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benign esophageal lesions: Endoscopic and pathologic features

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World Journal of Gastroenterology 2015年第4期21卷 1091-1098页

作者： Shu-Jung Tsai Ching-Chung Lin Chen-Wang Chang Chien-Yuan Hung Tze-Yu Shieh Horng-Yuan Wang Shou-Chuan Shih Ming-Jen Chen Division of Gastroenterology Department of Internal MedicineMackay Memorial Hospital Department of Nursing Nursing and Management Mackay Junior College of Medicine Mackay Medical College

benign esophageal lesions have a wide spectrum of clinical and pathologic features. Understanding the endoscopic and pathologic features of esophageal lesions is essential for their detection, differential diagnosis, and management. The purpose of this review is to provide updated features that may help physicians to appropriately manage these esophageal lesions. The endoscopic features of 2997 patients are reviewed. In epithelial lesions, the frequency of occurrence was in the following order: glycogenic acanthosis, heterotopic gastric mucosa, squamous papilloma, hyperplastic polyp, ectopic sebaceous gland and xanthoma. In subepithelial lesions, the order was as follows: hemangioma, leiomyoma, dysphagia aortica and granular cell tumor. Most benign esophageal lesions can be diagnosed according to their endoscopic appearance and findings on routine biopsy, and submucosal lesions, by endoscopic resection. Management is generally based upon the confidence of diagnosis and whether the lesion causes symptoms. We suggest endoscopic resection of all granular cell tumors and squamous papillomas because, while rare, these lesions have malignant potential. Dysphagia aortica should be considered in the differential diagnosis of dysphagia in the elderly.

关键词： benign tumor Esophagus Epithelial lesions Subepith

Does prostate-specific antigen (PSA)mass or free PSA mass improve the accuracy of predicting total prostate volume in relation to obesity in men with biopsy-proven benign prostatic hyperplasia?

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Asian Journal of Andrology 2019年第1期21卷 86-91页

作者： Jin-Woo Jung young Dong Yu Young Ju Lee Jung Jun Kim Hak Min Lee Jong Jin Oh Sangchul Lee Sang Wook Lee Sang Eun Lee Seong Jin Jeong Department of Urology Catholic Kwandong Univerisity International St.Mary's HospitalIncheon 22711Korea Department of Urology Seoul National University Bundang HospitalSeongnam 13620Korea Department of Urology Kangwon National University School of MedicineChuncheon 24341Korea

We evaluated whether the prostate-specific antigen (PSA)mass or free PSA (fPSA)mass (i.e.,absolute amount of total circulating PSA or fPSA protein,respectively),versus serum PSA or fPSA concentration,improves the accuracy of predicting the total prostate volume (TPV)in relation to *** men whose multicore (≥12)transrectal prostate biopsy was negative,586 who had a PSA of <10 ng ml^-1 and underwent the fPSA test prior to biopsy were *** PSA mass or fPSA mass (pg)was calculated by multiplying the serum level by plasma *** each TPV cut-off point (30 ml,40 ml,and 50 ml),the areas under the receiver operating characteristics curve (AUCs)of each variable were compared in obesity-based *** of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1%at all cut-off points. Subgroup analyses based on obesity showed that,although PSA mass and fPSA mass enhanced accuracy by 4%(P =0.031)and 1.8%(P =0.003),respectively,for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men,they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off ***,compared with serum PSA or fPSA,the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off ***,these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.

关键词： benign prostatic hyperplasia obesity prostate volume prostate-specific antigen mass

A Numerical Investigation of the Effects of benign Paroxysmal Positional Vertigo on the Balance Function of the Inner Ear

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Computer Modeling in Engineering & Sciences 2018年第8期116卷 315-322页

作者： Shen Yu Jizhe Wang Yan Guo Xiuzhen Sun Shuang Shen State Key Laboratory of Structural Analysis for Industrial Equipment Dalian University of TechnologyDalian116024China. Department of Otorhinalaryngology the Second Affiliated Hospital of Dalian Medical UniversityDalian116027China. School of Special Education Binzhou Medical UniversityYantai264003China.

A three-dimensional numerical model of the membranous labyrinth of the semicircular canal of the inner ear was established to investigate the effects of canalithiasis of BPPV on the balance function of the inner *** movement of otolith particles in the membranous labyrinth was simulated when a person turns his head to a specific *** effects of otolith movements on the balance function of the inner ear were simulated for different numbers,diameters,and initial positions of *** simulation results show that the otolith diameter affects the movement duration of otoliths in the membranous *** number and diameter of otoliths,the diameter of the membranous labyrinth,and the initial position of the otoliths can cause changes in the pressure difference on both sides of the cupula of the crista ampullaris(cupula).The latent period and onset period are related to the diameter of otolith particles and the position of the *** is also a correlation between the severity of the disease and the diameter and number of otolith particles.

关键词： benign paroxysmal positional pertigo membranous labyrinth cupula of the crista ampullaris otolith

Enhanced recovery after surgery program in the patients undergoing hepatectomy for benign liver lesions

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 122-128页

作者： Jia-Min Zhou Xi-Gan He Miao Wang Yi-Ming Zhao Lian Shu Long-Rong Wang Lu Wang An-Rong Mao Department of Hepatic Surgery Shanghai Cancer CenterFudan UniversityShanghai 200032China Education Department Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China

Background:Enhanced recovery after surgery(ERAS)has shown effectiveness in terms of reducing the hospital stay and ***,the benefit of ERAS in patients undergoing hepatectomy for benign liver lesions is still ***:ERAS was implemented in our center since March 1st,*** September 2016 to Febru-ary 2018,109 patients were enrolled into the control group,and from March 2018 to June 2019,124 patients were enrolled into the ERAS *** the indicators related to operation,liver functions,and postoperative outcomes were included in the ***:The clinicopathologic baselines were similar in these two groups.A significantly higher propor-tion of patients underwent laparoscopic surgery in the ERAS *** the whole,intraoperative blood loss(100.00 mL vs.200.00 mL,Pbenign liver lesions.

关键词： Enhanced recovery after surgery Hepatectomy benign liver lesions Laparoscopy Liver function

Development and validation of a model to determine risk of refractory benign esophageal strictures

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World Journal of Clinical Cases 2019年第13期7卷 1623-1633页

作者： Qing Lu Tian-Tian Lei Yi-Lan Wang Hai-Lin Yan Bo Lin Lin-Lin Zhu Hong-Sheng Ma Jin-Lin Yang Department of Gastroenterology West China Hospital of Sichuan University Chengdu 610041 Sichuan Province China Department of Day Surgery West China Hospital of Sichuan University Chengdu 610041 Sichuan Province China

BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile, the long-term outcomes of RBES remain unclear. The aim of this study was to develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures. And we also explored the long-term outcomes and safety in patients with RBES. AIM To develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures, based on the demographic data and endoscopic findings. METHODS A total of 507 benign esophageal stricture patients treated by dilation alone or in combination with stenting were retrospectively enrolled between January 2009 and February 2018. The primary outcome was to establish a risk-scoring model predicting RBES in benign esophageal strictures. The secondary outcome was to explore the clinical effectiveness and adverse events in patients with RBES. RESULTS In the study, age, etiology, and number and length of strictures were the independent risk factors for the refractory performance of benign esophageal strictures. According to risk factors of benign esophageal strictures, a risk-scoring model for predicting RBES in benign esophageal strictures was established: The risk score ranged from 0 to 8 points, and the risk scores were divided into low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-8 points). The proportions of RBES in the corresponding risk categories were 1.0%, 12.2%, and 76.0%, respectively. Among 507 patients, 57 had RBES (39 males;median age, 60 years). The success rate of dilation treatment (51.2%, 21/41) was higher than that of stent placement (37.5%, 6/16). CONCLUSION In this study, 11.3%(57/507) patients had RBES at our hospital. The risk-scoring model predicting RBES in benign esophageal strictures could predict the longterm outco

关键词： Refractory benign esophageal strictures Esophageal dilation Esophageal stents Long-term outcomes Retrospective analysis

Intralesional steroid is beneficial in benign refractory esophageal strictures:A meta-analysis

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World Journal of Gastroenterology 2018年第21期24卷 2311-2319页

作者： László Szapáry Benedek Tinusz Nelli Farkas Katalin Márta Lajos Szakó Agnes Meczker Roland Hágendorn Judit Bajor Aron Vincze Zoltan Gyongyi Alexandra Mikó Dezso Csupor Péter Hegyi Balint Eross Institute for Translational Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Institute of Bioanalysis Medical SchoolUniversity of PécsPécs 7624Hungary Department of Gastroenterology First Department of MedicineMedical SchoolUniversity of PécsPécs 7624Hungary Department of Public Health Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Department of Pharmacognosy Faculty of PharmacyUniversity of SzegedSzeged 6720Hungary

AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal *** A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment *** Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(MD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(MD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SMD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid *** Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research.

关键词： Intralesional steroid Meta-analysis benign refractory esophageal stricture Dilation

Silicone-covered biodegradable magnesium stent for treating benign esophageal stricture in a rabbit model

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World Journal of Gastroenterology 2019年第25期25卷 3207-3217页

作者： Kai Yang Jun Cao Tian-Wen Yuan Yue-Qi Zhu Bi Zhou Ying-Sheng Cheng Department of Radiological Intervention Shanghai Sixth People's Hospital East Campus Affiliated to Shanghai University of Medicine&Health SciencesShanghai 201306China Department of Radiological Intervention Shanghai Sixth People's Hospital East Campus Affiliated to Shanghai Jiao Tong UniversityShanghai 201306China Department of Tumor Intervention Dahua HospitalShanghai 200237China Department of Radiological Intervention Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong UniversityShanghai 200233China

BACKGROUND Stent insertion can effective alleviate the symptoms of benign esophageal strictures(BES).Magnesium alloy stents are a good candidate because of biological safety,but show a poor corrosion resistance and a quick loss of mechanical support in *** To test the therapeutic and adverse effects of a silicone-covered magnesium alloy biodegradable esophageal *** Fifteen rabbits underwent silicone-covered biodegradable magnesium stent insertion into the benign esophageal stricture under fluoroscopic guidance(stent group).The wall reconstruction and tissue reaction of stenotic esophagus in the stent group were compared with those of six esophageal stricture models(control group).Esophagography was performed at 1,2,and 3 ***,six,and five rabbits in the stent group and two rabbits in the control groups were euthanized,respectively,at each time point for histological *** All stent insertions were well *** esophageal diameters at immediately,1,2 and 3 wk were 9.8±0.3 mm,9.7±0.7 mm,9.4±0.8 mm,and 9.2±0.5 mm,respectively(vs 4.9±0.3 mm before stent insertion;P0.05).CONCLUSION Esophageal silicone-covered biodegradable magnesium stent insertion is feasible for BES without causing severe injury or tissue *** study suggests that insertion of silicone-covered magnesium esophageal stent is a promising approach for treating BES.

关键词： benign esophageal stricture Biodegradable stent Magnesium Silicone membrane

Hepatocyte isolation from resected benign tissues: Results of a 5-year experience

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World Journal of Gastroenterology 2016年第36期22卷 8178-8186页

作者： Fan-Ying Meng Li Liu Jun Liu Chun-You Li Jian-Ping Wang Feng-Hui Yang Zhi-Shui Chen Ping Zhou Division of Hepato-Biliary-Pancreatic Surgery Institute of Organ Transplantation Shandong Provincial Hospital affiliated to Shandong University Institute of Organ Transplantation Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

AIM To analyze retrospectively a 5-year experience of human hepatocyte isolation from resected liver tissues with benign *** We established a method of modified four-step retrograde perfusion to isolate primary human hepatocytes. Samples were collected from the resected livers of patients with intrahepatic duct calculi(n = 7) and liver hemangioma(n = 17). Only the samples weighing ≥ 15 g were considered suitable for hepatocyte isolation. By using the standard trypan blue exclusion technique, hepatocyte viability and yield were immediately determined after *** Twenty-four liver specimens, weighing 15-42 g, were immediately taken from the margin of the removed samples and transferred to the laboratory for hepatocyte isolation. Warm ischemia time was 5-35 min and cold ischemia time was 15-45 min. For the 7 samples of intrahepatic duct calculi, the method resulted in a hepatocyte yield of 3.49 ± 2.31 × 10~6 hepatocytes/g liver, with 76.4% ± 10.7% viability. The 17 samples of liver hemangioma had significantly higher yield of cells(5.4 ± 1.71 × 10~6 cells/g vs 3.49 ± 2.31 × 10~6 cells/g, P 0.05). We obtained a cell yield of 5.31 ± 1.87 × 10~6 hepatocytes/g liver when the samples weighed > 20 g. However, for the tissues weighing ≤ 20 g, a reduction in yield was found(3.08 ± 1.86 × 10~6 cells/g vs 5.31 ± 1.87 × 10~6 cells/g, P benign diseased livers are valuable sources for largenumber hepatocyte isolation. Our study represents the largest number of primary human hepatocytes isolated from resected specimens from patients with benign liver disease. We evaluated the effect of donor liver characteristics on cell isolation, and we found that samples of liver hemangioma can provide better results than intrahepatic duct calculi, in terms of cell yield. Furthermore, the size of the

关键词： Human hepatocyte Primary hepatocyte Cell isolation benign liver disease Hepatocyte isolation

CA19-9 antigen levels can distinguish between benign and malignant pancreaticobiliary disease

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Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 620-626页

作者： Gareth Morris-Stiff Mary Teli Nicky Jardine Malcolm CA Puntis Department of Surgery University Hospital of Wales

BACKGROUND:CA19-9 is a carbohydrate tumor-associated antigen which is frequently upregulated in pancreatobiliary ***,it may also be elevated in patients with jaundice in the absence of a tumor due to biliary obstruction,and in other non-hepato-pancreatico-biliary *** study aimed to evaluate whether CA19-9 levels could accurately differentiate between benign and malignant pancreatobiliary ***:All patients referred to a single surgeon for investigation of pancreaticobiliary disease in 2003 in whom a firm diagnosis had been established were *** malignant disease,a histological diagnosis was required but for benign disease a firm radiological diagnosis was deemed *** patients were divided into 4 categories:pancreatic adenocarcinoma(PCa);cholangiocarcinoma(CCa);chronic pancreatitis(CP)and biliary calculous disease(Calc).Bilirubin and alkaline phosphatase levels corresponding to the point of assessment of CA19-9 were also ***:Final diagnoses were made of pancreatic adenocarcinoma(PCa,n=73),cholangiocarcinoma(CCa,n=19),ampullary carcinoma(Amp,n=7),neuroendocrine carcinoma(Neu,n=4),duodenal carcinoma(Duo,n=3),chronic pancreatitis(CP,n=115),and biliary calculous disease(Calc,n=27).Median CA19-9 levels(U/ml)were:PCa,653;CCa,408;Duo,403;Calc,27;CP,19;Neu,10.5;Amp,8(reference range:0-37).The CA19-9 levels were significantly greater for malignant than for benign disease,could differentiate PCa from CCa/Duo,and were significantly higher in unresectable than in resectable *** sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)for CA19-9 were 84.9%,69.7%,67.7%and 86.1%,respectively.A ROC analysis provided an area under the curve for CA19-9 of 0.871(0.820-0.922),giving an optimal CA19-9 of 70.5 U/ml for differentiating benign from malignant *** this cut-off,the sensitivity was 82.1%,while specificity,PPV and NPV improved to 85.9%,81.3%and 86.5%,*** sta

关键词： CA19-9 antigen pancreatic disease biliary tract disease malignant benign