Background: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointest... more Background: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. They are positive for the expression of c-Kit protein at immunohistochemistry and their clinical presentation is variable. We conducted a study to identify true GISTs with known pathological and immunohistochemical criteria from other tumors of the gastrointestinal tract. Methods: The clinical records of patients with the diagnosis of schwannoma, leiomyoma, leiomyosarcoma and tumor of uncertain biological behavior of the gastrointestinal tract were identified and the slides of paraffin obtained for review by two experienced pathologists in the diagnosis of GISTs. The clinical presentation, treatment and outcomes were analyzed. Results: Twenty four GISTs (11 low-risk and 13 high-risk) were identified from 76 cases reviewed. All the confirmed GISTs were positive at immunohistochemistry for c-Kit expression. The two predominant location of the tumors were the stomach and small intestine. The outcome was good for benign and completely resected tumors. Conclusions: True GISTs can be recognized from other tumors by histological analysis. Immunohistochemistry to identify c-Kit protein expression is useful to confirm the diagnosis. Physicians must consider GISTs in patients with a lesion of the gastrointestinal tract resembling a smooth muscle tumor or/and in association with chronic or acute bleeding.
In this paper, an M"c-integral is presented for evaluation of the energy change due to prese... more In this paper, an M"c-integral is presented for evaluation of the energy change due to presence of multiple irregularly shaped inclusions in 2-D hyperelastic solids. The integral is shown to be path-independent and so can be accurately evaluated by using finite elements. The formulation is considered to be feasible for problems subjected to large deformation. The energy change can be exactly evaluated by M"c when the hyperelastic solids are homogeneously stressed (i.e. the material characteristic), and effectively approximated when the solids are nonhomogeneously stressed (i.e. the structural characteristic). It is thus suggested that M"c be used as an energy parameter that quantitatively measures the change of material and/or structural integrity due to presence of the inclusions. The applicability of the proposed integral is illustrated by using it for identifying the associated effective material properties.
A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and ... more A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and peritoneal irritation. A panendoscopic study was performed and an ulcer localized at the large curva-ture of the stomach was disclosed. In the gastrecto-my specimen the ulcer showed necrosis, edema, fibrosis, chronic inflammatory infiltrate with lym-phocytes and plasma cells. Additionally, atypical cells with irregular and hyperchromatic nuclei or vacuolated cytoplasm were seen in the lamina propia and infiltrating the muscular layers; isolated signet-ring-like cells were also seen. Histochemical study with periodic acid-Schiff, mucicarmin, and colloidal stains revealed mucosubstances in these cells. A poorly differentiated carcinoma was initial-ly diagnosed. However, the immunohistochemical study were positive for histiocytic markers (CD-68, S-100 protein) and negative for epithelial markers (cytokeratin; and epithelial membrane antigen). The positivity of mucus stains in the histiocyte...
Despues de haber observado que los pacientes diabeticos tienen elevadas las concentraciones plasm... more Despues de haber observado que los pacientes diabeticos tienen elevadas las concentraciones plasmaticas de bilirrubina conjugada y de acido glucuronico y conociendo que este forma parte de la estructura quimica de los glucosaminoglicanos (acido hialuronico, heparina y condroitin), que a su vez forman parte de la estructura de los capilares, vasos de mayor calibre y tejido conectivo, planteamos la hipotesis de que las elevaciones de las concentraciones de acido glucuronico origenan la elevacion de los niveles de glucosaminoglicanos, y de que estos intervienen en forma fundamental en las lesiones vasculares que presentan como complicacion cronica los pacientes con diabetes mellitus. Se trato a 10 ratas Wistar con acido glucuronico (30 mg) en 50 ml de agua para beberlo ad livitum por tiempo sin definir. A los 60 dias, todas las ratas estaban ciegas y no respondian a estimulos luminosos. Estudios de oftalmoscopia, anatomopatologicos del ojo y rinon y de microscopia electronica del rinon...
Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion, 2004
BACKGROUND Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointesti... more BACKGROUND Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. They are positive for the expression of c-Kit protein at immunohistochemistry and their clinical presentation is variable. We conducted a study to identify true GISTs with known pathological and immunohistochemical criteria from other tumors of the gastrointestinal tract. METHODS The clinical records of patients with the diagnosis of schwannoma, leiomyoma, leiomyosarcoma and tumor of uncertain biological behavior of the gastrointestinal tract were identified and the slides of paraffin obtained for review by two experienced pathologists in the diagnosis of GISTs. The clinical presentation, treatment and outcomes were analyzed. RESULTS Twenty four GISTs (11 low-risk and 13 high-risk) were identified from 76 cases reviewed. All the confirmed GISTs were positive at immunohistochemistry for c-Kit expression. The two predominant location of the tumors were the stomach and small inte...
fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxiall... more fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxially in good position. Post procedure abdominal xray in supine position showed second stent being placed through the wall of the first stent being pinched off in its mid position in a cross position. Despite the positioning, patient had moderate symptom relief lasting for two months of follow up. Conclusions: Self-expandable metal stent is an effective re-decompression modality in patients with restenosed SEMS by tumor ingrowth. Our experience underscores the importance of confirmation of the wire position by changing patient's position prior to the deployment of the stent to avoid through-thewall stent position, especially if there is more than usual resistance in positioning stent across the strictured area.
A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and ... more A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and peritoneal irritation. A panendoscopic study was performed and an ulcer localized at the large curvature of the stomach was disclosed. In the gastrectomy specimen the ulcer showed necrosis, edema, fibrosis, chronic inflammatory infiltrate with lymphocytes and plasma cells. Additionally, atypical cells with irregular and hyperchromatic nuclei or vacuolated cytoplasm were seen in the lamina propia and infiltrating the muscular layers; isolated signet-ring-like cells were also seen. Histochemical study with periodic acid-Schiff, mucicarmin, and colloidal stains revealed mucosubstances in these cells. A poorly differentiated carcinoma was initially diagnosed. However, the immunohistochemical study were positive for histiocytic markers (CD-68, S-100 protein) and negative for epithelial markers (cytokeratin; and epithelial membrane antigen). The positivity of mucus stains in the histiocytes could be explained in this case by phagocytosis of mucous substances released from broken hyperplastic glands in the vicinity of the ulcer. To our knowledge, atypical histiocytic infiltration in gastric ulcers has not been previously described; thus, it should be included in the group of gastric carcinoma mimicks.
Revista de investigación clínica; organo del Hospital de Enfermedades de la Nutrición
Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. ... more Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. They are positive for the expression of c-Kit protein at immunohistochemistry and their clinical presentation is variable. We conducted a study to identify true GISTs with known pathological and immunohistochemical criteria from other tumors of the gastrointestinal tract. The clinical records of patients with the diagnosis of schwannoma, leiomyoma, leiomyosarcoma and tumor of uncertain biological behavior of the gastrointestinal tract were identified and the slides of paraffin obtained for review by two experienced pathologists in the diagnosis of GISTs. The clinical presentation, treatment and outcomes were analyzed. Twenty four GISTs (11 low-risk and 13 high-risk) were identified from 76 cases reviewed. All the confirmed GISTs were positive at immunohistochemistry for c-Kit expression. The two predominant location of the tumors were the stomach and small intestine. The outcome was good...
A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and ... more A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and peritoneal irritation. A panendoscopic study was performed and an ulcer localized at the large curvature of the stomach was disclosed. In the gastrectomy specimen the ulcer showed necrosis, edema, fibrosis, chronic inflammatory infiltrate with lymphocytes and plasma cells. Additionally, atypical cells with irregular and hyperchromatic nuclei or vacuolated cytoplasm were seen in the lamina propia and infiltrating the muscular layers; isolated signet-ring-like cells were also seen. Histochemical study with periodic acid-Schiff, mucicarmin, and colloidal stains revealed mucosubstances in these cells. A poorly differentiated carcinoma was initially diagnosed. However, the immunohistochemical study were positive for histiocytic markers (CD-68, S-100 protein) and negative for epithelial markers (cytokeratin; and epithelial membrane antigen). The positivity of mucus stains in the histiocytes could be explained in this case by phagocytosis of mucous substances released from broken hyperplastic glands in the vicinity of the ulcer. To our knowledge, atypical histiocytic infiltration in gastric ulcers has not been previously described; thus, it should be included in the group of gastric carcinoma mimicks.
fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxiall... more fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxially in good position. Post procedure abdominal xray in supine position showed second stent being placed through the wall of the first stent being pinched off in its mid position in a cross position. Despite the positioning, patient had moderate symptom relief lasting for two months of follow up. Conclusions: Self-expandable metal stent is an effective re-decompression modality in patients with restenosed SEMS by tumor ingrowth. Our experience underscores the importance of confirmation of the wire position by changing patient's position prior to the deployment of the stent to avoid through-thewall stent position, especially if there is more than usual resistance in positioning stent across the strictured area.
Background: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointest... more Background: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. They are positive for the expression of c-Kit protein at immunohistochemistry and their clinical presentation is variable. We conducted a study to identify true GISTs with known pathological and immunohistochemical criteria from other tumors of the gastrointestinal tract. Methods: The clinical records of patients with the diagnosis of schwannoma, leiomyoma, leiomyosarcoma and tumor of uncertain biological behavior of the gastrointestinal tract were identified and the slides of paraffin obtained for review by two experienced pathologists in the diagnosis of GISTs. The clinical presentation, treatment and outcomes were analyzed. Results: Twenty four GISTs (11 low-risk and 13 high-risk) were identified from 76 cases reviewed. All the confirmed GISTs were positive at immunohistochemistry for c-Kit expression. The two predominant location of the tumors were the stomach and small intestine. The outcome was good for benign and completely resected tumors. Conclusions: True GISTs can be recognized from other tumors by histological analysis. Immunohistochemistry to identify c-Kit protein expression is useful to confirm the diagnosis. Physicians must consider GISTs in patients with a lesion of the gastrointestinal tract resembling a smooth muscle tumor or/and in association with chronic or acute bleeding.
In this paper, an M"c-integral is presented for evaluation of the energy change due to prese... more In this paper, an M"c-integral is presented for evaluation of the energy change due to presence of multiple irregularly shaped inclusions in 2-D hyperelastic solids. The integral is shown to be path-independent and so can be accurately evaluated by using finite elements. The formulation is considered to be feasible for problems subjected to large deformation. The energy change can be exactly evaluated by M"c when the hyperelastic solids are homogeneously stressed (i.e. the material characteristic), and effectively approximated when the solids are nonhomogeneously stressed (i.e. the structural characteristic). It is thus suggested that M"c be used as an energy parameter that quantitatively measures the change of material and/or structural integrity due to presence of the inclusions. The applicability of the proposed integral is illustrated by using it for identifying the associated effective material properties.
A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and ... more A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and peritoneal irritation. A panendoscopic study was performed and an ulcer localized at the large curva-ture of the stomach was disclosed. In the gastrecto-my specimen the ulcer showed necrosis, edema, fibrosis, chronic inflammatory infiltrate with lym-phocytes and plasma cells. Additionally, atypical cells with irregular and hyperchromatic nuclei or vacuolated cytoplasm were seen in the lamina propia and infiltrating the muscular layers; isolated signet-ring-like cells were also seen. Histochemical study with periodic acid-Schiff, mucicarmin, and colloidal stains revealed mucosubstances in these cells. A poorly differentiated carcinoma was initial-ly diagnosed. However, the immunohistochemical study were positive for histiocytic markers (CD-68, S-100 protein) and negative for epithelial markers (cytokeratin; and epithelial membrane antigen). The positivity of mucus stains in the histiocyte...
Despues de haber observado que los pacientes diabeticos tienen elevadas las concentraciones plasm... more Despues de haber observado que los pacientes diabeticos tienen elevadas las concentraciones plasmaticas de bilirrubina conjugada y de acido glucuronico y conociendo que este forma parte de la estructura quimica de los glucosaminoglicanos (acido hialuronico, heparina y condroitin), que a su vez forman parte de la estructura de los capilares, vasos de mayor calibre y tejido conectivo, planteamos la hipotesis de que las elevaciones de las concentraciones de acido glucuronico origenan la elevacion de los niveles de glucosaminoglicanos, y de que estos intervienen en forma fundamental en las lesiones vasculares que presentan como complicacion cronica los pacientes con diabetes mellitus. Se trato a 10 ratas Wistar con acido glucuronico (30 mg) en 50 ml de agua para beberlo ad livitum por tiempo sin definir. A los 60 dias, todas las ratas estaban ciegas y no respondian a estimulos luminosos. Estudios de oftalmoscopia, anatomopatologicos del ojo y rinon y de microscopia electronica del rinon...
Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion, 2004
BACKGROUND Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointesti... more BACKGROUND Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. They are positive for the expression of c-Kit protein at immunohistochemistry and their clinical presentation is variable. We conducted a study to identify true GISTs with known pathological and immunohistochemical criteria from other tumors of the gastrointestinal tract. METHODS The clinical records of patients with the diagnosis of schwannoma, leiomyoma, leiomyosarcoma and tumor of uncertain biological behavior of the gastrointestinal tract were identified and the slides of paraffin obtained for review by two experienced pathologists in the diagnosis of GISTs. The clinical presentation, treatment and outcomes were analyzed. RESULTS Twenty four GISTs (11 low-risk and 13 high-risk) were identified from 76 cases reviewed. All the confirmed GISTs were positive at immunohistochemistry for c-Kit expression. The two predominant location of the tumors were the stomach and small inte...
fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxiall... more fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxially in good position. Post procedure abdominal xray in supine position showed second stent being placed through the wall of the first stent being pinched off in its mid position in a cross position. Despite the positioning, patient had moderate symptom relief lasting for two months of follow up. Conclusions: Self-expandable metal stent is an effective re-decompression modality in patients with restenosed SEMS by tumor ingrowth. Our experience underscores the importance of confirmation of the wire position by changing patient's position prior to the deployment of the stent to avoid through-thewall stent position, especially if there is more than usual resistance in positioning stent across the strictured area.
A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and ... more A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and peritoneal irritation. A panendoscopic study was performed and an ulcer localized at the large curvature of the stomach was disclosed. In the gastrectomy specimen the ulcer showed necrosis, edema, fibrosis, chronic inflammatory infiltrate with lymphocytes and plasma cells. Additionally, atypical cells with irregular and hyperchromatic nuclei or vacuolated cytoplasm were seen in the lamina propia and infiltrating the muscular layers; isolated signet-ring-like cells were also seen. Histochemical study with periodic acid-Schiff, mucicarmin, and colloidal stains revealed mucosubstances in these cells. A poorly differentiated carcinoma was initially diagnosed. However, the immunohistochemical study were positive for histiocytic markers (CD-68, S-100 protein) and negative for epithelial markers (cytokeratin; and epithelial membrane antigen). The positivity of mucus stains in the histiocytes could be explained in this case by phagocytosis of mucous substances released from broken hyperplastic glands in the vicinity of the ulcer. To our knowledge, atypical histiocytic infiltration in gastric ulcers has not been previously described; thus, it should be included in the group of gastric carcinoma mimicks.
Revista de investigación clínica; organo del Hospital de Enfermedades de la Nutrición
Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. ... more Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. They are positive for the expression of c-Kit protein at immunohistochemistry and their clinical presentation is variable. We conducted a study to identify true GISTs with known pathological and immunohistochemical criteria from other tumors of the gastrointestinal tract. The clinical records of patients with the diagnosis of schwannoma, leiomyoma, leiomyosarcoma and tumor of uncertain biological behavior of the gastrointestinal tract were identified and the slides of paraffin obtained for review by two experienced pathologists in the diagnosis of GISTs. The clinical presentation, treatment and outcomes were analyzed. Twenty four GISTs (11 low-risk and 13 high-risk) were identified from 76 cases reviewed. All the confirmed GISTs were positive at immunohistochemistry for c-Kit expression. The two predominant location of the tumors were the stomach and small intestine. The outcome was good...
A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and ... more A 83-year old man treated with naproxen during two years was admitted because of hypovolemia and peritoneal irritation. A panendoscopic study was performed and an ulcer localized at the large curvature of the stomach was disclosed. In the gastrectomy specimen the ulcer showed necrosis, edema, fibrosis, chronic inflammatory infiltrate with lymphocytes and plasma cells. Additionally, atypical cells with irregular and hyperchromatic nuclei or vacuolated cytoplasm were seen in the lamina propia and infiltrating the muscular layers; isolated signet-ring-like cells were also seen. Histochemical study with periodic acid-Schiff, mucicarmin, and colloidal stains revealed mucosubstances in these cells. A poorly differentiated carcinoma was initially diagnosed. However, the immunohistochemical study were positive for histiocytic markers (CD-68, S-100 protein) and negative for epithelial markers (cytokeratin; and epithelial membrane antigen). The positivity of mucus stains in the histiocytes could be explained in this case by phagocytosis of mucous substances released from broken hyperplastic glands in the vicinity of the ulcer. To our knowledge, atypical histiocytic infiltration in gastric ulcers has not been previously described; thus, it should be included in the group of gastric carcinoma mimicks.
fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxiall... more fluoroscopic guidance and patient in left lateral position, SEMS appeared to be deployed coaxially in good position. Post procedure abdominal xray in supine position showed second stent being placed through the wall of the first stent being pinched off in its mid position in a cross position. Despite the positioning, patient had moderate symptom relief lasting for two months of follow up. Conclusions: Self-expandable metal stent is an effective re-decompression modality in patients with restenosed SEMS by tumor ingrowth. Our experience underscores the importance of confirmation of the wire position by changing patient's position prior to the deployment of the stent to avoid through-thewall stent position, especially if there is more than usual resistance in positioning stent across the strictured area.
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