Value of expression of insulin-like growth factor-1 receptor in gastric adenocarcinomas and normal gastric tissues.

BACKGROUND/AIMS: Insulin-like growth factor-1 receptor (IGF-1R) plays critical roles in cell proliferation, differentiation, apoptosis, and transformation. Suppression of IGF-1R by means of antisense methods and specific antibodies causes cell apoptosis and growth inhibition of cancer cells. The present study aims to investigate whether there is a difference between normal and cancerous tissue with respect to IGF-1R expression and to assess the relationship between IGF-1R expression and tumor stage, degree of differentiation, and lymph node metastasis by examining IGF-1R expression in cancerous and normal tissues of gastric adenocarcinoma cases of different stages. MATERIALS AND METHODS: By using immunohistochemical methods, IGF-1Rb (H-60) (1/100, Santa Cruz Biotechnology, SC-9038, Texas,USA) expression was investigated in paraffin-embedded blocks obtained from total/partial gastrectomy material pertaining to 47 gastric adenocarcinoma cases. IGF-1R expression was evaluated semi-quantitatively in terms of intensity and distribution in both normal and cancerous tissues. RESULTS: Insulin-like growth factor-1 receptor expression mean score was 5.38 and 8.40 for cancerous and for normal gastric tissues, respectively. IGF-1R expression decreased significantly in cancerous tissues compared normal tissue (p:0.001). When all cases with and without lymph node metastasis were analyzed, IGF-1R expression was observed to decrease for cases with lymph node metastasis compared to those without lymph node metastasis (p:0.035). CONCLUSION: Insulin-like growth factor-1 receptor expression in gastric cancer tissue has proven to be considerably lower than IGF-1R expression in normal gastric mucosa. Metastatic progression reduces IGF-1R expression gradually in cancer tissue.

Alpha-2-adrenergic receptor gene polymorphism in Turkish population with irritable bowel syndrome.

BACKGROUND/AIMS: Irritable bowel syndrome is a multifactorial functional gastrointestinal disorder affecting more than 10% of world population. Genetic component in pathophysiology of irritable bowel syndrome is still unknown. The aim of this study was to examine the potential impact of C-1291G polymorphism in α2-adrenergic receptor gene promoter region in the etiology of the disease. MATERIALS AND METHOD: This prospective case-control study included 100 irritable bowel syndrome patients and 100 healthy controls adjusted for sex and age. The subjects were genotyped by using polymerase chain reaction amplification of the promoterregion of α2-adrenergic receptor gene. Allele and genotype frequencies were compared in patient and control groups. The study was approved by the University ethics committee. RESULTS: The frequency of C allele was 72% and 75%, G allele was 28% and 25% in patient and control groups, respectively (p>0.05). We found that the frequencies of C1291C, C1291G, and G1291G genotypes were 50, 44, and 6%, respectively, in the patient group and 51, 48, and 1%, respectively, in the control group (p>0.05). The subgroup analysis of patients revealed that 70 patients were constipation-predominant, 27 patients were alternating diarrhea and constipation, and 3 patients were diarrhea-predominant irritable bowel syndrome. CONCLUSION: No significant association was observed between α2-adrenergic receptor gene C-1291G polymorphism and irritable bowel syndrome in Turkish population. The high number of constipation predominant irritable bowel syndrome and very low number of diarrhea predominant irritable bowel syndrome patients might be the reason for statistical non-significance since α2-adrenergic receptor gene is found to be responsible for mediating intestinal antisecretory action and probably is involved in the pathogenesis of diarrhea predominant irritable bowel syndrome. Further investigations are needed.

Double-balloon endoscopy in patients with Peutz-Jeghers syndrome.

BACKGROUND/AIMS: Peutz-Jeghers syndrome is a rare hereditary syndrome characterized by mucocutaneous pigmentation and hamartomatous polyps of the gastrointestinal tract, especially in the small intestine. Double-balloon endoscopy is a new endoscopic technique that enables both endoscopic visualization of the entire small bowel and therapeutic interventions in a single procedure. In this study, we evaluate the efficacy and safety of double-balloon endoscopy for both treatment and surveillance of patients with Peutz-Jeghers syndrome. MATERIALS AND METHODS: We retrospectively evaluated 7 consecutive patients who were referred to Dokuz Eylül University, Gastroenterology Department, with the diagnosis of Peutz-Jeghers syndrome between 2007 and 2010. RESULTS: Patients with Peutz-Jeghers syndrome (M/F: 5/2) underwent a total 31 double-balloon endoscopy procedures: 21 by the oral route, 9 by the anal route, and 1 intraoperatively. All of the patients had a history of laparotomy and small bowel resection due to complications such as invagination and ileus. In 7 patients, we found a total of 110 polyps ≥10 mm in diameter (10-100 mm) and polypectomies were performed in all of them. The only complication was a bleeding after polypectomy, which was controlled by sclerotherapy. In 1 patient, because of the intraabdominal adhesions due to past laparotomies, polypectomy was done by intraoperative endoscopy. In 2 of our patients, we made surveillance colonoscopies, found new polyps in the small intestine, and performed polypectomies. CONCLUSIONS: Double-balloon endoscopy is an effective and safe endoscopic technique, and represents a milestone for both treatment and surveillance of patients with Peutz-Jeghers syndrome. Polypectomies made in the small intestine might decrease the complication rate due to these polyps and the need for surgery.

Ectopic pancreas presenting with intractable diarrhea: case report.

Ectopic pancreas is an uncommon congenital anomaly, which is usually found incidentally in clinical practice. It presents with nonspecific gastrointestinal symptoms like epigastric pain and dyspepsia and rarely with the clinical findings of obstructive jaundice or intestinal obstruction, or it may mimic gastrointestinal system cancer. Herein, we describe a case of ectopic pancreas in the duodenum, which was the cause of the intractable diarrhea. In our patient, upper gastrointestinal endoscopy and endoscopic ultrasonography revealed a 1.5 cm submucosal lesion, which was umbilicated centrally with a normal in appearance overlying mucosa. Endoscopic biopsy of the lesion was normal. Pathological examination of the lesion after surgical excision was compatible with ectopic pancreas. After total excision of the lesion, the clinical findings of the patient normalized. Ectopic pancreas presenting with diarrhea has not been reported previously in the literature.