scholarly journals Massive Submucosal Ganglia in Colonic Inertia

2017 ◽  
Vol 142 (2) ◽  
pp. 208-212 ◽  
Author(s):  
Kaveh Naemi ◽  
Michael J. Stamos ◽  
Mark Li-cheng Wu
Keyword(s):  
Diagnostic Criteria ◽  
Chronic Constipation ◽  
Small Study ◽  
Unknown Etiology ◽  
Colonic Inertia ◽  
Submucosal Plexus ◽  
Limited Sampling

Context.— Colonic inertia is a debilitating form of primary chronic constipation with unknown etiology and diagnostic criteria, often requiring pancolectomy. We have occasionally observed massively enlarged submucosal ganglia containing at least 20 perikarya, in addition to previously described giant ganglia with greater than 8 perikarya, in cases of colonic inertia. These massively enlarged ganglia have yet to be formally recognized. Objective.— To determine whether such “massive submucosal ganglia,” defined as ganglia harboring at least 20 perikarya, characterize colonic inertia. Design.— We retrospectively reviewed specimens from colectomies of patients with colonic inertia and compared the prevalence of massive submucosal ganglia occurring in this setting to the prevalence of massive submucosal ganglia occurring in a set of control specimens from patients lacking chronic constipation. Results.— Seven of 8 specimens affected by colonic inertia harbored 1 to 4 massive ganglia, for a total of 11 massive ganglia. One specimen lacked massive ganglia but had limited sampling and nearly massive ganglia. Massive ganglia occupied both superficial and deep submucosal plexus. The patient with 4 massive ganglia also had 1 mitotically active giant ganglion. Only 1 massive ganglion occupied the entire set of 10 specimens from patients lacking chronic constipation. Conclusions.— We performed the first, albeit distinctly small, study of massive submucosal ganglia and showed that massive ganglia may be linked to colonic inertia. Further, larger studies are necessary to determine whether massive ganglia are pathogenetic or secondary phenomena, and whether massive ganglia or mitotically active ganglia distinguish colonic inertia from other types of chronic constipation.

Smooth muscle abnormalities in female patients with chronic constipation due to colonic inertia

2003 ◽  
Vol 124 (4) ◽  
pp. A569
Author(s):  
Zuo-Liang Xiao ◽  
Victor Pricolo ◽  
Wenzhong Liu ◽  
Piero Biancani ◽  
Jose Behar
Keyword(s):  
Smooth Muscle ◽  
Chronic Constipation ◽  
Colonic Inertia ◽  
Female Patients

scholarly journals 1011. Sepsis and Secondary Hemophagocytic Lymphohistiocytosis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S301-S301 ◽  
Author(s):  
Farhan Fazal ◽  
Naveet Wig ◽  
Manish Soneja ◽  
Dipendra K Mitra ◽  
Sk Panda ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Nk Cell ◽  
Immunosuppressive Treatment ◽  
Cell Activity ◽  
Unknown Etiology ◽  
Laboratory Features ◽  
Life Threatening ◽  
Non Hodgkins Lymphoma ◽  
Staphylococcal Aureus

Abstract Background Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory condition diagnosed by HLH 2004 criteria. This criterion has common clinical and laboratory features with sepsis and tropical fevers, but there is marked difference in management and outcome of these two entities. The study is conducted to know whether there is any difference in the clinico-laboratory features, management, and outcome of sepsis with or without secondary HLH. Methods This is a prospective observational study where patients presenting with sepsis and bicytopenia are included. The patients underwent relevant investigations according to 2004 HLH diagnostic criteria. The patients are divided into sepsis with or without HLH. The underlying etiology, treatment, and outcome of the two groups are analysed. Results Fifty sepsis patients are included in the study, out of which 28 fulfilled the HLH diagnostic criteria which comprised of 18 men and 10 women. The etiology were bacterial (three enteric fever, three tuberculosis, two scrub typhus, one Staphylococcal aureus), viral (one dengue fever, two HIV, two encephalitis), fungal (one aspergillosis, one mucormycosis, two others), parasites (three malaria, one leishmania) malignancy (two hodgkin lymphoma, one non-Hodgkins lymphoma), and unknown etiology in six patients, with >1 etiology in three patients (Figure 2). The percentage of each criterion fulfilled in both groups is given in Figure 1, showing an increased occurrence of splenomegaly, low NK cell activity, hypertriglyceridemia in HLH patients. Steroids along with supportive treatment was given to 53% and etoposide was added in 7%. Treatment for underlying etiology alone without immunosuppressive treatment was given in 39%. The mortality in those with HLH vs. without HLH was 42% and 31%, respectively. The median duration of hospital stay was 18 and 36 days in HLH and without HLH group, respectively. Conclusion HLH should be suspected in sepsis patients with bicytopenia specially in tropical fevers. There is increased mortality if the sepsis patients fulfil HLH criteria. Early diagnosis and management is of paramount importance. Disclosures All authors: No reported disclosures.

scholarly journals Case Report: Painless obstructive jaundice caused by IgG4 autoimmune pancreatitis; the role of endoscopic ultrasound in diagnosis

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1344
Author(s):  
Sofia Voidila ◽  
Panagiotis Sideris ◽  
Constantinos Letsas ◽  
Elias Anastasopoulos ◽  
Ioanna Oikonomou
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Diagnostic Criteria ◽  
Endoscopic Ultrasound ◽  
Autoimmune Pancreatitis ◽  
Correct Diagnosis ◽  
Final Diagnosis ◽  
Unknown Etiology ◽  
Type I

We report the case of a 60-year-old woman, presenting with painless obstructive jaundice of unknown etiology, who was finally found to suffer from type I autoimmune pancreatitis (AIP). This case emphasizes AIP as a rare cause in the differential diagnosis of obstructive jaundice and the role of endoscopic ultrasound (EUS) in final diagnosis, which is difficult to establish. According to diagnostic criteria, we combined the results from serologic, imaging and histological features (specifically lgG4 levels, computed tomography, magnetic resonance imaging/magnetic resonance cholangiopancreatography and EUS) with cytological results, leading to a final diagnosis. Our patient’s response to corticosteroids was impressive, confirming the diagnosis, leading to complete remission of the disease. Whilst diagnosis of AIP is challenging, the application of diagnostic criteria can lead to correct diagnosis. Therapy is corticosteroid based, with very satisfying outcomes.

Sa1379 VIP Expression in the Submucosal Plexus in Patients With Parkinson Disease and Chronic Constipation

2015 ◽  
Vol 148 (4) ◽  
pp. S-309
Author(s):  
Fiorella Giancola ◽  
Rocco Latorre ◽  
Francesca Bianco ◽  
Francesco Torresan ◽  
Alexandros Ioannou ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Chronic Constipation ◽  
Submucosal Plexus

Isolated colonic inertia is not usually the cause of chronic constipation

2011 ◽  
Vol 13 (11) ◽  
pp. 1299-1302 ◽  
Author(s):  
J. Ragg ◽  
R. McDonald ◽  
R. Hompes ◽  
O. M. Jones ◽  
C. Cunningham ◽  
...  
Keyword(s):  
Chronic Constipation ◽  
Colonic Inertia

scholarly journals Seronegative Autoimmune Hepatitis A Clinically Challenging Difficult Diagnosis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Jagannath M. Sherigar ◽  
Arefiev Yavgeniy ◽  
Debra Guss ◽  
Nhu Ngo ◽  
Smruti Mohanty
Keyword(s):  
Liver Disease ◽  
Autoimmune Hepatitis ◽  
Diagnostic Criteria ◽  
Unknown Etiology ◽  
Routine Practice ◽  
Specificity And Sensitivity ◽  
Appropriate Treatment ◽  
Immune Mediated ◽  
Clinical Presentations ◽  
International Autoimmune Hepatitis Group

Autoimmune hepatitis (AIH) is a complex liver disease of unknown cause which results in immune-mediated liver injury with varied clinical presentations. Seronegative AIH follows a similar course to autoantibody-positive disease and diagnosis may be challenging. There are no single serologic tests of sufficient diagnostic specificity, and delay in appropriate treatment may lead to progression of the liver disease and liver failure. The revised conventional diagnostic criteria (RDC) scoring for AIH is complex and not routinely used in the clinical practice. The more recent simplified diagnostic criteria (SDC) scoring proposed by International Autoimmune Hepatitis Group in 2008 has wider application in routine practice facilitating the diagnosis of AIH with a specificity and sensitivity of ~90%. In this report, we describe a case of seronegative autoimmune hepatitis diagnosed using RDC. SDC score calculated in our case was 4 and was not diagnostic for AIH. We subsequently used the complex revised diagnostic criteria for definitive diagnosis. Some of the patients previously diagnosed as cryptogenic active hepatitis of unknown etiology probably had an unrecognized diagnosis of seronegative autoimmune hepatitis. SDC scoring may not be applicable in patients with seronegative autoimmune hepatitis. These patients should be reassessed by using RDC.

Current Understanding of the Genetic Basis of Reading and Spelling Disability

2001 ◽  
Vol 24 (3) ◽  
pp. 141-157 ◽  
Author(s):  
Wendy H. Raskind
Keyword(s):  
Diagnostic Criteria ◽  
Genetic Basis ◽  
Developmental Disorder ◽  
Unknown Etiology ◽  
The Past ◽  
Biological Studies ◽  
Genetic Technologies ◽  
Genomic Locations ◽  
Genetic Contributions ◽  
Reading And Spelling

Dyslexia is a common developmental disorder of unknown etiology. Behavioral and biological studies of dyslexia are complicated by its phenotypic heterogeneity and the lack of uniformly applied diagnostic criteria. In the past 20 years, increasingly powerful genetic technologies and statistical methodologies have been applied to identify genomic locations for genes involved in this complex heterogeneous disorder. This article reviews studies addressing the genetic contributions to dyslexia.

CONGENITAL MEGACOLON

PEDIATRICS ◽  
1953 ◽  
Vol 12 (1) ◽  
pp. 1-4
Author(s):  
ORVAR SWENSON
Keyword(s):  
Surgical Treatment ◽  
Physical Examination ◽  
Intestinal Obstruction ◽  
Diagnostic Criteria ◽  
Chronic Constipation ◽  
Abdominal Distention ◽  
Congenital Megacolon ◽  
Intestinal Function ◽  
Practical Standpoint ◽  
History Of

TWO years ago I had the privilege of presenting to this Academy our concepts of the pathology, the related dysfunction of the colon, and the surgical treatment of congenital megacolon. I should now like to relate our interim clinical experience with these patients and particularly to stress diagnostic criteria of this disease. Children with constipation should, from a practical standpoint, be divided into two groups: those with chronic constipation on a habit or psychologic basis who should be treated medically; and those with congenital megacolon who should be treated surgically. The differentiation of the two groups is usually not difficult from the information gained in taking the history and performing the physical examination. The large majority of our patients with congenital megacolon have a history of constipation from birth. Often obstipation, vomiting and abdominal distention have been of such prominence during the first few days of life that a diagnosis of intestinal obstruction has been entertained and exploration occasionally performed. A considerable number of infants die of congenital megacolon in the first weeks of life. The surviving infants continue to have varying amounts of constipation with intermittent abdominal distention and require frequent enemas or some other aid in evacuation. In contrast to this the children with chronic constipation on a habit basis have histories of no symptoms until they are 2 or 3 years of age, and abdominal distention is rarely present. Furthermore, there is usually a history of parental overanxiety concerning intestinal function, and this emotional attitude toward the child's problem accounts for their tendency to exaggerate symptoms.

Isolation of Asbestos from Lung Tissue and Sputum

1982 ◽  
Vol 40 ◽  
pp. 330-331
Author(s):  
M. G. Williams ◽  
C. Corn ◽  
R. F. Dodson ◽  
G. A. Hurst
Keyword(s):  
Sodium Hypochlorite ◽  
Lung Tissue ◽  
Body Fluids ◽  
Unknown Etiology ◽  
The Past

During this century, interest in the particulate content of the organs and body fluids of those individuals affected by pneumoconiosis, cancer, or other diseases of unknown etiology developed and concern was further prompted with the increasing realization that various foreign particles were associated with or caused disease. Concurrently particularly in the past two decades, a number of methods were devised for isolating particulates from tissue. These methods were recently reviewed by Vallyathan et al. who concluded sodium hypochlorite digestion was both simple and superior to other digestion procedures.

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