Pyloric gland adenoma:a clinicopathological analysis of 16 cases / 临床与实验病理学杂志

Purpose To investigate the clinical feature and histopathology of pyloric gland adenoma.Methods Clinical da-ta of 16 cases of pyloric adenomas were collected.The expres-sion of Pepsinogen I,p53,MUC6,MUC5AC,CgA,Syn,CD56,Ki67,CDX-2,MUC2,β-catenin,and CD10 was detec-ted by immunohistochemistry EnVision method.The relationship with clinicopathological features and prognosis was analyzed.Results There were 7 males and 9 females,aged from 26 to 81 years with an average of 58 years.Tumor diameters ranged from 0.2 to 4 centimeter with a mean of 1.3 centimeter.The anatomi-cal sites of the 16 PGA were stomach(6 cases),including 3 ca-ses in body,3 cases in fundus and duodenum(3 cases).7 ca-ses of low-grade PGAs were composed of closely packed pyloric-type glands,lined by cuboidal/low columnar epithelia.The nu-clei(round to ovoid)were basally located,with inconspicuous nucleoli.Neoplastic cells characterized by a defined ground-glass appearance,with clear or eosinophilic cytoplasm.The cell was lack of a well-defined apical mucin cap.1 case of high-grade PGAs consistently exhibited architecture,crowded nuclei,and loss of nuclear polarity.The remaining 8 cases had both low-and high-grade components.Squamous morula was found in 5 cases.According to immunohistochemical characteristics,8 of 16 cases were mixed pattern(MUC5AC+,MUC6+).Others were pure pyloric type(MUC5AC-,MUC6+).No foveolar-dominant type(MUC5AC+,MUC6-)was found.Conclusion PGA is a rare tumor of the digestive system,with characteristic morpholog-ical characteristics and immunophenotype.Clinicians and pathol-ogists need to strengthen their understanding and better manage patients because of the risk of malignant transformation.Early detection,early diagnosis and early treatment are needed.

BLENDED LEARNING INNOVATIVE EFFECTIVE STUDENT CANTERED EDUCATIONAL STRATEGIES IN THE NURSING PROFESSION

Blended learning, a pedagogical approach is nowadays widely accepted as a combination of both “face-to-face” and online learning components. Concerns have grown throughout time regarding an instructional methodology and a teaching and learning strategy. Several studies and reviews all over the world highlighted that Blended Learning is the most effective method of transferring knowledge to the students and implementation of this approach in professional fields like medical, nursing, and paramedical courses will not only improve the teaching- learning environment but also motivate the students in the self-directed learning approach. The term is specifically given to the educational practice of using a combination of traditional classroom teaching and digital learning. National and internationally this method are being used in an educational institution to motivate the students in effective learning. Computers and technology have their own impact on Integrated learning and the teaching-learning process utilizes these impacts to improve the learning methods of the students.

AN ELECTRO-CONVULSIVE REFRACTORY, DIFFICULT TO TREAT CASE OF RECURRENT SEVERE DEPRESSION WITH CATATONIA

We report on a 24 year old woman presented with low mood, reduced appetite, disturbed sleep and anxiety for which she was prescribed oral medication from a local practitioner in form of antidepressant(SSRI), anxiolytic(BZD) and upon no improvement, she underwent 8 rounds of successful electroconvulsive therapy (ECT) on which she responded partially and was discharged on SSRI. A few days after visited the same doctor and reported of having low mood, crying spells, referential and paranoid ideas and an attempt of suicide for which 10 more sessions of ECT were given. She presented in psychiatry OPD with catatonia where she was advised admission and diagnosed as a case of recurrent depressive disorder with catatonia and was managed with suprathreshold doses of SSRI and responded well.

PYLORIC GLAND ADENOMA OF STOMACH: A RARE CASE

Pyloric gland adenoma is an uncommon precancerous polypoidal growth. Pyloric gland adenoma of stomach accounts for 2.7% of all gastric polyp. Mostly Pyloric gland adenoma are found in stomach but can be found in other anatomical sites. Pyloric gland adenoma of stomach occur in elderly population and having female predominance. Pyloric gland adenoma of stomach is commonly seen in chronic gastritis patients, autoimmune gastritis but can also occur in some genetic disease like familial adenomatous polyposis and Lynch syndrome. Early identification and therapeutic polypectomy by endoscopically and histopathological evaluation and confirmation of pyloric gland adenoma may reduce the chances of transformation of invasive adenocarcinoma

A Case of Pyloric Gland Adenoma in the Cardia of the Stomach, Treated by Endoscopic Submucosal Dissection / 대한내과학회지

Pyloric gland adenoma is a recently described neoplasia that is very rare. It was first classified as a gastric tumor in 1990. Pyloric gland adenomas occur predominantly in old age, more frequently in women than in men, and they are often found in patients suffering from autoimmune gastritis. The diagnosis can be confirmed by immunohistochemistry, which is strongly positive for MUC6 and MUC5AC, expressed in the superficial layer. A pyloric gland adenoma is a type of gastric tumor, but it has also been reported in the gallbladder, pancreatic duct, duodenum, cervix of the uterus, rectum, and Barrett's esophagus. In 30% of gastric pyloric adenomas, transition to well-differentiated adenocarcinoma has been noted. Therefore, these lesionsshould be removed. In our case, the lesion was removed by endoscopic submucosal dissection. We report a case of pyloric gland adenoma in the cardia of the stomach showing typical endoscopic and microscopic features. This is the first case of pyloric gland adenoma of the stomach reported in Korea.