Rare histological subtype of invasive micropapillary carcinoma in the ampulla of Vater: A case report

paythelady.612 shared this article with you from Inoreader Rare histological subtype of invasive micropapillary carcinoma in the ampulla of Vater: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 16;9(11):2671-2678. doi: 10.12998/wjcc.v9.i11.2671. ABSTRACT BACKGROUND: Carcinoma of the ampulla of Vater is an uncommon ampullo-pancreatobiliary neoplasm, and the most common histological type is adenocarcinoma with a tubular growth pattern. Invasive micropapillary carcinoma (IMPC) is an aggressive variant of adenocarcinoma in several organs that is associated with lymph node metastasis and poor prognosis. IMPC was first described as a histological subtype of breast cancer; however, IMPC of the ampulla of Vater is extremely rare, with only three articles reported in the English literature. CASE SUMMARY: We have reported a case of IMPC of the ampulla of Vater in an 80-year-old man. Microscopically, the surface area of the carcinoma was composed of tubulopapillary structures mimicking intra-ampullary papillary-tubular neoplasm, and the deep invasive front area exhibited a pattern of IMPC. The carcinom a showed lymphatic invasion and extensive lymph node metastasis. The immunohistochemical study revealed mixed intestinal and gastric/pan-creatobiliary phenotypes. CONCLUSION: This rare subtype tumor in the ampulla of Vater showed a histologically mixed phenotype and exhibited aggressive behavior. PMID:33889635 | PMC:PMC8040169 | DOI:10.12998/wjcc.v9.i11.2671 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Differences in dietary habits of people with vs without irritable bowel syndrome and their association with symptom and psychological status: A pilot study

paythelady.612 shared this article with you from Inoreader Differences in dietary habits of people with <em>vs</em> without irritable bowel syndrome and their association with symptom and psychological status: A pilot study Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 16;9(11):2487-2502. doi: 10.12998/wjcc.v9.i11.2487. ABSTRACT BACKGROUND: Previous studies have demonstrated that dietary factors are involved in irritable bowel syndrome (IBS), but the role of diet was evaluated mostly based on food frequency questionnaire. Whether food categories, quantity per time, and intake frequency are different between IBS patients and non-IBS individuals has not been clearly clarified. AIM: To explore differences in dietary habits of people with vs without IBS and their correlation with symptom and psychological status. METHODS: A total of 220 questionnaires were administered in a community population and the Rome IV criteria was applied to diagnose IBS. The dietary questionnaire used in this study was multidimensional from food categories, quantity per time, and intake frequency, in contrast to "yes or no" classification used in previous studies. Questionnaires i ncluding IBS symptom severity scale (IBS-SSS), IBS quality of life, visceral sensitivity index, hospital anxiety and depression score (HADS), and gastrointestinal symptom rating scale were used to assess the participants. Rank sum test was used to compare the quantity per time and intake frequency between IBS patients and non-IBS participants. The correlation between psychological factors and diet was evaluated by Spearman correlation analysis. Logistic regression analysis was used to assess the possible dietary risk factors for IBS. RESULTS: In total, 203 valid questionnaires were collected (response rate 92.3%). Twenty-five participants met the Rome IV criteria for IBS, including 15 (60.0%) women and 10 (40.0%) men. Compared with the non-IBS group, the quantity per time and intake frequency of soybean and its products, spicy food, and dry-fried nuts were statistically significant in IBS participants (P < 0.05). They were positively associated with IBS-SSS and HADS anxiety and depression scores (P < 0.05). Besides, seafood, soft drinks, vegetables, and fruits differed only in quantity per time. The intake frequencies of egg, barbecue, and coarse grain were statistically significant in IBS patients (P < 0.05). We also found that the frequency of soybean and its products (≥ 7 times/week, odds ratio = 11.613, 95% confidence interval: 2.145-62.855, P = 0.004) was an independent risk factor for IBS. CONCLUSION: Both quantity per time and intake frequency, especially soybean, differ between IBS patients and non-IBS participants. Dietary habits might play potential roles in the pathophysiology of IBS. PMID:33889614 | PMC:PMC8040167 | DOI:10.12998/wjcc.v9.i11.2487 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Contrast-enhanced ultrasound using SonoVue mixed with oral gastrointestinal contrast agent to evaluate esophageal hiatal hernia: Report of three cases and a literature review

paythelady.612 shared this article with you from Inoreader Contrast-enhanced ultrasound using SonoVue mixed with oral gastrointestinal contrast agent to evaluate esophageal hiatal hernia: Report of three cases and a literature review Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 16;9(11):2679-2687. doi: 10.12998/wjcc.v9.i11.2679. ABSTRACT BACKGROUND: Due to a thicker abdominal wall in some patients, ultrasound artifacts from gastrointestinal gas and surrounding tissues can interfere with routine ultrasound examination, precluding its ability to display or clearly show the structure of a hernial sac (HS) and thereby diminishing diagnostic performance for esophageal hiatal hernia (EHH). Contrast-enhanced ultrasound (CEUS) imaging using an oral agent mixture allows for clear and intuitive identification of an EHH sac and dynamic observation of esophageal reflux. CASE SUMMARY: In this case series, we report three patients with clinically-suspected EHH, including two females and one male with an average age of 67.3 ± 16.4 years. CEUS was administered with an oral agent mixture (microbubble-based SonoVue and gastrointestinal contrast agent) and identified a direct sign of supradia phragmatic HS (containing the hyperechoic agent) and indirect signs [e.g., widening of esophageal hiatus, hyperechoic mixture agent continuously or intermittently reflux flowing back and forth from the stomach into the supradiaphragmatic HS, and esophagus-gastric echo ring (i.e., the "EG" ring) seen above the diaphragm]. All three cases received a definitive diagnosis of EHH by esophageal manometry and gastroscopy. Two lesions resolved upon drug treatment and one required surgery. The recurrence rate in follow-up was 0%. The data from these cases suggest that the new non-invasive examination method may greatly improve the diagnosis of EHH. CONCLUSION: CEUS with the oral agent mixture can facilitate clear and intuitive identification of HS and dynamic observation of esophageal reflux. PMID:33889636 | PMC:PMC8040161 | DOI:10.12998/wjcc.v9.i11.2679 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nemaline myopathy with dilated cardiomyopathy and severe heart failure: A case report

paythelady.612 shared this article with you from Inoreader Nemaline myopathy with dilated cardiomyopathy and severe heart failure: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Apr 16;9(11):2569-2575. doi: 10.12998/wjcc.v9.i11.2569. ABSTRACT BACKGROUND: Nemaline myopathy (NM) is a rare type of congenital myopathy, with an incidence of 1:50000. Patients with NM often exhibit hypomyotonia and varying degrees of muscle weakness. Skeletal muscles are always affected by this disease, while myocardial involvement is uncommon. However, with improvements in genetic testing technology, it has been found that NM with a mutation in the myopalladin (MYPN) gene not only causes slow, progressive muscle weakness but also results in dilated or hypertrophic cardiomyopathy. CASE SUMMARY: A 3-year-old pre-school boy was admitted to our hospital with cough, edema, tachypnea, and an increased heart rate. The patient was clinically diagnosed with severe dilated cardiomyopathy and heart failure, and subsequent gene examination confirmed the diagnosis of NM with a mutation in MYPN. Captop ril, diuretics, low-dose digoxin, and dobutamine were administered. After 22 d of hospitalization, the patient was discharged due to the improvement of clinical symptoms. During the follow-up period, the patient died of refractory heart failure. CONCLUSION: Decreased muscular tone and dilated cardiomyopathy are common features of MYPN-mutated NM. Heart transplantation may be a solution to this type of cardiomyopathy. PMID:33889622 | PMC:PMC8040187 | DOI:10.12998/wjcc.v9.i11.2569 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Paeoniflorin suppresses allergic and inflammatory responses by promoting autophagy in rats with urticaria

xlomafota13 shared this article with you from Inoreader Paeoniflorin suppresses allergic and inflammatory responses by promoting autophagy in rats with urticaria Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jun;21(6):590. doi: 10.3892/etm.2021.10022. Epub 2021 Apr 8. ABSTRACT Paeoniflorin (PF) has been reported to be effective against several skin disorders, such as allergic contact dermatitis and psoriasis; however, it remains unclear whether PF can protect against urticarial lesions. Herein, the effects of PF on rats with urticarial lesions and the possible underlying mechanism were investigated. The effects of PF administration on a rat model of ovalbumin-induced urticarial-like lesions were evaluated via pathological analysis using hematoxylin-eosin staining. Toluidine blue staining was performed to detect mast cells and ELISA was performed to determine serum histamine levels. PF-induced regulatory effects on autophagic activity and the potential underlying mechanism of this were also investigated using transmission electron microscopy, immunohistochemistry and reverse transcription-quantitative PCR. It was demonstr ated that PF suppressed allergic and inflammatory responses to improve urticarial lesions, as evidenced by the attenuation of pathological abnormalities, mast cell infiltration and histamine secretion. Mechanistically, PF treatment was found to markedly limit the production and release of inflammatory cytokine interleukin (IL)-23, while the levels of IL-17 remained unchanged. PF intervention led to an increased number of autophagosomes, along with higher levels of light chain 3B (LC3B) and Beclin-1, and lower levels of P62, indicating that PF could augment autophagic activity in urticarial lesions. PF treatment increased the expression of liver kinase B1 (LKB1) and AMP-activated protein kinase-α (AMPK-α), contributing to the PF-enhanced autophagic activity. In conclusion, PF could effectively improve urticarial lesions by inhibiting inflammatory cytokine IL-23 and increasing the autophagic activity via the LKB1/AMPK-α pathway. PMID:33884028 | PMC:PMC8056118 | DOI:10.3892/etm.2021.10022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Microcirculatory disturbance in acute liver injury

xlomafota13 shared this article with you from Inoreader Microcirculatory disturbance in acute liver injury Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jun;21(6):596. doi: 10.3892/etm.2021.10028. Epub 2021 Apr 9. ABSTRACT Microcirculatory disturbance is thought to be involved in the pathogenesis of acute liver injury (ALI). The current study examined the pathophysiologic role of hepatic microcirculatory disturbance in patients with ALI and in mouse models of ALI. Using serum aminotransferase (ALT)/lactate dehydrogenase (LDH) ratio as a hypoxic marker, 279 patients with ALI were classified into the low ALT/LDH ratio (ALT/LDH ≤1.5) and high ALT/LDH ratio group (ALT/LDH >1.5). In the low ALT/LDH ratio group, serum ALT, LDH, fibrinogen degradation products and prothrombin time-international normalized ratio were increased relative to the high ALT/LDH ratio group. Histologically, hepatic expression of tissue factor (TF) and hypoxia-related proteins was enhanced in the low ALT/LDH ratio group, and this was accompanied by sinusoidal fibrin deposition. Sinusoidal hyper coagulation and intrahepatic hypoxia was also analyzed in two different mouse models of ALI; Concanavalin A (ConA) mice and Galactosamine/tumor necrosis factor (TNF)-α (G/T) mice. Serum ALT/LDH ratio in ConA mice was significantly lower compared with G/T mice. Pimonidazole staining revealed the upregulation of hypoxia-related proteins in ConA mice. Recombinant human soluble thrombomodulin improved liver damage in ConA mice in association with reduced sinusoidal hypercoagulation and intrahepatic hypoxia. The present study provides evidence that serum ALT/LDH ratio aids in the identification of patients with ALI and intrahepatic hypoxia as a result of microcirculatory disturbance. The results facilitate the improved understanding of the pathogenesis of ALI, thereby offering a novel therapeutic strategy against ALI, which arises from sinusoidal hypercoagulation. PMID:33884034 | PMC:PMC8056117 | DOI:10.3892/etm.2021.10028 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Downregulation of miR-588 is associated with tumor progression and unfavorable prognosis in patients with osteosarcoma

xlomafota13 shared this article with you from Inoreader Downregulation of miR-588 is associated with tumor progression and unfavorable prognosis in patients with osteosarcoma Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jun;21(6):592. doi: 10.3892/etm.2021.10024. Epub 2021 Apr 8. ABSTRACT Osteosarcoma (OS) is a primary malignant tumor characterized by a high metastatic potential and poor prognosis. The dysregulation of miR-588 has been demonstrated to serve crucial roles in the progression of numerous types of cancer. The present study aimed to investigate the expression and function of miR-588 in the development of OS. To do so, clinical samples were collected and analyzed, and in vitro experiments were conducted. A total of 104 patients with OS were recruited between 2012 and 2014. The expression of miR-588 was analyzed by reverse transcription quantitative PCR. The association between miR-588 expression and the clinicopathological characteristics and survival rate of patients with OS was evaluated. Furthermore, Cell Counting Kit-8 and Transwell assays were used to evaluate the effect of miR-588 on the proliferation and the migrat ory and invasive abilities of various OS cell lines. The results demonstrated that miR-588 expression in OS tissues and cells was significantly lower compared with normal tissues and cells. In addition, miR-588 expression was closely associated with the Musculoskeletal Tumor Society (MSTS) staging of patients with OS. miR-588 expression and MSTS staging were therefore considered as independent indicators for the prognosis of patients with OS. In addition, miR-588 downregulation significantly stimulated the proliferation and migratory and invasive abilities of OS cells. Taken together, these findings indicated that miR-588 may serve as an independent prognostic factor and tumor suppressor in OS. PMID:33884030 | P MC:PMC8056108 | DOI:10.3892/etm.2021.10024 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.