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At least 1,009 records · Page 56Linked to original sources
PubMed2003

Genetic alterations in goblet cell carcinoids of the vermiform appendix and comparison with gastrointestinal carcinoid tumors.

Goblet cell carcinoid is a relatively rare neuroendocrine tumor of the vermiform appendix with poorly understood molecular pathogenesis. We studied the clinicopathologic features and genetic alterations, including allelic loss of chromosomes 11q, 16q, and 18q; sequencing of the K-ras, beta-catenin, and DPC4 (SMAD4) genes; and p53 overexpression and loss of DPC4 by immunohistochemistry; in 16 goblet cell carcinoids. We compared the allelic loss in goblet cell carcinoids to those in 18 gastrointestinal carcinoid tumors. For goblet cell carcinoids, appendiceal perforation was the most common (70%, 7/10) clinical presentation. The mean tumor size was 2.0 +/- 1.5 cm (range, 0.4 to 4.5 cm). The tumor invaded to appendiceal serosa in 50% (8/16) of patients, and two patients had metastasis in lymph nodes or adjoining viscera. With mean follow-up of 24 +/- 14 months (median, 23 mo), 1 of 10 patients had died of disease, and 2 others had tumor recurrence. All four patients with metastases, recurrences, and/or death from disease had serosal involvement at presentation (P =.02). Loss of heterozygosity of chromosome 11q was present in 25% of goblet cell carcinoids, 14% of ileal carcinoid tumors, and 9% of nonileal carcinoid tumors; of chromosome 16q in 38%, 29%, and 0 (P =.02); and of chromosome 18q in 56%, 86%, and 9% (P =.002), respectively. No mutations of K-ras, beta-catenin, or DPC4 genes; p53 overexpression; or loss of staining for DPC4 was present in any tumors. These findings suggest that allelic loss of chromosomes 11q, 16q, and 18q in goblet cell carcinoids and ileal carcinoids may have an important role in the pathogenesis of these tumors.

Adult↗
PubMed2003

Regional and systemic cytokine responses to acute inflammation of the vermiform appendix.

OBJECTIVE: To measure local (peritoneal fluid) and systemic (plasma) cytokine profiles in patients with infection-inflammation of the vermiform appendix, a relatively mild, localized inflammatory process. SUMMARY BACKGROUND DATA: The systemic host response to invading microorganisms, often termed the systemic inflammatory response syndrome (SIRS), includes changes in heart rate, respiratory rate, body temperature, and circulating white blood cell numbers. Although these changes can be induced experimentally by administering proinflammatory cytokines, the mediators that appear in the bloodstream during early, localized infection in humans have not been defined. METHODS: The authors studied 56 patients with pathologically proven appendicitis. Blood was obtained before the induction of anesthesia, when 82% of the patients met the criteria for SIRS. Peritoneal fluid (PF) was obtained by intraoperative lavage. Cytokines were measured by immunoassay. To assess the net impact of the mediators within plasma, the authors studied the ability of patient plasma to augment or suppress bacterial lipopolysaccharide (LPS) stimulation of monocytes in vitro. RESULTS: Of the proinflammatory cytokines, tumor necrosis factor-alpha was present in PF but not in plasma, interleukin (IL)-1beta and interferon-gamma were found in low concentrations in both PF and plasma, and IL-12 (p70) was detectable in plasma but not PF. In contrast, IL-6 and IL-1 receptor antagonist (IL-1ra) were the most abundant cytokines in the PF and plasma, and the concentrations of IL-4 and IL-10 were also elevated in both compartments. Patients with more severe appendicitis had higher plasma levels of IL-6 and IL-10 and lower plasma levels of IL-12 and interferon-gamma than did those with uncomplicated disease. Patient plasma inhibited LPS-induced stimulation of a monocyte cell line, and this inhibition was accentuated by complicated disease. CONCLUSIONS: As judged from the pattern of soluble cytokines in plasma and the effect of the plasma on monocyte activation by LPS, mild, localized infection can induce a systemic response that is predominantly anti-inflammatory.

Acute Disease↗
PubMed2005

Laparoscopic resection of a torsioned appendix epiploica in a previously appendectomized patient.

Torsion of the appendices epiploicae is a rare condition that may present with acute abdominal pain and mimics appendicitis. We report a 20-year-old previously appendectomized man presenting with right lower abdominal quadrant pain. Abdominal ultrasonography showed a localized omental thickening in the right paracolic region. Contrast-enhanced computed tomography revealed well-circumscribed fatty tissue adjacent to the cecum with heterogeneous hyperdense infiltration of the mesentery near the sigmoid colon. Diagnostic laparoscopy revealed 2-cm diameter torsioned and edematous fatty tissue floating on the omentum in the right lower quadrant. The torsioned mass was elevated, and a thick stalk was seen to be connecting the fatty tissue to the sigmoid colon. At this point, the torsioned fatty tissue was considered as a sigmoidal appendix epiploica that was elongated and neighboring on the previously operated-on region. The lesion was removed by laparoscopic means using 3 ports. Grossly, fat necrosis and internal bleeding were seen. Histopathologic analysis of the resected tissue demonstrated adipose tissue surrounded by fibrotic inflammatory changes with marked infiltration of numerous lymphocytes and histiocytes. In conclusion, torsion of appendices epiploicae should be included in the differential diagnosis of acute abdomen when evaluating patients with right lower quadrant pain and a history of appendectomy. Laparoscopic surgery provides definite diagnosis and prevents unnecessary open procedures for such lesions leading to peritoneal irritation.

Adult↗
PubMed2006

Laparoscopic resection of mucinous cystadenoma of appendix: a careful decision.

Appendiceal mucoceles are mainly due to cystadenoma or cystadenocarcinoma. Definite diagnosis is difficult preoperatively and is usually peroperatively. Surgical excision, either by laparoscopy or by laparotomy, is the mainstay of treatment. Rupture of the lesion causes pseudomyxoma peritonei. We present a case to highlight this point and especially deplore the use of laparoscopy if the tumor clearly extends beyond the appendix.

Aged, 80 and over↗
PubMed1995

Oleic Acid and Its Positional Isomer, cis-Vaccinic Acid, in the Appendix of Sauromatum guttatum during Anthesis.

The fatty acid profiles of various organs of the thermogenic inflorescence of Sauromatum guttatum and of the sporophylls of thermogenic male cones of two cycad species (Encephalartos ferox and Dioon edule var edule and var angustifolium) were determined by gas chromatography. During anthesis, palmitate (16:0), oleate [18:1 (9)], cis-vaccinate [18:1 (11)], and linoleate [18:2 (9, 12)] were the most abundant fatty acids in the Sauromatum appendix. cis-Vaccinic acid, a positional isomer of oleic acid, was identified by comparing its retention time on a gas chromatography column and its mass spectrum to an authentic compound. The percentage of oleic acid from total fatty acids dropped from about 9 in the morning 3 d before heat production to 6 in the morning 2 d before heat production. At this time, the percentage of cis-vaccinic acid increased from 3 to 11%, and then remained at this level until the inflorescence dried and died. Palmitoleic acid [16:1 (9)], the common precursor of cis-vaccinic acid, is a minor component of total fatty acids. In six other organs of the Sauromatum inflorescence including thermogenic organs, such as male flowers and lower spadix, palmitate, oleate, and linoleate were prevalent but cis-vaccinate was not. The thermogenic male cones of the two cycad species were rich in palmitic, oleic, and linolenic acids. The level of cis-vaccinic acid in these organs was less than 0.5%.

Journal Article↗
PubMed1992

A case of dermatomyositis associated with pseudomyxoma peritonei originating from mucinous adenocarcinoma of the appendix.

A 69-year-old Japanese woman with erythema, severe edema on the face, Gottron's papules and poikiloderma was diagnosed as having dermatomyositis. She also noticed muscle weakness in her extremities, although her electromyogram showed neurogenic patterns. Her levels of CA19-9 and CEA were elevated and a CT of her abdomen revealed a giant, multilobular, cystic lesion in the pelvis. This tumor was diagnosed as pseudomyxoma peritonei originating from a mucinous adenocarcinoma of the appendix.

Adenocarcinoma, Mucinous↗
PubMed1990

Cystadenocarcinoma of the appendix testis.

We report an example of what we believe to be an adenocarcinoma of the appendix testis. This very rare neoplasm arose in a patient on long term treatment with oestrogens which may be implicated as an aetiological factor.

Cystadenocarcinoma↗
PubMed1994

Mucinous cystadenoma of the appendix with unusual sonographic appearances.

A case of an appendiceal cystadenoma resulting in a large mucocele in a 35 year old man presenting with abdominal pain is reported. On ultrasonography, an unusual appearance of strand-like layers of varying echo-texture suggesting a solid lesion was seen. On computed tomography, calcification and contrast enhancement of the rim was noted. The spectrum of imaging appearances of appendix mucoceles is reviewed.

Adult↗
PubMed1991

Goblet cell carcinoid of the vermiform appendix with ovarian metastasis mimicking mucinous cystadenocarcinoma.

We describe a case of goblet cell carcinoid of the vermiform appendix, which metastasized to the bilateral ovaries, uterus, vagina and peritoneum three years and four months after appendectomy. The appendiceal tumor showed transmural infiltration of carcinoembryonic antigen-positive goblet cell-type tumor cells, intermingled with a small number of argyrophilic cells immunoreactive for serotonin and chromogranin A. The presence of neurosecretory-type granules was confirmed ultrastructurally in some mucin-negative tumor cells. The pattern of proliferation was typical of carcinoid tumor originating from the lower-most part of the mucosa, and showed lymphatic permeation. The metastatic lesions in the pelvic organs showed either diffuse infiltration of goblet cell-type tumor cells or mucinous cystadenocarcinoma-like features, the latter being evident in the right ovary. No neuroendocrine component was identified in the metastatic deposits. The kinship of appendiceal goblet cell carcinoid to adenocarcinoma is discussed.

Adult↗
PubMed2004

Mucinous cystadenoma of the appendix.

Mucinous neoplasms of the Appendix are rare conditions, usually diagnosed intraoperatively or postoperatively on the pathology report. They have an association with colonic and ovarian neoplasms, and spillage can result in pseudomyxoma peritonei. While appendicectomy is adequate treatment for cystadenomas, cystadenocarcinomas require a right hemicolectomy. Open approach is recommended for the surgical treatment of these lesions.

Aged↗
PubMed1990

Non-Hodgkin's lymphoma of the ovaries and appendix: a case report.

Involvement of the female genital tract by non-Hodgkin's lymphoma is extremely rare. Here is the report of a patient who presented as a bilateral malignant ovarian tumour and was diagnosed by laparotomy and subsequent histopathology to have non-Hodgkin's lymphoma of both ovaries and appendix. The patient had radical surgery followed by multiagent chemotherapy and is alive without disease at one year of follow-up.

Adult↗
PubMed2006

New appendix criteria open for a broader concept of chronic migraine.

After the introduction of chronic migraine and medication overuse headache as diagnostic entities in The International Classification of Headache Disorders, Second Edition, ICHD-2, it has been shown that very few patients fit into the diagnostic criteria for chronic migraine (CM). The system of being able to use CM and the medication overuse headache (MOH) diagnosis only after discontinuation of overuse has proven highly unpractical and new data have suggested a much more liberal use of these diagnoses. The International Headache Classification Committee has, therefore, worked out the more inclusive criteria for CM and MOH presented in this paper. These criteria are included in the appendix of ICHD-2 and are meant primarily for further scientific evaluation but may be used already now for inclusion into drug trials, etc. It is now recommended that the MOH diagnosis should no longer request improvement after discontinuation of medication overuse but should be given to patients if they have a primary headache plus ongoing medication overuse. The latter is defined as previously, i.e. 10 days or more of intake of triptans, ergot alkaloids mixed analgesics or opioids and 15 days or more of analgesics/NSAIDs or the combined use of more than one substance. If these new criteria for CM and MOH prove useful in future testing, the plan is to include them in a future revised version of ICHD-2.

Chronic Disease↗
PubMed1985

Cellular uptake disguises action of L-glutamate on N-methyl-D-aspartate receptors. With an appendix: diffusion of transported amino acids into brain slices.

Pharmacological properties of the guanosine 3'5'-cyclic monophosphate (cyclic GMP) responses to excitatory amino acids and their analogues were compared in slices and dissociated cells from the developing rat cerebellum maintained in vitro. The intention was to determine the extent to which cellular uptake might influence the apparent properties of receptor-mediated actions of these compounds. In slices, the potencies of the weakly (or non-) transported analogues, N-methyl-D-aspartate (NMDA) and kainate (KA) (EC50 = 40 microM each) were higher than those of the transported amino acids, D- and L-aspartate (EC50 = 250 microM and 300 microM) and D- and L-glutamate (EC50 = 540 microM and 480 microM). Quisqualate (up to 300 microM) failed to increase cyclic GMP levels significantly. The sensitivity of agonist responses to the NMDA receptor antagonist, DL-2-amino-5-phosphonovalerate (APV), was in the order NMDA greater than L-aspartate greater than L-glutamate, KA. In dissociated cells, L-glutamate was 280 fold more potent (calculated EC50 = 1.7 microM). L- and D-aspartate (calculated EC50 = 13 microM) and D-glutamate (EC50 = 130 microM) were also more effective than in slices. The potencies of NMDA and KA were essentially unchanged. Responses to NMDA, L-glutamate and L-aspartate under these conditions were equally sensitive to inhibition by APV but the response to KA remained relatively resistant to this antagonist. The implications of these results are that, in slices, cellular uptake is responsible for (i) the dose-response curves to L-glutamate, L- and D-aspartate bearing little or no relationship to the true (or relative) potencies of these amino acids; (ii) the potency of APV towards the actions of transported agonists acting at NMDA receptors being reduced and (iii) a differential sensitivity to APV of responses to L-glutamate and L-aspartate being created, the consequence being that a potent action of L-glutamate on NMDA receptors is disguised. These conclusions are supported by theoretical considerations relating to the diffusion of transported amino acids into brain slices, as elaborated in the Appendix.

Aging↗
PubMed1983

Endometriosis of the vermiform appendix.

The pathological findings and clinical aspects of 22 patients with endometriosis of the vermiform appendix are presented. The cases were found among 10,000 appendices examined from 1950 to 1981. During this period of 32 years, 800 cases of pelvic endometriosis were seen. In 10 patients no other locations of pelvic endometriosis were found.

Abdomen, Acute↗
PubMed2006

Benign mesothelioma of the appendix: an incidental finding in a case of sigmoid diverticular disease.

Benign multicystic mesothelioma is a well recognised but rare entity. The aim of this report is to describe a case of a small mesothelial proliferation of the peritoneum. A 58 year old postmenopausal woman presented with left sided abdominal pain and altered bowel habit. Radiological investigations (barium enema and computed tomography scan of the abdomen and pelvis) were undertaken. An operation was performed for symptomatic sigmoid diverticular disease. Unusually, the appendix was adherent to the sigmoid colon. Microscopy revealed a benign mesothelioma. The patient remains symptom free to date.

Appendiceal Neoplasms↗
PubMed1968

Argentaffin and non-argentaffin carcinoid tumorurs of the appendix.

Tumours of the vermiform appendix were studied. The majority proved to be carcinoid tumours of the usual argentaffin-positive type but a substantial minority, generally tumours of minute size, were found to have a somewhat different histological pattern and were argentaffinnegative. Some contained argyrophil granules. The non-argentaffin tumours are considered to form a subgroup of carcinoid tumours.

Adult↗