AIM:To evaluate the usefulness of stool-PCR test for diagnosis of Helicobacter pylori(H pylori)infection in pediatric populations. METHODS:Based on endoscopic features(including nodular gastritis,erosive duodenitis an...AIM:To evaluate the usefulness of stool-PCR test for diagnosis of Helicobacter pylori(H pylori)infection in pediatric populations. METHODS:Based on endoscopic features(including nodular gastritis,erosive duodenitis and ulcer)and/or a positive rapid urease test(RUT)obtained during endoscopy,28 children from a group of children admitted to the Children's Medical Center of Tehran for persistent upper gastrointestinal problems were selected to compare biopsy-based tests with stoolPCR.Their gastric activity and bacterial density were graded by the updated Sydney system,and their first stool after endoscopy was stored at-70℃.Biopsies were cultured on modified campy-blood agar plates and identified by gram-staining,biochemical tests,and PCR.Two methods of phenol-chloroform and boiling were used for DNA extraction from H pylori isolates. Isolation of DNA from stool was performed using a stool DNA extraction kit(Bioneer Inc,Korea).PCR was performed using primers for detection of vacA,cagA,and 16srRNA genes in both isolates and stool. RESULTS:Sixteen out of 28 child patients(57%) were classified as H pylori positive by biopsy-based tests,of which 11(39%)were also positive by stoolPCR.Sensitivity and specificity of stool-PCR was 62.5% and 92.3%respectively.H pylori was observed in histological sections for 10 out of 11 stool-positivepatients.Association was observed between higher score of H pylori in histology and positivity of stoolPCR.Also association was observed between the more severe form of gastritis and a positive stool-PCR. CONCLUSION:Association between higher score of H pylori in histology and a positive stool-PCR make it a very useful test for detection of H pylori active infection in children.We also suggest that a simple stool-PCR method can be a useful test for detection of H pylori virulence genes in stool.展开更多
AIM: To compare the safety and efficacy of subconjunctival injection with conbercept and 5-fluorouracil(5-FU) for open angle glaucoma(OAG) patients after filtration surgery. METHODS: As a prospective randomized interv...AIM: To compare the safety and efficacy of subconjunctival injection with conbercept and 5-fluorouracil(5-FU) for open angle glaucoma(OAG) patients after filtration surgery. METHODS: As a prospective randomized interventional trial, 36 eyes from 36 patients after OAG surgery were collected and divided randomly into conbercept and 5-FU groups. All patients were subconjunctivally injected with either conbercept(0.2 mL) or 5-FU(0.2 mL) on the 5th day post-operatively. The intraocular pressure(IOP), number of medications used, type of conjunctival bleb, and complications were recorded and analyzed pre-operatively and 1d, 1wk, 1, 3 and 6mo post-injection. RESULTS: There were significant differences in IOP between the conbercept and 5-FU groups 1mo(conbercept group: 12.17±1.04 mm Hg; 5-FU group: 13.50±2.33 mm Hg, t=2.214, P=0.037), 3mo(conbercept group: 13.00±1.88 mm Hg; 5-FU group: 14.50±2.28 mm Hg, t=2.153, P=0.039), and 6mo post-injection(conbercept group: 13.28±2.95 mm Hg; 5-FU group: 15.22±2.49 mm Hg, t=2.140, P=0.040); however, in the number of medications, a prominent difference was not shown between groups on post-injection 6mo(t=1.312, P=0.200). Moreover, there was mild vascularity observed in the conbecept group than the 5-FU group 1d(3a, 3b, 3c: t=8.497, 6.693, 4.515, P=0.000), 1wk(3a, 3b, 3c: t=3.431, 6.408, 3.984, P=0.002, 0.000, 0.000), and 1mo post-injection(3a, 3b, 3c: t=2.466, 2.466, 2.503, P=0.019, 0.019, 0.017). Simultaneously, differences from other indicators between the two groups were not demonstrated. Also, there was a lower probability of corneal epithelial stripping in the conbercept group than the 5-FU group(χ2=4.500, P=0.034). CONCLUSION: Subconjunctival injection of conbercept has a safe, effective, and tolerable profile for open angle glaucoma patients with distinct conjunctival congestion after filtration surgery.展开更多
Foreign bodies and bezoars are commonly encountered in children. We describe a child aged 11 years who ingested large amounts of plastic material used for knitting chairs and charpoys. The conglomerate of plastic thre...Foreign bodies and bezoars are commonly encountered in children. We describe a child aged 11 years who ingested large amounts of plastic material used for knitting chairs and charpoys. The conglomerate of plastic threads, entrapped food material and other debris, formed a huge mass occupying the whole stomach. Chronic irritation of the gastric antral mucosa led to ulceration and formation of hyperplastic polyps. We labeled this new entity as a “plastobezoar”. The entire bezoar could be removed endoscopically.展开更多
AIM To evaluate the incidence of lymph node metastasis(LNM) and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas.METHODS We enrolled 85 patients [69 men, 16 women; median age(range), 6...AIM To evaluate the incidence of lymph node metastasis(LNM) and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas.METHODS We enrolled 85 patients [69 men, 16 women; median age(range), 67(38-84) years] who had undergone esophagectomy or proximal gastrectomy for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas. Predictive risk factors of LNM included age, sex, location of the tumor center, confirmed Barrett's esophageal adenocarcinoma, tumor size, macroscopic tumor type, pathology, invasion depth, presence of ulceration, and lymphovascular invasion. Multivariate logistic regression analysis was used to identify factors predicting LNM. We also evaluated the frequencies of LNM for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas in meta-data analysis.RESULTS LNMs were found in 11 out of 85 patients(12.9%, 95%CI: 5.8-20.0). Only 1 of the 15 patients(6.6%, 95%CI: 0.0-19.2) who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 10 ofthe 70 patients(14.2%, 95%CI: 6.0-22.4) with a final diagnosis of pT1b adenocarcinoma had positive LNM. Furthermore, only one of the 30 patients(3.3%, 95%CI: 0.0-9.7) with a tumor invasion depth within 500 μm from muscularis mucosae had positive LNM. Poor differentiation and lymphovascular invasion were independently associated with a risk of LNM. In meta-data analysis, 12 of the 355 patients(3.3%, 95%CI: 1.5-5.2) who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 91 of the 438 patients(20.7%, 95%CI: 16.9-24.5) with a final diagnosis of pT1b adenocarcinoma had positive LNM. CONCLUSION We consider endoscopic submucosal dissection(ESD) is suitable for patients with Siewert type Ⅰ and type Ⅱ T1 a adenocarcinomas. For patients with T1b adenocarcinoma, especially invasion depth is within 500 μm from muscularis mucosae with no other risk factor for LNM, diagnostic ESD could be a treatment option according to the overall status of patients and the presence of comorbidities.展开更多
AIM: To study the role of retrograde terminal ileoscopy in patients suspected to have ileocolonic tuberculosis. METHODS: A retrospective analysis was performed for patients undergoing colonoscopy for suspected ileocol...AIM: To study the role of retrograde terminal ileoscopy in patients suspected to have ileocolonic tuberculosis. METHODS: A retrospective analysis was performed for patients undergoing colonoscopy for suspected ileocolonic tuberculosis between January 2000 and June 2004, in whom retrograde ileoscopy had been performed. Only patients diagnosed with tuberculosis on the basis of histological findings of either a caseating granuloma or those having non-caseating granuloma or a collection of epithelioid cells at a minimum of one endoscopic lesion (either in the colon or the terminal ileum) on histology with good responses to conventional anti-tuberculous drugs were enrolled for the study. RESULTS: Fifty-three patients were included. The terminal ileum was involved in only 11 patients. Eight of these patients had involvement of the cecum too. Two patients had ileal lesions without cecal involvement; however, lesions were noted in the ascending colon. In one patient the whole colon was normal and only the terminal ileum showed nodularity and ulceration. Histological examination of the ileal biopsies obtained from the ileal lesions showed noncaseating granulomas in five, collection of epithelioid cells in four and nonspecific histology in two patients. Mucosal biopsies obtained from the lesion in the terminal ileum, in the patient in whom mucosal abnormality was observed to be confined to the ileum, showed noncaseating granulomas. In two other patients the ileal biopsies alone showed histological evidence of tuberculosis with biopsies from the colonic lesions showing non-specific inflammatory changes only. CONCLUSION: Retrograde ileoscopy should be performed in all patients undergoing colonoscopy for suspected ileocolonic tuberculosis. In some patients only the terminal ileum may be involved and histological examination may reveal evidence of tuberculosis only from the lesions in the terminal ileum. This approach would lead to additional lesions being picked up andincreasing the chances of well-timed diagnosis of tuberculosis.展开更多
We report three cases of patients with acute liver injury induced by weight-loss herbal supplements. One patient took Hydroxycut while the other two took Herbalife supplements. Liver biopsies for all patients dem onst...We report three cases of patients with acute liver injury induced by weight-loss herbal supplements. One patient took Hydroxycut while the other two took Herbalife supplements. Liver biopsies for all patients dem onstrated f indings consistent with drug-induced acute liver injury. To our knowledge, we are the fi rst instit ute to report acute liver injury from both of these two typ es of weight-loss herbal supplements together as a case series. The series emphasizes the importance of taking a cautious approach when consuming herbal supp lements for the purpose of weight loss.展开更多
文摘AIM:To evaluate the usefulness of stool-PCR test for diagnosis of Helicobacter pylori(H pylori)infection in pediatric populations. METHODS:Based on endoscopic features(including nodular gastritis,erosive duodenitis and ulcer)and/or a positive rapid urease test(RUT)obtained during endoscopy,28 children from a group of children admitted to the Children's Medical Center of Tehran for persistent upper gastrointestinal problems were selected to compare biopsy-based tests with stoolPCR.Their gastric activity and bacterial density were graded by the updated Sydney system,and their first stool after endoscopy was stored at-70℃.Biopsies were cultured on modified campy-blood agar plates and identified by gram-staining,biochemical tests,and PCR.Two methods of phenol-chloroform and boiling were used for DNA extraction from H pylori isolates. Isolation of DNA from stool was performed using a stool DNA extraction kit(Bioneer Inc,Korea).PCR was performed using primers for detection of vacA,cagA,and 16srRNA genes in both isolates and stool. RESULTS:Sixteen out of 28 child patients(57%) were classified as H pylori positive by biopsy-based tests,of which 11(39%)were also positive by stoolPCR.Sensitivity and specificity of stool-PCR was 62.5% and 92.3%respectively.H pylori was observed in histological sections for 10 out of 11 stool-positivepatients.Association was observed between higher score of H pylori in histology and positivity of stoolPCR.Also association was observed between the more severe form of gastritis and a positive stool-PCR. CONCLUSION:Association between higher score of H pylori in histology and a positive stool-PCR make it a very useful test for detection of H pylori active infection in children.We also suggest that a simple stool-PCR method can be a useful test for detection of H pylori virulence genes in stool.
文摘AIM: To compare the safety and efficacy of subconjunctival injection with conbercept and 5-fluorouracil(5-FU) for open angle glaucoma(OAG) patients after filtration surgery. METHODS: As a prospective randomized interventional trial, 36 eyes from 36 patients after OAG surgery were collected and divided randomly into conbercept and 5-FU groups. All patients were subconjunctivally injected with either conbercept(0.2 mL) or 5-FU(0.2 mL) on the 5th day post-operatively. The intraocular pressure(IOP), number of medications used, type of conjunctival bleb, and complications were recorded and analyzed pre-operatively and 1d, 1wk, 1, 3 and 6mo post-injection. RESULTS: There were significant differences in IOP between the conbercept and 5-FU groups 1mo(conbercept group: 12.17±1.04 mm Hg; 5-FU group: 13.50±2.33 mm Hg, t=2.214, P=0.037), 3mo(conbercept group: 13.00±1.88 mm Hg; 5-FU group: 14.50±2.28 mm Hg, t=2.153, P=0.039), and 6mo post-injection(conbercept group: 13.28±2.95 mm Hg; 5-FU group: 15.22±2.49 mm Hg, t=2.140, P=0.040); however, in the number of medications, a prominent difference was not shown between groups on post-injection 6mo(t=1.312, P=0.200). Moreover, there was mild vascularity observed in the conbecept group than the 5-FU group 1d(3a, 3b, 3c: t=8.497, 6.693, 4.515, P=0.000), 1wk(3a, 3b, 3c: t=3.431, 6.408, 3.984, P=0.002, 0.000, 0.000), and 1mo post-injection(3a, 3b, 3c: t=2.466, 2.466, 2.503, P=0.019, 0.019, 0.017). Simultaneously, differences from other indicators between the two groups were not demonstrated. Also, there was a lower probability of corneal epithelial stripping in the conbercept group than the 5-FU group(χ2=4.500, P=0.034). CONCLUSION: Subconjunctival injection of conbercept has a safe, effective, and tolerable profile for open angle glaucoma patients with distinct conjunctival congestion after filtration surgery.
文摘Foreign bodies and bezoars are commonly encountered in children. We describe a child aged 11 years who ingested large amounts of plastic material used for knitting chairs and charpoys. The conglomerate of plastic threads, entrapped food material and other debris, formed a huge mass occupying the whole stomach. Chronic irritation of the gastric antral mucosa led to ulceration and formation of hyperplastic polyps. We labeled this new entity as a “plastobezoar”. The entire bezoar could be removed endoscopically.
文摘AIM To evaluate the incidence of lymph node metastasis(LNM) and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas.METHODS We enrolled 85 patients [69 men, 16 women; median age(range), 67(38-84) years] who had undergone esophagectomy or proximal gastrectomy for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas. Predictive risk factors of LNM included age, sex, location of the tumor center, confirmed Barrett's esophageal adenocarcinoma, tumor size, macroscopic tumor type, pathology, invasion depth, presence of ulceration, and lymphovascular invasion. Multivariate logistic regression analysis was used to identify factors predicting LNM. We also evaluated the frequencies of LNM for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas in meta-data analysis.RESULTS LNMs were found in 11 out of 85 patients(12.9%, 95%CI: 5.8-20.0). Only 1 of the 15 patients(6.6%, 95%CI: 0.0-19.2) who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 10 ofthe 70 patients(14.2%, 95%CI: 6.0-22.4) with a final diagnosis of pT1b adenocarcinoma had positive LNM. Furthermore, only one of the 30 patients(3.3%, 95%CI: 0.0-9.7) with a tumor invasion depth within 500 μm from muscularis mucosae had positive LNM. Poor differentiation and lymphovascular invasion were independently associated with a risk of LNM. In meta-data analysis, 12 of the 355 patients(3.3%, 95%CI: 1.5-5.2) who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 91 of the 438 patients(20.7%, 95%CI: 16.9-24.5) with a final diagnosis of pT1b adenocarcinoma had positive LNM. CONCLUSION We consider endoscopic submucosal dissection(ESD) is suitable for patients with Siewert type Ⅰ and type Ⅱ T1 a adenocarcinomas. For patients with T1b adenocarcinoma, especially invasion depth is within 500 μm from muscularis mucosae with no other risk factor for LNM, diagnostic ESD could be a treatment option according to the overall status of patients and the presence of comorbidities.
文摘AIM: To study the role of retrograde terminal ileoscopy in patients suspected to have ileocolonic tuberculosis. METHODS: A retrospective analysis was performed for patients undergoing colonoscopy for suspected ileocolonic tuberculosis between January 2000 and June 2004, in whom retrograde ileoscopy had been performed. Only patients diagnosed with tuberculosis on the basis of histological findings of either a caseating granuloma or those having non-caseating granuloma or a collection of epithelioid cells at a minimum of one endoscopic lesion (either in the colon or the terminal ileum) on histology with good responses to conventional anti-tuberculous drugs were enrolled for the study. RESULTS: Fifty-three patients were included. The terminal ileum was involved in only 11 patients. Eight of these patients had involvement of the cecum too. Two patients had ileal lesions without cecal involvement; however, lesions were noted in the ascending colon. In one patient the whole colon was normal and only the terminal ileum showed nodularity and ulceration. Histological examination of the ileal biopsies obtained from the ileal lesions showed noncaseating granulomas in five, collection of epithelioid cells in four and nonspecific histology in two patients. Mucosal biopsies obtained from the lesion in the terminal ileum, in the patient in whom mucosal abnormality was observed to be confined to the ileum, showed noncaseating granulomas. In two other patients the ileal biopsies alone showed histological evidence of tuberculosis with biopsies from the colonic lesions showing non-specific inflammatory changes only. CONCLUSION: Retrograde ileoscopy should be performed in all patients undergoing colonoscopy for suspected ileocolonic tuberculosis. In some patients only the terminal ileum may be involved and histological examination may reveal evidence of tuberculosis only from the lesions in the terminal ileum. This approach would lead to additional lesions being picked up andincreasing the chances of well-timed diagnosis of tuberculosis.
基金Supported by Harbor UCLA Medical Center and The Division of Gastroenterology
文摘We report three cases of patients with acute liver injury induced by weight-loss herbal supplements. One patient took Hydroxycut while the other two took Herbalife supplements. Liver biopsies for all patients dem onstrated f indings consistent with drug-induced acute liver injury. To our knowledge, we are the fi rst instit ute to report acute liver injury from both of these two typ es of weight-loss herbal supplements together as a case series. The series emphasizes the importance of taking a cautious approach when consuming herbal supp lements for the purpose of weight loss.