Roy NattivJanet M WojcickiElizabeth A GarnettNeera Gupta...
1229-1234页
查看更多>>摘要：AIM:TO assess attitudes and trends regarding the use of high-dose infliximab among pediatric gastroenterologists for treatment of pediatric ulcerative colitis (UC).METHODS:A 19-item survey was distributed to subscribers of the pediatric gastroenterology (PEDSGI)listserv.Responses were submitted anonymously and results compiled in a secure website.RESULTS:A total of 113 subscribers (88％ based in the United States) responded (101 pediatric gastroenterology attendings and 12 pediatric gastroenterology fellows).There were 46％ in academic medical institutions and 39％ in hospital-based practices.The majority (91％) were treating ＞10 patients with UC; 13％ were treating ＞100 patients with UC; 91％ had prescribed infliximab (IFX) 5 mg/kg for UC; 72％ had prescribed IFX 10 mg/kg for UC.Using a 5-point Likert scale,factors that influenced the decision not to increase IFX dosing in patients with UC included:"improvement on initial dose of IFX" (mean:3.88) and "decision to move to colectomy" (3.69).Lowest mean Likert scores were:"lack of guidelines or literature regarding increased IFX dosing" (1.96) and "insurance authorization or other insurance issues" (2.34)."Insurance authorization or other insurance issues" was identified by 39％ as at least somewhat of a factor (Likert score ≥ 3) in their decision not to increase the IFX dose.IFX 10 mg/kg was more commonly used for the treatment of pediatric UC among responders based in the United States (75/100) compared to non-United States responders (6/13,P =0.047).Induction of remission was reported by 78％ of all responders and 81％ reported maintenance of remission with IFX 10 mg/kg.One responder reported one death with IFX 10 mg/kg.CONCLUSION:IFX 10 mg/kg is more commonly used in the United States to treat pediatric UC.Efficacy and safety data are required to avoid insurance barriers for its use.
查看更多>>摘要：AIM:To investigate toll-like receptor 2 (TLR2)-196 to -174 del,and TLR4 (+896A/G rs4986790 and +1196C/ T rs4986791) polymorphisms at risk of chronic gastritis and gastric cancer in a Brazilian population and association of gastric lesions with risk factors such as smoking,alcohol intake and Helicobacterpylori infection.METHODS:In this case-control study,polymorphism at TLR2-196 to-174 del was investigated by using the allele-specific polymerase chain reaction (PCR) method,while the PCR-restriction fragment length polymorphism technique was carried out to identify the TLR4 (rs4986790 and rs4986791) genotypes in 607 Brazilian individuals (208 with chronic gastritis-CG,174 with gastric cancer-GC and 225 controls-C).RESULTS:The single nucleotide polymorphisms TLR4+1196C/T was not associated with risk of chronic gastritis or gastric cancer and the homozygous genotypes TLR4+896GG and TLR4+1196TT were absent in the studied population.However,the frequency of TLR2-196 to-174 ins/del + del/del and TLR4+896AG genotypes was significantly higher (P ＜ 0.01 and P =0.01,respectively) in the cancer group (33.4％ and 11.5％,respectively) than in the control group (16.9％ and 4.5％,respectively).It was also observed that the G-C haplotype of the TLR4+896A/G+1196C/T (P =0.02) and the combination of variant alleles of the TLR2/TLR4+896G (P =0.02) are associated with susceptibility to gastric cancer.In addition,the multiple logistic regression showed that male gender [odds ratio (OR) =2.70; 95％ CI:1.66-4.41; P ＜ 0.01],alcohol intake (OR =2.93; 95％ CI:1.76-4.87; P ＜ 0.01),TLR2-196 to-174 del (OR =2.64; 95％ CI:1.56-4.44;P ＜ 0.01) and TLR4+896G (OR =3.19; 95％ CI:1.34-7.61; P ＜ 0.01) polymorphisms were associated with a higher susceptibility to developing this neoplasm.CONCLUSION:Our data indicate that TLR2-196 to -174 del and TLR4+896G may increase the risk of gastric cancer in a Brazilian population.
查看更多>>摘要：AIM:To investigate whether,under the influence of polypectomy,the incidence of adenoma decreases with age.METHODS:Consecutive patients with colonic adenomas identified at index colonoscopy were retrospectively selected if they had undergone three or more complete colonoscopies,at least 24 mo apart.Patients who had any first-degree relative with colorectal cancer were excluded.Data regarding number of adenomas at each colonoscopy,their location,size and histological classification were recorded.The monthly incidence density of adenomas after the index examination was estimated for the study population,by using the person-years method.Baseline adenomas were excluded from incidence calculations but their characteristics were correlated with recurrence at follow-up,using the x2 test.RESULTS:One hundred and fifty-six patients were included (109 male,mean age at index colonoscopy 56.8 ± 10.3 years),with follow-up that ranged from 48 to 232 mo.No significant correlations were observed between the number,the presence of villous component,or the size of adenomas at index colonoscopy and the presence of adenomas at subsequent colonoscopies (P =0.49,0.12 and 0.78,respectively).The incidence of colonic adenomas was observed to decay from 1.4％person-months at the beginning of the study to values close to 0％,at 12 years after index colonoscopy.CONCLUSION:Our results suggest the sporadic formation of adenomas occurs within a discrete period and that,when these adenomas are removed,all neoplasia-prone clones may be extinguished.
查看更多>>摘要：AIM:TO investigate how a complex network of CC chemokine ligands (CCLs) and their receptors influence the progression of tumor and metastasis.METHODS:In the present study,we used immunohistochemistry to examine the expression of CCL7,CCL8 and CCL21 in 194 gastric cancer samples and adjacent normal tissues.We analyzed their correlation with tumor metastasis,clinicopathologic parameters and clinical outcome.RESULTS:We found that the higher expression of CCL7 and CCL21 in cancer tissues than in normal tissues was significantly correlated with advanced depth of wall invasion,lymph node metastasis and higher tumor node metastasis stage.Moreover,Kaplan-Meier survival analysis revealed that CCL7 and CCL21 overexpression in cancer tissues was correlated with poor prognosis.CONCLUSION:These results suggest that overexpression of these two CC chemokine ligands is associated with tumor metastasis and serves as a prognostic factor in patients with gastric cancer.
查看更多>>摘要：AIM:To investigate the non-Helicobacter pylori (H.pylorl) bacterial flora concurrent with H.py/ori infection.METHODS:A total of 103 gastric biopsy specimens from H.py/ori positive patients were selected for bacterial culture.All the non-H.py/ori bacterial isolates were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS).RESULTS:A total of 201 non-H.py/ori bacterial isolates were cultivated from 67 (65.0％) of the 103 gastric samples,including 153 isolates identified successfully at species level and 48 at genus level by MALDI-TOF MS.The dominant species were Streptococcus,Neisseria,Rothia and Staphylococcus,which differed from the predominantly acid resistant species reported previously in healthy volunteers.The prevalence of non-H.pylori bacteria was higher in non-ulcer dyspepsia group than in gastric ulcer group (100％ vs 42.9％,P ＜ 0.001).Six bacterial species with urease activity (Staphylococcus epidermidis,Staphylococcus warneri,Staphylococcus capitis,Staphylococcus aureus,Brevibacterium spp.and Klebsiella pneumoniae) were also isolated.CONCLUSION:There is a high prevalence of the non-H.pylori bacteria concurrent with H.pylori infection,and the non-H.pylori bacteria may also play important as-yet-undiscovered roles in the pathogenesis of stomach disorders.
查看更多>>摘要：AIM:TO investigate the incidence and mortality of gastric cancer (GC) in Zhuanghe region,northeast China and the influencing factors for their changing trends.METHODS:All new cancer cases and deaths registered from 2005 to 2010 in Zhuanghe County were reviewed.The annual GC cases,constituent ratio,crude rates,age-standardized rates,their sex and age distribution and temporal trends were assessed.The method of annual percentage change (APC) was used to estimate the trends of GC.RESULTS:Altogether 2634 new cases of GC and 1722 related deaths were registered,which accounted for 21.04％ and 19.13％ of all cancer-related incidence and deaths,respectively.The age-standardized incidence rate steadily decreased from 57.48 in 2005 to 44.53 in 2010 per 105 males,and from 18.13 to 14.70 per 105 females,resulting in a APC of-5.81％ for males and-2.89％ for females over the entire period.The magnitude of APC in GC mortality amounted to-11.09％ and-15.23％,respectively,as the agestandardized mortality rate steadily decreased from 42.08 in 2005 to 23.71 in 2010 per 105 males,and from 23.86 to 10.78 per 105 females.Females had a significantly lower incidence (a male/female ratio 2.80,P ＜ 0.001) and mortality (a male/female ratio 2.30,P ＜ 0.001).In both genders,the peak incidence and mortality occurred in the 80-84 years age group.The age-standardized mortality/incidence ratio also decreased from the peak of 0.73 in 2005 to 0.53 in 2010 for males,and from 1.32 to 0.73 for females.CONCLUSION:Encouraging declines of incidence and mortality of GC were observed in Zhuanghe region between 2005 and 2010,possibly due to the economic development and efficient GC control strategies.
Anna Wiechowska-KozlowskaEwa WunschMarek MajewskiPiotr Milkiewicz...
1270-1272页
查看更多>>摘要：Esophageal duplication cysts are rare inherited lesions usually diagnosed in early childhood.Most of them are found in the mediastinum and manifest themselves as separate masses along or in continuity with the native esophagus.Their prevalence remains unknown and they are treated either surgically or endoscopically.In this report we describe a series of four adult patients in whom esophageal duplication cysts were localised intramurally as masses pressing on the esophageal lumen and who were diagnosed with endoscopic ultrasonography.All patients were initially referred to other centres for upper gastroduodenoscopy due to non-specific dyspeptic symptoms.After finding suspicious lesions in the esophagus their endoscopists referred them for endoscopic ultrasound examination at our centre.In two of the cases lesions mimicked esophageal varices and the other two submucosal tumours.In all four patients endoscopic ultrasonography has shown esophageal duplication cysts.Patients had no symptoms suggesting disease of the esophagus and required no treatment.As the true prevalence of esophageal cysts is unknown,it is very likely that in many patients,like in these four described by us,they may cause no symptoms,remain undetected and require no intervention.Increasing availability of new diagnostic modalities such as endoscopic ultrasonography may change the current view regarding the prevalence of esophageal duplication cysts and prove that they may,in fact,not be such rare findings.
查看更多>>摘要：Non-hepatocellular carcinoma (non-HCC) wlth macroscoplc bile duct:tumor thrombus (BDTT) formation is rare,few radlologlcal studies have been reported.In this case report,we retrospectively analyzed the Imaging findings of three cases of non-HCC with macroscopic BDTT on dynamic enhanced multlsllce computed tomography (MSCT) scan.One case of primary hepatic carcinosarcoma was presented as a solitary,large welldefined tumor with significant necrotic changes.One case of liver metastasis from colon cancer was presented as a lobulated,large Ⅲ-defined tumor.One case of intraductal oncocytic papillary neoplasm involved the entire pancreas,presented as a cystic and solid mass with multilocular changes (the Individual locull were less than 5.0 mm in diameter).The bile duct was dilated due to expansible growth of the BDTr in all three patients.The BDTr was contiguous with hepatic or pancreatic tumor,and both of them showed the same enhancement patterns on dynamic contrast-enhanced computed tomography scan:early enhancement in the hepatic arterial phase and a quick wash-out of contrast agent in the portal and equilibrium phases.Macroscopic BDTT in non-HCC patient is rare,dynamic enhanced MSCT scan may be valuable in the diagnosis of non-HCC with BDTT.
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