[Comparison of blood leptin concentration and colonic mucosa leptin expression in colon adenoma patients and healthy control]

BACKGROUND/AIMS

Obesity increases the risk of colorectal cancer and adenomatous polyp, and one of the underlying mechanisms of this increase is considered to be due to the growth promoting effects of adipokines, such as leptin. In order to investigate this finding, leptin expression in the colonic tissue and blood leptin concentration of the colonic adenoma patients were compared to those of the control group.

METHODS

Colonic adenoma tissues were obtained by polypectomy (n=60). In these patients, normal colonic mucosa at remote areas from the polyp was also obtained and blood samples were collected as well. Age and sex matched control subjects were selected among those who showed normal colonic mucosa in health screening colonoscopy (n=60).

RESULTS

There was no significant difference in serum leptin concentration between the colonic adenoma patients and control subjects. Leptin expression was noted in 43.3% of the colonic adenomas, but only in 6.7% of normal colonic mucosa from the control subjects (p<0.01). There were ten cases of concurrent adenocarcinoma in situ in adenoma patients, eight cases of which expressed leptin (p=0.01). In adenoma group, leptin expression rate was significantly high in larger adenomas and in obese patients (p<0.05). However, there was no statistically significant relationship between leptin expression in colonic mucosa and serum leptin level.

CONCLUSIONS

Leptin expression was more frequently observed in colonic adenomas, especially in larger adenomas associated with adenocarcinoma in situ, but blood leptin level was not related to tissue leptin expression. Leptin expression was more frequently observed in obese patients from the adenoma group. Therefore, leptin may play an important role in colonic tumorigenesis and progression, especially in obese patient.

A case of hepatoblastoma misdiagnosed as combined hepatocellular carcinoma and cholangiocarcinoma in an adult

Hepatoblastoma usually occurs in children under the age of 2 years, with very few cases reported in adults. We experienced a case of adult hepatoblastoma in a 36-year-old female with chronic hepatitis B. She had experienced sudden onset abdominal pain. Her serum alpha-fetoprotein level was markedly elevated, and abdominal CT showed a 9-cm mass with internal hemorrhage in the right hepatic lobe with hemoperitoneum, so an emergency hepatic central bisectionectomy was performed. The initial histologic examination revealed that the mass mimicked combined hepatocellular carcinoma and cholangiocarcinoma with spindle-cell metaplasia of the cholangiocarcinoma element. Follow-up abdominal CT performed 3 months later showed a 5.5-cm metastatic mass in the left subphrenic area. Laparoscopic splenectomy with mass excision was performed, and hepatoblastoma was confirmed histologically. A histologic re-examination of previously obtained surgical specimens also confirmed the presence of hepatoblastoma. Metastatic hepatoblastoma was found at multiple sites of the abdomen during follow-up, and so chemotherapy with cisplatin, 5-fluorouracil (5-FU), and vincristine was applied, followed by carboplatin and doxorubicin. Despite surgery and postoperative chemotherapy, she died 12 months after symptom onset.

Is endoscopic retrograde cholangiopancreatography safe in patients 90 years of age and older?

Background/Aims

This case-control study evaluated the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in patients 90 years of age and older.

Methods

From January 2005 to August 2011, 5,070 cases of ERCP were performed at our institution. Of these, 43 cases involved patients 90 years of age and older (mean age, 91.7±1.9 years). A control group of 129 cases (mean age, 65.7±14.8 years) was matched by the patient sex, sphincterotomy, and presence of choledocholithiasis using a propensity score. The patients’ medical records were retrospectively reviewed for comorbidity, periampullary diverticulum, urgent procedure, conscious sedation, technical success, procedure duration, ERCP-related complication, and death.

Results

Between the case and control groups, there was no significant difference with regard to comorbidity, periampullary diverticulum, and urgent procedure. Conscious sedation was performed significantly less in the patient group versus the control group (28 [65%] vs 119 [92%], respectively; p=0.000). There was no significant difference in the technical success, procedure duration, or ERCP-related complications. In both groups, there was no major bleeding or perforation related to ERCP. Post-ERCP pancreatitis occurred significantly less in the patient group compared to the control group (0 vs 13 [10%], respectively; p=0.004). One death occurred from respiratory arrest in the case group.

Conclusions

ERCP can be performed safely and successfully in patients aged 90 years and older without any significant increase in complications.

A case of minimal change disease treated successfully with mycophenolate mofetil in a patient with systemic lupus erythematosus

The World Health Organization classifies lupus nephritis as class I to V or VI. However, a few cases of minimal change glomerulopathy have been reported in association with systemic lupus erythematosus (SLE). Mycophenolate mofetil has been shown to be effective for treatment of minimal change disease and lupus nephritis. A 24-year-old woman diagnosed with SLE five years prior to presentation complained of a mild generalized edema. The urinalysis showed microscopic hematuria and proteinuria. The assessed amount of total proteinuria was 1,618 mg/24 hours. A renal biopsy demonstrated diffuse fusion of the foot processes of podocytes on electron microscopy. Mycophenolate mofetil was started in addition to the maintenance medications of prednisolone 10 mg/day and hydroxychloroquine 400 mg/day. After six months of treatment, the microscopic hematuria and proteinuria resolved, and the total urine protein decreased to 100 mg/24 hours.

Variations in the memory capability of nonvolatile memory devices fabricated using hybrid composites of InP nanoparticles and a polystyrene layer due to the scale-down

InP nanoparticles were formed using a solution method, and the InP nanoparticles that were embedded in a polystyrene (PS) layer were formed using the spin-coating method. The transmission electron microscopy images showed that the InP nanoparticles were randomly distributed in the PS layer. The measured capacitance-voltage (C-V) of the Al/InP nanoparticles embedded in the PS layer/PS/p-Si(100) device at 300 K showed a clockwise hysteresis of the C-V curve. Based on the C-V results, the origin of variations in the memory storage of nonvolatile memory devices that were fabricated using InP nanoparticles embedded in a PS layer due to the scale-down was described.

A case of acute pericarditis with hemophagocytic syndrome, cytomegalovirus infection and systemic lupus erythematosus

Hemophagocytic syndrome, cytomegalovirus infection and systemic lupus erythematosus (SLE) would each be critical diseases separately. Viral infections, autoimmune diseases or malignancies can complicate the Hemophagocytic syndrome. Cytomegalovirus infection is known to be prevalent in immune compromised hosts, and can exacerbate the symptoms of systemic lupus erythematosus. A 25-year-old man presented with fever and acute pericarditis with the hemophagocytic syndrome, cytomegalovirus infection and systemic lupus erythematosus; all developed concurrently at the onset of illness. With treatment, using ganciclovir and glucocorticoid medication the patient improved. Here we report this rare case and review the medical literature.

Holographic image archive

This paper presents an associative technique for content-based retrieval into image archive, based on a computing paradigm called Multidimensional Holographic Associative Computing (MHAC). Unlike any prior Artificial Associative Memory (AAM), MHAC has the unique ability fo focus on any subject of pixels in the sample image and retrieve learned images based on the similarity of the visual objects. In addition, MHAC is adaptive, graciously accommodative of imprecision, efficient, parallelizable, scalable and optically realizable. Together, these excellent properties of MHAC offer a promising novel approach to a content-based search into massive image archives. The paper presents the necessary transformational steps to incorporate this new mechanism into a complete image archival and retrieval system. This is the first associative search approach for content-based retrieval in image repository. The results show that this search system is capable of retrievals by using pattern objects as small as 10-15% of the query image frame at better than 90% accuracy. This demonstrates the potential of MHAC for handing contest-based image applications far beyond the capability of current associative memories. The design, methodology and performance of this system have been illustrated in this paper through its application in managing a Medical Image Archive (MEDIA).