The prevalence, anatomic distribution, and diagnosis of colonic causes of chronic diarrhea.

BACKGROUND: The prevalence of chronic diarrhea from a colonic disease and the optimal method of its diagnosis have not been ascertained. METHODS: Eight hundred nine patients with chronic non-bloody diarrhea unassociated with human immunodeficiency virus (HIV) infection underwent colonoscopy with biopsy specimen taken from throughout the colon and, if reached, the terminal ileum. The prevalence and anatomic distribution of ileocolonic histopathology and whether flexible sigmoidoscopy or colonoscopy represents the safest and most cost-effective test for diagnosis were determined. RESULTS: 122 of 809 patients (15%) had colonic histopathology (microscopic colitis in 80 patients, Crohn's disease in 23, melanosis coli in 8, ulcerative colitis in 5, other forms of colitis in 5, and nodular lymphoid hyperplasia in 1). A correct assessment of colonic histology (normal or abnormal) could have been made from biopsies of the distal colon in 99.7% of patients. CONCLUSION: In a referral setting, colonic histopathology occurs in 15% of patients with chronic diarrhea without HIV infection. According to this prevalence and the nearly universal diffuse anatomic distribution of colonic disease in these patients, a diagnostic investigation for chronic colonic diarrhea using a 60 cm flexible sigmoidoscope is highly efficient and cost-effective.

Gastric leiomyosarcoma presenting as a gastric wall abscess.

Gastric abscess is a rare disorder with approximately 500 cases reported. Two variants are seen diffuse (Phlegemous) or localized. We report a spindle cell tumor (leiomyosarcoma) presenting as a localized gastric wall abscess.

Detection of acidic fibroblast growth factor mRNA in the rat ovary using reverse transcription-polymerase chain reaction amplification.

We have examined the expression of acidic fibroblast growth factor (aFGF) in the rat ovary using reverse transcription-polymerase chain reaction (RT-PCR). RNA was extracted from hypothalami of adult rats and whole ovaries or isolated granulosa cells of gonadotropin-primed immature rats. The RNA was reverse transcribed and amplified by PCR using oligonucleotide primers specific for rat aFGF. RNA from hypothalamus or whole ovary yielded a dominant DNA band corresponding in size to the aFGF segment spanned by the two primers (301 base pairs, bp). Its identity with the aFGF sequence was confirmed by restriction enzyme analysis. The aFGF product was also obtained from two of four granulosa cell RNA preparations; when obtained, the intensity of the signal was less than that from whole ovary, indicating that the major sites of aFGF expression are outside the granulosa layer.