Gastric inverted hyperplastic polyp: A rare cause of iron deficiency anemia.

Gastric inverted hyperplastic polyp (IHP) is a rare gastric polyp characterized by the downward growth of hyperplastic mucosal components into the submucosal layer. Macroscopically, a gastric IHP resembles a subepithelial tumor (SET); as a result, accurately diagnosing gastric IHP is difficult. This issue has clinical significance because gastric IHP can be misdiagnosed as SET or as malignant neoplasm In addition, adenocarcinoma can accompany benign gastric IHP. Although in most cases, gastric IHPs are asymptomatic and are found incidentally, these polyps may cause anemia secondary to chronic bleeding. Here, we report one case involving gastric IHP accompanied by chronic iron deficiency anemia that was successfully managed using endoscopic submucosal dissection.

Gastrointestinal stromal tumor solitary distant recurrence in the left brachialis muscle.

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract that are most commonly found in the stomach. Although GISTs can spread to the liver and peritoneum, metastasis to the skeletal muscle is very rare and only four cases have previously been reported. These cases involved concurrent skeletal metastases of primary GISTs or liver metastases. Here, we report the first case of a distant recurrence in the brachialis muscle after complete remission of an extra-luminal gastric GIST following a wedge resection of the stomach, omental excision, and adjuvant imatinib therapy for one year. Ten months after therapy completion, the patient presented with swelling and tenderness in the left arm. Magnetic resonance imaging revealed a large mass in the brachialis muscle, which showed positivity for c-kit and CD34 upon pathologic examination. This is the first reported case of a solitary distant recurrence of a GIST in the muscle after complete remission had been achieved.

High-concentration glutaraldehyde fixation of bovine pericardium in organic solvent and post-fixation glycine treatment: in vitro material assessment and in vivo anticalcification effect.

OBJECTIVE: Glutaraldehdye (GA)-fixed xenografts are widely used in cardiovascular surgery. The objective of this study was to evaluate the anticalcification effect of glycine treatment and high-concentration GA fixation in organic solvent on GA-fixed bovine pericardium, and to evaluate the possible synergistic effect of combined treatment. METHODS: Bovine pericardial tissues were divided into four groups according to the methods of treatment. Group 1 consisted of tissues fixed with 0.5% GA (control), group 2 fixed with 0.5% GA and post-treated with glycine, group 3 fixed with 2% GA in organic solvent (65% ethanol+5% octanol), and group 4 fixed with 2% GA in organic solvent and post-treated with glycine. The material characteristics of the treated tissues were assessed by amino acid analysis, thermal stability test, uniaxial mechanical test and light microscopy. The tissues were subcutaneously implanted into 4-week-old rats for 8 weeks, and the calcium contents of the explanted tissues were measured. RESULTS: Differently treated tissues resulted in no significant alterations in material characteristics and morphology as assessed by amino acid analysis, thermal stability test, uniaxial mechanical test, and light microscopy. Median calcium contents of groups 1, 2, 3, and 4 were 80.5 µg mg(-1), 1.0 µg mg(-1), 0.5 µg mg(-1) and 1.7 µg mg(-1), respectively. The calcium contents of groups 2, 3 and 4 were all significantly lower than that of group 1 (p < 0.05). CONCLUSIONS: Post-fixation treatment with glycine, high-concentration GA fixation in organic solvent and combined treatment of these all strongly prevented calcification of GA-fixed bovine pericardium in rat subcutaneous implantation model.

Study on genipin: a new alternative natural crosslinking agent for fixing heterograft tissue.

BACKGROUND: In cardiac surgery, especially in the reconstruction of vascular structures and intracardiac defects, glutaraldehyde has usually been used as the reagent for fixing porcine or bovine pericardial tissues. But the well-known problem of calcification or cytotoxicity of glutaraldehyde motivates the search for a replacement. The aim of this study is to investigate the physical, mechanical, and biochemical characteristics of bovine pericardial tissues fixed with genipin, which is known to be a less toxic and more natural fixing reagent. MATERIALS AND METHODS: Bovine pericardial tissues were fixed with different concentrations and conditions of glutaraldehyde and genipin. To determine the physical, mechanical, and biochemical differences among different concentrations and conditions, we divided the tissue into 18 groups by concentration, the addition of organic solvents, and the timing of adding the organic solvents, and compared the characteristics of each group. RESULTS: Tensile strength, physical activity, and thermal stability tests revealed that the tissues fixed with glutaraldehyde were better with regard to mechanical strength and biochemical durability. However, the difference was not significant statistically. CONCLUSION: Genipin can be used as an alternative crosslinking agent for pericardial tissue, considering given its physical, mechanical, biochemical characteristics and low cytotoxicity comparable to glutaraldehyde. However, further studies are needed on the immune reaction and the long term changes in genipin-fixed tissues in the human body.

Synchronous development of KIT positive acute myeloid leukemia in a patient with gastrointestinal stromal tumor.

We report a case of synchronous occurrence of KIT-positive acute myeloid leukemia (AML) and gastrointestinal stromal tumor (GIST). A 63-year-old woman was hospitalized for dizziness, and abdominal computed tomography revealed an exophytic gastric mass and hepatic metastasis. The patient was diagnosed with GIST and was administered imatinib (400 mg/day) for the metastatic unresectable tumor. After 2 weeks of imatinib treatment, the patient developed pancytopenia, which persisted even after the drug was discontinued, thereby necessitating bone marrow biopsy. Biopsy examination indicated AML, and karyotyping revealed a complex karyotype. We did not observe point mutations at residues D816 and N822 of KIT. Therefore, the patient received standard induction chemotherapy, but on the 18(th) day after completion of chemotherapy, she died of septic shock and multi-organ failure. Since KIT plays an important role in both GIST and AML, we consider that both these malignancies may have been associated with each other.