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Purpose: The aim of this study was to evaluate computed tomography enteroclysis (CTE) of the small intestinal tract.Materials and Methods: A total of 36 patients underwent CTE for further examination of small intestinal disease.Results: The indications were obscure gastrointestinal bleeding (OGIB) (n = 16), suspected Crohn's disease (n = 7), suspected and diagnosed by exclusion a small intestinal tumor (n = 5), and others (n = 8). Regarding OGIB, positive findings were observed in nine patients: angiodysplasia (n = 2), suspected ileac tumor (n = 2), colon cancer (n = 1), colon diverticulosis and diverticulitis (n = 2), Crohn's disease (n = 1), and enteritis (n = 1). As for Crohn's disease, hyperplasia of the small intestinal wall was shown in six patents. Positive findings of a small intestinal tumor were observed in two patients. In the "others" category, colon diverticulitis was found in three patients and isolated dissection of the superior mesenteric artery in one of four patients with abdominal pain. Primary carcinoid was identified in the pancreas in one patient, with liver carcinoid metastasis in the remaining four patients.Conclusion: CT enteroclysis is a noninvasive method and useful approach in the diagnosis of small intestinal diseases. [ABSTRACT FROM AUTHOR]

This is a case study of a 66-year-old woman who had a vascular malformation of the small bowel that was visualized on computed tomography enteroclysis (CTE). She presented with repeated tarry stool and severe anemia. Although the source of bleeding was not identified on upper and lower gastrointestinal endoscopy, active bleeding was revealed by capsule endoscopy in the deep jejunum. The cause of bleeding was not found on capsule endoscopy. CTE was requested as double-balloon endoscopy would have been difficult because of strong adhesion of the small intestine. A continual subtle vascular malformation of the jejunum, starting from the third jejunal branch end, was demonstrated on CTE with dynamic contrast enhancement. Because this vascular malformation was considered the cause of small intestinal bleeding, selective arterial coil embolization was performed. After embolization, the repeated tarry stool disappeared and the severe anemia dramatically improved. CTE may be a safe and useful method for determining the cause of small intestinal bleeding and for subsequent therapy. [ABSTRACT FROM AUTHOR]

Background: Ulcerative colitis (UC) is a chronic disorder of undetermined etiology, but a genetic predisposition to UC is well recognized. Among cytokines induced in UC, interleukin 1 (IL-1) appears to have a central role because of its immunological upregulatory and proinflammatory activities. The aim of this study was to assess whether UC is associated with polymorphisms of the IL-1beta gene and three additional genes inducible with IL-1beta in Japanese subjects.Methods: A total of 96 patients with UC and 106 ethnically matched controls were genotyped at polymorphic sites in IL-1beta, matrix metalloproteinase 1 (MMP-1), matrix metalloproteinase 3 (MMP-3), and inducible nitric oxide synthase (iNOS) genes, using polymerase chain reaction (PCR)-based methods.Results: There was no significant difference in genotype distributions of IL-1beta, MMP-1, MMP-3, and iNOS genes between controls and UC patients in a Japanese population. Also, no significant association of those polymorphisms with various clinical parameters of the patients was found. However, concerning association of age at onset with clinical factors in UC, the frequency of pancolitis was significantly higher in UC patients with age at onset being less than 30 years than in those more than 30 years of age (P = 0.049).Conclusions: No association of the IL-1beta and three IL-1beta-inducible gene polymorphisms with UC was observed in a Japanese population. [ABSTRACT FROM AUTHOR]

Endoscopic ultrasonography (EUS) is considered to be useful for deciding the treatment course for early gastric cancer. To determine reliable indications suggesting submucosal tumor invasion, we retrospectively analyzed EUS images of the hyperechoic third layer, which corresponds to the submucosa. The subjects enrolled in this study were 75 patients, with 78 gastric cancers (diagnosed as mucosal cancer without ulcerous changes on endoscopy and as histologically differentiated adenocarcinoma on biopsy), who were also examined by EUS. We retrospectively classified EUS features of the third layer (submucosa) into five groups: (1) irregular narrowing, (2) budding sign, (3) multiple echo-free spots, (4) unclear, and (5) no changes. In endoscopically diagnosed gastric mucosal cancer, 16 of the 78 lesions were associated with histologic submucosal invasion. EUS features that were associated with a high incidence of histological submucosal tumor invasion were irregular narrowing (submucosal invasion, 60.0%) and the budding sign (85.7%), and 90.9% of lesions with either of these features had submucosal invasion of tumors when tumorous changes in the third layer exceeded 1 mm in depth. Endosonographic irregular narrowing and a budding sign of more than 1 mm in depth in the third layer are useful for the diagnosis of submucosal invasion in gastric cancers that are diagnosed as mucosal cancers without ulcerous change on endoscopy. [ABSTRACT FROM AUTHOR]

Pericryptal myofibroblasts (PMFs) are thought to be involved in the production of the basement membrane (BM) of the colonic epithelium. To clarify the involvement of PMFs in the formation of the BM during the growth of colon cancer, we conducted an immunohistological study of tumor specimens from 85 patients with colorectal epithelial tumor to detect the presence of PMFs. The tumor specimens were classified as adenoma with low-grade dysplasia, adenoma with high-grade dysplasia, or colon cancer. PMFs were detected in 66.6% of the specimens from patients with adenoma with low-grade dysplasia; 20% of specimens of adenoma with high-grade dysplasia; and 3.2% of specimens of colon cancer. As the degree of dysplasia of the tumor increased, the probability that PMFs existed decreased. We also tested 49 of the tumor specimens for the presence of laminin, a component of the BM, and found that in most of these 49 cases, the BM and PMFs co-existed. This provides further evidence that PMFs are involved in the production of the BM. These findings are important in gaining an understanding of the cause and growth of colorectal epithelial tumors. [ABSTRACT FROM AUTHOR]

Gastroduodenal involvement by Crohn's disease is relatively rare and occasionally causes pyloric stenosis, for which medical therapy may be ineffective and surgery may be required. We report on a 44-year-old man patient in whom corticosteroids had a marked effect in reducing pyloric stenosis caused by Crohn's disease. A proton-pump inhibitor was not effective, and Helicobacter pylori was negative. [ABSTRACT FROM AUTHOR]

A case of adamantinoma of the humerus with Ewing-like pathological features has been reported. In addition to the unusual pathological features, the apparently juxtacortical location of the lesion is of great interest--also a highly unusual feature for an adamantinoma. [ABSTRACT FROM AUTHOR]