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No literature is available regarding the possible presence of specialized intestinal metaplasia of the esophagus as a consequence of chronic reflux in adult celiac patients. Our purpose was to evaluate endoscopically and histologically the esophagi of a group of untreated celiac patients.

The distal esophagus was evaluated and multiple biopsies were taken. Hematoxylin-eosin and alcian blue stainings were performed. A group of nonceliac, age- and sex-matched patients was used as a control. We found intestinal metaplasia in the distal esophagus of 16 of 60 Among the celiac group with metaplasia , only one patient had reflux-like symptoms. None had esophagitis.

In conclusion, we observed an increased prevalence of esophageal metaplasia in patients with celiac disease. This finding could be the result of motor abnormalities leading to chronic acid reflux, combined with a mucosa which is sensitive to gliadin. Squamous metaplasia of the rete ovarii in a Zebu cow. Background Stratified keratinizing squamous epithelium in the ovary has been associated with the diagnosis of ovarian teratoma in cows. A case of squamous metaplasia of the rete ovarii in a Zebu cow is described in this report.

Case presentation A crossbreed Zebu cow had both ovaries enlarged with multiple cysts. Most cysts were lined by well differentiated keratinizing stratified squamous epithelium and filled with keratinized lamellar material. Some cysts were lined by an epithelial layer that ranged from single cuboidal, double cuboidal epithelium, stratified non keratinized epithelium, and areas of keratinizing stratified squamous epithelium.

Single or double layered cuboidal epithelia of the cysts expressed low molecular weight cytokeratin 7, whose expression was absent in the keratinizing stratified squamous epithelia of same cysts. Conversely, high molecular weight cytokeratins 1, 5, 10, and 14 were strongly expressed by the keratinizing stratified epithelium. Conclusion Squamous metaplasia of the rete ovarii was diagnosed. Squamous metaplasia of the rete ovarii, may account for some of the previously described squamous lesions in the ovary, which may have been misinterpreted as teratoma or epidermoid cysts.

Both environmental pollution and smoking affect the respiratory epithelium, causing cellular adaptation changes. Therefore, this work explores the presence of metaplasia in smokers compared with non-smokers from Mexico City. A prospective cohort study was performed. The sample was performed through a home interview covering the five Mexico City zones delimited to the study and monitoring of air quality.

We searched metaplastic cells and inflammation in sputum cytology stained with Papanicolaou technique, and we assessed the air quality in Mexico City. We calculated relative risk RR and attributable risk AR in relation to the presence of metaplasia and smoking. We performed home interviews obtaining a final sample of 30 participants.

The RR in association with the presence of metaplasia in sputum cytology and smoking was 1. The air quality in this city has led the population to undergo changes of cellular adaptation in the respiratory epithelium by the simple fact of being exposed to environmental pollution. Metaplastic changes in non-smokers suggest strongly that pollution causes the same effect as smoking.

Mucinous metaplasia of the endometrium occurs as a spectrum of epithelial alterations ranging from the formation of simple, tubular glands to architecturally complex glandular proliferation with intraglandular papillary projection and cellular tufts. Endometrial mucinous metaplasia often presents a diagnostic challenge in endometrial curettage. We analyzed the clinicopathological characteristics and the mutation status for V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog KRAS of 11 cases of endometrial mucinous metaplasia.

Electronic medical record review and histopathological examination were performed. KRAS mutation status was analyzed using a pyrosequencing technique. Papillary mucinous metaplasia is frequently associated with endometrial neoplastic lesions. The high incidence of KRAS mutations in papillary mucinous metaplasia suggests that papillary mucinous metaplasia may be a precancerous lesion of a certain subset of mucinous carcinomas of the endometrium.

George J. Delinasios , All rights reserved. Mucinous metaplasia of the vulva in a case of lichen sclerosus. A case report. Mucinous metaplasia of the genital area is a rare condition characterised by the emergence of mucin containing cells in stratified squamous epithelium. This report describes a unique case of benign mucinous metaplasia of the vulva associated with lichen sclerosus in a 60 year old woman. Histopathology revealed cervical type metaplasia with otherwise typical lichen sclerosus.

This report discusses the pathogenesis and differential diagnosis of mucinous epithelium. Esophageal adenocarcinoma develops in the setting of gastroesophageal reflux and columnar metaplasia in distal esophagus. Columnar metaplasia arising in gastroesophageal reflux models has developed in rat; however, gastroesophageal reflux models in mice have not been well-characterized. The animals were euthanized after 40 weeks and the histology of the junction was examined.

CDX-2 was positive in all cases of metaplasias , but decreased in some cases of dysplasia. No metaplasia developed in the EJ model in which gastric juice and duodenal content mixed before reflux. Thus, duodenal contents alone can induce columnar metaplasia and dysplasia; however, the combination of gastric acid with duodenal content reflux can cause metaplasia and dysplasia more efficiently.

The cartilage and bone metaplasia occurring in both the heart and blood vessels, are the result of risk factors or chronic diseases that gradually adversely affect the performance of a person in society; however, clinical signs are reversible in early and intermediate stages of alterations. To establish how the molecular mechanisms underlying the increased vascular metaplastic changes and possible aspects of treatment and prevention.

A systematic review was performed by searching for articles indexed in PubMed, Scopus and Science Direct data from to The MeSH descriptors used were metaplasia and vascular calcification, which terms associated were molecular mechanisms, condrogenic and osteogenic. Multiple factors influence the metaplastic change, especially the pro-inflammatory associated with vascular oxidation and the presence of free radicals; this development is reversible by treatment with antioxidants and changes in lifestyle and secondary prevention as there is a diagnosis of chronic degenerative disease.

Long-term Helicobater pylori infection results in atrophic gastritis and intestinal metaplasia , and increases the risk of gastric cancer. However, it is still controversial that eradication of H. Therefore, we investigated histological changes after the H. One hundred seven patients who received successful eradication of H.

Antral biopsy was taken before the eradication to confirm the H. After a certain period of time, antral biopsy was repeatedly taken to confirm the eradication and investigate histological changes of atrophy or metaplasia.

Mean age of the patients was Endoscopic diagnosis included gastric ulcer, duodenal ulcer, non-ulcer antral gastritis. Atrophy was observed in 41 of 91 and their average score was 0. After the eradication of H. However, metaplasia which was observed in 49 of , did not significantly improve during the follow-up period. Newly developed atrophy 7 of 38 or metaplasia 18 of 49 was observed in patients who without atrophy or metaplasia initially.

Their average scores were slightly lower than those of cases with pre-existing atrophy or metaplasia without statistical significance. Distribution and ultrastructural characteristics of dark cells in squamous metaplasias of the respiratory tract epithelium.

Dark epithelial basal cells were found in both carcinogen-induced and non-carcinogen-induced squamous metaplasias of the tracheal epithelium. In the atypical metaplasias induced by DMA this percentage increased to On the basis of ultrastructural observations, five types of dark epithelial cells could be distinguished in the metaplastic epithelia: Type I ovoid or fusiform dark cell with abundant cytoplasmic filaments, desmosomes, and free ribosomes--dark keratinocyte type ; Type II ovoid or spherical small cell with scant cytoplasm with few organelles--basal respiratory type ; Type III irregular or ovoid, few cytoplasmic filaments and organelles and desmosomes, extremely abundant free ribosomes--dedifferentiated type ; Type IV fusiform or ovoid, large mitochondria, prominent ergastoplasm, secretion droplets--mucous cell type ; and type V irregular shape, organelle remnants, vacuoles, pyknotic nuclei--involutional-cell type.

Type I was the predominant cell type in formaldehyde-induced metaplasias and was also commonly seen in DMBA-induced metaplasias without atypia. Type II predominated in metaplasias induced by vitamin A deficiency. Type IV cells. Multiple factors are involved in the developmental process of OM with mucoid effusion, especially disorders of mucin production resulting from middle ear bacterial infection and Eustachian tube dysfunction. In this review, we will focus on several aspects of this disorder by analyzing the cellular and molecular events such as mucin production and mucous cell differentiation in the middle ear mucosa with OM.

In addition, infectious agents, mucin production triggers, and relevant signaling pathways will be discussed. Evolving management of metaplasia and dysplasia in Barrett's epithelium. Oesophageal cancer affects more than people worldwide and despite continued medical advancements the incidence of oesophageal cancer is increasing.

Currently diagnosis the of Barrett's oesophagus is predominantly made after endoscopic visualisation and histopathological confirmation. Minimally invasive techniques are being developed to improve the viability of screening programs. The management of Barrett's oesophagus can vary greatly dependent on the presence and severity of dysplasia.

There is no consensus between the major international medical societies to determine and agreed surveillance and intervention pathway. In this review we analysed the current literature to demonstrate the evolving management of metaplasia and dysplasia in Barrett's epithelium. Squamous metaplasia refers to the pathological transformation of the urothelium leading to nonkeratinised stratified squamous metaplasia N-KSM.

To present our experiences in the diagnosis and treatment of N-KSM of the urinary bladder in children. Materials and Methods. In this study, we present our experiences in the diagnosis and treatment of N-KSM of the urinary bladder in children aged from 5 to 17 years.

From to , metaplasia was diagnosed in patients. The reasons behind visiting the hospital were nonspecific intense pain in the abdomen, recurrent urinary tract infections, and urination disorders. The most common symptoms of urinary bladder dysfunction were pollakiuria and difficulties in initiating micturition and retention of urine reduced detrusor muscle activity.

The changes characteristic for squamous metaplasia were diagnosed—in all these patients, a biopsy was performed. In all patients, a squamous metaplasia was histopathologically diagnosed. Squamous metaplasia of the urinary bladder mucosa occurs in children and adolescents. Symptomatic treatment is administered mainly to improve the patients' quality of life and disease prognosis.

Gastric intestinal metaplasia with basal gland atypia: a morphological and biologic evaluation in a large Chinese cohort. Gastric intestinal metaplasia can display cytoarchitectural atypia that falls short of qualifying for dysplasia but can be classified as indefinite for dysplasia. Yet few studies have evaluated the prevalence, the morphologic, and biologic characteristics of this variant.

The relationship between the subtypes and various clinicopathologic features, mucin immunophenotypes, and biologic characteristics was evaluated. The final cohort consisted of cases of simple intestinal metaplasia , 93 intestinal metaplasia with hyperplasia, 16 intestinal metaplasia with basal gland atypia, and 21 gastric dysplasia. Intestinal metaplasia with basal gland atypia had a prevalence of 2.

Alternatively, simple intestinal metaplasia and intestinal metaplasia with hyperplasia did not differ statistically with regard to the various characteristics evaluated. We concluded that gastric intestinal metaplasia can be divided into 2 broad categories that are readily defined by cytoarchitectural and biologic characteristics. Based on the characteristics of intestinal metaplasia with basal gland atypia and in keeping with others, we confirm that this subtype could represent a preneoplastic lesion that needs further evaluation.

Chronic gastritis with intestinal metaplasia : clinico-statistical, histological and immunohistochemical study. Chronic gastritis has a high incidence in adults, causing progressive destruction of glandular structures, favoring the development of gastric atrophy. The association of chronic gastritis with intestinal type metaplasia of gastric mucosa has a poor outcome as intestinal metaplasia is regarded as a precancerous lesion. Metaplasia is common in patients with Helicobacter pylori infection and also heavy smokers.

The aim of our study was to evaluate the relationship between chronic gastritis and intestinal metaplasia. The study was conducted on a total of patients, aged between 5 and 90 years, who presented for dyspeptic disorders in the period and were examined clinically and endoscopically.

During the gastroscopic examination, fragments of gastric mucosa were collected for the histopathological study and for highlighting the H. A diagnosis of gastritis was established in patients, representing approximately Most cases with gastritis were found in people of middle age. Gastritis was present in almost all age groups, from teenagers to the elders. Of the cases of gastritis, urease test was positive in patients, representing approximately Histopathological examination identified the presence of intestinal metaplasia in PCNA immunohistochemistry revealed that cell proliferation processes are intensified in intestinal metaplasia.

This study highlights the importance of chronic gastritis, intestinal metaplasia , and H. Molecular defense mechanisms of Barrett's metaplasia estimated by an integrative genomics. Barrett's esophagus is characterized by the replacement of squamous epithelium with specialized intestinal metaplastic mucosa.

The exact mechanisms of initiation and development of Barrett's metaplasia remain unknown, but a hypothesis of "successful adaptation" against noxious reflux components has been proposed. To search for the repertoire of adaptation mechanisms of Barrett's metaplasia , we employed high-throughput functional genomic and proteomic methods that defined the molecular background of metaplastic mucosa resistance to reflux. Transcriptional profiling was established for 23 pairs of esophageal squamous epithelium and Barrett's metaplasia tissue samples using Affymetrix UA 2.

Differences in protein composition were assessed by electrophoretic and mass-spectrometry-based methods. Among 2, genes differentially expressed between Barrett's metaplasia and squamous epithelium, we observed significantly overexpressed metaplastic mucosa genes that encode cytokines and growth factors, constituents of extracellular matrix, basement membrane and tight junctions, and proteins involved in prostaglandin and phosphoinositol metabolism, nitric oxide production, and bioenergetics.

Their expression likely reflects defense and repair responses of metaplastic mucosa, whereas overexpression of genes encoding heat shock proteins and several protein kinases in squamous epithelium may reflect lower resistance of normal esophageal epithelium than Barrett's metaplasia to reflux components.

Despite the methodological and interpretative difficulties in data analyses discussed in this paper, our studies confirm that Barrett's metaplasia may be regarded as a specific microevolution allowing for accumulation of mucosal morphological and physiological changes that better protect against reflux injury.

Apocrine hidradenocarcinoma showing Paget's disease and mucinous metaplasia. A year-old man presented with a solitary, erythematous, rapidly growing 1-cm nodule on his scalp that had arisen over the previous 3 months. He had no history of skin cancer. An excisional biopsy of the lesion showed a fairly well-circumscribed but focally invasive tumor consisting of areas of typical-appearing clear cell hidradenoma as well as areas with mucinous goblet-type cells and cells with eosinophilic cytoplasm and decapitation-type secretion.

There was marked cellular atypia, numerous atypical mitotic figures and focal necrosis. The tumor cells focally involved the overlying epidermis Paget's disease. Large areas of mucin were identified throughout the lesion. The tumor cells stained with markers for cytokeratin 7 and focally for EMA and CEA, confirming ductal differentiation.

The goblet cells and mucinous areas stained with mucicarmine and PASD. The patient was diagnosed with hidradenocarcinoma with mucinous differentiation. Associated Paget's disease has only rarely been reported, and mucinous metaplasia is a previously unreported feature in hidradenocarcinoma. Oncocytic metaplasia in inflammatory fibrous hyperplasia: Histopathological and immunohistochemical analysis. Oncocytic metaplasia OM is not a well-known feature in inflammatory fibrous hyperplasia IFH lesions, although it may be common, as proposed in our previous study about this lesion.

In the present paper, we assessed the histopathological and immunohistochemical features of 18 cases of IFH containing OM areas. These findings suggest that oncocytic cells present in IFH might develop from salivary duct epithelium, and T-lymphocytes might play an important role in its etiopathogenesis.

Intestinal metaplasia in Barrett's oesophagus: An essential factor to predict the risk of dysplasia and cancer development. To date, there is still uncertainty on the role of specialized intestinal metaplasia in the carcinogenic process of Barrett's oesophagus BE ; this fact seems of importance for planning adequate surveillance programs.

For each patient, all histological reports performed during a follow-up of years were analyzed. The histological identification of intestinal metaplasia seems to be an essential factor for the progression towards dysplasia and cancer in BE patients. Published by Elsevier Ltd. All rights reserved. Wang, David H. Recognizing that Hedgehog signaling is required for early esophageal development, we sought to determine if the Hedgehog pathway is reactivated in Barrett's esophagus, and if genes downstream of the pathway could promote columnar differentiation of esophageal epithelium.

Methods Immunohistochemistry, immunofluorescence, and quantitative real-time PCR were used to analyze clinical specimens, human esophageal cell lines, and mouse esophagi. Human esophageal squamous epithelial HET-1A and adenocarcinoma OE33 cells were subjected to acid treatment and used in transfection experiments. Swiss Webster mice were used in a surgical model of bile reflux injury. An in vivo transplant culture system was created using esophageal epithelium from Sonic hedgehog transgenic mice.

Results Marked upregulation of Hedgehog ligand expression, which can be induced by acid or bile exposure, occurs frequently in Barrett's epithelium and is associated with stromal expression of the Hedgehog target genes PTCH1 and BMP4. BMP4 signaling induces expression of SOX9, an intestinal crypt transcription factor, which is highly expressed in Barrett's epithelium. Finally, transgenic expression of Sonic hedgehog in mouse esophageal epithelium induces expression of stromal Bmp4, epithelial Sox9 and columnar cytokeratins.

Conclusions Epithelial Hedgehog ligand expression may contribute to the initiation of Barrett's esophagus through induction of stromal BMP4, which triggers reprogramming of esophageal epithelium in favor of a columnar phenotype. Metaplasia can result when injury reactivates latent developmental signaling pathways that determine cell phenotype.

Hedgehog Hh signaling is active in columnar-lined, embryonic esophagus and inactive in squamous-lined, adult esophagus. By microarray analysis, we found that the transcription factor Foxa2 is more highly expressed in murine embryonic esophagus compared with postnatal esophagus.

Hacking cell differentiation: transcriptional rerouting in reprogramming, lineage infidelity and metaplasia. Initiating neoplastic cell transformation events are of paramount importance for the comprehension of regeneration and vanguard oncogenic processes but are difficult to characterize and frequently clinically overlooked.

In epithelia, pre-neoplastic transformation stages are often distinguished by the appearance of phenotypic features of another differentiated tissue, termed metaplasia. Here we compare the similarity between molecular events of experimental cell trans-differentiation as an emerging therapeutic concept, with lineage confusion, as in metaplasia and dysplasia forecasting tumour development.

Clear cell renal cell carcinoma with osseous metaplasia : Rare case report. Osseous metaplasia with clear cell renal cell carcinoma RCC is exceedingly rare. There are less than 20 reported cases of osseous metaplasia in association with RCC. We present a case of year-old male patient presented to outpatient department with complaints of pain in the left lumbar region since 4 years.

Computed tomography scan revealed a heterogeneous enhanced mass lesion having areas of necrosis and specks of calcification involving the left kidney. Clinicoradiological diagnosis of RCC was made and left radical nephrectomy was performed. Histological sections from the growth revealed features of clear cell carcinoma Fuhrman grade-2 with a focal area of metaplastic bone formation. The prognostic implications of calcification per se are not very clearly mentioned in the literature.

Patients with osseous metaplasia generally present with early stage disease and a favorable prognosis. However, few of them were of high grade and poorer prognosis. Canine breeds associated with gastric carcinoma, metaplasia and dysplasia diagnosed by histopathology of endoscopic biopsy samples. Gastric carcinoma GC is a rather rare pathological finding in dogs, with the exception of some breeds which seem predisposed.

The etiopathogenesis is largely unknown in dogs, whereas in humans GC often develops from gastric mucosal metaplasia and dysplasia. This study investigates whether dogs of certain breeds are more often subject to gastroduodenoscopy GDS , and diagnosed with GC, mucosal metaplasia or dysplasia. A retrospective clinical database search was performed at the Veterinary Teaching Hospital at the University of Helsinki, Finland.

Between and , from a total of canine patients presented, dogs underwent GDS. Inclusion criteria were met in dogs of 20 different pure breeds. Fourteen dogs of eight breeds had gastric mucosal metaplasia or dysplasia. A log-binomial statistical model revealed that dogs in the following breeds had a significantly higher probability to undergo GDS than the others in the study population: Australian Terrier, Belgian Tervuren, Cairn Terrier, Collie and Siberian Husky. The results indicate a very low incidence of GC in dogs.

The Belgian Tervuren, however, appears as predisposed. The histopathologic descriptions of mucosal changes such as metaplasia and dysplasia were also rare, but were more frequent in the. The origin of pre-neoplastic metaplasia in the stomach: Chief cells emerge from the Mist.

Goldenring, James R. The digestive-enzyme secreting, gastric epithelial chief zymogenic cell is remarkable and underappreciated. Here, we discuss how all available evidence suggests that mature chief cells in the adult, mammalian stomach are postmitotic, slowly turning over cells that arise via a relatively long-lived progenitor, the mucous neck cell, The differentiation of chief cells from neck cells does not involve cell division, and the neck cell has its own distinct pattern of gene expression and putative physiological function.

Thus, the ontogeny of the normal chief cell lineage exemplifies transdifferentiation. Especially in the presence of inflammation, this metaplastic lineage can regain proliferative capacity and, in humans may also further differentiate into intestinal metaplasia.

The results indicate that gastric fundic lineages display remarkable plasticity in both physiological ontogeny and pathophysiological pre-neoplastic metaplasia. Mechanisms of asbestos-induced squamous metaplasia in tracheobronchial epithelial cells. Within 1 to 4 weeks after exposure to asbestos, differentiated rodent and human tracheobronchial epithelial cells in organ culture undergo squamous metaplasia , a putative preneoplastic lesion characterized by conversion of mucociliary cell types to keratinizing cells.

The exogenous addition of retinal acetate RA to culture medium of hamster tracheal organ cultures reverses preestablished, asbestos-induced squamous metaplasia , although data suggest that the effectiveness of RA decreases as the length of time between exposure to asbestos and initial application of RA increases.

Basal cell hyperplasia and increased incorporation of 3H-thymidine by tracheal epithelial cells also are seen after addition of the polyamines, putrescine or spermidine, to tracheal organ cultures, an observation supporting the importance of polyamines in the development of this lesion. Degree of neutrophil, atrophy, and metaplasia intestinal were associate with malondialdehyde level in gastritis patients.

The main pathogenesis of gastritis is inflammation that closely related to free radicals. Malondialdehyde MDA is a free radical biomarker and is found to increase in gastritis patients. However, these studies are generally performed on experimental animals as well as MDA examination in gastric mucosa. This study aim was to determine the association of degrees of gastritis degree of lymphocyte infiltration, neutrophil activity, atrophy, and intestinal metaplasia with plasma MDA level.

A cross-sectional study of 80 consecutive gastritis patients who came to an endoscopic unit of Adam Malik General Hospital in Medan, Indonesia, from May—September Assessed for severity of chronic inflammatory, neutrophil activity, atrophy, and intestinal metaplasia refers to Updated Sydney System. Univariate analysis, bivariate chi-square and Fisher exact test , and multivariate binary logistic regression test were programmed with SPSS version There was no significant association between degree of lymphocyte infiltration with MDA level.

Ectopic ossification presenting as osteoid metaplasia in a salivary mucocele in a Shih Tzu dog. Background Salivary mucocele is an accumulation of saliva in a single or multiloculated cavity lined by connective tissue that is contiguous to a salivary gland-duct complex and is the most common condition affecting the salivary glands in dogs.

Occasionally, different types of metaplastic lesions, such as squamous and osseous metaplasia - which are rare lesions in animals - can be observed in association with salivary mucocele. Case presentation A right facial enlargement was suddenly observed in a 4-year-old non-spayed female Shih-Tzu dog. The lesion presented itself as a soft and fluctuant mass located in the right side of the face near to the neck.

Histologically, the mass consisted of a cavitary formation without an epithelial lining. Additionally, microscopic examination revealed the presence of osteoid-producing cells which gave rise to areas of bone formation, probably induced by irritation due to the presence sialoliths. Such cells and bone formations were also present in the cavity wall, consequently leading us to classify the condition as a salivary mucocele with osseous metaplasia.

Conclusions In the present case, the pathogenesis was probably associated with the presence of sialoliths, which can behave as etiological agents for the metaplastic lesion. The occurrence of osteoid metaplasia is a rare peculiar condition in the canine salivar y gland, and due to the rarity and lack of information about this specific disease, no clinical data can yet be associated with the development of salivary mucocele with osseous metaplasia in dogs. Squamous metaplasia is a common pathologic condition in ocular surface diseases for which there is no therapeutic medication in clinic.

Human conjunctival explants were cultured for up to 12 days under airlifting conditions. Pterygium clinical samples were cultured under airlifting conditions with or without APR for 4 days. Airlift conjunctival explants resulted in increased stratification and intrastromal epithelial invagination. Such pathology was accompanied by increases in K10, K14, and p63 expression, whereas K19 and Pax6 levels declined when compared to those in freshly isolated tissue. Furthermore, K19 and Pax6 increased along with rises in goblet cell density.

These effects of APR were accompanied by near restoration of normal conjunctival epithelial histology. APR also reversed squamous metaplasia in pterygial epithelium that had developed after 4 days in ex vivo culture. Reductions in squamous metaplasia induced by APR suggest it may provide a novel therapeutic approach in different squamous metaplasia -associated ocular surface diseases.

Sousa, Josane F. Early diagnosis and curative resection are the predominant factors associated with increased survival in patients with gastric cancer. However, most gastric cancer cases are still diagnosed at later stages.

Since most pathologic specimens are archived as FFPE samples, the ability to use them to generate expression profiles can greatly improve cancer biomarker discovery. We sought to uncover new biomarkers for stomach preneoplastic metaplasias and neoplastic lesions by generating proteome profiles using FFPE samples.

We combined peptide isoelectric focusing and liquid chromatography—tandem mass spectrometry analysis to generate proteomic profiles from FFPE samples of intestinal-type gastric cancer, metaplasia , and normal mucosa. The expression patterns of selected proteins were analyzed by immunostaining first in single tissue sections from normal stomach, metaplasia , and gastric cancer and later in larger tissue array cohorts. We detected 60 proteins up-regulated and 87 proteins down-regulated during the progression from normal mucosa to metaplasia to gastric cancer.

Two of the up-regulated proteins, LTF and DMBT1, were validated as specific markers for spasmolytic polypeptide—expressing metaplasia and intestinal metaplasia , respectively. Thus, proteomic profiling using FFPE samples has led to the identification of two novel markers for stomach metaplasias and gastric cancer prognosis.

Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis. Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging MRI scans may develop after resolution of inflammation in patients with ankylosing spondylitis AS and may predict new bone formation in the spine. Similar tissue, termed backfill, may also fill areas of excavated bone in the sacroiliac SI joints and may reflect resolution of inflammation and tissue repair at sites of erosions.

The purpose of this study was to test our hypothesis that SI joint ankylosis develops following repair of erosions and that tissue characterized by fat metaplasia is a key intermediary step in this pathway. Univariate and multivariate regression analyses focused first on identifying significant MRI predictors of new backfill and fat metaplasia. We then assessed the role of backfill and fat metaplasia in the development of new ankylosis. All analyses were adjusted for demographic features, treatment, and baseline and 2-year change in SSS values for parameters of inflammation and MRI structural lesions.

Resolution of inflammation and reduction of erosions were each independently associated with the development of new backfill and fat metaplasia at 2 years on multivariate analyses. Our data support a disease model whereby ankylosis develops following repair of erosions, and fat metaplasia and backfill are key intermediary steps in this pathway. Helicobacter heilmannii is a zoonotic bacterium that has been associated with gastric disease in humans.

Markers for acid production by parietal cells and mucous metaplasia were also examined. In the first 9 weeks postinfection, the mRNA expression of Muc6 was clearly upregulated in both the antrum and fundus of the stomach of H.

Interestingly, Muc13 was upregulated already at 1 day postinfection in the fundus of the stomach. Its expression level remained high in the stomach over the course of the infection. This mucin is, however, not expressed in a healthy stomach, and high expression of this mucin has so far only been described in gastric cancer. Mucous metaplasia present in the mucosa surrounding low-grade mucosa-associated lymphoid tissue MALT lymphoma-like lesions was also histologically confirmed.

Our findings indicate that H. Structural alterations of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence. Accumulating evidence suggests that the extracellular matrix play important roles in intercellular communications and contribute to the development of a number of diseases, including diseases of the gastrointestinal tract. The present study examined the structural characteristics and alterations of the extracellular matrix of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence.

A total of 41 esophageal tissue specimens 15 esophageal adenocarcinoma, 10 Barrett's esophagus intestinal metaplasia , seven dysplasia and nine normal esophagus were studied. The present study used transmission electron microscopy and computerized quantitative electron-microscopic analysis in order to investigate the characteristics of the extracellular matrix of the mucosa.

The study revealed that marked structural alterations of the mucosa stroma, relating to changes in the distribution and appearance of collagen fibers as well as to changes in numbers of matrix microvesicles, occur in Barrett's esophagus and esophageal adenocarcinoma. It was found that there were 3.

The findings suggest that the redistribution of collagen fibers and increases in numbers of matrix microvesicles may play roles in the formation of specialized intestinal metaplasia and the development of adenocarcinoma. Relation between reflux of bile acids into the stomach and gastric mucosal atrophy, intestinal metaplasia in biopsy specimens. During endoscopic examinations we collected fluid in the stomach that included reflux fluid from the duodenum, and assessed the effect of quantitatively determined bile acids on glandular atrophy and intestinal metaplasia using biopsy specimens.

A total of outpatients were enrolled in this study. Total bile acid concentration was measured by an enzyme immunoassay. Glandular atrophy and intestinal metaplasia scores were graded according to the Updated Sydney System. An effect of refluxed bile acids on atrophy and intestinal metaplasia was shown in the high-concentration reflux group in comparison with the control group. However, when the odds ratios ORs were calculated according to whether Helicobacter pylori H. The same was true for intestinal metaplasia in the H.

We could not clarify the effect of the reflux of bile acids into the stomach in the progression of atrophy. High-concentration bile acids had an effect on the progression of intestinal metaplasia in the H. Gastric intestinal metaplasia is a precancerous change of the mucosa of the stomach with intestinal epithelium, and is associated with an increased risk of dysplasia and cancer.

The pathogenesis to gastric cancer is proposed by the Correa hypothesis as the transition from normal gastric epithelium to invasive cancer via inflammation followed by intramucosal cancer and invasion. Multiple risk factors have been associated with the development of gastric intestinal metaplasia interplay, including Helicobacter pylori infection and associated genomics, host genetic factors, environmental milieu, rheumatologic disorders, diet, and intestinal microbiota.

Globally, screening guidelines have been established in countries with high incidence. In the United States, no such guidelines have been developed due to lower, albeit increasing, incidence. The American Society for Gastrointestinal Endoscopy recommends a case-by-case patient assessment based upon epidemiology, genetics, and environmental risk factors.

Studies have examined the use of a serologic biopsy to stratify risk based upon factors such as H pylori status and virulence factors, along with serologic markers of chronic inflammation including pepsinogen I, pepsinogen II, and gastrin. High-risk patients may then be advised to undergo endoscopic evaluation with mapping biopsies from the antrum greater curvature, lesser curvature , incisura angularis, and corpus greater curvature, lesser curvature.

Surveillance guidelines have not been firmly established for patients with known gastric intestinal metaplasia , but include repeat endoscopy at intervals according to the histologic risk for malignant transformation. Intestinal metaplasia in Barrett's oesophagus BO represents an important risk factor for oesophageal adenocarcinoma.

Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia CLO , posing an issue about its clinical management. The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells.

These findings suggest that some immunophenotypic changes are present in CLO and they can precede the appearance of the goblet cells or can be present independently of them, confirming the conception of BO as the condition characterized by any extention of columnar epithelium. METHODS: Distal esophageal mucosal samples obtained by endoscopy and histologically diagnosed as gastric-type non-specialized columnar metaplasia , were studied thoroughly. Deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer: A correlated study.

AIM: To investigate the correlation among the presence and degree of gastric metaplasia of duodenal regenerating mucosa, the deformity of bulb and the recurrence of duodenal ulcer. All patients received follow-up endoscopic examinations 6 wk after treatment.

When the ulcer s were noted to be healed, two biopsies were taken from the ulcer scar for histological study of gastric metaplasia , and 4 biopsies were taken from antrum for Helicobacter pylori H pylori study. Out of these cases, 44 received further follow-up endoscopic examinations after 3, 6 and 12 mo respectively for studying the recurrence rate of duodenal ulcers.

The correlation among ulcer recurrence, degree of gastric metaplasia of regenerating mucosa, bulbar deformity, and colonization of H pylori in the stomach was then studied. RESULTS: The results showed that there was a strong correlation between the deformity of duodenal bulb and the degree of gastric metaplasia of regenerating duodenal mucosa. A more severely deformed duodenal bulb is closely related to a greater extent of gastric metaplasia. Both factors contribute to the recurrence of duodenal ulcer.

Clinical significance of spasmolytic polypeptide-expressing metaplasia and intestinal metaplasia in Epstein-Barr virus-associated and Epstein-Barr virus-negative gastric cancer. Spasmolytic polypeptide-expressing metaplasia SPEM and intestinal metaplasia IM have been recognized as neoplastic precursors in gastric carcinogenesis.

Acute and chronic inflammation was graded as absent, mild, moderate, and marked. Univariate and multivariate logistic regression analyses were conducted to analyze the correlation between SPEM, IM, and inflammation. Our study revealed that SPEM was detected in Atrophy and intestinal metaplasia are early phenotypic markers in gastric carcinogenesis.

White light endoscopy does not allow direct biopsy of intestinal metaplasia due to a lack of contrast of the mucosa. Narrow-band imaging is known to enhance the visibility of intestinal metaplasia , to reduce sampling error, and to increase the diagnostic yield of endoscopy for intestinal metaplasia in Asian patients.

The aim of our study was to validate the diagnostic performance of narrow-band imaging using 1. A retrospective cohort study was conducted on consecutive patients with dyspeptic symptoms at a private endoscopy center within the time frame of January to December The prevalence of H.

Among the patients with intestinal metaplasia , Two patients had low-grade dysplasia. The sensitivity of white light endoscopy was The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of narrow-band imaging with a positive light blue crest were 85, 98, Through the assessment of the microsurface structure and light blue crest sign, non-optical zoom narrow-band imaging had high predictive values for detecting intestinal metaplasia in patients from a general Western setting.

Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico. Intestinal metaplasia is a precursor lesion of gastric cancer. Infection by Helicobacter pylori is the principal cause of metaplasia.

While evidence of the regression of metaplasia after treatment to eradicate this infection has been demonstrated, controversy remains with regard to this subject. The objective of this study was to determine the frequency of the regression of gastric intestinal metaplasia one year after the eradication of Helicobacter pylori.

A prospective longitudinal designed study was carried out. The population studied in this research consisted of patients attending the Endoscopy Unit to undergo an upper endoscopy, in whom various symptoms indicated intestinal metaplasia associated with Helicobacter pylori, and who received standard empiric triple therapy to eradicate the bacteria.

An upper endoscopy was performed in which four gastric biopsy samples were taken two from the antrum and two from the body before and after the eradicating treatment, with the endoscopic and histological findings studied after one year of monitoring. The statistical analysis was conducted using the Fisher's exact test and the McNemar's test.

Forty-six patients were studied, of whom 20 Complete intestinal metaplasia type I was found in 35 patients Non-atrophic chronic gastritis was found in 35 In this study, gastric intestinal metaplasia associated with Helicobacter pylori infection showed a regression of Cigarette smoke suppresses Bik to cause epithelial cell hyperplasia and mucous cell metaplasia.

Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis. Because the Bcl-2 family of proteins is crucial for airway epithelial homeostasis, identifying the players that reduce cigarette smoke CS -induced mucous cell metaplasia can help to develop effective therapies.

To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia. We screened for dysregulated expression of the Bcl-2 family members. We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects.

Restoring Bik expression significantly suppressed CS-induced mucous cell metaplasia in differentiated primary HAEC cultures and in airways of mice in vivo. These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis. Foveolar gastric metaplasia of the duodenum: a frequent, so far neglected type of duodenal polyp.

Foveolar gastric metaplasia of the duodenum FGM is considered as imperfect mucosal healing in the context of H. During diagnostic histological examinations we observed a frequent so far not described association of FGM with endoscopically observed duodenal polyps. In Institute 2, cases of FGM were diagnosed. In conclusion, foveolar gastric metaplasia is a frequent, so far neglected correlate of endoscopically detected duodenal polyps.

Rationale: Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis. Objectives: To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia. Methods: We screened for dysregulated expression of the Bcl-2 family members.

Measurements and Main Results: We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects. Conclusions: These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis. Heterotopic gastric mucosa in the gallbladder is an unusual entity and is usually clinically silent.

We report a year-old female patient who presented with intermittent upper abdomial pain radiating to the back. Abdominal imaging studies showed a sessile polypoid lesion and a gallstone in the gallbladder. Gallbladder carcinoma was suspected and cholecystectomy performed.

Intraoperative frozen section examination suggested mucinous tumor, suspicious for malignancy. However, the permanent sections revealed aberrant gastric tissue consisted of gastric pyloric and fundic glands of heterotopic gastric mucosa with intestinal metaplasia in the gallbladder.

Dysplastic intestinal-type metaplasia of appendiceal endometriosis: a mimic of low grade appendiceal mucinous neoplasm. We report an example of dysplastic intestinal-type metaplasia involving endometriosis of the appendix in a 45 year old woman. One other example of this phenomenon has been reported. As it occurs within the muscular wall of the appendix, confusion with low grade appendiceal mucinous neoplasm LAMN may occur.

Evidence supporting the metaplastic nature of the intestinal epithelium is offered. As the initial pathological diagnosis was of invasive cancer with perforation of the appendix treatment consisted of peritonectomy and hyperthermic intraperitoneal chemotherapy HIPEC. Pathological documentation of complete elimination of Barrett's metaplasia following endoscopic multipolar electrocoagulation therapy.

The previous paradigm that Barrett's is an irreversible premalignant lesion has recently been challenged by a proliferation of reports documenting elimination of Barrett's by a variety of endoscopic techniques. Whether Barrett's is entirely eliminated is unknown as endoscopic biopsy samples the surface of the epithelium only.

Numerous reports document underlying specialised columnar epithelium in many of these trials. Until now there have been no reports of pathological examination of the entire oesophagus as a specimen. This case documents complete elimination of intestinal metaplasia from the oesophagus and supports the biological plausibility of these research techniques. Factors to improve the interobserver agreement for gastric atrophy and intestinal metaplasia : consensus of definition and criteria.

Intestinal metaplasia and atrophy of the gastric mucosa are associated with Helicobacter pylori infection and are considered premalignant lesions. The updated Sydney system is used for these parameters, but experienced pathologists and consensus processes are required for interobserver agreement.

We sought to determine the influence of the consensus process on the assessment of intestinal metaplasia and atrophy. Two study sets were used: consensus and validation. The consensus set was circulated and five gastrointestinal pathologists evaluated them independently using the updated Sydney system. The consensus of the definitions was then determined at the first consensus meeting. The same set was recirculated to determine the effect of the consensus. The second consensus meeting was held to standardise the grading criteria and the validation set was circulated to determine the influence.

Two additional circulations were performed to assess the maintainance of consensus and intraobserver variability. This study suggests that interobserver variability regarding intestinal metaplasia and atrophy may result from lack of a precise definition and fine criteria, and can be reduced by consensus of definition and standardisation of grading criteria. The diagnosis of patients with short segments of intestinal metaplasia in the distal esophagus, has increased in recent years.

To assess the clinical, pathological and functional features of patients with esophageal intestinal metaplasia. A prospective study was performed in 95 control subjects, patients with cardial intestinal metaplasia and 89 patients with short Barret esophagus with intestinal metaplasia. All had clinical and endoscopic assessments, esophageal manometry and determination of 24 h esophageal exposure to acid and duodenal content. Control patients were younger and, in this group, the pathological findings in the mucosa distal to the squamous-columnar change, showed a preponderance of fundic over cardial mucosa.

In patients with intestinal metaplasia and short Barret esophagus, there was only cardial mucosa, that is the place where intestinal metaplasia implants. Low grade dysplasia was only seen in the presence of intestinal metaplasia. Gastroesophageal sphincter pressure decreased and gastric and duodenal reflux increased along with increases in the extension of intestinal metaplasia.

These findings confirm the need to obtain multiple biopsies from the squamous-columnar mucosal junction in all patients with gastroesophageal reflux symptoms, for the detection of early pathological changes of Barret esophagus and eventual dysplasia. Preliminary characterization of wild lactic acid bacteria and their abilities to produce flavour compounds in ripened model cheese system. The aim of this work was to preliminary characterize wild lactic acid bacteria LAB , previously isolated during artisanal Pecorino Siciliano PS cheese -making for technological and flavour formation abilities in a model cheese system.

Case presentation A right facial enlargement was suddenly observed in a 4-year-old non-spayed female Shih-Tzu dog. The lesion presented itself as a soft and fluctuant mass located in the right side of the face near to the neck. Histologically, the mass consisted of a cavitary formation without an epithelial lining. Additionally, microscopic examination revealed the presence of osteoid-producing cells which gave rise to areas of bone formation, probably induced by irritation due to the presence sialoliths.

Such cells and bone formations were also present in the cavity wall, consequently leading us to classify the condition as a salivary mucocele with osseous metaplasia. Conclusions In the present case, the pathogenesis was probably associated with the presence of sialoliths, which can behave as etiological agents for the metaplastic lesion. The occurrence of osteoid metaplasia is a rare peculiar condition in the canine salivar y gland, and due to the rarity and lack of information about this specific disease, no clinical data can yet be associated with the development of salivary mucocele with osseous metaplasia in dogs.

Squamous metaplasia is a common pathologic condition in ocular surface diseases for which there is no therapeutic medication in clinic. Human conjunctival explants were cultured for up to 12 days under airlifting conditions. Pterygium clinical samples were cultured under airlifting conditions with or without APR for 4 days. Airlift conjunctival explants resulted in increased stratification and intrastromal epithelial invagination.

Such pathology was accompanied by increases in K10, K14, and p63 expression, whereas K19 and Pax6 levels declined when compared to those in freshly isolated tissue. Furthermore, K19 and Pax6 increased along with rises in goblet cell density. These effects of APR were accompanied by near restoration of normal conjunctival epithelial histology. APR also reversed squamous metaplasia in pterygial epithelium that had developed after 4 days in ex vivo culture. Reductions in squamous metaplasia induced by APR suggest it may provide a novel therapeutic approach in different squamous metaplasia -associated ocular surface diseases.

Sousa, Josane F. Early diagnosis and curative resection are the predominant factors associated with increased survival in patients with gastric cancer. However, most gastric cancer cases are still diagnosed at later stages. Since most pathologic specimens are archived as FFPE samples, the ability to use them to generate expression profiles can greatly improve cancer biomarker discovery. We sought to uncover new biomarkers for stomach preneoplastic metaplasias and neoplastic lesions by generating proteome profiles using FFPE samples.

We combined peptide isoelectric focusing and liquid chromatography—tandem mass spectrometry analysis to generate proteomic profiles from FFPE samples of intestinal-type gastric cancer, metaplasia , and normal mucosa. The expression patterns of selected proteins were analyzed by immunostaining first in single tissue sections from normal stomach, metaplasia , and gastric cancer and later in larger tissue array cohorts. We detected 60 proteins up-regulated and 87 proteins down-regulated during the progression from normal mucosa to metaplasia to gastric cancer.

Two of the up-regulated proteins, LTF and DMBT1, were validated as specific markers for spasmolytic polypeptide—expressing metaplasia and intestinal metaplasia , respectively. Thus, proteomic profiling using FFPE samples has led to the identification of two novel markers for stomach metaplasias and gastric cancer prognosis. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis.

Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging MRI scans may develop after resolution of inflammation in patients with ankylosing spondylitis AS and may predict new bone formation in the spine. Similar tissue, termed backfill, may also fill areas of excavated bone in the sacroiliac SI joints and may reflect resolution of inflammation and tissue repair at sites of erosions.

The purpose of this study was to test our hypothesis that SI joint ankylosis develops following repair of erosions and that tissue characterized by fat metaplasia is a key intermediary step in this pathway. Univariate and multivariate regression analyses focused first on identifying significant MRI predictors of new backfill and fat metaplasia. We then assessed the role of backfill and fat metaplasia in the development of new ankylosis. All analyses were adjusted for demographic features, treatment, and baseline and 2-year change in SSS values for parameters of inflammation and MRI structural lesions.

Resolution of inflammation and reduction of erosions were each independently associated with the development of new backfill and fat metaplasia at 2 years on multivariate analyses. Our data support a disease model whereby ankylosis develops following repair of erosions, and fat metaplasia and backfill are key intermediary steps in this pathway. Helicobacter heilmannii is a zoonotic bacterium that has been associated with gastric disease in humans.

Markers for acid production by parietal cells and mucous metaplasia were also examined. In the first 9 weeks postinfection, the mRNA expression of Muc6 was clearly upregulated in both the antrum and fundus of the stomach of H.

Interestingly, Muc13 was upregulated already at 1 day postinfection in the fundus of the stomach. Its expression level remained high in the stomach over the course of the infection. This mucin is, however, not expressed in a healthy stomach, and high expression of this mucin has so far only been described in gastric cancer. Mucous metaplasia present in the mucosa surrounding low-grade mucosa-associated lymphoid tissue MALT lymphoma-like lesions was also histologically confirmed.

Our findings indicate that H. Structural alterations of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence. Accumulating evidence suggests that the extracellular matrix play important roles in intercellular communications and contribute to the development of a number of diseases, including diseases of the gastrointestinal tract. The present study examined the structural characteristics and alterations of the extracellular matrix of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence.

A total of 41 esophageal tissue specimens 15 esophageal adenocarcinoma, 10 Barrett's esophagus intestinal metaplasia , seven dysplasia and nine normal esophagus were studied. The present study used transmission electron microscopy and computerized quantitative electron-microscopic analysis in order to investigate the characteristics of the extracellular matrix of the mucosa.

The study revealed that marked structural alterations of the mucosa stroma, relating to changes in the distribution and appearance of collagen fibers as well as to changes in numbers of matrix microvesicles, occur in Barrett's esophagus and esophageal adenocarcinoma.

It was found that there were 3. The findings suggest that the redistribution of collagen fibers and increases in numbers of matrix microvesicles may play roles in the formation of specialized intestinal metaplasia and the development of adenocarcinoma.

Relation between reflux of bile acids into the stomach and gastric mucosal atrophy, intestinal metaplasia in biopsy specimens. During endoscopic examinations we collected fluid in the stomach that included reflux fluid from the duodenum, and assessed the effect of quantitatively determined bile acids on glandular atrophy and intestinal metaplasia using biopsy specimens. A total of outpatients were enrolled in this study.

Total bile acid concentration was measured by an enzyme immunoassay. Glandular atrophy and intestinal metaplasia scores were graded according to the Updated Sydney System. An effect of refluxed bile acids on atrophy and intestinal metaplasia was shown in the high-concentration reflux group in comparison with the control group. However, when the odds ratios ORs were calculated according to whether Helicobacter pylori H. The same was true for intestinal metaplasia in the H.

We could not clarify the effect of the reflux of bile acids into the stomach in the progression of atrophy. High-concentration bile acids had an effect on the progression of intestinal metaplasia in the H. Gastric intestinal metaplasia is a precancerous change of the mucosa of the stomach with intestinal epithelium, and is associated with an increased risk of dysplasia and cancer. The pathogenesis to gastric cancer is proposed by the Correa hypothesis as the transition from normal gastric epithelium to invasive cancer via inflammation followed by intramucosal cancer and invasion.

Multiple risk factors have been associated with the development of gastric intestinal metaplasia interplay, including Helicobacter pylori infection and associated genomics, host genetic factors, environmental milieu, rheumatologic disorders, diet, and intestinal microbiota. Globally, screening guidelines have been established in countries with high incidence.

In the United States, no such guidelines have been developed due to lower, albeit increasing, incidence. The American Society for Gastrointestinal Endoscopy recommends a case-by-case patient assessment based upon epidemiology, genetics, and environmental risk factors. Studies have examined the use of a serologic biopsy to stratify risk based upon factors such as H pylori status and virulence factors, along with serologic markers of chronic inflammation including pepsinogen I, pepsinogen II, and gastrin.

High-risk patients may then be advised to undergo endoscopic evaluation with mapping biopsies from the antrum greater curvature, lesser curvature , incisura angularis, and corpus greater curvature, lesser curvature. Surveillance guidelines have not been firmly established for patients with known gastric intestinal metaplasia , but include repeat endoscopy at intervals according to the histologic risk for malignant transformation.

Intestinal metaplasia in Barrett's oesophagus BO represents an important risk factor for oesophageal adenocarcinoma. Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia CLO , posing an issue about its clinical management.

The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells. These findings suggest that some immunophenotypic changes are present in CLO and they can precede the appearance of the goblet cells or can be present independently of them, confirming the conception of BO as the condition characterized by any extention of columnar epithelium. METHODS: Distal esophageal mucosal samples obtained by endoscopy and histologically diagnosed as gastric-type non-specialized columnar metaplasia , were studied thoroughly.

Deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer: A correlated study. AIM: To investigate the correlation among the presence and degree of gastric metaplasia of duodenal regenerating mucosa, the deformity of bulb and the recurrence of duodenal ulcer. All patients received follow-up endoscopic examinations 6 wk after treatment.

When the ulcer s were noted to be healed, two biopsies were taken from the ulcer scar for histological study of gastric metaplasia , and 4 biopsies were taken from antrum for Helicobacter pylori H pylori study. Out of these cases, 44 received further follow-up endoscopic examinations after 3, 6 and 12 mo respectively for studying the recurrence rate of duodenal ulcers. The correlation among ulcer recurrence, degree of gastric metaplasia of regenerating mucosa, bulbar deformity, and colonization of H pylori in the stomach was then studied.

RESULTS: The results showed that there was a strong correlation between the deformity of duodenal bulb and the degree of gastric metaplasia of regenerating duodenal mucosa. A more severely deformed duodenal bulb is closely related to a greater extent of gastric metaplasia. Both factors contribute to the recurrence of duodenal ulcer. Clinical significance of spasmolytic polypeptide-expressing metaplasia and intestinal metaplasia in Epstein-Barr virus-associated and Epstein-Barr virus-negative gastric cancer.

Spasmolytic polypeptide-expressing metaplasia SPEM and intestinal metaplasia IM have been recognized as neoplastic precursors in gastric carcinogenesis. Acute and chronic inflammation was graded as absent, mild, moderate, and marked. Univariate and multivariate logistic regression analyses were conducted to analyze the correlation between SPEM, IM, and inflammation.

Our study revealed that SPEM was detected in Atrophy and intestinal metaplasia are early phenotypic markers in gastric carcinogenesis. White light endoscopy does not allow direct biopsy of intestinal metaplasia due to a lack of contrast of the mucosa. Narrow-band imaging is known to enhance the visibility of intestinal metaplasia , to reduce sampling error, and to increase the diagnostic yield of endoscopy for intestinal metaplasia in Asian patients.

The aim of our study was to validate the diagnostic performance of narrow-band imaging using 1. A retrospective cohort study was conducted on consecutive patients with dyspeptic symptoms at a private endoscopy center within the time frame of January to December The prevalence of H.

Among the patients with intestinal metaplasia , Two patients had low-grade dysplasia. The sensitivity of white light endoscopy was The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of narrow-band imaging with a positive light blue crest were 85, 98, Through the assessment of the microsurface structure and light blue crest sign, non-optical zoom narrow-band imaging had high predictive values for detecting intestinal metaplasia in patients from a general Western setting.

Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico. Intestinal metaplasia is a precursor lesion of gastric cancer. Infection by Helicobacter pylori is the principal cause of metaplasia. While evidence of the regression of metaplasia after treatment to eradicate this infection has been demonstrated, controversy remains with regard to this subject.

The objective of this study was to determine the frequency of the regression of gastric intestinal metaplasia one year after the eradication of Helicobacter pylori. A prospective longitudinal designed study was carried out. The population studied in this research consisted of patients attending the Endoscopy Unit to undergo an upper endoscopy, in whom various symptoms indicated intestinal metaplasia associated with Helicobacter pylori, and who received standard empiric triple therapy to eradicate the bacteria.

An upper endoscopy was performed in which four gastric biopsy samples were taken two from the antrum and two from the body before and after the eradicating treatment, with the endoscopic and histological findings studied after one year of monitoring. The statistical analysis was conducted using the Fisher's exact test and the McNemar's test.

Forty-six patients were studied, of whom 20 Complete intestinal metaplasia type I was found in 35 patients Non-atrophic chronic gastritis was found in 35 In this study, gastric intestinal metaplasia associated with Helicobacter pylori infection showed a regression of Cigarette smoke suppresses Bik to cause epithelial cell hyperplasia and mucous cell metaplasia.

Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis. Because the Bcl-2 family of proteins is crucial for airway epithelial homeostasis, identifying the players that reduce cigarette smoke CS -induced mucous cell metaplasia can help to develop effective therapies. To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia.

We screened for dysregulated expression of the Bcl-2 family members. We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects. Restoring Bik expression significantly suppressed CS-induced mucous cell metaplasia in differentiated primary HAEC cultures and in airways of mice in vivo. These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis.

Foveolar gastric metaplasia of the duodenum: a frequent, so far neglected type of duodenal polyp. Foveolar gastric metaplasia of the duodenum FGM is considered as imperfect mucosal healing in the context of H. During diagnostic histological examinations we observed a frequent so far not described association of FGM with endoscopically observed duodenal polyps.

In Institute 2, cases of FGM were diagnosed. In conclusion, foveolar gastric metaplasia is a frequent, so far neglected correlate of endoscopically detected duodenal polyps. Rationale: Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis.

Objectives: To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia. Methods: We screened for dysregulated expression of the Bcl-2 family members. Measurements and Main Results: We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects.

Conclusions: These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis. Heterotopic gastric mucosa in the gallbladder is an unusual entity and is usually clinically silent. We report a year-old female patient who presented with intermittent upper abdomial pain radiating to the back. Abdominal imaging studies showed a sessile polypoid lesion and a gallstone in the gallbladder.

Gallbladder carcinoma was suspected and cholecystectomy performed. Intraoperative frozen section examination suggested mucinous tumor, suspicious for malignancy. However, the permanent sections revealed aberrant gastric tissue consisted of gastric pyloric and fundic glands of heterotopic gastric mucosa with intestinal metaplasia in the gallbladder.

Dysplastic intestinal-type metaplasia of appendiceal endometriosis: a mimic of low grade appendiceal mucinous neoplasm. We report an example of dysplastic intestinal-type metaplasia involving endometriosis of the appendix in a 45 year old woman. One other example of this phenomenon has been reported. As it occurs within the muscular wall of the appendix, confusion with low grade appendiceal mucinous neoplasm LAMN may occur.

Evidence supporting the metaplastic nature of the intestinal epithelium is offered. As the initial pathological diagnosis was of invasive cancer with perforation of the appendix treatment consisted of peritonectomy and hyperthermic intraperitoneal chemotherapy HIPEC. Pathological documentation of complete elimination of Barrett's metaplasia following endoscopic multipolar electrocoagulation therapy.

The previous paradigm that Barrett's is an irreversible premalignant lesion has recently been challenged by a proliferation of reports documenting elimination of Barrett's by a variety of endoscopic techniques.

Whether Barrett's is entirely eliminated is unknown as endoscopic biopsy samples the surface of the epithelium only. Numerous reports document underlying specialised columnar epithelium in many of these trials. Until now there have been no reports of pathological examination of the entire oesophagus as a specimen. This case documents complete elimination of intestinal metaplasia from the oesophagus and supports the biological plausibility of these research techniques.

Factors to improve the interobserver agreement for gastric atrophy and intestinal metaplasia : consensus of definition and criteria. Intestinal metaplasia and atrophy of the gastric mucosa are associated with Helicobacter pylori infection and are considered premalignant lesions. The updated Sydney system is used for these parameters, but experienced pathologists and consensus processes are required for interobserver agreement.

We sought to determine the influence of the consensus process on the assessment of intestinal metaplasia and atrophy. Two study sets were used: consensus and validation. The consensus set was circulated and five gastrointestinal pathologists evaluated them independently using the updated Sydney system.

The consensus of the definitions was then determined at the first consensus meeting. The same set was recirculated to determine the effect of the consensus. The second consensus meeting was held to standardise the grading criteria and the validation set was circulated to determine the influence. Two additional circulations were performed to assess the maintainance of consensus and intraobserver variability. This study suggests that interobserver variability regarding intestinal metaplasia and atrophy may result from lack of a precise definition and fine criteria, and can be reduced by consensus of definition and standardisation of grading criteria.

The diagnosis of patients with short segments of intestinal metaplasia in the distal esophagus, has increased in recent years. To assess the clinical, pathological and functional features of patients with esophageal intestinal metaplasia. A prospective study was performed in 95 control subjects, patients with cardial intestinal metaplasia and 89 patients with short Barret esophagus with intestinal metaplasia.

All had clinical and endoscopic assessments, esophageal manometry and determination of 24 h esophageal exposure to acid and duodenal content. Control patients were younger and, in this group, the pathological findings in the mucosa distal to the squamous-columnar change, showed a preponderance of fundic over cardial mucosa.

In patients with intestinal metaplasia and short Barret esophagus, there was only cardial mucosa, that is the place where intestinal metaplasia implants. Low grade dysplasia was only seen in the presence of intestinal metaplasia. Gastroesophageal sphincter pressure decreased and gastric and duodenal reflux increased along with increases in the extension of intestinal metaplasia. These findings confirm the need to obtain multiple biopsies from the squamous-columnar mucosal junction in all patients with gastroesophageal reflux symptoms, for the detection of early pathological changes of Barret esophagus and eventual dysplasia.

Down-regulation of EMP1 is associated with epithelial hyperplasia and metaplasia in nasal polyps. The aim of this study was to assess protein and mRNA expression of epithelial membrane protein 1 EMP1 in the nasal mucosa of patients with nasal polyps NP , and to determine what changes occur in response to glucocorticosteroid GC treatment. NP tissue was obtained from 55 patients, 18 of whom were treated with nasal GCs i. Biopsies of inferior turbinate mucosa from 30 healthy subjects were used as controls.

Their immunoreactivity was significantly greater in controls than NP patients. Positive correlations between EMP1 and other epithelial cell-related gene e. EMP1 could be a biomarker for aberrant epithelial remodelling and metaplasia in chronic inflammatory upper airway mucosa e.

Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis. There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease IBD.

However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented. We report a case of a year-old female with a history of colonic adenocarcinoma who presented with pruritic, erythematous, scaly plaques on the right lower abdomen, present since reversal of her ileostomy in Skin biopsy revealed benign foci of colonic epithelium with no evidence of adenomatous change. Benign intraepidermal colonic mucosa was diagnosed based on histopathologic findings and immunohistochemistry.

To our knowledge, this is the first case of intraepidermal benign colonic metaplasia forming in a patient following ostomy reversal. The case emphasizes the importance of patient education and physical examination of the stoma or stoma remnants for detection of unusual or changing lesions due to the risk for malignant transformation.

It also demonstrates that benign colonic mucosa should be considered in the differential diagnosis when evaluating lesions near ileostomy sites, regardless of whether the patient has a history of familial adenomatous polyposis or IBD. Transitional metaplasia in intestinal epithelium of rats submitted to intestinal cystoplasty and treatment with L -lysine. To evaluated the effects of L-lysine on the intestinal and urothelial epithelia in cystoplasty in rats.

No inflammatory cells, dysplasia or abnormalities were observed. Staining with Alcian blue revealed a substantial reduction of goblet cells and mucins in the colon segment Groups A and B. The administration of L-lysine to rats accelerated the development of transitional metaplasia in the epithelium of the colon segment in cystoplasty.

Influence of cyclic hydrostatic pressure on fibrocartilaginous metaplasia of achilles tendon fibroblasts. The goal of this study was to demonstrate whether cyclically imposed hydrostatic pressure, compressive in nature, could induce fibrocartilaginous metaplasia in a purely tendinous cell source in vitro.

The effect of short-duration cyclic hydrostatic pressure on tendon fibroblasts tenocytes expanded from rat Achilles tendon was studied. Total RNA was isolated either immediately after loading or 24 h later. Noticeably, for RNA samples isolated 24 h later, there were further increases in mRNA expression of Aggrecan and Collagen type II, whereas Collagen type I increased roughly three-fold relative to the non-loaded control.

These findings support the hypothesis that cyclic hydrostatic pressurization can induce fibrocartilaginous metaplasia in tenocytes by upregulation of cartilaginous gene expression. Also, it was demonstrated that changes in mRNA expression as a result of single 2 h pressurization persist even up to 24 h. The predictive value of gastric metaplasia in the duodenal mucosa in patients Helicobacter pylori-positive patients with duodenal bulb ulcer DBU was investigated.

One hundred and twenty four randomly selected patients with DBU were included in this prospective study. Regions of gastric metaplasia of the duodenum were confirmed by periodic acid-Schiff and alcian blue Serva staining pH 1. Gastric metaplasia in the duodenum was found in 64 or The following facts about the predictive factor for the prognosis of DU complication were found: the sensitivity of The study revealed a high and significant p metaplasia in the duodenum as a marker of non-complicated clinical course of DU in HP-positive patients within an 8 to year period.

Ecuador currently holds the 15th place of countries with the highest incidence of stomach cancer for both sexes. All participants were personally interviewed using a structured questionnaire to collect data about dietary habits, lifestyle and medical history. Pylori infection AOR: 0. Interleukin 10 is an essential modulator of mucoid metaplasia in a mouse otitis media model. In wild-type mice, both S. In IL knockout mice, the number of goblet cells and mucin-producing cells in the middle ear was significantly reduced after bacterial middle ear infection compared with that in wild-type mice.

In this study, we report about a patient with extra-uterine endometriosis EM in the abdominal wall muscle with evident metaplasia based on the abundant alpha smooth muscle actin ASMA -expressing myofibroblasts. Laparotomy excision of the abdominal wall EM was done following ultrasonographic evidence of a hypodense swelling in the right rectus abdominis, which was confirmed by MRI.

Immunohistochemistry staining for ASMA and collagen I was done, with the results confirming that endometriotic stromal cells expressed both. Anterior abdominal wall endometriosis was suspected because of the patient's history of recurrent EM combined with the cyclic nature of symptoms. MRI is useful in determining the extent of the disease. In case of persisting symptoms even under hormonal treatment, surgical excision is mandatory.

The expression of both ASMA and collagen I in and around EM lesions supports the notion of the metaplastic process in the course of disease development. Karger AG, Basel. Label-free identification of intestinal metaplasia in the stomach using multiphoton microscopy.

The early diagnosis of intestinal metaplasia IM in the stomach together with effective therapeutic interventions is crucial to reducing the mortality-rates of the patients associated with gastric cancer. Here, we describe a label-free imaging method, multiphoton microscopy MPM , for the identification of IM in the stomach.

It was found that multiphoton imaging provides cellular and subcellular details to the identification of IM from normal gastric tissues. In particular, there is significant difference in the population density of goblet cells between normal and IM gastric tissues, providing substantial potential to become a quantitative intrinsic marker for in vivo clinical diagnosis of early gastric lesions.

To our knowledge, this is the first demonstration of the potential of MPM for the identification of IM. Columnar metaplasia in a surgical mouse model of gastro-esophageal reflux disease is not derived from bone marrow-derived cell. The incidence of esophageal adenocarcinoma has increased in the last 25 years. Columnar metaplasia in Barrett's mucosa is assumed to be a precancerous lesion for esophageal adenocarcinoma.

However, the induction process of Barrett's mucosa is still unknown. To analyze the induction of esophageal columnar metaplasia , we established a mouse gastro-esophageal reflux disease GERD model with associated development of columnar metaplasia in the esophagus.

To analyze the contribution of bone marrow-derived cells to columnar metaplasia in this surgical GERD model, some mice were transplanted with GFP-marked bone marrow after the operation. Bone marrow-derived cells were not detected in columnar metaplastic epithelia. However, scattered epithelial cells in the thickened squamous epithelia in regions of esophagitis did show bone marrow derivation.

The results demonstrate that reflux induced by esophago-jejunostomy in mice leads to the development of columnar metaplasia in the esophagus. However, bone marrow-derived cells do not contribute directly to columnar metaplasia in this mouse model. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy. The vast majority of urothelial carcinomas infiltrating the bladder are consistente with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies.

In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes.

Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma.

In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin 34BetaE12 and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years.

The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients.

Extended intestinal metaplasia. A survey of gastrectomies from dwellers of the Pacific basin. To assess the extent of gastric intestinal metaplasia IM in gastrectomy specimens in populations of the Pacific basin having different incidence of gastric carcinoma. One thousand three hundred and nine-two gastrectomies were investigated: had a gastric carcinoma and miscellaneous gastric diseases. Twenty-one thousand three hundred and fourteen histological sections were reviewed under low-power 4X.

The percent of gastrectomies harboring a carcinoma increased significantly with increasing age more notably in those with diffuse carcinomas DC than in those with intestinal carcinomas IC. The percent of gastrectomies with EIM was significantly higher in specimens with IC than with DC, particularly among elderly patients, and in specimens from countries with a high cancer incidence. Migration per se did not influence the frequency of specimens with EIM in elderly Japanese patients: Japanese migrants to Hawaii had a similarly high frequency of EIM as those dwelling in Japan.

Japanese patients with a gastric carcinoma showed atypical mitoses in areas with EIM far from the tumor, suggesting that cellular mutation s play a role in the evolution of EIM towards gastric dysplasia and carcinoma in that ethnic group. The drawback of gastric biopsies in assessing the extent of gastric intestinal metaplasia and, thereby, estimating possible cancer risk in long-term studies has been stressed.

Esophagogastric metaplasia relates to nodal metastases in adenocarcinoma of esophagus and cardia. Immunohistochemical profiles of esophageal and cardia adenocarcinoma differ according to the presence or absence of Barrett's epithelium BIM and gastric intestinal metaplasia GIM in the fundus and antrum.

Different lymphatic spreading has been demonstrated in esophageal adenocarcinoma. We investigated the correlation among the presence or absence of intestinal metaplasia in the esophagus and stomach and lymphatic metastases in patients who underwent radical surgery for esophageal and cardia adenocarcinoma. The mucosa surrounding the adenocarcinoma and the gastric mucosa were analyzed. The radical thoracic station numbers 2, 3, 4R, 7, 8, and 9 and abdominal station numbers 15 through 20 lymphadenectomy was identical in both procedures except for the greater curvature.

According to the presence or absence of BIM and GIM in the esophagus and cardia, adenocarcinoma correspond to three different patterns of lymphatic metastasization, which may reflect different biologic and carcinogenetic pathways. Published by Elsevier Inc. Loss of p27 expression is frequently observed in pancreatic adenocarcinomas in human and is associated with decreased patient survival.

Similarly, in a mouse model of K-Ras-driven pancreatic cancer, loss of p27 accelerates tumor development and shortens survival, suggesting an important role for p27 in pancreatic tumorigenesis. Here, we sought to determine how p27 might contribute to early events leading to tumor development in the pancreas.

We found that K-Ras activation in the pancreas causes p27 mislocalization at pre-neoplastic stages. Moreover, loss of p27 or expression of a mutant p27 that does not bind cyclin-CDKs causes the mislocalization of several acinar polarity markers associated with metaplasia and induces the nuclear expression of Sox9 and Pdx1 two transcription factors involved in acinar-to-ductal metaplasia. Finally, we found that p27 directly represses transcription of Sox9, but not that of Pdx1.

Thus, our results suggest that K-Ras activation, the earliest known event in pancreatic carcinogenesis, may cause loss of nuclear p27 expression which results in derepression of Sox9, triggering reprogramming of acinar cells and metaplasia. Alpha 1-protease inhibitor moderates human neutrophil elastase-induced emphysema and secretory cell metaplasia in hamsters.

A study was undertaken to determine whether emphysema and airway secretory cell metaplasia , induced in hamsters by intratracheal treatment with human neutrophil elastase HNE , could be moderated by pretreatment with human alpha 1-protease inhibitor API. API 4. Eight weeks later, lung volumes and pressure-volume relationships were measured in the anaesthetized animals.

Mean linear intercepts and secretory cell indices were measured in lung sections. Nevertheless, we conclude that human API given intratracheally is efficacious against HNE-induced emphysema and secretory cell metaplasia. Atrophic gastritis AG and intestinal metaplasia IM are the main precursor lesions of gastric cancer as the incidence of gastric cancer increases in the gastric mucosa involved with AG and IM.

The prevalence of AG and IM vary depending on countries, even it represents diverse results in the same nation. The sensitivity and specificity of diagnostic methods to detect AG and IM are different. Furthermore, the management strategy of AG and IM has not been established, yet. Helicobacter pylori infection has been proved as the most important cause of AG and IM. Thus the eradication of H. Therefore, the understanding and early diagnosis of AG and IM are very important, especially, in high incidence area of gastric cancer such as Republic of Korea.

Helicobacter pylori infection with intestinal metaplasia : An independent risk factor for colorectal adenomas. Histopathological results were obtained by gastric and colorectal biopsies. Stratification based on H. Squamous metaplasia amplifies pathologic epithelial-mesenchymal interactions in COPD patients. Squamous metaplasia SM is common in smokers and is associated with airway obstruction in chronic obstructive pulmonary disease COPD.

A major mechanism of airway obstruction in COPD is thickening of the small airway walls. We asked whether SM actively contributes to airway wall thickening through alteration of epithelial-mesenchymal interactions in COPD. Gastric intestinal metaplasia as detected by a monoclonal antibody is highly associated with gastric adenocarcinoma.

Background: Some forms of gastric intestinal metaplasia GIM may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised. Mucin staining, as a means of differentiating GIM, is difficult. A monoclonal antibody, mAb Das-1 initially called 7E12H12 , whose staining is phenotypically specific to colon epithelium, was used to investigate this issue. Cancer areas from the same 56 patients also reacted. Some forms of gastric intestinal metaplasia GIM may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised.

A monoclonal antibody, mAb Das-1 initially called 7E 12 H 12 , whose staining is phenotypically specific to colon epithelium, was used to investigate this issue. Acinar-to-ductal metaplasia ADM is a reversible epithelial transdifferentiation process that occurs in the pancreas in response to acute inflammation. Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia. METHODS Pathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study.

Patient demographics, insurance status, and other clinical factors were reviewed. The aim of this study is to evaluate associations among the pH of gastric juice, atrophic gastritis AG , intestinal metaplasia IM , pepsinogen, and Helicobacter pylori infection. Methods Gastric biopsies and juice were collected from 46 subjects who underwent endoscopies at Seoul National University Bundang Hospital between November and March Results The mean pH of gastric juice was higher in the H.

When patients were divided into pH Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis. Whether gastric atrophy GA and intestinal metaplasia IM are reversible after the eradication of Helicobacter pylori remains controversial. The purpose of this meta-analysis was to systematically review histological alterations in GA and IM by comparing histological scores before and after H.

English-language articles in the medical literature containing information about the association between infection with H. Review Manager 4. Twelve studies containing a total of 2, patients were included in the first meta-analysis.

Comparing the histological alterations before and after H. Our study shows that eradication of H. Consequently, all patients with GA in the corpus should be tested for H. Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett's esophagus. To determine whether magnified observation of short-segment Barrett's esophagus BE is useful for the detection of specialized intestinal metaplasia SIM.

The magnified images were analyzed with respect to their pit-patterns, which were simultaneously classified into five epithelial types [I small round , II straight , III long oval , IV tubular , V villous ] by Endo's classification. Then, a 0. The patterns of the magnified image and MB staining were analyzed. Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy.

The magnified observation of a short-segment BE according to the mucosal pattern and its classification can be predictive of SIM. Gastric adenocarcinoma is one of the leading causes of cancer mortality worldwide.

Gastric juice plays a crucial role in the physiology of the stomach. Gastric biopsies and juice were collected from 46 subjects who underwent endoscopies at Seoul National University Bundang Hospital between November and March The mean pH of gastric juice was higher in the H. There is a relationship between chronic H.

Effect of Saraca asoca Asoka on estradiol-induced keratinizing metaplasia in rat uterus. Estrogen-mediated uterus endometrium instability is considered as one of the etiological factors in dysfunctional uterine bleeding DUB and uterine cancer. Saraca asoca Family: Fabaceae and its fermented preparation, Asokarishta, are extensively used as uterine tonic to treat gynecological disorders in Ayurveda. The present study evaluated the effect of S.

Uterus endometrial thickening was analyzed histopathologically and serum estrogen level by radioimmunoassay RIA. Cyclooxygenase COX-2 expression in rat uterus was also estimated by Western blot. Anti-inflammatory activity of the extract was analyzed by formalin- and carrageenan-elicited paw edema models in mouse.

Uterus endometrium proliferation and keratinized metaplasia with seven to eight stratified epithelial layers on day 16 was observed in rats administered with estradiol. Treatment with S. A reduction of formalin- and carrageenan-induced paw edema in mouse by S. Lower level of lipopolysaccharides LPS -induced COX-2 enzyme in rat uterus by the extract further confirms its anti-inflammatory activity.

Present study reveals the antiproliferative and antikeratinizing effects of S. Sirtuin-1 regulates acinar-to-ductal metaplasia and supports cancer cell viability in pancreatic cancer. The exocrine pancreas can undergo acinar-to-ductal metaplasia ADM , as in the case of pancreatitis where precursor lesions of pancreatic ductal adenocarcinoma PDAC can arise.

In this study, we examined the expression and the role of Sirt1 in different stages of pancreatic carcinogenesis, i. In addition, we analyzed the expression of KIAA, a key mediator of Sirt1 function, along with potential Sirt1 downstream targets. Sirt1 was co-expressed with KIAA in the nuclei of normal pancreatic acinar cells. In ADM, Sirt1 underwent a transient nuclear-to-cytoplasmic shuttling. Experiments where during ADM, we enforced repression of Sirt1 shuttling, inhibition of Sirt1 activity or modulation of its expression, all underscore that the temporary decrease of nuclear and increase of cytoplasmic Sirt1 stimulate ADM.

Our results reveal that Sirt1 is an important regulator and potential therapeutic target in pancreatic carcinogenesis. Canine mammary minute oncocytomas with neuroendocrine differentiation associated with multifocal acinar cell oncocytic metaplasia.

Two solitary and minute tumors of 1 and 1. The former tumors were well circumscribed and were composed of small-to-large polyhedral neoplastic oncocytes with finely granular eosinophilic cytoplasm, and were arranged in solid nests separated by fine fibrovascular septa. Scattered lumina of variable sizes containing eosinophilic secretory material were evident.

Cellular atypia was minimal, and no mitotic figures were visible. One tumor had several oncocytic cellular foci revealing cellular transition, with perivascular pseudorosettes consisting of columnar epithelial cells surrounding the fine vasculature. Scattered foci of mammary acinar cell hyperplasia showing oncocytic metaplasia were also observed. One tumor also had oncocytic cellular foci forming perivascular pseudorosettes showing cellular membrane immunoreactivity for neural cell adhesion molecule.

The tumors were negative for smooth muscle actin, neuron-specific enolase, vimentin, desmin, S, and synaptophysin. Ultrastructural observation confirmed the abundant mitochondria in the cytoplasm of both neoplastic and hyperplastic cells, the former cells also having neuroendocrine granule-like electron-dense bodies. From these results, our case was diagnosed with mammary oncocytomas accompanied by neuroendocrine differentiation.

Scattered foci of mammary oncocytosis might be related to the multicentric occurrence of these oncocytomas. Splenic myeloid metaplasia in warm autoimmune hemolytic anemia wAIHA : a retrospective study. The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion SC.

All patients received steroids as first-line treatment and splenectomy as second-line treatment. Among the thirty-six splenectomized patients, 15 No differences were found in clinical characteristics between two groups. Uterine serous carcinoma USC is an aggressive variant of Type 2 endometrial carcinoma, which in most cases exhibits, at least focally, a papillary architecture. Occasionally, especially in small biopsy specimens, it may be difficult to distinguish between USC and a variety of metaplastic or reactive processes.

In particular, papillary syncytial metaplasia PSM , as a result of endometrial breakdown, may be confused with USC or its precursor serous endometrial intraepithelial carcinoma. In such cases, immunohistochemistry is often undertaken, the panel of markers usually including estrogen receptor ER , p53, p16, and MIB1. The expected immunoprofile of USC is ER negative, p53 and p16 positive, and a high MIB1 proliferation index, although studies have shown that significant numbers of cases deviate from this immunophenotype.

With regard to the aforementioned markers, PSM has not been studied extensively, but intuitively, the expected immunophenotype would be ER positive, p53 and p16 negative, and a low MIB1 proliferation index.

We illustrate that compared with a nonbreaking down endometrium, PSM is characterized by a decreased expression of ER and an increased expression of p53 although still wild-type staining and p16, the latter marker typically being diffusely positive. In cases of PSM, which are morphologically problematic, the immunophenotype may further heighten the suspicion of serous malignancy and potentially result in a misdiagnosis.

Intestinal metaplasia with a high salt diet induces epithelial proliferation and alters cell composition in the gastric mucosa of mice. Intestinal metaplasia of the gastric mucosa is an important component in the pathway to adenocarcinoma. The mechanisms that induce the progression from intestinal metaplasia to cancer have not been elucidated. High dietary salt has been known as one of the risk factors for gastric cancer development in humans. Therefore, we investigated the role of high salt diet on gastric epithelial cell proliferation and differentiation, using our mouse model that ectopically expressed Cdx2 homeodomain transcription factor and induced an intestinal metaplastic phenotype in the gastric epithelia.

Sixty Cdx2 transgenic and sixty age-matched wild-type littermates were studied. Fifty-percent Cdx2 transgenic and wild type mice were administered a high-salt diet and the other fifty-percent was fed a standard diet starting at 12 weeks after birth. At 10, 20 and 40 weeks after initiation of the diets, histopathological changes were determined by Hemotoxylin and Eosin, alcian blue, and periodic acid-Schiff PAS staining.

Cell types and cell kinetics were assessed by immunohistochemistry.

AIDING ABETTING ILLEGAL ALIEN

These effects of APR were accompanied by near restoration of normal conjunctival epithelial histology. APR also reversed squamous metaplasia in pterygial epithelium that had developed after 4 days in ex vivo culture. Reductions in squamous metaplasia induced by APR suggest it may provide a novel therapeutic approach in different squamous metaplasia -associated ocular surface diseases.

Sousa, Josane F. Early diagnosis and curative resection are the predominant factors associated with increased survival in patients with gastric cancer. However, most gastric cancer cases are still diagnosed at later stages. Since most pathologic specimens are archived as FFPE samples, the ability to use them to generate expression profiles can greatly improve cancer biomarker discovery.

We sought to uncover new biomarkers for stomach preneoplastic metaplasias and neoplastic lesions by generating proteome profiles using FFPE samples. We combined peptide isoelectric focusing and liquid chromatography—tandem mass spectrometry analysis to generate proteomic profiles from FFPE samples of intestinal-type gastric cancer, metaplasia , and normal mucosa. The expression patterns of selected proteins were analyzed by immunostaining first in single tissue sections from normal stomach, metaplasia , and gastric cancer and later in larger tissue array cohorts.

We detected 60 proteins up-regulated and 87 proteins down-regulated during the progression from normal mucosa to metaplasia to gastric cancer. Two of the up-regulated proteins, LTF and DMBT1, were validated as specific markers for spasmolytic polypeptide—expressing metaplasia and intestinal metaplasia , respectively.

Thus, proteomic profiling using FFPE samples has led to the identification of two novel markers for stomach metaplasias and gastric cancer prognosis. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis. Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging MRI scans may develop after resolution of inflammation in patients with ankylosing spondylitis AS and may predict new bone formation in the spine.

Similar tissue, termed backfill, may also fill areas of excavated bone in the sacroiliac SI joints and may reflect resolution of inflammation and tissue repair at sites of erosions. The purpose of this study was to test our hypothesis that SI joint ankylosis develops following repair of erosions and that tissue characterized by fat metaplasia is a key intermediary step in this pathway.

Univariate and multivariate regression analyses focused first on identifying significant MRI predictors of new backfill and fat metaplasia. We then assessed the role of backfill and fat metaplasia in the development of new ankylosis. All analyses were adjusted for demographic features, treatment, and baseline and 2-year change in SSS values for parameters of inflammation and MRI structural lesions. Resolution of inflammation and reduction of erosions were each independently associated with the development of new backfill and fat metaplasia at 2 years on multivariate analyses.

Our data support a disease model whereby ankylosis develops following repair of erosions, and fat metaplasia and backfill are key intermediary steps in this pathway. Helicobacter heilmannii is a zoonotic bacterium that has been associated with gastric disease in humans. Markers for acid production by parietal cells and mucous metaplasia were also examined.

In the first 9 weeks postinfection, the mRNA expression of Muc6 was clearly upregulated in both the antrum and fundus of the stomach of H. Interestingly, Muc13 was upregulated already at 1 day postinfection in the fundus of the stomach. Its expression level remained high in the stomach over the course of the infection.

This mucin is, however, not expressed in a healthy stomach, and high expression of this mucin has so far only been described in gastric cancer. Mucous metaplasia present in the mucosa surrounding low-grade mucosa-associated lymphoid tissue MALT lymphoma-like lesions was also histologically confirmed. Our findings indicate that H.

Structural alterations of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence. Accumulating evidence suggests that the extracellular matrix play important roles in intercellular communications and contribute to the development of a number of diseases, including diseases of the gastrointestinal tract.

The present study examined the structural characteristics and alterations of the extracellular matrix of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence. A total of 41 esophageal tissue specimens 15 esophageal adenocarcinoma, 10 Barrett's esophagus intestinal metaplasia , seven dysplasia and nine normal esophagus were studied. The present study used transmission electron microscopy and computerized quantitative electron-microscopic analysis in order to investigate the characteristics of the extracellular matrix of the mucosa.

The study revealed that marked structural alterations of the mucosa stroma, relating to changes in the distribution and appearance of collagen fibers as well as to changes in numbers of matrix microvesicles, occur in Barrett's esophagus and esophageal adenocarcinoma. It was found that there were 3. The findings suggest that the redistribution of collagen fibers and increases in numbers of matrix microvesicles may play roles in the formation of specialized intestinal metaplasia and the development of adenocarcinoma.

Relation between reflux of bile acids into the stomach and gastric mucosal atrophy, intestinal metaplasia in biopsy specimens. During endoscopic examinations we collected fluid in the stomach that included reflux fluid from the duodenum, and assessed the effect of quantitatively determined bile acids on glandular atrophy and intestinal metaplasia using biopsy specimens.

A total of outpatients were enrolled in this study. Total bile acid concentration was measured by an enzyme immunoassay. Glandular atrophy and intestinal metaplasia scores were graded according to the Updated Sydney System. An effect of refluxed bile acids on atrophy and intestinal metaplasia was shown in the high-concentration reflux group in comparison with the control group.

However, when the odds ratios ORs were calculated according to whether Helicobacter pylori H. The same was true for intestinal metaplasia in the H. We could not clarify the effect of the reflux of bile acids into the stomach in the progression of atrophy. High-concentration bile acids had an effect on the progression of intestinal metaplasia in the H. Gastric intestinal metaplasia is a precancerous change of the mucosa of the stomach with intestinal epithelium, and is associated with an increased risk of dysplasia and cancer.

The pathogenesis to gastric cancer is proposed by the Correa hypothesis as the transition from normal gastric epithelium to invasive cancer via inflammation followed by intramucosal cancer and invasion. Multiple risk factors have been associated with the development of gastric intestinal metaplasia interplay, including Helicobacter pylori infection and associated genomics, host genetic factors, environmental milieu, rheumatologic disorders, diet, and intestinal microbiota.

Globally, screening guidelines have been established in countries with high incidence. In the United States, no such guidelines have been developed due to lower, albeit increasing, incidence. The American Society for Gastrointestinal Endoscopy recommends a case-by-case patient assessment based upon epidemiology, genetics, and environmental risk factors. Studies have examined the use of a serologic biopsy to stratify risk based upon factors such as H pylori status and virulence factors, along with serologic markers of chronic inflammation including pepsinogen I, pepsinogen II, and gastrin.

High-risk patients may then be advised to undergo endoscopic evaluation with mapping biopsies from the antrum greater curvature, lesser curvature , incisura angularis, and corpus greater curvature, lesser curvature.

Surveillance guidelines have not been firmly established for patients with known gastric intestinal metaplasia , but include repeat endoscopy at intervals according to the histologic risk for malignant transformation. Intestinal metaplasia in Barrett's oesophagus BO represents an important risk factor for oesophageal adenocarcinoma.

Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia CLO , posing an issue about its clinical management. The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells. These findings suggest that some immunophenotypic changes are present in CLO and they can precede the appearance of the goblet cells or can be present independently of them, confirming the conception of BO as the condition characterized by any extention of columnar epithelium.

METHODS: Distal esophageal mucosal samples obtained by endoscopy and histologically diagnosed as gastric-type non-specialized columnar metaplasia , were studied thoroughly. Deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer: A correlated study.

AIM: To investigate the correlation among the presence and degree of gastric metaplasia of duodenal regenerating mucosa, the deformity of bulb and the recurrence of duodenal ulcer. All patients received follow-up endoscopic examinations 6 wk after treatment. When the ulcer s were noted to be healed, two biopsies were taken from the ulcer scar for histological study of gastric metaplasia , and 4 biopsies were taken from antrum for Helicobacter pylori H pylori study.

Out of these cases, 44 received further follow-up endoscopic examinations after 3, 6 and 12 mo respectively for studying the recurrence rate of duodenal ulcers. The correlation among ulcer recurrence, degree of gastric metaplasia of regenerating mucosa, bulbar deformity, and colonization of H pylori in the stomach was then studied.

RESULTS: The results showed that there was a strong correlation between the deformity of duodenal bulb and the degree of gastric metaplasia of regenerating duodenal mucosa. A more severely deformed duodenal bulb is closely related to a greater extent of gastric metaplasia. Both factors contribute to the recurrence of duodenal ulcer. Clinical significance of spasmolytic polypeptide-expressing metaplasia and intestinal metaplasia in Epstein-Barr virus-associated and Epstein-Barr virus-negative gastric cancer.

Spasmolytic polypeptide-expressing metaplasia SPEM and intestinal metaplasia IM have been recognized as neoplastic precursors in gastric carcinogenesis. Acute and chronic inflammation was graded as absent, mild, moderate, and marked. Univariate and multivariate logistic regression analyses were conducted to analyze the correlation between SPEM, IM, and inflammation. Our study revealed that SPEM was detected in Atrophy and intestinal metaplasia are early phenotypic markers in gastric carcinogenesis.

White light endoscopy does not allow direct biopsy of intestinal metaplasia due to a lack of contrast of the mucosa. Narrow-band imaging is known to enhance the visibility of intestinal metaplasia , to reduce sampling error, and to increase the diagnostic yield of endoscopy for intestinal metaplasia in Asian patients. The aim of our study was to validate the diagnostic performance of narrow-band imaging using 1.

A retrospective cohort study was conducted on consecutive patients with dyspeptic symptoms at a private endoscopy center within the time frame of January to December The prevalence of H. Among the patients with intestinal metaplasia , Two patients had low-grade dysplasia. The sensitivity of white light endoscopy was The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of narrow-band imaging with a positive light blue crest were 85, 98, Through the assessment of the microsurface structure and light blue crest sign, non-optical zoom narrow-band imaging had high predictive values for detecting intestinal metaplasia in patients from a general Western setting.

Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico. Intestinal metaplasia is a precursor lesion of gastric cancer. Infection by Helicobacter pylori is the principal cause of metaplasia. While evidence of the regression of metaplasia after treatment to eradicate this infection has been demonstrated, controversy remains with regard to this subject.

The objective of this study was to determine the frequency of the regression of gastric intestinal metaplasia one year after the eradication of Helicobacter pylori. A prospective longitudinal designed study was carried out. The population studied in this research consisted of patients attending the Endoscopy Unit to undergo an upper endoscopy, in whom various symptoms indicated intestinal metaplasia associated with Helicobacter pylori, and who received standard empiric triple therapy to eradicate the bacteria.

An upper endoscopy was performed in which four gastric biopsy samples were taken two from the antrum and two from the body before and after the eradicating treatment, with the endoscopic and histological findings studied after one year of monitoring. The statistical analysis was conducted using the Fisher's exact test and the McNemar's test.

Forty-six patients were studied, of whom 20 Complete intestinal metaplasia type I was found in 35 patients Non-atrophic chronic gastritis was found in 35 In this study, gastric intestinal metaplasia associated with Helicobacter pylori infection showed a regression of Cigarette smoke suppresses Bik to cause epithelial cell hyperplasia and mucous cell metaplasia.

Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis. Because the Bcl-2 family of proteins is crucial for airway epithelial homeostasis, identifying the players that reduce cigarette smoke CS -induced mucous cell metaplasia can help to develop effective therapies.

To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia. We screened for dysregulated expression of the Bcl-2 family members. We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects. Restoring Bik expression significantly suppressed CS-induced mucous cell metaplasia in differentiated primary HAEC cultures and in airways of mice in vivo.

These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis. Foveolar gastric metaplasia of the duodenum: a frequent, so far neglected type of duodenal polyp. Foveolar gastric metaplasia of the duodenum FGM is considered as imperfect mucosal healing in the context of H. During diagnostic histological examinations we observed a frequent so far not described association of FGM with endoscopically observed duodenal polyps.

In Institute 2, cases of FGM were diagnosed. In conclusion, foveolar gastric metaplasia is a frequent, so far neglected correlate of endoscopically detected duodenal polyps. Rationale: Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis.

Objectives: To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia. Methods: We screened for dysregulated expression of the Bcl-2 family members. Measurements and Main Results: We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects.

Conclusions: These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis. Heterotopic gastric mucosa in the gallbladder is an unusual entity and is usually clinically silent. We report a year-old female patient who presented with intermittent upper abdomial pain radiating to the back. Abdominal imaging studies showed a sessile polypoid lesion and a gallstone in the gallbladder.

Gallbladder carcinoma was suspected and cholecystectomy performed. Intraoperative frozen section examination suggested mucinous tumor, suspicious for malignancy. However, the permanent sections revealed aberrant gastric tissue consisted of gastric pyloric and fundic glands of heterotopic gastric mucosa with intestinal metaplasia in the gallbladder. Dysplastic intestinal-type metaplasia of appendiceal endometriosis: a mimic of low grade appendiceal mucinous neoplasm. We report an example of dysplastic intestinal-type metaplasia involving endometriosis of the appendix in a 45 year old woman.

One other example of this phenomenon has been reported. As it occurs within the muscular wall of the appendix, confusion with low grade appendiceal mucinous neoplasm LAMN may occur. Evidence supporting the metaplastic nature of the intestinal epithelium is offered. As the initial pathological diagnosis was of invasive cancer with perforation of the appendix treatment consisted of peritonectomy and hyperthermic intraperitoneal chemotherapy HIPEC.

Pathological documentation of complete elimination of Barrett's metaplasia following endoscopic multipolar electrocoagulation therapy. The previous paradigm that Barrett's is an irreversible premalignant lesion has recently been challenged by a proliferation of reports documenting elimination of Barrett's by a variety of endoscopic techniques. Whether Barrett's is entirely eliminated is unknown as endoscopic biopsy samples the surface of the epithelium only.

Numerous reports document underlying specialised columnar epithelium in many of these trials. Until now there have been no reports of pathological examination of the entire oesophagus as a specimen. This case documents complete elimination of intestinal metaplasia from the oesophagus and supports the biological plausibility of these research techniques.

Factors to improve the interobserver agreement for gastric atrophy and intestinal metaplasia : consensus of definition and criteria. Intestinal metaplasia and atrophy of the gastric mucosa are associated with Helicobacter pylori infection and are considered premalignant lesions. The updated Sydney system is used for these parameters, but experienced pathologists and consensus processes are required for interobserver agreement.

We sought to determine the influence of the consensus process on the assessment of intestinal metaplasia and atrophy. Two study sets were used: consensus and validation. The consensus set was circulated and five gastrointestinal pathologists evaluated them independently using the updated Sydney system. The consensus of the definitions was then determined at the first consensus meeting. The same set was recirculated to determine the effect of the consensus.

The second consensus meeting was held to standardise the grading criteria and the validation set was circulated to determine the influence. Two additional circulations were performed to assess the maintainance of consensus and intraobserver variability. This study suggests that interobserver variability regarding intestinal metaplasia and atrophy may result from lack of a precise definition and fine criteria, and can be reduced by consensus of definition and standardisation of grading criteria.

The diagnosis of patients with short segments of intestinal metaplasia in the distal esophagus, has increased in recent years. To assess the clinical, pathological and functional features of patients with esophageal intestinal metaplasia. A prospective study was performed in 95 control subjects, patients with cardial intestinal metaplasia and 89 patients with short Barret esophagus with intestinal metaplasia. All had clinical and endoscopic assessments, esophageal manometry and determination of 24 h esophageal exposure to acid and duodenal content.

Control patients were younger and, in this group, the pathological findings in the mucosa distal to the squamous-columnar change, showed a preponderance of fundic over cardial mucosa. In patients with intestinal metaplasia and short Barret esophagus, there was only cardial mucosa, that is the place where intestinal metaplasia implants. Low grade dysplasia was only seen in the presence of intestinal metaplasia. Gastroesophageal sphincter pressure decreased and gastric and duodenal reflux increased along with increases in the extension of intestinal metaplasia.

These findings confirm the need to obtain multiple biopsies from the squamous-columnar mucosal junction in all patients with gastroesophageal reflux symptoms, for the detection of early pathological changes of Barret esophagus and eventual dysplasia. Down-regulation of EMP1 is associated with epithelial hyperplasia and metaplasia in nasal polyps. The aim of this study was to assess protein and mRNA expression of epithelial membrane protein 1 EMP1 in the nasal mucosa of patients with nasal polyps NP , and to determine what changes occur in response to glucocorticosteroid GC treatment.

NP tissue was obtained from 55 patients, 18 of whom were treated with nasal GCs i. Biopsies of inferior turbinate mucosa from 30 healthy subjects were used as controls. Their immunoreactivity was significantly greater in controls than NP patients. Positive correlations between EMP1 and other epithelial cell-related gene e. EMP1 could be a biomarker for aberrant epithelial remodelling and metaplasia in chronic inflammatory upper airway mucosa e.

Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis. There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease IBD. However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented.

We report a case of a year-old female with a history of colonic adenocarcinoma who presented with pruritic, erythematous, scaly plaques on the right lower abdomen, present since reversal of her ileostomy in Skin biopsy revealed benign foci of colonic epithelium with no evidence of adenomatous change. Benign intraepidermal colonic mucosa was diagnosed based on histopathologic findings and immunohistochemistry.

To our knowledge, this is the first case of intraepidermal benign colonic metaplasia forming in a patient following ostomy reversal. The case emphasizes the importance of patient education and physical examination of the stoma or stoma remnants for detection of unusual or changing lesions due to the risk for malignant transformation. It also demonstrates that benign colonic mucosa should be considered in the differential diagnosis when evaluating lesions near ileostomy sites, regardless of whether the patient has a history of familial adenomatous polyposis or IBD.

Transitional metaplasia in intestinal epithelium of rats submitted to intestinal cystoplasty and treatment with L -lysine. To evaluated the effects of L-lysine on the intestinal and urothelial epithelia in cystoplasty in rats. No inflammatory cells, dysplasia or abnormalities were observed. Staining with Alcian blue revealed a substantial reduction of goblet cells and mucins in the colon segment Groups A and B. The administration of L-lysine to rats accelerated the development of transitional metaplasia in the epithelium of the colon segment in cystoplasty.

Influence of cyclic hydrostatic pressure on fibrocartilaginous metaplasia of achilles tendon fibroblasts. The goal of this study was to demonstrate whether cyclically imposed hydrostatic pressure, compressive in nature, could induce fibrocartilaginous metaplasia in a purely tendinous cell source in vitro.

The effect of short-duration cyclic hydrostatic pressure on tendon fibroblasts tenocytes expanded from rat Achilles tendon was studied. Total RNA was isolated either immediately after loading or 24 h later. Noticeably, for RNA samples isolated 24 h later, there were further increases in mRNA expression of Aggrecan and Collagen type II, whereas Collagen type I increased roughly three-fold relative to the non-loaded control.

These findings support the hypothesis that cyclic hydrostatic pressurization can induce fibrocartilaginous metaplasia in tenocytes by upregulation of cartilaginous gene expression. Also, it was demonstrated that changes in mRNA expression as a result of single 2 h pressurization persist even up to 24 h. The predictive value of gastric metaplasia in the duodenal mucosa in patients Helicobacter pylori-positive patients with duodenal bulb ulcer DBU was investigated. One hundred and twenty four randomly selected patients with DBU were included in this prospective study.

Regions of gastric metaplasia of the duodenum were confirmed by periodic acid-Schiff and alcian blue Serva staining pH 1. Gastric metaplasia in the duodenum was found in 64 or The following facts about the predictive factor for the prognosis of DU complication were found: the sensitivity of The study revealed a high and significant p metaplasia in the duodenum as a marker of non-complicated clinical course of DU in HP-positive patients within an 8 to year period.

Ecuador currently holds the 15th place of countries with the highest incidence of stomach cancer for both sexes. All participants were personally interviewed using a structured questionnaire to collect data about dietary habits, lifestyle and medical history. Pylori infection AOR: 0. Interleukin 10 is an essential modulator of mucoid metaplasia in a mouse otitis media model. In wild-type mice, both S. In IL knockout mice, the number of goblet cells and mucin-producing cells in the middle ear was significantly reduced after bacterial middle ear infection compared with that in wild-type mice.

In this study, we report about a patient with extra-uterine endometriosis EM in the abdominal wall muscle with evident metaplasia based on the abundant alpha smooth muscle actin ASMA -expressing myofibroblasts. Laparotomy excision of the abdominal wall EM was done following ultrasonographic evidence of a hypodense swelling in the right rectus abdominis, which was confirmed by MRI.

Immunohistochemistry staining for ASMA and collagen I was done, with the results confirming that endometriotic stromal cells expressed both. Anterior abdominal wall endometriosis was suspected because of the patient's history of recurrent EM combined with the cyclic nature of symptoms. MRI is useful in determining the extent of the disease. In case of persisting symptoms even under hormonal treatment, surgical excision is mandatory. The expression of both ASMA and collagen I in and around EM lesions supports the notion of the metaplastic process in the course of disease development.

Karger AG, Basel. Label-free identification of intestinal metaplasia in the stomach using multiphoton microscopy. The early diagnosis of intestinal metaplasia IM in the stomach together with effective therapeutic interventions is crucial to reducing the mortality-rates of the patients associated with gastric cancer.

Here, we describe a label-free imaging method, multiphoton microscopy MPM , for the identification of IM in the stomach. It was found that multiphoton imaging provides cellular and subcellular details to the identification of IM from normal gastric tissues. In particular, there is significant difference in the population density of goblet cells between normal and IM gastric tissues, providing substantial potential to become a quantitative intrinsic marker for in vivo clinical diagnosis of early gastric lesions.

To our knowledge, this is the first demonstration of the potential of MPM for the identification of IM. Columnar metaplasia in a surgical mouse model of gastro-esophageal reflux disease is not derived from bone marrow-derived cell. The incidence of esophageal adenocarcinoma has increased in the last 25 years. Columnar metaplasia in Barrett's mucosa is assumed to be a precancerous lesion for esophageal adenocarcinoma.

However, the induction process of Barrett's mucosa is still unknown. To analyze the induction of esophageal columnar metaplasia , we established a mouse gastro-esophageal reflux disease GERD model with associated development of columnar metaplasia in the esophagus. To analyze the contribution of bone marrow-derived cells to columnar metaplasia in this surgical GERD model, some mice were transplanted with GFP-marked bone marrow after the operation.

Bone marrow-derived cells were not detected in columnar metaplastic epithelia. However, scattered epithelial cells in the thickened squamous epithelia in regions of esophagitis did show bone marrow derivation. The results demonstrate that reflux induced by esophago-jejunostomy in mice leads to the development of columnar metaplasia in the esophagus.

However, bone marrow-derived cells do not contribute directly to columnar metaplasia in this mouse model. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy. The vast majority of urothelial carcinomas infiltrating the bladder are consistente with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied.

We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes. Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts.

The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma. In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin 34BetaE12 and thrombomodulin.

No metastases were found in either of the patients, and one of them has survived for five years. The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients. Extended intestinal metaplasia.

A survey of gastrectomies from dwellers of the Pacific basin. To assess the extent of gastric intestinal metaplasia IM in gastrectomy specimens in populations of the Pacific basin having different incidence of gastric carcinoma. One thousand three hundred and nine-two gastrectomies were investigated: had a gastric carcinoma and miscellaneous gastric diseases. Twenty-one thousand three hundred and fourteen histological sections were reviewed under low-power 4X.

The percent of gastrectomies harboring a carcinoma increased significantly with increasing age more notably in those with diffuse carcinomas DC than in those with intestinal carcinomas IC. The percent of gastrectomies with EIM was significantly higher in specimens with IC than with DC, particularly among elderly patients, and in specimens from countries with a high cancer incidence. Migration per se did not influence the frequency of specimens with EIM in elderly Japanese patients: Japanese migrants to Hawaii had a similarly high frequency of EIM as those dwelling in Japan.

Japanese patients with a gastric carcinoma showed atypical mitoses in areas with EIM far from the tumor, suggesting that cellular mutation s play a role in the evolution of EIM towards gastric dysplasia and carcinoma in that ethnic group. The drawback of gastric biopsies in assessing the extent of gastric intestinal metaplasia and, thereby, estimating possible cancer risk in long-term studies has been stressed.

Esophagogastric metaplasia relates to nodal metastases in adenocarcinoma of esophagus and cardia. Immunohistochemical profiles of esophageal and cardia adenocarcinoma differ according to the presence or absence of Barrett's epithelium BIM and gastric intestinal metaplasia GIM in the fundus and antrum. Different lymphatic spreading has been demonstrated in esophageal adenocarcinoma. We investigated the correlation among the presence or absence of intestinal metaplasia in the esophagus and stomach and lymphatic metastases in patients who underwent radical surgery for esophageal and cardia adenocarcinoma.

The mucosa surrounding the adenocarcinoma and the gastric mucosa were analyzed. The radical thoracic station numbers 2, 3, 4R, 7, 8, and 9 and abdominal station numbers 15 through 20 lymphadenectomy was identical in both procedures except for the greater curvature. According to the presence or absence of BIM and GIM in the esophagus and cardia, adenocarcinoma correspond to three different patterns of lymphatic metastasization, which may reflect different biologic and carcinogenetic pathways.

Published by Elsevier Inc. Loss of p27 expression is frequently observed in pancreatic adenocarcinomas in human and is associated with decreased patient survival. Similarly, in a mouse model of K-Ras-driven pancreatic cancer, loss of p27 accelerates tumor development and shortens survival, suggesting an important role for p27 in pancreatic tumorigenesis.

Here, we sought to determine how p27 might contribute to early events leading to tumor development in the pancreas. We found that K-Ras activation in the pancreas causes p27 mislocalization at pre-neoplastic stages. Moreover, loss of p27 or expression of a mutant p27 that does not bind cyclin-CDKs causes the mislocalization of several acinar polarity markers associated with metaplasia and induces the nuclear expression of Sox9 and Pdx1 two transcription factors involved in acinar-to-ductal metaplasia.

Finally, we found that p27 directly represses transcription of Sox9, but not that of Pdx1. Thus, our results suggest that K-Ras activation, the earliest known event in pancreatic carcinogenesis, may cause loss of nuclear p27 expression which results in derepression of Sox9, triggering reprogramming of acinar cells and metaplasia. Alpha 1-protease inhibitor moderates human neutrophil elastase-induced emphysema and secretory cell metaplasia in hamsters.

A study was undertaken to determine whether emphysema and airway secretory cell metaplasia , induced in hamsters by intratracheal treatment with human neutrophil elastase HNE , could be moderated by pretreatment with human alpha 1-protease inhibitor API.

API 4. Eight weeks later, lung volumes and pressure-volume relationships were measured in the anaesthetized animals. Mean linear intercepts and secretory cell indices were measured in lung sections. Nevertheless, we conclude that human API given intratracheally is efficacious against HNE-induced emphysema and secretory cell metaplasia.

Atrophic gastritis AG and intestinal metaplasia IM are the main precursor lesions of gastric cancer as the incidence of gastric cancer increases in the gastric mucosa involved with AG and IM. The prevalence of AG and IM vary depending on countries, even it represents diverse results in the same nation. The sensitivity and specificity of diagnostic methods to detect AG and IM are different. Furthermore, the management strategy of AG and IM has not been established, yet. Helicobacter pylori infection has been proved as the most important cause of AG and IM.

Thus the eradication of H. Therefore, the understanding and early diagnosis of AG and IM are very important, especially, in high incidence area of gastric cancer such as Republic of Korea. Helicobacter pylori infection with intestinal metaplasia : An independent risk factor for colorectal adenomas. Histopathological results were obtained by gastric and colorectal biopsies. Stratification based on H. Squamous metaplasia amplifies pathologic epithelial-mesenchymal interactions in COPD patients.

Squamous metaplasia SM is common in smokers and is associated with airway obstruction in chronic obstructive pulmonary disease COPD. A major mechanism of airway obstruction in COPD is thickening of the small airway walls. We asked whether SM actively contributes to airway wall thickening through alteration of epithelial-mesenchymal interactions in COPD. Gastric intestinal metaplasia as detected by a monoclonal antibody is highly associated with gastric adenocarcinoma.

Background: Some forms of gastric intestinal metaplasia GIM may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised. Mucin staining, as a means of differentiating GIM, is difficult. A monoclonal antibody, mAb Das-1 initially called 7E12H12 , whose staining is phenotypically specific to colon epithelium, was used to investigate this issue.

Cancer areas from the same 56 patients also reacted. Some forms of gastric intestinal metaplasia GIM may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised. A monoclonal antibody, mAb Das-1 initially called 7E 12 H 12 , whose staining is phenotypically specific to colon epithelium, was used to investigate this issue. Acinar-to-ductal metaplasia ADM is a reversible epithelial transdifferentiation process that occurs in the pancreas in response to acute inflammation.

Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia. METHODS Pathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed.

The aim of this study is to evaluate associations among the pH of gastric juice, atrophic gastritis AG , intestinal metaplasia IM , pepsinogen, and Helicobacter pylori infection. Methods Gastric biopsies and juice were collected from 46 subjects who underwent endoscopies at Seoul National University Bundang Hospital between November and March Results The mean pH of gastric juice was higher in the H.

When patients were divided into pH Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis. Whether gastric atrophy GA and intestinal metaplasia IM are reversible after the eradication of Helicobacter pylori remains controversial. The purpose of this meta-analysis was to systematically review histological alterations in GA and IM by comparing histological scores before and after H.

English-language articles in the medical literature containing information about the association between infection with H. Review Manager 4. Twelve studies containing a total of 2, patients were included in the first meta-analysis. Comparing the histological alterations before and after H. Our study shows that eradication of H. Consequently, all patients with GA in the corpus should be tested for H. Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett's esophagus.

To determine whether magnified observation of short-segment Barrett's esophagus BE is useful for the detection of specialized intestinal metaplasia SIM. The magnified images were analyzed with respect to their pit-patterns, which were simultaneously classified into five epithelial types [I small round , II straight , III long oval , IV tubular , V villous ] by Endo's classification.

Then, a 0. The patterns of the magnified image and MB staining were analyzed. Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy. The magnified observation of a short-segment BE according to the mucosal pattern and its classification can be predictive of SIM. Gastric adenocarcinoma is one of the leading causes of cancer mortality worldwide.

Gastric juice plays a crucial role in the physiology of the stomach. Gastric biopsies and juice were collected from 46 subjects who underwent endoscopies at Seoul National University Bundang Hospital between November and March The mean pH of gastric juice was higher in the H. There is a relationship between chronic H. Effect of Saraca asoca Asoka on estradiol-induced keratinizing metaplasia in rat uterus. Estrogen-mediated uterus endometrium instability is considered as one of the etiological factors in dysfunctional uterine bleeding DUB and uterine cancer.

Saraca asoca Family: Fabaceae and its fermented preparation, Asokarishta, are extensively used as uterine tonic to treat gynecological disorders in Ayurveda. The present study evaluated the effect of S. Uterus endometrial thickening was analyzed histopathologically and serum estrogen level by radioimmunoassay RIA.

Cyclooxygenase COX-2 expression in rat uterus was also estimated by Western blot. Anti-inflammatory activity of the extract was analyzed by formalin- and carrageenan-elicited paw edema models in mouse. Uterus endometrium proliferation and keratinized metaplasia with seven to eight stratified epithelial layers on day 16 was observed in rats administered with estradiol.

Treatment with S. A reduction of formalin- and carrageenan-induced paw edema in mouse by S. Lower level of lipopolysaccharides LPS -induced COX-2 enzyme in rat uterus by the extract further confirms its anti-inflammatory activity. Present study reveals the antiproliferative and antikeratinizing effects of S. Sirtuin-1 regulates acinar-to-ductal metaplasia and supports cancer cell viability in pancreatic cancer. The exocrine pancreas can undergo acinar-to-ductal metaplasia ADM , as in the case of pancreatitis where precursor lesions of pancreatic ductal adenocarcinoma PDAC can arise.

In this study, we examined the expression and the role of Sirt1 in different stages of pancreatic carcinogenesis, i. In addition, we analyzed the expression of KIAA, a key mediator of Sirt1 function, along with potential Sirt1 downstream targets. Sirt1 was co-expressed with KIAA in the nuclei of normal pancreatic acinar cells. In ADM, Sirt1 underwent a transient nuclear-to-cytoplasmic shuttling.

Experiments where during ADM, we enforced repression of Sirt1 shuttling, inhibition of Sirt1 activity or modulation of its expression, all underscore that the temporary decrease of nuclear and increase of cytoplasmic Sirt1 stimulate ADM. Our results reveal that Sirt1 is an important regulator and potential therapeutic target in pancreatic carcinogenesis.

Canine mammary minute oncocytomas with neuroendocrine differentiation associated with multifocal acinar cell oncocytic metaplasia. Two solitary and minute tumors of 1 and 1. The former tumors were well circumscribed and were composed of small-to-large polyhedral neoplastic oncocytes with finely granular eosinophilic cytoplasm, and were arranged in solid nests separated by fine fibrovascular septa.

Scattered lumina of variable sizes containing eosinophilic secretory material were evident. Cellular atypia was minimal, and no mitotic figures were visible. One tumor had several oncocytic cellular foci revealing cellular transition, with perivascular pseudorosettes consisting of columnar epithelial cells surrounding the fine vasculature.

Scattered foci of mammary acinar cell hyperplasia showing oncocytic metaplasia were also observed. One tumor also had oncocytic cellular foci forming perivascular pseudorosettes showing cellular membrane immunoreactivity for neural cell adhesion molecule. The tumors were negative for smooth muscle actin, neuron-specific enolase, vimentin, desmin, S, and synaptophysin.

Ultrastructural observation confirmed the abundant mitochondria in the cytoplasm of both neoplastic and hyperplastic cells, the former cells also having neuroendocrine granule-like electron-dense bodies. From these results, our case was diagnosed with mammary oncocytomas accompanied by neuroendocrine differentiation. Scattered foci of mammary oncocytosis might be related to the multicentric occurrence of these oncocytomas. Splenic myeloid metaplasia in warm autoimmune hemolytic anemia wAIHA : a retrospective study.

The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion SC. All patients received steroids as first-line treatment and splenectomy as second-line treatment. Among the thirty-six splenectomized patients, 15 No differences were found in clinical characteristics between two groups.

Uterine serous carcinoma USC is an aggressive variant of Type 2 endometrial carcinoma, which in most cases exhibits, at least focally, a papillary architecture. Occasionally, especially in small biopsy specimens, it may be difficult to distinguish between USC and a variety of metaplastic or reactive processes.

In particular, papillary syncytial metaplasia PSM , as a result of endometrial breakdown, may be confused with USC or its precursor serous endometrial intraepithelial carcinoma. In such cases, immunohistochemistry is often undertaken, the panel of markers usually including estrogen receptor ER , p53, p16, and MIB1. The expected immunoprofile of USC is ER negative, p53 and p16 positive, and a high MIB1 proliferation index, although studies have shown that significant numbers of cases deviate from this immunophenotype.

With regard to the aforementioned markers, PSM has not been studied extensively, but intuitively, the expected immunophenotype would be ER positive, p53 and p16 negative, and a low MIB1 proliferation index. We illustrate that compared with a nonbreaking down endometrium, PSM is characterized by a decreased expression of ER and an increased expression of p53 although still wild-type staining and p16, the latter marker typically being diffusely positive.

In cases of PSM, which are morphologically problematic, the immunophenotype may further heighten the suspicion of serous malignancy and potentially result in a misdiagnosis. Intestinal metaplasia with a high salt diet induces epithelial proliferation and alters cell composition in the gastric mucosa of mice. Intestinal metaplasia of the gastric mucosa is an important component in the pathway to adenocarcinoma. The mechanisms that induce the progression from intestinal metaplasia to cancer have not been elucidated.

High dietary salt has been known as one of the risk factors for gastric cancer development in humans. Therefore, we investigated the role of high salt diet on gastric epithelial cell proliferation and differentiation, using our mouse model that ectopically expressed Cdx2 homeodomain transcription factor and induced an intestinal metaplastic phenotype in the gastric epithelia. Sixty Cdx2 transgenic and sixty age-matched wild-type littermates were studied.

Fifty-percent Cdx2 transgenic and wild type mice were administered a high-salt diet and the other fifty-percent was fed a standard diet starting at 12 weeks after birth. At 10, 20 and 40 weeks after initiation of the diets, histopathological changes were determined by Hemotoxylin and Eosin, alcian blue, and periodic acid-Schiff PAS staining. Cell types and cell kinetics were assessed by immunohistochemistry. At 52 weeks, significant alterations in pathology were observed in the Cdx2 transgenic mice fed a high-salt diet, including elongation of gastric pits, reduction of the glandular zone in the gastric corpus, and deepening of glands in the antrum.

In the Cdx2 transgenic mice fed a high salt diet, the parietal and chief cells were significantly decreased in the gastric corpus. A significant increase in cell proliferation and apoptosis in the corpus and antrum were observed in Cdx2 transgenic mice fed a high-salt diet as compared to wild-type littermates. Taken together, these data implicate that intestinal metaplasia in concert with a high-salt diet induces epithelial proliferation, apoptosis, and alters cellular types in the gastric mucosa of mice.

Alteration in the composition of the gastric epithelium may play a role in influencing the microenvironment to engender susceptibility to carcinogens. Gary; Levine, Ross L. Subsequent analysis has shown that constitutive activation of the JAK-STAT signal transduction pathway is an important pathogenetic event in these patients, and that enzymatic inhibition of JAK2VF may be of therapeutic benefit in this context. In a murine bone marrow transplant assay, expression of MPLWL, but not wild-type MPL, resulted in a fully penetrant myeloproliferative disorder characterized by marked thrombocytosis Plt count 1.

MPLWL is a novel somatic activating mutation in myelofibrosis with myeloid metaplasia. A randomized, prospective cross-over trial comparing methylene blue-directed biopsy and conventional random biopsy for detecting intestinal metaplasia and dysplasia in Barrett's esophagus. The value of methylene blue-directed biopsies MBDB in detecting specialized intestinal metaplasia and dysplasia in Barrett's esophagus remains unclear.

The aim of this study was to compare the accuracy of MBDB with random biopsy in detecting intestinal metaplasia and dysplasia in patients with Barrett's esophagus. A prospective, randomized, cross-over trial was undertaken to compare MBDB with random biopsy in patients with Barrett's esophagus segments 3 cm or more in length without macroscopic evidence of dysplasia or cancer.

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Cdx genes, inflammation, and the pathogenesis of intestinal metaplasia.

Each way horse betting rules for horse Among the risk factors 18 betting, only family joelmir betting pterygium hazard ratio, 3. The aim of our study was to validate the diagnostic performance of narrow-band imaging using 1. Barrett's oesophagus: intestinal metaplasia is not essential for cancer risk. The five point ordinal scale and profile tests were used for evaluation. During endoscopic examinations we collected fluid in the stomach that included reflux fluid from the duodenum, and assessed the effect of quantitatively determined bile acids on glandular atrophy and intestinal metaplasia using biopsy specimens.
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Joelmir betting pterygium Currently diagnosis the of Barrett's oesophagus is predominantly made after endoscopic visualisation and histopathological confirmation. Last post: Feb 07,pm Collecting Crypto Income The findings joelmir betting pterygium that joelmir betting pterygium redistribution of collagen fibers and increases in numbers of matrix microvesicles may play roles in the formation of specialized intestinal metaplasia and the development of adenocarcinoma. Mild motor dysfunction is seen with gastro-esophageal reflux disease GERD and we feel that the demonstration of localized ganglioneuromatosis was not likely related etiologically. Univariate analysis, bivariate chi-square and Fisher exact testand multivariate binary logistic regression test were programmed with SPSS version There was no significant association between degree of lymphocyte infiltration with MDA level. Here, we discuss how all available evidence suggests that mature chief cells in the adult, mammalian stomach are postmitotic, slowly turning over cells that arise via a relatively long-lived progenitor, the mucous neck cell, The differentiation of chief cells from neck cells does not involve cell division, and the neck cell has its own distinct pattern of gene expression and putative physiological function.
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Joelmir betting pterygium During cheese ripening naturally occurring milk protease — plasmin, and thermostable proteases of raw milk microflora are also involved in proteolytic process. Full Text Available Abstract Despite their great importance for the food industry, flavorings, in general, raise a number of joelmir betting pterygium regarding their cytotoxicity, mutagenicity and carcinogenicity, since, in the literature, there are few studies found evaluating the toxicity on the systemic and cellular level, of these chemical compounds. No literature is available regarding the possible presence of specialized intestinal metaplasia of the esophagus as a consequence of chronic reflux in adult celiac patients. Gastric intestinal metaplasia with basal gland atypia: a morphological and biologic evaluation in a large Chinese cohort. BMP4 signaling induces expression of SOX9, an intestinal crypt transcription factor, which is highly expressed in Barrett's epithelium. Intraocular osseous metaplasia.
No deposit bonus binary options 2021 chevy Single or double layered cuboidal epithelia of the cysts expressed low molecular weight cytokeratin joelmir betting pterygium, whose expression was absent in the keratinizing stratified squamous epithelia of same cysts. Oesophageal cancer affects more than people worldwide and despite continued medical bovada sports betting rules the incidence of oesophageal cancer is increasing. It has been suggested that only patients with intestinal metaplasia are at risk of cancer, but the British Society of Gastroenterology BSG guidelines suggest that glandular mucosa is all that is needed. At 10, 20 and 40 weeks after initiation of the diets, histopathological changes were determined by Hemotoxylin and Eosin, alcian blue, and periodic acid-Schiff PAS staining. The mucosa surrounding the adenocarcinoma and the gastric mucosa were analyzed. Cigarette smoke suppresses Bik to cause epithelial cell hyperplasia and mucous cell metaplasia. The previous paradigm that Barrett's is an irreversible premalignant lesion has recently been challenged by a proliferation of reports documenting elimination of Barrett's by a variety of endoscopic techniques.
Joelmir betting pterygium The Baranyi model was fitted to the growth data of Staph. Enzymes predominantly responsible for the primary degradation of protein in soft cheese and for joelmir betting pterygium related changes in consistency were mammoth bait dota 2 item betting. The classic diagnosis of Barret esophagus is based on the finding of three of more cm of distal esophagus covered by specialized columnar epithelium. To search for the repertoire of adaptation mechanisms of Barrett's metaplasiawe employed high-throughput functional genomic and proteomic methods that defined the molecular background of metaplastic mucosa resistance to reflux. The physicochemical changes that occur during ripening were not big enough to inhibit the growth of undesirable microorganisms. KRAS mutation status was analyzed using a pyrosequencing technique. A reduction of formalin- and carrageenan-induced paw edema in mouse by S.
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In most mild cases, treatment may include the use of prescription eye drops with corticosteroid to reduce redness and inflammation. The doctor may also suggest the use of artificial tears to keep the eyes well lubricated. For more serious issues, patients may need to undergo surgery to remove the pterygium and to regraft the conjunctiva. This procedure is done as an outpatient procedure in approximately thirty minutes with local anesthetics. If you live in the area of Skokie, IL and require an evaluation with an eye physician, we encourage you to book an appointment.

The practice is located at Crawford Avenue, Suite and can be reached by phone at Skip to content Pterygium treatment. Frequently asked questions about pterygium What is pterygium? What causes pterygium? What are the signs of pterygium? Request an appointment with Dr. Sondheimer today! Joelmir had a stroke before to watch the first match after the downgrading. He made a tomography early in the morning. In some minutes the doctor a fanatic Corinthians supporter said another giant could no longer rise again.

In the day after to the diabolic second-class division my father started to go to Heaven. The chances to recover from an autoimmune disease were not so good. They became almost impossible with the bleeding of his privileged brain. Irrigated and ventilated as too few among those who know and recognize him. Beloved and cherished for those not too few that had the privilege to know him. Do I need to say anything else to the best Babbo in the world that turned to be the best Nonno in the Universe?

I need. But I don't know. Usually he knew everything. When he didn't knew, he invented with the same class as he talked what he knew. Every father looks like that to his son. But a journalist's father to someone which is also a journalist gets even more orphan. I have never seen my father as a super-hero. Only as a super human. But I could never realize he would get ill and weak in flesh.

I have never admitted we could lose the one that made us only gain. He taught me so many things I couldn't describe them. One of them is, not all words are needed to be said. They should only be thought. Those who talks about what thinks, doesn't think about what he talks. Those who feels what he talks doesn't need to say it. But, today, I need to thank for my 46 years. For the 49 years of love from my mother. For his 75 years. More than everything, for the affection from the people that know him — therefore like him.

And specially for the people who don't know him — and some who cried like he was an old friend. I've learned a thing from you, babbo. Before become a great journalist it is needed to be a great person. I have learned from him I don't need to work to be a great professional. I need to try to be a great person. As you did both. Excuse me, but I won't cry.

I cry for everything. Because of that I always cry for the family. Palmeiras, loves, pains, colours, songs. But I won't cry for everything more than anything in the world, my parents. My parents which could be also called my mothers [note 4] were always ready. A gift from God. My father never missed me even when absent by his work.

I never missed him because he had that wonderful woman, Mrs. According to Mr. Joelmir, the second biggest thing in his life. Because the first one always was his love he felt for her since When they became a family. My brother and I. Sons of the radio. Sons of a pioneer, respected economics' journalist, a recognized, innovator TV anchorman, a communication master, brilliant and labourer. I always knew I would never be in my profession nothing even closer he was.

WELLINGTON PHOENIX VS MELBOURNE VICTORY BETTING EXPERT NFL

All analyses were adjusted for demographic features, treatment, and baseline and 2-year change in SSS values for parameters of inflammation and MRI structural lesions. Resolution of inflammation and reduction of erosions were each independently associated with the development of new backfill and fat metaplasia at 2 years on multivariate analyses. Our data support a disease model whereby ankylosis develops following repair of erosions, and fat metaplasia and backfill are key intermediary steps in this pathway.

Helicobacter heilmannii is a zoonotic bacterium that has been associated with gastric disease in humans. Markers for acid production by parietal cells and mucous metaplasia were also examined. In the first 9 weeks postinfection, the mRNA expression of Muc6 was clearly upregulated in both the antrum and fundus of the stomach of H.

Interestingly, Muc13 was upregulated already at 1 day postinfection in the fundus of the stomach. Its expression level remained high in the stomach over the course of the infection. This mucin is, however, not expressed in a healthy stomach, and high expression of this mucin has so far only been described in gastric cancer. Mucous metaplasia present in the mucosa surrounding low-grade mucosa-associated lymphoid tissue MALT lymphoma-like lesions was also histologically confirmed. Our findings indicate that H.

Structural alterations of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence. Accumulating evidence suggests that the extracellular matrix play important roles in intercellular communications and contribute to the development of a number of diseases, including diseases of the gastrointestinal tract. The present study examined the structural characteristics and alterations of the extracellular matrix of the mucosa stroma in the Barrett's esophagus metaplasia -dysplasia-adenocarcinoma sequence.

A total of 41 esophageal tissue specimens 15 esophageal adenocarcinoma, 10 Barrett's esophagus intestinal metaplasia , seven dysplasia and nine normal esophagus were studied. The present study used transmission electron microscopy and computerized quantitative electron-microscopic analysis in order to investigate the characteristics of the extracellular matrix of the mucosa.

The study revealed that marked structural alterations of the mucosa stroma, relating to changes in the distribution and appearance of collagen fibers as well as to changes in numbers of matrix microvesicles, occur in Barrett's esophagus and esophageal adenocarcinoma. It was found that there were 3. The findings suggest that the redistribution of collagen fibers and increases in numbers of matrix microvesicles may play roles in the formation of specialized intestinal metaplasia and the development of adenocarcinoma.

Relation between reflux of bile acids into the stomach and gastric mucosal atrophy, intestinal metaplasia in biopsy specimens. During endoscopic examinations we collected fluid in the stomach that included reflux fluid from the duodenum, and assessed the effect of quantitatively determined bile acids on glandular atrophy and intestinal metaplasia using biopsy specimens.

A total of outpatients were enrolled in this study. Total bile acid concentration was measured by an enzyme immunoassay. Glandular atrophy and intestinal metaplasia scores were graded according to the Updated Sydney System. An effect of refluxed bile acids on atrophy and intestinal metaplasia was shown in the high-concentration reflux group in comparison with the control group.

However, when the odds ratios ORs were calculated according to whether Helicobacter pylori H. The same was true for intestinal metaplasia in the H. We could not clarify the effect of the reflux of bile acids into the stomach in the progression of atrophy. High-concentration bile acids had an effect on the progression of intestinal metaplasia in the H.

Gastric intestinal metaplasia is a precancerous change of the mucosa of the stomach with intestinal epithelium, and is associated with an increased risk of dysplasia and cancer. The pathogenesis to gastric cancer is proposed by the Correa hypothesis as the transition from normal gastric epithelium to invasive cancer via inflammation followed by intramucosal cancer and invasion. Multiple risk factors have been associated with the development of gastric intestinal metaplasia interplay, including Helicobacter pylori infection and associated genomics, host genetic factors, environmental milieu, rheumatologic disorders, diet, and intestinal microbiota.

Globally, screening guidelines have been established in countries with high incidence. In the United States, no such guidelines have been developed due to lower, albeit increasing, incidence. The American Society for Gastrointestinal Endoscopy recommends a case-by-case patient assessment based upon epidemiology, genetics, and environmental risk factors. Studies have examined the use of a serologic biopsy to stratify risk based upon factors such as H pylori status and virulence factors, along with serologic markers of chronic inflammation including pepsinogen I, pepsinogen II, and gastrin.

High-risk patients may then be advised to undergo endoscopic evaluation with mapping biopsies from the antrum greater curvature, lesser curvature , incisura angularis, and corpus greater curvature, lesser curvature. Surveillance guidelines have not been firmly established for patients with known gastric intestinal metaplasia , but include repeat endoscopy at intervals according to the histologic risk for malignant transformation. Intestinal metaplasia in Barrett's oesophagus BO represents an important risk factor for oesophageal adenocarcinoma.

Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia CLO , posing an issue about its clinical management. The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells. These findings suggest that some immunophenotypic changes are present in CLO and they can precede the appearance of the goblet cells or can be present independently of them, confirming the conception of BO as the condition characterized by any extention of columnar epithelium.

METHODS: Distal esophageal mucosal samples obtained by endoscopy and histologically diagnosed as gastric-type non-specialized columnar metaplasia , were studied thoroughly. Deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer: A correlated study. AIM: To investigate the correlation among the presence and degree of gastric metaplasia of duodenal regenerating mucosa, the deformity of bulb and the recurrence of duodenal ulcer.

All patients received follow-up endoscopic examinations 6 wk after treatment. When the ulcer s were noted to be healed, two biopsies were taken from the ulcer scar for histological study of gastric metaplasia , and 4 biopsies were taken from antrum for Helicobacter pylori H pylori study. Out of these cases, 44 received further follow-up endoscopic examinations after 3, 6 and 12 mo respectively for studying the recurrence rate of duodenal ulcers.

The correlation among ulcer recurrence, degree of gastric metaplasia of regenerating mucosa, bulbar deformity, and colonization of H pylori in the stomach was then studied. RESULTS: The results showed that there was a strong correlation between the deformity of duodenal bulb and the degree of gastric metaplasia of regenerating duodenal mucosa. A more severely deformed duodenal bulb is closely related to a greater extent of gastric metaplasia.

Both factors contribute to the recurrence of duodenal ulcer. Clinical significance of spasmolytic polypeptide-expressing metaplasia and intestinal metaplasia in Epstein-Barr virus-associated and Epstein-Barr virus-negative gastric cancer.

Spasmolytic polypeptide-expressing metaplasia SPEM and intestinal metaplasia IM have been recognized as neoplastic precursors in gastric carcinogenesis. Acute and chronic inflammation was graded as absent, mild, moderate, and marked. Univariate and multivariate logistic regression analyses were conducted to analyze the correlation between SPEM, IM, and inflammation. Our study revealed that SPEM was detected in Atrophy and intestinal metaplasia are early phenotypic markers in gastric carcinogenesis.

White light endoscopy does not allow direct biopsy of intestinal metaplasia due to a lack of contrast of the mucosa. Narrow-band imaging is known to enhance the visibility of intestinal metaplasia , to reduce sampling error, and to increase the diagnostic yield of endoscopy for intestinal metaplasia in Asian patients. The aim of our study was to validate the diagnostic performance of narrow-band imaging using 1. A retrospective cohort study was conducted on consecutive patients with dyspeptic symptoms at a private endoscopy center within the time frame of January to December The prevalence of H.

Among the patients with intestinal metaplasia , Two patients had low-grade dysplasia. The sensitivity of white light endoscopy was The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of narrow-band imaging with a positive light blue crest were 85, 98, Through the assessment of the microsurface structure and light blue crest sign, non-optical zoom narrow-band imaging had high predictive values for detecting intestinal metaplasia in patients from a general Western setting.

Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico. Intestinal metaplasia is a precursor lesion of gastric cancer. Infection by Helicobacter pylori is the principal cause of metaplasia. While evidence of the regression of metaplasia after treatment to eradicate this infection has been demonstrated, controversy remains with regard to this subject.

The objective of this study was to determine the frequency of the regression of gastric intestinal metaplasia one year after the eradication of Helicobacter pylori. A prospective longitudinal designed study was carried out. The population studied in this research consisted of patients attending the Endoscopy Unit to undergo an upper endoscopy, in whom various symptoms indicated intestinal metaplasia associated with Helicobacter pylori, and who received standard empiric triple therapy to eradicate the bacteria.

An upper endoscopy was performed in which four gastric biopsy samples were taken two from the antrum and two from the body before and after the eradicating treatment, with the endoscopic and histological findings studied after one year of monitoring. The statistical analysis was conducted using the Fisher's exact test and the McNemar's test. Forty-six patients were studied, of whom 20 Complete intestinal metaplasia type I was found in 35 patients Non-atrophic chronic gastritis was found in 35 In this study, gastric intestinal metaplasia associated with Helicobacter pylori infection showed a regression of Cigarette smoke suppresses Bik to cause epithelial cell hyperplasia and mucous cell metaplasia.

Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis. Because the Bcl-2 family of proteins is crucial for airway epithelial homeostasis, identifying the players that reduce cigarette smoke CS -induced mucous cell metaplasia can help to develop effective therapies. To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia.

We screened for dysregulated expression of the Bcl-2 family members. We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects. Restoring Bik expression significantly suppressed CS-induced mucous cell metaplasia in differentiated primary HAEC cultures and in airways of mice in vivo.

These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis. Foveolar gastric metaplasia of the duodenum: a frequent, so far neglected type of duodenal polyp. Foveolar gastric metaplasia of the duodenum FGM is considered as imperfect mucosal healing in the context of H.

During diagnostic histological examinations we observed a frequent so far not described association of FGM with endoscopically observed duodenal polyps. In Institute 2, cases of FGM were diagnosed. In conclusion, foveolar gastric metaplasia is a frequent, so far neglected correlate of endoscopically detected duodenal polyps.

Rationale: Aberrant regulation of airway epithelial cell numbers in airways leads to increased mucous secretions in chronic lung diseases such as chronic bronchitis. Objectives: To identify the Bcl-2 family of proteins that play a role in reducing CS-induced mucous cell metaplasia. Methods: We screened for dysregulated expression of the Bcl-2 family members. Measurements and Main Results: We identified Bik to be significantly reduced in bronchial brushings of patients with chronic epithelial cell hyperplasia compared with nondiseased control subjects.

Conclusions: These studies show that CS suppresses Bik expression to block airway epithelia cell death and thereby increases epithelial cell hyperplasia in chronic bronchitis. Heterotopic gastric mucosa in the gallbladder is an unusual entity and is usually clinically silent. We report a year-old female patient who presented with intermittent upper abdomial pain radiating to the back. Abdominal imaging studies showed a sessile polypoid lesion and a gallstone in the gallbladder.

Gallbladder carcinoma was suspected and cholecystectomy performed. Intraoperative frozen section examination suggested mucinous tumor, suspicious for malignancy. However, the permanent sections revealed aberrant gastric tissue consisted of gastric pyloric and fundic glands of heterotopic gastric mucosa with intestinal metaplasia in the gallbladder. Dysplastic intestinal-type metaplasia of appendiceal endometriosis: a mimic of low grade appendiceal mucinous neoplasm.

We report an example of dysplastic intestinal-type metaplasia involving endometriosis of the appendix in a 45 year old woman. One other example of this phenomenon has been reported. As it occurs within the muscular wall of the appendix, confusion with low grade appendiceal mucinous neoplasm LAMN may occur.

Evidence supporting the metaplastic nature of the intestinal epithelium is offered. As the initial pathological diagnosis was of invasive cancer with perforation of the appendix treatment consisted of peritonectomy and hyperthermic intraperitoneal chemotherapy HIPEC. Pathological documentation of complete elimination of Barrett's metaplasia following endoscopic multipolar electrocoagulation therapy.

The previous paradigm that Barrett's is an irreversible premalignant lesion has recently been challenged by a proliferation of reports documenting elimination of Barrett's by a variety of endoscopic techniques. Whether Barrett's is entirely eliminated is unknown as endoscopic biopsy samples the surface of the epithelium only. Numerous reports document underlying specialised columnar epithelium in many of these trials.

Until now there have been no reports of pathological examination of the entire oesophagus as a specimen. This case documents complete elimination of intestinal metaplasia from the oesophagus and supports the biological plausibility of these research techniques. Factors to improve the interobserver agreement for gastric atrophy and intestinal metaplasia : consensus of definition and criteria. Intestinal metaplasia and atrophy of the gastric mucosa are associated with Helicobacter pylori infection and are considered premalignant lesions.

The updated Sydney system is used for these parameters, but experienced pathologists and consensus processes are required for interobserver agreement. We sought to determine the influence of the consensus process on the assessment of intestinal metaplasia and atrophy. Two study sets were used: consensus and validation.

The consensus set was circulated and five gastrointestinal pathologists evaluated them independently using the updated Sydney system. The consensus of the definitions was then determined at the first consensus meeting. The same set was recirculated to determine the effect of the consensus. The second consensus meeting was held to standardise the grading criteria and the validation set was circulated to determine the influence.

Two additional circulations were performed to assess the maintainance of consensus and intraobserver variability. This study suggests that interobserver variability regarding intestinal metaplasia and atrophy may result from lack of a precise definition and fine criteria, and can be reduced by consensus of definition and standardisation of grading criteria. The diagnosis of patients with short segments of intestinal metaplasia in the distal esophagus, has increased in recent years.

To assess the clinical, pathological and functional features of patients with esophageal intestinal metaplasia. A prospective study was performed in 95 control subjects, patients with cardial intestinal metaplasia and 89 patients with short Barret esophagus with intestinal metaplasia. All had clinical and endoscopic assessments, esophageal manometry and determination of 24 h esophageal exposure to acid and duodenal content.

Control patients were younger and, in this group, the pathological findings in the mucosa distal to the squamous-columnar change, showed a preponderance of fundic over cardial mucosa. In patients with intestinal metaplasia and short Barret esophagus, there was only cardial mucosa, that is the place where intestinal metaplasia implants. Low grade dysplasia was only seen in the presence of intestinal metaplasia. Gastroesophageal sphincter pressure decreased and gastric and duodenal reflux increased along with increases in the extension of intestinal metaplasia.

These findings confirm the need to obtain multiple biopsies from the squamous-columnar mucosal junction in all patients with gastroesophageal reflux symptoms, for the detection of early pathological changes of Barret esophagus and eventual dysplasia. Down-regulation of EMP1 is associated with epithelial hyperplasia and metaplasia in nasal polyps. The aim of this study was to assess protein and mRNA expression of epithelial membrane protein 1 EMP1 in the nasal mucosa of patients with nasal polyps NP , and to determine what changes occur in response to glucocorticosteroid GC treatment.

NP tissue was obtained from 55 patients, 18 of whom were treated with nasal GCs i. Biopsies of inferior turbinate mucosa from 30 healthy subjects were used as controls. Their immunoreactivity was significantly greater in controls than NP patients. Positive correlations between EMP1 and other epithelial cell-related gene e.

EMP1 could be a biomarker for aberrant epithelial remodelling and metaplasia in chronic inflammatory upper airway mucosa e. Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis. There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease IBD.

However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented. We report a case of a year-old female with a history of colonic adenocarcinoma who presented with pruritic, erythematous, scaly plaques on the right lower abdomen, present since reversal of her ileostomy in Skin biopsy revealed benign foci of colonic epithelium with no evidence of adenomatous change.

Benign intraepidermal colonic mucosa was diagnosed based on histopathologic findings and immunohistochemistry. To our knowledge, this is the first case of intraepidermal benign colonic metaplasia forming in a patient following ostomy reversal. The case emphasizes the importance of patient education and physical examination of the stoma or stoma remnants for detection of unusual or changing lesions due to the risk for malignant transformation.

It also demonstrates that benign colonic mucosa should be considered in the differential diagnosis when evaluating lesions near ileostomy sites, regardless of whether the patient has a history of familial adenomatous polyposis or IBD. Transitional metaplasia in intestinal epithelium of rats submitted to intestinal cystoplasty and treatment with L -lysine.

To evaluated the effects of L-lysine on the intestinal and urothelial epithelia in cystoplasty in rats. No inflammatory cells, dysplasia or abnormalities were observed. Staining with Alcian blue revealed a substantial reduction of goblet cells and mucins in the colon segment Groups A and B. The administration of L-lysine to rats accelerated the development of transitional metaplasia in the epithelium of the colon segment in cystoplasty.

Influence of cyclic hydrostatic pressure on fibrocartilaginous metaplasia of achilles tendon fibroblasts. The goal of this study was to demonstrate whether cyclically imposed hydrostatic pressure, compressive in nature, could induce fibrocartilaginous metaplasia in a purely tendinous cell source in vitro. The effect of short-duration cyclic hydrostatic pressure on tendon fibroblasts tenocytes expanded from rat Achilles tendon was studied.

Total RNA was isolated either immediately after loading or 24 h later. Noticeably, for RNA samples isolated 24 h later, there were further increases in mRNA expression of Aggrecan and Collagen type II, whereas Collagen type I increased roughly three-fold relative to the non-loaded control.

These findings support the hypothesis that cyclic hydrostatic pressurization can induce fibrocartilaginous metaplasia in tenocytes by upregulation of cartilaginous gene expression. Also, it was demonstrated that changes in mRNA expression as a result of single 2 h pressurization persist even up to 24 h.

The predictive value of gastric metaplasia in the duodenal mucosa in patients Helicobacter pylori-positive patients with duodenal bulb ulcer DBU was investigated. One hundred and twenty four randomly selected patients with DBU were included in this prospective study.

Regions of gastric metaplasia of the duodenum were confirmed by periodic acid-Schiff and alcian blue Serva staining pH 1. Gastric metaplasia in the duodenum was found in 64 or The following facts about the predictive factor for the prognosis of DU complication were found: the sensitivity of The study revealed a high and significant p metaplasia in the duodenum as a marker of non-complicated clinical course of DU in HP-positive patients within an 8 to year period.

Ecuador currently holds the 15th place of countries with the highest incidence of stomach cancer for both sexes. All participants were personally interviewed using a structured questionnaire to collect data about dietary habits, lifestyle and medical history. Pylori infection AOR: 0. Interleukin 10 is an essential modulator of mucoid metaplasia in a mouse otitis media model. In wild-type mice, both S. In IL knockout mice, the number of goblet cells and mucin-producing cells in the middle ear was significantly reduced after bacterial middle ear infection compared with that in wild-type mice.

In this study, we report about a patient with extra-uterine endometriosis EM in the abdominal wall muscle with evident metaplasia based on the abundant alpha smooth muscle actin ASMA -expressing myofibroblasts. Laparotomy excision of the abdominal wall EM was done following ultrasonographic evidence of a hypodense swelling in the right rectus abdominis, which was confirmed by MRI. Immunohistochemistry staining for ASMA and collagen I was done, with the results confirming that endometriotic stromal cells expressed both.

Anterior abdominal wall endometriosis was suspected because of the patient's history of recurrent EM combined with the cyclic nature of symptoms. MRI is useful in determining the extent of the disease. In case of persisting symptoms even under hormonal treatment, surgical excision is mandatory.

The expression of both ASMA and collagen I in and around EM lesions supports the notion of the metaplastic process in the course of disease development. Karger AG, Basel. Label-free identification of intestinal metaplasia in the stomach using multiphoton microscopy. The early diagnosis of intestinal metaplasia IM in the stomach together with effective therapeutic interventions is crucial to reducing the mortality-rates of the patients associated with gastric cancer.

Here, we describe a label-free imaging method, multiphoton microscopy MPM , for the identification of IM in the stomach. It was found that multiphoton imaging provides cellular and subcellular details to the identification of IM from normal gastric tissues.

In particular, there is significant difference in the population density of goblet cells between normal and IM gastric tissues, providing substantial potential to become a quantitative intrinsic marker for in vivo clinical diagnosis of early gastric lesions. To our knowledge, this is the first demonstration of the potential of MPM for the identification of IM.

Columnar metaplasia in a surgical mouse model of gastro-esophageal reflux disease is not derived from bone marrow-derived cell. The incidence of esophageal adenocarcinoma has increased in the last 25 years. Columnar metaplasia in Barrett's mucosa is assumed to be a precancerous lesion for esophageal adenocarcinoma.

However, the induction process of Barrett's mucosa is still unknown. To analyze the induction of esophageal columnar metaplasia , we established a mouse gastro-esophageal reflux disease GERD model with associated development of columnar metaplasia in the esophagus. To analyze the contribution of bone marrow-derived cells to columnar metaplasia in this surgical GERD model, some mice were transplanted with GFP-marked bone marrow after the operation.

Bone marrow-derived cells were not detected in columnar metaplastic epithelia. However, scattered epithelial cells in the thickened squamous epithelia in regions of esophagitis did show bone marrow derivation. The results demonstrate that reflux induced by esophago-jejunostomy in mice leads to the development of columnar metaplasia in the esophagus. However, bone marrow-derived cells do not contribute directly to columnar metaplasia in this mouse model.

Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy. The vast majority of urothelial carcinomas infiltrating the bladder are consistente with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies.

In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes.

Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma.

In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin 34BetaE12 and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years. The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia.

It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients. Extended intestinal metaplasia. A survey of gastrectomies from dwellers of the Pacific basin. To assess the extent of gastric intestinal metaplasia IM in gastrectomy specimens in populations of the Pacific basin having different incidence of gastric carcinoma.

One thousand three hundred and nine-two gastrectomies were investigated: had a gastric carcinoma and miscellaneous gastric diseases. Twenty-one thousand three hundred and fourteen histological sections were reviewed under low-power 4X.

The percent of gastrectomies harboring a carcinoma increased significantly with increasing age more notably in those with diffuse carcinomas DC than in those with intestinal carcinomas IC. The percent of gastrectomies with EIM was significantly higher in specimens with IC than with DC, particularly among elderly patients, and in specimens from countries with a high cancer incidence.

Migration per se did not influence the frequency of specimens with EIM in elderly Japanese patients: Japanese migrants to Hawaii had a similarly high frequency of EIM as those dwelling in Japan. Japanese patients with a gastric carcinoma showed atypical mitoses in areas with EIM far from the tumor, suggesting that cellular mutation s play a role in the evolution of EIM towards gastric dysplasia and carcinoma in that ethnic group.

The drawback of gastric biopsies in assessing the extent of gastric intestinal metaplasia and, thereby, estimating possible cancer risk in long-term studies has been stressed. Esophagogastric metaplasia relates to nodal metastases in adenocarcinoma of esophagus and cardia. Immunohistochemical profiles of esophageal and cardia adenocarcinoma differ according to the presence or absence of Barrett's epithelium BIM and gastric intestinal metaplasia GIM in the fundus and antrum.

Different lymphatic spreading has been demonstrated in esophageal adenocarcinoma. We investigated the correlation among the presence or absence of intestinal metaplasia in the esophagus and stomach and lymphatic metastases in patients who underwent radical surgery for esophageal and cardia adenocarcinoma.

The mucosa surrounding the adenocarcinoma and the gastric mucosa were analyzed. The radical thoracic station numbers 2, 3, 4R, 7, 8, and 9 and abdominal station numbers 15 through 20 lymphadenectomy was identical in both procedures except for the greater curvature. According to the presence or absence of BIM and GIM in the esophagus and cardia, adenocarcinoma correspond to three different patterns of lymphatic metastasization, which may reflect different biologic and carcinogenetic pathways.

Published by Elsevier Inc. Loss of p27 expression is frequently observed in pancreatic adenocarcinomas in human and is associated with decreased patient survival. Similarly, in a mouse model of K-Ras-driven pancreatic cancer, loss of p27 accelerates tumor development and shortens survival, suggesting an important role for p27 in pancreatic tumorigenesis.

Here, we sought to determine how p27 might contribute to early events leading to tumor development in the pancreas. We found that K-Ras activation in the pancreas causes p27 mislocalization at pre-neoplastic stages. Moreover, loss of p27 or expression of a mutant p27 that does not bind cyclin-CDKs causes the mislocalization of several acinar polarity markers associated with metaplasia and induces the nuclear expression of Sox9 and Pdx1 two transcription factors involved in acinar-to-ductal metaplasia.

Finally, we found that p27 directly represses transcription of Sox9, but not that of Pdx1. Thus, our results suggest that K-Ras activation, the earliest known event in pancreatic carcinogenesis, may cause loss of nuclear p27 expression which results in derepression of Sox9, triggering reprogramming of acinar cells and metaplasia. Alpha 1-protease inhibitor moderates human neutrophil elastase-induced emphysema and secretory cell metaplasia in hamsters. A study was undertaken to determine whether emphysema and airway secretory cell metaplasia , induced in hamsters by intratracheal treatment with human neutrophil elastase HNE , could be moderated by pretreatment with human alpha 1-protease inhibitor API.

API 4. Eight weeks later, lung volumes and pressure-volume relationships were measured in the anaesthetized animals. Mean linear intercepts and secretory cell indices were measured in lung sections. Nevertheless, we conclude that human API given intratracheally is efficacious against HNE-induced emphysema and secretory cell metaplasia. Atrophic gastritis AG and intestinal metaplasia IM are the main precursor lesions of gastric cancer as the incidence of gastric cancer increases in the gastric mucosa involved with AG and IM.

The prevalence of AG and IM vary depending on countries, even it represents diverse results in the same nation. The sensitivity and specificity of diagnostic methods to detect AG and IM are different. Furthermore, the management strategy of AG and IM has not been established, yet. Helicobacter pylori infection has been proved as the most important cause of AG and IM.

Thus the eradication of H. Therefore, the understanding and early diagnosis of AG and IM are very important, especially, in high incidence area of gastric cancer such as Republic of Korea. Helicobacter pylori infection with intestinal metaplasia : An independent risk factor for colorectal adenomas.

Histopathological results were obtained by gastric and colorectal biopsies. Stratification based on H. Squamous metaplasia amplifies pathologic epithelial-mesenchymal interactions in COPD patients. Squamous metaplasia SM is common in smokers and is associated with airway obstruction in chronic obstructive pulmonary disease COPD. A major mechanism of airway obstruction in COPD is thickening of the small airway walls. We asked whether SM actively contributes to airway wall thickening through alteration of epithelial-mesenchymal interactions in COPD.

Gastric intestinal metaplasia as detected by a monoclonal antibody is highly associated with gastric adenocarcinoma. Background: Some forms of gastric intestinal metaplasia GIM may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised.

Mucin staining, as a means of differentiating GIM, is difficult. A monoclonal antibody, mAb Das-1 initially called 7E12H12 , whose staining is phenotypically specific to colon epithelium, was used to investigate this issue. Cancer areas from the same 56 patients also reacted. Some forms of gastric intestinal metaplasia GIM may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised.

A monoclonal antibody, mAb Das-1 initially called 7E 12 H 12 , whose staining is phenotypically specific to colon epithelium, was used to investigate this issue. Acinar-to-ductal metaplasia ADM is a reversible epithelial transdifferentiation process that occurs in the pancreas in response to acute inflammation. Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia. METHODS Pathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study.

Patient demographics, insurance status, and other clinical factors were reviewed. The aim of this study is to evaluate associations among the pH of gastric juice, atrophic gastritis AG , intestinal metaplasia IM , pepsinogen, and Helicobacter pylori infection. Methods Gastric biopsies and juice were collected from 46 subjects who underwent endoscopies at Seoul National University Bundang Hospital between November and March Results The mean pH of gastric juice was higher in the H.

When patients were divided into pH Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis. Whether gastric atrophy GA and intestinal metaplasia IM are reversible after the eradication of Helicobacter pylori remains controversial. The purpose of this meta-analysis was to systematically review histological alterations in GA and IM by comparing histological scores before and after H.

English-language articles in the medical literature containing information about the association between infection with H. Review Manager 4. Twelve studies containing a total of 2, patients were included in the first meta-analysis. Comparing the histological alterations before and after H. Our study shows that eradication of H. Consequently, all patients with GA in the corpus should be tested for H. Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett's esophagus.

To determine whether magnified observation of short-segment Barrett's esophagus BE is useful for the detection of specialized intestinal metaplasia SIM. The magnified images were analyzed with respect to their pit-patterns, which were simultaneously classified into five epithelial types [I small round , II straight , III long oval , IV tubular , V villous ] by Endo's classification.

Then, a 0. The patterns of the magnified image and MB staining were analyzed. Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy. The magnified observation of a short-segment BE according to the mucosal pattern and its classification can be predictive of SIM.

Gastric adenocarcinoma is one of the leading causes of cancer mortality worldwide. Gastric juice plays a crucial role in the physiology of the stomach. Gastric biopsies and juice were collected from 46 subjects who underwent endoscopies at Seoul National University Bundang Hospital between November and March The mean pH of gastric juice was higher in the H. There is a relationship between chronic H. Effect of Saraca asoca Asoka on estradiol-induced keratinizing metaplasia in rat uterus.

Estrogen-mediated uterus endometrium instability is considered as one of the etiological factors in dysfunctional uterine bleeding DUB and uterine cancer. Saraca asoca Family: Fabaceae and its fermented preparation, Asokarishta, are extensively used as uterine tonic to treat gynecological disorders in Ayurveda. The present study evaluated the effect of S. Uterus endometrial thickening was analyzed histopathologically and serum estrogen level by radioimmunoassay RIA.

Cyclooxygenase COX-2 expression in rat uterus was also estimated by Western blot. Anti-inflammatory activity of the extract was analyzed by formalin- and carrageenan-elicited paw edema models in mouse. Uterus endometrium proliferation and keratinized metaplasia with seven to eight stratified epithelial layers on day 16 was observed in rats administered with estradiol.

Treatment with S. A reduction of formalin- and carrageenan-induced paw edema in mouse by S. Lower level of lipopolysaccharides LPS -induced COX-2 enzyme in rat uterus by the extract further confirms its anti-inflammatory activity. Present study reveals the antiproliferative and antikeratinizing effects of S. Sirtuin-1 regulates acinar-to-ductal metaplasia and supports cancer cell viability in pancreatic cancer.

The exocrine pancreas can undergo acinar-to-ductal metaplasia ADM , as in the case of pancreatitis where precursor lesions of pancreatic ductal adenocarcinoma PDAC can arise. In this study, we examined the expression and the role of Sirt1 in different stages of pancreatic carcinogenesis, i.

In addition, we analyzed the expression of KIAA, a key mediator of Sirt1 function, along with potential Sirt1 downstream targets. Sirt1 was co-expressed with KIAA in the nuclei of normal pancreatic acinar cells. In ADM, Sirt1 underwent a transient nuclear-to-cytoplasmic shuttling. Experiments where during ADM, we enforced repression of Sirt1 shuttling, inhibition of Sirt1 activity or modulation of its expression, all underscore that the temporary decrease of nuclear and increase of cytoplasmic Sirt1 stimulate ADM.

Our results reveal that Sirt1 is an important regulator and potential therapeutic target in pancreatic carcinogenesis. Canine mammary minute oncocytomas with neuroendocrine differentiation associated with multifocal acinar cell oncocytic metaplasia. Two solitary and minute tumors of 1 and 1.

The former tumors were well circumscribed and were composed of small-to-large polyhedral neoplastic oncocytes with finely granular eosinophilic cytoplasm, and were arranged in solid nests separated by fine fibrovascular septa. Scattered lumina of variable sizes containing eosinophilic secretory material were evident.

Cellular atypia was minimal, and no mitotic figures were visible. One tumor had several oncocytic cellular foci revealing cellular transition, with perivascular pseudorosettes consisting of columnar epithelial cells surrounding the fine vasculature. Scattered foci of mammary acinar cell hyperplasia showing oncocytic metaplasia were also observed. One tumor also had oncocytic cellular foci forming perivascular pseudorosettes showing cellular membrane immunoreactivity for neural cell adhesion molecule.

The tumors were negative for smooth muscle actin, neuron-specific enolase, vimentin, desmin, S, and synaptophysin. Ultrastructural observation confirmed the abundant mitochondria in the cytoplasm of both neoplastic and hyperplastic cells, the former cells also having neuroendocrine granule-like electron-dense bodies. From these results, our case was diagnosed with mammary oncocytomas accompanied by neuroendocrine differentiation.

Scattered foci of mammary oncocytosis might be related to the multicentric occurrence of these oncocytomas. Splenic myeloid metaplasia in warm autoimmune hemolytic anemia wAIHA : a retrospective study. The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion SC.

All patients received steroids as first-line treatment and splenectomy as second-line treatment. Among the thirty-six splenectomized patients, 15 No differences were found in clinical characteristics between two groups. Uterine serous carcinoma USC is an aggressive variant of Type 2 endometrial carcinoma, which in most cases exhibits, at least focally, a papillary architecture. Occasionally, especially in small biopsy specimens, it may be difficult to distinguish between USC and a variety of metaplastic or reactive processes.

In particular, papillary syncytial metaplasia PSM , as a result of endometrial breakdown, may be confused with USC or its precursor serous endometrial intraepithelial carcinoma. In such cases, immunohistochemistry is often undertaken, the panel of markers usually including estrogen receptor ER , p53, p16, and MIB1.

The expected immunoprofile of USC is ER negative, p53 and p16 positive, and a high MIB1 proliferation index, although studies have shown that significant numbers of cases deviate from this immunophenotype. With regard to the aforementioned markers, PSM has not been studied extensively, but intuitively, the expected immunophenotype would be ER positive, p53 and p16 negative, and a low MIB1 proliferation index.

We illustrate that compared with a nonbreaking down endometrium, PSM is characterized by a decreased expression of ER and an increased expression of p53 although still wild-type staining and p16, the latter marker typically being diffusely positive. In cases of PSM, which are morphologically problematic, the immunophenotype may further heighten the suspicion of serous malignancy and potentially result in a misdiagnosis.

Intestinal metaplasia with a high salt diet induces epithelial proliferation and alters cell composition in the gastric mucosa of mice. Intestinal metaplasia of the gastric mucosa is an important component in the pathway to adenocarcinoma. The mechanisms that induce the progression from intestinal metaplasia to cancer have not been elucidated. High dietary salt has been known as one of the risk factors for gastric cancer development in humans.

Therefore, we investigated the role of high salt diet on gastric epithelial cell proliferation and differentiation, using our mouse model that ectopically expressed Cdx2 homeodomain transcription factor and induced an intestinal metaplastic phenotype in the gastric epithelia. Sixty Cdx2 transgenic and sixty age-matched wild-type littermates were studied. Fifty-percent Cdx2 transgenic and wild type mice were administered a high-salt diet and the other fifty-percent was fed a standard diet starting at 12 weeks after birth.

At 10, 20 and 40 weeks after initiation of the diets, histopathological changes were determined by Hemotoxylin and Eosin, alcian blue, and periodic acid-Schiff PAS staining. Cell types and cell kinetics were assessed by immunohistochemistry.

At 52 weeks, significant alterations in pathology were observed in the Cdx2 transgenic mice fed a high-salt diet, including elongation of gastric pits, reduction of the glandular zone in the gastric corpus, and deepening of glands in the antrum. In the Cdx2 transgenic mice fed a high salt diet, the parietal and chief cells were significantly decreased in the gastric corpus.

A significant increase in cell proliferation and apoptosis in the corpus and antrum were observed in Cdx2 transgenic mice fed a high-salt diet as compared to wild-type littermates. Taken together, these data implicate that intestinal metaplasia in concert with a high-salt diet induces epithelial proliferation, apoptosis, and alters cellular types in the gastric mucosa of mice.

Alteration in the composition of the gastric epithelium may play a role in influencing the microenvironment to engender susceptibility to carcinogens. Gary; Levine, Ross L. Subsequent analysis has shown that constitutive activation of the JAK-STAT signal transduction pathway is an important pathogenetic event in these patients, and that enzymatic inhibition of JAK2VF may be of therapeutic benefit in this context. In a murine bone marrow transplant assay, expression of MPLWL, but not wild-type MPL, resulted in a fully penetrant myeloproliferative disorder characterized by marked thrombocytosis Plt count 1.

MPLWL is a novel somatic activating mutation in myelofibrosis with myeloid metaplasia. A randomized, prospective cross-over trial comparing methylene blue-directed biopsy and conventional random biopsy for detecting intestinal metaplasia and dysplasia in Barrett's esophagus. The value of methylene blue-directed biopsies MBDB in detecting specialized intestinal metaplasia and dysplasia in Barrett's esophagus remains unclear. The aim of this study was to compare the accuracy of MBDB with random biopsy in detecting intestinal metaplasia and dysplasia in patients with Barrett's esophagus.

A prospective, randomized, cross-over trial was undertaken to compare MBDB with random biopsy in patients with Barrett's esophagus segments 3 cm or more in length without macroscopic evidence of dysplasia or cancer. Dysplasia was graded as: indefinite for dysplasia, low-grade dysplasia, high-grade dysplasia, or carcinoma, and was reported in a blinded fashion.

Fifty-seven patients were recruited, 44 of whom were male. A total of 1, biopsies were taken MBDB, random biopsie Dark blue staining was associated with increased detection of specialized intestinal metaplasia P Interobserver Variability and Accuracy of High-Definition Endoscopic Diagnosis for Gastric Intestinal Metaplasia among Experienced and Inexperienced Endoscopists.

Accurate diagnosis of gastric intestinal metaplasia is important; however, conventional endoscopy is known to be an unreliable modality for diagnosing gastric intestinal metaplasia IM. The aims of the study were to evaluate the interobserver variation in diagnosing IM by high-definition HD endoscopy and the diagnostic accuracy of this modality for IM among experienced and inexperienced endoscopists. Selected 50 cases, taken with HD endoscopy, were sent for a diagnostic inquiry of gastric IM through visual inspection to five experienced and five inexperienced endoscopists.

The interobserver agreement between endoscopists was evaluated to verify the diagnostic reliability of HD endoscopy in diagnosing IM, and the diagnostic accuracy, sensitivity, and specificity were evaluated for validity of HD endoscopy in diagnosing IM. Since diagnosis through visual inspection is unreliable in the diagnosis of IM, all suspicious areas for gastric IM should be considered to be biopsied.

Furthermore, endoscopic experience and education are needed to raise the diagnostic accuracy of gastric IM. Interobserver variability and accuracy of high-definition endoscopic diagnosis for gastric intestinal metaplasia among experienced and inexperienced endoscopists. Sporadic ganglioneuromatosis of esophagogastric junction in a patient with gastro-esophageal reflux disorder and intestinal metaplasia. A year-old female with a recurrent history of upper abdominal pain and intermittent dysphagia underwent endoscopic evaluation that demonstrated an irregular and nodular esophago-gastric EG junction and grade I erosive esophagitis.

Biopsies showed prominent intestinal metaplasia of Barrett's type without dysplasia, chronic inflammation and multiple aggregates of large cells within the mucosal lamina propria, some with spindle shaped nuclei. This, together with routine stains, was diagnostic for mucosal ganglioneuromatosis. The background of chronic inflammation with intestinal type metaplasia was consistent with long-term reflux esophagitis. No evidence of achalasia was seen.

Biopsies of gastric antrum and fundus were unremarkable, without ganglioneural proliferation. Colonoscopy was unremarkable. Last post: Feb 07, , pm Collecting Crypto Income Last post: Feb 07, , pm Betfury. Last post: Mar 31, , pm Re: Binary. Last post: Apr 08, , am Re: easyMarkets Review Last post: Apr 17, , pm Re: Wann ist die beste T Last post: Oct 19, , pm Re: Brokers. Last post: Apr 23, , am Re: Recensioner Valutaha Last post: Apr 26, , am Re: İkili Opsiyonlardan Last post: Dec 20, , am Re: The beginners' guide Last post: Feb 10, , am axdvwmmc by Direct Lender Loans.

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