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[Pregnancy and diffuse intestinal polyposis].

A follow-up of 52 pregnant women with diffuse polyps of the colon showed that gestation deteriorated the course of diffuse polyposis and provoked the appearance of the first symptoms of this disease. Diffuse polyposis had virtually no effect on the course of pregnancy and labor. Gestation eventuated in normal full-term delivery in 22 patients, in preterm delivery in 4, in 3 patients cesarean section was performed, in 1 the fetus was extracted with obstetrical forceps, 1 delivery finished with manual detachment and extraction of the placenta. Late spontaneous abortions occurred in 4 women, induced abortions were carried out in various periods in 68 women. Previous extensive resections of the colon undertaken for diffuse polyposis were not a contraindication to surgical delivery.

Colonic Polyps↗

[Thyroid cancer and familial rectocolonic polyposis].

Thyroid carcinoma and familial intestinal polyposis are not accidentally associated. A new case is described which, along with the other 32 cases already published, reveals an incidence of thyroid carcinoma 100 times higher in patients with polyposis than in the general population, and 160 times higher in female patients under 35 years of age. Several features of these thyroid carcinomas can be pointed out: greatest incidence in women, occurrence at a young age, existence of a papillary tumor appearing independently from the evolution of the polyposis, and probably familial disease. It is therefore necessary to systematically examine the thyroid body in all subjects with familial intestinal polyposis.

Adenomatous Polyposis Coli↗

Administration of an unconjugated bile acid increases duodenal tumors in a murine model of familial adenomatous polyposis.

Intestinal carcinogenesis involves the successive accumulation of multiple genetic defects until cellular transformation to an invasive phenotype occurs. This process is modulated by many epigenetic factors. Unconjugated bile acids are tumor promoters whose presence in intestinal tissues is regulated by dietary factors. We studied the role of the unconjugated bile acid, chenodeoxycholate, in an animal model of familial adenomatous polyposis. Mice susceptible to intestinal tumors as a result of a germline mutation in Apc (Min/+ mice) were given a 10 week dietary treatment with 0.5% chenodeoxycholate. Following this, the mice were examined to determine tumor number, enterocyte proliferation, apoptosis and beta-catenin expression. Intestinal tissue prostaglandin E2 (PGE2) levels were also assessed. Administration of chenodeoxycholate in the diet increased duodenal tumor number in Min/+ mice. Promotion of duodenal tumor formation was accompanied by increased beta-catenin expression in duodenal cells, as well as increased PGE2 in duodenal tissue. These data suggest that unconjugated bile acids contribute to periampullary tumor formation in the setting of an Apc mutation.

Adenomatous Polyposis Coli↗

Small intestinal adenomatous polyposis resulting in protein-losing enteropathy in a horse.

A 4-year-old Quarter Horse gelding was presented with a history of weight loss of 6 months duration, along with extensive ventral subcutaneous edema. Clinicopathologic findings included a markedly low serum total protein (2.9 g/dl) and a low packed cell volume (24%). The mucosal surface of the distal jejunum and entire ileum were carpeted with numerous polypoid, papillary, and glandular masses comprised of pseudostratified tall columnar cells and large numbers of interspersed goblet cells. Neoplastic change was diffuse throughout the mucosa of each mass, but abrupt demarcation occurred between neoplastic masses and adjacent mucosa. Immunohistochemical staining for protein of the p53 tumor suppressor gene revealed only occasional cytoplasmic reactivity within polyps and normal mucosa. Nuclear staining for papillomavirus antigens was not observed. Electron microscopic examination revealed features of well-differentiated intestinal epithelial cells, including apical tight junctions and microvilli, desmosomes, and the presence of numerous goblet cells. Microorganisms were not detected. Small intestinal polyposis should be considered as a rare differential diagnosis for protein-losing enteropathy in the horse.

Adenomatous Polyps↗

[Dermatology and polyposis of the gastro-intestinal tract (author's transl)].

The authors study three rare syndromes which are characterized by the association of cutaneous manifestations with an intestinal polyposis: Gardner's syndrome, Peutz-Jeghers-Touraine's syndrome, Cronkhite-Canada's syndrome. The Gardner's syndrome is transmitted with an autosomal prevalence, and its vital prognosis remains very porr. It is characterized by the association of various cutaneous manifestations such as fibromas, freckles, etc. with osteomas, neuro-fibromas and polyps of the large bowel. Its severity is related to the very early malignant degeneration of digestive polyps. The Peutz-Jeghers-Touraine's syndrome is transmitted in an autosomal prevalence and its vital prognosis is benign. The cutaneous manifestations are the very early occurrence of lentigines on the face, around the hiatus, and on the lips. The polyps are situated on the small bowel, and are the source of important functional phenomenons; their malignant change is rare. The Cronkhite-Canada's syndrome is rare. Its etiology is unknown and its prognosis is very poor. Its manifestation is the association of more or less wide-spread cutaneous pigmentations, alopecia, and onyxis with a digestive syndrome secondary to a pseudo-polyposis which is the origin for afecal and serous diarrhea, a cause for very severe denutrition. The diagnosis and the treatment of these three syndromes are discussed.

Alopecia↗

[Hyperplastic gastric polyposis and familial colonic adenomas. Apropos of a case].

A case of gastric hyperplastic polyposis is reported in a 48-year old woman, with iron deficiency anemia. An hyperplastic gastric polyposis was discovered. This patient had been operated 17 years previously for a large adenomatous polyp of the caecum. Her son had also several adenomatous polyps of the right colon. A gastrectomy was performed. Hyperplastic gastric polyposis is very rare, and is quite always associated with colorectal adenomas. The relationship between gastric hyperplastic polyposis and intestinal polyposis is not quite clear.

Adenomatous Polyps↗

Wnt signaling and gastrointestinal tumorigenesis in mouse models.

The canonical Wnt signaling plays important roles in embryonic development and tumorigenesis. For the latter, induced mutations in mice have greatly contributed to our understanding of the molecular mechanisms of cancer initiation and progression. Here, I will review recent reports on gastrointestinal cancer model mice, with an emphasis on the roles of the Wnt signal pathway. They include: mouse models for familial adenomatous polyposis; modifying factors that affect mouse intestinal polyposis, including the genes that help cancer progression; Wnt target genes that affect mouse intestinal polyposis; and a mouse model of gastric cancer that mimics Helicobacter pyroli infection.

Adenomatous Polyposis Coli↗