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22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses

World Journal of Gastroenterology 2016年第39期22卷 8820-8830页

作者： William Sterlacci Athanasios D Sioulas Lothar Veits Pervin G?nüllü Guido Schachschal Stefan Groth Mario Anders Christos K Kontos Theodoros Topalidis Andrea Hinsch Michael Vieth Thomas R?sch Ulrike W Denzer Institute of pathology Clinic of Bayreuth Department of Interdisciplinary Endoscopy University Hospital Hamburg-Eppendorf Department of Biochemistry and Molecular Biology University of Athens Institute of pathology Institute of pathology University Hospital Hamburg-Eppendorf

AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal *** Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge(G) AN(Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22 G PC(Echo Tip Pro Core; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and *** Fifty six consecutive patients(29 men; mean age 68 years) with pancreatic lesions(n = 38), lymphadenopathy(n = 13), submucosal tumors(n = 4), or others lesions(n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy(AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy(AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes(AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score(AN: 1.7 vs PC: 1.1, P = 0.058), and complications(none). A diagnosis on the basis of histology was achieved in the PC group in 36(64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN(AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical *** Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.

关键词： Endoscopic ultrasound Cytology Fine needle aspiration Abdominal tumors Core biopsy needle

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Gastric adenocarcinoma of fundic gland type spreading to heterotopic gastric glands

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World Journal of Gastroenterology 2017年第38期23卷 7047-7053页

作者： Shigeo Manabe Ken-ichi Mukaisho Takayuki Yasuoka Fumitaka Usui Tatsuzo Matsuyama Ikuhiro Hirata Yoshio Boku Shuji Takahashi Department of Gastroenterology Kouseikai Takeda Hospital Department of pathology Shiga University of Medical Science Fujita clinic

Herein, we present a case of gastric adenocarcinoma of fundic gland type(GA-FG) spreading to heterotopic gastric glands(HGG) in the submucosa. A 58-year-old man with epigastric pain was referred to our hospital and underwent an esophagogastroduodenoscopy. A Borrmann type II gastric cancer at the antrum and a 10 mm submucosal tumor-like lesion in the lesser curvature of the upper third of the stomach were detected. Histological examination of the biopsy specimens obtained from the submucosal tumorlike lesion suggested a GA-FG. Therefore, endoscopic submucosal dissection was performed as excisional biopsy, and histopathological examination of the resected specimen confirmed a GA-FG and HGG proximal to the GA-FG. Although the GA-FG invaded the submucosal layer slightly, the submucosal lesion of the GA-FG had a poor stromal reaction and was located just above the HGG in the submucosa. Therefore, wefinally diagnosed the lesion as a GA-FG invading the submucosal layer by spreading to HGG.

关键词： Gastric adenocarcinoma of fundic gland type Heterotopic gastric glands Endoscopic submucosal dissection Paracancerous lesion Pepsinogen-I H/K-ATPase

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Wireless capsule endoscopy

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World Journal of Gastroenterology 2008年第13期14卷 1969-1971页

作者： A Mata J Llach JM Bordas Digestive Endoscopy Unit Gastroenterology Service Imd Hospital Clinic Barcelona Barcelona 08036 Spain

Wireless capsule endoscopy is a new technique that allows complete exploration of the small bowel without exlemal wires. Its role has been analyzed in many small bowel diseases such as obscure gastrointestinal bleeding, Crohn＇s disease and gastrointestinal polyposis syndromes with promising results. Studies on other pathologies （i.e. small bowel tumour, celiac disease） are under evaluation to define the role of this technique.

关键词： Wireless capsule endoscopy Small bowel Obscure gastrointestinal bleeding Crohn's disease Gastrointestinal polyposis syndrome

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Cystic lymphangioma of the jejunal mesentery in an adult: A case report

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World Journal of Gastroenterology 2005年第32期11卷 5084-5086页

作者： Sheng-Der Hsu Chien-Hua Lin Jyh-Cherng Yu Division of General SurgeryDepartment of Surgery Department of PathologyTri-Service General HospitalTaipeiTaiwanChina

We herein describe the case of a 27-year-old female, who presented with a large mass of the upper left abdominal cavity discovered incidentally, through an annual health examination. Preoperative studies including abdominal ultrasonography and magnetic resonance imaging were performed, but they could not accurately determine the nature of the tumor. At laparotomy, a large cystic tumor of the small bowel mesentery was found. Histopathologic examination diagnosed the tumor as a cystic *** lymphangiomas are rare, especially in the abdomen of adults, they may sometimes present as acute abdomen,causing complications that require emergent surgery.

关键词： Jejunum Lymphangioma Small bowel mesentery

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In vivo subsurface morphological and functional cellular and subcellular imaging of the gastrointestinal tract with confocal mini-microscopy

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World Journal of Gastroenterology 2007年第15期13卷 2160-2165页

作者： Martin Goetz Beena Memadathil Stefan Biesterfeld Constantin Schneider Sebastian Gregor Peter R Galle Markus F Neurath Ralf Kiesslich Medical clinic Johannes Gutenberg-Universit(a|¨)t MainzGermany Department of pathology Johannes Gutenberg-Universit(a|¨)t MainzGermany

AIM： To evaluate a newly developed hand-held confocal probe for in vivo microscopic imaging of the complete gastrointestinal tract in rodents. METHODS： A novel rigid confocal probe （diameter 7 mm） was designed with optical features similar to the flexible endomicroscopy system for use in humans using a 488 nm single line laser for fluorophore excitation, Light emission was detected at 505 to 750 nm. The field of view was 475 μm × 475 μm. Optical slice thickness was 7 μm with a lateral resolution of 0.7 μm. Subsurface serial images at different depths （surface to 250 μm） were generated in real time at 1024 × 1024 pixels （0.8 frames/s） by placing the probe onto the tissue in gentle, stable contact. Tissue specimens were sampled for histopathological correlation.RESULTS： The esophagus, stomach, small and large intestine and meso, liver, pancreas and gall bladder were visualised in vivo at high resolution in n = 48 mice. Real time microscopic imaging with the confocal minimicroscopy probe was easy to achieve. The different staining protocols （fluorescein, acriflavine, FITC-labelled dextran and L. esculentum lectin） each highlighted specific aspects of the tissue, and in vivo imaging correlated excellently with conventional histology. In vivo blood flow monitoring added a functional quality to morphologic imaging.CONCLUSION： Confocal microscopy is feasible in vivo allowing the visualisation of the complete GI tract at high resolution even of subsurface tissue structures. The new confocal probe design evaluated in this study is compatible with laparoscopy and significantly expands the field of possible applications to intra-abdominal organs. It allows immediate testing of new in vivo staining and application options and therefore permits rapid transfer from animal studies to clinical use in patients.

关键词： Confocal microscopy in vivo imaging Endomicroscopy Fluorescence

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Gene mutations in stool from gastric and colorectal neoplasia patients by next-generation sequencing

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World Journal of Gastroenterology 2017年第47期23卷 8291-8299页

作者： Omar Youssef Virinder Sarhadi Homa Ehsan Tom Bohling Monika Carpelan-Holmstrom Selja Koskensalo Pauli Puolakkainen Arto Kokkola Sakari Knuutila Department of pathology Faculty of MedicineUniversity of Helsinki Department of pathology University of Helsinki and HUSLABHelsinki University Hospital The HUCH Gastrointestinal clinic University Central Hospital of Helsinki

AIM To study cancer hotspot mutations by next-generation sequencing(NGS) in stool DNA from patients with different gastrointestinal tract(GIT) neoplasms. METHODS Stool samples were collected from 87 Finnish patients diagnosed with various gastric and colorectal neoplasms, including benign tumors, and from 14 healthy controls. DNA was isolated from stools by usingthe PSP~? Spin Stool DNA Plus Kit. For each sample, 20 ng of DNA was used to construct sequencing libraries using the Ion AmpliS eq Cancer Hotspot Panel v2 or Ion AmpliS eq Colon and Lung Cancer panel v2. Sequencing was performed on Ion PGM. Torrent Suite Software v.5.2.2 was used for variant calling and data *** NGS was successful in assaying 72 GIT samples and 13 healthy controls, with success rates of the assay being78% for stomach neoplasia and 87% for colorectal tumors. In stool specimens from patients with gastric neoplasia, five hotspot mutations were found in APC,CDKN2 A and EGFR genes, in addition to seven novel mutations. From colorectal patients, 20 mutations were detected in AKT1, APC, ERBB2, FBXW7, KIT, KRAS,NRAS, SMARCB1, SMO, STK11 and TP53. Healthy controls did not exhibit any hotspot mutations, except for two novel ones. APC and TP53 were the most frequently mutated genes in colorectal neoplasms, with five mutations, followed by KRAS with two *** was the most commonly mutated gene in stools of patients with premalignant/benign GIT *** Our results show that in addition to colorectal neoplasms,mutations can also be assayed from stool specimens of patients with gastric neoplasms.

关键词： Stool DNA Next-generation sequencing Mutations Gastric neoplasia Colorectal neoplasia

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Forensic Sciences Research 2019年第3期4卷 257-266页

作者： Benito Morentin M.Paz Suárez-Mier Ana Monzó Pilar Molina Joaquín S.Lucena Section of Forensic pathology Basque Institute of Legal MedicineBilbaoSpain Histopathology service Department of MadridNational Institute of Toxicology and Forensic SciencesSpain Forensic pathology service Institute of Legal Medicine and Forensic SciencesValenciaSpain Forensic pathology service Institute of Legal Medicine and Forensic SciencesSevilleSpain

This is a multicentre forensic study that identifies all sports-related sudden deaths (SRSDs) in young people,due to myocardial diseases (MDs) that occurred in a large area of *** aim of the study is to assess the epidemiology,causes of death,and sport activities associated with these *** is a retrospective study based on forensic autopsies performed in the provinces of Biscay,Seville,Valencia and in the jurisdiction covered by the National Institute of Toxicology and Forensic Sciences in Madrid (Spain).The retrospective study encompasses from 2010 to *** sudden cardiac deaths (SCDs) in persons 1-35years old were *** total number of SCDs were divided into death occurred during exercise (SRSD) and death during rest,sleep or normal activities (non-SRSD).Each of these two groups was subdivided according to the cause of death into MD (primary cardiomyopathies and myocarditis) and ***-pathological,toxicological and genetic characteristics of SRSD due to MD were *** the 8-year study period,we identified 645 cases of SCD in the young: 75 SRSD (11.6%) and 570 non-SRSD (88.4%).MD was diagnosed in 33 (44.0%) of the SRSD and in 112 (19.6%) of the non-SRSD *** cases of SRSD due to MD were males (mean age (24.0±7.6) years) practicing recreational sports (85%).SRSDs were more frequent in arrhythmogenic cardiomyopathy (ACM) (37%) and hypertrophic cardiomyopathy (HCM) (24%),followed by myocarditis (15%) and idiopathic left ventricular hypertrophy (ILVH) (9%).Only in five cases of SRSD the MD responsible of death (HCM) had been diagnosed in *** symptoms related to the disease were present in other seven patients (six of them with ACM).Postmortem genetic studies were performed in 15/28 (54%) primary cardiomyopathies with positive results in 12 (80%) *** most frequent sports disciplines were football (49%) followed by gymnastics (15%) and running (12%).In Spain,SRSD in young people due to MDs occurs in mal

关键词： Forensic sciences forensic pathology sudden cardiac death sports myocardial diseases autopsy young

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Dysplasia in perforated intestinal pneumatosis complicating a previous jejuno-ileal bypass:A cautionary note

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World Journal of Gastroenterology 2009年第33期15卷 4189-4192页

作者： Nazario Portolani Gian Luca Baiocchi Stefano Gadaldi Simona Fisogni Vincenzo Villanacci Department of Medical and Surgical Sciences Surgical ClinicBrescia University 2nd Department of pathology Spedali Civili

We present the case of an elderly woman who developed a bowel perforation related to pneumatosis intestinalis, 33 years after a jejuno-ileal bypass for severe obesity. Final histological examination revealed the presence of dysplasia in the resected specimen. On the basis of our case and a review of the literature, we discuss the etiopathogenesis, the clinical aspects and the treatment of this rare condition.

关键词： Acute abdomen Pneumatosis intestinalis Peritonitis Obesity Dysplasia

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Sessile serrated adenomas:Demographic,endoscopic and pathological characteristics

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World Journal of Gastroenterology 2010年第27期16卷 3402-3405页

作者： Suryakanth R Gurudu Russell I Heigh Giovanni De Petris Evelyn G Heigh Jonathan A Leighton Shabana F Pasha Isaac B Malagon Ananya Das Division of Gastroenterology Mayo Clinic ArizonaScottsdaleAZ 85259United States Department of pathology Mayo Clinic ArizonaAZ 85259United States Department of Kinesiology Arizona State University

AIM:To study the demographic and endoscopic characteristics of patients with sessile serrated adenoma(SSA) in a single ***:Patients with SSA were identified by review of the pathology database of Mayo clinic Arizona from 2005 to 2007.A retrospective chart review was performed to extract data on demographics,polyp characteristics,presence of synchronous adenomatous polyps or cancer,polypectomy methods,and related ***:One hundred and seventy-one(2.9%) of all patients undergoing colonoscopy had a total of 226 *** mean(SE) size of the SSAs was 8.1(0.4) mm;42% of SSAs were ≤ 5 mm,and 69% were ≤ 9 ***-one per cent of SSAs were located in the cecum or ascending *** half of the patients had synchronous polyps of other histological types,including hyperplastic and adenomatous *** adenocarcinoma was present in seven(4%) ***-seven percent of polyps were removed by ***:Among patients with colon polyps,2.9% were found to have *** of the SSAs were located in the right side and were safely managed by colonoscopy.

关键词： Sessile serrated polyp Sessile serrated adenoma Colonoscopy

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Corneal epithelial defects following vitreoretinal surgery:incidence and outcomes from the DISCOVER study

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International Journal of Ophthalmology(English edition) 2022年第1期15卷 83-88页

作者： Kubra Sarici Daniel Petkovsek Alison Martin Alex Yuan Jeffrey M.Goshe Sunil K.Srivastava Jamie L.Reese Justis P.Ehlers The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research Cole Eye InstituteCleveland ClinicClevelandOH 44195USA Vitreoretinal service Cole Eye InstituteCleveland ClinicClevelandOH 44195USA Cornea service Cole Eye InstituteCleveland ClinicClevelandOH 44195USA

AIM:To investigate the incidence,risk factors,clinical course,and outcomes of corneal epithelial defects(CED)following vitreoretinal surgery in a prospective study ***:This was a post-hoc analysis of all participants in DISCOVER intraoperative optical coherence tomography *** with CED 1 d after surgery without intraoperative corneal debridement was defined as the postoperative CED *** who underwent intraoperative debridement were defined as intraoperative debridement *** were matched 2:1 with controls(eyes without postoperative CED)for comparative *** primary outcomes were the incidence of CED on postoperative day one and the incidence of required intraoperative *** outcomes included time to defect closure,delayed healing(>2 wk),visual acuity(VA)and presence of scarring at one year and cornea ***:This study included 856 eyes that underwent vitreoretinal *** corneal debridement was performed to 61(7.1%)subjects and postoperative CED developed spontaneously in 94(11.0%)*** factors associated with postoperative CED included prolonged surgical duration(P=0.003),diabetes mellitus(P=0.04),postoperative ocular hypotension(P2 wk)was associated with corneal scar formation at the end of the 1 y in all epithelial defect subjects(P<0.001).The overall rate of corneal scarring for all eyes undergoing vitrectomy was 1.8%.CONCLUSION:Prolonged duration of surgery is the strongest factor associated with both intraoperative debridement and spontaneous postoperative *** defect closure is associated with a greater risk of corneal scarring at one *** overall rate of corneal scarring following vitrectomy is low at<2%.

关键词： corneal epithelial defect vitreoretinal surgery intraoperative optical coherence tomography

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