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https://www.readbyqxmd.com/read/28617917/genomic-profiling-of-small-bowel-adenocarcinoma
#1
Alexa B Schrock, Craig E Devoe, Robert McWilliams, James Sun, Thomas Aparicio, Philip J Stephens, Jeffrey S Ross, Richard Wilson, Vincent A Miller, Siraj M Ali, Michael J Overman
Importance: Small-bowel adenocarcinomas (SBAs) are rare cancers with a significantly lower incidence, later stage at diagnosis, and worse overall survival than other intestinal-derived cancers. To date, comprehensive genomic analysis of SBA is lacking. Objective: To perform in-depth genomic characterization of a large series of SBAs and other gastrointestinal tumors to draw comparisons and identify potentially clinically actionable alterations. Design, Setting, and Participants: Prospective analysis was performed of clinical samples from patients with SBA (n = 317), colorectal cancer (n = 6353), and gastric carcinoma (n = 889) collected between August 24, 2012, and February 3, 2016, using hybrid-capture-based genomic profiling, at the request of the individual treating physicians in the course of clinical care for the purpose of making therapy decisions...
June 15, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28617885/the-role-of-wireless-capsule-endoscopy-wce-in-the-detection-of-occult-primary-neuroendocrine-tumors
#2
Manuele Furnari, Andrea Buda, Gabriele Delconte, Davide Citterio, Theodor Voiosu, Giovanni Ballardini, Flaminia Cavallaro, Edoardo Savarino, Vincenzo Mazzaferro, Emanuele Meroni
BACKGROUND AND AIMS: Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms with unclear etiology that may show functioning or non-functioning features. Primary tumor localization often requires integrated imaging. The European Neuroendocrine Tumors Society (ENETS) guidelines proposed wireless-capsule endoscopy (WCE) as a possible diagnostic tool for NETs, if intestinal origin is suspected. However, its impact on therapeutic management is debated. We aimed to evaluate the yield of WCE in detecting intestinal primary tumors in patients showing liver NET metastases when first-line investigations are inconclusive...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28609828/congenital-jejunal-diverticular-bleeding-in-a-young-adult
#3
Ji-Yung Lee, Jae-Young Jang, Min-Je Kim, Tae-In Lee, Jung-Wook Kim, Young-Woon Chang
Diverticular bleeding of the small bowel is rare and occurs primarily in adults aged more than 60 years. In younger adults, Meckel's diverticulum, a true diverticulum that congenitally occurs in the distal ileum, is the most common cause of diverticular bleeding of the small bowel. Unlike Meckel's diverticula, other kinds of small bowel diverticula are not congenital and their incidence is related to age. Furthermore, congenital true diverticular bleeding of the jejunum in adults is very rare. We report the case of a 24-year-old man with subepithelial tumor-like lesion accompanied with obscure overt gastrointestinal bleeding (OOGIB)...
June 14, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28609357/the-surgical-management-of-small-bowel-neuroendocrine-tumors-consensus-guidelines-of-the-north-american-neuroendocrine-tumor-society
#4
James R Howe, Kenneth Cardona, Douglas L Fraker, Electron Kebebew, Brian R Untch, Yi-Zarn Wang, Calvin H Law, Eric H Liu, Michelle K Kim, Yusuf Menda, Brian G Morse, Emily K Bergsland, Jonathan R Strosberg, Eric K Nakakura, Rodney F Pommier
Small bowel neuroendocrine tumors (SBNETs) have been increasing in frequency over the past decades, and are now the most common type of small bowel tumor. Consequently, general surgeons and surgical oncologists are seeing more patients with SBNETs in their practices than ever before. The management of these patients is often complex, owing to their secretion of hormones, frequent presentation with advanced disease, and difficulties with making the diagnosis of SBNETs. Despite these issues, even patients with advanced disease can have long-term survival...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28596986/international-core-curriculum-for-capsule-endoscopy-training-courses
#5
Ignacio Fernandez-Urien, Simon Panter, Cristina Carretero, Carolyn Davison, Xavier Dray, Evgeny Fedorov, Richard Makins, Miguel Mascarenhas, Mark McAlindon, Deirdre McNamara, Hansa Palmer, Jean Francoise Rey, Jean Christophe Saurin, Uwe Seitz, Cristiano Spada, Ervin Toth, Felix Wiedbrauck, Martin Keuchel
Capsule endoscopy (CE) has become a first-line noninvasive tool for visualisation of the small bowel (SB) and is being increasingly used for investigation of the colon. The European Society of Gastrointestinal Endoscopy (ESGE) guidelines have specified requirements for the clinical applications of CE. However, there are no standardized recommendations yet for CE training courses in Europe. The following suggestions in this curriculum are based on the experience of European CE training courses directors. It is suggested that 12 hours be dedicated for either a small bowel capsule endoscopy (SBCE) or a colon capsule endoscopy (CCE) course with 4 hours for an introductory CCE course delivered in conjunction with SBCE courses...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28584517/a-rare-case-of-mesenteric-gastrointestinal-stromal-tumor-presenting-as-acute-abdomen
#6
Anant Sadanand Ramani, Guruprasad Huske, Francisco P Noronha
Gastrointestinal stromal tumours (GIST) are rare tumours arising from mesenchyme of gastrointestinal tract and overexpress C-kit protein. Mainly seen in stomach and small bowel. Mesenteric GIST are rarely reported as they constitute less than 1% of total GIST. We here report such a rare case of GIST arising from mesentery of small bowel and presenting as acute abdomen. Good surgical clearance ensures good survival whereas incomplete resection results in a high incidence of recurrences with distant metastasis...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/28583893/clinicopathologic-features-surgical-treatments-and-outcomes-of-small-bowel-tumors-a-retrospective-study-in-china
#7
Shuisheng Zhang, Cuiling Zheng, Yingtai Chen, Quan Xu, Jie Ma, Wei Yuan, Qinglong Jiang, Yajie Zhao, Jianwei Zhang, Xu Che, Chengfeng Wang, Xiaozhun Huang, Fang Chen, Nianchang Wang, Xiao Ma, Zhongmin Lan
BACKGROUND: Small bowel tumors are relatively rare. Accumulation of data regarding their clinical presentation, pathologic features, prognostic factors, treatment modalities, and outcome has been an issue. We summarize the clinicopathologic features and evaluate the long-term outcome of patients with small bowel tumors who underwent surgery. METHODS: This is a retrospective study of medical records of 456 patients with small bowel tumors treated surgically at a Cancer Hospital between 1999 and 2016...
June 2, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28579583/a-case-of-intussusceptions-at-two-parts-of-the-ileum-caused-by-an-ileus-tube
#8
Yutaka Okagawa, Kohichi Takada, Hiroki Sakamoto, Takumi Miura, Shigeki Abeshima, Junji Kato
An 87-year-old woman was admitted to our hospital for paralytic ileus, and she was treated using an ileus tube. Although her symptoms improved, abdominal fullness developed again on day 3 after ileus tube insertion. Abdominal computed tomography indicated intussusceptions at the ileum and the terminal part of the ileum;therefore, an emergency surgery was performed. During the surgery, antegrade intussusceptions were found in the ileum 60cm from the ileocecal valve and the terminal part of the ileum into the ascending colon...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28562682/an-elevated-serum-alkaline-phosphatase-level-in-hepatic-metastases-of-grade-1-and-2-gastrointestinal-neuroendocrine-tumors-is-unusual-and-of-prognostic-value
#9
Maeva Andriantsoa, Solene Hoibian, Aurelie Autret, Marine Gilabert, Anthony Sarran, Patricia Niccoli, Jean-Luc Raoul
BACKGROUND: In our clinical practice we have observed that despite a high hepatic metastatic tumor burden, serum alkaline phosphatase (AP) levels are frequently normal in cases of metastatic neuroendocrine tumor (NET). PATIENTS AND METHODS: We retrospectively reviewed the records of patients with grade 1 and 2 NETs with liver metastases but without bone metastases seen at our institution in 2013. In total, 49 patients were included (22 female), with a median age of 60 years (range: 28 to 84 years)...
2017: PloS One
https://www.readbyqxmd.com/read/28560024/neuroendocrine-carcinoma-as-a-rare-cause-of-jejunal-intussusception-in-an-adult-management-and-literature-review
#10
Georgios Sahsamanis, Georgios Mitsopoulos, Titos Deverakis, Alexandra Terzoglou, Paschalis Evangelidis, Georgios Dimitrakopoulos
Intussusception of the small bowel is an uncommon condition, with the majority of cases being observed during infancy. A number of points are responsible, with benign and malignant lesions of the small intestine being the most common. Herein, we present the case of a 75-year-old male patient with vague abdominal pain and black stool during defecation, who underwent surgery due to jejunal intussusception. Pathology report demonstrated a neuroendocrine carcinoma as the underlying cause for his condition, with no additional metastases during the initial diagnosis...
May 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28559783/long-term-results-of-serial-transverse-enteroplasty-with-neovalve-creation-for-extreme-short-bowel-syndrome-report-of-two-cases
#11
REVIEW
Mireia Botey, Antonio Alastrué, Henrik Haetta, Jaume Fernández-Llamazares, Arantxa Clavell, Pau Moreno
OBJECTIVE: The aim of this article was to determine whether serial transverse enteroplasty (STEP) and the creation of a new ileocecal valve in extreme short bowel syndrome (SBS) cases (<45 cm) is effective in intestinal adaptation and improvement of nutritional parameters and serum citrulline levels. PATIENTS AND METHODS: We present 2 cases of SBS treated with STEP. Enterectomy was performed for massive intestinal ischemia secondary to a gastrointestinal stromal tumor in the first case and to catastrophic antiphospholipid syndrome in the second...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28550641/a-fascia-lata-free-flap-in-pelvic-exenteration-for-fournier-gangrene-due-to-advanced-rectal-cancer-a-case-report
#12
Hiroshi Sawayama, Nobutomo Miyanari, Hidetaka Sugihara, Shiro Iwagami, Takao Mizumoto, Tatsuo Kubota, Yoshio Haga, Hideo Baba
BACKGROUND: Fournier gangrene due to advanced rectal cancer is a rapidly progressive gangrene of the perineum and buttocks. Emergency surgical debridement of necrotic tissue is crucial, and secondary surgery to resect tumors is necessary for wound healing. However, pelvic exenteration damages the pelvic floor, increasing the likelihood of herniation of internal organs into the infectious wound. The management of pelvic exenteration for rectal cancer with Fournier gangrene has not yet been established...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28550275/detection-of-small-bowel-tumor-in-wireless-capsule-endoscopy-images-using-an-adaptive-neuro-fuzzy-inference-system
#13
Alizadeh Mahdi, Haji Maghsoudi Omid, Sharzehi Kaveh, Reza Hemati Hamid, Kamali Asl Alireza, Talebpour Alireza
Automatic diagnosis tool helps physicians to evaluate capsule endoscopic examinations faster and more accurate. The purpose of this study was to evaluate the validity and reliability of an automatic post-processing method for identifying and classifying wireless capsule endoscopic images, and investigate statistical measures to differentiate normal and abnormal images. The proposed technique consists of two main stages, namely, feature extraction and classification. Primarily, 32 features incorporating four statistical measures (contrast, correlation, homogeneity and energy) calculated from co-occurrence metrics were computed...
May 26, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28541845/a-metastatic-rectal-gastrointestinal-stromal-tumor-to-the-small-bowel-mesentery-treated-with-neoadjuvant-imatinib-and-debulking-surgery-followed-by-low-anterior-resection
#14
James Barger, James Kurtz, Kristin Ryan
No abstract text is available yet for this article.
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28540052/a-unique-case-of-massive-gastrointestinal-bleeding
#15
Akihiko Kida, Koichiro Matsuda, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
OBJECTIVES: Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation. METHODS/RESULTS: We report a case of massive gastrointestinal bleeding from a jejunal lipoma combined with intussusception. A preoperative diagnosis of gastrointestinal bleeding derived from a jejunal lipoma combined with intussusception was made based on double-balloon enteroscopy and contrast-enhanced computed tomography, and partial resection of the small intestine was performed...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28536826/a-phase-ii-study-of-5-fluorouracil-l-leucovorin-oxaliplatin-mfolfox6-in-japanese-patients-with-metastatic-or-unresectable-small-bowel-adenocarcinoma
#16
Takahiro Horimatsu, Norisuke Nakayama, Toshikazu Moriwaki, Yoshinori Hirashima, Mikio Fujita, Masako Asayama, Ichiro Moriyama, Koji Nakashima, Eishi Baba, Hiroshi Kitamura, Takao Tamura, Ayumu Hosokawa, Kenichi Yoshimura, Manabu Muto
BACKGROUND: Several studies have suggested that chemotherapy prolonged survival in patients with metastatic or recurrent small bowel adenocarcinoma (SBA); however, there is still no standard chemotherapy regimen. Here, we evaluated the efficacy and safety of a 5-fluorouracil (5-FU)/L-leucovorin (l-LV)/oxaliplatin (mFOLFOX6) protocol as a first-line therapy for patients with SBA. PATIENTS AND METHODS: This was a multicenter, single-arm, open-label phase II study...
May 23, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28523588/advances-in-the-development-of-janus-kinase-inhibitors-in-inflammatory-bowel-disease-future-prospects
#17
Mathurin Flamant, Josselin Rigaill, Stephane Paul, Xavier Roblin
Inflammatory bowel disease (IBD) is caused by a dysregulation of the immune system, inducing the production of proinflammatory cytokines and adhesion molecules. A better understanding of the mucosal immune response in IBD has led to the development of new drugs directed at inflammatory cytokines and leukocyte-trafficking molecules. Beyond tumor necrosis factor antagonists and anti-integrin molecules, which act by blocking the interaction between gut-specific lymphocytes and their receptor on vascular endothelium, the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway represents a new target in IBD...
May 18, 2017: Drugs
https://www.readbyqxmd.com/read/28522902/non-invasive-evaluation-of-intestinal-disorders-the-role-of-elastographic-techniques
#18
REVIEW
Federica Branchi, Flavio Caprioli, Stefania Orlando, Dario Conte, Mirella Fraquelli
Over the recent years the non-invasive techniques for the evaluation of the small bowel have been playing a major role in the management of chronic intestinal diseases, such as inflammatory bowel diseases (IBD). The diagnostic performances of magnetic resonance imaging, computed tomography and ultrasound in the field of small bowel disorders, have been assessed and established for more than two decades. Newer sonographic techniques, such as strain elastography and shear wave elastography, have been put forward for the assessment of disease activity and characterization of IBD-related damage in the setting of Crohn's disease and other gastrointestinal disorders...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28493308/north-central-cancer-treatment-group-n0543-alliance-a-phase-2-trial-of-pharmacogenetic-based-dosing-of-irinotecan-oxaliplatin-and-capecitabine-as-first-line-therapy-for-patients-with-advanced-small-bowel-adenocarcinoma
#19
Robert R McWilliams, Nathan R Foster, Michelle R Mahoney, Thomas C Smyrk, Joseph A Murray, Matthew M Ames, L Elise Horvath, Daniel J Schneider, Timothy J Hobday, Aminah Jatoi, Jeffrey P Meyers, Matthew P Goetz
BACKGROUND: Oxaliplatin in combination with either 5-fluorouracil or capecitabine is commonly used as first-line therapy for patients with small bowel adenocarcinoma. The addition of irinotecan improves survival in other gastrointestinal tumors but at the cost of hematologic toxicity. The authors performed a phase 2 cooperative group study (North Central Cancer Treatment Group N0543, Alliance) using genotype-dosed capecitabine, irinotecan, and oxaliplatin (gCAPIRINOX), with dosing assigned based on UDP glucuronosyltransferase family 1 member A1 (UGT1A1) genotype to test: 1) whether the addition of irinotecan would improve outcomes; and 2) whether UGT1A1 genotype-based dosing could optimize tolerability...
May 10, 2017: Cancer
https://www.readbyqxmd.com/read/28490979/dose-to-organ-at-risk-and-dose-prescription-in-liver-sbrt
#20
REVIEW
Rives Michel, Izar Françoise, Parent Laure, Modesto Anouchka, Portier Guillaume, Kirzin Sylvain
Stereotactic body radiation therapy (SBRT) is delivered in a curative intent to many primary and secondary tumors. Concerning liver metastasis, SBRT can be safely delivered using one to five fractions. An excellent local control is obtained with doses from 20 to 60 Gy. For primary hepatic tumors, results are also good, but the risk of hepatic toxicity related to liver pre-existent pathology must be taken into account. Radiation induced liver disease (RILD) is not frequent in its classical presentation, but modifications of liver enzymes are often observed...
March 2017: Reports of Practical Oncology and Radiotherapy
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