these regions or domains. AIMS: The phenotype in patients without an identified causative APC mutation was compared with the phenotype...... in patients with a known APC mutation and with the phenotypes characteristic of patients with mutations in specific APC regions and domains. PATIENTS: Data on 121 FAP probands and 149 call up patients from 70 different families were extracted from the Danish Polyposis register. METHODS: Differences in 16...

  17. Laparoscopic Restorative Total Proctocolectomy With Ileal Pouch Anal Anastomosis for Familial Adenomatous Polyposis

    OpenAIRE

    Palanivelu, C.; Jani, Kalpesh; Sendhilkumar, K.; Parthasarathi, R.; Senthilnathan, P.; Maheshkumar, G.

    2008-01-01

    Background: Familial adenomatous polyposis is a hereditary disease characterized by the presence of thousands of colonic adenomas, which, if untreated, invariably undergo malignant transformation. Because this disease manifests at a young age, the laparoscopic approach to perform surgery would be desirable due to its cosmetic benefits. We describe our experience with this procedure and review the literature on the topic. Methods: This is a case series of 15 patients who underwent restorative ...

  18. Gallbladder stones and gallbladder polyps associated with increased risk of colorectal adenoma in men.

    Science.gov (United States)

    Liu, Yen-Ling; Wu, Jin-Shang; Yang, Yi-Ching; Lu, Feng-Hwa; Lee, Chih-Ting; Lin, Wan-Ju; Chang, Chih-Jen

    2018-04-01

    Most cases of colorectal cancer develop via an adenoma to carcinoma sequence. Gallbladder polyps share some risk factors with colorectal polyps. Little is known about the relationship between gallbladder diseases and different status of colorectal polyps by gender. This study was to investigate the association of gallbladder stones and polyps with colorectal adenomas by gender in a Taiwanese population. A total of 7066 eligible subjects who underwent a total colonoscopy as a part of health check-up between January 2001 and August 2009 were recruited. Colonoscopic findings were classified into polyp-free, non-neoplastic polyps and colorectal adenomas. Gallbladder stones and gallbladder polyps were diagnosed based on ultrasonographic findings. There was a significant difference in the status of colon polyps between subjects with and without gallbladder polyps. However, the status of colon polyps was not significantly different between subjects with or without gallbladder stones. After adjusting obesity, fasting plasma glucose, and other variables, there was a positive relationship between gallbladder polyps and colorectal adenomas (odds ratio [OR]: 1.396, 95% confidence interval [CI]: 1.115-1.747) but not non-neoplastic polyps in all subjects. In men, gallbladder polyps (OR: 1.560, 95% CI: 1.204-2.019) and gallbladder stones (OR: 1.465, 95% CI 1.081-1.984) were positively associated with colorectal adenomas. In women, neither gallbladder polyps nor gallbladder stones were significantly related to colon polyps. Both gallbladder polyps and gallbladder stones were associated with an increased risk of colorectal adenomas in men but not in women. Gender difference was significant for the association between gallbladder lesions and colorectal polyps. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  19. Polyp Removal of a Bloom Forming Jellyfish, Aurelia coerulea, in Korean Waters and Its Value Evaluation

    Science.gov (United States)

    Yoon, Wonduk; Chae, Jinho; Koh, Byoung-Seol; Han, Changhoon

    2018-04-01

    Aurelia coerulea is a bloom forming jellyfish that first appeared before 1980 in the western and southern Korean seas and which has been blamed for huge economical losses in all fields of marine activities. As a preventive measure to reduce economical losses, polyp removal was undertaken at Lake Shihwa, Lake Saemangeum, and Masan Bay, Korea. In the course of efforts during 2 years to remove polyps, polyps were surveyed, quantified, and removed. In these areas, the initial total polyp abundance was 5.04 × 109 and 46.25% of them were removed; Lake Shihwa the highest rates of removal and Lake Saemangeum the lowest. These efforts to remove polyps prevented the appearance of 1.20 × 109 medusae, corresponding to 78.28 × 106 kg. The cost of polyp removal was evaluated and compared with that of medusae removal. The ratio between the cost of polyp removal and that of medusae removal ranged between 0.78-3.14%, indicating large cost savings for polyp removal undertakings. However, the effect of polyp removal varied from positive to none, and we assumed that the cleared surface for polyp removal, quantity of removed polyp, and existence of polyps' hotspots in neighboring areas were the causes of the non-effectiveness of polyp removal undertakings.

  20. 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.

  1. A CpG island methylator phenotype of colorectal cancer that is contiguous with conventional adenomas, but not serrated polyps

    OpenAIRE

    HOKAZONO, KOJI; UEKI, TAKASHI; NAGAYOSHI, KINUKO; NISHIOKA, YASUNOBU; HATAE, TATSUNOBU; KOGA, YUTAKA; HIRAHASHI, MINAKO; ODA, YOSHINAO; TANAKA, MASAO

    2014-01-01

    A subset of colorectal cancers (CRCs) harbor the CpG island methylator phenotype (CIMP), with concurrent multiple promoter hypermethylation of tumor-related genes. A serrated pathway in which CIMP is developed from serrated polyps is proposed. The present study characterized CIMP and morphologically examined precursor lesions of CIMP. In total, 104 CRCs treated between January 1996 and December 2004 were examined. Aberrant promoter methylation of 15 cancer-related genes was analyzed. CIMP sta...

  2. Sulphomucin expression in ileal pouches: emerging differences between ulcerative colitis and familial adenomatous polyposis pouches.

    LENUS (Irish Health Repository)

    Bambury, Niamh

    2012-02-03

    PURPOSE: We characterized the expression of sialomucin and sulphomucin in pouches fashioned for familial adenomatous polyposis and ulcerative colitis. We correlated sulphomucin expression with bacterial colonization and mucosal inflammation. METHODS: Ethical approval and informed consent were obtained. Mucosal biopsies from 9 patients with familial adenomatous polyposis and 12 with ulcerative colitis were obtained. Sulphomucin levels were assessed by using the high iron-diamine stain. Mucous gel layer composition was correlated with villous height, crypt depth, and total mucosal thickness. Mucous gel layer composition was correlated with acute and chronic inflammatory infiltrates. Colonization by a panel of seven bacterial species (including sulphate reducing bacteria) was established and correlated with sulphomucin levels. RESULTS: High-iron-diamine positivity (i.e., sulphomucin expression) was greater in ulcerative colitis pouch mucous gel (2.083 +\\/- 0.5 vs. 0.556 +\\/- 0.4, P = 0.003). Sulphomucin expression correlated with reduced crypt depth, villous height, and total mucosal thickness. In the ulcerative colitis group, chronic inflammatory infiltrate scores were significantly greater for high-iron-diamine-positive patients. Colonization by sulphate reducing bacteria was increased in high-iron-diamine-positive patients. CONCLUSIONS: Sulphomucin expression is increased in the mucous gel layer of the ulcerative colitis pouch compared with that of the familial adenomatous polyposis pouch. Sulphomucin expression is associated with colonization by sulphate-reducing bacteria and increased chronic inflammation.

  3. Colorectal adenomatous polyposis syndromes: Genetic determinism, clinical presentation and recommendations for care.

    Science.gov (United States)

    Buecher, Bruno

    2016-02-01

    Colorectal adenomatous polyposis constitutes a diverse group of disorders with different modes of inheritance. Molecular diagnosis of this condition has become more complex. In fact, somatic mosaicism for APC mutations now appears to be more frequent than previously thought and rare germline alterations of this gene may be implicated in patients tested negative for "classical" APC mutations (point mutations and large genomic rearrangements). Moreover, the knowledge concerning several aspects of the MUTYH-associated polyposis has improved since its first description in 2002 and germline mutations in new genes have recently been implicated in some cases of unexplained adenomatous polyposis. Genetic testing in probands and their relatives should be conducted in the context of pre- and post-test genetic counseling. The recent advent of New Generation Sequencing (NGS) techniques affords the opportunity to rapidly screen patients for a comprehensive panel of colorectal cancer susceptibility genes in a cost-effective fashion. This type of approach will probably replace the classical sequential approach based on clinical presumptive diagnoses in the near future. The risk of colorectal cancer is very high in affected patients in the absence of appropriate care. Clinical management is complex and should be provided in centers with special expertise in these diseases. This review focuses on the various colorectal adenomatous polyposis syndromes with special attention to more innovative and important aspects. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  4. Laparoscopic restorative total proctocolectomy with ileal pouch anal anastomosis for familial adenomatous polyposis.

    Science.gov (United States)

    Palanivelu, C; Jani, Kalpesh; Sendhilkumar, K; Parthasarathi, R; Senthilnathan, P; Maheshkumar, G

    2008-01-01

    Familial adenomatous polyposis is a hereditary disease characterized by the presence of thousands of colonic adenomas, which, if untreated, invariably undergo malignant transformation. Because this disease manifests at a young age, the laparoscopic approach to perform surgery would be desirable due to its cosmetic benefits. We describe our experience with this procedure and review the literature on the topic. This is a case series of 15 patients who underwent restorative proctocolectomy with ileo-anal pouch anastomosis for familial adenomatous polyposis between 2000 and 2007. The salient operative steps are described. There were 9 males and 6 females, 32 to 52 years of age, with an average age of 44.8 years. The median body mass index was 21.5 (range, 17 to 28). Rectal cancer was already present in 4 patients at the time of diagnosis. The median operating time was 225 minutes. Mean blood loss was 60 mL, with none of the patients requiring perioperative blood transfusion. None of the surgeries required conversion to the open approach. Bowel function resumed on the second postoperative day in 12 patients and on the third postoperative day in 3 patients. The median hospital stay was 8 days. Postoperatively, there was no mortality and no serious morbidity. Laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis is a feasible surgery for familial adenomatous polyposis, and considering its cosmetic benefit, is a desirable option for this group of predominantly young patients.

  5. Attenuated familial adenomatous polyposis and Muir-Torre syndrome linked to compound biallelic constitutional MYH gene mutations.

    Science.gov (United States)

    Ponti, G; Ponz de Leon, M; Maffei, S; Pedroni, M; Losi, L; Di Gregorio, C; Gismondi, V; Scarselli, A; Benatti, P; Roncari, B; Seidenari, S; Pellacani, G; Varotti, C; Prete, E; Varesco, L; Roncucci, L

    2005-11-01

    Attenuated familial adenomatous polyposis and Muir-Torre syndrome linked to compound biallelic constitutional MYH gene mutations.Peculiar dermatologic manifestations are present in several heritable gastrointestinal disorders. Muir-Torre syndrome (MTS) is a genodermatosis whose peculiar feature is the presence of sebaceous gland tumors associated with visceral malignancies. We describe one patient in whom multiple sebaceous gland tumors were associated with early onset colon and thyroid cancers and attenuated polyposis coli. Her family history was positive for colonic adenomas. She had a daughter presenting with yellow papules in the forehead region developed in the late infancy. Skin and visceral neoplasms were tested for microsatellite instability and immunohistochemical status of mismatch repair (MMR), APC and MYH proteins. The proband colon and skin tumors were microsatellite stable and showed normal expression of MMR proteins. Cytoplasmic expression of MYH protein was revealed in colonic cancer cells. Compound heterozygosity due to biallelic mutations in MYH, R168H and 379delC, was identified in the proband. The 11-year-old daughter was carrier of the monoallelic constitutional mutation 379delC in the MYH gene; in the sister, the R168H MYH gene mutation was detected. This report presents an interesting case of association between MYH-associated polyposis and sebaceous gland tumors. These findings suggest that patients with MTS phenotype that include colonic polyposis should be screened for MYH gene mutations.

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

    Energy Technology Data Exchange (ETDEWEB)

    Babiker, Babiker Eltayeb [Faculty of Medicine, University of Khartoum, Khartoum (Sudan)

    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)

  7. Clinical and radiographic characteristics of ureteral polyps in children

    International Nuclear Information System (INIS)

    Niu Zhibing; Wang Changlin; Yang Qi; Hou Ying

    2007-01-01

    Objective: To analyze the clinical and radiographic characterstics of ureteral polyps with hydronephrosis in children. Methods: Thirteen patients with ureteral polyps and hydronephrosis were studied retrospectively. All patients underwent abdominal plain film, intravenous pyelogram (IVP) and ultrasound (US) examinations,contrast-enhanced CT scan was performed in 10 cases. Results: Intermittent or recurrent abdominal pain with painless hematuria was presented in most cases. Hydronephrosis was demonstrated in radiographic images. IVP delineated the dilatation of the ureter and filling defects within the ureteral lumen in 5 cases. Computed tomography (CT) showed all abnormal changes of ureter and irregular intraluminal soft tissue masses in 6 cases. Moderate and low echoic structures were showed in ureters by US in 2 cases. Conclusion: US and CT, as an important imaging modalities, can improve the diagnostic accuracy for ureteral polyps. (authors)

  8. Placental polyp: a rare cause of iron deficiency anemia

    Directory of Open Access Journals (Sweden)

    Fernando Peixoto Ferraz de Campos

    2011-12-01

    Full Text Available Placental polyps are defined as pedunculated or polypoid fragments of placentaor ovular membranes retained for an indefinite period of time into the uterus afterabortion or child birth. An important cause of retention is placental accretism, anabnormal adherence of the placenta into the uterine wall. Chronic cases are rarelyreported in the literature. In these cases, the placental retention in the immediatepostpartum is not followed by heavy bleeding what makes the diagnosischallenging. We report a rare case of iron-deficiency anemia in a multiparous29-year-old female patient two years after the last delivery. She sought medicalcare with clinical symptoms of anemia and recent menses alterations. Therewas no history of abortion. On gynecological examination, there was a twofoldenlarged uterus, and the pelvic ultrasound revealed an image compatible with anendometrial polyp. She underwent open hysterectomy because of uncontrollablebleeding followed by hypotension after curettage. The histolopathologicexamination revealed a partially hyalinized and necrotic placental polyp.

  9. 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.

  10. Structure and signaling at hydroid polyp-stolon junctions, revisited

    Directory of Open Access Journals (Sweden)

    Katherine L. Harmata

    2015-09-01

    Full Text Available The gastrovascular system of colonial hydroids is central to homeostasis, yet its functional biology remains poorly understood. A probe (2′,7′-dichlorodihydrofluorescein diacetate for reactive oxygen species (ROS identified fluorescent objects at polyp-stolon junctions that emit high levels of ROS. A nuclear probe (Hoechst 33342 does not co-localize with these objects, while a mitochondrial probe (rhodamine 123 does. We interpret these objects as mitochondrion-rich cells. Confocal microscopy showed that this fluorescence is situated in large columnar cells. Treatment with an uncoupler (2,4-dinitrophenol diminished the ROS levels of these cells relative to background fluorescence, as did removing the stolons connecting to a polyp-stolon junction. These observations support the hypothesis that the ROS emanate from mitochondrion-rich cells, which function by pulling open a valve at the base of the polyp. The open valve allows gastrovascular fluid from the polyp to enter the stolons and vice versa. The uncoupler shifts the mitochondrial redox state in the direction of oxidation, lowering ROS levels. By removing the stolons, the valve is not pulled open, metabolic demand is lowered, and the mitochondrion-rich cells slowly regress. Transmission electron microscopy identified mitochondrion-rich cells adjacent to a thick layer of mesoglea at polyp-stolon junctions. The myonemes of these myoepithelial cells extend from the thickened mesoglea to the rigid perisarc on the outside of the colony. The perisarc thus anchors the myoepithelial cells and allows them to pull against the mesoglea and open the lumen of the polyp-stolon junction, while relaxation of these cells closes the lumen.

  11. Syndromic Gastric Polyps : At the Crossroads of Genetic and Environmental Cancer Predisposition

    NARCIS (Netherlands)

    Brosens, Lodewijk A A; Giardiello, Francis M; Offerhaus, G Johan; Montgomery, Elizabeth A

    2016-01-01

    Gastric polyps occur in 1-4 % of patients undergoing gastroscopy. Although most are sporadic, some gastric polyps are part of an underlying hereditary syndrome. Gastric polyps can be seen in each of the well-known gastrointestinal polyposis syndromes, but also in Lynch syndrome and in several rare

  12. Further refinements of the polyp snare for interuterine surgery--a new modality for treatment of myomas and polyps.

    Science.gov (United States)

    McLucas, B

    1995-01-01

    Hysteroscopic treatment of 30 patients suffering from menorrhagia or post-partum complications was accomplished using an electrosurgical polyp snare. Using this method, 18 polyps and 12 myomas were successfully removed in less than twenty minutes without complications. Local anaesthesia was used in 12 patients. Three patients have presented with recurrence of menorrhagia, with a minimum of six months follow-up. Benefits of this technique compared to uterine resectoscopy include shorter operative time, decreased risk of fluid overload, and less risk of uterine perforation. The snare is difficult to use and a learning curve exists. Higher currents than that used for resection are required.

  13. 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

    , 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...... women were positively associated, whereas the use of oral contraceptive pills was negatively associated with endometrial polyps. Hypertension and cervical polyps were not associated with endometrial polyps. Endometrial polyps were infrequently related to premalignant and malignant disease....

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

    African Journals Online (AJOL)

    A rare case of prolapsed submucous uterine fibroid polyp associated with intemittent acute urinary retention in a 34 year old Para 4+4 woman is described. She presented with one year history of increased menstrual blood loss and secondary dysmenorrhea and six months history of a mass protruding down the vagina, ...

  15. 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.

  16. Computer-aided diagnosis of colonic polyp by CT colonography

    International Nuclear Information System (INIS)

    Yoshida, Hiroyuki

    2007-01-01

    The outcome of National CT Colonography Trial, by American College of Radiology Imaging Network, 2006 (www.acrin.org/6664 protocol), possibly leads to the introduction of colorectal cancer screening in the US because CT colonography (CTCG) has been approved in the health insurance system. This paper describes the outline of computer-aided diagnosis (CAD) of colonic polyp by CTCG, its polyp detectability and future aspects. CTCG essentially derives from the virtual, abdominal 3D CT images and gives as many as about 500 images/patient, in the reading of which CAD support the expert. CAD technology in CTCG is said to have been essentially established in the first half of 2000s, which involves the cleansing of fecal tagging effect, extraction of the colonal wall from the image, detection of suspicious polyp, reduction of false-positive findings and displaying of the detected polyp. The detectability is thought to be at comparable level to expert's. The last displaying is done on the user-interface like Colon CAD Workstation. More efficient expert's reading with CAD, imaging without previous gut cleansing, detection of the flat lesion and further reduction of false-positive are the forthcoming tasks in clinical practice. Significance of CTCG is becoming in realization and its usage with CAD is thought to be more popular in Japan. (R.T.)

  17. A Rare Presentation of Odontogenic Keratocyst Mimicking an Antral Polyp

    OpenAIRE

    Sudhakar, S; Geethika, V; Ramaswamy, P; Kumar, PK; Sreenivasulu, P

    2014-01-01

    Maxillary sinus harbours many pathological lesions. Many of those presents as a sinonasal mass and are rarely symptomatic. These masses are usually an antral polyp, mucoceles or mucous retention cysts. Odontogenic keratocyst, a benign odontogenic lesion presenting within the maxillary sinus is a rare entity. We present a case of odontogenic keratocyst of the maxillary sinus in a 35 years old female.

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

    African Journals Online (AJOL)

    Polyp prevalence at colonoscopy among Nigerians: A prospective observational study. ... Materials and Methods: This is a prospective study of all colonoscopy examinations performed at the endoscopy unit of our hospital from January, 2007 to December 2013. The patient demographics, indications for colonoscopy, ...

  19. 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 ...

  20. 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...

  1. Hamartomatous Polyp of the Tonsil: A Case Report

    African Journals Online (AJOL)

    dysphagia. These are nonspecific symptoms due to mass effect. We present a case of hamartomatous polyp to stress on the benign nature of this rare lesion, clinically diagnosed as neoplasm. We want to emphasize the hamartomatous nature of this lesion with review of literature. CASE REPORT. A 17‑year‑old male patient ...

  2. 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.

  3. 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.

  4. 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

  5. The Effects of Size and Type of Vocal Fold Polyp on Some Acoustic Voice Parameters

    Directory of Open Access Journals (Sweden)

    Elaheh Akbari

    2018-03-01

    Full Text Available Background: Vocal abuse and misuse would result in vocal fold polyp. Certain features define the extent of vocal folds polyp effects on voice acoustic parameters. The present study aimed to define the effects of polyp size on acoustic voice parameters, and compare these parameters in hemorrhagic and non-hemorrhagic polyps. Methods: In the present retrospective study, 28 individuals with hemorrhagic or non-hemorrhagic polyps of the true vocal folds were recruited to investigate acoustic voice parameters of vowel/ æ/ computed by the Praat software. The data were analyzed using the SPSS software, version 17.0. According to the type and size of polyps, mean acoustic differences and correlations were analyzed by the statistical t test and Pearson correlation test, respectively; with significance level below 0.05. Results: The results indicated that jitter and the harmonics-to-noise ratio had a significant positive and negative correlation with the polyp size (P=0.01, respectively. In addition, both mentioned parameters were significantly different between the two types of the investigated polyps. Conclusion: Both the type and size of polyps have effects on acoustic voice characteristics. In the present study, a novel method to measure polyp size was introduced. Further confirmation of this method as a tool to compare polyp sizes requires additional investigations.

  6. 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.

  7. Phosphorylation near nuclear localization signal regulates nuclear import of adenomatous polyposis coli protein

    OpenAIRE

    Zhang, Fang; White, Raymond L.; Neufeld, Kristi L.

    2000-01-01

    Mutation of the adenomatous polyposis coli (APC) gene is an early step in the development of colorectal carcinomas. APC protein is located in both the cytoplasm and the nucleus. The objective of this study was to define the nuclear localization signals (NLSs) in APC protein. APC contains two potential NLSs comprising amino acids 1767–1772 (NLS1APC) and 2048–2053 (NLS2APC). Both APC NLSs are well conserved among human, mouse, rat, and fly. NLS1APC and NLS2APC each w...

  8. Clinical and ethical implications of genetic counselling in familial adenomatous polyposis Implicaciones clínicas y éticas del consejo genético en la poliposis adenomatosa familiar

    Directory of Open Access Journals (Sweden)

    A. Fernández-Suárez

    2005-09-01

    Full Text Available The association of specific genetic disturbances with the development of hereditary cancer helps us to understand the risk of suffering from it, the possibility of an earlier diagnosis, and the treatment and prevention of this disease. Familial adenomatous polyposis (FAP is a pre-neoplastic syndrome characterized by the presence of hundreds of adenomatous polyps in the colon, which develop into a carcinoma. FAP can be diagnosed using sequencing techniques to detect mutations in the germinal line of the APC (adenomatous polyposis coli gene. The genetic diagnostic approach in families with FAP, previously followed up in the Gastrointestinal Clinic, has both advantages and disadvantages, and places us nearer the disease and patient. Disclosing the results of this genetic test entails relevant problems in clinical practice, which affect the health field and raise legal and ethical issues, along with the familial, occupational, and social implications that knowing the genetic status can have on the patient. Genetic analysis is rare in normal clinical practice, which involves errors in the interpretation of the results obtained, and during the process of genetic counselling. Specialized multidisciplinary units are necessary for the management of patients with FAP undergoing analysis and appropriate genetic counselling, thus providing an individualized service. The creation of FAP registers and protocols for this healthcare process should optimize the management of these patients and their families.La asociación de determinadas alteraciones genéticas con la aparición de cáncer hereditario, nos permite conocer el riesgo de padecerlo, posibilitando el diagnóstico precoz, el tratamiento y la prevención de la enfermedad. La poliposis adenomatosa familiar (PAF es un síndrome preneoplásico que se caracteriza por la presencia de cientos de pólipos adenomatosos en colon, que evolucionarán hacia carcinoma. La PAF puede ser diagnosticada mediante t

  9. 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

  10. Evaluating success of curettage in the surgical treatment of endometrial polyps.

    Science.gov (United States)

    Hafizi, Leili; Mousavifar, Nezhat; Zirak, Nahid; Khadem, Nayereh; Davarpanah, Sousan; Akhondi, Mohsen

    2015-02-01

    To determine treatment efficacy of curettage on endometrial polyp. The quasi-experimental pre-and-post study was conducted in 2011-12 at the gynaecology department of Imam Reza Hospital, Mashhad, Iran, and comprised patients who underwent hysteroscopy for endometrial polyp. Location, size, number and base condition of the polyps were recorded before the patient underwent curettage. Hysteroscopy was then performed and the condition of the remaining polyps was compared with initial findings. Also, the remaining polyps were resected. SPSS 13 was used for statistical analysis. There were 51 patients in the study with a mean age of 33.14 ± 8.19 years (range: 23-59 years)Besides, there were 82 polyps; 38(46.3%) having a narrow base, and 44(53.7%) having a wide base. The mean polyp size was 2.39 ± 2.63cm.After performing curettage, 23 (28.0%) polyps were removed completely, 39(47.6%) had size reduction, and 20(24.4%) had no change in size. Curettage could not significantly remove polyps (p < 0.001). Polyps smaller than 2cm were more likely to have been removed compared to the bigger ones (p = 0.003).Polyps with wide base were more significantly removed than those with narrow base (p < 0.001).Further, those with wide base and also smaller than 2 cm were removed more significantly than others (p < 0.001).The location of polyps had no effect on removal probability by curettage (p = 0.114). Curettage was not found to be a reliable method for endometrial polyp removal. If hysteroscopy is not accessible, the size of the polyp should be determined by vaginal sonograghy to estimate the probability of its removal by curettage.

  11. Rare mutations predisposing to familial adenomatous polyposis in Greek FAP patients

    International Nuclear Information System (INIS)

    Mihalatos, Markos; Fountzilas, George; Agnantis, Niki J; Nasioulas, Georgios; Apessos, Angela; Dauwerse, Hans; Velissariou, Voula; Psychias, Aristidis; Koliopanos, Alexander; Petropoulos, Konstantinos; Triantafillidis, John K; Danielidis, Ioannis

    2005-01-01

    Familial Adenomatous Polyposis (FAP) is caused by germline mutations in the APC (Adenomatous Polyposis Coli) gene. The vast majority of APC mutations are point mutations or small insertions / deletions which lead to truncated protein products. Splicing mutations or gross genomic rearrangements are less common inactivating events of the APC gene. In the current study genomic DNA or RNA from ten unrelated FAP suspected patients was examined for germline mutations in the APC gene. Family history and phenotype were used in order to select the patients. Methods used for testing were dHPLC (denaturing High Performance Liquid Chromatography), sequencing, MLPA (Multiplex Ligation – dependent Probe Amplification), Karyotyping, FISH (Fluorescence In Situ Hybridization) and RT-PCR (Reverse Transcription – Polymerase Chain Reaction). A 250 Kbp deletion in the APC gene starting from intron 5 and extending beyond exon 15 was identified in one patient. A substitution of the +5 conserved nucleotide at the splice donor site of intron 9 in the APC gene was shown to produce frameshift and inefficient exon skipping in a second patient. Four frameshift mutations (1577insT, 1973delAG, 3180delAAAA, 3212delA) and a nonsense mutation (C1690T) were identified in the rest of the patients. Screening for APC mutations in FAP patients should include testing for splicing defects and gross genomic alterations

  12. Adenomatous polyposis coli is required for early events in the normal growth and differentiation of the developing cerebral cortex

    Directory of Open Access Journals (Sweden)

    Price David J

    2009-01-01

    Full Text Available Abstract Background Adenomatous polyposis coli (Apc is a large multifunctional protein known to be important for Wnt/β-catenin signalling, cytoskeletal dynamics, and cell polarity. In the developing cerebral cortex, Apc is expressed in proliferating cells and its expression increases as cells migrate to the cortical plate. We examined the consequences of loss of Apc function for the early development of the cerebral cortex. Results We used Emx1Cre to inactivate Apc specifically in proliferating cerebral cortical cells and their descendents starting from embryonic day 9.5. We observed reduction in the size of the mutant cerebral cortex, disruption to its organisation, and changes in the molecular identity of its cells. Loss of Apc leads to a decrease in the size of the proliferative pool, disrupted interkinetic nuclear migration, and increased apoptosis. β-Catenin, pericentrin, and N-cadherin proteins no longer adopt their normal high concentration at the apical surface of the cerebral cortical ventricular zone, indicating that cell polarity is disrupted. Consistent with enhanced Wnt/β-catenin signalling resulting from loss of Apc we found increased levels of TCF/LEF-dependent transcription and expression of endogenous Wnt/β-catenin target genes (Axin2 (conductin, Lef1, and c-myc in the mutant cerebral cortex. In the Apc mutant cerebral cortex the expression of transcription factors Foxg1, Pax6, Tbr1, and Tbr2 is drastically reduced compared to normal and many cells ectopically express Pax3, Wnt1, and Wt1 (but not Wnt2b, Wnt8b, Ptc, Gli1, Mash1, Olig2, or Islet1. This indicates that loss of Apc function causes cerebral cortical cells to lose their normal identity and redirect to fates normally found in more posterior-dorsal regions of the central nervous system. Conclusion Apc is required for multiple aspects of early cerebral cortical development, including the regulation of cell number, interkinetic nuclear migration, cell polarity, and

  13. Predictors of Colorectal Polyp Recurrence after the First Polypectomy in Private Practice Settings: A Cohort Study

    Science.gov (United States)

    Viel, Jean-François; Studer, Jean-Marie; Ottignon, Yves; Hirsch, Jean-Pierre

    2012-01-01

    Background Supplementary observational data in the community setting are required to better assess the predictors of colorectal polyp recurrence and the effectiveness of colonoscopy surveillance under real circumstances. Aim The goal of this study was to identify patient characteristics and polyp features at baseline colonoscopy that are associated with the recurrence of colorectal polyps (including hyperplastic polyps) among patients consulting private practice physicians. Patients and Methods This cohort study was conducted from March 2004 to December 2010 in 26 private gastroenterology practices (France). It included 1023 patients with a first-time diagnosis of histologically confirmed polyp removed during a diagnostic or screening colonoscopy. At enrollment, interviews were conducted to obtain data on socio-demographic variables and risk factors. Pathology reports were reviewed to abstract data on polyp features at baseline colonoscopy. Colorectal polyps diagnosed at the surveillance colonoscopy were considered as end points. The time to event was analyzed with an accelerated failure time model assuming a Weibull distribution. Results Among the 1023 patients with colorectal polyp at baseline, 553 underwent a surveillance colonoscopy. The mean time interval from baseline colonoscopy to first surveillance examination was 3.42 (standard deviation, 1.45) years. The recurrence rates were 50.5% and 32.9% for all polyps and adenomas, respectively. In multivariate models, the number of polyps at baseline was the only significant predictor for both polyp recurrence (hazard ratio [HR] 1.19, 95% CI 1.06 to 1.33), and adenoma recurrence (HR 1.17, 95% CI 1.03 to 1.34). Conclusion The efficacy of surveillance colonoscopy in community gastroenterology practice compared favorably with academic settings. This study provides further evidence that the number of initial colorectal polyps is useful for predicting the risk of polyp recurrence, even in the community setting. PMID

  14. 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.

  15. Korean Guidelines for Colorectal Cancer Screening and Polyp Detection

    International Nuclear Information System (INIS)

    Lee, Bo In; Hong, Sung Pil; Kim, Seong Eun

    2012-01-01

    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.

  16. Management and diagnosis of gallbladder polyps: a systematic review.

    Science.gov (United States)

    Babu, Benoy I; Dennison, Ashley R; Garcea, Giuseppe

    2015-05-01

    Recommendation for management of gallbladder polyps (GBPs) >1 cm is cholecystectomy. No consensus exists on management of GBPs extraction was used to retrieve specified end points. Literature search yielded 43 manuscripts with a dataset of 11,685 patients with GBPs. M:F ratio was 1.3:1. Average age (range) was 49 years (32-83). Patients with malignant GBPs had an average (range) age of 58 (50-66) years with M:F ratio of 0.78:1. Cholesterol polyps constituted 60.5% of GBPs followed by adenomas (15.2%) and cancer (11.6%). Malignant GBPs ≥1 cm, 1 cm is appropriate. For GBPs 10 mm.

  17. 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.)

  18. 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.)

  19. Telomerase activity and telomere length in the colorectal polyp-carcinoma sequence Actividad de la telomerasa y longitud del telómero en la secuencia pólipo-carcinoma colorrectal

    Directory of Open Access Journals (Sweden)

    C. Valls Bautista

    2009-03-01

    Full Text Available Objective: the role of telomerase activity and telomere length in the adenoma-carcinoma sequence of colon carcinogenesis has not been well established. The objective of this study was to determine telomerase activity and telomere length patterns in patients with adenomatous polyps either associated or not with colorectal cancer, as well as the role of telomeric instability in the adenoma-carcinoma sequence. Patients and methods: we included in the study 14 patients who underwent surgery for colorectal cancer and/or polyps. In 6 of these patients fresh samples of tumor tissue, polyps, and normal mucosa were obtained; in the 8 remaining cases, we collected only polyps and normal mucosa. We used the fluorescent-telomeric repeat amplification protocol assay (TRAP-F to determine telomerase activity and telomere length using Southern-blot testing. Results: telomerase activity was detected in 86% of polyps and 50% of associated normal mucosa. Mean telomerase activity in polyp tissue was 5.85; in the normal mucosa it was 0.58 TPG. Mean telomere length was 6.78 Kbp and 7.78, respectively. Polyps in patients without synchronous cancer had a telomerase activity that was significantly higher (9.4 than in those with cancer (1.1. Conclusions: telomerase activity increases in the colorectal adenoma-carcinoma sequence, concurrently with a decrease in telomere length. The presence of synchronous cancer modifies telomerase activity in polyps.Objetivo: el papel de la actividad de la telomerasa y la longitud del telómero en la secuencia adenoma-carcinoma de la carcinogénesis colónica no ha sido bien establecido. El objetivo fue determinar el comportamiento de la actividad de la telomerasa y la longitud del telómero en pacientes con pólipos adenomatosos asociados o no a cáncer colorrectal y conocer el papel de la inestabilidad telomérica en la secuencia adenoma-carcinoma. Pacientes y métodos: se estudiaron 14 pacientes intervenidos de cáncer colorrectal y

  20. A Rare Presentation of Odontogenic Keratocyst Mimicking an Antral Polyp

    Directory of Open Access Journals (Sweden)

    S Sudhakar

    2014-02-01

    Full Text Available Maxillary sinus harbours many pathological lesions. Many of those presents as a sinonasal mass and are rarely symptomatic. These masses are usually an antral polyp, mucoceles or mucous retention cysts. Odontogenic keratocyst, a benign odontogenic lesion presenting within the maxillary sinus is a rare entity. We present a case of odontogenic keratocyst of the maxillary sinus in a 35 years old female.

  1. 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...

  2. Biochemical and immunohistochemical estrogen and progesterone receptors in adenomatous hyperplasia and endometrial carcinoma: correlations with stage and other clinicopathologic features

    DEFF Research Database (Denmark)

    Nyholm, H C; Nielsen, A L; Lyndrup, J

    1992-01-01

    OBJECTIVE: This study investigates clinicopathologic associations of estrogen and progesterone receptor content in endometrial carcinoma. STUDY DESIGN: One hundred fifty-two patients with endometrial cancer and 12 with adenomatous hyperplasia were included. Dextran-coated charcoal receptor assay...... receptor dextran-coated charcoal values and immunohistochemical histologic scores correlated inversely (p dextran-coated charcoal values was independent...

  3. 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.

  4. Clinical Significance of Colonoscopy in Patients with Upper Gastrointestinal Polyps and Neoplasms: A Meta-Analysis

    Science.gov (United States)

    Wu, Zhen-Jie; Lin, Yuan; Xiao, Jun; Wu, Liu-Cheng; Liu, Jun-Gang

    2014-01-01

    Background Some authors have studied the relationship between the presence of polyps, adenomas and cancers of upper gastrointestinal tract (stomach and duodenum) and risk of colorectal polyps and neoplasms; however, the results are controversial, which may be due to study sample size, populations, design, clinical features, and so on. No meta-analysis, which can be generalized to a larger population and could provide a quantitative pooled risk estimate of the relationship, of this issue existed so far. Methods We performed a meta-analysis to evaluate risk of colorectal polyps or neoplasms in patients with polyps, adenomas or cancers in upper gastrointestinal tract comparing with controls. A search was conducted through PubMed, EMBASE, reference lists of potentially relevant papers, and practice guidelines up to 27 November 2013 without languages restriction. Odd ratios (ORs) were pooled using random-effects models. Results The search yielded 3 prospective and 21 retrospective case-control studies (n = 37152 participants). The principal findings included: (1) OR for colorectal polyps was 1.15 (95% CI, 1.04–1.26) in the gastric polyps group comparing with control groups; (2) Patients with gastric polyps and neoplasms have higher risk (OR, 1.31 [95% CI, 1.06–1.62], and 1.72 [95% CI, 1.42–2.09], respectively) of colorectal neoplasms comparing with their controls; and (3) Positive association was found between the presence of colorectal neoplasms and sporadic duodenal neoplasms (OR, 2.59; 95% CI, 1.64–4.11). Conclusions Findings from present meta-analysis of 24 case-control studies suggest that the prevalence of colorectal polyps was higher in patients with gastric polyps than in those without gastric polyps, and the risk of colorectal neoplasms increases significantly in patients with gastric polyps, neoplasms, and duodenal neoplasms. Therefore, screening colonoscopy should be considered for patients with upper gastrointestinal polyps and neoplasms. PMID

  5. 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.

  6. Male and female stem cells and sex reversal in Hydra polyps

    OpenAIRE

    Bosch, Thomas C. G.; David, Charles N.

    1986-01-01

    Single interstitial stem cells of male polyps of Hydra magnipapillata give rise to clones that differentiate either male or female gametes. To test the sexual stability of these clones, stem cells were recloned. The results indicate that stem cells from female clones are stable in their sexual differentiation capacity; male stem cells, by comparison, switch sexual phenotype at the rate of 10-2 per cell per generation. As a result, female polyps contain only female stem cells; male polyps cont...

  7. 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.

  8. Diagnostic Performance of CT Colonography for the Detection of Colorectal Polyps

    International Nuclear Information System (INIS)

    Yun, Ji Young; Ro, Hee Jeong; Choi, Jung Bin; Chung, Ji Eun; Kim, Yong Jin; Suh, Won Hyuck; Lee, Jong Kyun; Park, Jong Beom

    2007-01-01

    To investigate the diagnostic value of CT colonography for the detection of colorectal polyps. From December 2004 to December 2005, 399 patients underwent CT colonography and follow-up conventional colonoscopy. We excluded cases of advanced colorectal cancer. We retrospectively analyzed the CT colonography findings and follow-up conventional colonoscopy findings of 113 patients who had polyps more than 6 mm in diameter. Radiologists using 3D and 2D computer generated displays interpreted the CT colonography images. The colonoscopists were aware of the CT colonography findings before the procedure. CT colonography detected 132 polyps in 107 of the 113 patients and conventional colonoscopy detected 114 colorectal polyps more than 6 mm in diameter in 87 of the 113 patients. The sensitivity of CT colonography analyzed per polyp was 91% (41/45) for polyps more than 10 mm in diameter and 89% (101/114) for polyps more than 6 mm in diameter. Thirteen polyps were missed by CT colonography and were detected on follow-up conventional colonoscopy. CT colonography is a sensitive diagnostic tool for the detection of colorectal polyps and adequate bowel preparation, optimal bowel distention and clinical experience are needed to reduce the rate of missing appropriate lesions

  9. 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.

  10. Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features

    International Nuclear Information System (INIS)

    Kawakami, S.; Takashima, S.; Li, F.; Yang, Z.G.; Maruyama, Y.; Hasegawa, M.; Wang, J.C.; Sone, S.; Honda, T.

    2001-01-01

    We describe herein the CT features of atypical adenomatous hyperplasia (AAH) of the lung and its histopathological characteristics. Among 17,919 individuals screened for lung cancer by CT scanning, ten AAH nodules were detected in nine asymptomatic subjects. On high-resolution CT, the lesions measured from 6 x 6 mm to 15 x 17 mm and their CT number ranged from -500 to -760 HU. The AAHs appeared as round nodules with smooth and distinct borders and showed a ground-glass opacity. Plain chest radiographs failed to identify all lesions. Histopathologically, AAH lesions showed atypical epithelial cell proliferation along slightly thickened alveolar septa. Whereas it is often easy to differentiate these nodules from inflammatory and benign lung lesions, histopathological examination remains at present the only method to differentiate AAH from lung cancers. (orig.)

  11. Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features

    Energy Technology Data Exchange (ETDEWEB)

    Kawakami, S.; Takashima, S.; Li, F.; Yang, Z.G.; Maruyama, Y.; Hasegawa, M.; Wang, J.C. [Dept. of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Sone, S. [Dept. of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Azumi General Hospital, Ikeda, Nagano (Japan); Honda, T. [Dept. of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto (Japan)

    2001-05-01

    We describe herein the CT features of atypical adenomatous hyperplasia (AAH) of the lung and its histopathological characteristics. Among 17,919 individuals screened for lung cancer by CT scanning, ten AAH nodules were detected in nine asymptomatic subjects. On high-resolution CT, the lesions measured from 6 x 6 mm to 15 x 17 mm and their CT number ranged from -500 to -760 HU. The AAHs appeared as round nodules with smooth and distinct borders and showed a ground-glass opacity. Plain chest radiographs failed to identify all lesions. Histopathologically, AAH lesions showed atypical epithelial cell proliferation along slightly thickened alveolar septa. Whereas it is often easy to differentiate these nodules from inflammatory and benign lung lesions, histopathological examination remains at present the only method to differentiate AAH from lung cancers. (orig.)

  12. A metabolic switch controls intestinal differentiation downstream of Adenomatous polyposis coli (APC).

    Science.gov (United States)

    Sandoval, Imelda T; Delacruz, Richard Glenn C; Miller, Braden N; Hill, Shauna; Olson, Kristofor A; Gabriel, Ana E; Boyd, Kevin; Satterfield, Christeena; Remmen, Holly Van; Rutter, Jared; Jones, David A

    2017-04-11

    Elucidating signaling pathways that regulate cellular metabolism is essential for a better understanding of normal development and tumorigenesis. Recent studies have shown that mitochondrial pyruvate carrier 1 (MPC1) , a crucial player in pyruvate metabolism, is downregulated in colon adenocarcinomas. Utilizing zebrafish to examine the genetic relationship between MPC1 and Adenomatous polyposis coli (APC), a key tumor suppressor in colorectal cancer, we found that apc controls the levels of mpc1 and that knock down of mpc1 recapitulates phenotypes of impaired apc function including failed intestinal differentiation. Exogenous human MPC1 RNA rescued failed intestinal differentiation in zebrafish models of apc deficiency. Our data demonstrate a novel role for apc in pyruvate metabolism and that pyruvate metabolism dictates intestinal cell fate and differentiation decisions downstream of apc .

  13. 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.

  14. The Assessment of the Colo-rectal Polyps in Order to the New Diagnostic and Therapeutic Strategies

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    Raluca Diac Andreea

    2015-09-01

    Full Text Available Objective. Assessment of the histological and endoscopic features of the colo-rectal polyps is requered for the application of the new diagnostic and therapeutical strategies in the managment of the diminutive polyps.

  15. 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

  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. Modelling coral polyp calcification in relation to ocean acidification

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    S. Hohn

    2012-11-01

    Full Text Available Rising atmospheric CO2 concentrations due to anthropogenic emissions induce changes in the carbonate chemistry of the oceans and, ultimately, a drop in ocean pH. This acidification process can harm calcifying organisms like coccolithophores, molluscs, echinoderms, and corals. It is expected that ocean acidification in combination with other anthropogenic stressors will cause a severe decline in coral abundance by the end of this century, with associated disastrous effects on reef ecosystems. Despite the growing importance of the topic, little progress has been made with respect to modelling the impact of acidification on coral calcification. Here we present a model for a coral polyp that simulates the carbonate system in four different compartments: the seawater, the polyp tissue, the coelenteron, and the calcifying fluid. Precipitation of calcium carbonate takes place in the metabolically controlled calcifying fluid beneath the polyp tissue. The model is adjusted to a state of activity as observed by direct microsensor measurements in the calcifying fluid. We find that a transport mechanism for bicarbonate is required to supplement carbon into the calcifying fluid because CO2 diffusion alone is not sufficient to sustain the observed calcification rates. Simulated CO2 perturbation experiments reveal decreasing calcification rates under elevated pCO2 despite the strong metabolic control of the calcifying fluid. Diffusion of CO2 through the tissue into the calcifying fluid increases with increasing seawater pCO2, leading to decreased aragonite saturation in the calcifying fluid. Our modelling study provides important insights into the complexity of the calcification process at the organism level and helps to quantify the effect of ocean acidification on corals.

  18. 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

    OBJECTIVE: A subgroup of patients with hamartomatous polyps in the GI tract has a hereditary Hamartomatous Polyposis Syndrome with an increased risk of cancer. The distinction between patients with one or few polyps and patients with a syndrome can be difficult. A pathogenic germline mutation can...... significance of genetic variants can be difficult to interpret. A family history of polyps, cancer, or extraintestinal findings or a minimum of 3-5 polyps seems to be relevant information to include before genetic testing....

  19. 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

  20. 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.

  1. Effects of Surgery on the Phonation Threshold Pressure in Patients With Vocal Fold Polyps

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    Tyng-Guey Wang

    2010-01-01

    Conclusion: Laryngomicrosurgery can lower PTP in patients with vocal fold polyps and improve the ease of phonation. PTP is one of the objective measurements for assessing the effects of surgery in patients with vocal fold polyps. Use of an accelerometer to detect vocal fold vibration improved the measurement of PTP.

  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. 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.

  4. Thermal coagulation-induced changes of the optical properties of normal and adenomatous human colon tissues in vitro in the spectral range 400-1100 nm

    International Nuclear Information System (INIS)

    Ao Huilan; Xing Da; Wei Huajiang; Gu Huaimin; Wu Guoyong; Lu Jianjun

    2008-01-01

    The absorption coefficients, the reduced scattering coefficients and the optical penetration depths for native and coagulated human normal and adenomatous colon tissues in vitro were determined over the range of 400-1100 nm using a spectrophotometer with an internal integrating sphere system, and the inverse adding-doubling method was applied to calculate the tissue optical properties from diffuse reflectance and total transmittance measurements. The experimental results showed that in the range of 400-1100 nm there were larger absorption coefficients (P < 0.01) and smaller reduced scattering coefficients (P < 0.01) for adenomatous colon tissues than for normal colon tissues, and there were smaller optical penetration depths for adenomatous colon tissues than for normal colon tissues, especially in the near-infrared wavelength. Thermal coagulation induced significant increase of the absorption coefficients and reduced scattering coefficients for the normal and adenomatous colon tissues, and significantly reduced decrease of the optical penetration depths for the normal and adenomatous colon tissues. The smaller optical penetration depth for coagulated adenomatous colon tissues is a disadvantage for laser-induced thermotherapy (LITT) and photodynamic therapy (PDT). It is necessary to adjust the application parameters of lasers to achieve optimal therapy

  5. Detection of helicobacter pylori in nasal polyps using rapid urease test and ELISA

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    Masood Kaviani

    2009-01-01

    Full Text Available Introduction: Nasal polyposis is an inflammatory condition of unknown etiology. Recently concerns regarding gastroesophageal reflux or helicobacter pylori as a possible pathologic cause of nasal polyps have been increasing. The present study was planned to investigate the presence of helicobacter pylori in nasal polyps. Materials and Methods: This case-control study was undertaken enrolling 37 patients with nasal polyps who had undergone nasal endoscopic sinus surgery and 38 control subjects. Biopsy specimens of nasal polyps and inferior turbinates were assessed by rapid urease test. Blood samples of both study and control subjects were evaluated for anti H.pylori IgG by ELISA. H. pylori status was regarded positive, if both tests were positive. Results: Seropositivity was more common in the patients with nasal polyps (66.2% than control subjects (36.8% (P

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

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    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.

  7. Low-level APC mutational mosaicism is the underlying cause in a substantial fraction of unexplained colorectal adenomatous polyposis cases.

    Science.gov (United States)

    Spier, Isabel; Drichel, Dmitriy; Kerick, Martin; Kirfel, Jutta; Horpaopan, Sukanya; Laner, Andreas; Holzapfel, Stefanie; Peters, Sophia; Adam, Ronja; Zhao, Bixiao; Becker, Tim; Lifton, Richard P; Perner, Sven; Hoffmann, Per; Kristiansen, Glen; Timmermann, Bernd; Nöthen, Markus M; Holinski-Feder, Elke; Schweiger, Michal R; Aretz, Stefan

    2016-03-01

    In 30-50% of patients with colorectal adenomatous polyposis, no germline mutation in the known genes APC, causing familial adenomatous polyposis, MUTYH, causing MUTYH-associated polyposis, or POLE or POLD1, causing polymerase-proofreading-associated polyposis can be identified, although a hereditary aetiology is likely. This study aimed to explore the impact of APC mutational mosaicism in unexplained polyposis. To comprehensively screen for somatic low-level APC mosaicism, high-coverage next-generation sequencing of the APC gene was performed using DNA from leucocytes and a total of 53 colorectal tumours from 20 unrelated patients with unexplained sporadic adenomatous polyposis. APC mosaicism was assumed if the same loss-of-function APC mutation was present in ≥ 2 anatomically separated colorectal adenomas/carcinomas per patient. All mutations were validated using diverse methods. In 25% (5/20) of patients, somatic mosaicism of a pathogenic APC mutation was identified as underlying cause of the disease. In 2/5 cases, the mosaic level in leucocyte DNA was slightly below the sensitivity threshold of Sanger sequencing; while in 3/5 cases, the allelic fraction was either very low (0.1-1%) or no mutations were detectable. The majority of mosaic mutations were located outside the somatic mutation cluster region of the gene. The present data indicate a high prevalence of pathogenic mosaic APC mutations below the detection thresholds of routine diagnostics in adenomatous polyposis, even if high-coverage sequencing of leucocyte DNA alone is taken into account. This has important implications for both routine work-up and strategies to identify new causative genes in this patient group. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. 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.

  9. Aspirin augments the expression of Adenomatous Polyposis Coli protein by suppression of IKKβ

    International Nuclear Information System (INIS)

    Ashida, Noboru; Kishihata, Masako; Tien, Dat Nguyen; Kamei, Kaeko; Kimura, Takeshi; Yokode, Masayuki

    2014-01-01

    Highlights: • Clinical studies revealed aspirin inhibits cancer, but the mechanism is not known. • Adenomatous Polyposis Coli (APC) is a well-known tumor-suppressing gene. • We found aspirin up-regulates the protein of APC. • Aspirin suppressed the expression of IKKβ, an essential kinase in NFκB activation. • The deletion of IKKβ significantly increases the expression of APC protein. - Abstract: Aspirin has been widely used as analgesic, antipyretic and anti-inflammatory medicine for long. In addition to these traditional effects, clinical studies suggest that aspirin can protect against cancer, but its mechanism has not been explored. To unveil it, we identified the proteins up- or down-regulated after incubation with aspirin by using proteomics analysis with Nano-flow LC/MALDI-TOF system. Interestingly, the analysis identified the protein of Adenomatous Polyposis Coli (APC) as one of the most up-regulated protein. APC regulates cell proliferation or angiogenesis, and is widely known as a tumor-suppressing gene which can cause colorectal cancer when it is mutated. Western blots confirmed this result, and real-time PCR indicated it is transcriptionally regulated. We further tried to elucidate the molecular mechanism with focusing on IKKβ. IKKβ is the essential kinase in activation of nuclear factor-kappa B (NF-κB), major transcriptional factors that regulate genes responsible for inflammation or immune response. Previous reports indicated that aspirin specifically inhibits IKKβ activity, and constitutively active form of IKKβ accelerates APC loss. We found that aspirin suppressed the expression of IKKβ, and the deletion of IKKβ by siRNA increases the expression of APC in HEK294 cells. Finally, we observed similar effects of aspirin in human umbilical vein endothelial cells. Taken together, these results reveal that aspirin up-regulates the expression of APC via the suppression of IKKβ. This can be a mechanism how aspirin prevents cancer at

  10. Aspirin augments the expression of Adenomatous Polyposis Coli protein by suppression of IKKβ

    Energy Technology Data Exchange (ETDEWEB)

    Ashida, Noboru, E-mail: nashida@kuhp.kyoto-u.ac.jp [Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science, Faculty of Medicine, Kyoto University, Kyoto (Japan); Kishihata, Masako [Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science, Faculty of Medicine, Kyoto University, Kyoto (Japan); Tien, Dat Nguyen [Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science, Faculty of Medicine, Kyoto University, Kyoto (Japan); Department of Biomolecular Engineering, Kyoto Institute of Technology, Kyoto (Japan); Kamei, Kaeko [Department of Biomolecular Engineering, Kyoto Institute of Technology, Kyoto (Japan); Kimura, Takeshi [Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Yokode, Masayuki [Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science, Faculty of Medicine, Kyoto University, Kyoto (Japan)

    2014-04-04

    Highlights: • Clinical studies revealed aspirin inhibits cancer, but the mechanism is not known. • Adenomatous Polyposis Coli (APC) is a well-known tumor-suppressing gene. • We found aspirin up-regulates the protein of APC. • Aspirin suppressed the expression of IKKβ, an essential kinase in NFκB activation. • The deletion of IKKβ significantly increases the expression of APC protein. - Abstract: Aspirin has been widely used as analgesic, antipyretic and anti-inflammatory medicine for long. In addition to these traditional effects, clinical studies suggest that aspirin can protect against cancer, but its mechanism has not been explored. To unveil it, we identified the proteins up- or down-regulated after incubation with aspirin by using proteomics analysis with Nano-flow LC/MALDI-TOF system. Interestingly, the analysis identified the protein of Adenomatous Polyposis Coli (APC) as one of the most up-regulated protein. APC regulates cell proliferation or angiogenesis, and is widely known as a tumor-suppressing gene which can cause colorectal cancer when it is mutated. Western blots confirmed this result, and real-time PCR indicated it is transcriptionally regulated. We further tried to elucidate the molecular mechanism with focusing on IKKβ. IKKβ is the essential kinase in activation of nuclear factor-kappa B (NF-κB), major transcriptional factors that regulate genes responsible for inflammation or immune response. Previous reports indicated that aspirin specifically inhibits IKKβ activity, and constitutively active form of IKKβ accelerates APC loss. We found that aspirin suppressed the expression of IKKβ, and the deletion of IKKβ by siRNA increases the expression of APC in HEK294 cells. Finally, we observed similar effects of aspirin in human umbilical vein endothelial cells. Taken together, these results reveal that aspirin up-regulates the expression of APC via the suppression of IKKβ. This can be a mechanism how aspirin prevents cancer at

  11. Genomic Landscape of Atypical Adenomatous Hyperplasia Reveals Divergent Modes to Lung Adenocarcinoma.

    Science.gov (United States)

    Sivakumar, Smruthy; Lucas, F Anthony San; McDowell, Tina L; Lang, Wenhua; Xu, Li; Fujimoto, Junya; Zhang, Jianjun; Futreal, P Andrew; Fukuoka, Junya; Yatabe, Yasushi; Dubinett, Steven M; Spira, Avrum E; Fowler, Jerry; Hawk, Ernest T; Wistuba, Ignacio I; Scheet, Paul; Kadara, Humam

    2017-11-15

    There is a dearth of knowledge about the pathogenesis of premalignant lung lesions, especially for atypical adenomatous hyperplasia (AAH), the only known precursor for the major lung cancer subtype adenocarcinoma (LUAD). In this study, we performed deep DNA and RNA sequencing analyses of a set of AAH, LUAD, and normal tissues. Somatic BRAF variants were found in AAHs from 5 of 22 (23%) patients, 4 of 5 of whom had matched LUAD with driver EGFR mutations. KRAS mutations were present in AAHs from 4 of 22 (18%) of patients. KRAS mutations in AAH were only found in ever-smokers and were exclusive to BRAF -mutant cases. Integrative analysis revealed profiles expressed in KRAS -mutant cases ( UBE2C, REL ) and BRAF -mutant cases ( MAX ) of AAH, or common to both sets of cases (suppressed AXL ). Gene sets associated with suppressed antitumor (Th1; IL12A, GZMB ) and elevated protumor ( CCR2, CTLA-4 ) immune signaling were enriched in AAH development and progression. Our results reveal potentially divergent BRAF or KRAS pathways in AAH as well as immune dysregulation in the pathogenesis of this premalignant lung lesion. Cancer Res; 77(22); 6119-30. ©2017 AACR . ©2017 American Association for Cancer Research.

  12. Two Metachronous Neoplasms in the Radiotherapy Fields of a Young Man With Familial Adenomatous Polyposis

    Directory of Open Access Journals (Sweden)

    Patrick A. Williams BS

    2013-04-01

    Full Text Available Background: It is recognized that various radiation-induced malignancies often follow childhood radiotherapy. Radiation-induced neoplasms have been shown to occur with increased frequency in syndromes due to mutated tumor suppressor genes. There exist no recommendations for the management of cancer patients with germline APC gene mutations. Preclinical data suggest that APC gene mutations cause enhanced radiosensitivity, but no clinical observations exist that show that patients with this mutation are at higher risk for radiation-induced malignancies. Results: We report the case of a 32-year-old man with a genetic diagnosis of familial adenomatous polyposis (FAP who initially presented at age 10 with a medulloblastoma treated with radiotherapy and surgery. Radiation-induced papillary thyroid carcinoma followed 13 years later. Finally, radiation-induced soft tissue osteosarcoma occurred with widespread metastasis 20 years thereafter. Conclusions: This is the first report of 2 malignancies in the prior radiotherapy fields of a patient with a genetic diagnosis of FAP. More important, this suggests that APC-defective cells are at an enhanced sensitivity to the carcinogenic effects of radiotherapy compared with APC-proficient cells. This could argue for genetic screening in affected members of these families and for creation of treatment recommendations to more seriously consider the risks of radiation therapy.

  13. Clinical and genetic characterization of classical forms of familial adenomatous polyposis: a Spanish population study.

    Science.gov (United States)

    Rivera, B; González, S; Sánchez-Tomé, E; Blanco, I; Mercadillo, F; Letón, R; Benítez, J; Robledo, M; Capellá, G; Urioste, M

    2011-04-01

    Classical familial adenomatous polyposis (FAP) is characterized by the appearance of >100 colorectal adenomas. We screened the APC and MUTYH genes for mutations and evaluated the genotype-phenotype correlation in 136 Spanish classical FAP families. APC/MUTYH mutations were detected in 107 families. Sixty-four distinct APC point mutations were detected in 95 families of which all were truncating mutations. A significant proportion (39.6%) had not been previously reported. Mutations were spread over the entire coding region and great rearrangements were identified in six families. Another six families exhibited biallelic MUTYH mutations. No APC or MUTYH mutations were detected in 29 families. These APC/MUTYH-negative families showed clinical differences with the APC-positive families. A poor correlation between phenotype and mutation site was observed. Our results highlight that a broad approach in the genetic study must be considered for classical FAP due to involvement of both APC and MUTYH and the heterogeneous spectrum of APC mutations observed in this Spanish population. The scarcely consistent genotype-phenotype correlation does not allow making specific recommendations regarding screening and management. Differences observed in APC/MUTYH-negative families may reflect a genetic basis other than mutations in APC and MUTYH genes for FAP predisposition. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

  14. 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.

  15. Endoscopic mucosal resection for middle and large colorectal polyps with a double-loop snare.

    Science.gov (United States)

    Yoshida, Naohisa; Saito, Yutaka; Hirose, Ryohei; Ogiso, Kiyoshi; Inada, Yutaka; Yagi, Nobuaki; Naito, Yuji; Otake, Yosuke; Nakajima, Takeshi; Matsuda, Takahisa; Yanagisawa, Akio; Itoh, Yoshito

    2014-01-01

    This study aimed to analyze the endoscopic mucosal resection (EMR) with a novel uniquely shaped, double-loop snare (Dualoop, Medico's Hirata Inc., Tokyo, Japan) for colorectal polyps. This was a clinical trial conducted in two referral centers, Kyoto Prefectural University of Medicine and National Cancer Center Hospital in Japan. First, the firmness of various snares including 'Dualoop' was experimentally analyzed with a pressure gauge. Five hundred and eighty nine consecutive polyps that underwent EMR with 'Dualoop' were compared to 339 polyps with the standard round snare. Lesion characteristics, en bloc resection, and complications were analyzed. 'Dualoop' had the most firmness among the various snares. The average tumor size was 9.3 mm (5-30), and en bloc resection was achieved in 95.4%. The rate of en bloc resection for middle polyps 15-19 mm in diameter was significantly higher with the 'Dualoop' than that with the round snare (97.9 vs. 80.0%, p < 0.05). The rate of en bloc resection was 64.7% for large polyps ≥20 mm in diameter using 'Dualoop'. Higher age, larger tumor size, and superficial polyps were associated with the failure of en bloc resection. EMR with 'Dualoop' was effective for resecting both middle and large polyps en-bloc. © 2014 S. Karger AG, Basel.

  16. [Colonic polyps diagnosis by conventional video colonoscopes and chromoscopy with indigo carmine dye solution].

    Science.gov (United States)

    Nakao, Frank Shigueo; Araújo, Isabella Saraiva; Ornellas, Laura Cotta; Cury, Marcelo de Sousa; Ferrari, Angelo Paulo

    2002-01-01

    Magnification colonoscopy and contrast chromoscopy with indigo carmine dye solution have been used to differentiate neoplastic polyps (adenomas and adenocarcinomas) from non-neoplastic (hyperplastic, inflammatory, juvenile) in an attempt to obviate endoscopic polypectomy. On the other hand, little published information exists concerning conventional video colonoscopes and chromoscopy for polyp histology prediction. Aim - To assess usefullness of conventional video colonoscopes and contrast chromoscopy with indigo carmine solution for differential diagnosis of colon polyps. In a routine colonoscopy series, we performed chromoscopy with conventional video colonoscopes before endoscopic excision of detected polyps. If a sulcus pattern was observed on the surface of the lesion, it was classified as neoplastic. Polyps were classified as non-neoplastic if no sulcus was detected on its surface. These observations were then compared with histology. In the study period (18 months), we detected 133 polyps in 53 patients. We were able to compare results of histology and chromoscopy in 126 lesions. The sensitivity, specificity, diagnostic accuracy, negative predictive value, and positive predictive value were 56,4%, 79,2%, 65,1%, 52,8%, and 81,5%, respectively. On the base of the presented data, we concluded that conventional video colonoscopes and contrast chromoscopy with indigo carmine solution is not a good technique for differential diagnosis of colon polyps.

  17. Association between Laryngeal Pepsin Levels and the Presence of Vocal Fold Polyps.

    Science.gov (United States)

    Wang, Lu; Tan, Jia-Jie; Wu, Ting; Zhang, Rui; Wu, Jia-Nuan; Zeng, Fang-Fang; Liu, You-Li; Han, Xiao-Yan; Li, Yan-Fei; Li, Xiang-Ping

    2017-01-01

    Objective To determine whether pepsin, the main component of refluxed gastric contents, is significantly associated with vocal fold polyps and to evaluate the diagnostic value of pepsin in vocal fold polyps' tissues. Study Design Cross-sectional study. Setting Nanfang Hospital of Southern Medical University. Subjects and Methods The study included 32 patients with vocal fold polyps and 16 healthy controls between 2011 and 2012. Reflux symptom index and reflux finding score assessments, 24-hour combined multichannel intraluminal impedance and pH monitoring, and biopsy of the vocal fold polyp tissues or posterior laryngeal mucosa (healthy controls) for immunohistochemical pepsin staining were performed. Results The expression of pepsin was significantly higher in patients with vocal fold polyps than in controls (28/32, 75% vs 5/16, 31.25%; P vocal fold polyps formation. In addition, pepsin immunohistochemical analysis of polyp biopsy samples appears to be a more sensitive and effective test for diagnosing laryngopharyngeal reflux than the reflux symptom index, the reflux finding score, and 24-hour pH monitoring in a clinical setting.

  18. 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)

  19. 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 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].

  20. Increased Prevalence of Colorectal Polyp in Acromegaly Patients: A Case-Control Study

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    Ali Riza Koksal

    2014-01-01

    Full Text Available An increase in the prevalence of colorectal polyps and cancer is reported in patients with acromegaly. This trial is designed to determine whether there is an increase in the prevalence of colorectal polyps/cancer in Turkish acromegaly patients. Sixty-six patients, who were under follow-up with the diagnosis of acromegaly and underwent total colonoscopic examination, were enrolled in the study. Sixty-five age- and gender-matched patients with nonspecific complaints were selected as control. The mean age of acromegalic patients was 51.5±12.8 years of whom 27 (40.9% were females. In 20 (30.3% of the patients with acromegaly a total of 65 colorectal polyps were detected. Forty-seven (72.3% of the polyps were detected at the rectosigmoid region. In 8 (12.3% of the 65 control patients a total of 17 polyps were found. There was a statistically significant difference between the groups (P=0.018. At the logistic regression analysis we found that the risk for colon polyps increased 3.2-fold in the presence of acromegaly, irrespective of age and gender (OR: 3.191, 95% CI: 1.25–8.13. In conclusion, patients who were followed up with the diagnosis of acromegaly should be taken to the colonoscopic surveillance program and all polyps detected should be excised in order to protect them from colorectal cancer.

  1. 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.

  2. NASAL MUCOUS MEMBRANE MICROFLORA IN PATIENTS WITH POLYPOUS RHINOSINUSITIS

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    O. A. Kolenchukova

    2016-01-01

    Full Text Available Nasal mucous membrane microbiocenosis Research amongst patients with polypous rhinosinusitis is conducted. Patients with polypous rhinosinusitis (PRS, n = 58 aged from 18 till 64 years and group of control (n = 156. For an microflora assessment of nasal mucous membrane during an exacerbation of a disease carried out crops of microorga nisms on nutrient differential and diagnostic agars. When studying the microflora received from nasal mucous membrane 407 cultures of microorganisms at PRS were revealed. In control group of 174 microorganisms cultures are revealed. Among isolates were established 6 genera of 9 species of bacteria at PRS against 6 genera and 8 species in group of control. Microflora quantitative structure research of nasal mucous membrane at PRS of rather control group considerable prevalence of the microorganisms belonging to the sorts Staphylococcus and Streptococcus, and also to Enterobacteriaceae was revealed. It is also revealed increase S. pneumoniae. When determining specific accessory of the microorganisms relating to the Staphylococcus genera in PRS group concerning control the increase in total number of the strains of S. aureus relating to coagulase-positive and S. haemolyticus, S. epidermidis relating to coagulase-negative staphylococcus was established. A big variety the coagulase-negative of Staphylococcus is also revealed: S. epidermidis, S. haemolyticus, S. hominis, S. cohnii, S. capitis, S. hyicius and S. xylosus. In control group of such types as S. capitis and S. hyicius it isn’t revealed. Thus at a polypous rhinosinusitis nasal mucous membrane the expressed dysbacteriosis takes place. The analysis of frequency of occurrence of the microorganisms belonging to different childbirth showed that in PRS group bacteria of the sort Streptococcus and this Nesseria, and also S. pneumoniae, S. pyogenes were most often allocated concerning control. The frequency prevalence analysis of the gene ra Staphylococcus related

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

    International Nuclear Information System (INIS)

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

    2017-01-01

    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 7–8 months, 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. - Highlights: • Biofouling selectively controls in situ proliferation of scyphozoan polyps • The contribution

  4. Gastric Smooth Muscle Hamartomas Mimicking Polyps in a Dog: A Case Description and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Marian A. Taulescu

    2013-01-01

    Full Text Available This report presents a case of two smooth muscle hamartomas of the stomach in a 10-year-old male Boxer. The clinical history of the animal was of chronic vomiting, weight loss, and intermittent gastric distension, and it died because of chronic and congestive heart failure. Gross, histology, and immunohistochemistry (IHC exams were performed. On necropsy, in the pyloric region of the stomach, two closely related polypoid growths between 10 and 15 mm in diameter were identified. On the cut sections, both polyps presented white to gray color, with homogenous architecture and well-defined limits. The thickness of the submucosal layer was seen to be increased to 1 cm. No other gastric alterations were identified by the necropsy exam. Histologically, both masses growth consisted of hyperplastic glands lined by foveolar epithelium, arranged in a papillary or branching pattern, and supported by a core of well-vascularised and marked smooth muscle tissue interspersed between glands. No dysplastic cells and mitotic figures were observed in these lesions. Immunohistochemistry revealed a strong cytoplasm labelling for smooth muscle actin of the bundles around the mucosal glands. To our knowledge, this is the first report of smooth muscle hamartomas mimicking multiple gastric polyps in dogs.

  5. Hysteroscopic morcellator for removal of intrauterine polyps and myomas: a randomized controlled pilot study among residents in training.

    Science.gov (United States)

    van Dongen, Heleen; Emanuel, Mark Hans; Wolterbeek, Ron; Trimbos, J Baptist; Jansen, Frank Willem

    2008-01-01

    The purpose of this randomized controlled study was to compare conventional resectoscopy and hysteroscopic morcellation among residents in training (Canadian Task Force classification I). Sixty women with an intrauterine polyp or myoma were randomized to either hysteroscopic removal by conventional resectoscopy or hysteroscopic morcellation performed by 6 residents in training for obstetrics and gynecology (10 procedures per resident). The mean operating time for resectosocpy and morcellation was 17.0 (95% confidence interval [95% CI] 14.1-17.9, standard deviation [SD] 8.4) and 10.6 (95% CI 7.3-14.0, SD 9.5) min, respectively (p = .008). Multiple linear regression analysis showed that operating time increased significantly, for both resectoscopy and morcellator, when volume of intrauterine disorder increased. The use of the hysteroscopic morcellator reduced operating time more than 8 min in comparison to conventional resectoscopy (p learning curve was observed. In conclusion, the hysteroscopic morcellator for removal of intrauterine polyps and myomas offers a good alternative to conventional resectoscopy for residents in training.

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

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    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Gaglione, P; Koechler, C; Stanchi, L

    1974-12-01

    Polyp is an automatic device consisting of 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. The other seven pumps will inflate sequentially the other bags. The instrument is powered by rechargeable batteries and realized with C-MUS integrated circuits for a nearly negligible consumption. As it is foreseen for field operation it is waterproof.

  8. 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

  9. 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

  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

    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)

  12. The role of Phosphatidylinositol 3 kinase (PI3K and Cycloxygenase-2 (COX2 in carcinogenesis of colorectal polyps

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    Raul Alberto Anselmi Júnior

    2018-01-01

    Full Text Available Objectives: Determine immunohistochemical expression of Phosphatase and tensin homolog (PTEN, Phosphatidylinositol 3 kinase (PI3K, Cycloxygenase-2 (COX2 and one proliferation marker (Ki67 in colorectal polyps and correlate with clinical and pathological data in search of carcinogenic pathways. Methods: The reports of 297 polyps diagnosed through endoscopy were reviewed for parameters including age, gender, prior colorectal cancer, the presence of multiple polyps, and polyps’ location, appearance and size. Was conducted a microscopic morphometric computerized analysis of immunohistochemical expression using, the selected antibodies and correlated with clinical and pathological variables. Results: The tissue immunohistochemical expression was higher in right colon polyps for the proliferation marker and Phosphatidylinositol 3 kinase (p ≤ 0.0001 and 0.057 respectively. Cycloxygenase-2 and Phosphatase and tensin homolog demonstrated higher tissue immunoexpression in pedunculated polyps (p = 0.009 and 0.002 respectively. Cycloxygenase-2 exhibited higher immunoexpression in larger polyps (p = 0.005. Phosphatidylinositol 3 kinase, Cycloxygenase-2, Phosphatase and tensin homolog and the proliferation marker exhibited higher immunoexpression in high-grade dysplastic polyps (p = 0.031, 0.013, 0.044 and <0.001 respectively. Phosphatase and tensin homolog labeling was higher in polyps with high-grade dysplasia and lower in some of serrated lesions (p = 0.044. Conclusions: The greater expression of the proliferation marker and Phosphatidylinositol 3 kinase in the right colon may be related to right-sided colorectal carcinogenesis. The proliferation marker, Cycloxygenase-2 and Phosphatidylinositol 3 kinase results can be associated with progression of polyps to colorectal cancer. The higher Phosphatase and tensin homolog expression suggests its attempt to control the cell cycle. Resumo: Objetivos: Determinar a expressão imuno-histoquímica de

  13. 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...... 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...... in the follow-up period (1 patient had SSL, 4 had THP, and 2 had unspecified non-neoplastic lesions). Ten patients developed other gastrointestinal malignancies. The patient with SSL as index lesions who developed CRC harbored V600E BRAF mutation in both index lesion and the carcinoma. Sixteen percent...

  14. Attitudes toward genetic testing in childhood and reproductive decision-making for familial adenomatous polyposis.

    Science.gov (United States)

    Douma, Kirsten F L; Aaronson, Neil K; Vasen, Hans F A; Verhoef, Senno; Gundy, Chad M; Bleiker, Eveline M A

    2010-02-01

    Childhood DNA testing, prenatal diagnosis (PND) and preimplantation genetic diagnosis (PGD) are available for familial adenomatous polyposis (FAP). However, the use of PND and PGD is controversial. The purpose of this study was to investigate attitudes toward, and experiences with, childhood DNA testing, PND and PGD among members of families at high risk for FAP. In this nationwide, cross-sectional study, questionnaires were sent to individuals from families at high risk for FAP assessing attitudes toward and experiences with childhood testing, PND and PGD, as well as several sociodemographic, clinical and psychosocial variables. Of the individuals from FAP families invited to participate in the study, 525 members participated (response rate=64%). Most parents who had children who were minors (n=93) (82%) were satisfied with the DNA testing procedure. One-third of all individuals wanted DNA testing for their children before age 12. Forty percent of FAP patients indicated that the disease influenced their desire to have children. Only 15% considered termination of pregnancy for FAP acceptable. Approximately 30% of individuals with a FAP diagnosis and their partners considered PND and PGD as acceptable for themselves. A positive attitude was associated with higher levels of guilt and a positive attitude toward termination of pregnancy. Importantly, of those with FAP at childbearing age, 84% had had no previous information at all about either PND or PGD. Future efforts should be aimed at educating FAP family members about reproductive options, allowing them to make an informed choice about family planning. Routine discussion of all reproductive options with a medical specialist should be encouraged.

  15. A typical adenomatous hyperplasia of the lung: correlation of radiographic and pathologic findings

    International Nuclear Information System (INIS)

    Wang Jianwei; Ma Xiaohong; Wu Ning; Zhang Hongtu

    2007-01-01

    Objective: To study radiographic features of atypical adenomatous hyperplasia (AAH) of lung and correlate them with their pathologic findings, so as to improve the imaging diagnose. Methods: The imaging features of 8 patients with pathology- proved AAH were reviewed. All patients were women with age ranging from 35 to 74 years. All cases had chest radiography and HRCT. The radiographic findings were studied retrospectively and correlated with those of pat hology. Results: On chest X-ray, the foci in five patients presented as nodule-like area of a bit high attenuation, while the chest radiograph in the other three patients were negative. On HRCT, all 8 patients presented as non-solid nodules. All lesions were round or oval shaped with well-defined margin (n=4) or poor-defined margin (n=3). The greatest dimension of the lesions ranged from 5.0 mm to 20.0 mm. Their CT value ranged from -362.7 HU to -485.6 HU, the mean CT value was (-423.0 ± 47.0) HU. Air bronchograms and/or bubbles were seen in 5 lesions. Coarse spiculation and pleural tag was not seen in any lesion. Before operation, all the nodules did not change in size over a follow-up period from one month to six months. Pathologic findings showed atypical epithelial cell proliferation along thickened alveolar septa without alveolar collapse. Conclusion: AAH should be considered in cases with the following features: (1) nodules ate found in lung cancer screening or incidentally detected; (2) the diameter of the nodule is usually less than 10 mm; (3) the lesion presented as non-solid nodule on HRCT, air bronchogram and/or bubble sign can be seen; (4) no coarse spiculation and plural tag was seen. (authors)

  16. Polyp Morphology: An Interobserver Evaluation for the Paris Classification Among International Experts

    NARCIS (Netherlands)

    van Doorn, Sascha C.; Hazewinkel, Y.; East, James E.; van Leerdam, Monique E.; Rastogi, Amit; Pellisé, Maria; Sanduleanu-Dascalescu, Silvia; Bastiaansen, Barbara A. J.; Fockens, Paul; Dekker, Evelien

    2015-01-01

    OBJECTIVES: The Paris classification is an international classification system for describing polyp morphology. Thus far, the validity and reproducibility of this classification have not been assessed. We aimed to determine the interobserver agreement for the Paris classification among seven Western

  17. 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

  18. 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.

  19. Prevalence of advanced adenomas in small and diminutive colon polyps using direct measurement of size.

    Science.gov (United States)

    Tsai, Franklin C; Strum, Williamson B

    2011-08-01

    Most studies reporting polyp size use visual estimates. Determining the prevalence of advanced histology based on direct measurement of polyp size may help guide the management of polyps found at optical colonoscopy (OC) and CT colonography (CTC). We designed a large, prospective study to assess the prevalence of advanced adenomas based on direct measurement of polyp size by a certified pathologists' assistant as reported in the pathology report. Patients between 40 and 89 years of age who presented for screening colonoscopy were included in our study. Advanced adenomas were defined as ≥10 mm or ≥25% villous features, high grade dysplasia or cancer. Polyps were divided by size into three groups: diminutive (≤5 mm), small (6-9 mm) and large (≥10 mm). If more than one adenoma was present, the most advanced was used for analysis. We evaluated 6,905 consecutive patients referred for colonoscopy between January 2005 and December 2006. Of the 4,967 who met the inclusion criteria, the mean age was 58.8 and consisted of 59% women. Overall, 930 (18.7%) had an adenoma; 248 (5%) were advanced adenomas including 8 (0.16%) cancers. Of 89 polyps≥10 mm, 76 (85%) had advanced histology; of 247 polyps 6-9 mm, 67 (27%) were advanced; of 1,025 polyps ≤5 mm, 105 (10%) were advanced. Thus, 172 of 248 (69%) patients with advanced adenomas had small or diminutive adenomas. Our data indicate the majority (69%) of advanced adenomas are advanced adenomas (10%). These findings may help guide the management of sub-centimeter colon polyps found by OC or CTC.

  20. The Association Between Molecular Markers in Colorectal Sessile Serrated Polyps and Colorectal Cancer Risk

    Science.gov (United States)

    2017-08-01

    AWARD NUMBER: W81XWH-15-1-0273 TITLE: The Association between Molecular Markers in Colorectal Sessile Serrated Polyps and Colorectal Cancer ... Colorectal Cancer Risk 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1-0273 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Andrea Burnett-Hartman 5d... cancer in patients with sessile serrated colorectal polyps (SSPs). The project’s specific aims are as follows: 1) Estimate the risk of colorectal

  1. 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.)

  2. Prevalence of colonic polyp and its predictors in patients with acromegaly

    Directory of Open Access Journals (Sweden)

    Purnima Agarwal

    2016-01-01

    Full Text Available Background: There are conflicting data regarding the prevalence of colorectal polyp in patients with acromegaly. Subjects and Methods: Consecutive forty-seven acromegalic patients (21 men, 26 women, with a mean age of (40 ± 12 years attending endocrinology outpatient department underwent full colonoscopy. All the patients underwent clinical and biochemical evaluation (glucose suppressed growth hormone (GH, Insulin-like growth factor-1 [IGF-1], fasting insulin, and glucose. The control group (n = 120 for colonoscopy was adult subjects undergoing evaluation for symptoms of irritable bowel syndrome. Clinical and biochemical parameters in acromegalic patients with colonic polyp were compared to those without a polyp. Results: Patients with acromegaly had significantly higher prevalence of colonic polyp as compared to control subjects (10.6% vs. 0.8%. None of the patients with polyp had skin tags. There was no significant difference between subjects with and without colonic polyp in duration of illness, basal, and glucose-suppressed GH and most recent IGF-1. Fasting blood sugar was significantly higher (P < 0.05 in adenoma group after adjusting for age, body mass index (BMI, and insulin levels. Patients in adenoma group showed a trend toward male gender and younger age as compared to those without adenoma. Conclusions: Subjects with acromegaly as compared to control have a higher prevalence of colonic polyps. There was no association of polyps seen with age, BMI, skin tags, homeostasis model assessment of insulin resistance index, duration of disease, and basal and glucose-suppressed GH and IGF-1 levels. There were no specific predictive factors detected. Screening full colonoscopy is recommended in all cases with acromegaly.

  3. 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.

  4. An evidence-based treatment algorithm for colorectal polyp cancers: results from the Scottish Screen-detected Polyp Cancer Study (SSPoCS).

    Science.gov (United States)

    Richards, C H; Ventham, N T; Mansouri, D; Wilson, M; Ramsay, G; Mackay, C D; Parnaby, C N; Smith, D; On, J; Speake, D; McFarlane, G; Neo, Y N; Aitken, E; Forrest, C; Knight, K; McKay, A; Nair, H; Mulholland, C; Robertson, J H; Carey, F A; Steele, Rjc

    2018-02-01

    Colorectal polyp cancers present clinicians with a treatment dilemma. Decisions regarding whether to offer segmental resection or endoscopic surveillance are often taken without reference to good quality evidence. The aim of this study was to develop a treatment algorithm for patients with screen-detected polyp cancers. This national cohort study included all patients with a polyp cancer identified through the Scottish Bowel Screening Programme between 2000 and 2012. Multivariate regression analysis was used to assess the impact of clinical, endoscopic and pathological variables on the rate of adverse events (residual tumour in patients undergoing segmental resection or cancer-related death or disease recurrence in any patient). These data were used to develop a clinically relevant treatment algorithm. 485 patients with polyp cancers were included. 186/485 (38%) underwent segmental resection and residual tumour was identified in 41/186 (22%). The only factor associated with an increased risk of residual tumour in the bowel wall was incomplete excision of the original polyp (OR 5.61, p=0.001), while only lymphovascular invasion was associated with an increased risk of lymph node metastases (OR 5.95, p=0.002). When patients undergoing segmental resection or endoscopic surveillance were considered together, the risk of adverse events was significantly higher in patients with incomplete excision (OR 10.23, p<0.001) or lymphovascular invasion (OR 2.65, p=0.023). A policy of surveillance is adequate for the majority of patients with screen-detected colorectal polyp cancers. Consideration of segmental resection should be reserved for those with incomplete excision or evidence of lymphovascular invasion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Detection of flat colorectal polyps at screening CT colonography in comparison with conventional polypoid lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Takashi; Urata, Joji [Diagnostic Imaging Center, Saiseikai Kumamoto Hospital, Kumamoto (Japan); Mitsuzaki, Katsuhiko; Matsuda, Katsuhiko; Kawakami, Megumi [Medical Examination Center, Saiseikai Kumamoto Hospital, Kumamoto (Japan); Utsunomiya, Daisuke; Yamamura, Sadahiro; Yamashita, Yasuyuki [Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)], e-mail: utsunomi@kumamoto-u.ac.jp

    2012-09-15

    Background: Although the screening of small, flat polyps is clinically important, the role of CT colonography (CTC) screening in their detection has not been thoroughly investigated. Purpose: To evaluate the detection capability and usefulness of CTC in the screening of flat and polypoid lesions by comparing CTC with optic colonoscopy findings as the gold standard. Material and Methods: We evaluated the CTC detection capability for flat colorectal polyps with a flat surface and a height not exceeding 3 mm (n = 42) by comparing to conventional polypoid lesions (n = 418) according to the polyp diameter. Four types of reconstruction images including multiplanar reconstruction, volume rendering, virtual gross pathology, and virtual endoscopic images were used for visual analysis. We compared the abilities of the four reconstructions for polyp visualization. Results: Detection sensitivity for flat polyps was 31.3 %, 44.4 %, and 87.5 % for lesions measuring 2-3 mm, 4-5 mm, and {>=}6 mm, respectively; the corresponding sensitivity for polypoid lesions was 47.6 %, 79.0 %, and 91.7 %. The overall sensitivity for flat lesions (47.6%) was significantly lower than polypoid lesions (64.1%). Virtual endoscopic imaging showed best visualization among the four reconstructions. Colon cancers were detected in eight patients by optic colonoscopy, and CTC detected colon cancers in all eight patients. Conclusion: CTC using 64-row multidetector CT is useful for colon cancer screening to detect colorectal polyps while the detection of small, flat lesions is still challenging.

  6. Polyp bailout in Pocillopora damicornis following thermal stress [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Alexander J Fordyce

    2017-08-01

    Full Text Available Polyp bailout is an established but understudied coral stress response that involves the detachment of individual polyps from the colonial form as a means of escaping unfavourable conditions. This may influence both the mortality and asexual recruitment of coral genotypes across a range of species. It has been observed in response to numerous stressors including high salinity and low pH. Polyp expulsion in association with thermal stress has once been described in a geographically restricted, temperate species. We therefore cannot reliably apply this observation to tropical coral reefs around the world, which are increasingly under threat from thermal stress events. We present the first qualitative observation of polyp bailout following acute temperature shock  in a near-natural mesocosm experiment. Detached polyps show similar characteristics to those described in previous studies, including the retention of endosymbiotic zooxanthellae and the ability to disperse across short distances. This finding strongly suggests that polyp bailout occurs in tropical coral reef environments and warrants further detailed research into the implication of this response in terms of individual survival, rapid migration into cooler micro-habitats and local recruitment within the reef environment and its coral community.

  7. Knife-assisted snare resection: a novel technique for resection of scarred polyps in the colon.

    Science.gov (United States)

    Chedgy, Fergus J Q; Bhattacharyya, Rupam; Kandiah, Kesavan; Longcroft-Wheaton, Gaius; Bhandari, Pradeep

    2016-03-01

    There have been significant advances in the management of complex colorectal polyps. Previous failed resection or polyp recurrence is associated with significant fibrosis, making endoscopic resection extremely challenging; the traditional approach to these lesions is surgery. The aim of this study was to evaluate the efficacy of a novel, knife-assisted snare resection (KAR) technique in the resection of scarred colonic polyps. This was a prospective cohort study of patients, in whom the KAR technique was used to resect scarred colonic polyps > 2  cm in size. Patients had previously undergone endoscopic mucosal resection (EMR) and developed recurrence, or EMR had been attempted but was aborted as a result of technical difficulty. A total of 42 patients underwent KAR of large (median 40  mm) scarred polyps. Surgery for benign disease was avoided in 38 of 41 patients (93 %). No life-threatening complications occurred. Recurrence was seen in six patients (16 %), five of whom underwent further endoscopic resection. The overall cure rate for KAR in complex scarred colonic polyps was 90 %. KAR of scarred colonic polyps by an expert endoscopist was an effective and safe technique with low recurrence rates. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Inflammatory myoglandular colorectal polyps: a series of seven cases and review of literature.

    Science.gov (United States)

    Becheanu, G; Gheorghe, C; Dumbravă, M; Serban-Barbu, V; Diculescu, M

    2011-01-01

    Inflammatory myoglandular polyp is an unusual but distinct, non-neoplastic type of colorectal polyp, commonly with a distal localization at the recto-sigmoidian level. It was first described in 1992 by Nakamura and his colleagues and it is considered to have few particular histological features. We report a series of seven cases (two male and five female patients) of myoglandular polyps with different localization from 15 to 40 cm from anus. Only four out of seven cases presented with rectal bleeding, the others polyps we incidentally discovered. The polyps varied between 4 and 30 mm in the maximum diameter. Grossly, they had firm consistency and smooth reddish surface. Histological examination of the specimens revealed hyperplastic glands with occasional cystic dilatation, proliferation of smooth muscle with no regular distribution, a variable amount of granulation tissue (usually minimal) and no evidence of epithelial dysplasia. All the lesions were removed endoscopically without any complications. Inflammatory myoglandular polyps are distinct histopathological entities, with insufficiently investigated pathogenesis that can include local trauma, mucosal prolapse or ischemia. Being benign they can be removed endoscopically, surgical treatment being reserved in selected cases.

  9. Treatment of Hemorrhagic Vocal Polyps by Pulsed Dye Laser-Assisted Laryngomicrosurgery

    Directory of Open Access Journals (Sweden)

    Hyung Kwon Byeon

    2015-01-01

    Full Text Available Objective. Conventional surgical techniques of laryngomicrosurgery (LMS on hemorrhagic vocal polyps are often difficult due to obscuration of the surgical field by inadvertent bleeding from the lesion, and there are often significant amounts of mucosal epithelium loss. Here, we introduce our surgical technique using pulsed dye laser (PDL, which can effectively resect the polyp with vocal fold mucosa preservation. Methods. Patients who were diagnosed with hemorrhagic vocal polyp and who were surgically managed using PDL from March 2013 to October 2014 were retrospectively reviewed. Preoperative and postoperative clinical outcomes and surgical findings were evaluated. Results. A total of 39 patients were treated with PDL-assisted enucleation LMS. The average age was 43.7 years (range 20–73, and there were 20 males and 19 females (17 professional voice users. In all cases, the hemorrhagic polyp was successfully enucleated after application of PDL, thereby preserving the overlying epithelium. Postoperative voice outcomes were favorable with clear preservation of the vocal fold mucosal wave. Conclusion. PDL-assisted enucleation LMS for the treatment of hemorrhagic vocal polyps can be a safe and effective surgical technique. It can be considered a promising treatment option for hemorrhagic vocal polyps.

  10. 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.

  11. Presence of c.3956delC mutation in familial adenomatous polyposis patients from Brazil.

    Science.gov (United States)

    Moreira-Nunes, Caroline Aquino; Alcântara, Diego di Felipe Ávila; Lima-Júnior, Sérgio Figueiredo; Cavalléro, Sandro Roberto de Araújo; Rey, Juan Antonio; Pinto, Giovanny Rebouças; de Assumpção, Paulo Pimentel; Burbano, Rommel Rodriguez

    2015-08-21

    To characterize APC gene mutations and correlate them with patient phenotypes in individuals diagnosed with familial adenomatous polyposis (FAP) in northern Brazil. A total of 15 individuals diagnosed with FAP from 5 different families from the north of Brazil were analyzed in this study. In addition to patients with histopathological diagnosis of FAP, family members who had not developed the disease were also tested in order to identify mutations and for possible genetic counseling. All analyzed patients or their guardians signed a consent form approved by the Research Ethics Committee of the João de Barros Barreto University Hospital (Belem, Brazil). DNA extracted from the peripheral blood of a member of each of the affected families was subjected to direct sequencing. The proband of each family was sequenced to identify germline mutations using the Ion Torrent platform. To validate the detected mutations, Sanger sequencing was also performed. The samples from all patients were also tested for the identification of mutations by real-time quantitative polymerase chain reaction using the amplification refractory mutation system. Through interviews with relatives and a search of medical records, it was possible to construct genograms for three of the five families included in the study. All 15 patients from the five families with FAP exhibited mutations in the APC gene, and all mutations were detected in exon 15 of the APC gene. In addition to the patients with a histological diagnosis of FAP, family members without disease symptoms showed the mutation in the APC gene. In the present study, we detected two of the three most frequent germline mutations in the literature: the mutation at codon 1309 and the mutation at codon 1061. The presence of c.3956delC mutation was found in all families from this study, and suggests that this mutation was introduced in the population of the State of Pará through ancestor immigration (i.e., a de novo mutation that arose in one

  12. CT and MR imaging findings of sinonasal angiomatous polyps

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Jing [Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong (China); Man, Fengyuan [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China); Deng, Kai [Department of Radiology, Qingdao No. 4 People' s Hospital, Qingdao, Shandong (China); Zheng, Yuanyuan [Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong (China); Hao, Dapeng, E-mail: haodp_2009@163.com [Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong (China); Xu, Wenjian, E-mail: cjr.xuwenjian@vip.163.com [Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong (China)

    2014-03-15

    Objective: To characterize the CT and MR imaging findings of patients with sinonasal angiomatous polyps (SAPs) and evaluate their respective clinical value in the diagnosis of SAP. Methods: CT and MR imaging findings of 15 patients with pathologically proven SAP were examined. Assessed image features included location, size, margin, attenuation, and change of the bony walls of the sinonasal cavity on CT, and signal intensity and enhancement pattern on MR. Results: On CT, the SAP was mostly isoattenuated with patches of slight hyperattenuation. Most lesions caused changes in the adjacent bone, including expansile remodeling (n = 8), defect or destruction (n = 7), and hyperostosis (n = 6). All lesions examined by MR showed heterogeneous isointense signal intensity on T1-weighted images and mixed obvious hyperintense and hypointense signal intensity with linear hypointense septum internally (n = 10), and hypointense peripheral rim on T2-weighted images (n = 10). Postcontrast MR images demonstrated areas of heterogeneous and marked enhancement with an unenhanced hypointense rim and septa (n = 7). Conclusions: CT and MR imaging have respective advantages in the diagnosis of SAP. Combined application of CT and MR examinations is necessary for patients with suspected SAP.

  13. CT and MR imaging findings of sinonasal angiomatous polyps

    International Nuclear Information System (INIS)

    Zou, Jing; Man, Fengyuan; Deng, Kai; Zheng, Yuanyuan; Hao, Dapeng; Xu, Wenjian

    2014-01-01

    Objective: To characterize the CT and MR imaging findings of patients with sinonasal angiomatous polyps (SAPs) and evaluate their respective clinical value in the diagnosis of SAP. Methods: CT and MR imaging findings of 15 patients with pathologically proven SAP were examined. Assessed image features included location, size, margin, attenuation, and change of the bony walls of the sinonasal cavity on CT, and signal intensity and enhancement pattern on MR. Results: On CT, the SAP was mostly isoattenuated with patches of slight hyperattenuation. Most lesions caused changes in the adjacent bone, including expansile remodeling (n = 8), defect or destruction (n = 7), and hyperostosis (n = 6). All lesions examined by MR showed heterogeneous isointense signal intensity on T1-weighted images and mixed obvious hyperintense and hypointense signal intensity with linear hypointense septum internally (n = 10), and hypointense peripheral rim on T2-weighted images (n = 10). Postcontrast MR images demonstrated areas of heterogeneous and marked enhancement with an unenhanced hypointense rim and septa (n = 7). Conclusions: CT and MR imaging have respective advantages in the diagnosis of SAP. Combined application of CT and MR examinations is necessary for patients with suspected SAP

  14. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years

    DEFF Research Database (Denmark)

    Dreisler, E; Stampe Sorensen, S; Ibsen, P H

    2009-01-01

    OBJECTIVE: To estimate the prevalence of endometrial polyps and to investigate associated abnormal uterine bleeding in a Danish population aged 20-74 years. METHODS: This was a study of a random selection of women from the Danish Civil Registration System: 1660 women were invited of whom 686 were...... verified polyps were asymptomatic. In asymptomatic premenopausal women the prevalence of polyps was 7.6%, while it was 13% in asymptomatic postmenopausal women. AUB, in particular intermenstrual bleeding, was more frequent among women without polyps (38%). By ultrasound examination, submucosal myomas were...

  15. Nattokinase, profibrinolytic enzyme, effectively shrinks the nasal polyp tissue and decreases viscosity of mucus.

    Science.gov (United States)

    Takabayashi, Tetsuji; Imoto, Yoshimasa; Sakashita, Masafumi; Kato, Yukinori; Tokunaga, Takahiro; Yoshida, Kanako; Narita, Norihiko; Ishizuka, Tamotsu; Fujieda, Shigeharu

    2017-10-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) is often comorbid with asthma and resistant to therapeutic interventions. We recently reported that excessive fibrin deposition caused by impairment of fibrinolysis might play pivotal role in forming nasal polyp. Nattokinase (NK), a serine protease produced by Bacillus subtilis, has been reported to be a strong fibrinolytic enzyme. NK could be a promising drug candidate for use in the treatment of both CRSwNP and asthma. The objective of this study was to investigate the effects of NK on nasal polyp tissues from patients with CRSwNP. The nasal discharge from patients with CRSwNP and sputum from subjects with asthma were also used to investigate whether NK influences the viscosity of mucus. To examine the effects on NK on nasal polyp tissues, pieces of nasal polyps were incubated either with saline or NK (10-1000 FU/ml) at 37 °C for 24 h. We assessed the presence of fibrin in nasal polyp tissue incubated with NK by means of immunohistochemistry. To examine the effects of NK on nasal discharge and sputum from patients with CRSwNP and asthma, respectively, were incubated with NK solution at 37 °C for 1 h. NK effectively shrinks the nasal polyp tissue through fibrin degradation. We also found that the viscosity of the nasal discharge and sputum from patients with CRSwNP and asthma, respectively, was significantly reduced by incubation with NK solution. NK may be an effective alternative therapeutic option in patients with CRSwNP and comorbid asthma by causing fibrin degradation. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  16. Next-generation narrow band imaging system for colonic polyp detection: a prospective multicenter randomized trial.

    Science.gov (United States)

    Horimatsu, Takahiro; Sano, Yasushi; Tanaka, Shinji; Kawamura, Takuji; Saito, Shoichi; Iwatate, Mineo; Oka, Shiro; Uno, Koji; Yoshimura, Kenichi; Ishikawa, Hideki; Muto, Manabu; Tajiri, Hisao

    2015-07-01

    Previous studies have yielded conflicting results on the colonic polyp detection rate with narrow-band imaging (NBI) compared with white-light imaging (WLI). We compared the mean number of colonic polyps detected per patient for NBI versus WLI using a next-generation NBI system (EVIS LUCERA ELITE; Olympus Medical Systems) used with standard-definition (SD) colonoscopy and wide-angle (WA) colonoscopy. this study is a 2 × 2 factorial, prospective, multicenter randomized controlled trial. this study was conducted at five academic centers in Japan. patients were allocated to one of four groups: (1) WLI with SD colonoscopy (H260AZI), (2) NBI with SD colonoscopy (H260AZI), (3) WLI with WA colonoscopy (CF-HQ290), and (4) NBI with WA colonoscopy (CF-HQ290). the mean numbers of polyps detected per patient were compared between the four groups: WLI with/without WA colonoscopy and NBI with/without WA colonoscopy. Of the 454 patients recruited, 431 patients were enrolled. The total numbers of polyps detected by WLI with SD, NBI with SD, WLI with WA, and NBI with WA were 164, 176, 188, and 241, respectively. The mean number of polyps detected per patient was significantly higher in the NBI group than in the WLI group (2.01 vs 1.56; P = 0.032). The rate was not higher in the WA group than in the SD group (1.97 vs 1.61; P = 0.089). Although WA colonoscopy did not improve the polyp detection, next-generation NBI colonoscopy represents a significant improvement in the detection of colonic polyps.

  17. A novel mutation of adenomatous polyposis coli (APC) gene results in the formation of supernumerary teeth.

    Science.gov (United States)

    Yu, Fang; Cai, Wenping; Jiang, Beizhan; Xu, Laijun; Liu, Shangfeng; Zhao, Shouliang

    2018-01-01

    Supernumerary teeth are teeth that are present in addition to normal teeth. Although several hypotheses and some molecular signalling pathways explain the formation of supernumerary teeth, but their exact disease pathogenesis is unknown. To study the molecular mechanisms of supernumerary tooth-related syndrome (Gardner syndrome), a deeper understanding of the aetiology of supernumerary teeth and the associated syndrome is needed, with the goal of inhibiting disease inheritance via prenatal diagnosis. We recruited a Chinese family with Gardner syndrome. Haematoxylin and eosin staining of supernumerary teeth and colonic polyp lesion biopsies revealed that these patients exhibited significant pathological characteristics. APC gene mutations were detected by PCR and direct sequencing. We revealed the pathological pathway involved in human supernumerary tooth development and the mouse tooth germ development expression profile by RNA sequencing (RNA-seq). Sequencing analysis revealed that an APC gene mutation in exon 15, namely 4292-4293-Del GA, caused Gardner syndrome in this family. This mutation not only initiated the various manifestations typical of Gardner syndrome but also resulted in odontoma and supernumerary teeth in this case. Furthermore, RNA-seq analysis of human supernumerary teeth suggests that the APC gene is the key gene involved in the development of supernumerary teeth in humans. The mouse tooth germ development expression profile shows that the APC gene plays an important role in tooth germ development. We identified a new mutation in the APC gene that results in supernumerary teeth in association with Gardner syndrome. This information may shed light on the molecular pathogenesis of supernumerary teeth. Gene-based diagnosis and gene therapy for supernumerary teeth may become available in the future, and our study provides a high-resolution reference for treating other syndromes associated with supernumerary teeth. © 2017 The Authors. Journal of

  18. Quality of life after total colectomy with ileorectal anastomosis or proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis

    NARCIS (Netherlands)

    van Duijvendijk, P.; Slors, J. F.; Taat, C. W.; Oosterveld, P.; Sprangers, M. A.; Obertop, H.; Vasen, H. F.

    2000-01-01

    BACKGROUND: Knowledge of postoperative health status is important in decision-making about the type of operation necessary in patients with familial adenomatous polyposis (FAP). This study compared the quality of life (QoL) between patients with an ileorectal anastomosis (group 1) and those with an

  19. Rapidly progressive adenomatous polyposis in a patient with germline mutations in both the APC and MLH1 genes: the worst of two worlds.

    NARCIS (Netherlands)

    Scheenstra, R; Rijcken, FE; Koornstra, JJ; Hollema, H; Fodde, R; Menko, F.H.; Sijmons, RH; Bijleveld, CM; Kleibeuker, J.H.

    2003-01-01

    The two most common inherited forms of colorectal cancer are familial adenomatous polyposis and hereditary non-polyposis colorectal cancer. Simultaneous inheritance of both an APC gene mutation and a mismatch repair gene (for example, MLH1) mutation has never been described. In the present case

  20. Clinical characteristics and outcomes in familial adenomatous polyposis patients with a long-term treatment of celecoxib: a matched cohort study

    DEFF Research Database (Denmark)

    Huang, Kui; Gutierrez, Lia P; Bülow, Steffen

    2011-01-01

    Familial adenomatous polyposis (FAP) is a rare genetic disease. Without treatment, FAP patients have a 100% lifetime risk of developing colorectal cancer. This study was conducted to evaluate the effect of celecoxib treatment in prolonging the time to FAP-related events and to document the safety...

  1. Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for familial adenomatous polyposis using a double-stapled technique: report of two cases

    NARCIS (Netherlands)

    Vrouenraets, Bart C.; van Duijvendijk, Peter; Bemelman, Willem A.; Offerhaus, G. Johan A.; Slors, J. Frederik M.

    2004-01-01

    Restorative proctocolectomy with an ileal pouch-anal anastomosis is thought to abolish the risk of colorectal adenoma development in patients suffering from familial adenomatous polyposis. Both after mucosectomy with a handsewn anastomosis and after a double-stapled anastomosis, rectal mucosa is

  2. 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

  3. 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.

  4. Three-dimensional laryngeal flow fields induced by a model vocal fold polyp

    Energy Technology Data Exchange (ETDEWEB)

    Erath, Byron D., E-mail: erath@gwu.edu [Department of Mechanical and Aerospace Engineering, George Washington University, 801 22nd Street NW, 739 Phillips Hall, Washington, DC 20052 (United States); Plesniak, Michael W., E-mail: plesniak@gwu.edu [Department of Mechanical and Aerospace Engineering, George Washington University, 801 22nd Street NW, 739 Phillips Hall, Washington, DC 20052 (United States)

    2012-06-15

    Highlights: Black-Right-Pointing-Pointer Pathological speech with a unilateral polyp is modeled in a scaled-up flow facility. Black-Right-Pointing-Pointer Vortex shedding from the polyp disrupts normal flow behavior. Black-Right-Pointing-Pointer Hairpin vortices create spatial velocity asymmetries in the glottal flow. - Abstract: Pathological laryngeal flow fields are investigated in a dynamically-driven, scaled-up model of the vocal folds. Disruption of the flow field due to the presence of a geometric protuberance, representative of a sessile unilateral polyp, is investigated in both the streamwise and transverse flow directions using phase-averaged particle image velocimetry. It is shown that the protuberance disrupts the normal flow behavior of the glottal jet throughout the phonatory cycle. During the divergent portions of the glottal cycle, the flow is characterized by the formation of hairpin vortices downstream of the protuberance. The protuberance also introduces significant velocity gradients in the anterior-posterior direction, which cover {approx}30 - 40% of the vocal fold length. It is proposed that the disruption of the normal velocity behavior owing to the presence of a polyp will adversely impact the aerodynamic loadings that drive vocal fold motion, contributing to the temporal and spatial vocal fold asymmetries that are clinically-observed in patients with unilateral polyps.

  5. PET/CT colonography in patients with colorectal polyps: a feasibility study

    International Nuclear Information System (INIS)

    Mainenti, Pier P.; Pace, Leonardo; Salvatore, Marco; Salvatore, Barbara; D'Antonio, Dario; Bucci, Luigi; De Falco, Teresa; De Palma, Giovanni D.; D'Armiento, Francesco P.

    2007-01-01

    To examine: (1) the feasibility of PET/CT colonography (PET/CTc) in patients with colorectal polyps; (2) the impact of metabolic information on CTc interpretation and, conversely, the impact of morphological information on PET characterisation of focal colorectal uptake. Ten patients with colorectal polyps underwent PET/CTc, followed within 3 h by therapeutic conventional colonoscopy (CC). A radiologist and a nuclear medicine physician analysed the PET/CTc images. The agreement of morphological and metabolic information in the colon and rectum was evaluated. The sensitivity and specificity of PET, CT and PET/CT were calculated for colorectal polyps. Seventeen polypoid lesions were identified at CC: six≤5 mm, six between 6 and 9 mm, and five ≥10 mm (four hyperplastic polyps, 11 tubular adenomas, one adenocarcinoma and one submucosal lipoma). A total of 20 scans (supine and prone) were performed in the ten patients: the agreement of morphological and metabolic information was excellent in 17 scans, good in two and moderate in one. PET/CTc showed a sensitivity of 91% for lesions ≥6 mm and a specificity of 100%. The metabolic information did not disclose any further polyps missed on CTc. The morphological information permitted correct classification of all eight instances of focal radiotracer uptake. PET/CTc is a feasible study. Adding a colonographic protocol to PET/CT images seems to allow correct characterisation of all cases of colorectal focal radiotracer uptake. The metabolic information does not seem to increase the accuracy of CTc. (orig.)

  6. 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.

  7. Three-dimensional laryngeal flow fields induced by a model vocal fold polyp

    International Nuclear Information System (INIS)

    Erath, Byron D.; Plesniak, Michael W.

    2012-01-01

    Highlights: ► Pathological speech with a unilateral polyp is modeled in a scaled-up flow facility. ► Vortex shedding from the polyp disrupts normal flow behavior. ► Hairpin vortices create spatial velocity asymmetries in the glottal flow. - Abstract: Pathological laryngeal flow fields are investigated in a dynamically-driven, scaled-up model of the vocal folds. Disruption of the flow field due to the presence of a geometric protuberance, representative of a sessile unilateral polyp, is investigated in both the streamwise and transverse flow directions using phase-averaged particle image velocimetry. It is shown that the protuberance disrupts the normal flow behavior of the glottal jet throughout the phonatory cycle. During the divergent portions of the glottal cycle, the flow is characterized by the formation of hairpin vortices downstream of the protuberance. The protuberance also introduces significant velocity gradients in the anterior-posterior direction, which cover ∼30 − 40% of the vocal fold length. It is proposed that the disruption of the normal velocity behavior owing to the presence of a polyp will adversely impact the aerodynamic loadings that drive vocal fold motion, contributing to the temporal and spatial vocal fold asymmetries that are clinically-observed in patients with unilateral polyps.

  8. The CIMP Phenotype in BRAF Mutant Serrated Polyps from a Prospective Colonoscopy Patient Cohort.

    Science.gov (United States)

    Fernando, Winnie C; Miranda, Mariska S; Worthley, Daniel L; Togashi, Kazutomo; Watters, Dianne J; Leggett, Barbara A; Spring, Kevin J

    2014-01-01

    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.

  9. Specialist Endoscopists Are Associated with a Decreased Risk of Incomplete Polyp Resection During Endoscopic Mucosal Resection in the Colon.

    Science.gov (United States)

    Tavakkoli, Anna; Law, Ryan J; Bedi, Aarti O; Prabhu, Anoop; Hiatt, Tadd; Anderson, Michelle A; Wamsteker, Erik J; Elmunzer, B Joseph; Piraka, Cyrus R; Scheiman, James M; Elta, Grace H; Kwon, Richard S

    2017-09-01

    Endoscopic experience is known to correlate with outcomes of endoscopic mucosal resection (EMR), particularly complete resection of the polyp tissue. Whether specialist endoscopists can protect against incomplete polypectomy in the setting of known risk factors for incomplete resection (IR) is unknown. We aimed to characterize how specialist endoscopists may help to mitigate the risk of IR of large sessile polyps. This is a retrospective cohort study of patients who underwent EMR at the University of Michigan from January 1, 2006, to November 15, 2015. The primary outcome was endoscopist-reported polyp tissue remaining at the end of the initial EMR attempt. Specialist endoscopists were defined as endoscopists who receive tertiary referrals for difficult colonoscopy cases and completed at least 20 EMR colonic polyp resections over the study period. A total of 257 patients with 269 polyps were included in the study. IR occurred in 40 (16%) cases. IR was associated with polyp size ≥ 40 mm [adjusted odds ratio (aOR) 3.31, 95% confidence interval (CI) 1.38-7.93], flat/laterally spreading polyps (aOR 2.61, 95% CI 1.24-5.48), and difficulty lifting the polyp (aOR 11.0, 95% CI 2.66-45.3). A specialist endoscopist performing the initial EMR was protective against IR, even in the setting of risk factors for IR (aOR 0.13, 95% CI 0.04-0.41). IR is associated with polyp size ≥ 40 mm, flat and/or laterally spreading polyps, and difficulty lifting the polyp. A specialist endoscopist initiating the EMR was protective of IR.

  10. Meat intake and risk of colorectal polyps: results from a large population-based screening study in Germany.

    Science.gov (United States)

    Carr, Prudence R; Holleczek, Bernd; Stegmaier, Christa; Brenner, Hermann; Hoffmeister, Michael

    2017-06-01

    Background: Red and processed meats have been shown to be associated with colorectal adenomas in many, but not all, studies, and the association according to the type of colorectal adenoma or the location in the colorectum is unclear. Objectives: We investigated the association of meat intake in relation to colorectal polyps and further investigated the association according to histologic subtypes and subsites in a large population-based screening study in Germany. Design: In this cross-sectional study, 15,950 participants aged ≥55 y underwent a screening colonoscopy. We calculated prevalence ratios (PRs) and 95% CIs for associations between meat intake and the most-advanced findings from a colonoscopy with the use of log binomial regression. Results: Overall, 3340 participants (20.4%) had nonadvanced adenomas, 1643 participants (10.0%) had advanced adenomas, and 189 participants (1.2%) had colorectal cancer. We observed no statistically significant association between red or processed meat consumption and the prevalence of any adenomas or advanced adenomas [highest compared with lowest: red meat, PR: 1.07 (95% CI: 0.83, 1.37); processed meat, PR: 1.11 (95% CI: 0.91, 1.36)]. In site-specific analyses, although no dose-response relation was observed, processed meat was positively associated with the prevalence of advanced adenomas in the rectum only (multiple times per day compared with meat intake and the prevalence of any adenomas or advanced adenomas. However, processed meat may be positively associated with the prevalence of advanced adenomas in the rectum, but prospective cohort studies are needed to further clarify this association. There is no association between poultry consumption and the prevalence of colorectal polyps in this study. © 2017 American Society for Nutrition.

  11. A CpG island methylator phenotype of colorectal cancer that is contiguous with conventional adenomas, but not serrated polyps.

    Science.gov (United States)

    Hokazono, Koji; Ueki, Takashi; Nagayoshi, Kinuko; Nishioka, Yasunobu; Hatae, Tatsunobu; Koga, Yutaka; Hirahashi, Minako; Oda, Yoshinao; Tanaka, Masao

    2014-11-01

    A subset of colorectal cancers (CRCs) harbor the CpG island methylator phenotype (CIMP), with concurrent multiple promoter hypermethylation of tumor-related genes. A serrated pathway in which CIMP is developed from serrated polyps is proposed. The present study characterized CIMP and morphologically examined precursor lesions of CIMP. In total, 104 CRCs treated between January 1996 and December 2004 were examined. Aberrant promoter methylation of 15 cancer-related genes was analyzed. CIMP status was classified according to the number of methylated genes and was correlated with the clinicopathological features, including the concomitant polyps in and around the tumors. The frequency of aberrant methylation in each CRC showed a bimodal pattern, and the CRCs were classified as CIMP-high (CIMP-H), CIMP-low (CIMP-L) and CIMP-negative (CIMP-N). CIMP-H was associated with aberrant methylation of MLH1 (P=0.005) and with an improved recurrence-free survival (RFS) rate following curative resection compared with CIMP-L/N (five-year RFS rate, 93.8 vs. 67.1%; P=0.044), while CIMP-N tumors were associated with frequent distant metastases at diagnosis (P=0.023). No concomitant serrated lesions were present in the tumors, whereas conventional adenoma was contiguous with 11 (10.6%) of 104 CRCs, including four CIMP-H CRCs. CIMP-H was classified in CRCs by a novel CIMP marker panel and the presence of concomitant tumors revealed that certain CIMP-H CRCs may have arisen from conventional adenomas.

  12. Stat6 Promotes Intestinal Tumorigenesis in a Mouse Model of Adenomatous Polyposis by Expansion of MDSCs and Inhibition of Cytotoxic CD8 Response

    Directory of Open Access Journals (Sweden)

    Asha Jayakumar

    2017-08-01

    Full Text Available Intestinal tumorigenesis in the ApcMin/+ model is initiated by aberrant activation of Wnt pathway. Increased IL-4 expression in human colorectal cancer tissue and growth of colon cancer cell lines implied that IL-4–induced Stat6-mediated tumorigenic signaling likely contributes to intestinal tumor progression in ApcMin/+ mice. Stat6 also appears to promote expansion of myeloid-derived suppressor cells (MDSCs cells. MDSCs promote polyp formation in the ApcMin/+ model. Hence, Stat6 could have a broad role in coordinating both polyp cell proliferation and MDSC expansion. We found that IL-4–induced Stat6-mediated proliferation of intestinal epithelial cells is augmented by platelet-derived growth factor–BB, a tumor-promoting growth factor. To determine whether polyp progression in ApcMin/+ mice is dependent on Stat6 signaling, we disrupted Stat6 in this model. Total polyps in the small intestine were fewer in ApcMin/+ mice lacking Stat6. Furthermore, proliferation of polyp epithelial cells was reduced, indicating that Stat6 in part controlled polyp formation. Stat6 also promoted expansion of MDSCs in the spleen and lamina propria of ApcMin/+ mice, implying regulation of antitumor T-cell response. More CD8 cells and reduced PD-1 expression on CD4 cells correlated with reduced polyps. In addition, a strong CD8-mediated cytotoxic response led to killing of tumor cells in Stat6-deficient ApcMin/+ mice. Therefore, these findings show that Stat6 has an oncogenic role in intestinal tumorigenesis by promoting polyp cell proliferation and immunosuppressive mediators, and preventing an active cytotoxic process.

  13. Stat6 Promotes Intestinal Tumorigenesis in a Mouse Model of Adenomatous Polyposis by Expansion of MDSCs and Inhibition of Cytotoxic CD8 Response.

    Science.gov (United States)

    Jayakumar, Asha; Bothwell, Alfred L M

    2017-08-01

    Intestinal tumorigenesis in the ApcMin/+ model is initiated by aberrant activation of Wnt pathway. Increased IL-4 expression in human colorectal cancer tissue and growth of colon cancer cell lines implied that IL-4-induced Stat6-mediated tumorigenic signaling likely contributes to intestinal tumor progression in ApcMin/+ mice. Stat6 also appears to promote expansion of myeloid-derived suppressor cells (MDSCs) cells. MDSCs promote polyp formation in the ApcMin/+ model. Hence, Stat6 could have a broad role in coordinating both polyp cell proliferation and MDSC expansion. We found that IL-4-induced Stat6-mediated proliferation of intestinal epithelial cells is augmented by platelet-derived growth factor-BB, a tumor-promoting growth factor. To determine whether polyp progression in ApcMin/+ mice is dependent on Stat6 signaling, we disrupted Stat6 in this model. Total polyps in the small intestine were fewer in ApcMin/+ mice lacking Stat6. Furthermore, proliferation of polyp epithelial cells was reduced, indicating that Stat6 in part controlled polyp formation. Stat6 also promoted expansion of MDSCs in the spleen and lamina propria of ApcMin/+ mice, implying regulation of antitumor T-cell response. More CD8 cells and reduced PD-1 expression on CD4 cells correlated with reduced polyps. In addition, a strong CD8-mediated cytotoxic response led to killing of tumor cells in Stat6-deficient ApcMin/+ mice. Therefore, these findings show that Stat6 has an oncogenic role in intestinal tumorigenesis by promoting polyp cell proliferation and immunosuppressive mediators, and preventing an active cytotoxic process. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Gastroduodenal Intussusception Caused by a Peutz- Jeghers Polyp in a Young Child: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Jae Eun; Cho, Bum Sang; Lee, Seung Young; Jeon, Min Hee; Lee, Ji Hyuk; Lee, Ho Chang; Koo, Ji Hae [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2010-09-15

    Gastroduodenal intussusception is a rare condition caused by the prolapse of a gastric tumor with subsequent invagination of a portion of the gastric wall into the duodenum. Various gastric lesions including adenoma, lipoma, leiomyoma, hamartoma, adenocarcinoma, gastrointestinal stromal tumor (GIST), and as in our case a Peutz- Jeghers polyp, can serve as a lead point of intussusception. Only three cases of gastroduodenal intussusception secondary to a Peutz-Jeghers polyp have been reported. We experienced a case of gastroduodenal intussusception in a 36-month-old boy who presented with intermittent nonbilious vomiting, abdominal pain, and anemia. An abdominal ultrasound and contrast enhanced CT scan showed gastrointestinal intussusception and a mass-like lesion in the second portion of duodenum. A laparotomy revealed a 7x8 cm sized mass at the gastric body, which was pathologically confirmed as a Peutz-Jeghers polyp

  15. Individual polyp detection rate in routine daily endoscopy practice depends on case-mix.

    Science.gov (United States)

    Loffeld, R J L F; Liberov, B; Dekkers, P E P

    2015-07-01

    The adenoma detection rate (ADR), a marker of endoscopic quality, is confounded by selection bias. It is not known what the ADR is in normal daily practice. To study the polyp detection rate (PDR) in different endoscopists in the course of years. All consecutive endoscopies of the colon done in 11 years were included. Endoscopies in the regular surveillance programme after polyp removal and after surgery because of colorectal cancer or diverticular disease were scored separately. The number of yearly procedures per endoscopist and presence of polyps, anastomoses, surveillance and cancer were noted. In the period of 11 years, 14,908 consecutive endoscopies of colon and rectum were done by four endoscopists. Two endoscopists had a significantly lower PDR than the other two (p case-mix of patients presented for endoscopy. This result debates the use of the ADR as quality indicator for individual endoscopists.

  16. 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

  17. Clinical evaluation of endoscopic trimodal imaging for the detection and differentiation of colonic polyps.

    Science.gov (United States)

    van den Broek, Frank J C; Fockens, Paul; Van Eeden, Susanne; Kara, Mohammed A; Hardwick, James C H; Reitsma, Johannes B; Dekker, Evelien

    2009-03-01

    Endoscopic trimodal imaging (ETMI) incorporates high-resolution endoscopy (HRE) and autofluorescence imaging (AFI) for adenoma detection, and narrow-band imaging (NBI) for differentiation of adenomas from nonneoplastic polyps. The aim of this study was to compare AFI with HRE for adenoma detection and to assess the diagnostic accuracy of NBI for differentiation of polyps. This was a randomized trial of tandem colonoscopies. The study was performed at the Academic Medical Center in Amsterdam. One hundred patients underwent colonoscopy with ETMI. Each colonic segment was examined twice for polyps, once with HRE and once with AFI, in random order per patient. All detected polyps were assessed with NBI for pit pattern and with AFI for color, and subsequently removed. Histopathology served as the gold standard for diagnosis. The main outcome measures of this study were adenoma miss-rates of AFI and HRE, and diagnostic accuracy of NBI and AFI for differentiating adenomas from nonneoplastic polyps. Among 50 patients examined with AFI first, 32 adenomas were detected initially. Subsequent inspection with HRE identified 8 additional adenomas. Among 50 patients examined with HRE first, 35 adenomas were detected initially. Successive AFI yielded 14 additional adenomas. The adenoma miss-rates of AFI and HRE therefore were 20% and 29%, respectively (P = .351). The sensitivity, specificity, and overall accuracy of NBI for differentiation were 90%, 70%, and 79%, respectively; corresponding figures for AFI were 99%, 35%, and 63%, respectively. The overall adenoma miss-rate was 25%; AFI did not significantly reduce the adenoma miss-rate compared with HRE. Both NBI and AFI had a disappointing diagnostic accuracy for polyp differentiation, although AFI had a high sensitivity.

  18. Low lymphatic vessel density associates with chronic rhinosinusitis with nasal polyps.

    Science.gov (United States)

    Luukkainen, A; Seppälä, M; Renkonen, J; Renkonen, R; Hagstrő M, J; Huhtala, H; Rautiainen, M; Myller, J; Paavonen, T; Ranta, A; Torkkeli, T; Toppila-Salmi, S

    2017-06-01

    Chronic rhinosinusitis with and without nasal polyps (CRSwNP and CRSsNP) and antrochoanal polyps (ACP) are different upper airway inflammation phenotypes with different pathomechanisms. In order to understand the development of tissue edema, the present study aimed to evaluate lymphatic vessel density in CRSsNP, CRSwNP and ACP. 120 retrospective nasal and maxillary sinus specimens were stained immunohistochemically with a von Willebrand factor polyclonal antibody recognizing vascular and lymphatic endothelium, and with a podoplanin monoclonal antibody recognizing lymphatic endothelium. Vessels were studied by microscopy in a blinded fashion, and the vessel density and the relative density of lymphatic vessels were calculated. Patient characteristic factors and follow-up data of in average 9 years were collected from patient records. In the nasal cavity, the low absolute and relative density of vessels and of lymphatic vessels was associated with CRSwNP and ACP tissues compared to control inferior turbinate. This was observed also in the inflammatory hotspot area. In the maxillary sinus, lower absolute and relative density of lymphatic vessels associated with the CRSwNP phenotype. High lymphatic vessel density in polyp tissue associated with the need for revision CRS-surgery. As a conclusion, low density of lymphatic vessels distinguished patients with CRSwNP not only in the hotspot area of polyp tissue, but also in maxillary sinus mucosa. Yet, higher lymphatic vessel density seems to associate with polyp recurrence. Further studies are still needed to explore if formation of nasal polyps could be diminished by intranasal therapeutics affecting lymphangiogenesis.

  19. Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review

    Directory of Open Access Journals (Sweden)

    Chan Siew F

    2011-05-01

    Full Text Available Abstract Background Bowel symptoms are often considered an indication to perform colonoscopy to identify or rule out colorectal cancer or precancerous polyps. Investigation of bowel symptoms for this purpose is recommended by numerous clinical guidelines. However, the evidence for this practice is unclear. The objective of this study is to systematically review the evidence about the association between bowel symptoms and colorectal cancer or polyps. Methods We searched the literature extensively up to December 2008, using MEDLINE and EMBASE and following references. For inclusion in the review, papers from cross sectional, case control and cohort studies had to provide a 2×2 table of symptoms by diagnosis (colorectal cancer or polyps or sufficient data from which that table could be constructed. The search procedure, quality appraisal, and data extraction was done twice, with disagreements resolved with another reviewer. Summary ROC analysis was used to assess the diagnostic performance of symptoms to detect colorectal cancer and polyps. Results Colorectal cancer was associated with rectal bleeding (AUC 0.66; LR+ 1.9; LR- 0.7 and weight loss (AUC 0.67, LR+ 2.5, LR- 0.9. Neither of these symptoms was associated with the presence of polyps. There was no significant association of colorectal cancer or polyps with change in bowel habit, constipation, diarrhoea or abdominal pain. Neither the clinical setting (primary or specialist care nor study type was associated with accuracy. Most studies had methodological flaws. There was no consistency in the way symptoms were elicited or interpreted in the studies. Conclusions Current evidence suggests that the common practice of performing colonoscopies to identify cancers in people with bowel symptoms is warranted only for rectal bleeding and the general symptom of weight loss. Bodies preparing guidelines for clinicians and consumers to improve early detection of colorectal cancer need to take into

  20. 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

  1. Metachronous colon polyps in younger versus older adults: a case-control study.

    Science.gov (United States)

    Nagpal, Sajan Jiv Singh; Mukhija, Dhruvika; Sanaka, Madhusudhan; Lopez, Rocio; Burke, Carol A

    2018-03-01

    The incidence of colorectal cancer in the United States has decreased substantially in individuals aged 50 and older. In contrast, it is increasing in young adults. The polyp characteristics on baseline and follow-up colonoscopy in young adults are not well characterized. We describe the polyp characteristics on baseline and follow-up colonoscopy in adults 1 polyp removed on colonoscopy followed by a postpolypectomy colonoscopy were eligible. The primary outcome was the occurrence of advanced neoplasia or HR polyp features on follow-up colonoscopy. Secondary endpoints included factors associated with metachronous advanced neoplasia in young adults. The occurrence of metachronous advanced neoplasia in young adults was compared with a cohort of patients aged 50 years and older. Included were 128 patients with a mean age of 34.9 years; 124 patients (97%) had adenomas and 7% had sessile serrated polyps (SSPs). Advanced neoplasia was seen in 35% of patients at baseline. The median follow-up time was 33.6 months. Metachronous advanced neoplasia was identified in 7% of patients on follow-up colonoscopy. Baseline factors associated with metachronous advanced neoplasia included the presence of an SSP (hazard ratio, 7.8; 95% CI, 1.09-56.3; P = .041) with a trend in those with advanced neoplasia (hazard ratio, 3.4; 95% confidence interval, .89-12.8; P = .072). The occurrence of metachronous advanced neoplasia did not differ between the young and older cohorts (7% vs 12.2%, P = .58); however, young adults were less likely to have HR polyp features on follow-up (8.6% vs 20.3%, P = .008). More than 1 in 3 adults <40 years old undergoing colonoscopy had advanced neoplasia on baseline colonoscopy. The occurrence of metachronous advanced neoplasia in young adults is similar to older adults and appears to be associated with the size, pathology, and number of baseline polyps. Our data suggest young polyp-bearing adults may undergo postpolypectomy colonoscopy at intervals

  2. A rare cause of glans penis masses in childhood: Fibroepithelial polyp

    Science.gov (United States)

    Şencan, Arzu; Şencan, Aydın; Günşar, Cüneyt; Çayırlı, Hasan; Neşe, Nalan

    2015-01-01

    Fibroepithelial polyps of glans penis are very rarely seen in childhood. A 6-month-old male admitted to our institution with a slowly enlarging glans penis mass on the ventral side of the glans penis. The mass was totally excised, and hystopathological diagnosis was a fibroepithelial polyp. All of the reported cases published previously, except one, are of adult age and all of them have been associated with the history of long-term condom catheter use. The presence of the case in childhood; however, suggests that the pathology might be congenital. This is the second pediatric case presented in the English literature. PMID:25552832

  3. Needle knife-assisted polypectomy in hot snare-resistant fibrotic inflammatory polyps

    Directory of Open Access Journals (Sweden)

    Xian-rui Wu

    2014-01-01

    Full Text Available Background: Inflammatory polyps are common sequelae in patients with inflammatory bowel diseases (IBD. Those polyps can usually be removed with snare polypectomy. There were limited data evaluating the management of hot snare-resistant inflammatory polyps. Methods: We reported on two cases with hot snare-resistant inflammatory polyps, one was a Crohn's disease (CD patient with the polyp at the ileo-colonic anastomosis (ICA and the other one was an ulcerative colitis (UC patient with polyp at the pouch inlet. Results: Sedated endoscopy was performed, which showed a large 2.5 cm pedunculated polyp at the ICA in the first patient and a large 5 cm pedunculated polyp at the pouch inlet in the second patient. Hot snare polypectomy was initially attempted, but failed in both pa- tients. Then endoscopic needle knife polypectomy was performed, which helped complete polypectomy. Both procedures took approximately 25 minutes each. The patients tolerated the procedure well and continued to do well after the procedure. The final pathological diagnoses for both patients were inflammatory polyps with extensive fibrosis. Conclusions: Endoscopic needle knife-assisted polypectomy appeared to be an effective technique for the management of hot snare-resistant inflammatory polyps. Resumo: Experiência: Pólipos inflamatórios são sequelas comuns em pacientes com doença intestinal inflamatória (DII. Geralmente esses pólipos podem ser removidos pela polipectomia por cauterização com laço. São limitados os dados que avaliam o tratamento de pólipos infla- matórios resistentes à cauterização por laço. Métodos: Descrevemos dois casos com pólipos inflamatórios resistentes à cauterização por laço; um deles se tratava de paciente com doença de Crohn (DC com o pólipo na anas-tomose íleo-colônica (AIC, e o outro era paciente de colite ulcerativa (CU com pólipo na entrada da bolsa. Resultados: Foi efetuada uma endoscopia com o paciente sedado

  4. 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

  5. Usual Tumor at an Unusual Site - A Leiomyoma Masquerading as a Urethral Polyp.

    Directory of Open Access Journals (Sweden)

    Shilpa MN

    2013-01-01

    Full Text Available Polyps and papillomas encompass the most common benign tumors of the urethra.Leiomyoma of urethra is a rare clinical entity which can be diagnosed only with histopathological examination and only around 35 such cases have been reported worldwide.

  6. 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) bro...

  7. 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

  8. Effect of tea saponin on ephyrae and polyps of the moon jellyfish Aurelia sp.1.

    Science.gov (United States)

    Dong, Zhijun; Sun, Tingting; Liang, Likun; Wang, Lei

    2017-01-01

    The moon jellyfish (Aurelia sp.1) is thought to be a nuisance for the sea cucumber aquaculture, which commonly occur in the sea cucumber (Apostichopus japonicus) culture ponds of the Yellow Sea, China. To develop an appropriate method to control Aurelia sp.1 blooms, the toxic effects of tea saponin on Aurelia sp.1 ephyrae and polyps were tested in laboratory experiments. Our results revealed that tea saponin caused significant morphological changes, behavioral abnormality and mortality in Aurelia sp.1 ephyrae and polyps in 24 h and 48 h exposure experiments. The 24 h and 48 h median lethal concentrations (LC50) values of tea saponin for Aurelia sp.1 ephyrae were 1.9 and 1.1 mg L-1 respectively, while the LC50 value for Aurelia sp.1 polyps was 0.4 mg L-1 after 24h and 48 h of exposure to tea saponin. Comparison with literature results of tea saponin on A. japonicus indicates that the resistance of A. japonicus to tea saponin is 12-18 times greater than that of Aurelia sp.1 ephyrae. Therefore, the appropriate tea saponin dosage for the control of Aurelia sp.1 should be paid enough attention in order to minimize possible damage for sea cucumber. We suggest that the recommended level of tea saponin to eradicate Aurelia sp.1 ephyrae and polyps in sea cucumber culture ponds be lower than 1.35 mg L-1.

  9. Effect of tea saponin on ephyrae and polyps of the moon jellyfish Aurelia sp.1.

    Directory of Open Access Journals (Sweden)

    Zhijun Dong

    Full Text Available The moon jellyfish (Aurelia sp.1 is thought to be a nuisance for the sea cucumber aquaculture, which commonly occur in the sea cucumber (Apostichopus japonicus culture ponds of the Yellow Sea, China. To develop an appropriate method to control Aurelia sp.1 blooms, the toxic effects of tea saponin on Aurelia sp.1 ephyrae and polyps were tested in laboratory experiments. Our results revealed that tea saponin caused significant morphological changes, behavioral abnormality and mortality in Aurelia sp.1 ephyrae and polyps in 24 h and 48 h exposure experiments. The 24 h and 48 h median lethal concentrations (LC50 values of tea saponin for Aurelia sp.1 ephyrae were 1.9 and 1.1 mg L-1 respectively, while the LC50 value for Aurelia sp.1 polyps was 0.4 mg L-1 after 24h and 48 h of exposure to tea saponin. Comparison with literature results of tea saponin on A. japonicus indicates that the resistance of A. japonicus to tea saponin is 12-18 times greater than that of Aurelia sp.1 ephyrae. Therefore, the appropriate tea saponin dosage for the control of Aurelia sp.1 should be paid enough attention in order to minimize possible damage for sea cucumber. We suggest that the recommended level of tea saponin to eradicate Aurelia sp.1 ephyrae and polyps in sea cucumber culture ponds be lower than 1.35 mg L-1.

  10. How does the serrated polyp pathway alter CRC screening and surveillance?

    Science.gov (United States)

    Kahi, Charles J

    2015-03-01

    Screening and surveillance for colorectal cancer (CRC) reduces mortality through the detection of early-stage adenocarcinoma, and more importantly the detection and removal of premalignant polyps. While adenomas have historically been considered the most common and screening-relevant precursor lesions, there is accumulating evidence showing that the serrated pathway is an important contributor to CRC, and a disproportionate contributor to interval or postcolonoscopy CRC, particularly in the proximal colon. The serrated pathway is characterized by mutations in the BRAF gene, high levels of methylation of promoter CpG islands (CIMP-high), and the sessile serrated adenoma/polyp (SSA/P) is the most important precursor lesion. The study of serrated polyps has been complicated by evolving nomenclature, substantial variation among pathologists in the identification of SSA/Ps, high variability in endoscopic detection rates, and uncertainty regarding the relation to synchronous and metachronous colonic neoplasia. This paper presents an overview of the serrated polyp pathway and discusses its clinical implications including its impact on CRC screening.

  11. Polyp morphology: an interobserver evaluation for the Paris classification among international experts.

    Science.gov (United States)

    van Doorn, Sascha C; Hazewinkel, Y; East, James E; van Leerdam, Monique E; Rastogi, Amit; Pellisé, Maria; Sanduleanu-Dascalescu, Silvia; Bastiaansen, Barbara A J; Fockens, Paul; Dekker, Evelien

    2015-01-01

    The Paris classification is an international classification system for describing polyp morphology. Thus far, the validity and reproducibility of this classification have not been assessed. We aimed to determine the interobserver agreement for the Paris classification among seven Western expert endoscopists. A total of 85 short endoscopic video clips depicting polyps were created and assessed by seven expert endoscopists according to the Paris classification. After a digital training module, the same 85 polyps were assessed again. We calculated the interobserver agreement with a Fleiss kappa and as the proportion of pairwise agreement. The interobserver agreement of the Paris classification among seven experts was moderate with a Fleiss kappa of 0.42 and a mean pairwise agreement of 67%. The proportion of lesions assessed as "flat" by the experts ranged between 13 and 40% (Pagreement did not change (kappa 0.38, pairwise agreement 60%). Our study is the first to validate the Paris classification for polyp morphology. We demonstrated only a moderate interobserver agreement among international Western experts for this classification system. Our data suggest that, in its current version, the use of this classification system in daily practice is questionable and it is unsuitable for comparative endoscopic research. We therefore suggest introduction of a simplification of the classification system.

  12. 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, ...

  13. Clinical Evaluation of Endoscopic Trimodal Imaging for the Detection and Differentiation of Colonic Polyps

    NARCIS (Netherlands)

    van den Broek, Frank J. C.; Fockens, Paul; van Eeden, Susanne; Kara, Mohammed A.; Hardwick, James C. H.; Reitsma, Johannes B.; Dekker, Evelien

    2009-01-01

    Background & Aims: Endoscopic trimodal imaging (ETMI) incorporates high-resolution endoscopy (HRE) and autofluorescence imaging (AFI) for adenoma detection, and narrow-band imaging (NBI) for differentiation of adenomas from nonneoplastic polyps. The aim of this study was to compare AFI with HRE for

  14. Isolated abdominal wound recurrence of an endometrial adenocarcinoma confined to a polyp

    International Nuclear Information System (INIS)

    Barter, J.F.; Hatch, K.D.; Orr, J.W. Jr.; Shingleton, H.M.

    1986-01-01

    An unusual case of Stage IB moderately well-differentiated endometrial adenocarcinoma that was confined to a polyp and recurred only in the abdominal wound is presented. Eighteen months following complete excision, local electron beam therapy, and the institution of hormonal therapy, the patient is alive and without other evidence of recurrence. The mechanisms of metastasis in this case are discussed

  15. 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).

  16. 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.

  17. Poly-P storage by natural biofilms in streams with varying biogeochemistry

    Science.gov (United States)

    Carrick, H. J.

    2015-12-01

    Anthropogenic inputs of nitrogen (N) and phosphorus (P) have increased in many watersheds throughout the world; these inputs have been linked to the eutrophication of inland and coastal waters worldwide. We selected and surveyed 20, third-order streams that supported a range of water column biogeochemical conditions (conductivity, nutrient concentrations) located in the mid-Atlantic region, USA. Biofilm biomass, algal taxonomic composition, and nutrient stoichiometry (C, N, P, and poly-P) were measured at all stream sites. Pulse-amplitude modulation fluorometry (PAM) was used to estimate photosynthetic parameters for stream biofilms (e.g., alpha, Pmax), while microbiology techniques were used to verify poly-P storage by pro- and eukaryotic components of the biofilm (e.g., epi-fluorescent staining). As anticipated, chlorophyll ranged over 2 orders of magnitude among the streams (range 10-1,000 mg/m2). Biofilm chlorophyll and algal biovolume levels increased with water column nutrient contents, while the C:P ratio within the biofilm decreased. Both pro and eukaryotic organisms were present in resident biofilms and actively stored intracellular poly-P. Finally, the rate of photosynthetic within the biofilms appeared to be driven the nutritional condition of the biofilms; pmax and alpha values increased with significantly with stream biofilm poly-P content (r2 = 0.35 and 0.44, respectively). These results indicated that where nutrients are plentiful, biofilms P storage is favored, and this is likely a key regulator of stream biofilm biomass and productivity.

  18. New combinations for two coronate polyp species (Atorellidae and Nausithoidae, Coronatae, Scyphozoa, Cnidaria)

    NARCIS (Netherlands)

    Morandini, A.C.; Jarms, G.

    2005-01-01

    Within the order Coronatae, six valid species remain known only by their polyp stage. The inability to relate them to any medusae genera of the group is a problem that remains to be solved in the order. With the examination of type specimens, we reassign the species Stephanoscyphistoma sibogae and

  19. 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

  20. 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

  1. 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

  2. Physical activity reduces risk for colon polyps in a multiethnic colorectal cancer screening population

    Directory of Open Access Journals (Sweden)

    Sanchez Nelson F

    2012-06-01

    Full Text Available Abstract Background Identifying modifiable factors that influence the epidemiology of colorectal cancer incidence among multiethnic groups might be informative for the development of public health strategies targeting the disease. Minimal data exists describing the impact of physical activity on colorectal polyp risk in United States minority populations. The aim of this study is to evaluate the relationship of exercise on the prevalence of polyps in a multiethnic colorectal cancer screening population. Results We enrolled 982 patients: 558 Hispanic, 202 Asian,149 Black, and 69 White. Patients who reported exercising one or more hours weekly had a lower prevalence of any polyps (25.3% vs 33.2%, P = 0.008 as well as adenomas (13.8 vs. 18.9%, P = 0.03 compared to those who did not exercise. Black and Hispanic patients and those who were overweight or obese also had lower prevalence of polyps if they led an active lifestyle. Multivariate analysis revealed that age >55, male sex, and Black race/ethnicity were positively associated with the presence of adenomas, while a history of exercising one hour or more weekly was an independent negative predictor for the presence of adenomas anywhere in the colon (OR 0.67; 95% CI 0.4 - 0.9, P = 0.03. Conclusions Exercising one hour per week was associated with a lower prevalence of polyps and adenomas when compared to those who exercised less or not at all. An active lifestyle provides benefits to groups who are at risk for colorectal cancer, such as Blacks. It also provides significant protection to overweight and obese individuals. Public health initiatives should promote physical activity as a cancer prevention tool in multiethnic populations. Trial registration none

  3. A CLINICAL STUDY OF ENDOMETRIAL HISTOPATHOLOGY IN AUB AND INCIDENCE OF ENDOMETRIAL POLYP IN AUB

    Directory of Open Access Journals (Sweden)

    Renuka Devi Balakrishnan

    2016-11-01

    Full Text Available BACKGROUND Abnormal Uterine Bleeding (AUB is one of the most common menstrual complaints and a frequent indication for hysterectomy. It can be a manifestation of any number of pathological entities. Causes of AUB ranges from organic pathologies like leiomyoma, polyps, adenomyosis and malignancy to conditions like coagulopathy and drug-induced AUB and aetiologies vary in different age groups. Histopathological evaluation of endometrium is very vital to identify the cause of AUB. The objectives of this study are to, 1. To evaluate the endometrial histopathology in AUB, and 2. To estimate the incidence of endometrial polyp in AUB. MATERIALS AND METHODS This is a prospective study carried out on 120 women who presented with AUB. Endometrial samples collected were analysed for their histopathological pattern. RESULTS Out of 120 endometrial samples analysed among women of 30-39 years, proliferative endometrium was seen in 43.3% and secretory endometrium in 33.3% and endometrial polyp in 13.3%. In women of 40-49 years, proliferative endometrium in 36.8%, secretory endometrium in 30.9% and disordered proliferative endometrium was seen in 19% of women. The incidence of endometrial polyp was found to be 8.3% in our study. CONCLUSION There is an age-specific relation of abnormal endometrial histopathology. Among abnormal endometrial pathology, disordered proliferative endometrium was more common in perimenopausal age group and endometrial polyps in reproductive age group. The results of this study indicate that benign endometrial histopathology is common in AUB suggesting a role for more conservative therapeutic strategies.

  4. Registration of central paths and colonic polyps between supine and prone scans in computed tomography colonography: Pilot study

    International Nuclear Information System (INIS)

    Li Ping; Napel, Sandy; Acar, Burak; Paik, David S.; Jeffrey, R. Brooke Jr.; Beaulieu, Christopher F.

    2004-01-01

    Computed tomography colonography (CTC) is a minimally invasive method that allows the evaluation of the colon wall from CT sections of the abdomen/pelvis. The primary goal of CTC is to detect colonic polyps, precursors to colorectal cancer. Because imperfect cleansing and distension can cause portions of the colon wall to be collapsed, covered with water, and/or covered with retained stool, patients are scanned in both prone and supine positions. We believe that both reading efficiency and computer aided detection (CAD) of CTC images can be improved by accurate registration of data from the supine and prone positions. We developed a two-stage approach that first registers the colonic central paths using a heuristic and automated algorithm and then matches polyps or polyp candidates (CAD hits) by a statistical approach. We evaluated the registration algorithm on 24 patient cases. After path registration, the mean misalignment distance between prone and supine identical anatomic landmarks was reduced from 47.08 to 12.66 mm, a 73% improvement. The polyp registration algorithm was specifically evaluated using eight patient cases for which radiologists identified polyps separately for both supine and prone data sets, and then manually registered corresponding pairs. The algorithm correctly matched 78% of these pairs without user input. The algorithm was also applied to the 30 highest-scoring CAD hits in the prone and supine scans and showed a success rate of 50% in automatically registering corresponding polyp pairs. Finally, we computed the average number of CAD hits that need to be manually compared in order to find the correct matches among the top 30 CAD hits. With polyp registration, the average number of comparisons was 1.78 per polyp, as opposed to 4.28 comparisons without polyp registration

  5. Inactivation of promoter 1B of APC causes partial gene silencing: evidence for a significant role of the promoter in regulation and causative of familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Rohlin, A; Engwall, Y; Fritzell, K

    2011-01-01

    inactivation of promoter 1B is disease causing in FAP; (ii) expression of transcripts from promoter 1B is generated at considerable higher levels compared with 1A, demonstrating a hitherto unknown importance of 1B; (iii) adenoma formation in FAP, caused by impaired function of promoter 1B, does not require......Familial adenomatous polyposis (FAP) is caused by germline mutations in the adenomatous polyposis coli (APC) gene. Two promoters, 1A and 1B, have been recognized in APC, and 1B is thought to have a minor role in the regulation of the gene. We have identified a novel deletion encompassing half...... of this promoter in the largest family (Family 1) of the Swedish Polyposis Registry. The mutation leads to an imbalance in allele-specific expression of APC, and transcription from promoter 1B was highly impaired in both normal colorectal mucosa and blood from mutation carriers. To establish the significance...

  6. Rhinoplasty via the midface degloving approach for nasal deformity due to nasal polyps: A case report of Woakes’ syndrome

    Directory of Open Access Journals (Sweden)

    Misato Ueda, MD

    2017-09-01

    Full Text Available Nasal polyps are inflammatory proliferative tumors arising from the mucosa of the nasal cavity and paranasal sinuses. Although many cases concerning nasal polyps have been reported, those involving external nasal deformities are rare. We report a case of nasal polyposis filling the nasal cavity and paranasal sinuses, leading to external nasal and facial deformities. The condition above is known as Woakes’ syndrome, which is characterized by severe recurrent nasal polyps with deformity of the nasal pyramid, leading to broadening of the nose. We performed nasal osteotomy and facial bone-shaving via the midface degloving approach, which improved the patient’s facial appearance.

  7. The rare presentations of a large polyp and an esophageal carcinoma in heterotropic gastric mucosa: a case series

    Directory of Open Access Journals (Sweden)

    Alagozlu Hakan

    2007-11-01

    Full Text Available Abstract Background Heterotopic gastric mucosa (HGM is commonly seen in the upper esophagus during endoscopyand is generally considered a benign disease. A hyperplastic polyp and an adenocarcinoma arising in heterotopic gastric mucosa are quite rare occurences. Case presentations We present two cases: The first is a patient who suffered from dysphagia because of a large hyperplastic polyp that arose from HGM; the polyp was excised endoscopically. Secondly, we report a rare case of adenocarcinoma arising in HGM of the cervical esophagus. Conclusion Morphologic changes or malignant transformation can develop in the inlet patch. Therefore, gastroenterologists should be aware of the possibility of HGM just distal to the upper esophageal sphincter.

  8. 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.

  9. 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.

  10. Sessile serrated polyps of the colorectum are rare in patients with Lynch syndrome and in familial colorectal cancer families

    DEFF Research Database (Denmark)

    Andersen, S H; Lykke, E; Folker, M B

    2008-01-01

    Whereas the generally accepted carcinogenesis pathway of the microsatellite instabile high (MSI-H) colorectal carcinoma (CRC) involves the traditional adenoma in patients with Lynch syndrome, a serrate pathway involving serrate adenomas (SA) and sessile serrate polyps (SSP) characterize...... the sporadic MSI-H counterpart. Recent studies have, however, challenged such simple one-pathway models, inviting the consideration of alternative, unexpected pathways. Here, the issue as to the possible role of SSP, primarily in the context of Lynch syndrome, but also in subjects from familial CRC families...... (FCF) is addressed. Polyps coded as hyperplastic polyps (HP) from subjects with Lynch syndrome and FCF enrolled in the HNPCC-register at the Hvidovre University Hospital as well as adenomas from this population were retrieved and reviewed for features of SSP. Ninety-eight polyps coded as HP and 41...

  11. The clinical significance and synchronous polyp burden of large (≥ 20 mm) sessile serrated polyps in patients without serrated polyposis syndrome.

    Science.gov (United States)

    Desomer, Lobke; Tate, David J; Jayanna, Mahesh; Pellise, Maria; Awadie, Halim; Burgess, Nicholas G; McLeod, Duncan; Mahajan, Hema; Lee, Eric Y T; Williams, Stephen J; Bourke, Michael J

    2018-05-08

     Sessile serrated polyps (SSPs) are important precursors of colorectal carcinoma and interval cancer. Large SSPs (≥ 20 mm) outside the definition of serrated polyposis syndrome (SPS) have not been studied in comparison with SPS. We aimed to describe the characteristics of patients with large SSPs in this context.  Patients with at least one SSP (≥ 20 mm) were eligible. Data from three consecutive colonoscopies were used to compare clinical and endoscopic characteristics in three patient groups: SPS, a solitary large SSP, and patients with at least two SSPs without fulfilling the criteria for SPS (oligo-SSP). Data on the diagnostic colonoscopy were collected retrospectively, whereas the remaining data was collected prospectively.  67/146 patients (45.9 %) had SPS, 53/146 (36.3 %) had a solitary SSP, and 26/146 (17.8 %) were categorized as oligo-SSP. Personal (16.4 %, 9.4 %, and 11.5 %, respectively) and family (17.9 %, 17.0 %, and 23.1 %, respectively) history of colorectal carcinoma did not differ significantly between groups. Polyp burden was greater in SPS compared with solitary SSP but was not different from oligo-SSP (advanced adenomas: SPS 32.8 % vs. solitary SSP 9.4 % [ P  = 0.002] vs. oligo-SSP 34.6 % [ P  = 0.87]; ≥ 10 conventional adenomas: 11.9 % vs. 0 % [ P  = 0.01] vs. 3.8 % [ P  = 0.44], respectively). Dysplasia in large SSPs was frequent in all groups (41.1 % overall). SPS was recognized by referring endoscopists in only 9.0 % of cases.  Patients with oligo-SSPs have similar synchronous polyp burden and clinical characteristics as patients with SPS and may require similar surveillance. Modification of the criteria for the diagnosis of SPS to include this group seems warranted. Patients with a solitary SSP have a lower risk of synchronous polyps, including advanced adenomas. Larger studies are warranted to determine whether these patients may return to standard surveillance

  12. Adenomatous polyposis coli (APC) regulates miR17-92 cluster through β-catenin pathway in colorectal cancer.

    Science.gov (United States)

    Li, Yajuan; Lauriola, Mattia; Kim, Donghwa; Francesconi, Mirko; D'Uva, Gabriele; Shibata, Dave; Malafa, Mokenge P; Yeatman, Timothy J; Coppola, Domenico; Solmi, Rossella; Cheng, Jin Q

    2016-09-01

    Adenomatous polyposis coli (APC) mutation is the most common genetic change in sporadic colorectal cancer (CRC). Although deregulations of miRNAs have been frequently reported in this malignancy, APC-regulated miRNAs have not been extensively documented. Here, by using an APC-inducible cell line and array analysis, we identified a total of 26 deregulated miRNAs. Among them, members of miR-17-92 cluster were dramatically inhibited by APC and induced by enforced expression of β-catenin. Furthermore, we demonstrate that activated β-catenin resulted from APC loss binds to and activates the miR-17-92 promoter. Notably, enforced expression of miR-19a overrides APC tumor suppressor activity, and knockdown of miR-19a in cancer cells with compromised APC function reduced their aggressive features in vitro. Finally, we observed that expression of miR-19a significantly correlates with β-catenin levels in colorectal cancer specimens, and it is associated to the aggressive stage of tumor progression. Thus, our study reveals that miR-17-92 cluster is directly regulated by APC/β-catenin pathway and could be a potential therapeutic target in colon cancers with aberrant APC/β-catenin signaling.

  13. [miR-182 promotes cell proliferation of cervical cancer cells by targeting adenomatous polyposis coli (APC) gene].

    Science.gov (United States)

    Li, Pei; Hu, Jing; Zhang, Ying; Li, Jianping; Dang, Yunzhi; Zhang, Rui; Wei, Lichun; Shi, Mei

    2018-02-01

    Objective To investigate the role and mechanism of microRNA-182 (miR-182) in the proliferation of cervical cancer cells. Methods With liposome-mediated transient transfection method, the level of miR-182 in HeLa and SiHa cells was increased or decreased. CCK-8 assay and colony formation assay were used to observe the effect of miR-182 on the proliferation of cervical cancer cells. Using bioinformatics predictions, real-time quantitative PCR, and dual luciferase reporter assay, we clarified the role of miR-182 in posttranscriptional regulation of adenomatous polyposis coli (APC) gene and its effect on the downstream molecules (c-Myc and cyclin D1) of Wnt singling pathway. Results Up-regulation of miR-182 significantly promoted the proliferation of cervical cancer cells, while down-regulation of miR-182 significantly inhibited the proliferation of cervical cancer cells. Over-expression of miR-182 inhibited the expression of APC gene in cervical cancer cells and the regulation of miR-182 affected the expression of canonical Wnt signaling pathway downstream molecules in cervical cancer cells. Conclusion The miR-182 stimulates canonical Wnt signaling pathway by targeting APC gene and enhances the proliferation of cervical cancer cells.

  14. Multi-detector row CT colonography: effect of collimation, pitch, and orientation on polyp detection in a human colectomy specimen.

    Science.gov (United States)

    Taylor, Stuart A; Halligan, Steve; Bartram, Clive I; Morgan, Paul R; Talbot, Ian C; Fry, Nicola; Saunders, Brian P; Khosraviani, Kirosh; Atkin, Wendy

    2003-10-01

    To investigate the effects of orientation, collimation, pitch, and tube current setting on polyp detection at multi-detector row computed tomographic (CT) colonography and to determine the optimal combination of scanning parameters for screening. A colectomy specimen containing 117 polyps of different sizes was insufflated and imaged with a multi-detector row CT scanner at various collimation (1.25 and 2.5 mm), pitch (3 and 6), and tube current (50, 100, and 150 mA) settings. Two-dimensional multiplanar reformatted images and three-dimensional endoluminal surface renderings from the 12 resultant data sets were examined by one observer for the presence and conspicuity of polyps. The results were analyzed with Poisson regression and logistic regression to determine the effects of scanning parameters and of specimen orientation on polyp detection. The percentage of polyps that were detected significantly increased when collimation (P =.008) and table feed (P =.03) were decreased. Increased tube current resulted in improved detection only of polyps with a diameter of less than 5 mm. Polyps of less than 5 mm were optimally depicted with a collimation of 1.25 mm, a pitch of 3, and a tube current setting of 150 mA; polyps with a diameter greater than 5 mm were adequately depicted with 1.25-mm collimation and with either pitch setting and any of the three tube current settings. Small polyps in the transverse segment (positioned at a 90 degrees angle to the z axis of scanning) were significantly less visible than those in parallel or oblique orientations (P detector row CT is highly dependent on collimation, pitch, and, to a lesser extent, tube current. Collimation of 1.25 mm, combined with pitch of 6 and tube current of 50 mA, provides for reliable detection of polyps 5 mm or larger while limiting the effective radiation dose. Polyps smaller than 5 mm, however, may be poorly depicted with use of these settings in the transverse colon. Copyright RSNA, 2003

  15. Interobserver agreement in the histologic diagnosis of colorectal polyps. the experience of the multicenter adenoma colorectal study (SMAC).

    Science.gov (United States)

    Costantini, Massimo; Sciallero, Stefania; Giannini, Augusto; Gatteschi, Beatrice; Rinaldi, Paolo; Lanzanova, Giuseppe; Bonelli, Luigina; Casetti, Tino; Bertinelli, Elisabetta; Giuliani, Orietta; Castiglione, Guido; Mantellini, Paola; Naldoni, Carlo; Bruzzi, Paolo

    2003-03-01

    Current clinical practice guidelines for patients with colorectal polyps are mainly based on the histologic characteristics of their lesions. However, interobserver variability in the assessment of specific polyp characteristics was evaluated in very few studies. The purpose of this study was to evaluate the interobserver agreement of four pathologists in the diagnosis of histologic type of colorectal polyps and in the degree of dysplasia and of infiltrating carcinoma in adenomas. A stratified random sample of 100 polyps was obtained from the 4,889 polyps resected within the Multicentre Adenoma Colorectal Study (SMAC), and the slides were blindly reviewed by the four pathologists. Agreement was analyzed using kappa statistics. A median kappa of 0.89 (range 0.79-1.0) was estimated for the interobserver agreement for the diagnosis of hyperplastic polyp vs. adenoma. The agreement in the diagnosis of tubular, tubulovillous, and villous type, was given by median kappa values of 0.50, 0.15, and 0.36, respectively. The median kappa for the diagnosis of infiltrating carcinoma was 0.78 (range 0.73-0.84). Agreement on diagnosis of adenoma histologic subtypes, degrees of dysplasia, or infiltrating carcinoma in adenoma was moderate. A simpler classifications might help to better identify patients at different risk of colorectal cancer.

  16. Giant ileal inflammatory fibroid polyp: a rare cause of intestinal intussusception

    Directory of Open Access Journals (Sweden)

    Daniel Cury Ogata

    2012-09-01

    Full Text Available Ileal inflammatory fibroid polyp is a rare non-neoplastic lesion of the gastrointestinal tract. Intussusception caused by an inflammatory fibroid polyps is uncommon. The authors report a case of a 75 year-old female patient presenting with ileal obstruction due to intussusception of a polypoid lesion. The patient underwent surgical treatment and histopathology confirmed the diagnosis.Os pólipos fibroides inflamatórios são raras lesões não neoplásicas do trato gastrointestinal e a intussuscepção devido a essa entidade é incomum. Os autores relatam um caso de paciente do sexo feminino, 75 anos, que apresentou obstrução ileal devido a uma intussuscepção por lesão polipoide. A paciente foi submetida a tratamento cirúrgico, sendo diagnosticado pólipo fibroide inflamatório do íleo.

  17. The effects of food and photoperiod on strobilation of Aurelia aurita polyps

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    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. Histogram-based adaptive gray level scaling for texture feature classification of colorectal polyps

    Science.gov (United States)

    Pomeroy, Marc; Lu, Hongbing; Pickhardt, Perry J.; Liang, Zhengrong

    2018-02-01

    Texture features have played an ever increasing role in computer aided detection (CADe) and diagnosis (CADx) methods since their inception. Texture features are often used as a method of false positive reduction for CADe packages, especially for detecting colorectal polyps and distinguishing them from falsely tagged residual stool and healthy colon wall folds. While texture features have shown great success there, the performance of texture features for CADx have lagged behind primarily because of the more similar features among different polyps types. In this paper, we present an adaptive gray level scaling and compare it to the conventional equal-spacing of gray level bins. We use a dataset taken from computed tomography colonography patients, with 392 polyp regions of interest (ROIs) identified and have a confirmed diagnosis through pathology. Using the histogram information from the entire ROI dataset, we generate the gray level bins such that each bin contains roughly the same number of voxels Each image ROI is the scaled down to two different numbers of gray levels, using both an equal spacing of Hounsfield units for each bin, and our adaptive method. We compute a set of texture features from the scaled images including 30 gray level co-occurrence matrix (GLCM) features and 11 gray level run length matrix (GLRLM) features. Using a random forest classifier to distinguish between hyperplastic polyps and all others (adenomas and adenocarcinomas), we find that the adaptive gray level scaling can improve performance based on the area under the receiver operating characteristic curve by up to 4.6%.

  19. 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.

  20. Endotyping of Chronic Rhinosinusitis With and Without Polyp Using Transcription Factor Analysis

    OpenAIRE

    Pongsakorn Tantilipikorn; Nitat Sookrung; Soranart Muangsomboon; Jate Lumyongsatien; Anan Bedavanija; Triphoom Suwanwech

    2018-01-01

    Inflammation of the nose and paranasal sinus or rhinosinusitis (RS) is a significant global health problem that is both very common and very costly to treat. Previous reports reveal variability in histology and mechanism of inflammation in patients with chronic rhinosinusitis with and without polyp (CRScNP and CRSsNP, respectively). There are various methods and hypothesis that try to explain this variability. Accordingly, the aim of this study was to investigate the incidence of each type of...

  1. Postirradiation Leiomyosarcoma of Rectum Presenting as a Polyp: Case Report and Review of the Literature.

    Science.gov (United States)

    Jayakumar, Rajeswari; Basu, Prithwijit Patrick; Huang, Tao; Axiotis, Constantine A

    2016-04-01

    Radiation-induced leiomyosarcomas of the gastrointestinal tract are rare. Very few cases have been documented to date. The histological similarity to gastrointestinal stromal tumor has raised doubts if many of the cases originally reported to be leiomyosarcoma before the widespread use of CD117 were indeed gastrointestinal stromal tumors. We present a case of post-irradiation leiomyosarcoma presenting as a rectal polyp and review the literature. © The Author(s) 2015.

  2. 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...

  3. Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    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.

  4. Gastric Polyp Growth during Endoscopic Surveillance for Esophageal Varices or Barrett's Esophagus.

    Science.gov (United States)

    Livovsky, Dan M; Pappo, Orit; Skarzhinsky, Galina; Peretz, Asaf; Turvall, Elliot; Ackerman, Zvi

    2016-05-01

    We recently observed patients with chronic liver disease (CLD) or chronic reflux symptoms (CRS) who developed gastric polyps (GPs) while undergoing surveillance gastroscopies for the detection of esophageal varices or Barrett's esophagus, respectively. To identify risk factors for GP growth and estimate its growth rate. GP growth rate was defined as the number of days since the first gastroscopy (without polyps) in the surveillance program, until the gastroscopy when a GP was discovered. Gastric polyp growth rates in CLD and CRS patients were similar. However, hyperplastic gastric polyps (HGPs) were detected more often (87.5% vs. 60.5%, P = 0.051) and at a higher number (2.57 ± 1.33 vs. 1.65 ± 0.93, P = 0.021) in the CLD patients. Subgroup analysis revealed the following findings only in CLD patients with HGPs: (i) a positive correlation between the GP growth rate and the patient's age; the older the patient, the higher the GP growth rate (r = 0.7, P = 0.004). (ii) A negative correlation between the patient's age and the Ki-67 proliferation index value; the older the patient, the lower the Ki-67 value (r = -0.64, P = 0.02). No correlation was detected between Ki-67 values of HGPs in CLD patients and the presence of portal hypertension, infection with Helicobacter pylori, or proton pump inhibitor use. In comparison with CRS patients, CLD patients developed HGPs more often and at a greater number. Young CLD patients may have a tendency to develop HGPs at a faster rate than elderly CLD patients.

  5. Max-AUC feature selection in computer-aided detection of polyps in CT colonography.

    Science.gov (United States)

    Xu, Jian-Wu; Suzuki, Kenji

    2014-03-01

    We propose a feature selection method based on a sequential forward floating selection (SFFS) procedure to improve the performance of a classifier in computerized detection of polyps in CT colonography (CTC). The feature selection method is coupled with a nonlinear support vector machine (SVM) classifier. Unlike the conventional linear method based on Wilks' lambda, the proposed method selected the most relevant features that would maximize the area under the receiver operating characteristic curve (AUC), which directly maximizes classification performance, evaluated based on AUC value, in the computer-aided detection (CADe) scheme. We presented two variants of the proposed method with different stopping criteria used in the SFFS procedure. The first variant searched all feature combinations allowed in the SFFS procedure and selected the subsets that maximize the AUC values. The second variant performed a statistical test at each step during the SFFS procedure, and it was terminated if the increase in the AUC value was not statistically significant. The advantage of the second variant is its lower computational cost. To test the performance of the proposed method, we compared it against the popular stepwise feature selection method based on Wilks' lambda for a colonic-polyp database (25 polyps and 2624 nonpolyps). We extracted 75 morphologic, gray-level-based, and texture features from the segmented lesion candidate regions. The two variants of the proposed feature selection method chose 29 and 7 features, respectively. Two SVM classifiers trained with these selected features yielded a 96% by-polyp sensitivity at false-positive (FP) rates of 4.1 and 6.5 per patient, respectively. Experiments showed a significant improvement in the performance of the classifier with the proposed feature selection method over that with the popular stepwise feature selection based on Wilks' lambda that yielded 18.0 FPs per patient at the same sensitivity level.

  6. 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.

  7. Calcification process dynamics in coral primary polyps as observed using a calcein incubation method

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    Yoshikazu Ohno

    2017-03-01

    Full Text Available Calcification processes are largely unknown in scleractinian corals. In this study, live confocal imaging was used to elucidate the spatiotemporal dynamics of the calcification process in aposymbiotic primary polyps of the coral species Acropora digitifera. The fluorophore calcein was used as a calcium deposition marker and a visible indicator of extracellular fluid distribution at the tissue-skeleton interface (subcalicoblastic medium, SCM in primary polyp tissues. Under continuous incubation in calcein-containing seawater, initial crystallization and skeletal growth were visualized among the calicoblastic cells in live primary polyp tissues. Additionally, the distribution of calcein-stained SCM and contraction movements of the pockets of SCM were captured at intervals of a few minutes. Our experimental system provided several new insights into coral calcification, particularly as a first step in monitoring the relationship between cellular dynamics and calcification in vivo. Our study suggests that coral calcification initiates at intercellular spaces, a finding that may contribute to the general understanding of coral calcification processes.

  8. 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).

  9. Evaluation of Usefulness of hs-CRP and Ferritin Assays in Patients with Nasal Polyps

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    Robert Partyka

    2014-01-01

    Full Text Available Background. Chronic nature of the nasal polyps, tendency to recurrence, and lack of satisfying treatment need the diagnostic’s parameters which show early inflammatory state as ferritin and hs-CRP. The Aim of Study. Assessment of hs-CRP and ferritin blood levels in nasal polyps patients in evaluation of treatment efficacy. Methods. All 38 patients were divided into 2 groups. Group I included 19 patients with anti-inflammatory therapy 2 weeks after surgery. Group II included 19 patients without anti-inflammatory therapy 2 weeks after surgery. The levels of hs-CRP and ferritin have been assessed before and 2 and 6 weeks after surgical treatment. Results. Research showed statistically significant difference of ferritin’s concentration between examined groups 6 weeks after surgery (P<0.05 and statistically significant difference of hs-CRP concentration 2 and 6 weeks after surgery (P<0.05. Conclusion. (1 The analysis of serum ferritin and hs-CRP concentrations can be useful in early postoperative detection of inflammatory state in patients with nasal polyps and for the effectiveness of therapy. (2 Lack of correlation between mean ferritin and hs-CRP serum levels, at each diagnostic and monitoring stage, shows that they are independent and cannot be determined interchangeably.

  10. Clinical Significance of Contralateral Reactive Lesion in Vocal Fold Polyp and Cyst.

    Science.gov (United States)

    Cho, Jung-Hae; Choi, Yong-Sug; Joo, Young-Hoon; Park, Young-Hak; Sun, Dong-Il

    2018-01-01

    We investigated the clinical significance of contralateral reactive lesions in patients undergoing laryngeal microsurgery for benign vocal fold lesions such as vocal polyps and cysts. This was a retrospective, single institution cohort study. Patient medical records were reviewed for demographic characteristics; acoustic, aerodynamic, and perceptual analyses; and Voice Handicap Index score before and after laryngeal microsurgery. Definitive diagnoses were made via intraoperative microlaryngoscopic evaluations. Clinical parameters were assessed to identify risk factors for contralateral reactive lesions. We evaluated surgical outcome using voice analysis. We enrolled 268 patients (109 men and 159 women) with benign vocal fold lesions. A total of 195 (72.8%) had a contralateral reactive vocal fold lesion. A multivariable analysis revealed that being a never smoker and having a hoarseness duration ≥6 months, vocal polyps, and small primary lesions were independent risk factors for contralateral reactive lesions (P vocal fold lesions are frequently detected in patients with vocal polyp and cyst. The reactive lesions had an adverse effect on voice quality. Simultaneous excision of primary and contralateral reactive lesions may be an alternative treatment for better voice outcome. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  11. A role for the epidermal growth factor receptor signaling in development of intestinal serrated polyps in mice and humans.

    Science.gov (United States)

    Bongers, Gerold; Muniz, Luciana R; Pacer, Michelle E; Iuga, Alina C; Thirunarayanan, Nanthakumar; Slinger, Erik; Smit, Martine J; Reddy, E Premkumar; Mayer, Lloyd; Furtado, Glaucia C; Harpaz, Noam; Lira, Sergio A

    2012-09-01

    Epithelial cancers can be initiated by activating mutations in components of the mitogen-activated protein kinase signaling pathway such as v-raf murine sarcoma viral oncogene homolog B1 (BRAF), v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS), or epidermal growth factor receptor (EGFR). Human intestinal serrated polyps are a heterogeneous group of benign lesions, but some progress to colorectal cancer. Tumors that arise from these polyps frequently contain activating mutations in BRAF or KRAS, but little is known about the role of EGFR activation in their development. Polyp samples were obtained from adults during screening colonoscopies at Mount Sinai Hospital in New York. We measured levels of EGFR protein and phosphorylation in human serrated polyps by immunohistochemical and immunoblot analyses. We generated transgenic mice that express the ligand for EGFR, Heparin-binding EGF-like growth factor (HB-EGF), in the intestine. EGFR and the extracellular-regulated kinases (ERK)1/2 were phosphorylated in serrated areas of human hyperplastic polyps (HPPs), sessile serrated adenomas, and traditional serrated adenomas. EGFR and ERK1/2 were phosphorylated in the absence of KRAS or BRAF activating mutations in a subset of HPP. Transgenic expression of the EGFR ligand HB-EGF in the intestines of mice promoted development of small cecal serrated polyps. Mice that expressed a combination of HB-EGF and US28 (a constitutively active, G-protein-coupled receptor that increases processing of HB-EGF from the membrane) rapidly developed large cecal serrated polyps. These polyps were similar to HPPs and had increased phosphorylation of EGFR and ERK1/2 within the serrated epithelium. Administration of pharmacologic inhibitors of EGFR or MAPK to these transgenic mice significantly reduced polyp development. Activation of EGFR signaling in the intestine of mice promotes development of serrated polyps. EGFR signaling also is activated in human HPPs, sessile serrated adenomas

  12. Colonoscopia com magnificação de imagem no diagnóstico de carcinoma colorretal invasivo da submucosa na polipose adenomatosa familiar Magnifying colonoscopy diagnosis of submucosal invasive colorectal carcinoma in familial adenomatous polyposis

    Directory of Open Access Journals (Sweden)

    Cláudio TARTA

    2000-04-01

    Full Text Available O desenvolvimento da colonoscopia com magnificação de imagem possibilitou o estudo detalhado da mucosa colônica e o diagnóstico diferencial entre lesões neoplásicas e não-neoplásicas, a partir da observação dos pit patterns. Os resultados são comparáveis à estereomicroscopia, sendo possível, assim, presumir o diagnóstico histológico. Foi realizada colonoscopia com magnificação de imagem em paciente portadora de polipose adenomatosa familiar, demonstrando-se com este método, a diversidade de lesões polipóides benignas e as apresentações morfológicas do câncer colorretal precoce. Nesta paciente, a avaliação por magnificação (videocolonoscópio FUJINON 410 - CM -- 40X, combinada à cromoscopia com indigo carmine 0,4%, demonstrou ampla variedade de lesões distribuídas por todo o cólon: lesão de espalhamento lateral no ceco com padrão IIIL + IV, pólipos subpediculados e sésseis distribuídos pelo cólon com padrão tipo IIIL, pólipo subpediculado no cólon transverso com diâmetro aproximado de 2,0 cm e padrão IV + V, lesões plano-elevadas tipo IIIL e no cólon sigmóide lesão IIa + IIc, com padrão V de Kudo. A avaliação dos pit patterns de lesões no cólon transverso e sigmóide permitiu o diagnóstico endoscópico de lesão com invasão de submucosa.The development of colonoscopy with image magnification has enable to study the colonic mucosa in detail and to do differential diagnosis between neoplastic and non-neoplastic lesions from the observation of pit patterns. The results are comparable to stereomicroscopy being possible to predict the histologic diagnosis. In a patient with familial adenomatous polyposis magnifying colonoscopy was performed and this method demonstrated a wide variaton of benign polypoid lesions and the morphological features of early colorectal cancer. In this patient, the evaluation by image magnification, together with indigo carmin 0,4% chromoscopy, showed a wide variety of

  13. 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

  14. First Case Report of Turcot Syndrome Type 1 in Colombia

    Directory of Open Access Journals (Sweden)

    Vallejo Dora

    2012-01-01

    Full Text Available Turcot syndrome is an autosomal recessive disorder clinically characterized by the occurrence of primary tumors of the central nervous system and adenomatous colonic polyps during the first or second decades of life, with a spectrum of clinical features such as “café-au-lait” spots, axillary freckling, and hyperpigmented spots. Currently its prevalence globally and in Colombia remains unknown. We present the case of a 20-year-old male with a clinical presentation of both glioblastoma multiforme and multiple adenomatous colonic polyps. The molecular genetics study revealed a mutation in KrasAsp12 gene and altered expression of HMSH2 and HMSH6 proteins encoded by the DNA mismatch repair genes in two of the colonic polyps. Even though this clinical presentation may suggest a shorter survival rate, this patient is still alive after seven months of treatment. A literature review complements this report.

  15. High-resolution Melting Analysis for Gene Scanning of Adenomatous Polyposis Coli (APC) Gene With Oral Squamous Cell Carcinoma Samples.

    Science.gov (United States)

    Chang, Ya-Sian; Lin, Chien-Yu; Yang, Shu-Fen; Ho, Cheng Mao; Chang, Jan-Gowth

    2016-02-01

    There have been many different mutations reported for the large adenomatous polyposis coli (APC) tumor suppressor gene. APC mutations result in inactivation of APC tumor suppressor action, allowing the progression of tumorigenesis. The present study utilized a highly efficient method to identify APC mutations and investigated the association between the APC genetic variants Y486Y, A545A, T1493T, and D1822V and susceptibility to oral squamous cell carcinoma (OSCC). High-resolution melting (HRM) analysis was used to characterize APC mutations. Genomic DNA was extracted from 83 patient specimens of OSCC and 50 blood samples from healthy control subjects. The 14 exons and mutation cluster region of exon 15 were screened by HRM analysis. All mutations were confirmed by direct DNA sequencing. Three mutations and 4 single nucleotide polymorphisms (SNPs) were found in this study. The mutations were c.573T>C (Y191Y) in exon 5, c.1005A>G (L335L) in exon 9, and c.1488A>T (T496T) in exon 11. Two SNPs, c.4479G>A (T1493T) and c.5465A>T (D1822V), were located in exon 15, whereas c.1458T>C (Y486Y) and c.1635G>A (A545A) were located in exon 11 and 13, respectively. There was no observed association between OSCC risk and genotype for any of the 4 APC SNPs. The mutation of APC is rare in Taiwanese patients with OSCC. HRM analysis is a reliable, accurate, and fast screening method for APC mutations.

  16. Is prevalence of colorectal polyps higher in patients with family history of colorectal cancer?

    Directory of Open Access Journals (Sweden)

    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

  17. Computer-aided detection of colorectal polyps: can it improve sensitivity of less-experienced readers? Preliminary findings.

    Science.gov (United States)

    Baker, Mark E; Bogoni, Luca; Obuchowski, Nancy A; Dass, Chandra; Kendzierski, Renee M; Remer, Erick M; Einstein, David M; Cathier, Pascal; Jerebko, Anna; Lakare, Sarang; Blum, Andrew; Caroline, Dina F; Macari, Michael

    2007-10-01

    To determine whether computer-aided detection (CAD) applied to computed tomographic (CT) colonography can help improve sensitivity of polyp detection by less-experienced radiologist readers, with colonoscopy or consensus used as the reference standard. The release of the CT colonographic studies was approved by the individual institutional review boards of each institution. Institutions from the United States were HIPAA compliant. Written informed consent was waived at all institutions. The CT colonographic studies in 30 patients from six institutions were collected; 24 images depicted at least one confirmed polyp 6 mm or larger (39 total polyps) and six depicted no polyps. By using an investigational software package, seven less-experienced readers from two institutions evaluated the CT colonographic images and marked or scored polyps by using a five-point scale before and after CAD. The time needed to interpret the CT colonographic findings without CAD and then to re-evaluate them with CAD was recorded. For each reader, the McNemar test, adjusted for clustered data, was used to compare sensitivities for readers without and with CAD; a Wilcoxon signed-rank test was used to analyze the number of false-positive results per patient. The average sensitivity of the seven readers for polyp detection was significantly improved with CAD-from 0.810 to 0.908 (P=.0152). The number of false-positive results per patient without and with CAD increased from 0.70 to 0.96 (95% confidence interval for the increase: -0.39, 0.91). The mean total time for the readings was 17 minutes 54 seconds; for interpretation of CT colonographic findings alone, the mean time was 14 minutes 16 seconds; and for review of CAD findings, the mean time was 3 minutes 38 seconds. Results of this feasibility study suggest that CAD for CT colonography significantly improves per-polyp detection for less-experienced readers. Copyright (c) RSNA, 2007.

  18. 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.

  19. 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.

  20. 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.

  1. Evaluation of promoter methylation status of MLH1 gene in Iranian patients with colorectal tumors and adenoma polyps.

    Science.gov (United States)

    Zarandi, Ashkan; Irani, Shiva; Savabkar, Sanaz; Chaleshi, Vahid; Ghavideldarestani, Maryam; Mirfakhraie, Reza; Khodadoostan, Mahsa; Nazemalhosseini-Mojarad, Ehsan; Asadzadeh Aghdaei, Hamid

    2017-01-01

    The aim of this study was to evaluate the methylation status of the promoter region of MLH1 gene in colorectal cancer (CRC) and its precursor lesions as well as elucidate its association with various clinicopathological characteristics among Iranian population. Epigenetic silencing of mismatch repair genes, such as MLH1 , by methylation of CpG islands of their promoter region has been proved to be an important mechanism in colorectal carcinogenesis. Fifty colorectal cancer and polyp tissue samples including 13 Primary colorectal tumor and 37 Adenoma polyp samples were enrolled in this study. Methylation-specific polymerase chain reaction (MSP) was performed to find the frequency of MLH1 Promoter Methylation. Promoter methylation of MLH1 gene was detected in 5 out of 13 tumor tissues and 4 out of 37 adenoma polyp. The frequency of MLH1 methylation in tumor samples was significantly higher compared to that in polyp tissues (P= 0.026). No significant association was observed between MLH1 promoter methylation and clinicopathological characteristics of the patients. The frequency of  MLH1  promoter methylation in CRC and colon polyp was 18%. Our findings indicated that methylation of MLH1 promoter region alone cannot be considered as a biomarker for early detection of CRC.

  2. The comparison of CT virtual colonoscopy with video colonoscopy (the detection of simulated polyps in pig colon)

    International Nuclear Information System (INIS)

    Tang Wen; Gong Jianping; Gao Zhixin; Lu Zhian

    2000-01-01

    Objective: To assess the value of CT virtual colonoscopy for the detection of simulated polyps in pig colon. Methods: Injecting the smelted wax under the mucosa to simulate the polyps in pig colon, then detected by video colonoscopy and scanned by helical CT. The images were obtained with collimation 3 mm, 5 mm, 10 mm and with the table pitch 1 and 2. All images were reconstructed at 1 mm intervals. Results: The shapes were depicted as follows: those greater than 10 mm in diameter polyps were clearly depicted. 5-9 mm in diameter polyps were faintly depicted. Those smaller than 5 mm in diameter were depicted difficulty. The details depicted: polyps larger than 10 mm in diameter and 5-9 mm in diameter were clearly depicted and that smaller than 5 mm in diameter were depicted difficulty. The images quality lowered with the increasing collimation and pitch. Conclusion: CT virtual colonoscopy is a non-invasive diagnostic technique. It can show the inner wall of colon as same as video colonoscopy does, and is a good alternative in clinical application

  3. Feature-guided analysis for reduction of false positives in CAD of polyps for computed tomographic colonography

    International Nuclear Information System (INIS)

    Naeppi, Janne; Yoshida, Hiroyuki

    2003-01-01

    We evaluated the effect of our novel technique of feature-guided analysis of polyps on the reduction of false-positive (FP) findings generated by our computer-aided diagnosis (CAD) scheme for the detection of polyps from computed tomography colonographic data sets. The detection performance obtained by use of feature-guided analysis in the segmentation and feature analysis of polyp candidates was compared with that obtained by use of our previously employed fuzzy clustering technique. We also evaluated the effect of a feature called modified gradient concentration (MGC) on the detection performance. A total of 144 data sets, representing prone and supine views of 72 patients that included 14 patients with 21 colorectal polyps 5-25 mm in diameter, were used in the evaluation. At a 100% by-patient (95% by-polyp) detection sensitivity, the FP rate of our CAD scheme with feature-guided analysis based on round-robin evaluation was 1.3 (1.5) FP detections per patient. This corresponds to a 70-75 % reduction in the number of FPs obtained by use of fuzzy clustering at the same sensitivity levels. Application of the MGC feature instead of our previously used gradient concentration feature did not improve the detection result. The results indicate that feature-guided analysis is useful for achieving high sensitivity and a low FP rate in our CAD scheme

  4. 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

  5. Curcumin suppresses intestinal polyps in APC Min mice fed a high fat diet

    Directory of Open Access Journals (Sweden)

    Christina Pettan-Brewer

    2011-06-01

    Full Text Available Colorectal cancer (CRC is a leading cause of cancer deaths in the United States. Various risk factors have been associated with CRC including increasing age and diet. Epidemiological and experimental studies have implicated a diet high in fat as an important risk factor for colon cancer. High fat diets can promote obesity resulting in insulin resistance and inflammation and the development of oxidative stress, increased cell proliferation, and suppression of apoptosis. Because of the high consumption of dietary fats, especially saturated fats, by Western countries, it is of interest to see if non-nutrient food factors might be effective in preventing or delaying CRC in the presence of high saturated fat intake. Curcumin (Curcuma longa, the main yellow pigment in turmeric, was selected to test because of its reported anti-tumor activity. APC Min mice, which develop intestinal polyps and have many molecular features of CRC, were fed a diet containing 35% pork fat, 33% sucrose, and a protein and vitamin mineral mixture (HFD with or without 0.5% curcumin. These cohorts were compared to APC Min mice receiving standard rodent chow (RC with 8% fat. APC Min mice fed the HFD for 3 months had a 23% increase in total number of polyps compared to APC Min mice on RC. Curcumin was able to significantly reverse the accelerated polyp development associated with the HFD suggesting it may be effective clinically in helping prevent colon cancer even when ingesting high amounts of fatty foods. The anti-tumor effect of curcumin was shown to be associated with enhanced apoptosis and increased efficiency of DNA repair. Since curcumin prevented the gain in body weight seen in APC Min mice ingesting the HFD, modulation of energy metabolism may also be a factor.

  6. The effects of systemic, topical, and intralesional steroid treatments on apoptosis level of nasal polyps.

    Science.gov (United States)

    Kapucu, Burak; Cekin, Engin; Erkul, Bulent Evren; Cincik, Hakan; Gungor, Atila; Berber, Ufuk

    2012-09-01

    The purpose of this study was to compare the apoptotic responses to systemic, topical, and intrapolyp injection of glucocorticoid with no treatment in nasal polyps. Prospective, randomized controlled study. Tertiary training hospital. The study was performed on 48 patients with nasal polyposis in the Department of Otorhinolaryngology between 2008 and 2009. Patients were assigned to 1 of 4 groups of 12 patients. Group A was treated with oral methylprednisolone 1 mg/kg/d, and the dose was tapered gradually. Group B received 0.3 mL triamcinolone acetonide (40 mg/mL), which was injected into polyp tissue. Group C was treated with topical 55 µg triamcinolone acetonide 2 times daily for 1 month. Group D received no medication. Samples were collected endoscopically after the seventh day for groups A and B, the first month for group C, and the first visit for group D. Apoptotic indexes were determined using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method. Statistically significant differences in apoptotic index were found between each steroid-medicated group and the control group (P (D-A) = .0001; P (D-B) = .003; P (D-C) = .026) and between groups A and C (P (A-C) = .012). Group B did not differ significantly from either group A or C (P (A-B) = .11; P (B-C) = .75). The apoptotic index in nasal polyps treated with systemic, topical, and intrapolyp injection forms of glucocorticoids was higher than that in the control group. Systemic steroid treatment induced the most apoptosis.

  7. 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.

  8. Factors associated with delayed bleeding after resection of large nonpedunculated colorectal polyps.

    Science.gov (United States)

    Elliott, Timothy R; Tsiamoulos, Zacharias P; Thomas-Gibson, Siwan; Suzuki, Noriko; Bourikas, Leonidas A; Hart, Ailsa; Bassett, Paul; Saunders, Brian P

    2018-04-06

     Delayed bleeding is the most common significant complication after piecemeal endoscopic mucosal resection (p-EMR) of large nonpedunculated colorectal polyps (NPCPs). Risk factors for delayed bleeding are incompletely defined. We aimed to determine risk factors for delayed bleeding following p-EMR.  Data were analyzed from a prospective tertiary center audit of patients with NPCPs ≥ 20 mm who underwent p-EMR between 2010 and 2012. Patient, polyp, and procedure-related data were collected. Four post p-EMR defect factors were evaluated for interobserver agreement and included in analysis. Delayed bleeding severity was reported in accordance with guidelines. Predictors of bleeding were identified.  Delayed bleeding requiring hospitalization occurred after 22 of 330 procedures (6.7 %). A total of 11 patients required blood transfusion; of these, 4 underwent urgent colonoscopy, 1 underwent radiological embolization, and 1 required surgery. Interobserver agreement for identification of the four post p-EMR defect factors was moderate (kappa range 0.52 - 0.57). Factors associated with delayed bleeding were visible muscle fibers ( P  = 0.03) and the presence of a "cherry red spot" ( P  = 0.05) in the post p-EMR defect. Factors not associated with delayed bleeding were American Association of Anesthesiologists class, aspirin use, polyp size, site, and use of argon plasma coagulation.  Visible muscle fibers and the presence of a "cherry red spot" in the resection defect were associated with delayed bleeding after p-EMR. These findings suggest evaluation and photodocumentation of the post p-EMR defect is important and, when considered alongside other patient and procedural factors, may help to reduce the incidence and severity of delayed bleeding. © Georg Thieme Verlag KG Stuttgart · New York.

  9. 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

    2018-04-01

    Chronic rhinosinusitis (CRS) is a major disease condition with high morbidity and can 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 relationships between CRS with nasal polyps (CRSwNP) and asthma characteristics. A cross-sectional data set of 17,506 adult participants (≥18 years old) in the Korean National Health and Nutrition Examination Survey from 2010 through 2012 was analyzed. CRS was defined using structured questionnaires according to the international guideline, and presence of nasal polyps was objectively assessed using nasal endoscopy. Presence of asthma and its onset and current activity were assessed using structured questionnaires. CRS was significantly related to asthma, but the relationships were distinct by CRS and asthma status. CRSwNP was significantly associated with adult-onset asthma (onset after 18 years of age) or late-onset asthma (onset after 40 years of age), whereas CRS without nasal polyps was related to childhood-onset asthma (onset before 18 years) or early-onset asthma (onset before 40 years) in adults. The 2 CRS subgroups showed significant associations with current asthma but not with past asthma. However, the comorbid asthma rate was lower 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, the low prevalence of asthma in CRSwNP is in sharp contrast to findings in Western populations, which warrants further investigation for ethnic or regional differences in relationships between CRSwNP and asthma. Copyright © 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Report of the Association of Coloproctology of Great Britain and Ireland/British Society of Gastroenterology Colorectal Polyp Working Group: the development of a complex colorectal polyp minimum dataset.

    Science.gov (United States)

    Chattree, A; Barbour, J A; Thomas-Gibson, S; Bhandari, P; Saunders, B P; Veitch, A M; Anderson, J; Rembacken, B J; Loughrey, M B; Pullan, R; Garrett, W V; Lewis, G; Dolwani, S; Rutter, M D

    2017-01-01

    The management of large non-pedunculated colorectal polyps (LNPCPs) is complex, with widespread variation in management and outcome, even amongst experienced clinicians. Variations in the assessment and decision-making processes are likely to be a major factor in this variability. The creation of a standardized minimum dataset to aid decision-making may therefore result in improved clinical management. An official working group of 13 multidisciplinary specialists was appointed by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) to develop a minimum dataset on LNPCPs. The literature review used to structure the ACPGBI/BSG guidelines for the management of LNPCPs was used by a steering subcommittee to identify various parameters pertaining to the decision-making processes in the assessment and management of LNPCPs. A modified Delphi consensus process was then used for voting on proposed parameters over multiple voting rounds with at least 80% agreement defined as consensus. The minimum dataset was used in a pilot process to ensure rigidity and usability. A 23-parameter minimum dataset with parameters relating to patient and lesion factors, including six parameters relating to image retrieval, was formulated over four rounds of voting with two pilot processes to test rigidity and usability. This paper describes the development of the first reported evidence-based and expert consensus minimum dataset for the management of LNPCPs. It is anticipated that this dataset will allow comprehensive and standardized lesion assessment to improve decision-making in the assessment and management of LNPCPs. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  11. 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.

  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. 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

  14. 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.

  15. 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

  16. Inactivation of promoter 1B of APC causes partial gene silencing: evidence for a significant role of the promoter in regulation and causative of familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Rohlin, A; Engwall, Y; Fritzell, K

    2011-01-01

    Familial adenomatous polyposis (FAP) is caused by germline mutations in the adenomatous polyposis coli (APC) gene. Two promoters, 1A and 1B, have been recognized in APC, and 1B is thought to have a minor role in the regulation of the gene. We have identified a novel deletion encompassing half of ...... homozygous inactivation of APC allowing for alternative genetic models as basis for adenoma formation.Oncogene advance online publication, 6 June 2011; doi:10.1038/onc.2011.201....... in a panel of 20 various normal tissues examined. In FAP-related tumors, the APC germline mutation is proposed to dictate the second hit. Mutations leaving two or three out of seven 20-amino-acid repeats in the central domain of APC intact seem to be required for tumorigenesis. We examined adenomas from...... mutation carriers in Family 1 for second hits in the entire gene without any findings, however, loss of the residual expression of the deleterious allele was observed. Three major conclusions of significant importance in relation to the function of APC can be drawn from this study; (i) germline...

  17. 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)

  18. 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%.

  19. 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.

  20. Epithelial cell specific properties and genetic complementation in a delta F508 cystic fibrosis nasal polyp cell line.

    Science.gov (United States)

    Kunzelmann, K; Lei, D C; Eng, K; Escobar, L C; Koslowsky, T; Gruenert, D C

    1995-09-01

    Analysis of vectorial ion transport and protein trafficking in transformed cystic fibrosis (CF) epithelial cells has been limited because the cells tend to lose their tight junctions with multiple subcultures. To elucidate ion transport and protein trafficking in CF epithelial cells, a polar cell line with apical and basolateral compartments will facilitate analysis of the efficacy of different gene therapy strategies in a "tight epithelium" in vitro. This study investigates the genotypic and phenotypic properties of a CF nasal polyp epithelial, delta F508 homozygote, cell line that has tight junctions pre-crisis. The cells (sigma CFNPE14o-) were transformed with an origin-of-replication defective SV40 plasmid. They develop transepithelial resistance in Ussing chambers and are defective in cAMP-dependent Cl- transport as measured by efflux of radioactive Cl-, short circuit current (Isc), or whole-cell patch clamp. Stimulation of the cells by bradykinin, histamine, or ATP seems to activate both K(+)- and Ca(+2)-dependent Cl- transport. Measurement of 36Cl- efflux following stimulation with A23187 and ionomycin indicate a Ca(+2)-dependent Cl- transport. Volume regulatory capacity of the cells is indicated by cell swelling conductance. Expression of the CF transmembrane conductance regulator mRNA was indicated by RT-PCR amplification. When cells are grown at 26 degrees C for 48 h there is no indication of cAMP-dependent Cl- as has been previously indicated in heterologous expression systems. Antibodies specific for secretory cell antigens indicate the presence of antigens found in goblet, serous, and mucous cells; in goblet and serous cells; or in goblet and mucous cells; but not antigens found exclusively in mucous or serous cells.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Diagnostic accuracy of transabdominal high-resolution US for staging gallbladder cancer and differential diagnosis of neoplastic polyps compared with EUS.

    Science.gov (United States)

    Lee, Jeong Sub; Kim, Jung Hoon; Kim, Yong Jae; Ryu, Ji Kon; Kim, Yong-Tae; Lee, Jae Young; Han, Joon Koo

    2017-07-01

    To compare the diagnostic accuracy of transabdominal high-resolution ultrasound (HRUS) for staging gallbladder cancer and differential diagnosis of neoplastic polyps compared with endoscopic ultrasound (EUS) and pathology. Among 125 patients who underwent both HRUS and EUS, we included 29 pathologically proven cancers (T1 = 7, T2 = 19, T3 = 3) including 15 polypoid cancers and 50 surgically proven polyps (neoplastic = 30, non-neoplastic = 20). We reviewed formal reports and assessed the accuracy of HRUS and EUS for diagnosing cancer as well as the differential diagnosis of neoplastic polyps. Statistical analyses were performed using chi-square tests. The sensitivity, specificity, PPV, and NPV for gallbladder cancer were 82.7 %, 44.4 %, 82.7 %, and 44 % using HRUS and 86.2 %, 22.2 %, 78.1 %, and 33.3 % using EUS. HRUS and EUS correctly diagnosed the stage in 13 and 12 patients. The sensitivity, specificity, PPV, and NPV for neoplastic polyps were 80 %, 80 %, 86 %, and 73 % using HRUS and 73 %, 85 %, 88 %, and 69 % using EUS. Single polyps (8/20 vs. 21/30), larger (1.0 ± 0.28 cm vs. 1.9 ± 0.85 cm) polyps, and older age (52.5 ± 13.2 vs. 66.1 ± 10.3 years) were common in neoplastic polyps (p diagnostic accuracy for GB cancer compared with EUS. • HRUS and EUS showed similar diagnostic accuracy for differentiating neoplastic polyps. • Single, larger polyps and older age were common in neoplastic polyps. • HRUS is less invasive compared with EUS.

  2. 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.

  3. Observation of rat's colon polyps in real time by mini-endoscopy and raman spectroscopy

    Science.gov (United States)

    Andriana, Bibin Bintang; Mahardika, Anggara; Taketani, Akihiro; Sato, Hidetoshi

    2018-02-01

    Colorectal adenoma (CA) is a disease caused by various factors (such as genetic factors or environmental exposures). The appearance of colon polyp (CP) within colorectal might indicate the hint of CA development. Ball-lens hollow fiber Raman probe (BHRP) may has a high capability for detection of CA in living experimental animal and have already tested to rat's CP in this study, which was designed to collaborate between BHRP with mini-endoscopy to observe the biochemical alteration within normal colon tissue and rat's colon polyps in real time. BHRP and mini-endoscopy can distinguish the differences in their finger print spectra and make pictures the control and CP in the real time. At the first step, the real situation of normal colon and Rat's CP were washed by saline and observed with mini-endoscopy. BHRP was introduced to Dextran sodium sulphate (DSS)-induced Rat's CP to detect some of biochemical alteration. The main purpose of this study was to introduce mini-endoscopy to guide the BHRP for diagnosing of CP in real time and to compare it with spectra of normal colon (control group) in living rat. As the result, BHRP can provide the differences in band of control and CP group, which can inform that the biochemical of normal and CP has changed. As a major parameter to distinct normal and CP tissue were phosphatidylinositol, phosphodiester group, lipid, and collagen. Mini endoscopy and BHRP is very sensitive devices for diagnosing of CP in real time.

  4. 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.

  5. Environmental control of phase transition and polyp survival of a massive-outbreaker jellyfish.

    Directory of Open Access Journals (Sweden)

    Laura Prieto

    Full Text Available A number of causes have been proposed to account for the occurrence of gelatinous zooplankton (both jellyfish and ctenophore blooms. Jellyfish species have a complex life history involving a benthic asexual phase (polyp and a pelagic sexual phase (medusa. Strong environmental control of jellyfish life cycles is suspected, but not fully understood. This study presents a comprehensive analysis on the physicochemical conditions that control the survival and phase transition of Cotylorhiza tuberculata; a scyphozoan that generates large outbreaks in the Mediterranean Sea. Laboratory experiments indicated that the influence of temperature on strobilation and polyp survival was the critical factor controlling the capacity of this species to proliferate. Early life stages were less sensitive to other factors such as salinity variations or the competitive advantage provided by zooxanthellae in a context of coastal eutrophication. Coherently with laboratory results, the presence/absence of outbreaks of this jellyfish in a particular year seems to be driven by temperature. This is the first time the environmental forcing of the mechanism driving the life cycle of a jellyfish has been disentangled via laboratory experimentation. Projecting this understanding to a field population under climatological variability results in a pattern coherent with in situ records.

  6. Rectal red blood loss in a healthy toddler is not always a juvenile polyp.

    Science.gov (United States)

    Rousseff, T; Matthyssens, L; Van Renterghem, K; Van de Putte, D; De Wulf, D; Van Winckel, M; Van de Velde, S; De Bruyne, R; Van Biervliet, S

    2017-01-01

    Aim Heterotopic gastric mucosa is a well-known congenital anomaly in Meckel's diverticula and duplication cysts. Solitary heterotopic gastric mucosa in the rectum is a rare and frequently overlooked abnormality. Starting from a patient history, the literature is searched and all cases reported over the past 20 years are reviewed and compared to a summary of the older cases. Differences between adult and childhood presentation are outlined and our patient is compared with prior reported cases. Case A 3-year-old girl presented with recurrent rectal blood loss caused by heterotopic gastric mucosa without duplication cyst. She was endoscopically treated with two-stage endoscopic surgical dissection (ESD). Up to now, rectal heterotopic gastric mucosa has been reported in 34 adults and 24 children, including this patient. There is an overall male dominance (69%). Presenting complaints in children were recurrent fresh blood loss per anum (96%), pain (46%), perineal ulcers (25%), diarrhoea (8%) and one patient had an ano-cutaneous fistula. Endoscopy revealed a mucosal elevation with a slightly different aspect (33%), a polyp (42%) and a solitary ulcer (25%). Endoscopy in adults reveals more frequently polyps compared to children. Treatment in childhood is mainly surgical where adults are more frequently treated with endoscopic techniques. Conclusion In a child with recurrent rectal bleeding in good general health, it is important to withhold heterotopic gastric mucosa in the differential diagnosis and take sufficient biopsies during endoscopy. © Acta Gastro-Enterologica Belgica.

  7. Giant Inflammatory Fibroid Polyp of the Hepatic Flexure of Colon Presenting with an Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Ashish Lal Shrestha

    2016-01-01

    Full Text Available Background. Inflammatory Fibroid Polyp (IFP of the colon is an exceedingly rare condition. Since 1952 till now only 32 cases have been reported worldwide of which only 5 were giant (>4 cm polyps mostly found in the caecum (15 cases with only 3 in the descending colon. Case Presentation. A 36-year-old female with no previous illness presented to the emergency unit with an acute onset pain over the right hypochondrium for 3 days associated with intermittent fever and anorexia. As she had evidence of localized peritonitis she underwent a diagnostic laparoscopy and subsequently an exploratory laparotomy. A mass measuring 8 × 7 × 5 cm arising from the hepatic flexure of colon was noted. Right hemicolectomy with ileotransverse anastomosis was performed. The mass was subsequently reported to be IFP. Conclusion. IFP is a very rare condition with clinical presentation depending upon its size and location. Definitive diagnosis is possible with histopathological examination of tissue aided by immunohistochemical studies. Surgical resection has been the most common method of treatment especially for large and giant colonic IFPs owing to challenges in terms of diagnosis and technical difficulties associated with endoscopic methods.

  8. 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.

  9. The Intra Uterine Morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas.

    Science.gov (United States)

    Emanuel, Mark Hans; Wamsteker, Kees

    2005-01-01

    A new hysteroscopic operating technique was compared retrospectively with conventional resectoscopy. Retrospective comparison (Canadian Task Force Classification II-2). Gynecology department of a university-affiliated teaching hospital. Fifty-five women, 27 with endometrial polyps and 28 with submucous myomas. Patients were treated with a prototype of the Intra Uterine Morcellator (IUM). This cutting device, 35 cm in length, was inserted into a straight working channel of a 90-mm hysteroscope. The major advantages were ease of removal of tissue fragments through the instrument and the use of saline solution instead of electrolyte-free solutions used in monopolar high-frequency resectoscopy. The mean operating time was 8.7 minutes (95% CI: 7.3-10.1) for the removal of endometrial polyps compared with 30.9 minutes (CI: 27.0-34.8) for resectoscopy, and 16.4 minutes (CI: 12.6-20.2) for submucous myomas compared with 42.2 minutes (CI: 39.7-44.7) for resectoscopy. All procedures were uneventful. This new technique is faster, and it appears to be easier to perform. Therefore, it can be expected to result in fewer fluid-related complications and to lead to a shorter learning curve when compared with conventional resectoscopy.

  10. 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.

  11. Familial Adenomatous Polyposis

    Science.gov (United States)

    ... starting. For more information, talk with an assisted reproduction specialist at a fertility clinic. How common is ... cancer, along with either a glioblastoma or medulloblastoma brain tumor. Blood tests are available to look for ...

  12. 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.

  13. Giant esophageal fibrovascular polyp with clinical behaviour of inflammatory pseudotumor: A case report and the literature review

    Directory of Open Access Journals (Sweden)

    Ćuk Vladimir

    2014-01-01

    Full Text Available Introduction. Esophageal fibrovascular polyps are rare, benign, intraluminal, submucosal tumor-like lesions, characterized by pedunculated masses which can demonstrate enormous growth. The most frequent symptoms are dysphagia, vomiting and weight loss. Fibrovascular polyps with long stalks can regurgitate into the airways and cause asphyxia. Esophageal inflammatory pseudotumor is extremely rare lesion accompanied with various systemic manifestations as fever, anemia and thrombocytosis. Case report. We presented a 29-year-old man complaining of a long-lasting fever and dysphagia. He was found to have huge pedunculated submucosal tumor of esophagus, surgically completely resected. Histopathological examination showed that this giant tumor, 24 x 9 x 6 cm, was a fibrovascular polyp. The postoperative course was uneventful. The preoperative fever, anemia and thrombocytosis disappeared and did not recur in the postoperative course. Conclusion. We reported a patient with giant esophageal pedunculated tumor with clinical manifestations of inflammatory pseudotumor and histopathological picture of fibrovascular polyp, that we have not found described in the literature before.

  14. Zileuton, 5-lipoxygenase inhibitor, acts as a chemopreventive agent in intestinal polyposis, by modulating polyp and systemic inflammation.

    Directory of Open Access Journals (Sweden)

    Elias Gounaris

    Full Text Available Leukotrienes and prostaglandins, products of arachidonic acid metabolism, sustain both systemic and lesion-localized inflammation. Tumor-associated Inflammation can also contribute to the pathogenesis of colon cancer. Patients with inflammatory bowel disease (IBD have increased risk of developing colon cancer. The levels of 5-lipoxygenase (5-LO, the key enzyme for leukotrienes production, are increased in colon cancer specimens and colonic dysplastic lesions. Here we report that Zileuton, a specific 5-LO inhibitor, can prevent polyp formation by efficiently reducing the tumor-associated and systemic inflammation in APCΔ468 mice.In the current study, we inhibited 5-LO by dietary administration of Zileuton in the APCΔ468 mouse model of polyposis and analyzed the effect of in vivo 5-LO inhibition on tumor-associated and systemic inflammation.Zileuton-fed mice developed fewer polyps and displayed marked reduction in systemic and polyp-associated inflammation. Pro-inflammatory cytokines and pro-inflammatory innate and adaptive immunity cells were reduced both in the lesions and systemically. As part of tumor-associated inflammation Leukotriene B4 (LTB4, product of 5-LO activity, is increased focally in human dysplastic lesions. The 5-LO enzymatic activity was reduced in the serum of Zileuton treated polyposis mice.This study demonstrates that dietary administration of 5-LO specific inhibitor in the polyposis mouse model decreases polyp burden, and suggests that Zileuton may be a potential chemo-preventive agent in patients that are high-risk of developing colon cancer.

  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. 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.

  17. 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.

  18. New-Style Laparoscope and Endoscope Cooperative Gallbladder-Preserving Surgery for Polyps

    International Nuclear Information System (INIS)

    Li, M.; Wu, H.; Wei, S.

    2016-01-01

    Objective: To evaluate the feasibility and safety of a new style of Laparoscope and Endoscope Cooperative gallbladderpreserving Surgery (LECS), an improved method of minimally invasive gallbladder-preserving polypectomy. Study Design: An experimental study. Place and Duration of Study: Department of General Surgery, The Second Affiliated Hospital of Soochow University, China, from January 2009 to July 2013. Methodology: Clinical data of patients subjected to LECS and Laparoscopic Cholecystectomy (LC) was analysed. The inclusion criteria were normal size clear gallbladder bile with total volume (FV) of the gallbladder = 15 - 25 ml, the Residual Volume (RV) = 5 ml, and the Emptying Figure (EF) > 75 percentage, with polyps diagnosed definitively by B-type ultrasonic imaging or CT desirous of preserving gallbladder. Exclusion criteria were a history of midsection surgery, serious diseases of any organ, hepatic injury, or coagulation disturbance. Mean hospital stay and complications were also noted. Independent sample t-test, the frequency comparison used chi-square test (N > 5), and Fisher's exact test (N < 5) were used for statistical test. Results: The mean hospital stay after LECS was 3.50 ± 0.31 days, and 3.50 ± 0.31 days for the LC group. The mean age in LC and LECS group was 50 ± 25.4 and 44 ± 12.1 years, respectively. Complications after operation in the LECS were indigestion and diarrhea; LC group had indigestion (9.33 percentage), diarrhea (10.67 percentage), and gastroesophageal reflux (6.6.7 percentage). In the 3 months follow-up after discharging from the hospital, no patient had recurrence of any gallbladder disease; at 1 year follow-up, 1 patient (1.28 percentage) developed cholesterol crystals; at 3-year follow-up, 3 cases (3.84 percentage) were found to have recurring polyps (2-4 pieces), and 2 (2.56 percentage) patients developed cholesterol crystals. Conclusion: Minimally invasive gallbladder-preserving polypectomy which used a CHIAO

  19. A standardized imaging protocol for the endoscopic prediction of dysplasia within sessile serrated polyps (with video).

    Science.gov (United States)

    Tate, David J; Jayanna, Mahesh; Awadie, Halim; Desomer, Lobke; Lee, Ralph; Heitman, Steven J; Sidhu, Mayenaaz; Goodrick, Kathleen; Burgess, Nicholas G; Mahajan, Hema; McLeod, Duncan; Bourke, Michael J

    2018-01-01

    Dysplasia within sessile serrated polyps (SSPs) is difficult to detect and may be mistaken for an adenoma, risking incomplete resection of the background serrated tissue, and is strongly implicated in interval cancer after colonoscopy. The use of endoscopic imaging to detect dysplasia within SSPs has not been systematically studied. Consecutively detected SSPs ≥8 mm in size were evaluated by using a standardized imaging protocol at a tertiary-care endoscopy center over 3 years. Lesions suspected as SSPs were analyzed with high-definition white light then narrow-band imaging. A demarcated area with a neoplastic pit pattern (Kudo type III/IV, NICE type II) was sought among the serrated tissue. If this was detected, the lesion was labeled dysplastic (sessile serrated polyp with dysplasia); if not, it was labeled non-dysplastic (sessile serrated polyp without dysplasia). Histopathology was reviewed by 2 blinded specialist GI pathologists. A total of 141 SSPs were assessed in 83 patients. Median lesion size was 15.0 mm (interquartile range 10-20), and 54.6% were in the right side of the colon. Endoscopic evidence of dysplasia was detected in 36 of 141 (25.5%) SSPs; of these, 5 of 36 (13.9%) lacked dysplasia at histopathology. Two of 105 (1.9%) endoscopically designated non-dysplastic SSPs had dysplasia at histopathology. Endoscopic imaging, therefore, had an accuracy of 95.0% (95% confidence interval [CI], 90.1%-97.6%) and a negative predictive value of 98.1% (95% CI, 92.6%-99.7%) for detection of dysplasia within SSPs. Dysplasia within SSPs can be detected accurately by using a simple, broadly applicable endoscopic imaging protocol that allows complete resection. Independent validation of this protocol and its dissemination to the wider endoscopic community may have a significant impact on rates of interval cancer. (Clinical trial registration number: NCT03100552.). Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All

  20. Biopsies of colorectal clinical polyps--emergence of diagnostic information on deeper levels

    DEFF Research Database (Denmark)

    Warnecke, Mads; Engel, Ulla Højholt; Bernstein, Inge

    2009-01-01

    an increased risk of CRC (hereditary, n=19, including 15 hereditary non-polyposis colorectal cancer (HNPCC) cases). Sixty-five (13.5%) of the 480 samples were classified as NDB (normal morphology n=49, suspicious of adenoma n=5, suspicious of HP n=11), constituting roughly 10% of all biopsies from......Although the occasional appearance of a normal histology of biopsies from endoscopic colorectal (CR) polyps is generally held knowledge, its prevalence has rarely been focused on, and the yield of additional sections in such cases has been previously addressed in merely four communications...... specimens were obtained from 245 endoscopies and stratified in the following categories according to the clinical indications: relevant symptoms (symptomatic, n=127), previously documented sporadic large bowel neoplasia (follow-up, n=99), and documented or presumed hereditary condition that confer...

  1. Computer tomographic diagnosis and differential diagnosis of juvenile angiofibromas and angiomatous polyps

    International Nuclear Information System (INIS)

    Irnberger, T.

    1985-01-01

    Juvenile angiofibromas (JAF) and angiomatous polyps (AP) are vascular histologically benign tumors presenting with an identical clinical triad. Both lesions can be differentiated by their typical geographic pattern of growth, different pattern of tumor extension and their highly characteristic angiographic and angiocomputertomographic appearance. Time-density curves were of no use in differentiating the big variety of hypervascular lesions from each other. CT images of the vascular tumor phase after bolus injection of contrast medium however showed interesting pathomorphological details, which were extremely useful in differentiating JAF from AP and other vascular tumors. It is our opinion, that invasive angiography for diagnosing JAF has been surpassed, but is further essential for mapping of tumor perfusion, feeding vessels and praeoperative embolization therapy. (orig.) [de

  2. Exhaled and nasal nitric oxide in chronic rhinosinusitis patients with nasal polyps in primary care

    DEFF Research Database (Denmark)

    Frendø, M; Håkansson, K; Schwer, S

    2018-01-01

    BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder associated with lower airway disease. However, only few studies of CRSwNP from outside secondary/tertiary care centres have been published. We recently reported an asthma frequency of 44% and 65...... patients. Compared with controls, a high level of exhaled NO was significantly more prevalent in CRSwNP irrespective of asthma-status. Nasal NO was significantly lower in patients with CRSwNP compared with controls. CONCLUSION: Subclinical eosinophilic lower airway inflammation is common in CRSwNP......% in primary and secondary care patients respectively. Therefore, we hypothesise that inflammation of the lower airways could be present in all CRSwNP patients, even without asthma. Here, we assessed the degree of lower and upper airway inflammation using exhaled and nasal nitric oxide (NO) in primary care...

  3. Lymphangioma of the jejunal mesentery and jejunal polyps presenting as an acute abdomen in a teenager.

    Science.gov (United States)

    Jayasundara, Jasb; Perera, E; Chandu de Silva, M V; Pathirana, A A

    2017-03-01

    Cystic lymphangioma of the small bowel mesentery is a rare clinical entity, especially after childhood. Medical literature reveals a limited number of such cases presenting as acute abdomen due to bowel obstruction, small bowel volvulus and bleeding into the tumour. We present the management experience of an 18-year-old woman who presented with rapid onset diffuse peritonism and raised inflammatory markers. Computed tomography showed a mass in the small bowel mesentery with suspicion of segmental bowel ischaemia. Emergency laparotomy revealed a mass in the mid-jejunal mesentery close to the bowel wall with no bowel ischaemia. The patient made an uncomplicated recovery after segmental bowel resection and end-to-end anastomosis. Histology confirmed the mass as a cystic lymphangioma involving the jejunal mesentery and two small jejunal polyps. Lymphangioma could be considered in the differential diagnosis of an acute abdomen in a young adult when the presentation is atypical.

  4. CT Findings of a Gastric Inflammatory Fibroid Polyp Manifesting as Unexpected Growth: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Yang, Dal Mo; Jin, Wook; Nam, Deok Ho; Kim, Gou Young; Choi, Sung Il [East-west Neo Medical Center, Seoul (Korea, Republic of)

    2009-04-15

    Gastric inflammatory fibroid polyps (IFP) are rare benign entities that are usually encountered in the gastric antrum. The authors report the CT findings of a gastric IFP case experiencing marked growth over a five-month period. An initial CT revealed a polypoid wall thickening of about 3.5x2.5 cm in the gastric antrum. A follow-up CT performed five months later revealed a cauliflower-like submucosal mass of about 8x5 cm. The mass was surgically excised and confirmed as an IFP. The authors suggest that when an evolving cauliflower-like submucosal lesion of the stomach is detected, an IFP should be considered in the differential diagnoses.

  5. Gardner syndrome associated with multiple osteomas, intestinal polyposis, and epidermoid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Kwang Joon; Park, Ha Na; Kim, Kyoung A [Dept. of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju (Korea, Republic of)

    2016-12-15

    Gardner syndrome is known as a variant of familial adenomatous polyposis. This syndrome is characterized by multiple intestinal polyposes, osteomas, and epidermoid cysts. In addition, dental abnormalities include an increased frequency of multiple odontomas, as well as supernumerary and impacted teeth. The authors report the case of a 7-year-old male patient with Gardner syndrome. Radiographic findings revealed multiple osteomas in both sides of the maxilla, multiple diffuse enostoses in both jaws, and a complex odontoma in the left mandibular body. Two years later, multiple epidermoid cysts on the scalp were found. Since this patient was suspected to have Gardner syndrome, the authors recommended gastrointestinal endoscopy to check for intestinal polyposis. Gastrointestinal endoscopic examination revealed multiple polyposes in the upper gastrointestinal tract and fundus of the stomach. As a result, the final diagnosis was Gardner syndrome.

  6. Endometrial Polyps and Abnormal Uterine Bleeding (AUB-P): What is the relationship, how are they diagnosed and how are they treated?

    Science.gov (United States)

    Clark, T Justin; Stevenson, Helen

    2017-04-01

    The diagnosis and treatment of endometrial polyps will be familiar to most gynaecologists. However, the aetiology and natural history of these focal intrauterine lesions are yet to be elucidated. This lack of clarity is also true with regard to their clinical significance; whilst endometrial polyps are highly prevalent in all types of abnormal uterine bleeding (AUB), they are also commonly found in women without AUB. These controversies will be discussed along with current thoughts on the diagnosis and treatment of endometrial polyps. Criteria for diagnosis of uterine polyps vary according to the test used, but optimal testing is not yet solidified. Recent data from randomised trials evaluating new and established surgical technologies as well as comparing treatment protocols and settings will be examined. Copyright © 2016. Published by Elsevier Ltd.

  7. BRAF, KRAS and PIK3CA mutations in colorectal serrated polyps and cancer: Primary or secondary genetic events in colorectal carcinogenesis?

    International Nuclear Information System (INIS)

    Velho, Sérgia; Moutinho, Cátia; Cirnes, Luís; Albuquerque, Cristina; Hamelin, Richard; Schmitt, Fernando; Carneiro, Fátima; Oliveira, Carla; Seruca, Raquel

    2008-01-01

    BRAF, KRAS and PIK3CA mutations are frequently found in sporadic colorectal cancer (CRC). In contrast to KRAS and PIK3CA mutations, BRAF mutations are associated with tumours harbouring CpG Island methylation phenotype (CIMP), MLH1 methylation and microsatellite instability (MSI). We aimed at determine the frequency of KRAS, BRAF and PIK3CA mutations in the process of colorectal tumourigenesis using a series of colorectal polyps and carcinomas. In the series of polyps CIMP, MLH1 methylation and MSI were also studied. Mutation analyses were performed by PCR/sequencing. Bisulfite treated DNA was used to study CIMP and MLH1 methylation. MSI was detected by pentaplex PCR and Genescan analysis of quasimonomorphic mononucleotide repeats. Chi Square test and Fisher's Exact test were used to perform association studies. KRAS, PIK3CA or BRAF occur in 71% of polyps and were mutually exclusive. KRAS mutations occur in 35% of polyps. PIK3CA was found in one of the polyps. V600E BRAF mutations occur in 29% of cases, all of them classified as serrated adenoma. CIMP phenotype occurred in 25% of the polyps and all were mutated for BRAF. MLH1 methylation was not detected and all the polyps were microsatellite stable. The comparison between the frequency of oncogenic mutations in polyps and CRC (MSI and MSS) lead us to demonstrate that KRAS and PIK3CA are likely to precede both types of CRC. BRAF mutations are likely to precede MSI carcinomas since the frequency found in serrated polyps is similar to what is found in MSI CRC (P = 0.9112), but statistically different from what is found in microsatellite stable (MSS) tumours (P = 0.0191). Our results show that BRAF, KRAS and PIK3CA mutations occur prior to malignant transformation demonstrating that these oncogenic alterations are primary genetic events in colorectal carcinogenesis. Further, we show that BRAF mutations occur in association with CIMP phenotype in colorectal serrated polyps and verified that colorectal serrated

  8. BRAF, KRAS and PIK3CA mutations in colorectal serrated polyps and cancer: Primary or secondary genetic events in colorectal carcinogenesis?

    Directory of Open Access Journals (Sweden)

    Schmitt Fernando

    2008-09-01

    Full Text Available Abstract Background BRAF, KRAS and PIK3CA mutations are frequently found in sporadic colorectal cancer (CRC. In contrast to KRAS and PIK3CA mutations, BRAF mutations are associated with tumours harbouring CpG Island methylation phenotype (CIMP, MLH1 methylation and microsatellite instability (MSI. We aimed at determine the frequency of KRAS, BRAF and PIK3CA mutations in the process of colorectal tumourigenesis using a series of colorectal polyps and carcinomas. In the series of polyps CIMP, MLH1 methylation and MSI were also studied. Methods Mutation analyses were performed by PCR/sequencing. Bisulfite treated DNA was used to study CIMP and MLH1 methylation. MSI was detected by pentaplex PCR and Genescan analysis of quasimonomorphic mononucleotide repeats. Chi Square test and Fisher's Exact test were used to perform association studies. Results KRAS, PIK3CA or BRAF occur in 71% of polyps and were mutually exclusive. KRAS mutations occur in 35% of polyps. PIK3CA was found in one of the polyps. V600E BRAF mutations occur in 29% of cases, all of them classified as serrated adenoma. CIMP phenotype occurred in 25% of the polyps and all were mutated for BRAF. MLH1 methylation was not detected and all the polyps were microsatellite stable. The comparison between the frequency of oncogenic mutations in polyps and CRC (MSI and MSS lead us to demonstrate that KRAS and PIK3CA are likely to precede both types of CRC. BRAF mutations are likely to precede MSI carcinomas since the frequency found in serrated polyps is similar to what is found in MSI CRC (P = 0.9112, but statistically different from what is found in microsatellite stable (MSS tumours (P = 0.0191. Conclusion Our results show that BRAF, KRAS and PIK3CA mutations occur prior to malignant transformation demonstrating that these oncogenic alterations are primary genetic events in colorectal carcinogenesis. Further, we show that BRAF mutations occur in association with CIMP phenotype in colorectal

  9. Pre-exposure to simultaneous, but not individual, climate change stressors limits acclimation capacity of Irukandji jellyfish polyps to predicted climate scenarios

    KAUST Repository

    Klein, Shannon G.; Pitt, Kylie A.; Carroll, Anthony R.

    2017-01-01

    Researchers have investigated the immediate effects of end-of-century climate change scenarios on many marine species, yet it remains unclear whether we can reliably predict how marine species may respond to future conditions because biota may become either more or less resistant over time. Here, we examined the role of pre-exposure to elevated temperature and reduced pH in mitigating the potential negative effects of future ocean conditions on polyps of a dangerous Irukandji jellyfish Alatina alata. We pre-exposed polyps to elevated temperature (28 °C) and reduced pH (7.6), in a full factorial experiment that ran for 14 d. We secondarily exposed original polyps and their daughter polyps to either current (pH 8.0, 25 °C) or future conditions (pH 7.6, 28 °C) for a further 34 d to assess potential phenotypic plastic responses and whether asexual offspring could benefit from parental pre-exposure. Polyp fitness was characterised as asexual reproduction, respiration, feeding, and protein concentrations. Pre-exposure to elevated temperature alone partially mitigated the negative effects of future conditions on polyp fitness, while pre-exposure to reduced pH in isolation completely mitigated the negative effects of future conditions on polyp fitness. Pre-exposure to the dual stressors, however, reduced fitness under future conditions relative to those in the control treatment. Under future conditions, polyps had higher respiration rates regardless of the conditions they were pre-exposed to, suggesting that metabolic rates will be higher under future conditions. Parent and daughter polyps responded similarly to the various treatments tested, demonstrating that parental pre-exposure did not confer any benefit to asexual offspring under future conditions. Importantly, we demonstrate that while pre-exposure to the stressors individually may allow Irukandji polyps to acclimate over short timescales, the stressors are unlikely to occur in isolation in the long term, and

  10. Pre-exposure to simultaneous, but not individual, climate change stressors limits acclimation capacity of Irukandji jellyfish polyps to predicted climate scenarios

    KAUST Repository

    Klein, Shannon G.

    2017-05-20

    Researchers have investigated the immediate effects of end-of-century climate change scenarios on many marine species, yet it remains unclear whether we can reliably predict how marine species may respond to future conditions because biota may become either more or less resistant over time. Here, we examined the role of pre-exposure to elevated temperature and reduced pH in mitigating the potential negative effects of future ocean conditions on polyps of a dangerous Irukandji jellyfish Alatina alata. We pre-exposed polyps to elevated temperature (28 °C) and reduced pH (7.6), in a full factorial experiment that ran for 14 d. We secondarily exposed original polyps and their daughter polyps to either current (pH 8.0, 25 °C) or future conditions (pH 7.6, 28 °C) for a further 34 d to assess potential phenotypic plastic responses and whether asexual offspring could benefit from parental pre-exposure. Polyp fitness was characterised as asexual reproduction, respiration, feeding, and protein concentrations. Pre-exposure to elevated temperature alone partially mitigated the negative effects of future conditions on polyp fitness, while pre-exposure to reduced pH in isolation completely mitigated the negative effects of future conditions on polyp fitness. Pre-exposure to the dual stressors, however, reduced fitness under future conditions relative to those in the control treatment. Under future conditions, polyps had higher respiration rates regardless of the conditions they were pre-exposed to, suggesting that metabolic rates will be higher under future conditions. Parent and daughter polyps responded similarly to the various treatments tested, demonstrating that parental pre-exposure did not confer any benefit to asexual offspring under future conditions. Importantly, we demonstrate that while pre-exposure to the stressors individually may allow Irukandji polyps to acclimate over short timescales, the stressors are unlikely to occur in isolation in the long term, and

  11. Pre-exposure to simultaneous, but not individual, climate change stressors limits acclimation capacity of Irukandji jellyfish polyps to predicted climate scenarios

    Science.gov (United States)

    Klein, Shannon G.; Pitt, Kylie A.; Carroll, Anthony R.

    2017-09-01

    Researchers have investigated the immediate effects of end-of-century climate change scenarios on many marine species, yet it remains unclear whether we can reliably predict how marine species may respond to future conditions because biota may become either more or less resistant over time. Here, we examined the role of pre-exposure to elevated temperature and reduced pH in mitigating the potential negative effects of future ocean conditions on polyps of a dangerous Irukandji jellyfish Alatina alata. We pre-exposed polyps to elevated temperature (28 °C) and reduced pH (7.6), in a full factorial experiment that ran for 14 d. We secondarily exposed original polyps and their daughter polyps to either current (pH 8.0, 25 °C) or future conditions (pH 7.6, 28 °C) for a further 34 d to assess potential phenotypic plastic responses and whether asexual offspring could benefit from parental pre-exposure. Polyp fitness was characterised as asexual reproduction, respiration, feeding, and protein concentrations. Pre-exposure to elevated temperature alone partially mitigated the negative effects of future conditions on polyp fitness, while pre-exposure to reduced pH in isolation completely mitigated the negative effects of future conditions on polyp fitness. Pre-exposure to the dual stressors, however, reduced fitness under future conditions relative to those in the control treatment. Under future conditions, polyps had higher respiration rates regardless of the conditions they were pre-exposed to, suggesting that metabolic rates will be higher under future conditions. Parent and daughter polyps responded similarly to the various treatments tested, demonstrating that parental pre-exposure did not confer any benefit to asexual offspring under future conditions. Importantly, we demonstrate that while pre-exposure to the stressors individually may allow Irukandji polyps to acclimate over short timescales, the stressors are unlikely to occur in isolation in the long term, and

  12. Preoperative care of Polypoid exposed mucosal template in bladder exstrophy: the role of high-barrier plastic wraps in reducing inflammation and polyp size.

    Science.gov (United States)

    Sabetkish, Nastaran; Sabetkish, Shabnam; Kajbafzadeh, Abdol-Mohammad

    2018-01-26

    To assess the role of high-barrier plastic wrap in reducing the number and size of polyps, as well as decreasing the inflammation and allergic reactions in exstrophy cases, and to compare the results with the application of low-barrier wrap. Eight patients with bladder exstrophy-epispadias complex (BEEC) that had used a low density polyethylene (LDPE) wrap for coverage of the exposed polypoid bladder in preoperative care management were referred. The main complaint of their parents was increase in size and number of polyps. After a period of 2 months using the same wrap and observing the increasing pattern in size of polyps, these patients were recommended to use a high-barrier wrap which is made of polyvinylidene chloride (PVdC), until closure. Patients were monitored for the number and size of polyps before and after the change of barriers. The incidence of para-exstrophy skin infection/inflammation and skin allergy were assessed. Biopsies were taken from the polyps to identify histopathological characteristics of the exposed polyps. The high barrier wrap was applied for a mean ± SD duration of 12±2.1 months. Polyps' size and number decreased after 12 months. No allergic reaction was detected in patients after the usage of PVdC; three patients suffered from low-grade skin allergy when LDPE was applied. Also, pre-malignant changes were observed in none of the patients in histopathological examination after the application of PVdC. Polyps' size and number and skin allergy may significantly decrease with the use of a high-barrier wrap. Certain PVdC wraps with more integrity and less evaporative permeability may be more "exstrophy-friendly". Copyright® by the International Brazilian Journal of Urology.

  13. Can we ease the financial burden of colonoscopy? Using real-time endoscopic assessment of polyp histology to predict surveillance intervals.

    Science.gov (United States)

    Chandran, S; Parker, F; Lontos, S; Vaughan, R; Efthymiou, M

    2015-12-01

    Polyps identified at colonoscopy are predominantly diminutive (1%) of high-grade dysplasia or carcinoma; however, the cost of histological assessment is substantial. The aim of this study was to determine whether prediction of colonoscopy surveillance intervals based on real-time endoscopic assessment of polyp histology is accurate and cost effective. A prospective cohort study was conducted across a tertiary care and private community hospital. Ninety-four patients underwent colonoscopy and polypectomy of diminutive (≤5 mm) polyps from October 2012 to July 2013, yielding a total of 159 polyps. Polyps were examined and classified according to the Sano-Emura classification system. The endoscopic assessment (optical diagnosis) of polyp histology was used to predict appropriate colonoscopy surveillance intervals. The main outcome measure was the accuracy of optical diagnosis of diminutive colonic polyps against the gold standard of histological assessment. Optical diagnosis was correct in 105/108 (97.2%) adenomas. This yielded a sensitivity, specificity and positive and negative predictive values (with 95%CI) of 97.2% (92.1-99.4%), 78.4% (64.7-88.7%), 90.5% (83.7-95.2%) and 93% (80.9-98.5%) respectively. Ninety-two (98%) patients were correctly triaged to their repeat surveillance colonoscopy. Based on these findings, a cut and discard approach would have resulted in a saving of $319.77 per patient. Endoscopists within a tertiary care setting can accurately predict diminutive polyp histology and confer an appropriate surveillance interval with an associated financial benefit to the healthcare system. However, limitations to its application in the community setting exist, which may improve with further training and high-definition colonoscopes. © 2015 Royal Australasian College of Physicians.

  14. CT colonography: effect of computer-aided detection of colonic polyps as a second and concurrent reader for general radiologists with moderate experience in CT colonography

    International Nuclear Information System (INIS)

    Mang, Thomas; Ringel, Helmut; Weber, Michael; Bogoni, Luca; Anand, Vikram X.; Hermosillo, Gerardo; Raykar, Vikas; Salganicoff, Marcos; Wolf, Matthias; Chandra, Dass; Curtin, Andrew J.; Lev-Toaff, Anna S.; Noah, Ralph; Shaw, Robert; Summerton, Susan; Tappouni, Rafel F.R.; Obuchowski, Nancy A.

    2014-01-01

    To assess the effectiveness of computer-aided detection (CAD) as a second reader or concurrent reader in helping radiologists who are moderately experienced in computed tomographic colonography (CTC) to detect colorectal polyps. Seventy CTC datasets (34 patients: 66 polyps ≥6 mm; 36 patients: no abnormalities) were retrospectively reviewed by seven radiologists with moderate CTC experience. After primary unassisted evaluation, a CAD second read and, after a time interval of ≥4 weeks, a CAD concurrent read were performed. Areas under the receiver operating characteristic (ROC) curve (AUC), along with per-segment, per-polyp and per-patient sensitivities, and also reading times, were calculated for each reader with and without CAD. Of seven readers, 86 % and 71 % achieved a higher accuracy (segment-level AUC) when using CAD as second and concurrent reader respectively. Average segment-level AUCs with second and concurrent CAD (0.853 and 0.864) were significantly greater (p < 0.0001) than average AUC in the unaided evaluation (0.781). Per-segment, per-polyp, and per-patient sensitivities for polyps ≥6 mm were significantly higher in both CAD reading paradigms compared with unaided evaluation. Second-read CAD reduced readers' average segment and patient specificity by 0.007 and 0.036 (p = 0.005 and 0.011), respectively. CAD significantly improves the sensitivities of radiologists moderately experienced in CTC for polyp detection, both as second reader and concurrent reader. (orig.)

  15. Associations between inflammatory cells infiltrating the ethmoid sinus mucosa, and nasal polyp size and grade of ethmoid sinus opacification on CT images in chronic sinusitis

    International Nuclear Information System (INIS)

    Imajima, Naotoshi; Watanabe, So; Furuta, Atsuko; Shimizu, Toshiyuki; Yamada, Naohiro; Mochizuki, Yuichiro; Suzaki, Harumi

    2009-01-01

    We investigated the types and numbers of inflammatory cells that infiltrated the ethmoid sinus mucosa in cases of chronic sinusitis in order to identify any associations with nasal polyp size and the grade of ethmoid sinus opacification on computer tomography images. The subjects were patients with chronic sinusitis who underwent endoscopic sinus surgery. Seventeen subjects also had bronchial asthma as a complication (six with aspirin-induced asthma, 11 with another form of asthma) and 24 did not have bronchial asthma as a complication (16 with allergic rhinitis, 8 with chronic sinusitis alone). The nasal polyps in the patients with bronchial asthma were significantly larger than those in the patients without bronchial asthma. Investigation of the numbers of infiltrating inflammatory cells according to polyp size revealed significantly more eosinophils as polyp size increased. In addition, infiltration of significantly more mast cells was observed when the polyps were large. Assessment of the grade of opacification of the ethmoid sinuses on computer tomography images showed a significantly higher grade of opacification in the patients with bronchial asthma than in the patients without bronchial asthma. Comparisons between the grade of opacification of the ethmoid sinuses and the number of infiltrating inflammatory cells revealed significantly more infiltrating eosinophils and mast cells in the patients with intense ethmoid sinus opacification. The above findings suggest that eosinophils and mast cells play a major role in forming the persistent inflammation of the sinus mucosa and nasal polyp tissue of patients with chronic sinusitis complicated by bronchial asthma. (author)

  16. Congenital hairy polyp of the oropharynx presenting as an esophageal mass in a neonate, a case report and literature review.

    Science.gov (United States)

    Richter, Amy; Mysore, Krupa; Schady, Deb; Chandy, Binoy

    2016-01-01

    To review the literature of congenital hairy polyps and describe the clinical presentation, operative management, and histologic findings of a congenital hairy polyp arising from the palatopharyngeus muscle in a neonate with recurrent choking episodes. Chart review of a 2-month-old male referred to a tertiary care pediatric hospital. We present a case of a 2-month-old male who presented to the emergency room with recurrent episodes of choking and vomiting. The patient was previously healthy with no prior medical or neonatal history. The parents noted a small fleshy mass in the patient's oropharynx that he would chew on and swallow after several minutes. However, on physical exam, there was no evidence of oropharyngeal mass. The patient did not have respiratory distress. Imaging revealed a 22×7×11mm oblong, fatty mass in the lower cervical and upper thoracic esophagus with a thin stalk extending proximally to the upper collapsed esophagus. Intraoperative recorded laryngoscopy revealed a pedunculated soft palate mass attached to the right superior palatopharyngeus muscle. Histopathology revealed ectodermal and mesodermal elements in a polypoid structure lined by keratinizing squamous epithelium with adnexal structures and central mature adipose tissue, consistent with congenital hairy polyp resembling an accessory tragus of the ear and branchial anomaly. At 6-week follow up, the patient was doing well and gaining weight appropriately with no further choking episodes. There was no evidence of velopharyngeal dysfunction on follow up exam. The surgical site was completely healed and there was no evidence of recurrence. Congenital hairy polyps of the naso- and oropharynx are rare but may present as airway or esophageal masses, causing respiratory distress or choking episodes in a pediatric patient. The pathologic findings of keratinizing squamous epithelium, adnexal structures, adipose and cartilage tissues resemble congenital accessory tragus and may be considered a

  17. Analysis of colorectal cancer and polyp for presence herpes simplex virus and cytomegalovirus DNA sequences by polymerase chain reaction

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    Sahar Mehrabani khasraghi

    2016-05-01

    Full Text Available Introduction: In recent years, it was demonstrated that there is a clear association between the complicated course of colorectal cancer (CRC and the presence of herpes viruses. Despite a great number of published reports, the exact pathogenic role of herpes viruses remains unclear in these patients. The purpose of this study is to explore the prevalence of herpes simplex virus (HSV and cytomegalovirus (CMV in patients with CRC and polyp in comparison with healthy subjects using the polymerase chain reaction (PCR method. Methods: In this case-control study, 15 biopsies of patients with CRC and 20 colorectal polyp sample were selected. From each patient, two tissue samples were obtained: one sample from malignant tissue, and the other from normal colorectal tissue in an area located 15 cm away from the malignant tissue. Furthermore, 35 samples from healthy people as controls were selected. After DNA extraction, PCR was used to determine HSV and CMV genomes by specific primers. A statistical analysis was performed using the chi-square test. Results: Five CRC patients (33.3% had HSV DNA detected in both the malignant and the matched normal tissue. Five CRC patients (33.3% and seven polyp patients (35.0% had CMV DNA detected in both the malignant and the matched normal tissue. HSV DNA was found in 20% and CMV DNA in 37.1% of samples from healthy people as a control group. Thus, no significant association was observed between the prevalence of HSV and CMV, and an incidence of CRC and polyps according to the location of the samples as compared with the control group. Conclusion: The findings demonstrated that there is no direct molecular evidence to support the association between HSV and CMV and human colorectal malignancies. However, the results from this study do not exclude a possible oncogenic role of these viruses in the neoplastic development of colon cells.

  18. Detection of human papillomavirus infection by molecular tests and its relation to colonic polyps and colorectal cancer

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    Faten Gazzaz

    2016-03-01

    Full Text Available Objectives: To prospectively examine the association between human papilloma virus (HPV colonization of the colonic mucosa and the development of colorectal polyps (CRPs, and colorectal cancer (CRC in Saudi Arabia. Methods: A case control study was performed between January 2013 and December 2014. All eligible patients underwent standard diagnostic colonoscopy. Patients with polyps or colorectal cancer were considered cases, while those with any other endoscopic findings were controls. Biopsy samples from polyps and tumors, and/or from normal colonic mucosa were acquired. Human papilloma virus colonization was detected using a hybrid capture technique of samples taken from both normal tissue, and CRPs and CRC. The association between HPV and CRPs/CRC was evaluated. Results: A total of 132 patients were recruited. The mean age was 53 (±15.9 years. Sixty patients had endoscopically detectable CRPs/CRC, and 72 had either inflammation or normal endoscopic evaluations. Only 4 (0.8% of the 132 samples that were collected and analyzed were positive for the HPV gene. Statistical analysis did not identify any significant association between HPV colonization and the presence of CRPs/CRC. The only significant predictor of detecting CRPs/CRC on colonoscopy was symptomatic presentation (odds ratio=11.072, 95% confidence interval 4.7-26.2, p<0.001. Conclusion: Human papilloma virus colonic colonization is rare in Saudi Arabia. An association between HPV colonization and CRP/CRC development could not be identified in this cohort of patients.

  19. Inorganic polyphosphate (polyP) as an activator and structural component of the mitochondrial permeability transition pore.

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    Solesio, Maria E; Elustondo, Pia A; Zakharian, Eleonora; Pavlov, Evgeny V

    2016-02-01

    Mitochondrial permeability transition pore (mPTP) is a large channel located in the mitochondrial inner membrane. The opening of mPTP during pathological calcium overload leads to the membrane depolarization and disruption of ATP production. mPTP activation has been implicated as a central event during the process of stress-induced cell death. mPTP is a supramolecular complex composed of many proteins. Recent studies suggest that mitochondrial ATPase plays the central role in the formation of mPTP. However, the structure of the central conducting pore part of mPTP (mPTPore) remains elusive. Here we review current models proposed for the mPTPore and involvement of polyP in its formation and regulation. We discuss the underestimated role of polyP as an effector and a putative structural component of the mPTPore. We propose the hypothesis that inclusion of polyP can explain such properties of mPTP activity as calcium activation, selectivity and voltage-dependence. © 2016 Authors; published by Portland Press Limited.

  20. Naive and effector B-cell subtypes are increased in chronic rhinosinusitis with polyps.

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    Miljkovic, Dijana; Psaltis, Alkis; Wormald, Peter-John; Vreugde, Sarah

    2018-01-01

    Recent studies demonstrated that B cells and their chemoattractants are elevated in the nasal mucosa of patients with chronic rhinosinusitis (CRS) with nasal polyposis (CRSwNP). However, the presence of naive B cells and of plasmablasts and memory B-cell subsets in the mucosa and periphery of the same patient with CRS is yet to be characterized. Here we sought to quantify naive, plasmablasts, and memory B cells in mucosal tissue and peripheral blood of patients with CRSwNP, patients with CRS without nasal polyps (CRSsNP), and control patients. Polyps, mucosa, and peripheral blood samples were prospectively collected from the patients with CRS and from the non-CRS controls. We used flow cytometry to distinguish among naive, plasmablast, and memory B cells in sinus tissue and peripheral blood. A total of 45 patients were recruited for the study. The patients with CRSwNP had significantly increased mucosal B-cell numbers versus the controls (3.39 ± 4.05% versus 0.39 ± 1.05% of live cells; p Kruskal-Wallis test), which included naive B cells (0.61 ± 0.94 versus 0.11 ± 0.24% of live cells; p Kruskal-Wallis test), plasmablasts (0.06 ± 0.26 versus 0.00 ± 0.00% of live cells; p Kruskal-Wallis test), and memory B cells (0.62 ± 1.26 versus 0.05 ± 0.15% of live cells; p Kruskal-Wallis test). Our study identified increased frequencies of different B-cell subtypes in the mucosa of patients with CRSwNP but not in the peripheral blood. We also found that patients with CRSwNP had significantly increased B-cell subtypes compared with the patients with CRSsNP and the controls. These results implied a potential role for mucosal B cells in the ongoing inflammation in patients with CRSwNP.

  1. Down-regulation of EMP1 is associated with epithelial hyperplasia and metaplasia in nasal polyps.

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    Yu, Xue Min; Li, Chun Wei; Li, Ying Ying; Liu, Jing; Lin, Zhi Bin; Li, Tian Ying; Zhao, Li; Pan, Xin Liang; Shi, Li; Wang, De Yun

    2013-11-01

    The aim of this study was to assess protein and mRNA expression of epithelial membrane protein 1 (EMP1) in the nasal mucosa of patients with nasal polyps (NP), and to determine what changes occur in response to glucocorticosteroid (GC) treatment. NP tissue was obtained from 55 patients, 18 of whom were treated with nasal GCs (i.e. these 18 patients had NP biopsies taken before and after treatment). Biopsies of inferior turbinate mucosa from 30 healthy subjects were used as controls. Quantitative PCR and immunohistochemistry were performed to determine the expression levels of EMP1. EMP1 mRNA expression was significantly lower (2.77-fold) in tissues from NP patients before GC treatment when compared to controls, but was increased in these patients after GC treatment. EMP1 staining in nasal epithelium co-localized with both basal (p63(+)) and differentiated (CK18(+)) epithelial cells. Their immunoreactivity was significantly greater in controls than NP patients. EMP1 mRNA levels were lower in the epithelium with severe hyperplasia (1.79-fold) or with metaplasia (1.85-fold) as compared to those with mild to moderate hyperplasia or non-metaplastic epithelium, respectively. Positive correlations between EMP1 and other epithelial cell-related gene (e.g. JUN, PTGS2, AREG etc.) mRNAs were observed. EMP1 could be a biomarker for aberrant epithelial remodelling and metaplasia in chronic inflammatory upper airway mucosa (e.g. NP). © 2013 John Wiley & Sons Ltd.

  2. Inflammatory fibroid polyp in the duodenum of a common marmoset (Callithrix jacchus).

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    Yokouchi, Yusuke; Imaoka, Masako; Sayama, Ayako; Jindo, Toshimasa; Sanbuissho, Atsushi

    2013-01-01

    A 32-month-old male common marmoset had a firm and white-colored mass in the duodenal wall. The cut surface was smooth and grayish white in color. Histologically, the mass consisted of a proliferation of spindle cells with an oval to spindle-shaped nucleus and scant eosinophilic cytoplasm in a loose myxoid or fibrotic background. Most of the lesion displayed no specific growth pattern whereas some of the cells concentrated around the vessels and created an onion-bulb structure. Additionally, marked inflammatory cellular infiltration, mainly eosinophils, was observed throughout the lesion. Immunohistochemically, the spindle cells were positive for vimentin, α-smooth muscle actin, fascin, and cyclin D1, and negative for S-100, factor VIII-related antigen, and c-kit. These histological and immunohistochemical features did not meet any differential diagnoses such as gastrointestinal stromal tumor, inflammatory myofibroblastic tumor, solitary fibrous tumor/hemangiopericytoma, smooth muscle tumor, schwannoma, and hemangiosarcoma. Collectively, the authors diagnosed the mass as a lesion that corresponded to an inflammatory fibroid polyp (IFP) in humans. IFP is defined as a mesenchymal proliferation composed of spindle stromal cells, small blood vessels, and inflammatory cells, particularly eosinophils, and is currently classified as a nonneoplastic lesion. To the best of our knowledge, this is the first case of spontaneous IFP in nonhuman primates.

  3. [The standardized perioperative treatment of chronic rhinosinusitis with nasal polyps and asthma].

    Science.gov (United States)

    Li, Tingting; Ju, Jianbao; Yu, Hailing; Xie, Daoyu

    2015-04-01

    To discuss the perioperative treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma. Retrospective analysis of perioperative clinical data of 43 cases with CRSwNP and asthma. The admitted and under endoscopic surgery. Patients with preventing perioperative asthma attacks and corresponding standardized treatment were Observed. Thirty-five cases were stable during perioperative period and without asthma. Seven patients diagnosed as mild and moderate asthma attacks because of low pulse oximetry (SpO2 92%-95%) and scattered wheeze heard in the lungs. So these patients were sent to ICU for the treatment. They went back to ward after their conditions turned to stable and no asthma during perioperative. One patient diagnosed as severe asthma attack, because irritability and suffocation happened, SpO2 decreased from 99% to 84%-81%, diffuse wheeze could be heard in the whole lung . So we give him tracheal intubation and sent him to ICU for advanced treatment after breathing smooth. Five days later the patient retuned to the ward in stable condition and with no asthma attack again. Before operation the patients should be give some corresponding standardized comprehensive treatment according to the nasal symptoms and the degree of asthma attack, such as the application of topical steroid and antiallergic medicine. And some special treatment should be given to reduce airway hyperresponsiveness mucosa during anesthesia. These methods can reduce the risk of the asthma attacks and improve perioperative safety, prevent serious complications.

  4. Omalizumab treats chronic rhinosinusitis with nasal polyps and asthma together-a real life study.

    Science.gov (United States)

    Bidder, T; Sahota, J; Rennie, C; Lund, V J; Robinson, D S; Kariyawasam, H H

    2018-03-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy. To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP. SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma. SNOT-22 in a surgery only treated CRSwNP with asthma group (n=24) was compared. Rapid improvement was seen at 4 weeks and 16 weeks of treatment in both CRSwNP and asthma control. The improvement in CRSwNP with Omalizumab was similar to that seen in a group of patients who received upper airway surgery. Omalizumab treatment for severe allergic asthma also improves co-existent CRSwNP. Further clinical studies of current and emerging biological agents for severe asthma should include upper airway outcomes. These agents may be effective for severe CRSwNP and comparative studies with surgery are warranted.

  5. Is the Prevalence of Gallbladder Polyp Different between Vegetarians and General Population?

    Science.gov (United States)

    Jo, Hee Bum; Lee, Jun Kyu; Choi, Min Young; Han, In Woong; Choi, Han Seok; Kang, Hyoun Woo; Kim, Jae Hak; Lim, Yun Jeong; Koh, Moon Soo; Lee, Jin Ho

    2015-11-01

    Gallbladder polyps (GBP) are a common clinical finding that can express malignant potential. The aim of this study was to evaluate whether vegetarianism protects against GBP, together with other putative risk factors. A retrospective, cross-sectional study was conducted with subjects who received a health check-up from July 2005 to December 2011. Korean Buddhist priests, who are obligatory vegetarians by religious belief, were identified as vegetarians (vegetarian group) and compared with a non-vegetarian control group sampled from those coming for health check-ups at the same institution. Out of 18,483 subjects, GBP were found in 810 (4.4%). Al though GBP tended to be less common in the vegetarian group (23 [3.5%] out of 666) than in control group (787 [4.4%] out of 17,817), the difference was insignificant statistically (p=0.233). By logistic regression, old age (OR=1.61, 95% CI=1.1 9-2.26 for 30-39 years; OR=1.47, 95% CI=1.08-1.98 for 40-49 years), male gender (OR=1.51, 95% CI=1.31-1.75), high BMI (OR=1.18, 95% CI=1.00-1.39 for ≥ 23.0 kg/m(2) and vegetarianism.

  6. The Epidemiological and Clinical Aspects of Nasal Polyps that Require Surgery

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    Ahmad Meymane Jahromi

    2011-01-01

    Full Text Available Introduction: The objective of this retrospective cross-sectional study was to obtain epidemiological data from the charts of 297 patients with nasal polyposis who were operated on in a referral hospital in Mashhad and to determine the frequency of the presenting symptoms of nasal polyps.  Materials and Methods: The variables recorded included age, gender, the presence of asthma or allergic rhinitis, family history, and previous treatments. We studied the main symptoms of nasal polyposis (nasal obstruction, rhinorrhea, anosmia, headache, epistaxis, snoring, and so on, as well as ear problems and facial deformity.  Results: Nasal polyposis affects men (60.3% more frequently, at a mean age of 39.5 years. The most frequent symptom was nasal blockage (81.1 % followed by rhinorrhea (37.7%. A total of 11.1% of the patients had a history of epistaxis. Asthma was found in 10.4% of patients with nasal polyposis and the ears were affected in 5.1% of patients. In all, 7.4% of patients had first-degree relatives who suffered from asthma or allergic rhinitis.  Conclusion: This study highlights the need for large-scale epidemiologic research exploring the prevalence and incidence of nasal polyposis in Iran.

  7. COL11A1 in FAP polyps and in sporadic colorectal tumors

    International Nuclear Information System (INIS)

    Fischer, Heléne; Salahshor, Sima; Stenling, Roger; Björk, Jan; Lindmark, Gudrun; Iselius, Lennart; Rubio, Carlos; Lindblom, Annika

    2001-01-01

    We previously reported that the α-1 chain of type 11 collagen (COL11A1), not normally expressed in the colon, was up-regulated in stromal fibroblasts in most sporadic colorectal carcinomas. Patients with germline mutations in the APC gene show, besides colonic polyposis, symptoms of stromal fibroblast involvement, which could be related to COL11A1 expression. Most colorectal carcinomas are suggested to be a result of an activated Wnt- pathway, most often involving an inactivation of the APC gene or activation of β-catenin. We used normal and polyp tissue samples from one FAP patient and a set of 37 sporadic colorectal carcinomas to find out if the up-regulation of COL11A1 was associated with an active APC/β-catenin pathway. In this study we found a statistically significant difference in COL11A1 expression between normal tissue and adenomas from one FAP patient, and all adenomas gave evidence for an active APC/β-catenin pathway. An active Wnt pathway has been suggested to involve stromal expression of WISP-1. We found a strong correlation between WISP-1 and COL11A1 expression in sporadic carcinomas. Our results suggest that expression of COL11A1 in colorectal tumors could be associated with the APC/β-catenin pathway in FAP and sporadic colorectal cancer

  8. Massive-training artificial neural network (MTANN) for reduction of false positives in computer-aided detection of polyps: Suppression of rectal tubes

    International Nuclear Information System (INIS)

    Suzuki, Kenji; Yoshida, Hiroyuki; Naeppi, Janne; Dachman, Abraham H.

    2006-01-01

    One of the limitations of the current computer-aided detection (CAD) of polyps in CT colonography (CTC) is a relatively large number of false-positive (FP) detections. Rectal tubes (RTs) are one of the typical sources of FPs because a portion of a RT, especially a portion of a bulbous tip, often exhibits a cap-like shape that closely mimics the appearance of a small polyp. Radiologists can easily recognize and dismiss RT-induced FPs; thus, they may lose their confidence in CAD as an effective tool if the CAD scheme generates such ''obvious'' FPs due to RTs consistently. In addition, RT-induced FPs may distract radiologists from less common true positives in the rectum. Therefore, removal RT-induced FPs as well as other types of FPs is desirable while maintaining a high sensitivity in the detection of polyps. We developed a three-dimensional (3D) massive-training artificial neural network (MTANN) for distinction between polyps and RTs in 3D CTC volumetric data. The 3D MTANN is a supervised volume-processing technique which is trained with input CTC volumes and the corresponding ''teaching'' volumes. The teaching volume for a polyp contains a 3D Gaussian distribution, and that for a RT contains zeros for enhancement of polyps and suppression of RTs, respectively. For distinction between polyps and nonpolyps including RTs, a 3D scoring method based on a 3D Gaussian weighting function is applied to the output of the trained 3D MTANN. Our database consisted of CTC examinations of 73 patients, scanned in both supine and prone positions (146 CTC data sets in total), with optical colonoscopy as a reference standard for the presence of polyps. Fifteen patients had 28 polyps, 15 of which were 5-9 mm and 13 were 10-25 mm in size. These CTC cases were subjected to our previously reported CAD scheme that included centerline-based segmentation of the colon, shape-based detection of polyps, and reduction of FPs by use of a Bayesian neural network based on geometric and texture

  9. The serrated neoplasia pathway of colorectal tumors: Identification of MUC5AC hypomethylation as an early marker of polyps with malignant potential.

    Science.gov (United States)

    Renaud, Florence; Mariette, Christophe; Vincent, Audrey; Wacrenier, Agnès; Maunoury, Vincent; Leclerc, Julie; Coppin, Lucie; Crépin, Michel; Van Seuningen, Isabelle; Leteurtre, Emmanuelle; Buisine, Marie-Pierre

    2016-03-15

    The serrated neoplasia pathway accounts for 20-30% of colorectal cancers (CRC), which are characterized by extensive methylation (CpG island methylation phenotype, CIMP), frequent BRAF mutation and high microsatellite instability (MSI). We recently identified MUC5AC mucin gene hypomethylation as a specific marker of MSI CRC. The early identification of preneoplastic lesions among serrated polyps is currently challenging. Here, we performed a detailed pathological and molecular analysis of a large series of colorectal serrated polyps and evaluated the usefulness of mucin genes MUC2 and MUC5AC to differentiate serrated polyps and to identify lesions with malignant potential. A series of 330 colorectal polyps including 218 serrated polyps [42 goblet cell-rich hyperplastic polyps (GCHP), 68 microvesicular hyperplastic polyps (MVHP), 100 sessile serrated adenoma (SSA) and eight traditional serrated adenoma (TSA)] and 112 conventional adenomas was analyzed for BRAF/KRAS mutations, MSI, CIMP, MLH1 and MGMT methylation, and MUC2 and MUC5AC expression and methylation. We show that MUC5AC hypomethylation is an early event in the serrated neoplasia pathway, and specifically detects MVHP and SSA, arguing for a filiation between MVHP, SSA and CIMP-H/MSI CRC, whereas GCHP and TSA arise from a distinct pathway. Moreover, MUC5AC hypomethylation specifically identified serrated lesions with BRAF mutation, CIMP-H or MSI, suggesting that it may be useful to identify serrated neoplasia pathway-related precursor lesions. Our data suggest that MVHP should be recognized among HP and require particular attention. © 2015 UICC.

  10. Reduced expression of APC-1B but not APC-1A by the deletion of promoter 1B is responsible for familial adenomatous polyposis.

    Science.gov (United States)

    Yamaguchi, Kiyoshi; Nagayama, Satoshi; Shimizu, Eigo; Komura, Mitsuhiro; Yamaguchi, Rui; Shibuya, Tetsuo; Arai, Masami; Hatakeyama, Seira; Ikenoue, Tsuneo; Ueno, Masashi; Miyano, Satoru; Imoto, Seiya; Furukawa, Yoichi

    2016-05-24

    Germline mutations in the tumor suppressor gene APC are associated with familial adenomatous polyposis (FAP). Here we applied whole-genome sequencing (WGS) to the DNA of a sporadic FAP patient in which we did not find any pathological APC mutations by direct sequencing. WGS identified a promoter deletion of approximately 10 kb encompassing promoter 1B and exon1B of APC. Additional allele-specific expression analysis by deep cDNA sequencing revealed that the deletion reduced the expression of the mutated APC allele to as low as 11.2% in the total APC transcripts, suggesting that the residual mutant transcripts were driven by other promoter(s). Furthermore, cap analysis of gene expression (CAGE) demonstrated that the deleted promoter 1B region is responsible for the great majority of APC transcription in many tissues except the brain. The deletion decreased the transcripts of APC-1B to 39-45% in the patient compared to the healthy controls, but it did not decrease those of APC-1A. Different deletions including promoter 1B have been reported in FAP patients. Taken together, our results strengthen the evidence that analysis of structural variations in promoter 1B should be considered for the FAP patients whose pathological mutations are not identified by conventional direct sequencing.

  11. Reversible Modification of Adenomatous Polyposis Coli (APC) with K63-linked Polyubiquitin Regulates the Assembly and Activity of the β-Catenin Destruction Complex

    Science.gov (United States)

    Tran, Hoanh; Polakis, Paul

    2012-01-01

    The adenomatous polyposis coli (APC) tumor suppressor forms a complex with Axin and GSK3β to promote the phosphorylation and degradation of β-catenin, a key co-activator of Wnt-induced transcription. Here, we establish that APC is modified predominantly with K63-linked ubiquitin chains when it is bound to Axin in unstimulated HEK293 cells. Wnt3a stimulation induced a time-dependent loss of K63-polyubiquitin adducts from APC, an effect synchronous with the dissociation of Axin from APC and the stabilization of cytosolic β-catenin. RNAi-mediated depletion of Axin or β-catenin, which negated the association between APC and Axin, resulted in the absence of K63-adducts on APC. Overexpression of wild-type and phosphodegron-mutant β-catenin, combined with analysis of thirteen human cancer cell lines that harbor oncogenic mutations in APC, Axin, or β-catenin, support the hypothesis that a fully assembled APC-Axin-GSK3β-phospho-β-catenin complex is necessary for the K63-polyubiquitylation of APC. Intriguingly, the degree of this modification on APC appears to correlate inversely with the levels of β-catenin in cells. Together, our results indicate that K63-linked polyubiquitin adducts on APC regulate the assembly and/or efficiency of the β-catenin destruction complex. PMID:22761442

  12. Novel mutations and phenotypic associations identified through APC, MUTYH, NTHL1, POLD1, POLE gene analysis in Indian Familial Adenomatous Polyposis cohort.

    Science.gov (United States)

    Khan, Nikhat; Lipsa, Anuja; Arunachal, Gautham; Ramadwar, Mukta; Sarin, Rajiv

    2017-05-22

    Colo-Rectal Cancer is a common cancer worldwide with 5-10% cases being hereditary. Familial Adenomatous Polyposis (FAP) syndrome is due to germline mutations in the APC or rarely MUTYH gene. NTHL1, POLD1, POLE have been recently reported in previously unexplained FAP cases. Unlike the Caucasian population, FAP phenotype and its genotypic associations have not been widely studied in several geoethnic groups. We report the first FAP cohort from South Asia and the only non-Caucasian cohort with comprehensive analysis of APC, MUTYH, NTHL1, POLD1, POLE genes. In this cohort of 112 individuals from 53 FAP families, we detected germline APC mutations in 60 individuals (45 families) and biallelic MUTYH mutations in 4 individuals (2 families). No NTHL1, POLD1, POLE mutations were identified. Fifteen novel APC mutations and a new Indian APC mutational hotspot at codon 935 were identified. Eight very rare FAP phenotype or phenotypes rarely associated with mutations outside specific APC regions were observed. APC genotype-phenotype association studies in different geo-ethnic groups can enrich the existing knowledge about phenotypic consequences of distinct APC mutations and guide counseling and risk management in different populations. A stepwise cost-effective mutation screening approach is proposed for genetic testing of south Asian FAP patients.

  13. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum.

    Science.gov (United States)

    East, James E; Atkin, Wendy S; Bateman, Adrian C; Clark, Susan K; Dolwani, Sunil; Ket, Shara N; Leedham, Simon J; Phull, Perminder S; Rutter, Matt D; Shepherd, Neil A; Tomlinson, Ian; Rees, Colin J

    2017-07-01

    Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations-serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. Key recommendation : we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years ( weak recommendation, low quality evidence, 90% agreement ). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Seguimiento posquirúrgico de los pacientes con poliposis adenomatosa familiar: resultados en una población del sur de España Follow-up after surgical treatment of patients whit familial adenomatous polyposis: Results in Southern Spanish population

    Directory of Open Access Journals (Sweden)

    C. Cordero Fernández

    2007-08-01

    Full Text Available Objetivo: analizar la evolución de la mucosa rectal y del reservorio así como idoneidad de los intervalos de seguimiento y del tratamiento realizado para evitar la aparición del cáncer, en una serie de pacientes con poliposis adenomatosa familiar (PAF, intervenidos. Método: estudio prospectivo de 28 pacientes con PAF intervenidos mediante anastomosis íleo-rectal (20 pacientes y anastomosis íleo-anal con reservorio (8 pacientes. A todos se les había realizado un control endoscópico dos veces al año y análisis del número y características macroscópicas e histológicas de los pólipos antes y después de la cirugía así como del tratamiento realizado, de sus complicaciones y de la adecuación del intervalo de seguimiento. El seguimiento medio fue de 6,47 años (DE = 4,59; rango = 0,72-16,75 años. Resultados: ninguno de los 26 pacientes que cumplimentaron correctamente el protocolo de seguimiento desarrolló cáncer. Sólo dos pacientes lo desarrollaron al 1,75 y los 3 años, respectivamente del abandono del protocolo. Los pacientes que desarrollaron adenomas durante el seguimiento fueron tratados con éxito mediante polipectomía endoscópica, salvo en dos casos que se indicó cirugía. Conclusiones: en nuestra serie, el incumplimiento de las revisiones ha sido el factor que ha condicionado la aparición de cáncer.Objective: the study was to assess changes in the rectal mucosa and pouch in a series of patients with familial adenomatous polyposis (FAP who underwent either subtotal colectomy and ileorectal anastomosis (IRA or proctocolectomy and ileal pouch-anal anastomosis (IPAA, and to evaluate the suitability of the follow-up interval and postoperative treatment employed to prevent the development of cancer. Method: this study involved 28 patients with FAP who underwent IRA (n=20 or IPAA (n=8, and were followed endoscopically over a mean period of 7.47 years. The number and both macroscopic and histological features of polyps

  15. Detection of colorectal serrated polyps by stool DNA testing: comparison with fecal immunochemical testing for occult blood (FIT.

    Directory of Open Access Journals (Sweden)

    Russell I Heigh

    Full Text Available Precursors to 1/3 of colorectal cancer (CRC, serrated polyps have been under-detected by screening due to their inconspicuous, non-hemorrhagic, and proximal nature. A new multi-target stool DNA test (multi-target sDNA shows high sensitivity for both CRC and advanced adenomas. Screen detection of serrated polyps by this approach requires further validation. We sought to assess and compare noninvasive detection of sessile serrated polyps (SSP ≥ 1 cm by sDNA and an occult blood fecal immunochemical test (FIT.In a blinded prospective study, a single stool sample used for both tests was collected from 456 asymptomatic adults prior to screening or surveillance colonoscopy (criterion standard. All 29 patients with SSP ≥ 1 cm were included as cases and all 232 with no neoplastic findings as controls. Buffered stool samples were processed and frozen on receipt; Exact Sciences performed sDNA in batches using optimized analytical methods. The sDNA multi-marker panel targets methylated BMP3 (mBMP3 and NDRG4, mutant KRAS, β-actin, and hemoglobin. FIT (Polymedco OC-FIT Check was performed in separate lab ≤ 2 days post defecation and evaluated at cutoffs of 50 (FIT-50 and 100 ng/ml (FIT-100.MEDIAN AGES: cases 61 (range 57-77, controls 62 (52-70, p = NS. Women comprised 59% and 51%, p = NS, respectively. SSP median size was 1.2 cm (1-3 cm, 93% were proximal, and 64% had synchronous diminutive polyps. Among multi-target sDNA markers, mBMP3 proved highly discriminant for detection of SSP ≥ 1 cm (AUC = 0.87, p<0.00001; other DNA markers provided no incremental sensitivity. Hemoglobin alone showed no discrimination (AUC = 0.50, p = NS. At matched specificities, detection of SSP ≥ 1 cm by stool mBMP3 was significantly greater than by FIT-50 (66% vs 10%, p = 0.0003 or FIT-100 (63% vs 0%, p<0.0001.In a screening and surveillance setting, SSP ≥ 1 cm can be detected noninvasively by stool assay of exfoliated DNA markers, especially mBMP3. FIT appears to

  16. Look Out before Polypectomy in Patients with Diverticular Disease – A Case of a Large, Inverted Diverticulum of the Colon Resembling a Pedunculated Polyp

    Directory of Open Access Journals (Sweden)

    Omero Alessandro Paoluzi

    2010-01-01

    Full Text Available Diverticular disease of the colon may be responsible for abdominal symptoms requiring colonoscopy, which may reveal the presence of concomitant polyps. A polyp found during colonoscopy in patients with colonic diverticular disease may be removed by endoscopic polypectomy with electrosurgical snare, a procedure associated with an incidence of perforation of less than 0.05%. The risk of such a complication may be higher in the event of an inverted colonic diverticulum, which may be misinterpreted as a polypoid lesion at colonoscopy. To date, fewer than 20 cases of inverted colonic diverticula, diagnosed at colonoscopy or following air contrast barium enema, have been reported in the literature. The present report describes a 68-year-old woman who underwent a screening colonoscopy, which revealed a voluminous pedunculated polyp that was recognized to be an inverted giant colonic diverticulum before endoscopic polypectomy.

  17. Copy number of the Adenomatous Polyposis Coli gene is not always neutral in sporadic colorectal cancers with loss of heterozygosity for the gene

    International Nuclear Information System (INIS)

    Zauber, Peter; Marotta, Stephen; Sabbath-Solitare, Marlene

    2016-01-01

    Changes in the number of alleles of a chromosome may have an impact upon gene expression. Loss of heterozygosity (LOH) indicates that one allele of a gene has been lost, and knowing the exact copy number of the gene would indicate whether duplication of the remaining allele has occurred. We were interested to determine the copy number of the Adenomatous Polyposis Coli (APC) gene in sporadic colorectal cancers with LOH. We selected 38 carcinomas with LOH for the APC gene region of chromosome 5, as determined by amplification of the CA repeat region within the D5S346 loci. The copy number status of APC was ascertained using the SALSA® MLPA® P043-B1 APC Kit. LOH for the DCC gene, KRAS gene mutation, and microsatellite instability were also evaluated for each tumor, utilizing standard polymerase chain reaction methods. No tumor demonstrated microsatellite instability. LOH of the DCC gene was also present in 33 of 36 (91.7 %) informative tumors. A KRAS gene mutation was present in 16 of the 38 (42.1 %) tumors. Twenty-four (63.2 %) of the tumors were copy number neutral, 10 (26.3 %) tumors demonstrated major loss, while two (5.3 %) showed partial loss. Two tumors (5.3 %) had copy number gain. Results of APC and DCC LOH, KRAS and microsatellite instability indicate our colorectal cancer cases were typical of sporadic cancers following the ‘chromosomal instability’ pathway. The majority of our colorectal carcinomas with LOH for APC gene are copy number neutral. However, one-third of our cases showed copy number loss, suggesting that duplication of the remaining allele is not required for the development of a colorectal carcinoma

  18. WNT Inhibitory Activity of Malus Pumila miller cv Annurca and Malus domestica cv Limoncella Apple Extracts on Human Colon-Rectal Cells Carrying Familial Adenomatous Polyposis Mutations.

    Science.gov (United States)

    Riccio, Gennaro; Maisto, Maria; Bottone, Sara; Badolati, Nadia; Rossi, Giovanni Battista; Tenore, Gian Carlo; Stornaiuolo, Mariano; Novellino, Ettore

    2017-11-18

    Inhibitors of the Wingless-related Integration site (WNT)/β-catenin pathway have recently been under consideration as potential chemopreventive agents against Familial Adenomatous Polyposis (FAP). This autosomal-dominant syndrome is caused by germline mutations in the gene coding for the protein APC and leads to hyperactivation of the WNT/β-catenin signaling pathway, uncontrolled intestinal cell proliferation and formation of adenocarcinomas. The aim of the present work was to: (i) test, on in vitro cultures of cells carrying FAP mutations and on ex vivo biopsies of FAP patients, the WNT inhibitory activity of extracts from two common southern Italian apples, Malus pumila Miller cv. 'Annurca' and Malus domestica cv 'Limoncella'; (ii) identify the mechanisms underpinning their activities and; (iii) evaluate their potency upon gastrointestinal digestion. We here show that both Annurca and Limoncella apple extracts act as WNT inhibitors, mostly thanks to their polyphenolic contents. They inhibit the pathway in colon cells carrying FAP mutations with active dilutions falling in ranges close to consumer-relevant concentrations. Food-grade manufacturing of apple extracts increases their WNT inhibitory activity as result of the conversion of quercetin glycosides into the aglycone quercetin, a potent WNT inhibitor absent in the fresh fruit extract. However, in vitro simulated gastrointestinal digestion severely affected WNT inhibitory activity of apple extracts, as result of a loss of polyphenols. In conclusion, our results show that apple extracts inhibit the WNT pathway in colon cells carrying FAP mutations and represent a potential nutraceutical alternative for the treatment of this pathology. Enteric coating is advisable to preserve the activity of the extracts in the colon-rectal section of the digestive tract.

  19. Origin of Somatic Mutations in β-Catenin versus Adenomatous Polyposis Coli in Colon Cancer: Random Mutagenesis in Animal Models versus Nonrandom Mutagenesis in Humans.

    Science.gov (United States)

    Yang, Da; Zhang, Min; Gold, Barry

    2017-07-17

    Wnt signaling is compromised early in the development of human colorectal cancer (CRC) due to truncating nonsense mutations in adenomatous polyposis coli (APC). CRC induced by chemical carcinogens, such as heterocyclic aromatic amines and azoxymethane, in mice also involves dysregulation of Wnt signaling but via activating missense mutations in the β-catenin oncogene despite the fact that genetically modified mice harboring an inactive APC allele efficiently develop CRC. In contrast, activating mutations in β-catenin are rarely observed in human CRC. Dysregulation of the Wnt signaling pathway by the two distinct mechanisms reveals insights into the etiology of human CRC. On the basis of calculations related to DNA adduct levels produced in mouse CRC models using mutagens, and the number of stem cells in the mouse colon, we show that two nonsense mutations required for biallelic disruption of APC are statistically unlikely to produce CRC in experiments using small numbers of mice. We calculate that an activating mutation in one allele near the critical GSK3β phosphorylation site on β-catenin is >10 5 -times more likely to produce CRC by random mutagenesis due to chemicals than inactivating two alleles in APC, yet it does not occur in humans. Therefore, the mutagenesis mechanism in human CRC cannot be random. We explain that nonsense APC mutations predominate in human CRC because of deamination at 5-methylcytosine at CGA and CAG codons, coupled with the number of human colonic stem cells and lifespan. Our analyses, including a comparison of mutation type and age at CRC diagnosis in U.S. and Chinese patients, also indicate that APC mutations in CRC are not due to environmental mutagens that randomly damage DNA.

  20. Celecoxib and tauro-ursodeoxycholic acid co-treatment inhibits cell growth in familial adenomatous polyposis derived LT97 colon adenoma cells

    Energy Technology Data Exchange (ETDEWEB)

    Heumen, Bjorn W.H. van, E-mail: b.vanheumen@mdl.umcn.nl [Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Roelofs, Hennie M.J.; Morsche, Rene H.M. te [Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Marian, Brigitte [Institute of Cancer Research, Wien University, Vienna (Austria); Nagengast, Fokko M.; Peters, Wilbert H.M. [Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2012-04-15

    Chemoprevention would be a desirable strategy to avoid duodenectomy in patients with familial adenomatous polyposis (FAP) suffering from duodenal adenomatosis. We investigated the in vitro effects on cell proliferation, apoptosis, and COX-2 expression of the potential chemopreventives celecoxib and tauro-ursodeoxycholic acid (UDCA). HT-29 colon cancer cells and LT97 colorectal micro-adenoma cells derived from a patient with FAP, were exposed to low dose celecoxib and UDCA alone or in combination with tauro-cholic acid (CA) and tauro-chenodeoxycholic acid (CDCA), mimicking bile of FAP patients treated with UDCA. In HT-29 cells, co-treatment with low dose celecoxib and UDCA resulted in a decreased cell growth (14-17%, p < 0.01). A more pronounced decrease (23-27%, p < 0.01) was observed in LT97 cells. Cell growth of HT-29 cells exposed to 'artificial bile' enriched with UDCA, was decreased (p < 0.001), either in the absence or presence of celecoxib. In LT97 cells incubated with 'artificial bile' enriched with UDCA, cell growth was decreased only in the presence of celecoxib (p < 0.05). No clear evidence was found for involvement of proliferating cell nuclear antigen, caspase-3, or COX-2 in the cellular processes leading to the observed changes in cell growth. In conclusion, co-treatment with low dose celecoxib and UDCA has growth inhibitory effects on colorectal adenoma cells derived from a patient with FAP, and further research on this combination as promising chemopreventive strategy is desired. -- Highlights: Black-Right-Pointing-Pointer Celecoxib and UDCA acid co-treatment decreases cell growth in colon tumor cells. Black-Right-Pointing-Pointer UDCA enriched 'artificial bile' decreases LT-97 cell growth only in presence of celecoxib. Black-Right-Pointing-Pointer PCNA, caspase-3, nor COX-2 seem to be involved in the observed changes in cell growth.

  1. Celecoxib and tauro-ursodeoxycholic acid co-treatment inhibits cell growth in familial adenomatous polyposis derived LT97 colon adenoma cells

    International Nuclear Information System (INIS)

    Heumen, Bjorn W.H. van; Roelofs, Hennie M.J.; Morsche, René H.M. te; Marian, Brigitte; Nagengast, Fokko M.; Peters, Wilbert H.M.

    2012-01-01

    Chemoprevention would be a desirable strategy to avoid duodenectomy in patients with familial adenomatous polyposis (FAP) suffering from duodenal adenomatosis. We investigated the in vitro effects on cell proliferation, apoptosis, and COX-2 expression of the potential chemopreventives celecoxib and tauro-ursodeoxycholic acid (UDCA). HT-29 colon cancer cells and LT97 colorectal micro-adenoma cells derived from a patient with FAP, were exposed to low dose celecoxib and UDCA alone or in combination with tauro-cholic acid (CA) and tauro-chenodeoxycholic acid (CDCA), mimicking bile of FAP patients treated with UDCA. In HT-29 cells, co-treatment with low dose celecoxib and UDCA resulted in a decreased cell growth (14–17%, p < 0.01). A more pronounced decrease (23–27%, p < 0.01) was observed in LT97 cells. Cell growth of HT-29 cells exposed to ‘artificial bile’ enriched with UDCA, was decreased (p < 0.001), either in the absence or presence of celecoxib. In LT97 cells incubated with ‘artificial bile’ enriched with UDCA, cell growth was decreased only in the presence of celecoxib (p < 0.05). No clear evidence was found for involvement of proliferating cell nuclear antigen, caspase-3, or COX-2 in the cellular processes leading to the observed changes in cell growth. In conclusion, co-treatment with low dose celecoxib and UDCA has growth inhibitory effects on colorectal adenoma cells derived from a patient with FAP, and further research on this combination as promising chemopreventive strategy is desired. -- Highlights: ► Celecoxib and UDCA acid co-treatment decreases cell growth in colon tumor cells. ► UDCA enriched ‘artificial bile’ decreases LT-97 cell growth only in presence of celecoxib. ► PCNA, caspase-3, nor COX-2 seem to be involved in the observed changes in cell growth.

  2. Downregulation of adenomatous polyposis coli by microRNA-663 promotes odontogenic differentiation through activation of Wnt/beta-catenin signaling

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae-Sung; Park, Min-Gyeong; Lee, Seul Ah; Park, Sun-Young; Kim, Heung-Joong; Yu, Sun-Kyoung; Kim, Chun Sung; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Kim, Jin-Soo; Seo, Yo-Seob [Oral Biology Research Institute, School of Dentistry, Chosun University, Gwangju 501-759 (Korea, Republic of); Chun, Hong Sung [Department of Biomedical Science, Chosun University, Gwangju 501-759 (Korea, Republic of); Park, Joo-Cheol [Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, BK 21, Seoul National University, Seoul 110-749 (Korea, Republic of); Kim, Do Kyung, E-mail: kdk@chosun.ac.kr [Oral Biology Research Institute, School of Dentistry, Chosun University, Gwangju 501-759 (Korea, Republic of)

    2014-04-18

    Highlights: • miR-663 is significantly up-regulated during MDPC-23 odontoblastic cell differentiation. • miR-663 accelerates mineralization in MDPC-23 odontoblastic cells without cell proliferation. • miR-663 promotes odontoblastic cell differentiation by targeting APC and activating Wnt/β-catenin signaling in MDPC-23 cells. - Abstract: MicroRNAs (miRNAs) regulate cell differentiation by inhibiting mRNA translation or by inducing its degradation. However, the role of miRNAs in odontogenic differentiation is largely unknown. In this present study, we observed that the expression of miR-663 increased significantly during differentiation of MDPC-23 cells to odontoblasts. Furthermore, up-regulation of miR-663 expression promoted odontogenic differentiation and accelerated mineralization without proliferation in MDPC-23 cells. In addition, target gene prediction for miR-663 revealed that the mRNA of the adenomatous polyposis coli (APC) gene, which is associated with the Wnt/β-catenin signaling pathway, has a miR-663 binding site in its 3′-untranslated region (3′UTR). Furthermore, APC expressional was suppressed significantly by miR-663, and this down-regulation of APC expression triggered activation of Wnt/β-catenin signaling through accumulation of β-catenin in the nucleus. Taken together, these findings suggest that miR-663 promotes differentiation of MDPC-23 cells to odontoblasts by targeting APC-mediated activation of Wnt/β-catenin signaling. Therefore, miR-663 can be considered a critical regulator of odontoblast differentiation and can be utilized for developing miRNA-based therapeutic agents.

  3. Drosophila homologues of adenomatous polyposis coli (APC) and the formin diaphanous collaborate by a conserved mechanism to stimulate actin filament assembly.

    Science.gov (United States)

    Jaiswal, Richa; Stepanik, Vince; Rankova, Aneliya; Molinar, Olivia; Goode, Bruce L; McCartney, Brooke M

    2013-05-10

    Vertebrate APC collaborates with Dia through its Basic domain to assemble actin filaments. Despite limited sequence homology between the vertebrate and Drosophila APC Basic domains, Drosophila APC1 collaborates with Dia to stimulate actin assembly in vitro. The mechanism of actin assembly is highly conserved over evolution. APC-Dia collaborations may be crucial in a wide range of animal cells. Adenomatous polyposis coli (APC) is a large multidomain protein that regulates the cytoskeleton. Recently, it was shown that vertebrate APC through its Basic domain directly collaborates with the formin mDia1 to stimulate actin filament assembly in the presence of nucleation barriers. However, it has been unclear whether these activities extend to homologues of APC and Dia in other organisms. Drosophila APC and Dia are each required to promote actin furrow formation in the syncytial embryo, suggesting a potential collaboration in actin assembly, but low sequence homology between the Basic domains of Drosophila and vertebrate APC has left their functional and mechanistic parallels uncertain. To address this question, we purified Drosophila APC1 and Dia and determined their individual and combined effects on actin assembly using both bulk fluorescence assays and total internal reflection fluorescence microscopy. Our data show that APC1, similar to its vertebrate homologue, bound to actin monomers and nucleated and bundled filaments. Further, Drosophila Dia nucleated actin assembly and protected growing filament barbed ends from capping protein. Drosophila APC1 and Dia directly interacted and collaborated to promote actin assembly in the combined presence of profilin and capping protein. Thus, despite limited sequence homology, Drosophila and vertebrate APCs exhibit highly related activities and mechanisms and directly collaborate with formins. These results suggest that APC-Dia interactions in actin assembly are conserved and may underlie important in vivo functions in a broad

  4. Copy number of the Adenomatous Polyposis Coli gene is not always neutral in sporadic colorectal cancers with loss of heterozygosity for the gene.

    Science.gov (United States)

    Zauber, Peter; Marotta, Stephen; Sabbath-Solitare, Marlene

    2016-03-12

    Changes in the number of alleles of a chromosome may have an impact upon gene expression. Loss of heterozygosity (LOH) indicates that one allele of a gene has been lost, and knowing the exact copy number of the gene would indicate whether duplication of the remaining allele has occurred. We were interested to determine the copy number of the Adenomatous Polyposis Coli (APC) gene in sporadic colorectal cancers with LOH. We selected 38 carcinomas with LOH for the APC gene region of chromosome 5, as determined by amplification of the CA repeat region within the D5S346 loci. The copy number status of APC was ascertained using the SALSA® MLPA® P043-B1 APC Kit. LOH for the DCC gene, KRAS gene mutation, and microsatellite instability were also evaluated for each tumor, utilizing standard polymerase chain reaction methods. No tumor demonstrated microsatellite instability. LOH of the DCC gene was also present in 33 of 36 (91.7%) informative tumors. A KRAS gene mutation was present in 16 of the 38 (42.1%) tumors. Twenty-four (63.2%) of the tumors were copy number neutral, 10 (26.3%) tumors demonstrated major loss, while two (5.3%) showed partial loss. Two tumors (5.3%) had copy number gain. Results of APC and DCC LOH, KRAS and microsatellite instability indicate our colorectal cancer cases were typical of sporadic cancers following the 'chromosomal instability' pathway. The majority of our colorectal carcinomas with LOH for APC gene are copy number neutral. However, one-third of our cases showed copy number loss, suggesting that duplication of the remaining allele is not required for the development of a colorectal carcinoma.

  5. WNT Inhibitory Activity of Malus Pumila miller cv Annurca and Malus domestica cv Limoncella Apple Extracts on Human Colon-Rectal Cells Carrying Familial Adenomatous Polyposis Mutations

    Directory of Open Access Journals (Sweden)

    Gennaro Riccio

    2017-11-01

    Full Text Available Inhibitors of the Wingless-related Integration site (WNT/β-catenin pathway have recently been under consideration as potential chemopreventive agents against Familial Adenomatous Polyposis (FAP. This autosomal-dominant syndrome is caused by germline mutations in the gene coding for the protein APC and leads to hyperactivation of the WNT/β-catenin signaling pathway, uncontrolled intestinal cell proliferation and formation of adenocarcinomas. The aim of the present work was to: (i test, on in vitro cultures of cells carrying FAP mutations and on ex vivo biopsies of FAP patients, the WNT inhibitory activity of extracts from two common southern Italian apples, Malus pumila Miller cv. ‘Annurca’ and Malus domestica cv ‘Limoncella’; (ii identify the mechanisms underpinning their activities and; (iii evaluate their potency upon gastrointestinal digestion. We here show that both Annurca and Limoncella apple extracts act as WNT inhibitors, mostly thanks to their polyphenolic contents. They inhibit the pathway in colon cells carrying FAP mutations with active dilutions falling in ranges close to consumer-relevant concentrations. Food-grade manufacturing of apple extracts increases their WNT inhibitory activity as result of the conversion of quercetin glycosides into the aglycone quercetin, a potent WNT inhibitor absent in the fresh fruit extract. However, in vitro simulated gastrointestinal digestion severely affected WNT inhibitory activity of apple extracts, as result of a loss of polyphenols. In conclusion, our results show that apple extracts inhibit the WNT pathway in colon cells carrying FAP mutations and represent a potential nutraceutical alternative for the treatment of this pathology. Enteric coating is advisable to preserve the activity of the extracts in the colon-rectal section of the digestive tract.

  6. CT colonography: comparison of a colon dissection display versus 3D endoluminal view for the detection of polyps

    International Nuclear Information System (INIS)

    Juchems, Markus S.; Pauls, Sandra; Brambs, Hans-Juergen; Aschoff, Andrik J.; Fleiter, Thorsten R.; Schmidt, Stefan A.

    2006-01-01

    The purpose of this study was to compare sensitivity, specificity, and postprocessing time of a colon dissection approach to regular 3D-endoluminal workup of computed tomography (CT) colonography for the detection of polypoid lesions. Twenty-one patients who had received conventional colonoscopy after CT colonography were selected; 18 patients had either colon polyps or colon cancer and three had no findings. CT colonography was performed using a 4-channel multi-detector-row (MDR) CT in ten cases and a 16-channel MDR-CT in 11 cases. A blinded reader retrospectively evaluated all colonographies using both viewing methods in a randomized order. Thirty-seven polyps were identified by optical colonoscopy. An overall per-lesion sensitivity of 47.1% for lesions smaller than 5 mm, 56.3% for lesions between 5 mm and 10 mm, and 75.0% for lesion larger than 10 mm was calculated using the colon dissection approach. This compared to an overall per-lesion sensitivity of 35.3% ( 10 mm) using the endoluminal view. The average time consumption for CT colonography evaluation with the colon dissection software was 10 min versus 38 min using the endoluminal view. A colon dissection approach may provide a significant time advantage for evaluation of CT colonography while obtaining a high sensitivity. It is especially superior in the detection of lesions smaller than 5 mm. (orig.)

  7. Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

    Energy Technology Data Exchange (ETDEWEB)

    Tutein Nolthenius, Charlotte J. [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Boellaard, Thierry N.; Nio, C.Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Haan, Margriet C. de [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Thomeer, Maarten G.J. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Essink-Bot, Marie-Louise [University of Amsterdam, Public Health, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Kuipers, Ernst J. [Erasmus University Medical Center, Gastroenterology and Hepatology, Rotterdam (Netherlands); Erasmus University Medical Center, Internal medicine, Rotterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Gastroenterology and Hepatology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands)

    2016-11-15

    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 diagnosed with <3 polyps 6-9 mm, for which surveillance CTC after 3 years was advised. Validated questionnaires regarding expected and perceived burden (5-point Likert scales) were completed before and after index and surveillance CTC, also including items on burden of waiting for surveillance CTC. McNemar's test was used for comparison after dichotomization. Seventy-eight (77 %) of 101 invitees underwent surveillance CTC, of which 66 (85 %) completed the expected and 62 (79 %) the perceived burden questionnaire. The majority of participants (73 %) reported the experience of waiting for surveillance CTC as 'never' or 'only sometimes' burdensome. There was almost no difference in expected and perceived burden between surveillance and index CTC. Waiting for the results after the procedure was significantly more burdensome for surveillance CTC than for index CTC (23 vs. 8 %; p = 0.012). Waiting for surveillance CTC after primary CTC screening caused little or no burden for surveillance participants. In general, the burden of surveillance and index CTC were comparable. (orig.)

  8. Risk stratification of gallbladder polyps (1-2 cm) for surgical intervention with 18F-FDG PET/CT.

    Science.gov (United States)

    Lee, Jaehoon; Yun, Mijin; Kim, Kyoung-Sik; Lee, Jong-Doo; Kim, Chun K

    2012-03-01

    We assessed the value of (18)F-FDG uptake in the gallbladder polyp (GP) in risk stratification for surgical intervention and the optimal cutoff level of the parameters derived from GP (18)F-FDG uptake for differentiating malignant from benign etiologies in a select, homogeneous group of patients with 1- to 2-cm GPs. Fifty patients with 1- to 2-cm GPs incidentally found on the CT portion of PET/CT were retrospectively analyzed. All patients had histologic diagnoses. GP (18)F-FDG activity was visually scored positive (≥liver) or negative (L ratio) were also measured. Univariate and multivariate logistic regression analyses were performed to determine the utility of patient and clinical variables--that is, sex, age, gallstone, polyp size, and three (18)F-FDG-related parameters in risk stratification. Twenty GPs were classified as malignant and 30 as benign. Multivariate analyses showed that the age and all parameters (visual criteria, SUVgp, and GP/L) related to (18)F-FDG uptake were significant risk factors, with the GP/L being the most significant. The sex, size of GPs, and presence of concurrent gallstones were found to be insignificant. (18)F-FDG uptake in a GP is a strong risk factor that can be used to determine the necessity of surgical intervention more effectively than other known risk factors. However, all criteria derived from (18)F-FDG uptake presented in this series may be applicable to the assessment of 1- to 2-cm GPs.

  9. A patient-preference cohort study of office versus inpatient uterine polyp treatment for abnormal uterine bleeding.

    Science.gov (United States)

    Cooper, Natalie A M; Middleton, Lee; Smith, Paul; Denny, Elaine; Stobert, Lynda; Daniels, Jane; Clark, T Justin

    2016-01-01

    Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited. Office polypectomies were performed in office hysteroscopy clinics, and inpatient procedures were undertaken in operating theatres. Three hundred twenty-four of 399 (81 %) expressed a preference for office treatment. There was no difference found between office treatment and inpatient treatment in terms of alleviating abnormal uterine bleeding as assessed by patients and in improving disease-specific quality of life. Acceptability was lower and patient pain scores were significantly higher in the office group. When offered a choice of treatment setting for uterine polypectomy, patients have a preference for office over inpatient treatment. Ambulatory gynaecology services should be available within healthcare systems to meet patient demand.

  10. Composition and abundance of microbiota in the pharynx in patients with laryngeal carcinoma and vocal cord polyps.

    Science.gov (United States)

    Gong, Hongli; Wang, Boyan; Shi, Yi; Shi, Yong; Xiao, Xiyan; Cao, Pengyu; Tao, Lei; Wang, Yuezhu; Zhou, Liang

    2017-08-01

    The pharynx is an important site of microbiota colonization, but the bacterial populations at this site have been relatively unexplored by culture-independent approaches. The aim of this study was to characterize the microbiota structure of the pharynx. Pyrosequencing of 16S rRNA gene libraries was used to characterize the pharyngeal microbiota using swab samples from 68 subjects with laryngeal cancer and 28 subjects with vocal cord polyps. Overall, the major phylum was Firmicutes, with Streptococcus as the predominant genus in the pharyngeal communities. Nine core operational taxonomic units detected from Streptococcus, Fusobacterium, Prevotella, Granulicatella, and Veillonella accounted for 21.3% of the total sequences detected. However, there was no difference in bacterial communities in the pharynx from patients with laryngeal cancer and vocal cord polyps. The relative abundance of Firmicutes was inversely correlated with Fusobacteria, Proteobacteria, Actinobacteria, and Bacteroidetes. The correlation was evident at the genus level, and the relative abundance of Streptococcus was inversely associated with Fusobacterium, Leptotrichia, Neisseria, Actinomyces, and Prevotella. This study presented a profile for the overall structure of the microbiota in pharyngeal swab samples. Inverse correlations were found between Streptococcus and other bacterial communities, suggesting that potential antagonism may exist among pharyngeal microbiota.

  11. Hereditary familial polyposis and Gardner's syndrome: contribution of the odonto-stomatology examination in its diagnosis and a case description.

    Science.gov (United States)

    Chimenos-Küstner, Eduardo; Pascual, Montserrat; Blanco, Ignacio; Finestres, Fernando

    2005-01-01

    Familial Adenomatous Polyposis (FAP) and its phenotype variant, Gardner's syndrome, constitute a rare autosomal dominant inherited disorder. They are characterised by the development, generally during the second and third decades of life, of multiple adenomatous polyps in the colon and rectum. These polyps have a high risk of subsequently becoming malignant, which normally occurs in the third and fourth decades of life. The phenotypical features of FAP can be very variable. As well as colorectal polyps, these individuals can present with extra-colonic symptoms, among which are particularly: gastro-duodenal polyps, dermoid and epidermoid cysts, desmoid tumours, congenital hypertrophy of the retinal pigment epithelium, disorders of the maxillary and skeletal bones and dental anomalies. In this paper the most important aspects of this syndrome are reviewed, showing an example based on a well documented clinical case. The importance of odonto-stomatological examinations should be pointed out, among others, as a means of reaching a presumptive diagnosis, whose confirmation is vital to the patient.

  12. Naringin, a natural dietary compound, prevents intestinal tumorigenesis in Apc (Min/+) mouse model.

    Science.gov (United States)

    Zhang, Yu-Sheng; Li, Ye; Wang, Yan; Sun, Shi-Yue; Jiang, Tao; Li, Cong; Cui, Shu-Xiang; Qu, Xian-Jun

    2016-05-01

    Naringin is a natural dietary flavonoid compound. We aimed to evaluate the effects of naringin on intestinal tumorigenesis in the adenomatous polyposis coli multiple intestinal neoplasia (Apc (Min/+)) mouse model. Apc (Min/+) mice were given either naringin (150 mg/kg) or vehicle by p.o. gavage daily for 12 consecutive weeks. Mice were killed with ether, and blood samples were collected to assess the concentrations of IL-6 and PGE2. Total intestines were removed, and the number of polyps was examined. Tissue samples of intestinal polyps were subjected to the assays of histopathology, immunohistochemical analysis and Western blotting analysis. Apc (Min/+) mice fed with naringin developed less and smaller polyps in total intestines. Naringin prevented intestinal tumorigenesis without adverse effects. Histopathologic analysis revealed the reduction of dysplastic cells and dysplasia in the adenomatous polyps. The treatments' effects might arise from its anti-proliferation, induction of apoptosis and modulation of GSK-3β and APC/β-catenin signaling pathways. Naringin also exerted its effects on tumorigenesis through anti-chronic inflammation. Naringin prevented intestinal tumorigenesis likely through a collection of activities including anti-proliferation, induction of apoptosis, modulation of GSK-3β and APC/β-catenin pathways and anti-inflammation. Naringin is a potential chemopreventive agent for reducing the risk of colonic cancers.

  13. Prevalence, distribution and risk of sessile serrated adenomas/polyps at a center with a high adenoma detection rate and experienced pathologists

    NARCIS (Netherlands)

    IJspeert, Joep E. G.; de Wit, Koos; van der Vlugt, Manon; Bastiaansen, Barbara A. J.; Fockens, Paul; Dekker, Evelien

    2016-01-01

    Sessile serrated adenomas/polyps (SSA/Ps) are the precursors of 15 % - 30 % of colorectal cancers (CRC). We aimed to determine the prevalence and distribution of SSA/Ps and to evaluate the association between SSA/Ps and the risk of synchronous advanced neoplasia at a high quality colonoscopy center.

  14. A comparison of computer-assisted detection (CAD) programs for the identification of colorectal polyps: performance and sensitivity analysis, current limitations and practical tips for radiologists.

    Science.gov (United States)

    Bell, L T O; Gandhi, S

    2018-06-01

    To directly compare the accuracy and speed of analysis of two commercially available computer-assisted detection (CAD) programs in detecting colorectal polyps. In this retrospective single-centre study, patients who had colorectal polyps identified on computed tomography colonography (CTC) and subsequent lower gastrointestinal endoscopy, were analysed using two commercially available CAD programs (CAD1 and CAD2). Results were compared against endoscopy to ascertain sensitivity and positive predictive value (PPV) for colorectal polyps. Time taken for CAD analysis was also calculated. CAD1 demonstrated a sensitivity of 89.8%, PPV of 17.6% and mean analysis time of 125.8 seconds. CAD2 demonstrated a sensitivity of 75.5%, PPV of 44.0% and mean analysis time of 84.6 seconds. The sensitivity and PPV for colorectal polyps and CAD analysis times can vary widely between current commercially available CAD programs. There is still room for improvement. Generally, there is a trade-off between sensitivity and PPV, and so further developments should aim to optimise both. Information on these factors should be made routinely available, so that an informed choice on their use can be made. This information could also potentially influence the radiologist's use of CAD results. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. The biogenic reefs formed by the alien polychaete Hydroides dianthus (Serpulidae, Annelida) favor the polyp stage of Aurelia coerulea (Cnidaria, Scyphozoa) in a coastal artificial lake.

    Science.gov (United States)

    Dong, Zhijun; Sun, Tingting; Wang, Lei

    2018-04-01

    Blooms of the moon jellyfish Aurelia coerulea frequently occur in coastal waters. The increased availability of substrates for the settlement and proliferation of polyps due to the expansion of artificial structures in coastal areas has been proposed as a possible contributing factor in jellyfish blooms. This paper investigates whether a marine artificial lake (Fenghuang Lake) provides additional substrates for A. coerulea polyps and contributes to jellyfish blooms. High densities of A. coerulea ephyrae were discovered in this lake, with a mean density of 41 individuals/m 3 and a maximum measured density of 128 individuals/m 3 . Meanwhile, A. coerulea ephyrae were also found in the two emptying channels outside the lake, with a mean density of 13 individuals/m 3 . Underwater surveys revealed that dense colonies of A. coerulea polyps occurred mainly on biogenic reefs formed by a polychaete, which was identified as an invasive serpulid species Hydroides dianthus, based on the phylogenetic analysis of mitochondrial COI gene sequences. Our study highlights the potential modification of habitats by the alien polychaete H. dianthus, which might provide complex benthic habits suitable for the settlement and proliferation of A. coerulea polyps and may contribute to jellyfish blooms in the marine artificial lake and nearby coastal waters. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. The effect of systemic treatments on periostin expression reflects their interference with the eosinophilic inflammation in chronic rhinosinusitis with nasal polyps

    NARCIS (Netherlands)

    de Schryver, E.; Derycke, L.; Calus, L.; Holtappels, G.; Hellings, P. W.; van Zele, T.; Bachert, C.; Gevaert, P.

    2017-01-01

    Background: Periostin is a recently discovered biomarker for eosinophilic inflammation. Chronic rhinosinusitis with nasal polyps is a T-helper 2-skewed chronic inflammatory airway disease. Medical treatments aim to relieve symptoms and maintain clinical control by interfering with the inflammatory

  17. Computer tomography colonography participation and yield in patients under surveillance for 6-9 mm polyps in a population-based screening trial

    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.; van de Vijver, Marc J.; Biermann, Katharina; Kuipers, Ernst J.; Dekker, Evelien; Stoker, Jaap

    2016-01-01

    Surveillance CT colonography (CTC) is a viable option for 6-9 mm polyps at CTC screening for colorectal cancer. We established participation and diagnostic yield of surveillance and determined overall yield of CTC screening. In an invitational CTC screening trial 82 of 982 participants harboured 6-9

  18. A comparison of hysteroscopic mechanical tissue removal with bipolar electrical resection for the management of endometrial polyps in an ambulatory care setting: preliminary results.

    Science.gov (United States)

    Pampalona, Jennifer Rovira; Bastos, Maria Degollada; Moreno, Gemma Mancebo; Pust, Andrea Buron; Montesdeoca, Gemma Escribano; Guerra Garcia, Angel; Pruñonosa, Juan Carles Mateu; Collado, Ramon Carreras; Torras, Pere Bresco

    2015-01-01

    To assess and compare efficacy, pain, and the learning curve associated with diagnostic therapeutic hysteroscopy using mechanical tissue removal versus bipolar electrical resection in the management of endometrial polyps in an ambulatory care setting. A randomized controlled clinical trial (Canadian Task Force classification I). Hospital de Igulada, Barcelona, Spain. A total of 133 patients diagnosed with endometrial polyp(s) were included and randomly assigned to 1 of the 2 hysteroscopic methods. Criteria assessed were total hysteroscopy time, full polypectomy procedure time, pain experienced by patients, and learning curve of staff in training. The average time to perform total hysteroscopy using the mechanical tissue removal system (TRUCLEAR 5.0 System; Smith & Nephew Inc., Andover, MD) was 6 minutes 49 seconds versus 11 minutes 37 seconds required for the bipolar electrosurgery system (GYNECARE VERSAPOINT; Ethicon Inc, Somerville, NJ) (p .05). A study of the residents' learning curve showed a higher level of autonomy with hysteroscopy using the TRUCLEAR Tissue Removal System with which residents showed a higher level of confidence compared with hysteroscopy with the VERSAPOINT Bipolar Electrosurgery System. In hysteroscopic polypectomy, the mechanical tissue removal system was significantly faster, achieved a greater success rate for complete polypectomy, and required a shorter learning curve from staff being trained in the management of endometrial polyps when compared with bipolar electrical resection. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  19. Prevalence of human papillomavirus, Epstein-Barr virus, p21, and p53 expression in sinonasal inverted papilloma, nasal polyp, and hypertrophied turbinate in Hong Kong patients.

    Science.gov (United States)

    Sham, C L; To, K F; Chan, Paul K S; Lee, Dennis L Y; Tong, Michael C F; van Hasselt, C Andrew

    2012-04-01

    The purpose of this study of human papillomavirus (HPV), Epstein-Barr virus (EBV), p21, and p53 in sinonasal inverted papilloma (IP) was to help elucidate its pathogenesis. Seventy-three IPs, 48 nasal polyps, and 85 hypertrophied turbinates were subjected to HPV polymerase chain reaction (PCR) study. Seventy-three IPs, 30 nasal polyps, and 32 hypertrophied turbinates were subjected to EBV in situ hybridization (ISH), p21, and p53 immunohistochemical (IHC) studies. HPV was positive in 3 of 73 IPs (4.1%). All specimens were EBV negative. In all, 99% of IPs showed strong and diffuse p21 nuclear reactivity. Most nasal polyps and hypertrophied turbinates showed weak to moderate immunoreactivity of the basal and parabasal cells. Only focal p53 immunoreactivity of the basal and parabasal cells was found in 19% of IPs and 40% of nasal polyps. HPV prevalence of our IP is low. EBV is not present in IP. High p21 and low p53 expression in IP suggests a non-p53-dependent regulation pathway. Copyright © 2011 Wiley Periodicals, Inc.

  20. Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study

    International Nuclear Information System (INIS)

    Little, M. W.; Boardman, P.; Macdonald, A. C.; Taylor, N.; Macpherson, R.; Crew, J.; Tapping, C. R.

    2017-01-01

    PurposeTo investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).Materials and MethodsTwelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH. Patients were followed up with repeat MP-MRI at 3 months and 1 year. International prostate symptom score (IPSS), international index for erectile function (IIEF), and quality of life assessment from the IPSS and EQ-5D-5S questionnaires were recorded pre-PAE and at 6 weeks, 3 months, and 1 year.ResultsThe mean age of patients was 68 (61–76). All patients had PAE as a day-case procedure. The technical success in the cohort was 23/24 (96%). There was a significant reduction in prostate volume following embolization with a median reduction of 34% (30–55) in the AdBPH group, compared to a mean volume reduction of 22% (9–44) in the non-AdBPH group (p = 0.04). There was a significant reduction in IPSS in the AdBPH group following PAE when compared with the control group [AdBPH median IPSS 8 (3–15) vs. non-AdBPH median IPSS 13 (8–18), p = 0.01]. IPSS QOL scores significantly improved in the AdBPH group (p = 0.007). There was no deterioration in sexual function in either group post-PAE.ConclusionsThis is the first time that AdBPH has been identified as being a predictor of clinical success following PAE.

  1. Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study

    Energy Technology Data Exchange (ETDEWEB)

    Little, M. W., E-mail: m.little@doctors.org.uk; Boardman, P.; Macdonald, A. C.; Taylor, N.; Macpherson, R. [Oxford University Hospitals NHS Foundation Trust, Department of Radiology, Churchill Hospital (United Kingdom); Crew, J. [Oxford University Hospitals NHS Foundation Trust, Department of Urology, Churchill Hospital (United Kingdom); Tapping, C. R., E-mail: crtapping@doctors.org.uk [Oxford University Hospitals NHS Foundation Trust, Department of Radiology, Churchill Hospital (United Kingdom)

    2017-05-15

    PurposeTo investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).Materials and MethodsTwelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH. Patients were followed up with repeat MP-MRI at 3 months and 1 year. International prostate symptom score (IPSS), international index for erectile function (IIEF), and quality of life assessment from the IPSS and EQ-5D-5S questionnaires were recorded pre-PAE and at 6 weeks, 3 months, and 1 year.ResultsThe mean age of patients was 68 (61–76). All patients had PAE as a day-case procedure. The technical success in the cohort was 23/24 (96%). There was a significant reduction in prostate volume following embolization with a median reduction of 34% (30–55) in the AdBPH group, compared to a mean volume reduction of 22% (9–44) in the non-AdBPH group (p = 0.04). There was a significant reduction in IPSS in the AdBPH group following PAE when compared with the control group [AdBPH median IPSS 8 (3–15) vs. non-AdBPH median IPSS 13 (8–18), p = 0.01]. IPSS QOL scores significantly improved in the AdBPH group (p = 0.007). There was no deterioration in sexual function in either group post-PAE.ConclusionsThis is the first time that AdBPH has been identified as being a predictor of clinical success following PAE.

  2. Virtual chromoendoscopy for the real-time assessment of colorectal polyps in vivo: a systematic review and economic evaluation.

    Science.gov (United States)

    Picot, Joanna; Rose, Micah; Cooper, Keith; Pickett, Karen; Lord, Joanne; Harris, Petra; Whyte, Sophie; Böhning, Dankmar; Shepherd, Jonathan

    2017-12-01

    Current clinical practice is to remove a colorectal polyp detected during colonoscopy and determine whether it is an adenoma or hyperplastic by histopathology. Identifying adenomas is important because they may eventually become cancerous if untreated, whereas hyperplastic polyps do not usually develop into cancer, and a surveillance interval is set based on the number and size of adenomas found. Virtual chromoendoscopy (VCE) (an electronic endoscopic imaging technique) could be used by the endoscopist under strictly controlled conditions for real-time optical diagnosis of diminutive (≤ 5 mm) colorectal polyps to replace histopathological diagnosis. To assess the clinical effectiveness and cost-effectiveness of the VCE technologies narrow-band imaging (NBI), flexible spectral imaging colour enhancement (FICE) and i-scan for the characterisation and management of diminutive (≤ 5 mm) colorectal polyps using high-definition (HD) systems without magnification. Systematic review and economic analysis. People undergoing colonoscopy for screening or surveillance or to investigate symptoms suggestive of colorectal cancer. NBI, FICE and i-scan. Diagnostic accuracy, recommended surveillance intervals, health-related quality of life (HRQoL), adverse effects, incidence of colorectal cancer, mortality and cost-effectiveness of VCE compared with histopathology. Electronic bibliographic databases including MEDLINE, EMBASE, The Cochrane Library and Database of Abstracts of Reviews of Effects were searched for published English-language studies from inception to June 2016. Bibliographies of related papers, systematic reviews and company information were screened and experts were contacted to identify additional evidence. Systematic reviews of test accuracy and economic evaluations were undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analyses were conducted, where possible, to inform the independent

  3. Calibrating amino acid δ13C and δ15N offsets between polyp and protein skeleton to develop proteinaceous deep-sea corals as paleoceanographic archives

    Science.gov (United States)

    McMahon, Kelton W.; Williams, Branwen; Guilderson, Thomas P.; Glynn, Danielle S.; McCarthy, Matthew D.

    2018-01-01

    Compound-specific stable isotopes of amino acids (CSI-AA) from proteinaceous deep-sea coral skeletons have the potential to improve paleoreconstructions of plankton community composition, and our understanding of the trophic dynamics and biogeochemical cycling of sinking organic matter in the Ocean. However, the assumption that the molecular isotopic values preserved in protein skeletal material reflect those of the living coral polyps has never been directly investigated in proteinaceous deep-sea corals. We examined CSI-AA from three genera of proteinaceous deep-sea corals from three oceanographically distinct regions of the North Pacific: Primnoa from the Gulf of Alaska, Isidella from the Central California Margin, and Kulamanamana from the North Pacific Subtropical Gyre. We found minimal offsets in the δ13C values of both essential and non-essential AAs, and in the δ15N values of source AAs, between paired samples of polyp tissue and protein skeleton. Using an essential AA δ13C fingerprinting approach, we show that estimates of the relative contribution of eukaryotic microalgae and prokaryotic cyanobacteria to the sinking organic matter supporting deep-sea corals are the same when calculated from polyp tissue or recently deposited skeletal tissue. The δ15N values of trophic AAs in skeletal tissue, on the other hand, were consistently 3-4‰ lower than polyp tissue for all three genera. We hypothesize that this offset reflects a partitioning of nitrogen flux through isotopic branch points in the synthesis of polyp (fast turnover tissue) and skeleton (slow, unidirectional incorporation). This offset indicates an underestimation, albeit correctable, of approximately half a trophic position from gorgonin protein-based deep-sea coral skeleton. Together, our observations open the door for applying many of the rapidly evolving CSI-AA based tools developed for metabolically active tissues in modern systems to archival coral tissues in a paleoceanographic context.

  4. Can optical diagnosis of small colon polyps be accurate? Comparing standard scope without narrow banding to high definition scope with narrow banding.

    Science.gov (United States)

    Ashktorab, Hassan; Etaati, Firoozeh; Rezaeean, Farahnaz; Nouraie, Mehdi; Paydar, Mansour; Namin, Hassan Hassanzadeh; Sanderson, Andrew; Begum, Rehana; Alkhalloufi, Kawtar; Brim, Hassan; Laiyemo, Adeyinka O

    2016-07-28

    To study the accuracy of using high definition (HD) scope with narrow band imaging (NBI) vs standard white light colonoscope without NBI (ST), to predict the histology of the colon polyps, particularly those high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. Of participants in the study, 55 (37%) were male and median (interquartile range) of age was 56 (19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were scope (P = 0.7). The ST scope had a positive predictive value (PPV) and positive likelihood ratio (PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for