{"title":"Non-Invasive, Fast and Reliable Assessment of Age- And Gender-Related Pancreas and Liver Fat Content in Completely Healthy Individuals: Modified Dixon Method with 3 Tesla Magnetic Resonance Imaging","authors":"Feyza Yilmaz","doi":"10.15226/2374-815x/6/4/001135","DOIUrl":"https://doi.org/10.15226/2374-815x/6/4/001135","url":null,"abstract":"Method: The study enrolled a total of 62 patients aged between 20-62 years including 35 male (56.5%) and 27 female (43.5) patients as healthy liver donors who had normal BMI (18.2 25.7 kg/m2) according to Modified Dixon quantification (mDixon quant) sequence in 3 Tesla MR device. Fat content (%) and signal time value for iron (millisecond) in the liver tissue and fat content (%) in pancreas and muscle tissue were automatically quantified in the relevant areas through images. For normalization, muscle tissue was measured for the value of iron signal time. Liver segment VI, head, body and tail parts of pancreas, and two paraspinal muscles (multifidus) in the same section were quantified. Multivariate generalized linear models were used to test significant differences in fat contents and iron signal time values between age subgroups.","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83575077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adequacy of Bowel Wall Distension in Patients Undergoing CT Enterography: A Radiologist's Perspective","authors":"Md. Khizer Razak, Meena Gl","doi":"10.15226/2374-815X/6/4/001134","DOIUrl":"https://doi.org/10.15226/2374-815X/6/4/001134","url":null,"abstract":"The evaluation of patients with suspected small bowel disease, particularly in inflammatory bowel disease (IBD), has always been challenging because of the small bowel length and location. Capsule endoscopy has the advantage of direct visualization of the bowel lumen, but it is relatively contraindicated in the presence of strictures and has limited ability to assess extraluminal abnormality [1]. CT enteroclysis, another modality of small bowel imaging, requires fluoroscopic placement of a naso-jejunal tube to infuse contrast material; therefore, it has the disadvantages of poor patient tolerance associated with nasojejunal tube insertion and additional radiation exposure during the examination [2, 3]. Abstract","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84055820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Subramaniam, Senthil K. Perumal, Kamalakannan Rajendran, Saravanan Janakiraman, Thiruvarul Muthu kumarasamy, J. Sathyanesan, S. Jayachandran, R. Palaniappan
{"title":"An Interesting Presentation of Ameboma – A Case Report and Review of Literature","authors":"S. Subramaniam, Senthil K. Perumal, Kamalakannan Rajendran, Saravanan Janakiraman, Thiruvarul Muthu kumarasamy, J. Sathyanesan, S. Jayachandran, R. Palaniappan","doi":"10.15226/2374-815x/6/4/001133","DOIUrl":"https://doi.org/10.15226/2374-815x/6/4/001133","url":null,"abstract":"Entamoeba histolytica infection is common in developing countries due to the poor environment as well as in developed countries among travellers from highly endemic regions and among the immunocompromised population, including patients with AIDS or receiving organ transplantation [1]. Most patients with E. histolytica infection are asymptomatic, comprising about 90% of those infected [2]. Gastrointestinal presentations of E. histolytica infections range from asymptomatic (carrier) to colitis and the formation of abscesses and intestinal perforations. Amebomas are mostly located in the cecum and the ascending colon and can mimic cecal carcinomas [3]. The diagnostic approach of ileocecal masses includes ruling out other infectious and noninfectious causes. It usually manifests with lower gastrointestinal bleeding or bowel obstruction. Here we present Abstract","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86906752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Bleibel, Saad Saleem, W. Saad, S. Caldwell, A. Al-Osaimi
{"title":"Laboratory Predictors of Risk for Developing Hepatocellular Carcinoma in Cirrhosis","authors":"W. Bleibel, Saad Saleem, W. Saad, S. Caldwell, A. Al-Osaimi","doi":"10.15226/2374-815x/6/3/001132","DOIUrl":"https://doi.org/10.15226/2374-815x/6/3/001132","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the most common primary liver malignancy worldwide accounting for around 600,000 deaths every year and its incidence has been rising in many countries [1]. In men, it is the fifth most frequently diagnosed cancer worldwide, and the second leading cause of cancerrelated death. In women, it is the seventh most common cancer and the sixth cause of cancer-related death. Despite of significant advances in diagnosis and management, HCC continues to carry a very high case fatality rate [2, 3].","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85048181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyawzaw Lin, J. Sargi, Aung Naing Lin, La Min Phyu, K. Myint
{"title":"A Rare but Fetal Complication of PEG: Buried Bumper Syndrome (BBS)","authors":"Kyawzaw Lin, J. Sargi, Aung Naing Lin, La Min Phyu, K. Myint","doi":"10.15226/2374-815x/6/3/001130","DOIUrl":"https://doi.org/10.15226/2374-815x/6/3/001130","url":null,"abstract":"Buried Bumper Syndrome (BBS) is defined as migration of inner bumper (fixating internal part of PEG) along the stoma channel. The bumper may be partially covered by over-growth mucosa or completely dislodged outside the gastric wall. Complete BBS without visible part of inner pumper can be a challenge for endoscopic management. Here, we present a 72yearold nursing home resident with complete BBS.","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"66 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77432549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Yasutake, K. Ohe, K. Imai, Yusuke Murata, M. Enjoji
{"title":"Nutritional Dietary Approach for NAFLD: Carbohydrate Restriction or Fat Restriction","authors":"K. Yasutake, K. Ohe, K. Imai, Yusuke Murata, M. Enjoji","doi":"10.15226/2374-815x/6/3/001129","DOIUrl":"https://doi.org/10.15226/2374-815x/6/3/001129","url":null,"abstract":"","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75407692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyawzaw Lin, P. Patel, Michael Xian Wen Liauw, P. P. Hlaing, L. Yoe
{"title":"Dysphagia with Schatzki Ring or Steakhouse Syndrome: Better to Scope than to Watch","authors":"Kyawzaw Lin, P. Patel, Michael Xian Wen Liauw, P. P. Hlaing, L. Yoe","doi":"10.15226/2374-815X/6/3/001128","DOIUrl":"https://doi.org/10.15226/2374-815X/6/3/001128","url":null,"abstract":"A Schatzki ring (SR) is a thin symmetric circumferential constriction composed of mucosa and submucosa at the gastroesophageal junction. It was first described by Schatzki and Gary in 1953 [1]. The incidence was approximately 6% to 14%. SR is the most common cause of chronic episodic dysphagia in adults [1, 2]. Here, we present the case of an 82-year-old healthy man with six months of episodic dysphagia with an SR.","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78982053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anti-Fibrotic Potential of All Trans Retinoic Acid in Inflammatory Bowel Disease.","authors":"Dominick L Auci, Nejat K Egilmez, Gerald W Dryden","doi":"10.15226/2374-815X/6/3/001126","DOIUrl":"https://doi.org/10.15226/2374-815X/6/3/001126","url":null,"abstract":"Inflammatory bowel disease (IBD) embraces Crohn’s disease (CD), ulcerative colitis (UC) and the less common indeterminate colitis, all chronic inflammatory processes of the gastrointestinal (GI) tract. Together, they cause significant morbidity for a million and a half Americans [1]. Symptoms include diarrhea, nausea, abdominal pain, weight loss, which can occasionally prove fatal (i.e., toxic megacolon, perforated bowel) [2]. Patients are also at increased risk for colorectal cancer [3]. First line treatments, including various anti-inflammatory agents and antibiotics, are variably effective against active disease [4]. Remissions can be short-lived and uncontrolled activity is associated with significant side-effects [3]. Gut fibrosis will require most patients (80% and 45% of CD and UC patients, respectively) to undergo surgery [4]. Over the last decade, the so-called biological response modifiers or ‘biologics’, macromolecules that target inflammatory lymphocytes or the cytokines they produce, have emerged as effective therapeutic agents [5]. For example, infliximab, a chimeric anti-human tumor necrosis factor (TNF)-α antibody earned FDA approval almost 20 years ago, based on a high response rate, significant mucosal and fistula healing and long-term remissions in both CD and UC. Additional targets of biologics, either marketed or in various stages of development, include anti-p40, anti-p19, anti-interleukin (IL)-12/23, and anti-alpha 4/beta 7 integrin antibodies [5, 6]. However, an estimated 30% of patients will not respond to such treatments, and of those who initially respond, 50% will relapse within a year risking significant, often serious side effects including infections and increased risk of cancer. So far, biologics have had only a modest impact on surgery rates [7]. The need for novel therapies remains acute. \u0000 \u0000Literature reports indicate that All trans retinoic acid (ATRA) provides benefit in various rodent models of IBD, including potential anti-fibrotic activity [8, 9]. Retinoic acid can exist in the body as any of five different chemical isomers (all-trans-RA, 9-cisRA, 13-cisRA, 11-cisRA and 9, 13-dicisRA). ATRA is the biologically active isomer and the primary enzymatic product of retinaldehyde oxidation. The retinoic acid family regulates a wide range of biological processes, including embryonic development, reproduction, vision, cell growth and differentiation, as well as, apoptosis and inflammation [10]. Topical ATRA is known as tretinoin, and is currently marketed under several trade names such as Retin-A®, Retin-A Micro®, Atralin®, Renova®, and Avita® as FDA approved topical treatment for acne and skin wrinkles. Oral formulations, called isotretinoin (Accutane®, Claravis®, Sotret® and Amnesteem® and Vesanoid®) can cure severe acne and treat acute promyelocytic leukemia (APL), but oral dosing induces more severe side effects. Isotretinoin has not been tested in IBD clinical trials, perhaps due to the serious side effects as","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366833/pdf/nihms-983043.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36544778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremy Wang, Jihane N Benhammou, Kevin Ghassemi, Stephen Kim, Alireza Sedarat, James Farrell, Joseph R Pisegna
{"title":"Endoscopic Ultrasound-Guided Fine Needle Aspiration Accurately Diagnoses Smaller Pancreatic Neuroendocrine Tumors Compared To Computer Tomography-Guided Fine Needle Aspiration.","authors":"Jeremy Wang, Jihane N Benhammou, Kevin Ghassemi, Stephen Kim, Alireza Sedarat, James Farrell, Joseph R Pisegna","doi":"10.15226/2374-815X/4/2/00186","DOIUrl":"https://doi.org/10.15226/2374-815X/4/2/00186","url":null,"abstract":"<p><strong>Introduction: </strong>The role of EUS-guided FNA as a highly sensitive modality in the diagnosis of pancreatic adenocarcinoma is well documented. However, there is little published data on the role of EUS-FNA in diagnosing pancreatic neuroendocrine tumors (NETs).</p><p><strong>Objective: </strong>The aim of this study is to compare the sensitivity of EUS-FNA to that of CT-FNA for diagnosing pancreatic NETs.</p><p><strong>Methods: </strong>This is a single institution retrospective analysis of the operating characteristics of EUS-FNA and CT-FNA in detecting pancreatic NETs. Only patients with a final diagnosis of pancreatic NET were selected for this study. Procedure related data, including tumor size and location, and presence of a cytotechnologist were recorded. The results of each FNA were compared to the final clinico-pathological diagnosis to calculate sensitivity.</p><p><strong>Results: </strong>Twenty-eight patients undergoing FNA (19 by EUS, 9 by CT) were analyzed. NETs diagnosed by EUS-FNA were smaller compared with CT-FNA (2.7 ± 0.9cm vs. 6.5 ± 2.1cm, p = 0.009) and were more often found in the pancreatic head (47.4% vs. 11.1%, p = 0.035). There were no significant differences in sensitivity between EUS-FNA and CT-FNA specimens (73.7% vs. 88.9%, p = 0.33).</p><p><strong>Conclusion: </strong>EUS-guided FNA is as sensitive as CT-guided FNA in diagnosing pancreatic NETs, but its main advantage is in the diagnosis of smaller pancreatic NETs in the head of the pancreas. It may also be the preferred approach in the diagnosis of multifocal pancreatic NETs in the setting of MEN I Syndrome.</p>","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"4 2","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5837075/pdf/nihms895252.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35892044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Murli Manohar, Alok K Verma, Sathisha Upparahalli Venkateshaiah, Anil Mishra
{"title":"Significance of Eosinophils in Promoting Pancreatic malignancy.","authors":"Murli Manohar, Alok K Verma, Sathisha Upparahalli Venkateshaiah, Anil Mishra","doi":"10.15226/2374-815X/5/1/001109","DOIUrl":"https://doi.org/10.15226/2374-815X/5/1/001109","url":null,"abstract":"<p><strong>Background: </strong>Several reports indicate that eosinophils are induced in chronic pancreatitis including patients with pancreatic malignancy. However, significance of eosinophilic pancreatitis (EP) is poorly understood and unexplored.</p><p><strong>Aim: </strong>Accumulation and degranulation of eosinophils promote pancreatic fibrosis and malignancy.</p><p><strong>Method: </strong>Human pancreatic tissue biopsy samples including chronic pancreatitis (n=3), malignant (n=4), non-malignant (n=3), and normal (n=3) were used for H&E, anti-MBP staining, anti-tryptase staining, anti-IgE staining and Mason's trichrome staining.</p><p><strong>Results: </strong>We show induced eosinophils and degranulated eosinophils indicated by the presence of anti-MBP stained extracellular granules in the malignant pancreatic (pancreatic cancer) and non-malignant human pancreatic tissues. A comparable number of eosinophils were observed in non-malignant and malignant pancreatic tissue sections, but the sections differed in degranulated eosinophils and the presence of extracellular granules. Additionally, induced mast cells and tissue-specific IgE positive cells were also detected in the tissue sections of malignant pancreatitis patients compared to non-malignant human pancreatic patients. Tissue-specific IgE induction is critical for the degranulation of eosinophils and mast cells that may lead to increased accumulation of collagen in malignant compared to non-malignant human pancreatic tissue samples. We show a large number of anti-tryptase stained extracellular granules in the tissue sections of malignant pancreatic cancer patients. Both IgE and eosinophil major basic proteins (MBP) are reported for the activation and degranulation of mast cells in tissues.</p><p><strong>Conclusion: </strong>Taken together, our investigation concludes that eosinophils and mast cells accumulation and degranulation are critical in promoting pancreatitis pathogenesis that may lead to the development of pancreatic fibrosis and malignancy.</p>","PeriodicalId":90898,"journal":{"name":"Journal of gastroenterology, pancreatology & liver disorders","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5945222/pdf/nihms910856.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36094745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}