Are all the polyps in the stomach the same?

The article presents a clinical case of a 38-year-old patient with revealed polyps of the stomach body and iron deficiency anemia on the background of chronic atrophic gastritis. On the example of this observation, variants of the course were demonstrated, including endoscopic and histological manifestations of autoimmune (atrophic corpus) gastritis (AIG). In parallel, the issues of diagnosis and management of patients with the most common polyps in the stomach are discussed. The problem of timely diagnosis of AIG and the advantages of non-invasive methods for assessing the functional state of the stomach is also being actualized.

Analysis of pathological characteristics and nursing intervention of patients with gastric polyps based on image stitching algorithm and endoscopy

Original Article Linzhen Zhu1, Linlin Zhu2, Weihua Yu3 ABSTRACTObjectives: The paper uses image stitching algorithm to understand the clinical and pathological characteristics of gastric polyps under gastroscope, and provides objective basis for the clinical diagnosis and treatment of gastric polyps and nursing intervention. Methods: The endoscopic, pathological data and surgical conditions of 111 patients with gastric polyps detected in the hospital from January 2017 to August 2019 were retrospectively analyzed. Results: The elderly patients (≥60 years old) in this group were those with high incidence of gastric polyps (56.8%); 80 patients with single polyps (72.1%), 31 patients with multiple polyps (27.9%); polyps were mainly located in the stomach (53.2%); polyps diameter ≤0.5cm are more common (69.4%); polyps are mainly hyperplastic polyps (40.5%) and inflammatory polyps in 37 cases (33.3%). Polyps were removed by biopsy forceps in 30 cases, endoscopic submucosal injection of 0.9% NaCl solution combined with high-frequency electrosurgical removal of 54 cases, endoscopic mucosal resection (EMR) in 6 cases, and endoscopic submucosal dissection (ESD) in treatment of the 4 cases, the remaining 17 cases were treated with surgery, and 12 patients were followed up, 2 of whom relapsed. Conclusion: Gastric polyps are small in diameter and mostly single; polyps are mainly located in the stomach body, mainly hyperplastic polyps; treatment methods are mostly endoscopic resection, and there is a possibility of recurrence after polypectomy, and follow-up should be strengthened. Full preparation before the operation, close cooperation during the operation, and careful postoperative care are important links to ensure the safety of the operation and reduce complications such as upper gastrointestinal bleeding. KEYWORDS: Pathological characteristics; Nursing; Gastric polyps; Image stitching algorithm; Endoscopy. doi: https://doi.org/10.12669/pjms.37.6-WIT.4854How to cite this:Zhu L, Zhu L, Yu W. Analysis of pathological characteristics and nursing intervention of patients with gastric polyps based on image stitching algorithm and endoscopy. Pak J Med Sci. 2021;37(6):1620-1624. doi: https://doi.org/10.12669/pjms.37.6-WIT.4854 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Triplophysa wulongensis, a new species of cave-dwelling loach (Teleostei, Nemacheilidae) from Chongqing, Southwest China

We describe a new species of cave-dwelling loach, Triplophysa wulongensissp. nov., based on specimens collected in a subterranean pool in a cave in Wulong County, Chongqing, Southwest China. The pool is connected to the Wujiang River drainage. Triplophysa wulongensis differs from its congeners by the following combination of characters: eyes present, caudal fin with 18 branched rays; posterior chamber of the air bladder degenerate; stomach U-shaped; intestine without bends or loops immediately posterior to stomach; body smooth and scaleless, and lateral line complete. The mitochondrial cytochrome b sequence differs from those of other published sequences of species of Triplophysa by 14.9–24.9% in K2P distance. Phylogenetic analysis based on cytochrome b gene sequences recovered T. wulongensis as sister taxon to all other cave-dwelling species of Triplophysa.

Gastric perforation resulting into pneumoperitoneum in a neonate: a case report

Gastric perforation in a neonate is a rare surgical emergency in routine practice. The causes and predisposing factors for gastric perforation in a neonate vary from traumatic to benign conditions like inflammatory processes. Early detection, intensive care, stabilization and prompt surgery yield positive outcome. Early diagnosis is important for better prognosis. Simple investigation such as plain abdominal X-ray can adequately lead to the diagnosis by showing pneumoperinoneum. We present a 3-day-old neonate; born at term who presented with abdominal distension and vomiting. Plain abdominal X-ray revealed pneumoperitoneum. Emergency laparotomy was performed where a gastric perforation was found measuring 0.5 by 0.5 cm located on the anterior aspect of the stomach body near the pylorus. The baby underwent successful surgical intervention and recovered well.

Анализ изотопического состава выдыхаемого воздуха методами диодной лазерной спектроскопии в районе 2 μm для диагностики Helicobacter pylori-ассоциированных заболеваний-=SUP=-*-=/SUP=-

Spectral analysis of 13СО2/12СО2 isotope ratio in exhaled air based on tunable diode laser spec-troscopy was applied for diagnostics of digestive organ diseases associated with Helicobacter pylori infection. Special spectrophotometer based on tunable diode laser was developed for the analysis of breath isotope content. Spectral range near 2.05 microns where the rotational-vibration R-branch of the 20013-00001 band of 12CO2 interferes with the P-branch of the 20012-00001 band of 13CO2 was used. The 13C-Urea Breath Test (13C-UDT) was used for the H. pylori infection diagnostic in gastrointestinal tract of 309 tested persons. The results of the isotope breath test were compared with the data of morphological analysis of gastric and duodenal mu-cosa obtained by fibrogastroduodenoscopia. For the first time the total value of the histology analysis results for biopsy material taken in the stomach body, in the distal part of stomach and in the duodenum was proposed to be used for the comparative analysis with 13C-UBT data. A relationship of 13C-UBT data with age, nosology, activity and severity of inflammation process, atrophy degree, and type of eradication therapy was analyzed. Distribution of 13C-UBT data ob-tained before and after therapy was demonstrated to reflect epidemiology of gastroduodenal dis-eases, H.pylori infection incidence, specifics of gastrointestinal tract colonization by H.pylori, parameters of inflammation process, as well as therapy effectiveness and peculiarity of the in-fection restoration at failed eradication therapy.

BIOKINETIC MODEL DEVELOPMENT OF RADIOIODINE-131 VIA IN VIVO GAMMA CAMERA/8-SLICE CT TECHNIQUE: CASE-CONTROL STUDY OF FELINE HYPERTHYROIDISM

Objectives: A biokinetic model of iodine in the thyroid was developed and applied to a case-control study of hyperthyroid cat undertaken the NaI-131 dose administration using a gamma camera/8-slice CT with the in vivo study. Methods: The case-control hyperthyroid cats were administered 55.5 or 3.7[Formula: see text]MBq of I-131 radioactive solution and continuously surveyed by a gamma camera. The scan schedule was preset as 5- or 10-min counting per each hour from the initial time to the sixth hour, then on the 24th, 48th and 72nd hours, respectively. An in-house developed program run in the MATLAB was applied to evaluate the biokinetic model of iodine in the thyroid, in compliance with the ICRP-30 report regulations. The model was defined by five compartments (namely: stomach, body fluid, thyroid, whole body, and excretion) and allowed one to simulate the variations of time-dependent I-131 radioactive concentration among various compartments of each study subject. The numerical simulation via MATLAB was compiled with the empirical evaluation to optimize the time-dependent concentration of I-131 within the above compartments. Results: The derived biological half-life values for stomach, body fluid, thyroid, whole body, and excretion, respectively, were as follows: 17, 3, 10, 5 and 140[Formula: see text]h for hyperthyroid cat, 18, 1, 8, 2, and 40[Formula: see text]h for control #1 cat, and 22, 2, 12, 4, and 20[Formula: see text]h for control #2 cat. The cumulative radioactive doses from both gamma-ray and beta particles were assessed via a simplified algorithm as 0.135, 0.0082, and 0.005 Gy, for hyperthyroid cat, control #1, and control #2 ones, respectively. Conclusion: The derived biokinetic model was found to be helpful in the evaluation of the metabolic mechanism in case of feline hyperthyroidism. The revealed deviations from available human biomodels can be used for refining the radioiodine treatment of pets with hyperthyroidism.

IgG4-related disease manifesting as an isolated gastric lesion- a literature review

Introduction: IgG4-related disease (IgG4-RD) is a newly recognised disorder of unknown etiology and pathogenesis, characterised by dense IgG4+ cells infiltration and fibrosis. IgG4-RD can affect various organs, but gastrointestinal tract involvement is rare. First case of isolated gastric IgG4-RD reported in polish population was diagnosed in our Clinic and became the reason for conducting a literature review. Materials and methods: A literature review was performed using PubMed database. Eight studies of isolated gastric IgG4-RD, published between 2011 and 2017, and a case diagnosed by the authors were included. Results: Three out of nine analysed patients had gastrointestinal complaints. In other cases lesions were detected accidentally. The majority of them were submucosal tumors while only one was a gastric ulcer. The most commonly affected was the stomach body. In all cases malignancy had been suspected, and the lesions were surgically removed. Diagnosis was based on the histopathology image and immunohistochemical staining. Only one patient had elevated IgG4 serum level. No case of recurrence or other organ involvement was reported. Conclusion: IgG4-related disease may manifest as an isolated gastric lesion and should be taken in consideration in differential diagnosis. Making an ultimate diagnosis without histopathological specimen examination seems to be difficult and can lead to misdiagnosis followed by inappropriate treatment. IgG4-RD responds well to steroid therapy. However, on this matter further studies are needed.

Endoscopic removal of esophagus and stomach polyps using ligation device

Aim. To approbate method of endoscopic removal of esophagus and stomach polyps using a ligation device.Methods. During the period from 2013 to 2015, 37 endoscopic polyps removal using the variceal band ligation device «G-Flex» (Belgium) were performed to 34 patients (26 women and 8 men) aged 17 to 68 years. Removed polyps size ranged from 5 to 11 mm. Polyps localization was as follows: esophagus abdominal part and stomach cardia - 7 (19%), stomach subcardial part - 2 (5%), stomach body - 19 (52%), antrum - 9 (24%). Before polyps removal, lesions biopsy and gastric juice acidity determination were performed to all patients, in 45% of cases endosonography was performed. According to the histological study results, hyperplastic polyps were detected in 5 (15%) patients, adenomatous polyps - in 29 (85%). In 2 patients the endosonography results revealed submucosal lesion, coming from the mucous membrane muscular layer.Results. Technical possibilities of the esophagus and stomach polyps endoscopic removal using variceal band ligation device, depending on the lesion location and size, were evaluated. In all cases, regardless of the focus localization and the comorbidity severity, a successful technical surgery performance was achieved in the absence of complications and symptoms recurrence in the early and late postoperative periods. Method advantages and disadvantages, indications for its performance in the inpatient and outpatient settings are revealed.Conclusion. In certain indications and performance technique adherence, the esophagus and stomach polyps endoscopic removal using variceal band ligation device is a safe and radical method of upper gastrointestinal tract benign epithelial lesions treatment.