Mendozahoffman3620
A 62-year-old woman with no past history was referred to our hospital for endoscopic treatment of a large gastric bezoar measuring 10 cm in diameter. The bezoar had a hard surface and huge volume. A tunnel was created at the center of the bezoar using electrohydraulic lithotripsy and was dilated using a through-the-scope balloon. The bezoar was then gradually crushed using alligator forceps and snares to decrease the risk of intestinal obstruction by the crushed bezoar fragments. The sequential use of electrohydraulic lithotripsy, alligator forceps, and snares according to the therapeutic plan enabled the endoscopic treatment of the giant gastric bezoar without surgery.Colon cancer with mucinous components was accompanied by bacterial infection and abscess formation.Primary rectal squamous cell carcinoma is an extremely rare tumor and, in most cases, detected at an advanced stage. In our case, the tumor was at an early stage and had a submucosal appearance. Thus, the tumor was difficult to differentiate from other rectal submucosal tumors and, it was removed by endoscopic submucosal dissection for excisional biopsy.
The clinical applicability of digital next-generation sequencing (dNGS), which eliminates polymerase chain reaction (PCR) and sequencing error-derived noise by using molecular barcodes (MBs), has not been fully evaluated. We evaluated the utility of dNGS of cell-free DNA (cfDNA) in liquid biopsies obtained from patients with pancreatic cancer.
Fifty-eight patients with pancreatic cancer undergoing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) were included. Samples were subjected to sequencing of 50 cancer-related genes using next-generation sequencing (NGS). The results were used as reference gene alterations. NGS of cfDNA from plasma was performed for patients with a mutant allele frequency (MAF) >1% and an absolute mutant number > 10 copies/plasma mL in
or
by digital PCR. Sequence readings with and without MBs were compared with reference to EUS-FNA-derived gene alterations.
The concordance rate between dNGS of cfDNA and EUS-FNA-derived gene alterations was higher with than without MBs (
= 0.039), and MAF cut-off values in dNGS could be decreased to 0.2%. dNGS using MBs eliminated PCR and sequencing error by 74% and 68% for
and all genes, respectively. Overall, dNGS detected mutations in
(45%) and
(26%) and copy number alterations in
,
,
,
, and
, which are targets of molecular-targeted drugs.
dNGS of cfDNA using MBs is useful for accurate detection of gene alterations even with low levels of MAFs. These results may be used to inform the development of diagnostics and therapeutics that can improve the prognosis of pancreatic cancer.
dNGS of cfDNA using MBs is useful for accurate detection of gene alterations even with low levels of MAFs. These results may be used to inform the development of diagnostics and therapeutics that can improve the prognosis of pancreatic cancer.
Obesity affects the gut microbiome, which in turn increases the risk for colorectal cancer. Several studies have shown the mechanisms by which some bacteria may influence the development of colorectal cancer; however, gut microbiome characteristics in obese patients with colorectal cancer remain unclear. Therefore, this study evaluated their gut microbiome profile and its relationship with metabolic markers.
The study assessed fecal samples from 36 consecutive patients with colorectal cancer and 38 controls without colorectal cancer. To identify microbiotic variations between patients with colorectal cancer and controls, as well as between nonobese and obese individuals, 16S rRNA gene amplicon sequencing was performed.
Principal coordinate analysis showed significant differences in the overall structure of the microbiome among the study groups. The α-diversity, assessed by the Chao1 index or Shannon index, was higher in patients with colorectal cancer
controls. The relative abundance of the genera
,
, and
was significantly altered in obese patients with colorectal cancer, whose serum low-density lipoprotein concentrations were positively correlated with the abundance of the genus
; among the most abundant species was
, observed at lower levels in obese
nonobese patients.
This study demonstrated several compositional alterations of the gut microbiome in patients with colorectal cancer and showed that a reduced presence of
may be associated with obesity-related colorectal cancer development. The gut microbiome may provide novel insights into the potential mechanisms in obesity-related colorectal carcinogenesis.
This study demonstrated several compositional alterations of the gut microbiome in patients with colorectal cancer and showed that a reduced presence of E. faecalis may be associated with obesity-related colorectal cancer development. The gut microbiome may provide novel insights into the potential mechanisms in obesity-related colorectal carcinogenesis.
Due to the failure of antibiotic treatment and recurrence of infection in patients with
, this study was designed to find the possible cause of treatment failure and recurrence of the
infections in Ilam, Iran.
One hundred patients with specific symptoms of
infection were selected, and after taking a biopsy specimen, identification of
, antibiotic susceptibility assay, and persister cell assay were performed. In addition, after treatment, patients with persister cells were followed for possible recurrence of infection. Furthermore, an antibiotic susceptibility assay was performed.
Our results demonstrated that, among 100 patients, 50% (n = 50) showed positive results for the existence of
. Among the susceptible isolates, 18% (n = 9) were persister cells that were sensitive to clarithromycin as confirmed by a 5 folds higher than the Minimal Inhibitory Concentration (MIC) of clarithromycin. The data were confirmed by following up the suspected patients.
Our results demonstrated that persister cells in
infections may be responsible to recurrent infection and antibiotic treatment failure. However, more research is needed to obtain more information in this area.
Our results demonstrated that persister cells in H. pylori infections may be responsible to recurrent infection and antibiotic treatment failure. selleck compound However, more research is needed to obtain more information in this area.
Percutaneous radiofrequency ablation (RFA) is a minimally invasive and curative local treatment for hepatocellular carcinoma (HCC). However, serious concerns remain regarding critical recurrences such as metastasis, dissemination, and/or seeding due to RFA. In August 2006, we introduced selective feeding artery ablation before tumor ablation to reduce the risk of critical recurrence by blocking tumor blood flow. The aim of the present study was to clarify whether feeding artery ablation before tumor ablation can reduce the risk of critical recurrence after RFA.
This study retrospectively analyzed 279 patients with primary, solitary, and hypervascular HCC ≤5 cm in diameter who were treated with RFA alone between April 2001 and August 2013. Critical recurrence was defined as intra- or extrahepatic metastasis, dissemination, or seeding that was difficult to treat radically.
Of the 279 HCC patients, 157 patients were treated with conventional RFA alone, and 122 patients underwent RFA with prior feeding artery ablation. Although no significant differences were seen in the rates of local tumor progression-free survival, overall recurrence-free survival, or overall survival between a conventional RFA group and a prior feeding artery ablation group, significant differences were seen in rates of critical recurrence-free survival and cancer-specific survival (5-year, 69
81%,
= 0.01 and 76
88%,
= 0.03, respectively). On multivariate analysis, prior feeding artery ablation, tumor diameter, and alpha-fetoprotein were independent factors related to critical recurrence.
Feeding artery ablation before tumor ablation may reduce the risk of critical recurrence.
Feeding artery ablation before tumor ablation may reduce the risk of critical recurrence.
With the increasing prevalence of persons without
(HP) infection, cases of HP-negative gastric cancer are increasing. Although rare, cases of differentiated adenocarcinoma of the antrum have been reported in HP-negative patients. We collected cases with such lesions and investigated their endoscopic and histological features.
Of 1965 consecutive patients with early gastric cancer who underwent endoscopic resection between January 2009 and December 2017, we extracted 9 cases of HP-negative differentiated adenocarcinoma located in the antrum (HPN-DAA). The clinical data, endoscopic findings, and histopathological findings were reviewed.
Of the nine patients with HPN-DAA, seven were male, and the median age was 53.8 years. The tumor arose from the pyloric gland mucosa in all cases. According to the endoscopic findings, the lesions were flat-elevated or depressed, mimicking varioliform gastritis. Magnifying endoscopy with narrow-band imaging showed the absence of a clear demarcation line or an irregular microvessel/surface pattern. As for the histopathological findings, eight of the nine lesions were diagnosed as high-grade dysplasia/intraepithelial neoplasia, while the remaining case was diagnosed as tubular adenocarcinoma with submucosal infiltration. The findings of immunohistochemistry confirmed that three cases were of the intestinal mucin phenotype and six were of the mixed gastric and intestinal mucin phenotype.
HPN-DAA is a very rarely occurring cancer that had never been recognized earlier. They belong to the new category of HP-negative cancers, and there seems to be a certain number of such cases.
HPN-DAA is a very rarely occurring cancer that had never been recognized earlier. They belong to the new category of HP-negative cancers, and there seems to be a certain number of such cases.
Gastric antral vascular ectasia (GAVE) causes gastrointestinal bleeding. The initial treatment for GAVE bleeding is endoscopic hemostasis, and currently, the most performed technique to achieve hemostasis is argon plasma coagulation (APC). However, APC is associated with a high recurrence rate. To overcome this limitation, we examined the outcomes of the combination therapy of APC and polidocanol injection (PDI) for treating GAVE.
We retrospectively analyzed the outcomes of 15 consecutive GAVE patients treated with PDI + APC at Hiroshima University Hospital between November 2011 and September 2019 with respect to clinical characteristics, hemostatic efficacy, complications related to treatment, and recurrence rate.
The mean age of patients (4 men and 11 women) was 74 ± 8.4 years. Patients had comorbidities of liver cirrhosis (seven patients, 47%), chronic renal failure (seven patients, 47%), and autoimmune diseases (seven patients, 47%). Endoscopic hemostasis with PDI + APC was performed in all patients (
= 15). The mean number of PDIs attempted to stop bleeding was 1.5 ± 0.8 (1-4), and the mean number of APCs attempted was 2.1 ± 1.2 (1-5). Complications related to treatment occurred in two patients (14%) ulceration in one patient and hematoma in another patient, both of whom were treated conservatively. Two patients (13%) had recurrences during the follow-up period (average period, 42 months). Both were cured with additional treatment of PDI only.
The combination therapy of PDI and APC is effective for GAVE with a low recurrence rate.
The combination therapy of PDI and APC is effective for GAVE with a low recurrence rate.
