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1.
Rev Gastroenterol Peru ; 39(1): 81-83, 2019.
Article in Spanish | MEDLINE | ID: mdl-31042242

ABSTRACT

Lemmel's syndrome is a very rare condition as a cause of obstructive jaundice secondary to the presence of a duodenal diverticulum. We report a case, a 68-year-old female patient with a cholestatic pattern, biliary tract dilatation, who underwent ERCP, with a juxtapapillary diverticulum compressing the distal bile duct, which was sphincterotomy.


Subject(s)
Diverticulum/complications , Duodenal Diseases/complications , Jaundice, Obstructive/etiology , Abdominal Pain/etiology , Aged , Cholangiopancreatography, Endoscopic Retrograde , Common Bile Duct/pathology , Dilatation, Pathologic/pathology , Diverticulum/blood , Diverticulum/surgery , Duodenal Diseases/blood , Duodenal Diseases/surgery , Female , Humans , Jaundice, Obstructive/blood , Sphincterotomy, Endoscopic , Syndrome
2.
J Enzyme Inhib Med Chem ; 33(1): 428-432, 2018 Dec.
Article in English | MEDLINE | ID: mdl-29372651

ABSTRACT

The gamma-glutamyltransferase (GGT) is recognized in medical practice as a useful indicator for the detection of liver lesions, especially those induced by the excessive consumption of alcoholic or cholesterol-associated drinks. The present study, although it includes a very small number of cases diagnosed with colon diverticulosis-diverticulitis associated with polyposis at the same intestinal level, identifies the presence of increased circulating concentrations of this enzyme in the serum. Its serum levels are tracked "dynamically" throughout a year after the diagnosis and start of the therapy. The study calls into question the release of the enzyme from the edge of the enterocytes' brush-like edge, leading to the pathogenic disturbance of regional redox homeostasis. The hypothesis gives the circulating values of GGT predictive value for cellular oxidative stress, as well as for indirectly expressing the glutathione level in cytosol.


Subject(s)
Colon/enzymology , Diverticulum/enzymology , gamma-Glutamyltransferase/blood , Aged , Biomarkers/blood , Case-Control Studies , Colon/diagnostic imaging , Diverticulum/blood , Diverticulum/diagnosis , Female , Humans , Male , Middle Aged
3.
Pathol Int ; 66(3): 169-173, 2016 Mar.
Article in English | MEDLINE | ID: mdl-27500508

ABSTRACT

We present the first case of an unusual ureteral diverticular lesion demonstrating similarities to adenomyomatous hyperplasia of the gallbladder. A 68-year-old asymptomatic Japanese man with high prostate-specific antigen levels was clinically evaluated. Left hydronephrosis and benign prostatic hyperplasia were detected. A bilateral retrograde pyelogram revealed that the upper and middle portions of the left ureter exhibited an irregular narrow lumen and some pooling of contrast material, which was compatible with ureteral pseudodiverticulosis. Although no malignant cells were seen on cytology, computed tomography detected a fusiform shaped lesion with a circumferential thick wall including multiple diverticulae. Left nephroureterectomy was performed because malignancy could not be ruled out. Pathology demonstrated that the ureteral lesion showed a localized thick wall consisting of multilocules and/or multicysts and a hyperplastic muscularis propria. The cysts were mostly seen in the muscularis propria or a deeper site. The inner layers of the cysts were lined with normal urothelium, and some cysts opened onto the mucosal surface, indicating that they were derived from invaginated mucosal epithelium. We believe that this lesion may be a novel form of diverticular disorder demonstrating similarities to adenomyomatous hyperplasia of the gallbladder.


Subject(s)
Diverticulum/diagnosis , Hydronephrosis/diagnosis , Prostate-Specific Antigen/blood , Prostatic Hyperplasia/diagnosis , Ureter/diagnostic imaging , Ureteral Diseases/diagnosis , Aged , Diverticulum/blood , Diverticulum/diagnostic imaging , Diverticulum/surgery , Humans , Hydronephrosis/blood , Hydronephrosis/diagnostic imaging , Male , Prostatic Hyperplasia/blood , Prostatic Hyperplasia/diagnostic imaging , Treatment Outcome , Ureter/surgery , Ureteral Diseases/blood , Ureteral Diseases/diagnostic imaging , Ureteral Diseases/surgery , Urography
6.
PLoS One ; 9(4): e95232, 2014.
Article in English | MEDLINE | ID: mdl-24740401

ABSTRACT

Diverticulosis can lead to diverticulitis, a colon condition involving inflammation and other complications. Diverticulosis can result from biological, behavioral, or genetic causes. However, the etiology of diverticulosis is unknown. Although diet is associated with diverticulosis, recent studies suggest other factors influence risk. We sought to identify anthropometric or serum markers that were associated with the presence of diverticulosis. To determine these associations, 126 asymptomatic men (48-65 yr) were recruited at the time of preventative screening colonoscopy. Anthropometric measures were taken, and blood was collected for serum protein analysis. Data were analyzed by logistic regression and factor analysis. Obese individuals (BMI >30) were 7.8 (CI: 2.3-26.3) times more likely than normal weight (BMI <25) individuals to have diverticulosis. The relationship was similar for waist circumference. Individuals with a waist circumference >45 inches were 8.1 (CI: 2.8-23.8) times more likely to have diverticulosis than those with a waist circumference <38 inches. Leptin was also positively associated with diverticulosis (OR = 5.5, CI: 2.0-14.7). Both low molecular weight adiponectin (LMW, OR = 0.50; CI: 0.3-0.8) and the soluble receptor for advanced glycation end products (sRAGE, OR = 0.4, CI: 0.3-0.7) were inversely related to the presence of diverticulosis. sRAGE levels were not correlated with leptin or C-peptide concentrations. The pattern of high BMI, waist circumference, leptin and C-peptide increased the odds of diverticulosis while the pattern of high levels of sRAGE and LMW adiponectin decreased the odds of diverticulosis. Associations between diverticulosis and anthropometric or serum markers may elucidate the origins of diverticulosis and may enable physicians to identify individuals at risk for diverticulitis.


Subject(s)
Adiponectin/blood , Diverticulum/blood , Obesity/blood , Receptors, Immunologic/blood , Aged , Anthropometry , Asymptomatic Diseases , Biomarkers/blood , Body Mass Index , C-Peptide/blood , Colonoscopy , Cross-Sectional Studies , Diverticulum/complications , Diverticulum/diagnosis , Factor Analysis, Statistical , Humans , Leptin/blood , Logistic Models , Male , Middle Aged , Obesity/complications , Obesity/diagnosis , Receptor for Advanced Glycation End Products , Waist Circumference
9.
Med Monatsschr Pharm ; 33(10): 385-90; quiz 391-2, 2010 Oct.
Article in German | MEDLINE | ID: mdl-21072912

ABSTRACT

Blood in faeces or stains of blood on the surface or toilet paper are common problems among all age groups. Too few patients seek medical consultation because of these symptoms. The differential diagnosis is quite large. Most cases are caused by benign anorectal diseases like hemorrhoids. On the other hand neoplasias of the anus and intestine or inflammatory bowel disease are important diagnoses to be considered. We emphasize that every patient should be seen by a doctor and endoscopic investigation should be discussed.


Subject(s)
Feces/chemistry , Occult Blood , Colitis/complications , Colonic Neoplasms/blood , Colonic Neoplasms/diagnosis , Diagnosis, Differential , Diverticulum/blood , Diverticulum/diagnosis , Fissure in Ano/blood , Fissure in Ano/diagnosis , Hemorrhoids/blood , Hemorrhoids/diagnosis , Humans , Inflammatory Bowel Diseases/blood , Inflammatory Bowel Diseases/diagnosis , Vascular Malformations/blood , Vascular Malformations/diagnosis
10.
Dis Markers ; 27(6): 311-6, 2009.
Article in English | MEDLINE | ID: mdl-20075514

ABSTRACT

INTRODUCTION: Previous studies have suggested the use of soluble CD26 (sCD26) as a tumour marker for the detection of colorectal cancer (CRC) and advanced adenomas. The aim of this study was to assess the sCD26 concentration in a large cohort to evaluate its association to epidemiologic parameters and CRC-related symptoms/pathologies. SUBJECTS AND METHODS: Serum samples were collected from 2,754 putatively healthy individuals with ages ranging from 30-65 years, and with personal or familial history of polyps, CRC and/or CR symptoms. sCD26 levels were measured by ELISA. RESULTS: No association was found between the sCD26 concentration and age (< 50 and 50), the personal or familial history of polyps or CRC, rectal bleeding, haemorrhoids or diverticula. However, sCD26 was related to non-inflammatory benign pathologies (excluding rectal bleeding, changes in bowel habits, haemorrhoids, diverticula) and to inflammatory benign pathologies. DISCUSSION: Our results confirm that the sCD26 can be easily offered and evaluated in a large cohort. Additionally, the validation of sCD26 as a tumour marker for screening and case-finding purposes requires a further comparison with an established non-invasive test like the faecal occult blood.


Subject(s)
Dipeptidyl Peptidase 4/blood , Gastrointestinal Diseases/blood , Gastrointestinal Diseases/epidemiology , Adult , Age Factors , Aged , Biomarkers/blood , Cohort Studies , Colorectal Neoplasms/blood , Colorectal Neoplasms/epidemiology , Diverticulum/blood , Diverticulum/epidemiology , Female , Fissure in Ano/blood , Fissure in Ano/epidemiology , Gastrointestinal Diseases/pathology , Gastrointestinal Hemorrhage/blood , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Tract/pathology , Gastrointestinal Tract/physiopathology , Hemorrhoids/blood , Hemorrhoids/epidemiology , Humans , Inflammation/blood , Inflammation/epidemiology , Intestinal Polyps/blood , Intestinal Polyps/epidemiology , Irritable Bowel Syndrome/blood , Irritable Bowel Syndrome/epidemiology , Male , Middle Aged , Rectum/pathology , Rectum/physiopathology
12.
Gut ; 12(1): 27-33, 1971 Jan.
Article in English | MEDLINE | ID: mdl-4993410

ABSTRACT

Serumfolate folate levels and the bacteriology of the small intestine were studied in 13 patients with jejunal diverticulosis, 29 patients with partial gastrectomy, and five patients with ileal disease. The mean serum folate level in the patients with partial gastrectomy (7.2 mmug/ml) was similar to that of control subjects but the mean level in the patients with jejunal diverticulosis (14.6 mmug/ml) was significantly higher than the mean level of the control group (8.0 mmug/ml). Five of the 13 patients with jejunal diverticulosis and two of the patients with partial gastrectomy had levels above the upper limit of the control group (> 16.6 mmug/ml), and five of six patients with jejunal diverticulosis studied excreted raised amounts of folate in the urine (> 13.2 mug in 24 hours). Serum folate in one of these patients with jejunal diverticulosis was identified chromatographically as 5-methyltetrahydrofolic acid. The mean serum folate level (9.0 mmug/ml) in the patients with partial gastrectomy who had Esch. coli in the jejunal aspirates was significantly higher than in those without Esch. coli present (mean 4.2 mmug/ml). It is suggested that in gastrointestinal disease jejunal bacteria may contribute to the serum folate level even though this remains in an accepted normal range. Some patients had low serum folate levels despite having a large number of Esch. coli in the jejunum. No evidence of malabsorption of folic acid was found in three such patients even though one had lactobacilli capable of consuming folate in the jejunum. No relationship was found between serum folate level and ileal bacteriology.


Subject(s)
Adult , Chromatography, DEAE-Cellulose , Diverticulum/blood , Diverticulum/microbiology , Diverticulum/urine , Humans
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