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1
Content available remote Ectopic Pancreas Imitating Gastrointestinal Stromal Tumor (GIST) In The Stomach
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EN
Ectopic pancreas is a rare congenital disorder defined as pancreatic tissue lacking vascular or anatomic communication with the normal body of the pancreas. Most cases of ectopic pancreas are asymptomatic, but it may become clinically evident depending on the size, location and the pathological changes similar to those observed in case of the normal pancreas. It is often an incidental finding and can be located at different sites in the gastrointestinal tract. The most common locations are: the stomach, duodenum or the proximal part of small intestine. The risk of malignancy, bleeding and occlusion are the most serious complications. Despite the development in diagnostics, it still remains a challenge for the clinician to differentiate it from neoplasm. In this report, we described a case of 28-years old woman who presented recurrent epigastric pain. The upper gastrointestinal endoscopy revealed gastrointestinal stromal tumor on the border of the body and antrum of the back wall of great curvature of the stomach. The histopathological examination after surgery showed heterotopic pancreatic tissue. Ectopic pancreas should be considered in the differential diagnosis of gastric mass lesions.
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Content available Ciało i jego fragmenty w prozie Mikołaja Gogola
88%
PL
The article presents a perspective of somatic present in the prose of Nikolai Gogol. The body is treated here as a project - a collection of body fragments. Particular attention is paid to the figure of nose, which occurs in two selected short stories entitledNose and Diary of a Madman. Therefore, any attempt to emancipate the body part is a threat to the need to preserve the face. Nose is a sense of belonging. This part of the body is thus a limit to what we used to be referred to as belonging to us. Its location creates the last bastion of perception, the selfness.
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tom 18
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nr 74
207-211
EN
The gastrointestinal tract is an extraordinary human organ in terms of its morphology and function. Its complex structure and enormous length as well as frequent presence of gas discourage many doctors performing ultrasound examination from its exploration. Moreover, there are anatomical structures in multiple locations which can mimic certain abnormalities. It is difficult to present an exhaustive account of the problem of gastrointestinal tract ultrasound imaging errors in a single work; therefore, this study focuses mainly on false positive errors which usually result from a lack of knowledge of anatomical variants of the gastrointestinal tract structure. In the case of the stomach, rugae and muscle layer thickening towards the pylorus have been mentioned, which constitute variants of the structure of this organ examined when empty. Diagnostic pitfalls in the small intestine may include the dudenojejunal flexure (ligament of Treitz), the horizontal part of the duodenum and the ileocaecal valve. The status of the apparent lesions in all of the cases mentioned will be resolved following fluid intake by the patient. In the colon, the varied structure of semilunar folds should be taken note of. Their large thickness can warrant suspicion of wall invasion or a polyp. In addition, the study emphasises the importance of appropriate preparation of a patient for gastrointestinal tract examination since it determines the accuracy of the diagnosis. The authors also take note of common ‘sins’ of physicians such as hasty examination and failure to comply with the stomach and appendix examination protocol.
PL
Cewa pokarmowa to wyjątkowy pod względem morfologicznym i czynnościowym narząd ciała ludzkiego. Jej złożona budowa, ogromna długość oraz częsta obecność w niej gazu zniechęcają do jej eksploracji wielu lekarzy wykonujących badanie ultrasonograficzne. Ponadto w wielu miejscach można spotkać struktury anatomiczne mogące pozorować istnienie zmian patologicznych. W jednym opracowaniu trudno przedstawić całość problematyki związanej z błędami popełnianymi w diagnostyce ultrasonograficznej cewy pokarmowej, dlatego w prezentowanej pracy skupiono się głównie na błędach fałszywie pozytywnych, które w przeważającej mierze wynikają z nieznajomości wariantów anatomicznych budowy przewodu pokarmowego. W odniesieniu do żołądka zwrócono uwagę na tzw. ufałdowanie i grubiejącą w kierunku odźwiernika błonę mięśniową – zmienności budowy ściany tego narządu badanego na czczo. W jelicie cienkim pułapkę diagnostyczną mogą stanowić: zgięcie dwunastniczo-czcze Treitza, poziomy odcinek dwunastnicy i zastawka krętniczo-kątnicza. We wszystkich wymienionych przypadkach rozstrzygające będzie zachowanie się tych tzw. rzekomych zmian po napojeniu osoby badanej. W jelicie grubym należy zwracać uwagę na zróżnicowaną budowę fałdów półksiężycowatych, których duża grubość może nasuwać podejrzenie nacieku ściany bądź polipa. Ponadto w pracy podkreślono znaczenie prawidłowego przygotowania pacjenta do badania cewy pokarmowej, od tego bowiem zależy trafność stawianych rozpoznań. Autorzy zwracają także uwagę na częste „grzechy” w pracy lekarzy, takie jak pospieszne badanie oraz nietrzymanie się metodycznego standardu badania USG żołądka i wyrostka robaczkowego.
EN
Over the last decade, gastric cancer treatment has changed from extensive multiorgan resections towards less invasive approaches with limited resections and a more selective lymphadenectomy. Despite all available trials, the conclusions on the extent of necessary resections still remain debatable. The aim of the study was to assess the short term outcomes (morbidity and mortality) of a total gastrectomy depending on the simultaneous splenectomy status. Material and methods. We performed a retrospective analysis of the records of all patients treated with a curative intent using a total gastrectomy for gastric cancer between 1997 and 2003. 49 patients fulfilled the inclusion criteria. Patients were divided into two groups: S(+) gastrectomy with splenectomy group (29 patients) and S(-) total gastrectomy with spleen preservation (20 patients). Results. Survival analysis at one year showed that there was no difference in survival between the two groups (p=0.84). There were six recurrences, one in the group S(+) and five in group S(-) (p>0.05). Dissemination was observed in three patients in group S(-) (p>0.05). Other complications including infectious complications, exenteration, subileus, cardiovascular insufficiency, multiorgan failure were more frequent in the S(+) group (31% v 15%) although the difference was not significant (p=0.17). Conclusions. Splenectomy during gastrectomy for cancer has no statistically significant impact on short-term morbidity and mortality. Even though it does not show benefit in terms of 5-year overall survival rates it might be performed when needed in more advanced cases in properly selected patients (e.g. upper gastric T3/4 gastric cancer)
EN
The effects of extracellular K⁺ in relation to extracellular Ca²⁺ on acid production were studied. Studies were performed in vitro using isolated cells from rat stomachs, and acid production was indirectly determined by ¹⁴C-aminopyrine (AP) accumulation. In the absence of K⁺ in the incubation medium histamine-stimulated AP accumulation ratios were significantly decreased independently in the presence or absence of extracellular Ca²⁺. Under basal conditions, in the absence of extracellular Ca²⁺ , increasing concentrations of extracellular K⁺ enhanced AP accumulation ratios to significantly higher than those found in the presence of Ca²⁺. In histamine-, cAMP-, and carbachol-stimulated parietal cells, high K⁺ concentrations increased AP accumulation significantly less in Ca²⁺-free than in Ca²⁺-containing media. High K⁺ also induced significantly both an increase in cytosolic free Ca²⁺ concentration and ⁴⁵ Ca²⁺ uptake. The present results confirmed the importance of K⁺ in gastric acid production and suggested a role for Ca²⁺ as a modulator of mechanisms of parietal cell stimulation.
11
75%
EN
Two molecules - vascular endothelial growth factor involved in new vessels formation and survivin - antiapoptotic protein, reported to be associated with worse prognosis in various malignancies have been chosen for the study. Both are potential target for novel therapiesThe aim of the study was to determine the immunostaining of VEGF and survivin in gastric carcinoma and to analyse their relationship to the selected clinicopathological features and survival.Material and methods. Formalin-fixed, paraffin-embedded sections from 41 gastric adenocarcinomas were used for immunohistochemical reaction with monoclonal antibodies against vascular endothelial growth factor and survivin. The results were compared with selected clinicopathological features and survival.Results. Positive immunohistochemical reaction for vascular endothelial growth factor and survivin was revealed in 24 (58,53%) and 30 (73,17%), gastric carcinomas respectively. Vascular endothelial growth factor-negative gastric carcinomas were significantly more common in cases without metastases to regional lymph nodes and distant organs and in less advanced cases. Similar, distant metastases were also statistically less common in survivin-negative carcinomas. The differences in immunohistochemical reactions for survivin between less and more advanced cases almost reach statistical significance. The only factors significantly influenced 1, 2 and 3-year survival were vascular endothelial growth factor and survivin status. Statistically significant higher percentage of survival was noted in patients with vascular endothelial growth factor- and survivin-negative tumors.Conclusions. It seems that vascular endothelial growth factor and survivin play role in local invasion and spread of gastric adenocarcinoma and negatively influences survival. However, further studies are required to assess their true usefulness in the clinical practice.
EN
Fish of five species of Notothenioidei (104 specimens), Cottoperca trigloides, Patagonotothen brevicauda, P. longipes, P. tessellata and Champsocephalus esox, caught in the Beagle Channel (Magellanic sub-region, sub-Antarctica) were infected with Digenea of nine species (1130 specimens). Faunistic data on the occurrence of all nine parasites are provided. The most abundant digenean species was Macvicaria magellanica found in the intestine of three host species of the genus Patagonotothen. The second most abundant digenean species was Elytrophalloides oatesi found in the stomach of four host species, with exception of P. brevicauda. Three digenean species: Stenakron kerguelense, Whitegonimus ozoufae and Genolinea bowersi, were more abundant in fish caught at the harbor of Ushuaia (depth 7–9 m), remaining six species: M. magellanica, Neolepidapedoides subantarcticus, Postmonorchis variabilis, Derogenes varicus, E. oatesi and Lecithaster macrocotyle, in the eastern mouth of the Beagle Channel (depth 30 m).
EN
The aim of this study was the evaluation of gastric epithelial cell proliferation rate in connection with the gastric Helicobacter-like organisms (GHLO) infection in dogs. The study was performed on samples of the gastric mucosa obtained during necropsies from 60 dogs euthanasized for various reasons. Microscopic preparations were stained with the hematoxylin-eosin method, Giemsa method, Warthin-Starry silver method and immunohistochemical method (MIB-1 antibody) to investigate the expression Ki67 antigen. In glands of the gastric body and antrum different proliferation patterns were observed. The gastric epithelial cell proliferation rate in the gastric antrum was significantly higher in dogs with GHLO colonization in relation to dogs without GHLO, and in the gastric body was significantly higher in dogs with mild GHLO colonization as compared to dogs with significant GHLO colonization and without GHLO colonization. The gastric epithelial cell proliferation rate in the gastric body was significantly higher in dogs with gastritis in comparision with the dogs without gastritis irrespectively from the presence or absence of the GHLO colonization. It seems that the presence of the GHLO colonization, as well as the inflammatory state in the gastric mucosae, can alter the rate of the gastric epithelial cells proliferation in dogs.
EN
Helicobacter pylori is thought to represent a significant etiopathogenic factor in diseases of the upper gastrointestinal tract. It seems, therefore, important to elaborate effective techniques for its detection. The aim of the present study was to evaluate the effectiveness of Helicobacter pylori detection using the PCR technique on paraffin sections with various pairs of primers and to compare the results with those of a histological appraisal. Material for the studies involved 50 paraffin blocks with gastric mucosa biopsies fixed in 4% buffered formalin. In this material 4 tests were performed with the aim of diagnosing Helicobacter pylori infection: 1) H+E staining, 2) staining by the Giemsa technique, 3) an immunocytochemical technique with antibodies against H. pylori and 4) the PCR technique with various primers. In the present study the most reliable results for H. pylori detection as well as the most pronounced correlation were obtained by using the PCR technique with primers for the ureC gene, immunohistochemistry and staining according to Giemsa. Less compatible results were obtained employing the two PCR techniques which utilise various primers. The experiments confirmed the usefulness of the PCR technique in the detection of Helicobacter pylori in paraffin sections by using a suitable pair of primers, and also indicated that Giemsa staining and immunohistochemistry should be taken into account.
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