Ménétrier’s disease is a rare, acquired, premalignant disorder of the stomach distinguished by hypertrophic giant mucosal folds in the proximal part of the stomach (body and fundus), diminished acid secretion and excessive mucous production, resulting in hypoalbuminemia. Menetrier’s is also known as hypoproteinaemic hypertrophic gastropathy and giant hypertrophic gastritis. We present a case of four siblings who presented between 2010 and 2017 with symptomatic iron deficiency anaemia or upper gastrointestinal symptoms with confirmed Ménétrier’s disease.
The etiology of Ménétrier’s disease is unknown but it has been linked to raised TGF-α (transforming growth factor alpha protein) in the gastric mucosa causing increased signalling of epidermal growth factor. It is also associated with infections such as cytomegalovirus and
Helicobacter pylori
. Despite these associations, there have been cases without any of these viruses detected.
Diagnosis is usually made by barium swallow or endoscopic evaluation, which characteristically shows thickened gastric folds, while the biopsies' hallmark feature is massive foveolar hyperplasia. We present a case series of four siblings who presented between 2010 and 2017 with symptomatic iron deficiency anaemia or upper gastrointestinal symptoms with confirmed Ménétrier’s disease.
Research on reinforced concrete (RC) beam-column connections has significantly increased during the past few decades. Interest in this topic is related to the importance of beam-column connections in maintaining the integrity of the whole structure. The slotted RC beam-column connection was investigated as a promising low damage beam-column connection replacement for conventional design. A slotted RC beam consists of a conventional RC beam, modified with a narrow vertical slot adjacent to the face of the column that runs approximately threequarters of the beam depth. This study reviews the literature on the mechanics and design of slotted beams, illustrating the works of various researchers on developing and modifying this innovative system. Then, the research progress in the behavior of slotted RC beams is briefly described, in chronological order, to place each contribution in a wider context. Extremely promising structural performance was observed due to minimum beam elongation, non-tearing action, minimum cracks, high energy dissipation, and stable hysteresis response. At the end of the study, a list of the main gaps that need further investigation and recommendations to fill out these gaps are provided.
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