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At least 1,405 records · Page 78Linked to original sources
PubMed2000

Influence of image acquisition parameters on CT artifacts and polyp depiction in spiral CT colonography: in vitro evaluation.

PURPOSE: To quantify the effects of spiral computed tomographic (CT) acquisition parameters on the magnitude of three-dimensional (3D) rippling artifacts and polyp depiction. MATERIALS AND METHODS: An in vitro colon phantom was constructed with air-filled acrylic cylinders that contained synthetic polyps of 3-13 mm. The phantom was submerged in fluid and positioned at four angles of inclination relative to the z axis. Image data were acquired at collimation and pitch combinations of 3 mm and 1.67 and 5 mm and 1.6, respectively. Rippling artifacts were quantified by measuring the longitudinal variation of in-plane phantom edge width, and the influence of these artifacts on the depiction of pedunculated and sessile polyps was assessed qualitatively. RESULTS: The in-plane magnitude of the rippling artifact was a function of the angle of inclination relative to the longitudinal axis and the table increment. The through-plane periodicity of the artifact was equal to one-half the table increment. CONCLUSION: The table increment and angle of inclination of the surface of the object relative to the z axis determine the periodicity and magnitude of the rippling artifact at 3D spiral CT colonography. Although the depiction of small pedunculated polyps was not compromised, some sessile polyps were degraded by the artifact.

Artifacts↗
PubMed2005

The association of physical activity and body mass index with the risk of large bowel polyps.

PURPOSE AND METHOD: Several studies have suggested that physical inactivity and obesity increase the risk for colorectal neoplasia. In this study, we investigated the association of physical activity and body mass index (BMI) with the risk of different types of large bowel polyps. We did an observational analysis nested within a randomized double-blind placebo-controlled chemoprevention trial among patients with one or more recently resected histologically confirmed colorectal adenoma. Nine hundred thirty patients were randomized to calcium (1,200 mg/d, as carbonate) or placebo. Follow-up colonoscopies were conducted approximately 1 and 4 years after the qualifying examination. At study entry, we obtained each subject's current body weight and height, which we used to calculate BMI. After the second study colonoscopy, we asked subjects questions about their leisure time physical activity. Seven hundred eighty-seven subjects completed at least part of the physical activity questionnaire. RESULTS: We found no association between measures of physical activity or BMI and tubular adenomas or hyperplastic polyps. However, among men, there were strong inverse associations observed between physical activity and advanced neoplastic polyps. Compared with men whose total daily energy expenditure was in the lowest tertile, those in the highest tertile had a risk ratio of 0.35 (95% confidence interval, 17-0.72); there was no similar reduction observed among women (risk ratio, 1.21; 95% confidence interval, 0.36-4.03; P for interaction = 0.04). DATA INTERPRETATIONS: We found a significant inverse relationship between several measures of physical activity and risk of advanced colorectal neoplasms, particularly among men. No associations were found between BMI and hyperplastic polyps, tubular adenomas, or advanced neoplastic polyps.

Aged↗
PubMed2006

A follow-up study of physical activity and incidence of colorectal polyps in African-American women.

BACKGROUND: Physical activity is associated with a reduced risk of colon cancer, but the effect of activity on colorectal adenomas, which are precursors to colon cancer, is uncertain. The influence of physical activity on colorectal adenomas among African-American women is of particular interest because African-American women have an increased risk of colon cancer relative to other U.S. women. METHODS: We prospectively assessed the relation of physical activity to the incidence of colorectal polyps among African-American women. We followed 45,400 women in the Black Women's Health Study from 1997 to 2003. Data were obtained by biennial mailed questionnaires. During 287,029 person-years of follow-up, 1,390 women reported having been diagnosed with colorectal polyps. A review of medical records of 58 women who reported colorectal polyps indicated that 59% had adenomas and 41% had hyperplastic polyps. We converted hours per week of vigorous exercise and hours per week of walking to metabolic equivalent (MET)-hours. We estimated incidence rate ratios with Cox proportional hazard models, controlling for age, body mass index, smoking, family history of colorectal cancer, and education. RESULTS: For total MET-hours/wk spent in walking and vigorous exercise, the incidence rate ratio decreased from 0.94 for <5 MET-hours/wk to 0.72 for >or=40 MET-hours/wk (P(trend) = 0.01). The inverse association was apparent among most subgroups examined, including women who may be at higher risk of colorectal adenomas because of being obese. CONCLUSIONS: Increased physical activity is associated with a reduced incidence of colorectal polyps among African-American women.

Adult↗
PubMed2002

Does the introduction of new technology change population demographics? Minimally invasive technologies and endometrial polyps.

OBJECTIVE: To determine if the characteristics of women with endometrial polyps changed as minimally invasive modalities for diagnosis and surgical treatment were integrated to our clinical practice. MATERIALS AND METHODS: The pathologic reports of all women diagnosed with endometrial polyps in 1990 (220 patients) and 1996 (386 patients) were reviewed. The respective medical records were reviewed for anthropomorphic factors, bleeding pattern, diagnosis, and modality of surgical removal. Comparisons of dichotomous data and analysis of nominal variables with two or more categories were carried out with the chi(2) test. RESULTS: Differences in patient characteristics or pattern of bleeding were minimal. In both groups, endometrial polyps were more frequent in women with abnormal bleeding, reaching almost 80%. Diagnostic and therapeutic modalities were significantly different in 1990 vs. 1996. Diagnosis by ultrasound increased fivefold (3.6 vs. 16.8%) and operative hysteroscopy increased threefold (6.4 vs. 19.7). The frequency of incidental diagnosis of endometrial polyps at the time of hysterectomy decreased significantly. The most frequent modality of surgery done in 1990 was dilatation and curettage (44.6%), followed in frequency by endometrial biopsy and abdominal hysterectomy. In contrast, the most frequent modality in 1996 was hysteroscopic resection (36.8%), followed by dilatation and curettage (12.8%). CONCLUSIONS: The introduction of minimally invasive methods of diagnosis and treatment of endometrial polyps has not changed the overall patient population with this lesion.

Adult↗
PubMed2004

Multiple synchronous fibrovascular polyps of the hypopharynx.

PURPOSE OF THE STUDY: To evaluate the clinical, radiological presentation and surgical management of fibrovascular polyps of the hypopharynx. METHODS: Retrospective medical analysis of a case report. We report the case of a 66-year-old man, who presented with an incarcerated left inguinal hernia, vomiting and regurgitation of a large mass into the oral cavity resulting in syncope. MRI and cine-esophagram demonstrated a large mass in the cervical esophagus. At the time of herniorrhaphy, endoscopy revealed an 11.8-cm hypopharyngeal mass that completely obstructed the oropharynx. RESULTS: The airway was secured by tracheostomy and the lesion was subsequently removed via open pharyngotomy. Postoperatively, a second polyp was found ball-valving into the airway, and an endoscopic resection was performed prior to decannulation. Histopathology of both lesions confirmed the diagnosis of a fibrovascular polyp. CONCLUSION: Fibrovascular polyps are rare benign intraluminal esophageal lesions resulting in mild symptoms of dysphagia that may also cause significant morbidity such as syncope and asphyxia. This is the first report of synchronous fibrovascular polyps of the hypopharynx.

Aged↗
PubMed2005

Hormone receptor expressions and proliferation markers in postmenopausal endometrial polyps.

BACKGROUND/AIMS: Endometrial polyps are quite common in the general population, they have a significant role in postmenopausal bleeding, and the pathogenesis is unclear. The aim of this study was to investigate proliferation markers and expression of estrogen and progesterone receptors in endometrial polyps in postmenopausal women. METHODS: Endometrial polyps were removed by hysteroscopy from 36 women who presented with postmenopausal bleeding. None were using hormonal therapy. The control group consisted of 16 inactive-atrophic postmenopausal endometrial specimens removed at hysterectomy. Immunohistochemistry was used to demonstrate expression of estrogen and progesterone receptors and the cell growth and apoptosis markers, Ki67, bcl-2, c-erbB-2. RESULTS: In both the glandular epithelium and stroma of endometrial polyps, estrogen and progesterone receptors, Ki67 and bcl-2 showed significantly more positive staining than the inactive endometrium from the control group. There was no difference in expression of c-erbB-2 between the two groups. CONCLUSIONS: Estrogen may have a role in the development of postmenopausal endometrial polyps, either by direct stimulation of localized proliferation or by stimulation of proliferation via other pathways, such as activation of Ki67 or through inhibition of apoptosis via bcl-2. c- erbB-2 is unlikely to play any role in development of these lesions.

Adult↗
PubMed1993

Inflammatory endotracheal polyp resolved after antibiotic treatment.

We describe a rare case of asymptomatic inflammatory endotracheal polyp resolved by antibiotic treatment. Histological examination of biopsy specimens showed an inflammatory polyp consisting of fibrovascular stroma and sparse lymphocyte infiltration. The size of the polyp was unchanged during 3 months without any treatment and its etiology was unclear. Although a bacterial organism was never proven, the polyp decreased remarkably under treatment with an oral antibiotic (ciprofloxacin) and did not recur for 6 months. Antibiotic treatment may be of value for inflammatory tracheobronchial polyps in cases of unclear etiology.

Ciprofloxacin↗
PubMed1986

Nasal allergy and nasal polyp with special reference to the mucosal IgE antibodies.

Immunologic conditions were studied in 8 patients with nasal allergies and nasal polyps and in 20 patients with nasal polyps. The present study showed the following: Nasal polyp mucosa contains a low level of mucosal IgE antibodies; nasal polyp mucosa is devoid of or deficient in the capacity of producing IgE antibodies; the presence of mucosal IgE antibodies in nasal polyp mucosa does not always imply the clinical manifestation of nasal allergies, and the antigen and antibody interaction does not always result in nasal symptoms.

Humans↗
PubMed1993

Hematuria and voiding disorders in children caused by congenital urethral polyps. Principles of diagnosis and management.

Congenital urethral polyps may cause hematuria, various degrees of outflow obstruction and display a variety of, mostly nonspecific micturition abnormalities in young boys and infants, and should be considered and investigated when recurrent or persistent hematuria and voiding disturbances are encountered. Voiding cystography is the best available diagnostic method to detect urethral polyps. Following diagnosis, prompt complete resection of polyp is indicated. Resolution of signs and symptoms and excellent prognosis are the rule in most of the reported cases. In view of the rarity of this significant pathological condition, we present our experience with 6 children who suffered from urethral polyps and outline the principles of diagnostic evaluation and management of the child with urethral polyp.

Child, Preschool↗
PubMed1994

Nasal polyp inflammation. Effect of topical nasal steroid.

Topical nasal corticosteroid therapy produces clinical improvement in patients with nasal polyposis. To examine the mechanisms of steroid effect, we quantified the number of inflammatory cell types as well as the expression of relevant cell markers in nasal polyps from steroid treated patients (n = 11) and polyps from untreated patients (n = 10) judged to require polypectomy for symptomatic relief. We found that the majority of eosinophils in these tissues were in the stromal layers, and that the proportion of activated eosinophils (EG2+ versus total eosinophil count) was significantly lower in polyps from patients treated with the topical nasal steroid budesonide, 200 to 400 micrograms/d for 1 mo, than in polyps from untreated patients. We also found that in polyps from treated patients, the superficial stromal layer (SSL) and deep stromal layer (DSL) both contained a significantly lower tissue density of lymphocytes of CD3, CD4, and CD8 subsets. Treatment was also associated with a lower, albeit nonsignificant, expression of ICAM-1 and HLA-DR in the epithelium. The tissue density of CD14+ cells (monocyte/macrophage) and of tryptase+ cells (mast cells) was the same in the two groups. These findings demonstrate tissue effects of topical corticosteroid treatment which may point to the mechanisms of therapeutic benefit. In addition, these observations illustrate the value of markers that indicate cell functional activity rather than just cell numbers.

Administration, Intranasal↗
PubMedDate not supplied

Pathogenesis of vocal cord polyps.

Polyps of the vocal cords are a separate entity occurring nowhere else in the larynx or in the human body. Gelatinous and telangiectatic, but mainly transitional types of polyps can be discriminated. Histological, histochemical and electron microscopic investigations on a series of polyps show that an alteration of the permeability of blood vessels may be of importance, allowing the extravasation of edema fluid, fibrin or erythrocytes. Following this, reactive processes develop with the formation of labyrinthine vascular spaces. This process is very similar to the organization of a thrombus. Since polyps occur mainly in people who use their voices very intensively, and develop at the site of maximum muscular and aerodynamic forces exerted during phonation, vocal cord polyps are considered a sequela of a phonotrauma.

Humans↗
PubMed1990

Goblet cell density in nasal polyps.

The goblet cell density was determined in 29 nasal polyps from 22 patients by use of the periodic acid Schiff-alcian blue whole-mount method. The distribution of goblet cells was found to be extremely irregular, ranging from areas completely devoid of goblet cells to areas with a relatively high density. The median density varied from 280 cells/mm2 to 10,000 cells/mm2. The total median density for all 15 polyps located anteriorly in the nose was 3,450 cells/mm2, compared with 6,050 cells/mm2 for 14 posteriorly located polyps. The density was highest in pseudostratified, cylindric epithelium, although great variations occurred among the different areas with this type of epithelium. The goblet cell density may be influenced by several factors, such as the airflow, type and thickness of the epithelium, and whether the genesis of the nasal polyps is infectious or allergic, in addition to polyp growth, size, and age.

Basement Membrane↗
PubMed1998

Expression of basic fibroblast growth factor in nasal polyps.

Basic fibroblast growth factor (bFGF) is a polypeptide that is mitogenic for a wide variety of cell types. We used Northern blot analysis and immunohistochemistry to determine if bFGF is expressed in the nasal polyp tissue; bFGF messenger RNA was detectable in the polyps examined by Northern blot analysis. Strong immunostaining for bFGF was found in blood vessels and along the basement membrane of the epithelial cell layers. Basal epithelial cells and some infiltrating mononuclear cells also stained for bFGF. Proliferating cell nuclear antigen colocalized with bFGF to basal epithelial cells, endothelial cells, and areas of focal epithelial metaplasia. The polyp tissue was double-labeled with a mouse monoclonal antitryptase, a specific mast cell marker, and anti-bFGF. A significant number (65% +/- 19%) of the bFGF-positive mononuclear cells in the polyp tissues were positive for tryptase. These findings suggest that bFGF may contribute to the endothelial and epithelial proliferation in nasal polyp tissues and that mast cells are one source of this growth factor.

Adolescent↗
PubMed1978

Malignancy of colonic polyps. Diagnosis and management.

The risk of malignant degeneration of colonic polyps has traditionally rested on various roentgenographic criteria such as broad base, irregular surface and size larger than 1 cm. With the aim of facilitating the choice of treatment of colonic polyps, an appraisal is made of the morphology of 200 polyps removed from 154 patients. The results of barium enema and double contrast techniques are compared with those obtained at colonoscopy. Radiography is found to have considerable shortcomings in evaluation of the appearance of the polyp. As the correlation of the gross morphology of the polyp of histology is weak endoscopic polypectomy should be performed whenever possible.

Colon↗
PubMed1981

Value of multiple forceps biopsies in assessing the malignant potential of colonic polyps.

Fifty-nine colo-rectal polyps were detected at endoscopy and repeatedly biopsied before removal by endoscopic snare polypectomy. The aim of the present paper was to evaluate the reliability of multiple forceps biopsies in assessing both the malignant potential and the presence or absence of invasive cancer (IC) in colo-rectal adenomas (CRA). In order to achieve the first objective, the histologic types and the degree of dysplasia have been defined. The data obtained by means of multiple biopsies examination, compared with those of polyp in toto study, show that fractional biopsies were of value in the histologic classification of only the smallest 41 polyps (agreement 88.09%), whilst no reliability of biopsies was demonstrated in the 18 largest polyps (agreement 27.68%). In the field of dysplasia grading, the agreement was 55% and 61% for the smallest and the largest CRA respectively. These last figures are hardly acceptable. Biopsies examination gave also under- and overestimation of the histologic severity and of dysplasia as well as a significant incidence of false negative results in IC detection. It is concluded that polypectomy is the only method which provides adequate material for precise diagnosis, no matter how large a polyp. Therefore it should be performed whenever possible. Finally the authors discuss the management of small sessile adenomas.

Biopsy↗
PubMed1995

Case report: a hamartoma presenting as a giant oesophageal polyp.

Giant oesophageal polyp (GOP) is a very rare intraluminal tumour. It is usually a benign, fibrovascular polyp arising from the proximal third of the oesophagus. We describe a patient with such a polyp but with a histological diagnosis of hamartoma. Regurgitation of the polyp into the mouth, which can lead to asphyxia, is a feared complication. A barium swallow and oesophagoscopy are the common diagnostic procedures. The site of the polyp and its volume often define the method of resection.

Adult↗
PubMed2005

Colonic muco-submucosal elongated polyp: diagnosis with endoscopic ultrasound.

Colonic muco-submucosal elongated polyp is a new clinical entity first reported in 1998. The purpose of this report is to determine the value of endoscopic ultrasound in the diagnosis of this condition. We reviewed the endosonographic and histological findings of seven colonic muco-submucosal elongated polyps that were removed completely by endoscopic resection or surgery. The lesions appeared as pedunculated submucosal tumours, measuring 1-4 cm in maximal diameter. Endosonographically, all lesions consisted of mucosal and submucosal layers, and microcystic components were found in the submucosal layer. There were no echogenic masses or muscularis propria within the polyps. These endosonographic features corresponded to histological findings of this type of polyp which was covered with normal mucosa and composed of submucosal layer alone. The submucosal layer consisted of oedematous, loose, connective tissue and/or fibrous tissue, accompanied by dilated blood vessels and lymphatics. Endoscopic ultrasound enabled differentiation of colonic muco-submucosal elongated polyp from other submucosal lesions.

Adult↗
PubMed2001

Acute cholecystitis caused by a cholesterol polyp.

A 39-year-old man hospitalized with upper abdominal pain had been found to have a 3mm polyp in the body of the gallbladder 3 years previously. Laboratory tests on admission showed mild liver dysfunction. Ultrasonography depicted a dilated gallbladder with increased wall thickness; the polyp could no longer be seen. Computed tomography with drip infusion cholangiography again showed a dilated gallbladder, and also stenosis of the distal cystic duct. The resected specimen obtained by laparoscopic cholecystectomy showed disappearance of the polyp from the body of the gallbladder. A cholesterol stone was incarcerated in the cystic duct, representing an impacted detached cholesterol polyp causing acute cholecystitis. Spontaneous detachment of a cholesterol polyp from the gallbladder mucosa, then, can result in acute cholecystitis.

Acute Disease↗