We present a case of Cronkhite-Canada syndrome(CCS) in which the entire intestine was observed using a prototype of magnifying single-balloon enteroscope(SIF Y-0007, Olympus). CCS is a rare, non-familial gastrointesti...We present a case of Cronkhite-Canada syndrome(CCS) in which the entire intestine was observed using a prototype of magnifying single-balloon enteroscope(SIF Y-0007, Olympus). CCS is a rare, non-familial gastrointestinal polyposis with ectodermal abnormalities. To our knowledge, this is the first report showing magnified intestinal lesions of CCS. A 73-year-old female visited our hospital with complaints of diarrhea and dysgeusia. The blood test showed mild anemia and hypoalbuminemia. The esophagogastroduodenoscopy and colonoscopy revealed diffuse and reddened sessile to semi-pedunculated polyps, resulting in the diagnosis of CCS. In addition to the findings of conventional balloon-assisted enteroscopy or capsule endoscopy, magnifying observation revealed tiny granular structures, non-uniformity of the villus, irregular caliber of the loop-like capillaries, scattered white spots in the villous tip, and patchy redness of the villus. Histologically, the scattered white spots and patchy redness of the villus reflect lymphangiectasia and bleeding to interstitium, respectively.展开更多
AIM:To investigate colorectal uptake of solid lipid nanoparticles(SLNs) in mice receiving different doses of 1,2-dimethylhydrazine(DMH) using magnetic resonance(MR) and laser-scanning confocal fluorescence microscope(...AIM:To investigate colorectal uptake of solid lipid nanoparticles(SLNs) in mice receiving different doses of 1,2-dimethylhydrazine(DMH) using magnetic resonance(MR) and laser-scanning confocal fluorescence microscope(LSCFM) imaging.METHODS:Eight mice were sacrificed in a pilot study to establish the experimental protocol and to visualize colorectal uptake of SLNs in normal mice.Gadopentetate dimeglumine and fluorescein isothiocyanate(FITC)-loaded SLN(Gd-FITC-SLN) enemas were performed on mice receiving DMH for 10 wk(group 1,n = 9) or 16 wk(group 2,n = 7) and FITC-SLN enema wasperformed on 4 DMH-treated mice(group 3).Pre-and post-enema MR examinations were made to visualize the air-inflated distal colorectum.Histological and LSCFM examinations were performed to verify colorectal malignancy and to track the distribution of SLNs.RESULTS:Homogeneous enhancement and dense fluorescence(FITC) deposition in colorectal wall were observed in normal mice and 1 DMH-treated mouse(group 1) on fluid attenuated inversion recovery(FLAIR) and LSCFM images,respectively.Heterogeneous mural enhancement was found in 6 mice(4 in group 1;2 in group 2).No visible mural enhancement was observed in the other mice.LSCFM imaging revealed linear fluorescence deposition along the colorectal mucosa in all groups.Nine intraluminal masses and one prolapsed mass were detected by MR imaging with different enhancement modes and pathologies.Interstitial FITC deposition was identified where obvious enhancement was observed in FLAIR images.Bladder imaging agent accumulations were observed in 11 of 16 DMH-treated mice of groups 1 and 2.CONCLUSION:There are significant differences in colorectal uptake and distribution of SLNs between normal and DMH-treated mice,which may provide a new mechanism of contrast for MR colonography.展开更多
AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis...AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: "intervascular background coloration"; "proliferation of intrapapillary capillary loops(IPCL)"; and "dilation", "tortuosity", "change in caliber", and "various shapes(VS)" of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's criteria.RESULTS Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria, respectively.CONCLUSION The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBIME.展开更多
文摘We present a case of Cronkhite-Canada syndrome(CCS) in which the entire intestine was observed using a prototype of magnifying single-balloon enteroscope(SIF Y-0007, Olympus). CCS is a rare, non-familial gastrointestinal polyposis with ectodermal abnormalities. To our knowledge, this is the first report showing magnified intestinal lesions of CCS. A 73-year-old female visited our hospital with complaints of diarrhea and dysgeusia. The blood test showed mild anemia and hypoalbuminemia. The esophagogastroduodenoscopy and colonoscopy revealed diffuse and reddened sessile to semi-pedunculated polyps, resulting in the diagnosis of CCS. In addition to the findings of conventional balloon-assisted enteroscopy or capsule endoscopy, magnifying observation revealed tiny granular structures, non-uniformity of the villus, irregular caliber of the loop-like capillaries, scattered white spots in the villous tip, and patchy redness of the villus. Histologically, the scattered white spots and patchy redness of the villus reflect lymphangiectasia and bleeding to interstitium, respectively.
基金Supported by National Natural Science Foundation of China,No.30670610
文摘AIM:To investigate colorectal uptake of solid lipid nanoparticles(SLNs) in mice receiving different doses of 1,2-dimethylhydrazine(DMH) using magnetic resonance(MR) and laser-scanning confocal fluorescence microscope(LSCFM) imaging.METHODS:Eight mice were sacrificed in a pilot study to establish the experimental protocol and to visualize colorectal uptake of SLNs in normal mice.Gadopentetate dimeglumine and fluorescein isothiocyanate(FITC)-loaded SLN(Gd-FITC-SLN) enemas were performed on mice receiving DMH for 10 wk(group 1,n = 9) or 16 wk(group 2,n = 7) and FITC-SLN enema wasperformed on 4 DMH-treated mice(group 3).Pre-and post-enema MR examinations were made to visualize the air-inflated distal colorectum.Histological and LSCFM examinations were performed to verify colorectal malignancy and to track the distribution of SLNs.RESULTS:Homogeneous enhancement and dense fluorescence(FITC) deposition in colorectal wall were observed in normal mice and 1 DMH-treated mouse(group 1) on fluid attenuated inversion recovery(FLAIR) and LSCFM images,respectively.Heterogeneous mural enhancement was found in 6 mice(4 in group 1;2 in group 2).No visible mural enhancement was observed in the other mice.LSCFM imaging revealed linear fluorescence deposition along the colorectal mucosa in all groups.Nine intraluminal masses and one prolapsed mass were detected by MR imaging with different enhancement modes and pathologies.Interstitial FITC deposition was identified where obvious enhancement was observed in FLAIR images.Bladder imaging agent accumulations were observed in 11 of 16 DMH-treated mice of groups 1 and 2.CONCLUSION:There are significant differences in colorectal uptake and distribution of SLNs between normal and DMH-treated mice,which may provide a new mechanism of contrast for MR colonography.
文摘AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: "intervascular background coloration"; "proliferation of intrapapillary capillary loops(IPCL)"; and "dilation", "tortuosity", "change in caliber", and "various shapes(VS)" of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's criteria.RESULTS Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria, respectively.CONCLUSION The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBIME.
