Authors present two casas of familial metaphyseal dysplasia which was first described by Pyle as a skeletal disorder affecting the metaphyseal region of tubular bones. The cases reported here bear some resemblance to that of Bawkin and Krida.

No abstract available.
Thyroid Gland*

Heterotopic panereas is pancreactie tissue occuring outside its normal anatomical location and without any connection and normal pancreas and it is a developmental anormaly. The most commen site is stomach(esp. greater curvature of the antrum), duodenum and jejunum, In majority of cases heterotopic pancreas does not produce symptoms. When it produces complications, the symptoms depend on the site of lesion and the size of mass. Pathologically, the heterotopic pancreatic tissue is subject to all the lesions found in the normally placed pancreas. Tbe smooth broad base intramural defect with central niche ie typical radiologic fiadings of heterotoPic pancreas. Gastrofiberscopy revealed a small round, submucosal projection with a central umblication. The lesions are frequently confused with polys, lymphoma, in.tramural neoplasm and gastric uleer. Accurate diagnosis may prevent needless surgical procedures. Three cases of heterotopic pancreas of stomach were reported and the pertinent literature were reviewed briefly.
Diagnosis ; Duodenum ; Jejunum ; Lymphoma ; Pancreas* ; Stomach*

Two common gastrointestinal cancers, namely, gastric and colorectal cancers, cause high mortality and morbidity. The development of gastrointestinal cancers usually follows stepwise processes with recognizable pre-neoplastic changes. A class of noncoding RNA known as microRNA (miRNA) is increasingly recognized to play pleiotropic functions in the multistep development of gastrointestinal cancers. Abnormal patterns of miRNA expression in gastric and colorectal cancers have been widely reported. These dysregulated miRNAs function as novel proto-oncogenes and tumor-suppressor genes by controlling cellular malignant phenotypes, including unchecked cell proliferation, resistance to apoptosis, enhanced invasiveness and metastasis, and angiogenesis. Moreover, certain polymorphisms in miRNA genes or miRNA-binding sites are associated with disease risks whereas detection of circulating or fecal miRNAs may facilitate early diagnosis. The prognostic functions of a number of dysregulated miRNAs in gastrointestinal cancers have also been established. Delineating the pathophysiological basis of miRNA dysregulation will further our understanding of the pathogenesis of these two potentially fatal diseases. Such efforts will also result in the development of miRNA-based biomarkers and therapeutics for the risk stratification, diagnosis, prognostication, and treatment of gastrointestinal cancers.
Apoptosis ; Biomarkers ; Cell Proliferation ; Colorectal Neoplasms ; Early Diagnosis ; Gastrointestinal Neoplasms ; MicroRNAs ; Neoplasm Metastasis ; Phenotype ; Prognosis ; Proto-Oncogenes ; RNA, Untranslated ; Stomach Neoplasms

Artificial intelligence (AI) is coming to medicine in a big wave. From making diagnosis in various medical conditions, following the latest advancements in scientific literature, suggesting appropriate therapies, to predicting prognosis and outcome of diseases and conditions, AI is offering unprecedented possibilities to improve care for patients. Gastroenterology is a field that AI can make a significant impact. This is partly because the diagnosis of gastrointestinal conditions relies a lot on image-based investigations and procedures (endoscopy and radiology). AI-assisted image analysis can make accurate assessment and provide more information than conventional analysis. AI integration of genomic, epigenetic, and metagenomic data may offer new classifications of gastrointestinal cancers and suggest optimal personalized treatments. In managing relapsing and remitting diseases such as inflammatory bowel disease, irritable bowel syndrome, and peptic ulcer bleeding, convoluted neural network may formulate models to predict disease outcome, enhancing treatment efficacy. AI and surgical robots can also assist surgeons in conducting gastrointestinal operations. While the advancement and new opportunities are exciting, the responsibility and liability issues of AI-assisted diagnosis and management need much deliberations.

Many patients undergoing vitrectomy due to proliferative diabetic retinopathy also have diabetic ephropathy.Hence, to figure out the surgi-cal results of vitrectomy and the survival rate after vitrectomy in diabetic patients having diabetic nephropathy, we reviewed medical records of 70 patients[83 eyes]who had been followed for 3 months or longer after vitrectomy. Among them, 28 patients[33 eyes]were complicated by diabetic nephropathy.Visual acuity improved in 21 out of 33 eyes [63.6%]among the patients with nephropathy while vision improved in 29 out of 50 eyes[58.0%] among those without nephropathy.The two groups showed significant improvement of visual acuity postoperatively and the difference in visual acuity improvement between two groups was not statistically significant. The factors which affected postoperative visual acuity improvements in patients with diabetic nephropathy were preoperative panretinal photocoagulation[p=0.013]and intraoperative intraocular silicone oil injection[p=0.021]. Rate of occurrence of complications after vitrectomy and the types of the complications were similar in the two groups. During the 4-year follow up, 4 of 11 patients who had been on peritoneal dialysis or emodialysis died. These results showed that the result of vitrectomy for proliferative diabetic retinopathy in patients with iabetic nephropathy was not poor and suggested that diabetic nephropathy might not be a contraindication of vitrectomy for proliferative diabetic retinopathy.
Diabetic Nephropathies* ; Diabetic Retinopathy* ; Follow-Up Studies ; Humans ; Medical Records ; Peritoneal Dialysis ; Silicone Oils ; Survival Rate ; Visual Acuity ; Vitrectomy*

The Her-2/neu protooncogene encodes a transmembrane tyrosine kinase that is structurally homologous to the receptor for epidermal growth factor. Its amplification and overexpression are associated with poor prognosis in breast cancer patients. Neu differentiation factor is a ligand for Her-2/neu protooncogene and was detected in ras-transformed rat fibroblasts. Heregulin (human homologue of neu differentiation factor) is a 44-kilodalton glycoprotein that stimulates tyrosine phosphorylation and induces growth arrest or stimulation and differentiation in human breast cancer cell lines. In this study we examined the expression of heregulin mRNA by nested reverse transcription (RT) PCR with fresh tissue, Her-2/neu protein, ICAM-1 and steroid receptors by immunohistochemistry, and DNA ploidy pattern by flow cytometry with paraffin-embedded tissue in invasive breast carcinoma. We compared the data with nodal status, lymphovascular invasion, steroid receptor status and DNA ploidy pattern. For RT-PCR to heregulin mRNA, 38 cases of fresh breast cancer tissue were obtained. Total 68 cases of invasive breast carcinoma tissue were fixed in formalin, which were used for routine histology, immunohistochemistry and flow cytometry. The results are as follows; 1) Heregulin mRNA was expressed in 86.1% of patients with invasive breast carcinoma and 100% of patients with benign breast lesion using nested RT-PCR analysis. 2) Her-2/neu protein was overexpressed in 50.0% of tumors using immunohistochemistry. The expression of Her-2/neu protein was significantly correlated with high counts of lymph nodes with metastasis (p<0.05), and high nuclear grade (p<0.05). 3) Her-2/neu protein overexpression was significantly correlated with a high DNA index(p<0.05). All of the tumors showing Her-2/neu protein overexpression and no heregulin mRNA expression revealed near tetraploid DNA content. However, both Her-2/neu overexpression and heregulin mRNA expressing tumors revealed near tetraploidy in 38.9% and diploidy in 50.0%. Based on these results, heregulin mRNA expression rate was 86.1% in human invasive breast carcinoma. Her-2/neu protein overexpression is associated with high positive lymph node number and DNA index. Statistically significant reverse correlation with lymph node metastasis is not present.
Animals ; Breast Neoplasms* ; Breast* ; Cell Line ; Diploidy ; DNA* ; Epidermal Growth Factor ; Fibroblasts ; Flow Cytometry ; Formaldehyde ; Glycoproteins ; Humans* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Lymph Nodes ; Neoplasm Metastasis* ; Neuregulin-1* ; Phosphorylation ; Ploidies* ; Polymerase Chain Reaction ; Prognosis ; Protein-Tyrosine Kinases ; Rats ; Receptors, Steroid ; Reverse Transcription ; RNA, Messenger* ; Tetraploidy ; Tyrosine

No abstract available.

Long term use of steroid induces multiple side effects and morbidity. However, SW has been reported to be associated with increased incidence of acute and chronic rejection, and subsequently reduced graft outcome. MMF inhibits the proliferation and functions of lymphocytes, decreases the incidence of acute rejection in organ transplants, and therefore may decrease the graft rejection associated with SW. We tried to withdraw steroid from 21 renal transplants treated with prednisolone and cyclosporine, who had clinically significant steroid induced side effects. Reasons for SW were diabetes in 15 patients (pre-transplant DM 4 and post-transplant 11), moon face 4 and avascular necrosis of femur 2. Prednisolone was tapered at a rate of 2.5mg every 2 weeks and was discontinued. MMF, 1.0-2.0g/day, was initiated at the beginning of SW. The time interval between transplantation and SW was 26+/-5 (1.5-67) months. Mean age was 48(28-61). Two patients developed MMF-induced GI side effects, and were returned to previous immuno- suppressants. In 1 patient, serum creatinine increased during SW, and steroid was re-administered with the restoration of renal function. In 18(86%) of 21 patients, therefore, steroid was successfully with-drawn. At the follow up of 17+/-1(13-24) months after SW, 1 patient with drug incompliance developed chronic rejection. The rest showed stable renal function. Steroid can be safely withdrawn from renal transplants by simultaneous administration of MMF. The long-term safety, however, needs to be evaluated by prolonged follow up studies.
Creatinine ; Cyclosporine ; Femur ; Follow-Up Studies ; Graft Rejection ; Humans ; Incidence ; Kidney Transplantation ; Lymphocytes ; Necrosis ; Prednisolone ; Transplants