AIM To measure exogenous corticotropin-releasing factor(CRF)-induced motility of the isolated rat colon and to demonstrate the effect of pharmacologic inhibition on CRF-induced motility. METHODS The isolated vascularl...AIM To measure exogenous corticotropin-releasing factor(CRF)-induced motility of the isolated rat colon and to demonstrate the effect of pharmacologic inhibition on CRF-induced motility. METHODS The isolated vascularly-perfused rat colon was used. Luminal pressure was monitored via microtip catheter pressure transducers in the proximal and distal colon. At first, exogenous CRF was administered in a stepwise manner and the concentration of CRF yielding maximal colonic motility was selected. After recording basal colonic motility, hexamethonium, phentolamine, propranolol, atropine and tetrodotoxin were infused into the isolated colon. Initially, only the test drug was infused; then, CRF was added. The motility index was expressed as percentage change over basal level. RESULTS Administration of 1.4, 14.4, 144 and 288 pmol/L CRF progressively increased colonic motility in the proximal and distal colon. Infusion of atropine or tetrodotoxin reduced CRF-induced motility of both the proximal and distal colon, whereas hexamethonium, phentolamine and propranolol had no effect.CONCLUSION CRF-induced colonic motility appears to be mediated by local cholinergic signaling via muscarinic receptors. Muscarinic receptors are potential targets for counteracting CRF-induced colonic hypermotility.展开更多
AIM: To investigate the correlation among tumor markers, curative resection, and recurrence in gastric cancer.METHODS: The patients with preoperative tumormakers [Carcinoembryonic antigen, Carbohydrate antigen(CA) 19-...AIM: To investigate the correlation among tumor markers, curative resection, and recurrence in gastric cancer.METHODS: The patients with preoperative tumormakers [Carcinoembryonic antigen, Carbohydrate antigen(CA) 19-9, and CA 125] and elective gastrectomy between January 2000 and December 2009 at Chungbuk National University Hospital were enrolled in this study. We analyzed the relationship among the tumor makers, curative resection and recurrence, retrospectively.RESULTS: Among the 679 patients with gastric cancer, curative resection was 93.6%(n = 636) and noncurative resection was 6.4%(n = 43). The independent risk factors for the non-curative resection were tumor location and the positivity of preoperative serum CA 19-9 and CA 125 levels. After curative resection, the independent prognostic risk factors for recurrence in curative resection were gender, stage, and preoperative increased serum CA 125 level(HR = 2.431, P =0.020), in a multivariate analysis. CONCLUSION: Preoperative CA 125 is a useful predictive biomarker for curative resection and prognostic biomarker for recurrence in gastric cancer patients.展开更多
AIM To study the type and frequency of adverse events associated with anti-tumor necrosis factor(TNF)therapy and evaluate for any serologic and genetic associations.METHODS This study was a retrospective review of pat...AIM To study the type and frequency of adverse events associated with anti-tumor necrosis factor(TNF)therapy and evaluate for any serologic and genetic associations.METHODS This study was a retrospective review of patients attending the inflammatory bowel disease(IBD) centers at Cedars-Sinai IBD Center from 2005-2016. Adverse events were identified via chart review. IBD serologies were measured by ELISA. DNA samples were genotyped at Cedars-Sinai using Illumina Infinium Immunochipv1 array per manufacturer's protocol. SNPs underwent methodological review and were evaluated using several SNP statistic parameters to ensure optimal allele-calling. Standard and rigorous QC criteria were applied to the genetic data, which was generated using immunochip. Genetic association was assessed by logistic regression after correcting for population structure.RESULTS Altogether we identified 1258 IBD subjects exposed to anti-TNF agents in whom Immunochip data were available. 269/1258 patients(21%) were found to have adverse events to an anti-TNF-α agent that required the therapy to be discontinued. 25% of women compared to 17% of men experienced an adverse event. All adverse events resolved after discontinuing the antiTNF agent. In total: n = 66(5%) infusion reactions; n = 49(4%) allergic/serum sickness reactions; n = 19(1.5%) lupus-like reactions, n = 52(4%) rash, n = 18(1.4%) infections. In Crohn's disease, Ig A ASCA(P = 0.04) and Ig G-ASCA(P = 0.02) levels were also lower in patients with any adverse events, and anti-I2 level in ulcerative colitis was significantly associated with infusion reactions(P = 0.008). The logistic regression/human annotation and network analyses performed on the Immunochip data implicated the following five signaling pathways: JAK-STAT(Janus Kinase-signal transducer and activator of transcription), measles, IBD, cytokine-cytokine receptor interaction, and toxoplasmosis for any adverse event. CONCLUSION Our study shows 1 in 5 IBD patients experience an adverse event to anti-TNF therapy with novel serologic, genetic, and pathways associations.展开更多
BACKGROUND Anastomotic stenosis(AS)after colorectal surgery was treated with balloon dilation,endoscopic procedure or surgery.The endoscopic procedures including dilation,electrocautery incision,or radial incision and...BACKGROUND Anastomotic stenosis(AS)after colorectal surgery was treated with balloon dilation,endoscopic procedure or surgery.The endoscopic procedures including dilation,electrocautery incision,or radial incision and cutting(RIC)were preferred because of lower complication rates than surgery and are less invasive.Endoscopic RIC has a greater success rate than dilation methods.Most reports showed that repeated RICs were needed to maintain patency of the anastomosis.We report that single session RIC was applied only to treatment-naive patients with AS.CASE SUMMARY Two female patients presented with AS.One patient had advanced rectal cancer and the other had a refractory stenosis following surgery for endometriosis at sigmoid colon.The endoscopic RIC procedure was performed as follows.A single small incision was carefully made to increase the view of the proximal colon and the incision was expanded until the surgical stapling line.Finally,we made a further circumferential excision with endoscopic knife along the inner border of the surgical staple line.At the end of the procedure,the standard colonoscope was able to pass freely through the widened opening.All patients showed improved AS after a single session of RIC without immediate or delayed procedure-related complications.Follow-up colonoscopy at 7 and 8 mo after endoscopic RIC revealed intact anastomotic sites in both patients.No treatment-related adverse events or recurrence of the stenosis was demonstrated during follow-up periods of 20 and 23 mo.CONCLUSION The endoscopic RIC may play a role as one of treatment options for treatmentnaive AS with short stenotic lengths.展开更多
BACKGROUND Compared with colorectal adenocarcinoma,basaloid squamous cell carcinomas(BSCCs)arising in the colorectum are rare and have very poor prognosis.To date,only nine cases have been reported.Most BSCCs are exte...BACKGROUND Compared with colorectal adenocarcinoma,basaloid squamous cell carcinomas(BSCCs)arising in the colorectum are rare and have very poor prognosis.To date,only nine cases have been reported.Most BSCCs are extensively involved in metastasis to the lymph node,liver,and lung at diagnosis.Despite many clinicians attempting to effectively treat BSCCs,therapeutic consensus has not been established due to lack of information.CASE SUMMARY A 58-year-old woman presented with abdominal pain,diarrhea,fever,and hematochezia.She was referred from a department of gynecology and was diagnosed with a suspicious leiomyosarcoma of the rectum or a pedunculated myoma of the uterus.An exophytic growing mass at the right lateral wall of the rectum with an internal cystic portion and hemorrhage was observed on magnetic resonance imaging.The patient underwent low anterior resection and total hysterectomy with bilateral salphingo-oophorectomy.Histopathological findings revealed a cellular mass with a solid growth pattern and few glandular structures,many foci of intratumoral necrosis,and a palisading pattern.The pathologist diagnosed tumor as a BSCC,and the patient received chemotherapy with fluorouracil/leucovorin without radiotherapy.The patient is currently alive 8 years after the surgery with no manifestations of metastatic colon cancer.CONCLUSION Our case suggest that curative resection and chemotherapy play important roles in improving survival,and radiotherapy may be an option to avoid radiationassociated enteritis.展开更多
摘要AIM To measure exogenous corticotropin-releasing factor(CRF)-induced motility of the isolated rat colon and to demonstrate the effect of pharmacologic inhibition on CRF-induced motility. METHODS The isolated vascularly-perfused rat colon was used. Luminal pressure was monitored via microtip catheter pressure transducers in the proximal and distal colon. At first, exogenous CRF was administered in a stepwise manner and the concentration of CRF yielding maximal colonic motility was selected. After recording basal colonic motility, hexamethonium, phentolamine, propranolol, atropine and tetrodotoxin were infused into the isolated colon. Initially, only the test drug was infused; then, CRF was added. The motility index was expressed as percentage change over basal level. RESULTS Administration of 1.4, 14.4, 144 and 288 pmol/L CRF progressively increased colonic motility in the proximal and distal colon. Infusion of atropine or tetrodotoxin reduced CRF-induced motility of both the proximal and distal colon, whereas hexamethonium, phentolamine and propranolol had no effect.CONCLUSION CRF-induced colonic motility appears to be mediated by local cholinergic signaling via muscarinic receptors. Muscarinic receptors are potential targets for counteracting CRF-induced colonic hypermotility.
基金Supported by Research grant of Chungbuk National Universityin 2013
摘要AIM: To investigate the correlation among tumor markers, curative resection, and recurrence in gastric cancer.METHODS: The patients with preoperative tumormakers [Carcinoembryonic antigen, Carbohydrate antigen(CA) 19-9, and CA 125] and elective gastrectomy between January 2000 and December 2009 at Chungbuk National University Hospital were enrolled in this study. We analyzed the relationship among the tumor makers, curative resection and recurrence, retrospectively.RESULTS: Among the 679 patients with gastric cancer, curative resection was 93.6%(n = 636) and noncurative resection was 6.4%(n = 43). The independent risk factors for the non-curative resection were tumor location and the positivity of preoperative serum CA 19-9 and CA 125 levels. After curative resection, the independent prognostic risk factors for recurrence in curative resection were gender, stage, and preoperative increased serum CA 125 level(HR = 2.431, P =0.020), in a multivariate analysis. CONCLUSION: Preoperative CA 125 is a useful predictive biomarker for curative resection and prognostic biomarker for recurrence in gastric cancer patients.
摘要AIM To study the type and frequency of adverse events associated with anti-tumor necrosis factor(TNF)therapy and evaluate for any serologic and genetic associations.METHODS This study was a retrospective review of patients attending the inflammatory bowel disease(IBD) centers at Cedars-Sinai IBD Center from 2005-2016. Adverse events were identified via chart review. IBD serologies were measured by ELISA. DNA samples were genotyped at Cedars-Sinai using Illumina Infinium Immunochipv1 array per manufacturer's protocol. SNPs underwent methodological review and were evaluated using several SNP statistic parameters to ensure optimal allele-calling. Standard and rigorous QC criteria were applied to the genetic data, which was generated using immunochip. Genetic association was assessed by logistic regression after correcting for population structure.RESULTS Altogether we identified 1258 IBD subjects exposed to anti-TNF agents in whom Immunochip data were available. 269/1258 patients(21%) were found to have adverse events to an anti-TNF-α agent that required the therapy to be discontinued. 25% of women compared to 17% of men experienced an adverse event. All adverse events resolved after discontinuing the antiTNF agent. In total: n = 66(5%) infusion reactions; n = 49(4%) allergic/serum sickness reactions; n = 19(1.5%) lupus-like reactions, n = 52(4%) rash, n = 18(1.4%) infections. In Crohn's disease, Ig A ASCA(P = 0.04) and Ig G-ASCA(P = 0.02) levels were also lower in patients with any adverse events, and anti-I2 level in ulcerative colitis was significantly associated with infusion reactions(P = 0.008). The logistic regression/human annotation and network analyses performed on the Immunochip data implicated the following five signaling pathways: JAK-STAT(Janus Kinase-signal transducer and activator of transcription), measles, IBD, cytokine-cytokine receptor interaction, and toxoplasmosis for any adverse event. CONCLUSION Our study shows 1 in 5 IBD patients experience an adverse event to anti-TNF therapy with novel serologic, genetic, and pathways associations.
摘要BACKGROUND Anastomotic stenosis(AS)after colorectal surgery was treated with balloon dilation,endoscopic procedure or surgery.The endoscopic procedures including dilation,electrocautery incision,or radial incision and cutting(RIC)were preferred because of lower complication rates than surgery and are less invasive.Endoscopic RIC has a greater success rate than dilation methods.Most reports showed that repeated RICs were needed to maintain patency of the anastomosis.We report that single session RIC was applied only to treatment-naive patients with AS.CASE SUMMARY Two female patients presented with AS.One patient had advanced rectal cancer and the other had a refractory stenosis following surgery for endometriosis at sigmoid colon.The endoscopic RIC procedure was performed as follows.A single small incision was carefully made to increase the view of the proximal colon and the incision was expanded until the surgical stapling line.Finally,we made a further circumferential excision with endoscopic knife along the inner border of the surgical staple line.At the end of the procedure,the standard colonoscope was able to pass freely through the widened opening.All patients showed improved AS after a single session of RIC without immediate or delayed procedure-related complications.Follow-up colonoscopy at 7 and 8 mo after endoscopic RIC revealed intact anastomotic sites in both patients.No treatment-related adverse events or recurrence of the stenosis was demonstrated during follow-up periods of 20 and 23 mo.CONCLUSION The endoscopic RIC may play a role as one of treatment options for treatmentnaive AS with short stenotic lengths.
摘要BACKGROUND Compared with colorectal adenocarcinoma,basaloid squamous cell carcinomas(BSCCs)arising in the colorectum are rare and have very poor prognosis.To date,only nine cases have been reported.Most BSCCs are extensively involved in metastasis to the lymph node,liver,and lung at diagnosis.Despite many clinicians attempting to effectively treat BSCCs,therapeutic consensus has not been established due to lack of information.CASE SUMMARY A 58-year-old woman presented with abdominal pain,diarrhea,fever,and hematochezia.She was referred from a department of gynecology and was diagnosed with a suspicious leiomyosarcoma of the rectum or a pedunculated myoma of the uterus.An exophytic growing mass at the right lateral wall of the rectum with an internal cystic portion and hemorrhage was observed on magnetic resonance imaging.The patient underwent low anterior resection and total hysterectomy with bilateral salphingo-oophorectomy.Histopathological findings revealed a cellular mass with a solid growth pattern and few glandular structures,many foci of intratumoral necrosis,and a palisading pattern.The pathologist diagnosed tumor as a BSCC,and the patient received chemotherapy with fluorouracil/leucovorin without radiotherapy.The patient is currently alive 8 years after the surgery with no manifestations of metastatic colon cancer.CONCLUSION Our case suggest that curative resection and chemotherapy play important roles in improving survival,and radiotherapy may be an option to avoid radiationassociated enteritis.