ABSTRACT
With the improvement of surgical technique of heart transplantation and clinical application of potent immunosuppressant, the quantity of heart transplantation and the survival time of heart allograft have been significantly improved. However, a series of complications, such as right ventricular failure, ischemia-reperfusion injury, acute rejection, "Quilty lesion", infection and chronic rejection characterized by transplant coronary artery disease (TCAD) may still occur at different stages after heart transplantation. The application of endomyocardial biopsy (EMB) makes it possible to observe and understand the pathological features of multiple complications of heart allograft including rejection, which has become the most accurate diagnostic tool for postoperative complications. In this article, the brief history of heart allograft pathology, main postoperative complications and pathological diagnostic criteria, and cutting edge research progress on diagnostic criteria of rejection were illustrated, aiming to bring clinical benefits to more recipients undergoing heart transplantation.
ABSTRACT
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are neoplasms that develop from neuroendocrine cells and exhibit neuroendocrine functions. The lack of specific clinical symptoms and biological behaviors for NENs cause early misdiagnosis and missed diagnosis in a majority of cases. However, the molecular biology of GEP-NENs vary greatly in different primary sites and grades, contributing to the high heterogeneity in such type of tumors. Currently, the diagnosis of GEP-NENs mainly depends on traditional methods such as imaging and tissue biopsy, leading to imperfect diagnostics by only reflecting genetic information about the location of the biopsy sample in the overall neoplasm. With the rapid development of genome sequencing technology in recent years, the exploration of circulating biomarkers and liquid biopsy technology have compensated for the limitations of tissue biopsy, thereby creating new opportunities to improve the diagnostic rate of GEP-NENs and the realization of precise treatment. This review summarizes and compares the status of liquid biopsy applications in investigating GEP-NENs.
ABSTRACT
Primary lesions unknown metastatic cancer ( CUP) is a class of histopathologically confirmed metastases. However,a variety of clinical diagnosis and treatment can not clear the primary tumor. The identifica-tion of tumor primary site is the first step in the diagnosis of CUP. The histopathology,immunohistochemistry and PET /CT are commonly used clinical diagnosis and treatment. Gene expression profiling technique is a new meth-od for the diagnosis of primary tumor in recent years. It has high diagnostic accuracy,sensitivity and specificity, and is expected to achieve individual treatment of patients with CUP.
ABSTRACT
La gastrostomía endoscópica percutánea (GEP) es la técnica de elección para instaurar una vía de alimentación en pacientes que requieren soporte nutricional especial por más de 4 semanas; sin embargo, por ser una intervención realizada de forma percutánea, la incapacidad para evidenciar transiluminación de la pared abdominal, así como la no obtención de convexidad con la dígito-presión son consideradas usualmente contraindicaciones para la realización del procedimiento. Se reporta un caso en el cual a pesar de presentarse una contraindicación para la realización de GEP, esta se hizo bajo guía laparoscópica, proporcionando así una alternativa mínimamente invasiva y evitando la realización de un procedimiento quirúrgico abierto.
Percutaneous endoscopic gastrostomy (PEG) is the choice technique to establish a feeding route for patients that requiring special nutritional support for more than 4 weeks; however, to be an intervention performed percutaneously, the inability to demonstrate transillumination of the abdominal wall and the failure to obtain convexity with the finger-pressure are usually considered contraindications for its realization. This report is about a case in which spite of a major contraindication for PEG, it was performed under laparoscopic guidance, thus providing a minimally invasive alternative, avoiding the realization of an open surgical procedure.
Subject(s)
Humans , Male , Adult , Gastrostomy , LaparoscopyABSTRACT
Los tumores neuroendocrinos gastroenteropancreáticos son neoplasias raras distribuidas a lo largo del tubo digestivo y poseen características peculiares, como la captación de sales de plata, la expresión de marcadores de célula neuroendocrina y los gránulos secretorios de contenido hormonal. Según su tamaño, localización anatómica y la presencia de metástasis, estos tumores debutan con distintas características clínicas y pronóstico. El diagnóstico temprano, que requiere de un alto grado de sospecha y una confirmación con estudios especializados, resulta invaluable para tratar estas lesiones a tiempo y aumentar la sobrevida de los pacientes. El tratamiento quirúrgico es la herramienta de primera mano, y otras terapias médicas ayudan a mejorar los síntomas y la calidad de vida de aquellos pacientes con lesiones irresecables. En esta revisión, se tratan los aspectos más relevantes en cuanto a la clasificación, morfología, localización, diagnóstico y tratamiento de estas neoplasias gastrointestinales, y al final, se expone la única experiencia colombiana sobre la epidemiología y el manejo de los tumores neuroendocrinos.
Gastroenteropancreatic neuroendocrine tumors (GEP-NETS) are rare neoplasms which can occur anywhere in the gastrointestinal tract. Their particular characteristics include uptake of silver salts, neuroendocrine cell marker expression and hormonal secretory granules. Depending on their size, anatomical location and upon whether or not metastasis has occurred, these tumors can show different clinical patterns and have different prognoses. Early diagnosis is essential for treating these lesions and improving the patients prognoses, but it requires a high degree of suspicion and confirmation by special testing. Surgical treatment is the first choice, but other medical therapy can be helpful for patients who have unresectable disease. This review presents the most relevant aspects of classification, morphology, methods of locating tumors, diagnosis and treatment of GEP-NETS. It presents only the Colombian experience in the epidemiology and management of these tumors.
Subject(s)
Humans , Male , Female , Adult , Carcinoid Tumor , Gastrinoma , Malignant Carcinoid Syndrome , Neuroendocrine Tumors , Pancreatic NeoplasmsABSTRACT
RESUMO: Os sistemas nervoso e endócrino estão integrados para controlar os eventos motores e secretores, envolvidos no processo de digestão e absorção dos nutrientes no trato gastrointestinal (TGI). Nesta revisão, foi enfocado o sistema gastroenteropancreático (GEP), como um sistema endócrino difuso, constituído por células endócrinas dispersas ao longo do epitélio de revestimento do trato gastrointestinal e no pâncreas.Sobre esse sistema foram abordados conceitos e formas de classifi cação, distribuição das células endócrinas ao longo do TGI, principais tipos de secreção dessas células e sua ação sobre os eventos da digestão, além de alguns processos regulatórios que controlam tal secreção
RESUMEN: Los sistemas nervioso y endocrino interactúan para el control de la motilidad y la secreción involucradas en los proceso de digestión y absorción de los nutrientes en el tracto gastrointestinal (TGI). Esta revisión fue enfocada en el sistema gastroenteropancreatico (GEP), el cual se caracteriza por ser un sistema endocrino difuso formado por células endocrinas dispersas a lo largo del epitelio de revestimiento del TGI y en el páncreas. Sobre este sistema fueron abordados conceptos y formas de laclasifi cación, así como la distribución de las células endocrinas a lo largo de TGI, principales tipos de secreción de éstas células y su acción sobre los eventos de la digestión, además de algunos procesos reguladores que controlan esa secreción.
ABSTRACT: The nervous and endocrine systems are integrated to control the motor and secretor events which are involved in the digestion and absorption process of the nutrients in the gastrointestinal tract (GIT). In this revision the gastroenteropancreatic (GEP) system was focused as a diffuse endocrine system constituted by endocrine cells dispersed along the epithelial lining of the gastrointestinal tract and in the pancreas. On this system, concepts and forms of classifi cation were discussed, as well as the distribution of the endocrine cells along the GIT, main types of secretion of these cells and their action on the events of the digestion, besides some regulatory processes which control such secretion
Subject(s)
Animals , Enteroendocrine Cells/classification , Enteroendocrine Cells , Rodentia , Gastrointestinal TractABSTRACT
Objective:To study the effect of the extracting time and solvent on the concentration of main active components in Salvia Miltiorrhiza Bunge, and to provide basic data and theoretical guide to GEP(general extraction practice). Methods: Salvianolic acid B and Tanshinone ⅡA were extracted by 90% alcohol and water respectively from Salvia Miltiorrhiza Bunge and their contents were etermined by means of HPLC at regular intervals. Results: Extracting time and solvent were significant factors in the prcess of concentrating Salvianolic acid B and Tanshinone ⅡA from extract of Salvia Miltiorrhiza Bunge. Conclusion: Water is suitable for extracting Salvianolic acids, the extracting time is 40～50 minutes; alcohol is suitable for extracting Tanshinones, the extracting time is 20～30 minutes.
ABSTRACT
Distribution of GnRH immunoreactive cells and nerves in gastro entro-pancreatic system of rats was studied by using immunogold-silver staining. The GnRH immunoreactive epithelial cells can be seen in the stomach, small intestine, large intestine and pancreas. The apical portion of these GnRH postive epithelial cells extended to the luminal surface of surface epithelium and glands, and they belong to the open type endocrine cells. The GnRH immunoreactive nerve cells can be found in submucous plexus, myenteric plexus and serosa of the stomach and small intestine. The GnRH postive nerve fibers can be seen in lamina propria and submucosa of the small intestine. These results suggest that the GnRH may play an important role in the regulation of digestion.