It has been proved in recent studies that the chronic gastric disease (CGD) of Pi-Wei damp-heat syndrome type (CGD-PWDH) is closely related with heat shock protein 70 (HSP70) and nuclear factor-kappa B (NF-kappaB). HSP70 can protect the auto-stability of cells and elevate the immune function in organism against tumor or multiple exogenous pathogens. Increasing of NF-kappaB expression presents in case of Helicobacter pylori (Hp) stimulation, it could induce inflammatory reaction, while inflammation factors could act inversely to enhance the expression of NF-kappaB, thus to cause and expand the damage of gastric mucosa. In addition, HSP shows blocking effect on the activation and expression of NF-kappaB. So, the author considered that in patients of Hp associated CGD-PEDH, HSP 70 exhibits the effect as that of "vital energy" and NF-kappaB play a role as the "evil qi" in Chinese medicine, the expressions of the two may embody the vital-evil combating manner of Pi-Wei damp-heat syndrome.
Gastrointestinal Diseases ; diagnosis ; metabolism ; HSP70 Heat-Shock Proteins ; metabolism ; Humans ; Medicine, Chinese Traditional ; methods ; NF-kappa B ; metabolism

Actins ; metabolism ; Adenocarcinoma ; pathology ; Adult ; Diagnosis, Differential ; Endometriosis ; pathology ; Epithelium ; pathology ; Female ; Gastrointestinal Stromal Tumors ; pathology ; Hamartoma ; metabolism ; pathology ; Humans ; Muscle, Smooth ; pathology ; Stomach Diseases ; metabolism ; pathology

Collagenous gastritis, a counterpart of collagenous colitis, is an extremely rare disorder. The first case of collagenous gastritis in a Korean boy in his preteens who had been receiving treatment for refractory iron deficiency anemia has been reported. The patient had been suffering from intermittent abdominal pain, recurrent bloodtinged vomiting and poor oral intake. The gastric endoscopy revealed diffuse cobblestone appearance of the mucosa with easy touch bleeding throughout the stomach but no abnormalities in the esophagus, duodenum, and colon. Pathologic examination of the gastric biopsies from the antrum, body and cardia showed a subepithelial collagen deposition with entrapped dilated capillaries, moderate infiltrates of lymphoplasma cells and eosinophils of the lamina propria, and marked hypertrophy of the muscularis mucosa. The collagen deposition appeared as discontinuous bands with focally irregular extension into the deeper part of the antral mucosa. It measured up to 150 micrometer. Helicobacter pylori infection was not detected. The biopsies from the duodenum, esophagus and colon revealed no pathologic abnormalities.
Biopsy ; Child ; Colitis/*diagnosis/pathology ; Collagen/metabolism ; Endoscopy ; Gastric Mucosa/pathology ; Gastritis/pathology ; Gastrointestinal Hemorrhage/diagnosis/pathology ; Helicobacter pylori/metabolism ; Humans ; Korea ; Male ; Mucous Membrane/pathology ; Stomach Diseases/diagnosis/pathology

Porcine pancreatic extracts (PPE), which are widely used as a digestive drug in Korea, are composed of alpha-amylase and lipase. Such enzymes are commonly described as occupational allergens. This is the first report of occupational rhinitis caused by PPE developing into occupational asthma in a hospital nurse. She showed strong positive response in the skin prick test (SPT) (5+, wheal ratio of allergen to histamine) and had a high serum-specific IgE level to PPE, but showed a negative response in the methacholine bronchial challenge test (MBT). She had been exposed to PPE intermittently with intermittent medications for rhinitis. Two years later, she presented with rhinitis and additional asthmatic symptoms. In contrast to her first visit, she showed a positive response in the MBT, and developed bronchoconstriction in the PPE-bronchial provocation test (BPT). These findings suggest that inhalation of PPE powder can induce IgE-mediated occupational rhinitis in a hospital setting, which will develop into occupational asthma if avoidance is not complete.
Adult ; Animals ; Asthma/*diagnosis/etiology ; Bronchial Provocation Tests ; Female ; Gastrointestinal Agents/adverse effects ; Humans ; Immunoglobulin E/metabolism ; Methacholine Chloride/pharmacology ; Occupational Diseases/*diagnosis/etiology ; Pancreatic Extracts/*adverse effects ; Powders ; Rhinitis/*diagnosis/etiology ; Skin Tests ; Swine

OBJECTIVETo explore the histogenesis and neural differentiation of gastrointestinal stromal tumor (GIST).

METHODSThe ultrastructural morphology and neural differentiated antigen expression were studied in 20 cases of GIST using electron microscopy and immunohistochemistry.

RESULTSAll of the 20 cases mentioned were positive for c-kit expression. The ultrastructural features of neural differentiation were observed in 7 cases, while no neural or myogenic differentiation seen in 12 cases. Myogenic differentiation to smooth muscle was observed in one case. The ultrastructural features of neural differentiation included scattered or cluster distribution of dense core granules in cytoplasm and cytoplasmic processes; formation of synaptic construction of cell processes; and neurogenic-like processes. In some cases pinocytotic vesicles under the cell membrane and skenoid fibers were seen. Neural differentiation with dense core granules was seen in one case in benign, one case in borderline and five cases in malignant group. The positive reactivity of neural differentiated antigen NSE, CD99, S-100p and CD56 in cases of the neural differentiation group appeared in seven, seven, five and four cases respectively, which were significantly higher than that of the undifferentiated group.

CONCLUSIONSIt's rather difficult to differentiate GIST accompanying with neural differentiation from gastrointestinal autonomic nerve tumor if depending only on its histology and immunophenotype appearance, since many features were overlapping in both tumors. Examination of the neural ultrastructures and neural differentiated antigen in GIST might be helpful to clarify the neural differentiation and potential behavior of GIST.

12E7 Antigen ; Adolescent ; Adult ; Aged ; Antigens, CD ; metabolism ; Autonomic Nervous System Diseases ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; CD56 Antigen ; metabolism ; Calcium-Binding Proteins ; metabolism ; Cell Adhesion Molecules ; metabolism ; Cell Differentiation ; Child ; Diagnosis, Differential ; Female ; Gastrointestinal Stromal Tumors ; metabolism ; ultrastructure ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Proto-Oncogene Proteins c-kit ; metabolism ; Stromal Cells ; ultrastructure ; Synapses ; ultrastructure

OBJECTIVE: Suspicious incidental gastrointestinal FDG uptake during positron-emission tomography/computed tomography (PET/CT) examinations can be caused by different diseases, including malignancies. However, differentiation with PET alone is difficult. The aim of this study was to investigate the potential of PET alone, contrast-enhanced CT (ceCT), and low-dose CT (ldCT) in routine PET/CT protocols for differentiation of incidental gastrointestinal lesions. MATERIALS AND METHODS: Sixty patients with incidental gastrointestinal lesions who underwent a routine PET/CT protocol with ldCT and ceCT were retrospectively analysed. The PET lesions were evaluated regarding their FDG uptake patterns and the standard uptake value. The anatomical correlates in both CT protocols were compared in regard to the correct lesion classification with the reference standard endoscopy. RESULTS: Sixty-two lesions were found in 60 patients (17 malignant, 10 premalignant, 5 benign, 13 inflammatory, 17 physiological). The differentiation of the FDG uptake patterns did not enable reliable lesion classification. The positive predictive value for pathology was 0.81 for ceCT in PET/CT and 0.70 for ldCT. Malignancies were detected in 100% of the patients by ceCT vs. 29.4% by ldCT. The false negative rate of ceCT for all pathologies was 31.1%, vs. 68.9% for ldCT. False positive results (17/62) could not be excluded sufficiently by either CT protocol. CONCLUSION: PET/ceCT protocols provide additional benefit especially in detecting gastrointestinal malignancies as a cause of suspicious incidental gastrointestinal FDG uptake. However, since follow-up endoscopy cannot be forgone due to the considerable false negative rate even with ceCT, the addition of ceCT to a routine PET/ldCT protocol cannot be recommended for this purpose.
Adult ; Aged ; Aged, 80 and over ; Contrast Media/diagnostic use/pharmacokinetics ; Female ; Fluorodeoxyglucose F18/*diagnostic use/pharmacokinetics ; Follow-Up Studies ; Gastrointestinal Diseases/*diagnosis/metabolism ; Gastrointestinal Tract/*metabolism/radiography/radionuclide imaging ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography/*methods ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

Acetylcholinesterase ; analysis ; Antibodies, Monoclonal, Murine-Derived ; metabolism ; Australia ; Biopsy ; Calbindin 2 ; analysis ; Child ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Eosinophilic Esophagitis ; pathology ; Hirschsprung Disease ; metabolism ; pathology ; Humans ; Intestinal Diseases ; pathology ; Lymphangiectasis, Intestinal ; immunology ; pathology ; Multiple Endocrine Neoplasia Type 2b ; pathology ; Nervous System Diseases ; pathology ; Quality Control