Gastrointestinal Examination Research Articles

Cowden syndrome in a male patient with metachronous triple cancers and various clinical features:a case report

A 66-year-old male patient with a thyroid and nasopharyngeal cancer history visited our hospital because of a positive fecal occult blood test. Total colonoscopy detected sessile or subpedunculated polyps in the ascending colon, sigmoid colon, and rectum. These polyps were endoscopically resected, and the rectal polyp was pathologically diagnosed as adenocarcinoma in adenoma and the others as adenomas. Additionally, multiple sessile lesions were revealed in the sigmoid colon and rectum. A complete gastrointestinal tract examination revealed multiple foci of glycogenic acanthosis in the esophagus, multiple sessile lesions in the stomach, multiple sessile lesions, clubbings (rod-shaped lesions), and venous malformations in the small bowel. Mucocutaneous examination indicated hemangiomas on the body trunk, patchy pigmentation on the glans penis, and keratotic papules in the inguinal region. The National Comprehensive Cancer Network diagnostic criteria for Cowden syndrome were used in this case. The patient met four major and two minor criteria;thus, Cowden syndrome was diagnosed. Moreover, the patient was had phosphatase and tensin homolog deleted on chromosome 10 gene mutation. This is the first reported case of metachronal triple cancers in a male patient with Cowden syndrome, and our results indicate the importance of cancer surveillance.

Anticholinergic toxidrome: a rare consequence of lupin ingestion - a case report and literature review

Background: Lupin beans, a yellow legume seed from the Lupinus plant, are commonly used in Southern Europe, Latin America, and the Middle East. Despite their bitter taste, lupin beans are highly nutritious and rich in protein, making them popular snacks. The bitter taste is due to the presence of over 150 quinolizidine alkaloids, with Lupanine being the predominant alkaloid. If not properly debittered before ingestion, lupin toxicity and anticholinergic symptoms can occur. Case Presentation: A 49-year-old healthy Egyptian man presented with symptoms such as dry mouth, unsteadiness, constipation, and urinary retention for 6 hours. After investigation, it was discovered that he had consumed 400 g of bitter lupin beans within a 1-hour period, around 4-6 hours before the symptom onset. The patient was oriented, conscious, and alert, showing no signs of pain or distress. His vital signs were normal, and he had normal cardiovascular, pulmonary, gastrointestinal, and neurological examinations. His eye examination revealed fixed, dilated pupils bilaterally, blurry vision, and normal eye movement bilaterally. Laboratory tests were normal. The patient received Ringer's lactate intravenously and was closely monitored in the emergency department. Over a 3-hour period, all symptoms and signs resolved with fluid management alone, and the patient was discharged home following his improvement. Conclusion: This report highlights the importance of history taking in diagnosing food-related diseases and emphasizes that physicians should consider lupin toxicity as a differential diagnosis in cases presenting with anticholinergic symptoms.

An Investigation into the Characteristics and Distribution Patterns of Diseases Detected via Gastroscopy in Northern Xinjiang, China.

The aim of this study is to examine the distribution and features of gastroscopy in northern Xinjiang, a province in China. We included a group of 895 patients diagnosed with digestive diseases at Urumqi Friendship Hospital and analyzed their gastroscopic results and baseline data. Among patients aged 12 to 86 years in the specified region, females exhibited a heightened susceptibility to esophageal-gastrointestinal and intestinal disorders compared to males. The mean age for chronic gastritis onset was determined to be 54.79 years. In the context of esophageal-gastric-intestinal disorders, the distribution across various ethnic groups manifested as follows: the Han, Uygur, Hui, and Kazakh populations comprised 53.97%, 23.91%, 7.15%, and 3.46%, respectively. Through principal component-based dimension reduction analysis, we identified chronic non-atrophic gastritis with erosive gastritis, duodenal bulb inflammation, and chronic non-atrophic gastritis (predominantly in the gastric antrum) as pivotal factors contributing to differences in hiatal hernia. Multiple linear regression models were established for different ethnic groups, duodenal bulb inflammation, and hiatal hernia by age. The results revealed a heightened risk of duodenal bulb inflammation (P < 0.01) in Han, Kazakh, Hui, Mongolian, and Uygur women, while the risk of hiatal hernia exhibited a positive correlation with age (P = 0.001). Among patients undergoing gastrointestinal examinations in northern Xinjiang, the most prevalent pathological condition was identified as chronic gastritis. Notably, within this subgroup, the prevalence of duodenal bulb inflammation was found to be greater in women than in men. The ethnic composition within this context encompassed patients from the Han, Kazakh, Hui, and Mongolian ethnic groups. Furthermore, a positive correlation was identified between the incidence of esophageal hiatal hernia and age.

Evaluation of Deep Learning Models in Search by Example using Capsule Endoscopy Images

Wireless capsule endoscopy (WCE) has revolutionized the field of gastrointestinal examinations, being MedtronicTM WCE one of the most used in clinics. In those WCE videos, medical experts use RAPID READERTM tool to annotate findings in videos. However, the frame annotations are not available in an open format and, when exported, they have different resolutions and some annotated artefacts that make difficult their localization in the original videos. This difficult the use of WCE medical experts’ annotations in the research of new computed-aid diagnostic (CAD) methods. In this paper, we propose a methodology to compare image similarities and evaluate it in a private MedtronicTM WCE SB3 video dataset to automatically identify the annotated frames in the videos. We used state-of-the-art pre-trained convolutional neural network (CNN) models, including MobileNet, InceptionResNetv2, ResNet50v2, VGG19, VGG16, ResNet101v2, ResNet152v2, and DenseNet121, as frame features extractors and compared them with the Euclidean distance. We evaluated the methodology performance on a private dataset consisting of 100 WCE videos, totalling 905 frames. The experimental results showed promising performance. The MobileNet model achieved an accuracy of 94% for identifying the first match, while the top 5, top 10, and top 20 matches were identified with accuracies of 94%, 94%, and 98%, respectively. The VGG16 and ResNet50v2 models also demonstrated strong performance, achieving accuracies ranging from 88% to 93% for various match positions. These results highlight the effectiveness of our proposed methodology in localizing target frames and even identifying similar frames very use useful for training data-driven models in CAD research. The code utilized in this experiment is available on the Github†.

ED50 of ciprofol combined with different doses of remifentanil during upper gastrointestinal endoscopy in school-aged children: a prospective dose-finding study using an up-and-down sequential allocation method.

This study aimed to determine the 50% effective dose (ED50) of ciprofol when combined with different doses of remifentanil for upper gastrointestinal endoscopy of school-age children and to evaluate its safety. This study involved school-aged children who were scheduled to undergo upper gastrointestinal endoscopy under deep sedation. The children were randomly assigned to two groups: remifentanil 0.3μg/kg (R0.3) and remifentanil 0.5μg/kg (R0.5). Anesthesia was induced with remifentanil, followed by ciprofol. The dose of ciprofol for each patient was determined using the Dixon up-down sequential method. If the MOAA/S score was ≤1 and the child did not exhibit significant movement or coughing during the endoscopy process, sedation was considered successful. The first patient in each group received 0.5mg/kg ciprofol. The dose of ciprofol was adjusted by 0.05mg/kg based on the response of the previous patient. The primary outcome was the ED50 of the ciprofol-induction dose. The total ciprofol doses, onset times, awakening times, and adverse reactions were recorded. 1) The Dixon method was used to collect crossovers data from each group, and the ED50 values of the R0.3 and R0.5 groups were calculated to be 0.390mg/kg (95% CI 0.356-0.424mg/kg) and 0.332mg/kg (95% CI 0.291-0.374mg/kg), respectively. The ED50 of ciprofol in the R0.3 group was significantly higher than that in the R0.5 group (p < 0.05). 2) The onset time and recovery time of the R0.5 group were shorter than those of the R0.3 group (p < 0.05). When the two groups were compared, the total dose of ciprofol in the R0.5 group decreased (p < 0.05). 3) Compared with the R0.3 group, the incidence of respiratory depression during induction in the R0.5 group increased (p < 0.05). This study explored the ED50 of ciprofol combined with different doses of remifentanil for successful sedation in upper gastrointestinal examinations in school-aged children. Compared to the use of remifentanil 0.3μg/kg, the combination of ciprofol with remifentanil 0.5μg/kg significantly reduced the ED50 required to prevent body movement or cough during endoscope insertion but increased the incidence of respiratory depression.

Evaluation of Deep Learning Models in Search by Example using Capsule Endoscopy Images

Wireless capsule endoscopy (WCE) has revolutionized the field of gastrointestinal examinations, being MedtronicTM WCE one of the most used in clinics. In those WCE videos, medical experts use RAPID READERTM tool to annotate findings in videos. However, the frame annotations are not available in an open format and, when exported, they have different resolutions and some annotated artefacts that make difficult their localization in the original videos. This difficult the use of WCE medical experts’ annotations in the research of new computed-aid diagnostic (CAD) methods. In this paper, we propose a methodology to compare image similarities and evaluate it in a private MedtronicTM WCE SB3 video dataset to automatically identify the annotated frames in the videos. We used state-of-the-art pre-trained convolutional neural network (CNN) models, including MobileNet, InceptionResNetv2, ResNet50v2, VGG19, VGG16, ResNet101v2, ResNet152v2, and DenseNet121, as frame features extractors and compared them with the Euclidean distance. We evaluated the methodology performance on a private dataset consisting of 100 WCE videos, totalling 905 frames. The experimental results showed promising performance. The MobileNet model achieved an accuracy of 94% for identifying the first match, while the top 5, top 10, and top 20 matches were identified with accuracies of 94%, 94%, and 98%, respectively. The VGG16 and ResNet50v2 models also demonstrated strong performance, achieving accuracies ranging from 88% to 93% for various match positions. These results highlight the effectiveness of our proposed methodology in localizing target frames and even identifying similar frames very use useful for training data-driven models in CAD research. The code utilized in this experiment is available on the Github†.

Simulation and Verification of a Magnetically Controlled System for a Wireless Capsule Robot

Abstract The incidence of digestive system disease is increasing with the development of society, the environmental transition, and changes in people's lifestyles. A magnetically controlled system (MCS) aimed at the examination of the digestive tract based on octupole electromagnets was proposed to manipulate a wireless capsule endoscopy (WCE) with an internal permanent magnet inside. The parameterization was utilized to optimize the magnetic field of the MCS by determining the structure of the electromagnets. Theoretical calculation and numerical simulation were carried out to compare the external magnetic field generated by the electromagnets with the internal magnetic field generated by the WCE. In vitro tests were studied on the experimental platform to evaluate the performance of the MCS, and it was found that the MCS performed well in directing the WCE's movement and causing the WCE to execute the prescribed action. The system, as a preliminary exploration of the magnetic field control system, was supposed to be employed in gastrointestinal examinations in the future.

Endoscope Capsules: The Present Situation and Future Outlooks.

This paper presents new perspectives on photonic technologies for capsule endoscopy. It first presents a review of conventional endoscopy (upper endoscopy and colonoscopy), followed by capsule endoscopy (CE), as well as their techniques, advantages, and drawbacks. The technologies for CEs presented in this paper include integration with the existing endoscopic systems that are commercially available. Such technologies include narrow-band imaging (NBI), photodynamic therapy (PDT), confocal laser endomicroscopy (CLE), optical coherence tomography (OCT), and spectroscopy in order to improve the performance of the gastrointestinal (GI) tract examination. In the context of NBI, two optical filters were designed and fabricated for integration into endoscopic capsules, allowing for the visualization of light centered at the 415 nm and 540 nm wavelengths. These optical filters are based on the principle of Fabry-Perot and were made of thin films of titanium dioxide (TiO2) and silicon dioxide (SiO2). Moreover, strategies and solutions for the adaptation of ECs for PDT are also discussed.

Simple Scoring System for Esophagogastric Varices Prediction in Hepatocellular Carcinoma Patients without Liver Stiffness Evaluation

Introduction: For predicting esophagogastric varices (EGVs), the Virtual Baveno VII Consensus Workshop has proposed a combination of liver stiffness determination and platelet count measurement using a FibroScan^®. However, FibroScan^® is not available at all institutions. The present study aimed to develop a simple method to predict development of EGV using only general blood examination results. Materials and Methods: A total of 1,090 hepatocellular carcinoma patients were enrolled, after excluding 956 with major portal vein tumor thrombus (Vp3/Vp4) or without upper gastrointestinal endoscopy examination results available. Those with EGV (≥ grade F2) or a history of treatment for the condition were defined as positive for significant EGV, and then clinical factors were retrospectively evaluated to determine indicators of occurrence. Results: Logistic multivariate analysis showed platelet count (≤12 × 10⁴/μL) (odds ratio [OR] 3.79, p < 0.001), mALBI grade 2a (OR 1.52, p = 0.036), and mALBI 2b or 3 (OR 3.46, p < 0.001) as significant predictive factors. Based on the OR values, platelet count (≤12 × 10⁴/μL) and mALBI grade 2b/3 were each assigned 2 points and mALBI 2a was given 1 point, with the result termed recommendation for EGV screening (REGS) score. Significant EGV occurrence was noted in 2.9% (9/311) of the patients with a REGS score 0, 11.0% (13/118) with a score 1, 19.3% (53/274) with a score 2, 29.5% (39/132) with a score 3, and 38.0% (97/255) with a score 4 (p < 0.001). Conclusion: The findings indicate that REGS score can provide useful predictive information for development of significant EGV without the need for special equipment such as a FibroScan^®.

UY-NET: A Two-Stage Network to Improve the Result of Detection in Colonoscopy Images

The human digestive system is susceptible to various viruses and bacteria, which can lead to the development of lesions, disorders, and even cancer. According to statistics, colorectal cancer has been a leading cause of death in Taiwan for years. To reduce its mortality rate, clinicians must detect and remove polyps during gastrointestinal (GI) tract examinations. Recently, colonoscopies have been conducted to examine patients’ colons. Even so, polyps sometimes remain undetected. To help medical professionals better identify abnormalities, advanced deep learning algorithms that can accurately detect colorectal polyps from images should be developed. Prompted by this proposition, the present study combined U-Net and YOLOv4 to create a two-stage network algorithm called UY-Net. This new algorithm was tested using colonoscopy images from the Kvasir-SEG dataset. Results showed that UY-Net was significantly accurate in detecting polyps. It also outperformed YOLOv4, YOLOv3-spp, Faster R-CNN, and RetinaNet by achieving higher spatial accuracy and overall accuracy of object detection. As the empirical evidence suggests, two-stage network algorithms like UY-Net will be a reliable and promising aid to image detection in healthcare.

Ultrathin endoscope equipped with ultrasonic miniprobe for upper GI US in a porcine model

BackgroundUltrathin esophagogastroduodenoscopy (UT-EGD) is an ideal tool for unsedated upper gastrointestinal examination and pediatric gastroenterology but is rarely competent for endoscopic ultrasonography mini probe (EUS-MP). We developed a UT-EGD ultrasonography method(UT-EUS) and verified its clinical application value through animal experiments. MethodsFive Bama miniature pigs were selected. Using an acoustic medium, duodenum, stomach, and esophagus ultrasonography was performed respectively with conventional 20-MHz Endoscopic ultrasound miniprobe(EUS-MP-20), 20-MHz UT-EUS,(UT-EUS-20) and 30-MHz UT-EUS(UT-EUS-30). Record the time to acquire 5 consecutive stable ultrasound images, the number of identifiable wall layers, the quality, and the penetration depth of the images. ResultsThere was no significant difference in the time required to obtain images between EUS-MP-20 and UT-EUS-20 at each site (P > 0.05). UT-EUS-30 resolved the wall to more levels than UT-EUS-20 (P < 0.05). There was no significant difference between EUS-MP-20 and UT-EUS-20 in imaging quality and penetration depth (P > 0.05). ConclusionThe UT-EUS is easy to use, the obtained image quality is satisfactory, and it has potential clinical application value.

Audit of upper gastrointestinal tract series examinations for diagnosing intestinal malrotation in a resource-limited radiology department in Southern Africa

Intestinal malrotation is a congenitally acquired condition of abnormally rotated proximal small bowel in neonates and infants. Prompt recognition prevents lifethreatening complications. A structured approach to diagnosing malrotation at UGIS is required for accurate diagnosis. Retrospective analysis of the images and radiological reports of UGIS, with the aim of identifying potential shortfalls in diagnosing malrotation. A secondary objective is to formulate a reporting template to improve overall quality of UGIS reports, specifically in cases of suspected malrotation. Identification and retrospective review of UGIS studies which were subsequently re-read by a blinded consultant radiologist using the proposed reporting template adapted from the literature. 367 UGIS studies between 1 January 2016 and 31 December 2021 were included in the study cohort, which were then re-read. Using McNemar's chi-square test, we found discrepancy between the number of studies positive for malrotation on the original reports versus the re-read studies, highlighting shortfalls in our current practise. A structured approach is paramount to the correct diagnosis of malrotation at UGIS. The position of the DJ-flexure (on frontal and lateral projections) proves most sensitive and specific in the diagnosis of malrotation at UGIS. Dedicated true lateral images were often found to be excluded in daily practise. We propose a structured inclusive reporting template. Our proposed standardized reporting template aims to improve radiological, clinical, and surgical outcomes at UGIS, specifically in patients with suspected malrotation.

Aplastic Anemia with Epstein-Barr Virus Reactivation after Anti-thymocyte Globulin Therapy.

Lymphoproliferative disorders and Epstein-Barr virus reactivation (EBV-LPDs) have various forms of onset, ranging from infectious mononucleosis-like syndrome (IM-like) to lymphoma, although whether or not IM-like progresses to lymphoma remains unclear. A 61-year-old man was diagnosed with aplastic anemia (AA). Polyclonal atypical B-lymphocytes were observed in the peripheral blood, and IM-like was diagnosed. Atypical lymphocytes disappeared, but a gastrointestinal examination revealed diffuse large B-cell lymphoma (DLBCL). Rituximab was initiated but later discontinued because of severe acute respiratory syndrome coronavirus 2 infection. Pancytopenia due to AA exacerbation recurred. The patient ultimately died of multiple organ failure due to bacterial infection.

Gastrointestinal Angiodysplasia in Patients with Severe Aortic Stenosis: The Endoscopic Features of Heyde’s Syndrome

Introduction: Aortic stenosis (AS) is sometimes associated with gastrointestinal bleeding, and this phenomenon is known as Heyde’s syndrome. Such bleeding is most often considered to originate from gastrointestinal angiodysplasias, but the frequency and endoscopic features of such bleeding remain unclear. This study aimed to determine the frequency and endoscopic features of gastrointestinal angiodysplasia in patients with severe AS. Patients and Methods: In this multicenter, retrospective study, we evaluated consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with severe AS from May 2016 to December 2019. We extracted the data on the clinicopathological features according to the status of anemia, the proportion of patients who underwent gastrointestinal endoscopic examinations and demonstrated gastrointestinal angiodysplasia, and identified the endoscopic features associated with such patients. Results: In 325 patients, the rates of moderate/severe anemia (hemoglobin < 11 g/dL) were 52%. Regarding medicine, there were no significant differences between the patients with and without moderate/severe anemia. Patients were examined by esophagogastroduodenoscopy (21%), colonoscopy (12%), and balloon-assisted enteroscopy or small bowel capsule endoscopy (1.5%). Patients with moderate/severe anemia had significantly more angiodysplasia (38.3% vs. 7.7%; p < 0.0001) and active bleeding (23.4% vs. 0%; p < 0.01). Angiodysplasia was detected in 21 patients (stomach, n = 9; small intestine, n = 5, and colon, n = 10). Conclusions: The results suggest, for the first time, that patients with severe AS who underwent TAVI and moderate/severe anemia frequently had gastrointestinal angiodysplasia and active bleeding throughout the entire gastrointestinal tract.

Efficacy and safety of atezolizumab plus bevacizumab treatment for unresectable hepatocellular carcinoma patients with esophageal-gastric varices.

Bevacizumab inhibits vascular endothelial growth factor-A (VEGF-A), though is known to increase bleeding risk as an adverse event (AE). This study examined whether atezolizumab/bevacizumab (Atez/Bev) for unresectable hepatocellular carcinoma (uHCC) can be used for patients with esophageal-gastric varices (EGV). From October 2020 to December 2022, 506 uHCC patients (median 74years) underwent an upper gastrointestinal endoscopy examination were enrolled, after exclusion of those with portal vein tumor thrombus (PVTT). Patients with EGV (≧ F1) were defined as EGV positive, and the cohort was divided into non-EGV (n = 355) and EGV (n = 151). Before introducing Atez/Bev, endoscopic treatment was performed, when necessary. Prognosis was evaluated, retrospectively. The EGV group had significantly worse hepatic function, lower platelet count, elevated alpha-fetoprotein, and lower rate of extrahepatic metastasis, and lower rate of first-line use (each P < 0.05) than the other. However, progression-free survival (PFS) was also not a significantly difference between the EGV and non-EGV groups in analyses with (PFS rate at 6/12/18 months: 60%/38%/30% vs. 65%/46%/34%, P = 0.29) or without inverse probability weighting adjustment [median: 10.6months (95% CI 8.3-14.0) vs. 10.5months (95% CI 7.8-13.7), P = 0.79]. As for AEs, diarrhea was more frequent in the EGV group (≧ G3: 2.0% vs. 0.3%, P = 0.036), while no significant difference was noted for EGV hemorrhage (≧ G3: 1.3% vs. 0.6%, P = 0.345). Of 28 patients who underwent endoscopic treatments before introducing Atez/Bev, none showed EGV-associated hemorrhage. Atez/Bev might be an effective therapeutic option in patients with EGV, when appropriate endoscopic treatment for EGV is performed.

Multi-scale feature retention and aggregation for colorectal cancer diagnosis using gastrointestinal images

Colonoscopy is considered the gold standard for colorectal cancer diagnosis and prognosis. However, existing methods are less accurate and prone to overlooking lesions during gastrointestinal endoscopic examinations. Computer-assisted diagnosis combined with robot-assisted minimally invasive surgery (RMIS) can significantly help medical practitioners detect and treat lesions. Therefore, two novel architectures are developed for polyp and surgical instrument segmentation to aid colorectal cancer diagnosis, assessment, and treatment. Colorectal cancer segmentation network (CCS-Net) is the base network used in this study. It uses the maximum convolutional layers near the input image for effective feature extraction from low-level information. In addition, CCS-Net uses an efficient feature upsampling unit to efficiently increase the input spatial features’ map size. Hence, CCS-Net is capable of providing a fair performance with satisfactory computational efficiency The multi-scale feature retention and aggregation network (MFRA-Net) is the final network in this study. MFRA-Net is developed to improve the segmentation accuracy of the CCS-Net further as it uses multi-scale feature retention to retain low-level spatial features and transfers them to deep stages of the network. MFRA-Net also combines multi-scale high-strided low-level information with high-level information to boost network segmentation performance. Finally, all the transferred multi-scale features from the early stages of the network are aggregated with high-level features in the deep levels of the network. This multi-scale feature retention and aggregation mechanism enables the network to maintain a better segmentation performance compared with other methods even with challenging blur, specular reflection, low contrast, and high variation cases. We evaluated both architectures on four challenging datasets: Kvasir-SEG, CVC-ClinicDB, Kvasir-Instrument, and the UW-Sinus-Surgery-Live dataset. The proposed method achieves dice similarity coefficients of 95.98%, 94.19%, 92.81%, and 88.57% for the CVC-ClinicDB, Kvasir-SEG, Kvasir-Instrument, and UW-Sinus-Surgery-Live datasets. The proposed method achieves superior segmentation performance compared with state-of-the-art methods and requires only 4.9 million trainable parameters for complete training. Therefore, the proposed networks can effectively assist health professionals in surgical procedures and colorectal cancer diagnosis through surgical instruments and polyp segmentation, respectively.

Associations of Gastrointestinal Tract Tumor Necrosis Factor Receptor-Associated Factor 6 Expression with Clinical Features and Prognosis of Eosinophilic Gastroenteritis.

Few studies have been conducted to explore the expression of tumor necrosis factor receptor-associated factor 6 in eosinophilic gastroenteritis patients. Therefore, the expression profile of tumor necrosis factor receptor-associated factor 6 in the gastrointestinal tract of eosinophilic gastroenteritis patients and its associations with clinical features were explored in this study. Thirty-four eosinophilic gastroenteritis patients who presented in Ruijin Hospital from December 2012 to May 2019 and had accepted gastrointestinal endoscopic examinations were recruited. Medical records and endoscopic biopsies were collected, and the prognosis was followed up by telephone. Healthy persons were selected as the control group. Hematoxylin and eosin and immunohistochemical staining were performed in both eosinophilic gastroenteritis patients and healthy persons. The final results were analyzed by skilled pathologists, and mean optical density values of tumor necrosis factor receptor-associated factor 6 were calculated by Image J software. Final results were analyzed by Statistical Package for the Social Sciences software 22.0. Thirty-four patients (mean age: 25.56 ± 21.14 years, 61.76% males) were recruited for this study. There was no significant difference in tumor necrosis factor receptor-associated factor 6 mean optical density values of gastric tissues in eosinophilic gastroenteritis patients and healthy people (0.22 ± 0.16 vs. 0.14 ± 0.05, P > .05). Eosinophilic gastroenteritis patients had a significantly lower level of intestinal tumor necrosis factor receptor-associated factor 6 mean optical density values than that of healthy people (0.16 ± 0.05 vs. 0.23 ± 0.06, P < .05). Intestinal tumor necrosis factor receptor-associated factor 6 mean optical density values negatively linearly correlated with serum interleukin-10 level (r = -0.618, P = .043 < .05). There were no differences between eosinophilic gastroenteritis patients with or without relapse regarding the expression level of intestinal tumor necrosis factor receptor-associated factor 6 (P = .227 > .05). Patients with eosinophilic gastroenteritis might have a deficiency of intestinal tumor necrosis factor receptor-associated factor 6 compared to healthy controls.

Identification of intestinal parasites in wild American mink (Neovison vison) from Biebrza and Narew national parks (Poland)

American mink (Neovison vison) is an invasive species in the sylvatic environment of Poland. Mink are exposed to different parasite infections as their preys serve as intermediate and/or paratenic hosts. The study aimed to discriminate the pattern of intestinal parasite infections in mink inhabiting Biebrza (BNP) and Narew (NNP) national parks. Gastrointestinal tract examinations revealed Coccidia, Echinostomatidae, Taenidae, and Capillariidae parasites. There was no significant difference in the parasite burden of mink, but patterns of infections varied between both localizations. Coccidia were found in 3.8% of BNP vs. 6.7% of NNP mink. Fluke prevalence was significantly higher in NNP 27.5% compared to 7.7% in BNP mink. Tapeworms were only found in 3.4% of NNP mink. Significantly more Aonchotheca eggs were found in BNP 34.6% vs. 11.4% in NNP mink. The intensity of coccidiosis and aonchothecosis was low in both parks. Fluke intensity varied between low to moderate (ranging from 1 to 16) in BNP and low to massive (ranging from 1 to 117) in NNP mink. Coinfections of various parasite species were noted in both areas. Morphological and DNA analysis revealed that flukes belonged to Isthiomorpha melis and tapeworms to Versteria mustelae. It was the first isolation of V. mustelae in mink of those localizations. In conclusion, our study showed that mink indwelling Biebrza and Narew national parks are moderately infested with parasites. Results suggest that mink play an important role as a reservoir for parasites endangering endemic mustelids, becoming also a potential risk factor in case of accidental transmissions to farm mink. That is why, more strict biosecurity measures are required to protect farm mink.

Gastric morphological type: A supplementary addition for the evaluation of gastric cancer.

Clinical and pathological features are important factors that affect the prognosis and treatment strategies of patients with gastric cancer (GC). An upper gastrointestinal barium X-ray examination is commonly used to show gastric mucosa and morphological changes. The aim of the present study was to evaluate the association between gastric morphological type and the clinicopathological features of patients with GC, based on double-contrast barium X-ray imaging. A total of 329 patients with GC who underwent upper gastrointestinal barium X-ray examination were analyzed. The gastric morphological type was divided into four types on barium X-ray images: Horn-type, hook-type, weak-type and waterfall-type stomach. The χ2 test or Fisher's exact test was used to assess the association between gastric morphological type and the clinicopathological features. There was a statistically significant difference in the location of GC between different types of gastric morphology. Hook-type and horn-type GC were commonly present in the lower region of the stomach, while waterfall-type GC was mainly located in the upper region of the stomach. The incidence of waterfall-type non-poorly differentiated GC was higher than that of other gastric types. The incidence of waterfall-type intestinal-type GC was higher than that of other gastric types, and horn-type GC was more common in mixed-type GC. There was a statistically significant difference in the T-staging of GC between different types of gastric morphology. In conclusion, gastric morphological type correlates with the location and T-stage distribution of GC.

Magnetic Actuation Systems and Magnetic Robots for Gastrointestinal Examination and Treatment

Magnetic actuation technology (MAT) provides novel diagnostic tools for the early screening and treatment of digestive cancers, which have high morbidity and mortality rates worldwide. The application of magnetic actuation systems and magnetic robots in gastrointestinal (GI) diagnosis and treatment to provide a comprehensive reference manual for scholars in the field of MAT research are reviewed. It describes the basic principles of magnetic actuation and magnetic field safety, introduces the design, manufacturing, control, and performance parameters of magnetic actuation systems, as well as the applicability and limitations of each system for different parts of the GI tract. It analyzes the characteristics and advantages of different types and functions of magnetic robots, summarizes the challenges faced by MAT in clinical applications, and provides an outlook on the future prospects of the field.