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PubMedDate not supplied

Pyloric obstruction caused by prolapse of a hyperplastic gastric polyp.

Hyperplastic gastric polyps account for the majority of benign gastric polyps and are generally diagnosed by routine gastroscopy as they rarely become symptomatic. We report a 79-year-old woman who presented with intermittent attacks of bloating, belching, nausea and vomiting. Endoscopy showed a pedunculated polyp in the gastric antrum prolapsing through the pylorus, thus obstructing the gastric outlet. The polyp was repositioned with an endoscopic forceps and then removed at its pedicle by endoscopic snare excision. Histologic examination showed a hyperplastic polyp without dysplasia or malignancy. The significance of gastric polyps is discussed from the clinical point of view.

Aged↗
PubMed2002

[Construction and application of colorectal polyp database].

OBJECTIVE: To study the construction and application of computerized database of colorectal polyp in the clinical management and research of this disease. METHOD: A colorectal polyp database and its management system was constructed on the basis of Microsoft Access 2000. Clinical, endoscopic and pathological data, which went through standardized and elemental processing, of 2 627 cases (4 850 records) of colorectal polyp collected from 1990 to 2000 in Nanfang Hospital was entered into this database. RESULTS: Using this new database, the information on the population and age distribution, location and clinical features of colorectal polyps were obtained. Comparative study of the clinical and pathological findings in the cases, evaluation of the therapeutic effects, statistical review of the identification of the polyp and its canceration in the previous years as well as the analysis of other relevant factors were successfully accomplished, which greatly facilitated the follow-up study of some chosen cases that may be of clinical significance. CONCLUSIONS: Applications of modern informatics and computer technology greatly facilitates case management and clinical research of colorectal polyps, and standardized and elemental processing of the clinical data offers a new possibility for easy case information management.

Colonic Polyps↗
PubMed1976

The radiological demonstraction of colorectal polyps undetected by endoscopy.

In a consecutive series of 800 routine double contrast studies of the colon, 119 polyps were diagnosed radiologically in 78 patients. Follow-up studies were available in 46 patients with 72 polyps. Ultimately, 56 of these polyps were confirmed (55 by endoscopy and 1 by repeat radiology). Six of these polyps had been missed on the initial endoscopic examination. The missed polyps are usually located in the rectum behind a valve of Houston or in any area of the colon where there is sharp angulation. Radiologists and endoscopists should be aware of these as potential endoscopic blind spots. These cases illustrate the importance of higg quality radiological study of the colon and the complementary nature of radiology and endoscopy in the detection of colorectal polyps.

Adult↗
PubMed2002

Role of allergy in the therapeutic response of nasal polyps.

The objective of this study was to determine whether the allergy factor affects therapeutic response of nasal polyps. A total of 68 patients were enrolled between 1 October 1999 and 1 January 2002 at the Allergy and Rhinology Clinic, Faculty of Medicine, Songklanagarind Hospital. Allergy skin prick test was performed in order to divide patients into a positive skin test group and a negative skin test group. Their medical history was recorded including age, sex, nasal symptoms, concomitant diseases and medications. Patients in both groups were treated over a 6 week period with Budesonide nasal spray. Nasal symptoms, polyp size, nasal and oral expiratory peak flow were evaluated at each visit. Overall assessment of treatment efficacy was evaluated by patients at 3 and 6 weeks after treatment. The mean value of these variables during treatment and a baseline period were compared within and between groups. After 3 and 6 weeks of treatment of nasal polyps with topical Budesonide nasal spray, nasal symptoms, polyp size, nasal and oral expiratory peak flow index and overall response to treatment were improved within both groups. Comparing the two groups, there were greater improvements in the negative skin test group compared to the positive skin test group in all variables. These differences in variable scores between groups showed a tendency to increase overtime after treatment was terminated. The results demonstrate that nasal polyps with positive allergen skin test had less improvement compared to nasal polyps with negative allergen skin test in all nasal signs and symptoms and these differences in improvement showed a tendency to increase over time after treatment.

Administration, Topical↗
PubMed2001

[Roles of CD43, CD20 and local IgE in the pathogenesis of nasal polyps].

OBJECTIVE: To estimate the roles of CD43, CD20 and total IgE in the pathogenesis of nasal polyps. METHOD: Twenty-six cases of nasal polyps and 20 cases of mucosa of middle turbinates were used in present study. RESULTS: The number of CD43+ cells, CD20+ cells and plasma cells in nasal polyps were significantly more than that in middle turbinates (P < 0.01). The positive rate of local IgE+ cells in nasal polyps was significantly higher than in middle turbinate (P < 0.01). CONCLUSION: There were active cellular immunity and humoral immunity in nasal polyps. Local allergy may play a role in the pathogenesis of nasal polyps.

Adolescent↗
PubMed1999

[The significance of matrix metalloproteinases expression in nasal polyps].

OBJECTIVE: To explore the role of matrix metalloproteinases (MMPs) in nasal polyp formation. METHODS: The expression of MMP9, MMP2 and MMP3 was studied in 32 nasal polyps by immunohistochemical method. RESULTS: MMPs could not be detected in all samples of normal mucosa. In nasal polyp tissue, MMP9 was observed epithelial in cells, inflammatory cell and blood cells, MMP2 was detected in fibroblasts, epithelial cells and inflammatory cells, and MMP3 was detected in inflammatory cells and epithelial cells. Compare to normal mucosa, MMP9, MMP2 and MMP3 was over expressed in their positive cells of polyp. The expression of MMP9 was higher than that of MMP2 and MMP3 in nasal polyp tissue (P < 0.01). CONCLUSION: MMP9, MMP2 and MMP3 were strongly correlated with nasal polyp formation. They cause pathological changes in nasal mucosa and MMP9 may play the most important role among them.

Adolescent↗
PubMed2002

[Expression of tenascin and fibronectin in nasal polyps].

OBJECTIVE: To explore the role of tenascin (TN) and fibronectin (FN) in the pathophysiology of nasal polyp. METHODS: The expression of TN and FN in nasal polyps from 34 patients and in inferior turbinates from 20 patients with deviation of nasal septum was studied with immunohistochemical method. In patients with nasal polyps, the relations between expression and histopathologic characteristics, eosinophilias (EOS) infiltration, clinical staging and the size of nasal polyps were analyzed. RESULTS: (1) The gray score of TN and FN expression was 163.10 +/- 10.54 and 163.24 +/- 11.52 in nasal polyps respectively, whereas it was 175.49 +/- 9.29 and 173.93 +/- 7.92 in inferior turbinates respectively. The difference between two groups was significant(P < 0.01); (2) The expression of TN and FN in edematous type was significantly stronger than that in cystic fibrous and glandular type (P < 0.05); (3) The association between FN expression and EOS infiltration was significant(r = -0.60, P < 0.01); (4) The expression of TN and FN did not correlate with clinical staging and size(P > 0.05). CONCLUSION: Abnormal ECM may contribute to proliferation of epithelium, accumulation of EOS and edema formation, as a result, to enhance the development of nasal polyps.

Adolescent↗
PubMed2002

[Expression of P-selectin in nasal polyps and its mechanisms].

OBJECTIVE: To investigate the expression of P-selectin and its mechanism in nasal polyps. METHODS: The expression of P-selectin was detected with immunohistochemistry and reverse transcriptase polymerase chain reaction (RT-PCR) in nasal polyps from 24 patients and nasal epithelium from 9 normals. The production of P-selectin in supernatans of isolated cultured vascular endothelial cells induced by interleukin-5 (IL-5) was detected with enzyme-linked immunosorbent assay (ELISA). RESULTS: The positive rate of P-selectin in nasal polyps was 79.1% (19/24) while it was 22.2%(2/9) in normals. The relative density ratio of P-selectin and beta-actin were 0.68 +/- 0.11 in nasal polyps and 0.29 +/- 0.08 in normals indicated by RT-PCR and agrose electrophoresis. The concentration of P-selectin was (53.4 +/- 2.9) ng/L and (21.3 +/- 3.5) ng/L in the two groups respectively. CONCLUSIONS: P-selectin upregulated in nasal polyps correlated with the infiltrated eosinophils and IL-5 could induce the expression of P-selectin protein in the isolated cultured endothelial cells. It suggested that upregulation of P-selectin may play a role in the pathogenesis of nasal polyps and can be enhanced by cytokine IL-5.

Adolescent↗
PubMed2003

[Relationship between expressions of GATA-3 and interleukin-5 in nasal polyps].

OBJECTIVE: To evaluate the role of transcription factor GATA-3 in the pathogenesis of nasal polyps. METHODS: The expression of GATA-3 was detected by immunohistochemistry and reverse transcriptase polymerase chain reaction (RT-PCR) in 28 cases of nasal polyps and 17 specimens of normal nasal epithelium. The expression of interleukin-5 (IL-5) in these specimens was detected by enzyme-linked immunosorbent assay (ELISA) meanwhile. RESULTS: Immunohistochemistry showed, as confirmed by RT-PCR, a positive rate of GATA-3 of 89.3% in the nasal polyp (25/28) and 29.4% in the normal nasal mucosa (5/17), P < 0.05. GATA-3 was mainly distributed in submucous inflammatory cells. The relative density ratio of GATA-3 to GAPDH was 0.618 +/- 0.137 in nasal polyp and 0.21 +/- 0.11 in normal nasal mucosa (P < 0.05) as indicated by RT-PCR and agarose electrophoresis. The concentrations of IL-5 were 69.4 +/- 15.1 pg/ml and 25.7 +/- 13.0 pg/mg in the two groups respectively. The expression of GATA-3 was positively correlated to the expression of IL-5 in the nasal polyp. CONCLUSION: Contributing to the overexpression of such cytokines as IL-5, GATA-3 may play an important role in the pathogenesis of nasal polyps.

Adolescent↗
PubMed1992

Myb expression is higher in malignant human colonic carcinoma and premalignant adenomatous polyps than in normal mucosa.

Expression of the protooncogene c-Myb protein was assessed in normal mucosa and in tumor samples resected from six patients. We found that the tumor samples always expressed higher levels of full length Myb protein than the normal tissue. This contrasts with the situation in c-myb-associated hemopoietic malignancies of the mouse and chicken, in which Myb proteins are generally amino or carboxyl truncated. Tissues from five patients with colonic adenomatous polyps were also examined and found to express levels of Myb that were, in general, intermediate between those found in normal tissues and tumors. Of particular interest is that the more dysplastic polyps displayed higher Myb levels. In one patient with carcinoma and multiple colonic polyps, some polyps had intermediate levels of Myb, whereas one polyp with carcinoma in situ expressed tumor-like levels of Myb. To directly test the hypothesis that Myb expression may be important in determining the rate of colonic cell proliferation, we examined three colonic carcinoma cell lines and one polyp cell line. We found that the cell lines with the most rapid doubling times exhibited the highest Myb levels. In addition, we show that antisense myb oligonucleotides retard the proliferation of one of these colonic cell lines which expresses the highest level of Myb.

Base Sequence↗
PubMed2003

[Preliminary study of correlation factor in surgery effect of nasal polyps].

OBJECTIVE: To study the relation between nasal polyp pathology, cellular expression of CD45 RO, CD20, CD68, proliferating cell nuclear antigen (PCNA) in nasal polyps and the response to surgery. METHOD: Nasal polyp tissues from 50 patients were evaluated for cellular expression of CD45 RO, CD20, CD68, PCNA using immunohistochemistry SP by counting the average number in 5 chosen high-power fields, histopathological observations were combined with clinic and postoperative dates. Analyses were performed on SPSS10.0. RESULT: Significant correlation was found between CD68+ cells and eosinophils or PCNA positive cells on epithelium. PCNA positive cells on epithelium has significant correlation on fibroblast (P < 0.05). The nasal polyps dominated with CD68+ and high polyp score have significant correlation to cure. CONCLUSION: Extent of inflammatory cells infiltration especially CD68+ or eosinophilia or lymphocytes and polyp score have significant effect on cure rate.

Adolescent↗
PubMed2003

[Expression of CD68 CD45RO CD20 and proliferating cell nuclear antigen in nasal polyps].

OBJECTIVE: To study the cellular expression of CD45RO, CD20, CD68 and proliferating cell nuclear antigen (PCNA) in nasal polyps. METHODS: Nasal polyp tissues from 50 patients were evaluated for cellular expression of CD45RO, CD20, CD68 and PCNA using immunohistochemistry SP by counting the average number in 5 chosen high-power fields, Histopathological observations were combined with HE. Analyses were performed on SPSS10.0. RESULTS: CD68+ cells were expressed more in nasal polyps dominated by eosinophils than by neutrophils(P < 0.05). There was no difference between CD45RO and CD20, but both of them had negative correlation(P = 0.05). Significant correlation was found between CD68+ cells and eosinophils or PCNA positive cells on epithelium. PCNA positive cells on epithelium had significant correlation on fibroblast (P < 0.05). CONCLUSION: Inflammatory cell infiltration (eosinophilia CD45RO, CD20, CD68) and cell proliferating in epithelium cells, glandular cell and fibroblast are strongly correlated with formation of nasal polyps. The nasal polyps are not only characteristic of eosinophilia but also by lymphocytes dominated by CD45RO and CD68 positive cells. CD68 may be stem cell of nasal polyp.

Antigens, CD↗
PubMed2003

A randomized, double-blind, placebo-controlled trial of the effects of rofecoxib, a selective cyclooxygenase-2 inhibitor, on rectal polyps in familial adenomatous polyposis patients.

PURPOSE: The aim of this study was to examine the effect of a specific cyclooxygenase-2 inhibitor, rofecoxib, on rectal polyps in familial adenomatous polyposis patients. EXPERIMENTAL DESIGN: This was a randomized, double-blind, placebo-controlled study of the efficacy and safety of rofecoxib in the rectum. Initially, 21 patients were assigned randomly in a 1:1 ratio to receive either 25 mg rofecoxib once a day or a placebo p.o. for 9 months. Patients underwent endoscopy at the beginning of the study and then every 3 months thereafter. We reviewed the videotapes to measure the number and size of polyps in the same area throughout the study period in each individual patient. RESULTS: The polyp number, measured as the percentage of change from the baseline values, was significantly decreased in the rofecoxib group at 3, 6, and 9 months. At 9 months, the polyp number in the rofecoxib group decreased by 6.8% from the baseline values, whereas that in the placebo group increased by 3.1%. The 9.9% difference between the rofecoxib and placebo groups was statistically significant (P = 0.004). At 9 months, the rofecoxib group showed a significant reduction from the baseline in polyp size as compared with the placebo group (-16.2% versus 1.5%; P < 0.001). There was no statistically significant increase in the incidence of any adverse events in treatment with rofecoxib compared with placebo (P = 0.922). CONCLUSIONS: In this study, once-daily treatment with 25 mg rofecoxib, a cyclooxygenase 2-specific inhibitor, significantly decreased the number and size of rectal polyps in familial adenomatous polyposis patients.

Adenomatous Polyposis Coli↗
PubMed2003

Expression of cyclooxygenase-2 in human hyperplastic gastric polyps.

Cyclooxygenase (COX)-2, an inducible isoform of prostaglandin synthetase, has been reported to be a key molecular target of colon cancer prevention by nonsteroidal anti-inflammatory drugs. Recently, it has been shown that Helicobacter pylori (H. pylori) could induce COX-2 together with inflammatory cytokines. Although human hyperplastic gastric polyps disappeared or decreased in number and size after eradication of H. pylori, the mechanisms in this step, especially the roles of COX-2, have not been yet elucidated. The aims of the present study were to examine the expression and localization of COX-2 in human hyperplastic gastric polyps immunohistochemically. Twelve specimens of human hyperplastic gastric polyps were obtained from endoscopic polypectomy. The expression of the COX-2 protein was immunohistochemically examined on formalin-fixed and paraffin-embedded tissue sections using an anti-COX-2 antibody and an avidin-biotin complex method. Cells expressing COX-2 were further immunohistochemically identified using a specific antibody against macrophages (CD68), and myofibroblasts (alpha-smooth muscle actin). Immunoreactive COX-2 was predominantly and strongly expressed in interstitial cells in the sub-epithelial layer of 10 hyperplastic polyps. Semi-quantitative analysis revealed a significant increase in COX-2 expression in interstitial cells. The staining pattern of macrophages and myofibroblasts partly corresponded to that observed for COX-2 in hyperplastic gastric polyps. These results suggest that COX-2 in mesenchymal cells induced by H. pylori may play an important role in the tumorigenesis of human hyperplastic gastric polyps.

Aged↗
PubMed2003

Gallbladder polyps, cholesterolosis, adenomyomatosis, and acute acalculous cholecystitis.

Acute acalculous cholecystitis is characterized by acute inflammation of the gallbladder in the absence of stones, usually occurring in elderly and critically ill patients with atherosclerosis, recent surgery or trauma, or hemodynamic instability. Patients may present with only unexplained fever, leukocytosis, and hyperamylasemia without right upper quadrant tenderness. If untreated, rapid progression to gangrene and perforation occurs. Surgical cholecystectomy and cholecystostomy provide the most definitive treatment although recent studies indicate success with percutaneous or endoscopic cholecystostomy. Cholesterolosis and adenomyomatosis of the gallbladder are usually clinically silent and incidental findings at the time of cholecystectomy. Cholesterolosis is characterized by mucosal villous hyperplasia with excessive accumulation of cholesterol esters within epithelial macrophages. Usually clinically silent, the condition rarely is associated with biliary symptoms or idiopathic pancreatitis and cannot reliably be detected by ultrasonography. Adenomyomatosis describes an acquired, hyperplastic lesion of the gallbladder characterized by excessive proliferation of surface epithelium with invaginations into a thickened muscularis propria. Ultrasonography may reveal a thickened gallbladder wall with intramural diverticula. Adenomyomatosis may portend a higher risk of gallbladder malignancy. Most cases of cholesterolosis and adenomyomatosis identified by imaging require no specific treatment. Gallbladder polyps include all mucosal projections into the gallbladder lumen and include cholesterol polyps, adenomyomas, inflammatory polyps, adenomas, and other miscellaneous polyps. Most polyps are nonneoplastic and rarely cause symptoms. Cholecystectomy is advocated for polyps greater than 10 mm in size because of increased risk of adenomatous or carcinomatous features.

Acalculous Cholecystitis↗
PubMed2004

[Histological analysis of endometrial polyps in breast cancer patients treated with tamoxifen (nolvadex)].

Endometrial polyps are the most common endometrial pathology described in association with Tamoxifen exposure. The aim of this study was to evaluate the malignant potential of endometrial polyps in breast cancer patients receiving Tamoxifen. We analyzed 140 endometrial polyps divided into two groups: 1) 73 endometrial polyps from 57 breast cancer patients receiving Tamoxifen (Nolvadex): T+ endometrial polyps; 2) 67 control endometrial polyps received for analysis in the period January-December 2000. The analysis was performed on archival H&E sections. We found that the rates of endometrial carcinoma and atypical hyperplasia were high in patients treated with Tamoxifen (7.02% vs 2.99% and 17.54% vs 11.94%), but the results did not reach statistical significance (p > 0.05).

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

Histopathological features of nasal polyps with asthma association: an immunohistochemical study.

BACKGROUND: Myofibroblasts are related to airway remodeling and may play an important role in the pathogenesis of the histological features of nasal polyps associated with asthma. The aim of this study was to analyze and compare the eosinophilic cationic protein, transforming growth factor (TGF) beta, and myofibroblasts in the nasal polyps of patients with chronic sinusitis associated with and without asthma. METHODS: Nasal polyp samples were obtained during endoscopic sinus surgery and were classified into asthma and nonasthma groups. Immunohistochemistry was performed using antibodies against activated eosinophils, TGF-beta, and myofibroblasts. RESULTS: The asthma group showed an increased number of activated eosinophils, TGF-beta, and myofibroblasts compared with the nonasthma and control groups. We found no correlation of asthma and aspirin intolerance with the immunohistochemical findings. CONCLUSION: The increased number of myofibroblasts in the nasal polyps of the asthma group may be responsible for the extracellular matrix accumulation, polyp formation, and polyp recurrence.

Adolescent↗
PubMed2004

[Role of ICAM-1 in eosinophilia and prognosis of nasal polyps].

OBJECTIVE: To investigate the role of adhesion molecule ICAM-1 (Intercellular adhesion molecule-1) in eosinophilia and prognosis of nasal polyps. METHOD: Expression of ICAM-1 were detected and quantified in 35 cases of nasal polyps with fluorescence-immunohistochemistry analysis and its relationships to eosinophilia and prognosis of nasal polyps were evaluated. RESULT: The numbers of eosinophils in nasal polyps and control nasal mucosas were 28.4 +/- 10.7/mm2 and 9.9 +/- 8.6/mm2, and fluorescent densities of ICAM-1 were 115.9 +/- 82.4 and 28.2 +/- 17.1. The expression of ICAM-1 was associated with the heaviness of nasal polyps. CONCLUSION: ICAM-1 may play an important role in the formation and prognosis of nasal polyps.

Adult↗