Conundrum of a Large Bowel Neoplasm: Collision Tumor.

A 79-year-old Hispanic man was admitted to the intensive care unit with symptomatic iron-deficiency anemia and watery diarrhea. Radiological images revealed diffuse colonic wall thickening, a soft-tissue fullness in the ascending colon, and multiple mesenteric lymphadenopathies. Colonoscopy showed multiple aphthous ulcers throughout the colon and a large deep ulcer with irregular raised borders in the rectosigmoid area. Histological exam of the ulcers showed severe ulcerative colitis, while biopsy of the deep ulcer revealed a well-differentiated adenocarcinoma. Colectomy specimen was consistent with colliding diffuse large B-cell lymphoma and adenocarcinoma.

Diagnostic Yield of Video Capsule Endoscopy for Small Bowel Bleeding: Eight Consecutive Years of Experience at the VA Caribbean Healthcare System.

OBJECTIVE: To evaluate the diagnostic yield of video capsule endoscopy (VCE) in patients with small bowel gastrointestinal bleeding and examine the impact of this diagnostic technology on the clinical management of this complaint. METHODS: This was a retrospective study in which all patients who underwent VCE (May 7, 2003 - December 31, 2011) were included. Records were reviewed for the type of bleeding (overt vs. occult; when present), demographic data, lab results, and capsule endoscopy findings. Information regarding medical treatment (i.e., endoscopic intervention, surgical therapy, or both) was also recorded. RESULTS: A total of 229 subjects were included in the study. Most were men; the mean age of all the subjects was 69.8 years. Of the 229 VCEs, 154 (67.3%) were done because of occult bleeding and 75 (32%) because of overt bleeding. VCEs were normal in 34 (14.9%) cases and non-diagnostic in 15 (6.6%). Angiodysplasia, erosions, and ulcers were the most common findings (48.5%, 24.5%, and 10.92% respectively). Active bleeding was reported in 7 cases (3%). Nearly 20% of the 229 cases required either endoscopic or surgical intervention. CONCLUSION: In our study, VCE achieved a diagnostic yield of 78.6%. In 1 of every 5 subjects, video capsule endoscopy led to the identification of small bowel lesions that required either endoscopic or surgical resection, rather than conservative treatment with iron replacement. VCE proved to be a very useful investigative tool, not only for establishing the source of bleeding but also, most importantly, for directing the appropriate therapy for lesions that would otherwise have been missed by conventional studies.

Evaluation of two human dental pulp stem cell cryopreservation methods.

Dental pulp is a promising source of mesenchymal stem cells for use in cell therapy and regenerative medicine. Methods for storing stem cells with minimum compromise of cell viability, differentiation capacity and function should be developed for clinical and research applications. The aim of this study was to evaluate whether human dental pulp stem cells (hDPSCs) isolated and cryopreserved for 1, 7 and 30 days maintain viability and expression of specific stem cell markers. Human dental pulp stem cells were isolated from 23 healthy patients aged 18 to 31 years. Dental pulp was enzymatically dissociated, and CD105+ cells were separated using the Miltenyi™ system. The hDPSCs were cryopreserved using the Kamath and Papaccio methods. Post-cryopreservation viability was measured by flow cytometry (7AAD) and by the expression of the phenotype markers CD105+/ CD73+, CD34-/CD45-. The Papaccio method showed greater cell viability for cells that had been frozen for 30 days (59.5%) than the Kamath method (56.2%), while the Kamath method provided better results for 1 day (65.5%) and 7 days (56%). Post-cryopreservation expression of the markers CD105+/CD34- was greater after 1 and 7 days with the Kamath method and CD105+/CD45- were expressed after all 3 cryopreservation times. There was greater expression of CD73+ in the hDPSCs after 1 and 7 days with the Kamath method, and after 30 days with the Papaccio method. These results suggest that hDPSCs express mesenchymal stem cell markers after cryopreservation. However, cryopreservation time may affect marker expression, probably by altering the spatialconfiguration of cell membrane proteins or by compromising cells at a certain level of differentiation.

Evaluation of two human dental pulp stem cell cryopreservation methods / Evaluación de dos métodos de criopreservación de células troncales de pulpa dental humana

La pulpa dental es una fuente promisoria de células madre mesenquimales para ser utilizadas en terapia celular y medicina regenerativa. El desarrollo de métodos que permitan almacenar las células madre con mínimo compromiso de la viabilidad celular, capacidad de diferenciación y función es necesario para aplicaciones clínicas e investigación. El objetivo de este estudio fue evaluar si las células troncales depulpa dental humana (hDPSCs) aisladas y criopreservadas durante 1, 7 y 30 días conservan la viabilidad y expresiónde marcadores específicos de células troncales pos crio-preservación. Para esto, las hDPSCs se aislaron de 23pacientes sanos entre 18 y 31 años. La pulpa dental se disoció enzimáticamente, y las células CD105+ se separaron mediante el sistema Miltenyi™. Posteriormente, las hDPSCs se criopreservaron utilizando el método de Kamath y de Papaccio, se evaluó la viabilidad pos crio-preservación porcitometría de flujo (7AAD) y la expresión de marcadores CD105+/ CD73+, CD34-/CD45-. El método de Papaccio, mostró mayor viabilidad celular a los 30 días (59,5 por ciento)comparado con el método de Kamath, a 1 día (65,5%) y 7 días (56%) respectivamente. Se observó mayor expresión de los marcadores CD105+/CD34- a 1 y 7 días pos-criopreservación con el método Kamath y CD105+/CD45- a los 3 tiempos decriopreservación. CD73+ presentó mayor expresión en las hDPSCs a las 24 horas y 7 días con el método de Kamath, y al mes con el método Papaccio. Estos resultados sugieren que las hDPSCs expresan marcadores de células troncales mesenquimales postcriopreservación. Sin embargo el tiempo de criopreservación podría modificar la expresión de los marcadores probablemente por alterarla configuración espacial de las proteínas de membrana celular; o por comprometer a las células a cierto grado de diferenciación.

Dental pulp is a promising source of mesenchymal stem cells for use in cell therapy and regenerative medicine. Methods for storing stem cells with minimum compromise of cell viability, differentiation capacity and function should be developed for clinical and research applications. The aim of this study was toevaluate whether human dental pulp stem cells (hDPSCs)isolated and cryopreserved for 1, 7 and 30 days maintain viability and expression of specific stem cell markers. Human dental pulp stem cells were isolated from 23 healthy patients aged 18 to 31 years. Dental pulp was enzymatically dissociated, and CD105+ cells were separated using the Miltenyi™ system.The hDPSCs were cryopreserved using the Kamath andPapaccio methods. Post-cryopreservation viability wasmeasured by flow cytometry (7AAD) and by the expression of the phenotype markers CD105+/ CD73+, CD34-/CD45-. The Papaccio method showed greater cell viability for cells that had been frozen for 30 days (59.5%) than the Kamath method (56.2%), while the Kamath method provided better results for 1 day (65.5%) and 7 days (56%). Post-cryopreservation expression of the markers CD105+/CD34- was greater after 1 and 7 days with the Kamath method and CD105+/CD45- were expressed after all 3 cryopreservation times. There was greaterexpression of CD73+ in the hDPSCs after 1 and 7 days with the Kamath method, and after 30 days with the Papaccio method. These results suggest that hDPSCs express mesenchymal stem cell markers after cryopreservation. However, cryopreservationtime may affect marker expression, probably by altering the spatialconfiguration of cell membrane proteins or by compromising cells at a certain level of differentiation.