flexible-colonoscopy-mice-to-evaluate-severity-colitis-colorectal

Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System

The use of modern endoscopy for research purposes has greatly facilitated our understanding of gastrointestinal pathologies. In particular, experimental ...

Case Western Reserve University School of Medicine, Cleveland

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In large GISTs, cystic degeneration, necrosis and focal hemorrhage that occur inside the tumor can result in gastrointestinal bleeding. We describe a case of a 74-year old male with GIST of the stomach accompanied with a giant abscess that penetrated the gastric lumen. The patient experienced undiagnosed fever for two months prior to hospitalization. Gastrointestinal endoscopy, X-ray series and computed tomography of the patient's abdomen revealed a gastric submucosal tumor in the fornix, with a fistula to the gastric lumen that was inundated with a great deal of pus. The mass was diagnosed as a GIST from biopsy specimens. The patient was treated by endoscopic drainage of the abscess and intravenous administration of antibiotics. Eventually, a partial gastrectomy was performed. He was also administered Imanitib mesylate as adjuvant therapy. He was followed up for 2 years and no metastasis or recurrence was recognized at the follow-up examinations. This is the first report of a patient with clearly diagnosed GIST with endoscopic evidence of an abscess penetrating into the gastric lumen.

Gastrointestinal stromal tumor of the stomach with a giant abscess penetrating the gastric lumen.

Primary small bowel bezoars are rare and may cause acute abdomen due to small bowel obstruction (SBO). A 70-year-old Japanese woman presented to the emergency room with abdominal pain, nausea and vomiting. The patient reported that she had eaten a large amount of highly-concentrated, agar dissolved in boiling water two days prior to presentation. Double balloon enteroscopy (DBE) revealed that white-colored, hard bezoars were clogged in the jejunum. At surgery, many bezoars were found impacted in the distal jejunum, and enterotomy was performed. The bezoars were elastic hard, crystallized objects. These bezoars were considered to have formed from highly-concentrated, dissolvable agar.

Obstructing small bowel bezoars due to an agar diet: diagnosis using double balloon enteroscopy.

Although germ cell tumors are the most common malignancy in young men, extragonadal germ cell tumors are rare. Gastric metastasis presenting initially as upper gastrointestinal hemorrhage is also exceedingly rare. A 27-year-old man presented at our hospital with tarry stool. Gastric fiberscopy images revealed a bleeding gastric polypoid lesion in the anterior wall of the gastric body, from which a biopsy specimen was obtained. Histopathological analysis of the biopsy showed syncytiotrophoblast-like cells with multiple, large nuclei, consistent with choriocarcinoma. Based on these results, our diagnosis was extragonadal retroperitoneal germ cell tumor with gastric metastasis.

Gastrointestinal hemorrhage as the first manifestation of metastatic extragonadal choriocarcinoma.

Little is known about the patient characteristics and tumor characteristics associated with a high level of granulocyte colony-stimulating factor (G-CSF) and leukocytosis. Moreover, the prognosis of G-CSF-producing gastric cancer has been extremely poor.

Response to chemotherapy in a case of gastric adenocarcinoma producing granulocyte colony-stimulating factor.

Endoscopic mucosal resection using a cap-fitted panendoscope as a diagnostic procedure in a case of scirrhous gastric carcinoma.

Nucleotide-binding oligomerization domain-containing 2 (NOD2) is an intracellular receptor that plays an essential role in innate immunity as a sensor of a component of the bacterial cell wall, muramyl dipeptide (MDP). Crohn's disease (CD)-associated NOD2 variants lead to defective innate immune responses, including decreased NF-ÎºB activation and cytokine production. We report herein that SAMP1/YitFc (SAMP) mice, which develop spontaneous CD-like ileitis in the absence of NOD2 genetic mutations, fail to respond to MDP administration by displaying decreased innate cytokine production and dysregulated NOD2 signaling compared with parental AKR control mice. We show that, unlike in other mouse strains, in vivo administration of MDP does not prevent dextran sodium sulfate-induced colitis in SAMP mice and that the abnormal NOD2 response is specific to the hematopoietic cellular component. Moreover, we demonstrate that MDP fails to enhance intracellular bacterial killing in SAMP mice. These findings shed important light on the initiating molecular events underlying CD-like ileitis.

Article	Year
Gastrointestinal stromal tumor of the stomach with a giant abscess penetrating the gastric lumen. World journal of gastroenterology : WJG\| PubMed ID: 17511044	2007
Obstructing small bowel bezoars due to an agar diet: diagnosis using double balloon enteroscopy. Internal medicine (Tokyo, Japan)\| PubMed ID: 18379147	2008
Gastrointestinal hemorrhage as the first manifestation of metastatic extragonadal choriocarcinoma. Internal medicine (Tokyo, Japan)\| PubMed ID: 19336957	2009
Response to chemotherapy in a case of gastric adenocarcinoma producing granulocyte colony-stimulating factor. Medical science monitor : international medical journal of experimental and clinical research\| PubMed ID: 20885355	2010
Endoscopic mucosal resection using a cap-fitted panendoscope as a diagnostic procedure in a case of scirrhous gastric carcinoma. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society\| PubMed ID: 22507097	2012
Dysregulated NOD2 predisposes SAMP1/YitFc mice to chronic intestinal inflammation. Proceedings of the National Academy of Sciences of the United States of America\| PubMed ID: 24082103	2013

Tomohiro Kodani

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