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Early detection strategies for pancreatic ductal adenocarcinoma are needed. This article describes a high‐sensitivity platform for detection of epithelial cells shed from preneoplastic lesions at a high risk of becoming malignant and a combination of technologies that could be used for early detection of disease in high‐risk patients., Background. Recent work has demonstrated early shedding of circulating epithelial cells (CECs) from premalignant intraductal papillary mucinous neoplasms (IPMNs). However, the potential use of CECs as a “liquid biopsy” for patients with IPMNs has been limited by antigen dependence of CEC isolation devices and the lack of robust detection biomarkers across CEC phenotypes. Materials and Methods. We utilized a negative depletion microfluidic platform to purify CECs from contaminating leukocytes and coupled this platform with immunofluorescence, RNA in situ hybridization, and RNA sequencing (RNA‐seq) detection and enumeration. Results. Using established protein (EpCAM, cytokeratins) and novel noncoding RNA (HSATII, cytokeratins) biomarkers, we detected CECs in 88% of patients bearing IPMN lesions. RNA‐seq analysis for MUC genes confirm the likely origin of these CECs from pancreatic lesions. Conclusion. Our findings increase the sensitivity of detection of these cells and therefore could have clinical implications for cancer risk stratification. Implications for Practice. This work describes a high‐sensitivity platform for detection of epithelial cells shed from preneoplastic lesions at high risk of malignant transformation. Further research efforts are underway to define the transcriptional programs that might allow discrimination between circulating cells released from tumors that will become malignant and cells released from tumors that will not. After further refinement, this combination of technologies could be deployed for monitoring and early detection of patients at high risk for developing new or recurrent pancreatic malignancies.

INTRODUCTION: Glomerulonephritis is still the primary cause among the diseases causing end stage renal disease. Helicobacter pylori (HP), also having a local proinflammatory effect on gastric mucosa, can trigger a local and systemic inflammatory response, and consequently have a role in the development of extragastrointestinal defects. MATERIAL AND METHODS: The study was composed of patients diagnosed with primary glomerulonephritis who had dyspeptic complaints throughout the diagnosis. Patients who received endoscopic biopsy upon the determination of pathologic findings in their upper gastrointestinal endoscopy were HP positive in their biopsy material. A triple eradication therapy was initiated for HP. RESULTS: The study included 14 female and 19 male patients, 33 in total, whose biopsy material was determined to be HP positive. Before the eradication for HP, we found serum albumin to be 34.0 (19.0-51.0) g/l, serum total protein 58.6 ±12.9 g/l, serum creatinine 0.9 (0.5-1.2) and proteinuria 3069 (652-12392) mg/day in 24-hour urine. After the eradication, however, serum albumin was found to be 40 (20-52) g/l, serum total protein 62.3 ±11.1 g/l, serum creatinine 1.02 (0.6-1.29) mg/dl and proteinuria was 2850 (172-15181) mg/day in 24-hour urine. A comparison of the results showed that a statistically significant difference is established between the serum albumin, total protein and creatinine values (p = 0.001, p = 0.001 and p = 0.021, respectively), but not between proteinuria values in 24-hour urine (p = 0.990). CONCLUSIONS: Patients with primary glomerulonephritis, HP eradication treatment has an effect on serum albumin levels.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors arising from the gastrointestinal tract. GISTs can occur in any segment of the gastrointestinal tract from the distal esophagus to the anus, but they are most common in the stomach. The presence of c-KIT staining is a strong and universal marker of GISTs. Approximately 70 % patients with GISTs have some clinical symptoms, including gastrointestinal bleeding, manifested as melena, hematemesis, or bright red blood per rectum. Most GISTs are incidentally detected during endoscopic examinations. Endoscopic features are usually insufficient for the diagnosis of GISTs. Endoscopic ultrasonography (EUS) has become an important diagnostic tool for the evaluation of subepithelial lesions such as GISTs. EUS-guided sampling of GISTs is the preferred technique for histological diagnosis. The capability of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) for biopsy of GISTs is better than any other well-accepted method. The EUS-guided Tru-cut core biopsy technique provides a grossly visible sample of tissue, but it has some technical disadvantages. The curative treatment of GISTs is still complete surgical resection. However, optimal endoscopic treatment along with imatinib remains controversial. Advanced resection techniques by endoscopic devices, including endoscopic submucosal resection, endoscopic submucosal tunnel dissection, and endoscopic-laparoscopic combined approach, have been used in the treatment of GISTs.

Acromegaly is associated with an increased prevalence of colonic polyps. The aim of this study was to evaluate the prevalence and recurrence rate of colonic polyps in acromegalic patients. Ninety-six acromegalic patients and 100 irritable bowel syndrome patients (IBS) were enrolled in the study. Twenty patients who were cured exclusively by surgery, and 20 patients that could not be hormonally controlled were re-examined colonoscopically after 36 months. Twenty-nine of 96 acromegalic patients (30.2%) had colonic polyps. In the IBS group, 10 (10.0%) had colonic polyps. The prevalence of colonic polyps was significantly higher in acromegaly. The group of acromegalic patients with and without polyps did not differ significantly with regard to plasma GH, IGF-I, fasting insulin levels and glycemic status. The presence of colonic polyps was correlated with increased patient age and male gender. We did not observe a difference in terms of polyp recurrence frequencies in the patients cured by surgery compared to uncontrolled patients. Acromegalic patients have a higher prevalence of colonic polyps than that of control subjects. We could not identify any factors that could predict polyps within the acromegalic patients - but age and male sex.

Background Familial Mediterranean Fever (FMF) is a systemic relapsing autoinflammatory disorder. Adenosine deaminase (ADA) is an enzyme widely distribute in tissues and body fluids. Circulating levels of ADA have been shown to increase in several inflammatory conditions. This study was designed to evaluate the serum ADA in patients with FMF during acute attacks and attack-free periods. Methods The study groups comprised 23 FMF patients in attack-free period (male/female: 11/12), 30 FMF patients in attack period (male/female: 11/19) and 20 healthy control (male/female:10/10). The groups were similar for age, gender and disease duration. Results The mean age of FMF patients in attack-free period, patient with acute attack were 34.3±11.7 and 29.4±11.1 respectively. The disease durations were 13.1±10.2 and 8.2±7.6 years for patients in attack-free periods and patients with acute FMF attack, respectively. Patients with acute attack had significantly higher ADA levels than both patients with attack-free periods and healthy controls (for each, p Conclusion In this study we demonstrated that FMF patients with acute attacks had higher serum ADA levels than attack-free periods and healthy controls. It is likely that ADA may have a role in the cytokine network of the inflammatory cascade of FMF. Also, elevated ADA levels may be a part of the activated Th1 response in the disease. ADA may be used as a supportive marker to differentiate FMF attacks from attack-free periods. Further larger-scale studies are needed to support this result.

The aim of this study is to obtain a wide and deep phononic gap at low frequencies in a two-dimensional periodic solid structure with embedded inertial amplification mechanisms. Size and shape optimizations are performed on the building block mechanism of the periodic structure to maximize phononic gap (stop band) width and depth. It is shown that shape optimization offers a wider and deeper gap, when both size and shape optimized mechanisms have the same mass and stiffness values. Analysis of the shape optimized mechanism is carried out using two different finite element models, one using beam elements and the other using shell elements. Both models produced similar results for the stop band width and depth. A two-dimensional periodic structure is constructed with the shape optimized building block mechanisms. Moreover, experimental and numerical frequency response results of this periodic structure are obtained. The matching frequency response results indicate that the two-dimensional periodic structure has a wide and deep phononic gap for in-plane excitations. Furthermore, due to proper selection of the out-of-plane thickness of the periodic structure, out-of-plane vibration modes do not occur within the phononic gap. (C) 2015 Elsevier Ltd. All rights reserved. d