Preterm labor with and without chorioamnionitis is associated with activation of myometrial inflammatory networks: a comprehensive transcriptomic analysis.

Background: The onset of preterm labor is associated with inflammation. Previous studies suggested that this is distinct from the inflammation observed during term labor. Our previous work on 44 genes differentially expressed in myometria in term labor demonstrated a different pattern of gene expression from that observed in preterm laboring and nonlaboring myometria.

Preterm labor is a distinct process from term labor following computational analysis of human myometrium.

Background: The onset of the term human parturition involves myometrial gene expression changes to transform the uterus from a quiescent to a contractile phenotype. It is uncertain whether the same changes occur in the uterus during preterm labor.

Objective: This study aimed to compare the myometrial gene expression between term and preterm labor and to determine whether the presence of acute clinical chorioamnionitis or twin gestation affects these signatures.

Clinical Profiles and Survival Outcomes of Patients With Well-Differentiated Neuroendocrine Tumors at a Health Network in New South Wales, Australia: Retrospective Study.

Background: Neuroendocrine tumors (NETs) are a heterogeneous group of malignancies with varying and often indolent clinicobiological characteristics according to their primary location. NETs can affect any organ and hence present with nonspecific symptoms that can lead to a delay in diagnosis. The incidence of NETs is increasing in Australia; data regarding characteristics of NETs were collected from the cancer registry of Hunter New England, Australia.

Gastrointestinal infection in the immunocompromised (AIDS) patient.

In the past two decades acquired immunodeficiency syndrome (AIDS) has become one of the most devastating illnesses in human history. As the epidemic continues to spread increasingly, AIDS patients are no longer confined to a few specialized AIDS hospitals and are now seen in general hospitals and clinics everywhere. Radiologists need to recognize the appearances, to understand how-safely-to care for patients with this disease, and to know enough about the illness to be able to counsel their patients.

CT criteria for venous invasion in patients with pancreatic head carcinoma.

The purpose of the study was to evaluate CT criteria for venous invasion in patients with potentially resectable carcinoma of the pancreatic head, with surgical and histopathological correlation. In 113 patients evaluated with spiral CT for suspected pancreatic head carcinoma, several CT criteria for venous invasion were scored prospectively for the portal vein (PV) and the superior mesenteric vein (SMV): length of tumour contact with PV/SMV (0 mm, < 5 mm, > 5 mm); circumferential involvement of the vein (0 degree, 0-90 degrees, 90-180 degrees, > 180 degrees); degree of stenosis; irregularity of the vessel margin; and tumour convexity towards vessel. 65 patients underwent surgery.

Evaluation of a modified cholangiographic classification system for primary sclerosing cholangitis.

Background: There is no uniformly accepted classification system for the range of cholangiographic abnormalities encountered in primary sclerosing cholangitis (PSC). The aims of this study were to evaluate a previously developed classification system and to test the hypothesis that the pancreatic duct can be involved in PSC.

Methods: Two observers scored 132 endoscopic retrograde cholangiopancreatographies (ERCPs) from established PSC patients.

Staging of rectal cancer by double-contrast MR imaging using the rectally administered superparamagnetic iron oxide contrast agent ferristene and IV gadodiamide injection: results of a multicenter phase II trial.

The aim of this study was to assess the accuracy of double-contrast magnetic resonance imaging (MRI) with rectal application of the superparamagnetic iron oxide contrast agent (SPIO) ferristene and IV gadodiamide for preoperative staging of rectal cancer. In a randomized phase II dose-ranging trial, 113 patients were studied preoperatively with one of four different formulations of ferristene (Abdoscan) as an enema before MRI. T1-weighted spin-echo (T1w SE) and T2w turbo spin-echo (TSE) single-contrast images were obtained as well as T1w SE and gradient-echo (GRE) double-contrast images after IV gadodiamide injection (Omniscan).

[Gastrointestinal surgery and gastroenterology. VIII. Gastroenterologic aspects of chronic gastrointestinal ischemia].

The main cause of chronic gastrointestinal ischaemia is atherosclerosis. Stenotic lesions of the mesenteric circulation are relatively common, but lead to chronic ischaemic complaints due to collateral circulation in probably only 2-3 per 100,000 inhabitants per year. The classical presentation (post-prandial abdominal pain, weight loss, upper abdominal souffle) is present in a minority of patients only.

Percutaneous balloon dilatation for benign hepaticojejunostomy strictures.

Background: Percutaneous balloon dilatation of biliary tract strictures is generally accepted as a safe and inexpensive procedure. The effectiveness in selected groups of patients remains under discussion. The purpose of this study was to evaluate the results of percutaneous balloon dilatation in patients with a benign stricture of a hepaticojejunostomy.

Palliation of patients with esophagogastric neoplasms by insertion of a covered expandable modified Gianturco-Z endoprosthesis: experiences in 153 patients.

Background: We aimed to evaluate the short- and long-term outcomes of treatment by insertion of a covered expandable modified Gianturco-Z endoprosthesis (Song stent) in patients with esophagogastric malignancies.

Methods: Consecutive patients with esophagogastric malignancies in whom a Song stent was inserted were included. Data were retrieved retrospectively.

Primary sclerosing cholangitis and cholangiocarcinoma as a diagnostic and therapeutic dilemma.

Differentiating primary sclerosing cholangitis (PSC) from cholangiocarcinoma (CC) can be a diagnostic challenge with major therapeutic implications. In case of advanced or symptomatic PSC, liver transplantation (OLTx) can be life saving with excellent long-term outcome. However, the outcome of CC diagnosed prior or during OLTx is dismal.

Imaging and staging of biliopancreatic malignancy: role of ultrasound.

Most patients with a pancreatic head carcinoma, periampullary carcinoma or a cholangiocarcinoma of the liver hilum (Klatskin tumor) present with obstructive jaundice and therefore ultrasound often is the first imaging modality. Visualization is sufficient in more than 90% of cases for adequate diagnosis and staging. Even most small papillary tumors can be diagnosed with conventional abdominal ultrasound.

Spiral computed tomography for preoperative staging of potentially resectable carcinoma of the pancreatic head.

Background: Pancreatic cancer is often locally invasive. Preoperative staging attempts to identify patients suitable for resection, in order to minimize unnecessary operations. The aim of this study was to assess the improved imaging provided by spiral computed tomography (CT) in the preoperative staging of potentially resectable pancreatic head carcinoma.

[Acute hemorrhage from the lower digestive tract: a search for the source].

In four patients, women aged 65 and 86 years and men aged 22 and 46 years, admitted with profuse loss of fresh blood per anum, acute haemorrhage in the lower gastrointestinal tract was diagnosed. A systematic diagnostic and therapeutic strategy increases the possibility of localising the bleeding site in such patients. Urgent colonoscopy after oral purge for cleansing the colon of stool is feasible, safe and often both diagnostic and therapeutic.

Laparoscopic ultrasonography for abdominal tumor staging.

In recent years, laparoscopic ultrasonography has been introduced as an adjunct to diagnostic laparoscopy for staging of tumors of the upper gastrointestinal tract, liver, biliary tree, and pancreas. It has proved feasible to visualize most anatomic structures in the upper abdomen consistently and in detail with laparoscopic ultrasonography. Recent publications indicate that laparoscopic ultrasonography may be useful for detecting small liver metastases, lymph node metastases, small primary tumors of the pancreas and bile ducts, and for the assessment of the local extension of tumors of the pancreas and stomach.

Incidence and clinical findings of benign, inflammatory disease in patients resected for presumed pancreatic head cancer.

Background: The differentiation between cancer and benign disease in the pancreatic head is difficult. The aim of this study was to examine common features in a group of patients that had undergone pancreatoduodenectomy for a benign, inflammatory lesion misdiagnosed as pancreatic head cancer.

Methods: Among 220 pancreatoduodenectomies performed on the suspiscion of pancreatic head cancer, an inflammatory lesion in the pancreas or distal common bile duct was diagnosed in 14 patients (6%).

Dynamic rectal examination: its significant clinical value.

The aim of the present study was to carry out a proper correlation between patients' clinical symptoms and the radiological findings obtained by dynamic rectal examination (DRE). At DRE, the small bowel and in females the vagina are routinely opacified in addition to defecography. A prospective study of 248 consecutive patients (193 women and 55 men, ratio 3.

Laparoscopic ultrasonography for abdominal tumor staging: technical aspects and imaging findings.

Since 1992 diagnostic laparoscopy combined with laparoscopic ultrasonography has been performed in our center in more than 300 patients for staging of tumors of the liver, bile ducts, pancreas, esophagus, and gastric cardia. In this article our experience with laparoscopic ultrasonography for abdominal tumor staging is described, with particular attention for the technical aspects, imaging findings, limitations, and pitfalls.

Value of laparoscopic ultrasonography in staging of proximal bile duct tumors.

The additional value of laparoscopic ultrasonography was evaluated prospectively in 35 patients undergoing diagnostic laparoscopy for a suspected potentially resectable proximal bile duct tumor. Findings were compared with transabdominal ultrasonography, laparoscopy, surgery, and pathology. Laparoscopic ultrasonography was able to visualize the presence and origin of small bile duct tumors or stones and small liver metastases, which could not be seen or could be visualized only doubtfully by ultrasonography and laparoscopy.