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Objective:To study the clinical characteristics and endoscopic manifestations of patients with systemic amyloidosis involved in digestive tract.Methods:Clinical and endoscopic features, biopsy locations and positive rate of patients with systemic amyloidosis involved in digestive tract at Peking Union Medical College Hospital from December, 1991 to December, 2004 (1991 to 2004 diagnosed group, 18 cases) and from March 17th, 2009 to November 4th, 2020 (2009 to 2020 diagnosed group, 47 cases) were retrospectively analyzed and compared. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Among 47 patients in 2009 to 2020 diagnosed group, 41 were primary amyloid light chain (AL) amyloidosis, and the age of onset was older than that of 1991 to 2004 diagnosed group ((57.15±9.10) years old vs. (50.75±10.90) years old), and the time from disease onset to diagnosis was shorter than that of 1991 to 2004 diagnosed group ((13.48±11.72) months vs. (26.38±23.02) months), and the differences were statistically significant ( t=2.08 and -2.13, P=0.048 and 0.047). There was no significant difference in time from disease onset to diagnosis between patients with gastrointestinal manifestations at disease onset and patients without gastrointestinal manifestations at disease onset (10.5 months (6.0 months, 17.3 months) vs.14.0 months (5.8 months, 25.0 months), P>0.05). Among primary AL amyloidosis patients in 2009 to 2020 diagnosed group, weight loss was the most common clinical symptom, the proportion of patients was 87.8%(36/41); secondary was gastrointestinal bleeding, among which 18 patients (43.9%) were stool occult blood test positive and 4 patients (9.8%) were with melena or bloody stool. The endoscopic features of patients with biopsy-confirmed digestive tract involvemen vary, including mucosa hemorrhage and oozing of blood in 4 cases, fragile mucosa and easy to bleed in 3 cases, and 4 cases with bulged mucosa and all the 4 cases of biopsy at bulged mucosa was positive. Gingiva and tongue were the most common biopsy locations and the positive rate of biopsy was ≥60.0%. Rectal mucosa biopsy was performed in 15 patients and 6 were Congo red staining positive. Heart or kidney biopsy was performed in 3 and 6 patients, and the number of positive cases was 2 and 4, respectively. Conclusions:Weight loss and gastrointestinal bleeding are the common gastrointestinal symptoms of primary AL amyloidosis. The common endoscopic manifestations included mucosal bleeding, fragile and bulged mucosa. Biopsy at multiple locations according to experience may help earlier diagnosis and treatment.
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Objective To explore the relationship between autism spectrum disorder (ASD) and gastrointestinal problems. Methods 172 ASD children were investigated with self-made questionnaire from July, 2014 to Augest, 2015. The frequencies of motor behaviors, vocal behaviors and behavioral problems, and the intensity of the behavioral problems in the period with or without gastrointestinal symptoms were compared. Results The frequencies of motor behaviors (F=67.4, P<0.001), vocal behaviors (F=43.6, P<0.001) and behavioral prob-lems (F=79.4, P<0.001), and the intensity of the behavioral problems (F=65.7, P<0.001) were all more in the period with gastrointestinal symptoms than without gastrointestinal symptoms. Conclusion There are more behavioral problems in the ASD children with the presence of gastrointestinal symptoms;while the behavioral symptoms may be a indicator of gastrointestinal problems in children with ASD.
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Objective To study the roles of extracellular signal-regulated kinase(ERK1/2) and its substrate ets-like gene 1(Elk-1) in essential hypertension.Methods A comparative investigation was carried out to observe the expression of extracellular signal-regulated kinase1/2(ERKl/2) and Elk-1 in vascular smooth muscle cell (VSMC)and endothelium of gastrointestinal arterioles by means of immunohistochemistry in hypertension and nonhypertension patients.Results In the hypertension patients group,the positive rate of phosphorylated-ERK 1/2 in vascular smooth muscle cell(VSMC) and endothelium in gastrointestinal small arteries(8.32%and 4.97%,respectively) was significantly higher than that in the non-hypertension patients group(P
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One of the most problems is the diagnosis of the borderline lesion and/or borderline tumor to pathologists. It is necessary to make the correct diagnosis of the gastrointestinal borderline lesion and/or borderline tumor and correlative lesion such as gastrointestinal stromal tumors, gastrointestinal lymphoid proliferation and MALT lymphoma, IPSID, gastrointestinal adenoma and appendix carcinoid.[
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3. 0 cm in diameter). Methods During last 10 years, fifteen giant and symptomatic gastrointestinal lipomas were resected under endoscopy in our hospital. Of them, two giant lipomas with small stalk (
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Objective To study the anatomic characteristics of hepatogastric artery(HGA) and its significance in preventing gastrointestinal complications in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization(TACE).Methods 1000 cases of hepatic arteriograms were retrospectively reviewed,the aberrant gastrointestinal arteries that originate from proper hepatic artery(PHA)and distal intrahepatic arteries to PHA were named HGA.The frequency,origine,course and distribution of all of HGAs were carefully analyzed.The trial group consists of 34 cases(42 times of TACE)who had HGA and controlled group consists 32 cases(56 times of TACE)who had no HGA.The incidence of gastrointestinal complications after TACE between two groups were compared.Within trial group,superselective catheterization was made and had the tip of catheter away from orifice of the HGA before infusion of embolic agents(Lipiodol)during TACE in 18 times,which was called relative safety group;whereas,the tip of catheter was not laid distal to orifice of HGA when infused Lipiodol through catheter in 24 times,which was called dangerous group.The incidence of complications between this two groups was also compared.Results Of 1000 cases of hepatic arteriography,HGA was found in 740 cases (74%).The incidence of gastrointestinal complication and its grave degree in trial group were more excessive than that in controlled group((?=0.004),similarly,the frequency of gastrointestinal complication and its graveness in dangerous group exceeded significantly that in relative safety group((?=0.000).Conclusion HGA is common vascular variation.That embolic agents (Lipiodol)was perfused carelessly into HGA may induced occurrence of gastrointestinal complications in patients after TACE,and having the tip of catheter away from the orifice of HGA by superselective catheterization during TACE could efficiently prevent happening of this kind of complications after operation.
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Carcinoid tumors arise from enterochromaffin cells that are located predominantly in the gastrointestinal mucosa. Gastrointestinal carcinoids appear with equal frequency among men and women, most often during the fifth and sixth decades. A primary duodenal carcinoid is rare. Most carcinoid tumors of the appendix are incidentally discovered during other surgical procedures. Its natural course is usually benign and the size of the tumor is closely related with the liability of regional or distant metastasis. The vast majority of rectal carcinoid tumors are benign and can be safely treated by a local excision. Lesions larger than 2 cm that invade the muscular wall of the rectum should be considered as malignant and treated by a more radical procedure such as an abdominoperineal resection. Three cases are here in reported of gastrointestinal carcinoid tumors that were treated at presbyterian medical center.
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Female , Humans , Male , Appendix , Carcinoid Tumor , Enterochromaffin Cells , Mucous Membrane , Neoplasm Metastasis , Protestantism , RectumABSTRACT
In an attempt to elucidate the pathological effects of phenol, the present study was undertaken in male Sprague-Dawley rats. The control group of animals was fed a basal diet, and potable underground water. The experimental group of animals was fed a basal diet and potable underground water containing 30ppm, 60ppm, and 1% phenol with once a week administration of dimethylnitrosamine(DMN) 10 mg/kg I.P. Each group of animals was sacrificed on the 3rd, 6th, and 9th month. The liver and gastrointestinal tract were examined light microscopically, along with transmission electron microscopic studies of the liver and scanning electron microscopic studies of the gastric mucosa. The results were as follows: 1) In the acute phenol intoxicated group, the liver showed fatty changes in the hepatocytes with mitochondrial membrane destruction and myelin figure formation. 2) In the chronic phenol intoxicated group, fatty changes in the liver were observed. In addition, there was chronic inflammation in the gastrointestinal tract, with gastric mucosal erosion and central necrosis of the hepatic lobules, especially in the high phenol contaminated water treated group. 3) As a result of the examination under the light microscope, the DMN treated group showed hyperplastic nodules and liver cell dysplasia, the degree of which was proportional to the duration of the experiment, and was more severe in the DMN + phenol treated group. 4) As a result of the examination under the electron microscope, fatty changes in the liver, pleomorphism of the mitochondria and loss or shortness of bile canalicular microvilli in the DMN + phenol treated group were more severe than in the group treated only with DMN. In summary, the results obtained by the present study indicate chronic highly concentrated phenol intoxication induce liver cell necrosis and chronic inflammatory with a hepatotoxin such as DMN.
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Male , Humans , AnimalsABSTRACT
Ten cases of gastrointestinal adenocarcinomas were histochemically investigated for their lectin receptors by avidin-biotin-peroxidase complex (ABC) method. Results showed that gastric adenocarcinomas expressed more types of lectin receptors than large bowel adenocarcinomas. Positive rates of G1c/Man-and GlcNAc-specific lectin receptors in those tumors were higher than those of Gal/GalNAc- and Fuc-specific lectin receptoes. From the stomach to rectum, the spectrum of the lectin receptors in pericarcinomatous tissues gradually changed from the gastric type to rectal type. The expression of lectin receptors in gastrointestinal adenocarcinomas was obviously different from that in their corresponding pericarcinomatous tissues. The increase and decrease of lectin receptor expression, the appearance and disappearance of some types of lectin receptors as well as the change of the receptor distribution are indirectly regulated by cellular genome.