[Show abstract][Hide abstract] ABSTRACT: It is unclear whether synchronous multiple tumors arise from multicentric or monoclonal origins. To verify the multicentric origin of synchronous colorectal carcinomas at a genetic level, immunohistochemical and molecular techniques were used to determine the p53 alterations in individual lesions of synchronous colorectal carcinomas. This study was based on a total of 32 colorectal tumors from 16 patients. Twenty-one of the 32 (66%) advanced tumors examined had positive staining for p53. Single-strand conformation polymorphism and polymerase chain reaction direct sequencing were carried out for exons 5 to 8 of p53. All cases had p53 mutations in one or more tumors of synchronous lesions. In nine patients in this series, individual lesions were found to carry a different mutated codon of the p53 gene. In the other seven patients, a p53 mutation was found in one tumor but not in another. These results indicate discordance of the mutation pattern of p53 in individual lesions of multiple colorectal carcinomas and support the idea that most synchronous colorectal carcinomas are genetically distinguishable and are multicentric in origin. We also confirmed the high frequency of p53 mutations in left-sided (71%) and rectal (91%) carcinomas, rather than right-sided (43%; P = .04) carcinomas, suggesting that the molecular mechanism of synchronous colorectal carcinomas might differ between right- and left-sided tumors in the same patient.
[Show abstract][Hide abstract] ABSTRACT: To compare the gastrointestinal features of isosporiasis and strongyloidiasis.
Two patients with isosporiasis and three patients with strongyloidiasis were assessed by double-contrast radiography of the duodenum and small intestine, with reference to histology of the duodenal biopsy specimens.
Both conditions affected the duodenum and the proximal jejunum, and showed similar radiographic changes as the diseases progressed. Thus, three patients with diarrhoea lasting 1 year or less showed only minimal or irregularly thickened mucosal folds, which seemed to result from mucosal inflammation. Two patients with long-standing disease periods (17 years and 30 years) presented a markedly granular mucosal appearance with effacement of the folds on radiography. These chronological differences in the radiographic features seemed to reflect the degree of villous atrophy.
Isosporiasis has similar radiographic features of strongyloidiasis.
No preview · Article · Nov 1998 · Clinical Radiology
[Show abstract][Hide abstract] ABSTRACT: A 78-year-old man with end stage gastric cancer had lower abdominbal pain and hematochezia after starting steroid therapy. Colonoscopy showed multiple large deep ulcers from the rectum to the sigmoid colon. He was diagnosed to have cytomegalovirus (CMV) colitis with many cytomegalic inclusion bodies and positive stains with immunohistochemical technique using monoclonal antibody to CMV in biopsy specimens obtained from the base of the ulcer. CMV colitis demonstrated by colonoscopic examination is still rare in Japan, and its colonoscopic appearance may be similar to that of amebic colitis, as shown in our case. Differential diagnosis using histology and serology is thus considered to be necessary.
No preview · Article · Jul 1998 · Gastroenterological Endoscopy
[Show abstract][Hide abstract] ABSTRACT: We report a 59-year-old female with gastric antral vascular ectasia complicated with Basedow's disease. She was diagnosed as Basedow's disease at age 53 and iron deficiency anemia at age 54. Upper gastrointestinal endoscopic examination for iron deficiency anemia revealed multiple red spots in the antrum. She was referred to our hospital for treatment of the gastric lesions in August 1995. Barium meal study disclosed thickening of the folds in the antrum. Upper endoscopic examination showed linear vascular ectasia radiating from the pylorus. Biopsy specimens obtained from these lesions demonstrated capillary dilation and fibrin thrombus, consistent with gastric antral vascular ectasia (GAVE). She was diagnosed as GAVE and treated by heat probe therapy. After several treatments, vascular ectasia disappeared almost completely and anemia improved. Heat probe therapy is considered to be effective for GAVE.
[Show abstract][Hide abstract] ABSTRACT: We describe a 50-year-old Japanese woman with rheumatoid arthritis who presented with near-complete gastric outlet obstruction. The patient also suffered from secondary gastrointestinal and cardiac amyloidosis. Gastroscopy revealed multiple huge gastric antral ulcers in which amyloid deposits were identified on histologic examination. The ulcers became scars after treatment with omeprazole, which cause in severe pyloric stenosis. Endoscopic hydrostatic balloon dilation under fluoroscopic guidance was performed twice for 10 min. The pyloric outlet remained sufficiently patent 22 months later.
No preview · Article · Jul 1997 · Surgical Endoscopy
[Show abstract][Hide abstract] ABSTRACT: A 38-year-old female was admitted for the further evaluation of elevated lesions of the stomach. Gastroscopy revealed multiple small elevated lesions of the gastric body, which were diagnosed as carcinoid tumors on histologic examination of biopsy specimens. Hypergastremia (1048 pg/dl), iron deficiency anemia and positive parietal cell antibody were identified, whereas urine 5-HIAA, serum serotonin and histamine levels were within normal limits. Total gastrectomy was performed. Histological examination disclosed multiple endocrine cell micronests and approximately 90 carcinoid tumors up to 0.5 cm in diameter in atrophic fundic gland mucosa.
No preview · Article · Mar 1997 · Gastroenterological Endoscopy