Endoscopic ultrasound features of gastric schwannomas with radiological correlation:A case series report

Gastric schwannomas are rare mesenchymal tumors of the gastrointestinal tract.They are usually misdiagnosed as other submucosal tumors preoperatively.Experience of the imaging features of gastric schwannomas is extremely limited.In this report,we summarize the features of a series of endoscopic ultrasound(EUS) images of gastric schwannomas in an effort to improve the diagnosis and differential diagnosis rate.We retrospectively reviewed the endosonographic features of four patients with gastric schwannomas and their computed tomography imaging results.Gastric schwannomas had heterogeneous hypoechogenicity or isoechogenicity,and a well-demarcated margin.The tumors originated from the fourth layer.Cystic changes and calcification were uncommon.Marginal hypoechoic haloes were observed in two patients.The results described here were different from those of previous studies.In the EUS evaluation,the internal echogenicity of gastric schwannomas was heterogeneous and low,but slightly higher than that of muscularis pro-pria.These features might help us differentiate gastric schwannomas from other submucosal tumors.Further investigation is needed to differentiate these mesenchymal tumors.

Adiponectin levels are associated with the number and activity of circulating endothelial progenitor cells in patients with coronary artery disease

Objective:To study the relationship between plasma adiponectin concentration and the functional activities of circulating endothelial progenitor cells(EPCs) in patients with coronary artery disease(CAD).Methods:Circulating EPCs were enumerated as AC133+/KDR+ cells via flow cytometry and identified by co-staining with DiI-acLDL and fluorescein isothiocy-anate(FITC)-conjugated lectin under a fluorescent microscope.The migratory capacity of EPCs was measured by modified Boyden chamber assay.Adhesion capacity was performed to count adherent cells after replating EPCs on six-well culture dishes coated with fibronectin.Results:The number of circulating EPCs(AC133+/KDR+ cells) decreased significantly in CAD patients,compared with control subjects [(74.2±12.3) vs(83.5±12.9) cells/ml blood,P<0.01].In addition,the number of EPCs also decreased in CAD patients after ex vivo cultivation [(54.4±8.6) vs(71.9±11.6) EPCs/field,P<0.01].Both circulating EPCs and differentiated EPCs were positively correlated with plasma adiponectin concentration.The functional activities of EPCs from CAD patients,such as migratory and adherent capacities,were also impaired,compared with control subjects,and positively correlated with plasma adiponectin concentration.Conclusion:The study demonstrates that the impairment of the number and functional activities of EPCs in CAD patients is correlated with their lower plasma adiponectin concentrations.

Aorta-to-right atrium fistula,an unusual complication of endocarditis

Infective endocarditis(IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis,vegetation,perforation of noncoronary sinus,and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardiography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis,aggressive antibacterial therapy,and surgical treatment may improve the prognosis.