ABSTRACT
Keratins are proteins that form intermediate filaments of epithelial cell cytoskeleton. The utility of keratin expression determination is based on the fact that epithelial cells acquire a specific pattern of keratin expression during differentiation and maturation, which reflects the specificity of the tissue and the degree of maturation, and generally remains stable during carcinogenesis. Determination of the pattern makes it possible to identify the origin of cells in diagnosing neoplastic lesions as well as in research on pathophysiology or the possibility to apply keratin-positive cell detection in the process of cancer staging and treatment planning. As keratins undergo degradation during apoptosis as caspase substrate the identification of the caspase-derived K18 fragment by the use of specific monoclonal antibody allows us to estimate the apoptosis/necrosis ratio, especially in liver pathology, e.g. nonalcoholic steatohepatitis, chronic hepatitis or graft-versus-host disease or in assessing response to antiviral or antitumour therapy.
ABSTRACT
"Black esophagus" is a typical endoscopic manifestation of acute esophageal necrosis (AEN), a rare disease. The etiology of disease is still unclear and complicated. As a serious risk factor is responsible for a high mortality. Endoscopic black pigmentation of esophageal mucosa mainly in the distal part of esophagus is observed with histological confirmed necrotic lesions of mucosa and submucosa. The gastrointestinal bleedings are the most frequent clinical manifestation of AEN. The disease mostly affects the elderly people with poor general health status having many co-morbid conditions. The condition is often preceded by hemodynamic problems and symptoms of gastro-esophageal reflux. The case of 87-year-old female is presented with many risk factors. Her general health state was poor and endoscopic image of "black esophagus" was found during urgent endoscopy performed for the reason of gastrointestinal bleeding and hemodynamic dysfunction.
Subject(s)
Esophageal Diseases/diagnosis , Esophageal Diseases/pathology , Esophagoscopy , Aged, 80 and over , Esophageal Diseases/complications , Esophageal Diseases/therapy , Fatal Outcome , Female , Gastroesophageal Reflux/etiology , Gastrointestinal Hemorrhage/etiology , Humans , NecrosisABSTRACT
Esophageal perforation by a fixed plate is a rare complication in cervical spine surgery. Its appearance can lead to mediastinitis, which is an important clinical problem. Diagnosis of this complication should to be recognized as quickly as possible to make causal treatment effective. Endoscopic picture of this kind of complication was presented in the paper.
