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Ileo-ileal intussusception caused by lymphangioma of the small bowel treated by single-incision laparoscopic-assisted ileal resection

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World Journal of Gastroenterology 2017年第1期23卷 167-172页

作者： Atsushi Kohga Akihiro Kawabe Yuto Hasegawa Kiyoshige Yajima Takuya Okumura Kimihiro Yamashita Jun Isogaki Kenji Suzuki Akira Komiyama division of Surgery Fujinomiya City General Hospital Division of Pathology Fujinomiya City General Hospital

Intraabdominal lymphangiomas are uncommon;additionally,those affecting the gastrointestinal tract are rare and account for less than 1%of cases.Intussusception caused by a cystic lymphangioma of the small bowel is extremely rare.The patient was a20-year-old woman who visited our emergency room with a complaint of abdominal pain.A computed tomography image revealed ileo-ileal intussusception with a leading hypovascular mass measuring 1 cm in a diameter.Single-incision laparoscopic-assisted ileal resection was performed.The surgical specimen consisted of a soft polycystic mass.Macroscopically,a pedunculated polyp with a convolutional pattern was found.Microscopically,the inner surfaces of the cysts were covered with a single layer of endothelial cells.On immunohistochemical examination,the endothelial cells were partially positive for D2-40 and CD34.Smooth muscle cells were also found around the cysts.The lesion was diagnosed as a cystic lymphangioma.Dozens of cases of small bowel lymphangiomas have previously been reported.Of these,cases with intussusception were very rare.This is the first case of small bowel intussusception due to lymphangioma treated by singleincision laparoscopic-assisted surgery.

关键词：摄取单个切口的帮助 laparoscopic 的外科淋巴管瘤

Practical fecal calprotectin cut-off value for Japanese patients with ulcerative colitis

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World Journal of Gastroenterology 2018年第38期24卷 4384-4392页

作者： Jun Urushikubo Shunichi Yanai Shotaro Nakamura Keisuke Kawasaki Risaburo Akasaka Kunihiko Sato Yosuke Toya Kensuke Asakura Takahiro Gonai Tamotsu Sugai Takayuki Matsumoto division of Gastroenterology Department of Internal Medicine School of Medicine Iwate Medical University division of Molecular Diagnostic pathology Department of Pathology School of Medicine Iwate Medical University

AIM To determine appropriate fecal calprotectin cut-off values for the prediction of endoscopic and histologic remission in Japanese patients with ulcerative colitis(UC). METHODS We performed a cross-sectional observational study of 131 Japanese patients with UC and measured fecal calprotectin levels by fluorescence enzyme immunoassay. The clinical activity of UC was assessed with the partial Mayo score(PMS). Relapse was defined as increase of PMS by 2 points or more in stool frequency or rectal bleeding subscore. The endoscopic and histologic activities of UC were evaluated in 50 patients within a 2-mo period from fecal sampling. Endoscopic activity was determined by Mayo endoscopic subscore, Rachmilewitz endoscopic index, and ulcerative colitis endoscopic index of severity. The histologic grade of inflammation was evaluated with biopsy specimens obtained from the endoscopically most severely inflamed site, according to the scheme by Matts grade and Riley's score.RESULTS Fecal calprotectin levels varied from 1-20783 μg/g. There was a significant correlation between the partial Mayo score and fecal calprotectin levels(r = 0.548, P < 0.001). In 50 patients who underwent colonoscopy with biopsy, levels were significantly correlated with the Mayo endoscopic subscore(r = 0.574, P < 0.001), Rachmilewitz endoscopic index(r = 0.628, P < 0.001), ulcerative colitis endoscopic index of severity(r = 0.613, P < 0.001), Riley's histologic score(r = 0.400, P = 0.006), and Matts grade(r = 0.586, P < 0.001). Receiver-operating characteristic analyses identified the best cut-off value for the prediction of endoscopic remission as 288 μg/g, with an area under the curve of 0.777 or 0.823, while that for histologic remission was 123 or 125 μg/g, with an AUC of 0.881 or 0918, respectively. Of the 131 study patients, 88 patients in clinical remission were followed up 6 mo. During the follow-up period, 19 patients relapsed. The best fecal calprotectin cut-off value for predicting relapse was 175 μg/g.CONCLUSION Fecal calprotectin is a

关键词： Ulcerative colitis Remission Mucosal healing Colonoscopy Histology Biomarker Feces Calprotectin

Gastric plexiform fibromyxoma resected by endoscopic submucosal dissection after observation of chronological changes:A case report

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World Journal of Gastrointestinal Oncology 2017年第6期9卷 263-267页

作者： Fumiaki Kawara Shinwa Tanaka Takashi Yamasaki Yoshinori Morita Yoshiko Ohara Yoshihiro Okabe Namiko Hoshi Takashi Toyonaga Eiji Umegaki Hiroshi Yokozaki Takanori Hirose Takeshi Azuma division of Gastroenterology Department of Internal MedicineKobe University Graduate School of Medicine Division of Pathology Department of PathologyKobe University Graduate School of Medicine Department of Diagnostic pathology Hyogo Cancer Center

A 66-year-old man was diagnosed with a gastric submucosal tumor. Endoscopic ultrasound(EUS) revealed an iso/hypoechoic mass in the third layer. No malignant cells were detected in a histological examination. Yearly follow-up endoscopy and EUS showed the slow growth of the tumor. Endoscopic submucosal dissection(ESD) was performed and a glistening tumor was resected. The lesion showed a multinodular plexiform growth pattern consisting of spindle cells with an abundant fibromyxoid stroma that was rich in small vessels. The tumor was diagnosed as plexiform fibromyxoma(PF) by immunohistochemistry. Although difficulties are associated with reaching a diagnosis preoperatively, chronological changes on EUS may contribute to the diagnosis of PF. ESD may also be useful in the diagnosis and treatment of PF.

关键词： Plexiform fibromyxoma Plexiform angiomyxoid myofibroblastic 肿瘤内视镜的超声内视镜的 submucosal 解剖胃肠的 stromal 肿瘤

Upper gastrointestinal tract involvement of pediatric inflammatory bowel disease: A pathological review

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World Journal of Gastroenterology 2019年第16期25卷 1928-1935页

作者： Dua Abuquteish Juan Putra Division of Pathology Department of Paediatric Laboratory Medicine Hospital for Sick Children

Upper gastrointestinal(UGI) tract involvement of inflammatory bowel disease(IBD) is commonly seen in pediatric patients. Upper endoscopy is included in the routine workup of children with suspected IBD to enhance the diagnosis and management of these patients. Currently, childhood IBD is classified into ulcerative colitis(UC), atypical UC, Crohn's disease(CD) and IBD unclassified.Histologic confirmation of UGI tract involvement, in particular the presence of epithelioid(non-caseating) granulomas, is helpful in confirming the diagnosis of IBD and its classification. Herein, we reviewed selected IBD-associated UGI tract manifestations in children. Lymphocytic esophagitis, seen predominantly in CD,is histologically characterized by increased intraepithelial lymphocytes(> 20 in one high-power field) in a background of mucosal injury with absence of granulocytes. Focally enhanced gastritis is a form of gastric inflammation in pediatric IBD marked by a focal lymphohistiocytic pit inflammation with or without granulocytes and plasma cells in a relatively normal background gastric mucosa. Duodenal inflammation seen in children with IBD includes cryptitis,villous flattening, increased intraepithelial lymphocytes, and lamina propria eosinophilia. Finally, epithelioid granulomas not associated with ruptured gland/crypt are a diagnostic feature of CD. The clinicopathologic correlation and differential diagnosis of each microscopic finding are discussed. Clinicians and pathologists should be cognizant of the utility and limitations of these histologic features.

关键词： Pediatric Inflammatory bowel disease Lymphocytic esophagitis Focally enhanced gastritis Epithelioid granuloma Crohn’s disease Ulcerative colitis

Hepatitis C virus and type 2 diabetes

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World Journal of Gastroenterology 2009年第13期15卷 1537-1547页

作者： Francesco Negro Mahnaz Alaei division of Gastroenterology Hepatology and Clinical PathologyUniversity Hospitals division of Clinical pathology University Hospitals

This review focuses on the relationship between hepatitis C virus(HCV) infection and glucose metabolism derangements.Cross-sectional and longitudinal studies have shown that the chronic HCV infection is associated with an increased risk of developing insulin resistance(IR) and type 2 diabetes(T2D).The direct effect of HCV on the insulin signaling has been analyzed in experimental models.Although currently available data should be considered as preliminary,HCV seems to affect glucose metabolism via mechanisms that involve cellular pathways that have been implicated in the host innate immune response.IR and T2D not only accelerate the histological and clinical progression of chronic hepatitis C,but also reduce the early and sustained virological response to interferon-alpha-based therapy.Thus,a detailed knowledge of the mechanisms underlying the HCV-associated glucose metabolism derangements is warranted,in order to improve the clinical management of chronic hepatitis C patients.

关键词：丙型肝炎纤维化胰岛素抵抗胰岛素信号 2型糖尿病

What triggers tauopathy in chronic traumatic encephalopathy?

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Neural Regeneration Research 2018年第6期13卷 985-986页

作者： Liam Chen Neuropathology division Department of Pathology Johns Hopkins University School of Medicine

Chronic traumatic encephalopathy（CTE）is a neuropathologically defined tauopathy：CTE is closely related with repetitive,traumatic brain injury.In a most recent study of 202 deceased players of American football from a brain donation program,CTE was neuropathologically diagnosed in 177 players across all levels of play （87%）, including 110 of 111 former National Football League players （99%）（Mez et al., 2017）.

关键词： TDP CTE What triggers tauopathy in chronic traumatic encephalopathy

Cadmium in soybeans and the relevance to human exposure

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Journal of Environmental Sciences 2015年第11期27卷 157-162页

作者： Ashley M.Newbigging Xiaowen Yan X.Chris Le division of Analytical and Environmental Toxicology Department of Laboratory Medicine and Pathology University of Alberta

Introduction Cadmium is considered a human carcinogen by the International Agency for Research on Cancer（IARC,1993）and the US National Toxicology Program（NTP,1997）.Cadmium contamination of food crops is a persistent issue for both the agricultural industry as well as consumers.This is an issue for agriculture because cadmium can be present in soils naturally or as a result of industrial processes and can contaminate foods that are consumed by humans.Industrial

关键词： Cadmium Metals Food safety Dietary exposure Agricultural products Uptake of cadmium from soil

Study of the effects of bisphenol A using human fetal lung fibroblasts

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Journal of Environmental Sciences 2016年第10期28卷 6-10页

作者： Jeffrey Tao Lily Xiao Jing Sun X.Chris Le division of Analytical and Environmental Toxicology Department of Laboratory Medicine and Pathology University of Alberta

Bisphenol A （BPA, 2,2-bis（4-hydroxyphenyl） propane; CAS# 80-05-7） is a highly produced industrial chemical, with an estimated four billion kilograms produced worldwide each year （reviewed in Vandenberg et al., 2010）. BPA serves as a monomer in the manufacture of polycarbonate, a hard, clear plastic. Polycarbonate plastics are used in many consumer products

关键词： Bisphenol A （BPA）Estrogen receptorsEndocrine disruptorsDevelopmental effectsImmune effectsCytokinesAsthma

N-Nitrosamine formation from chloramination of two common ionic liquids

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Journal of Environmental Sciences 2020年第1期32卷 341-348页

作者： Ian J.Vander Meulen Ping Jiang Di Wu Steve E.Hrudey Xing-Fang Li division of Analytical and Environmental Toxicology Department of Laboratory Medicine and PathologyFaculty of Medicine and DentistryUniversity of Alberta

Ionic liquids(ILs)are a class of solvents increasingly used as"green chemicals."Widespread applications of ILs have led to concerns about their accidental entry to the environment.ILs have been assessed for some environmental impacts;however,little has been done to characterize their potential impacts on drinking water if ILs accidentally enter surface water.IL cations are often aromatic or alkyl quaternary amines that resemble structures of previously confirmed N-nitrosamine(NA)precursors.Therefore,this study has evaluated two common ILs,1-ethyl-3-methylimidazolium bromide(EMIm Br)and 1-ethyl-1-methylpyrrolidinium bromide(EMPyr Br),for their NA formation potential.Each IL species was reacted with pre-formed monochloramine under various laboratory conditions.The reaction mixtures were extracted using liquid–liquid extraction and analyzed for NAs using high performance liquid chromatography tandem mass spectrometry.At low concentration of IL(250μmol/L),the yields of NAs(NMEA or NPyr)increased with increasing doses of monochloramine from both IL species.The total NA yield was as high as 2.5±0.3 ng/mg from EMIm Br,and as high as 8.6±0.8 ng/mg from EMPyr Br.At high concentration of IL(5 mmol/L),the NA yield reached a maximum at 2.5 mmol/L NH2Cl,and then decreased with subsequent increases in the reactant concentrations,demonstrating ILs’solvent effects.This study re-emphasizes the importance of preventing discharge of ILs to water bodies to prevent secondary impacts on drinking water.

关键词： Ionic liquids N-nitrosamine Liquid–liquid extraction HPLC–MS/MS DBPs