Is narrow-band imaging a useful tool in screening colonoscopy performed by an experienced endoscopist? A prospective randomised study on 533 patients.

Introduction: The detection of adenomas is the basic goal for colorectal cancer screening programs; therefore, every possibility to improve the adenoma detection rate is valuable.

Aim: To answer the question of whether narrow-band imaging (NBI) can enhance detection quality in screening for colonoscopy.

Material And Methods: A group of 533 patients (202 men: 331 women; average age: 56.

Cogan's Syndrome in Patients With Inflammatory Bowel Disease--A Case Series.

Background: Cogan's syndrome (CSy) is a very rare autoimmune disorder, mainly affecting the inner ear and the eye, and is associated with inflammatory bowel disease (IBD).

Methods: This was a European Crohn's and Colitis Organisation (ECCO) retrospective observational study, performed as part of the CONFER project. A call to all ECCO members was made to report concomitant CSy and inflammatory bowel disease (IBD) cases.

A microRNA-based test improves endoscopic ultrasound-guided cytologic diagnosis of pancreatic cancer.

Background & Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in combination with cytopathology is the optimal method for diagnosis and staging of pancreatic ductal adenocarcinoma (PDAC) and other pancreatic lesions. Its clinical utility, however, can be limited by high rates of indeterminate or false-negative results. We aimed to develop and validate a microRNA (miRNA)-based test to improve preoperative detection of PDAC.

Differentiation of pancreatobiliary cancer from benign biliary strictures using neutrophil gelatinase-associated lipocalin.

Aim of the study was to investigate the value of serum and bile neutrophil gelatinase-associated lipocalin (NGAL) for distinguishing malignant strictures caused by cholangiocarcinoma (CCA) or pancreatic cancer from benign biliary strictures. The study was performed prospectively on patients admitted for endoscopic or radiologic biliary decompression. Forty patients with dilated biliary ducts, including 16 cases of CCA, 6 cases of pancreatic cancer, and 18 cases of benign biliary stricture were enrolled.

Non-endoscopic diagnosis of multifocal atrophic gastritis; efficacy of serum gastrin-17, pepsinogens and Helicobacter pylori antibodies.

Background/aims: Infection with H. pylori is an important risk factor for the development of gastric cancer and glandular atrophy is an intermediate stage in gastric carcinogenesis. While screening the patients with atrophic gastritis by endoscopy is unrealistic, a concept of "serological gastric biopsy" based on measurement of gastric secretory proteins and peptides should be further validated.

[Estimation of appropriateness of colonoscopy using RAND/UCLA method].

Multicenter European trials estimating appropriateness of colonoscopy are one of the hot topics in gastroenterology. The aim of the study was the estimation of appropriateness of colonoscopy and usefulness of panel experts criteria (elaborated according to RAND/UCLA method) in Department of Gastroenterology of Medical University of Silesia in Katowice and other gastroenterology centers throughout Europe. The trial was conducted between January 1st 2001 and May 30th 2001 in 18 centers in 9 European countries.

[Comparison of technical aspects of colonoscopy in various gastroenterologic centres].

There are ongoing multicenter European trials analyzing, among other factors, technical aspects of colonoscopy in various countries. The aim of the study was to compare the techniques of preparation and performance of colonoscopy in the Department of Gastroenterology at Medical University of Silesia in Katowice and other gastroenterology centers throughout Europe. The trial was conducted between January 1st 2001 and May 30th 2001 in 18 centers in 9 European countries.

[Evaluation of probability of bile duct stone presence by using of non-invasive procedures].

Precise evaluation of bile duct stones presence in particular moment, performed using the most non-invasive method, is important for the planning of optimal treatment. Not only simple imaging procedures (like conventional transabdominal ultrasound--US) but also more sophisticated imaging methods (CT or MRI) are frequently useless. The "gold standards" of bile duct stones diagnosis are still endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy and surgical choledochotomy.

[Digestive tract hemorrhage and recurrent ileus. Peutz-Jeghers syndrome-case report].

Authors describe a case of 24 years old woman with recurrent lower GI bleeding and mechanical obstruction. Crohn's disease was diagnosed at the beginning. It was impossible to treat the patient's profound anemia with blood transfusions due to her religion believes.

Even young patients with no alarm symptoms should undergo endoscopy for earlier diagnosis of gastric cancer.

Background And Study Aims: There has been a tendency in recent years to omit endoscopy in dyspeptic patients younger than 45 years with no so-called "alarm symptoms." This study was conducted to test whether this policy might lead to an increased rate of delayed diagnosis of gastric cancer, especially in a population with a high prevalence of the disease.

Patients And Methods: The study included 860 patients (465 women, 395 men; median age 44) referred for the first time for upper gastrointestinal endoscopy because of suspected upper gastrointestinal pathology, to a secondary referral center between 1983 and 1993.

Neuroendocrine pancreatic carcinoma causing sinistral portal hypertension.

Background: Non-functioning neuroendocrine pancreatic tumors are usually connected with non-specific syndromes.

Case Report: This case history presents the diagnosis and treatment of a non-functioning neuroendocrine pancreatic tumor causing sinistral portal hypertension and gastrointestinal bleeding in a 36-year-old man.

Results: A peripheral resection of the pancreas with splenectomy was performed.

Neurogenic tumors of the digestive tract: report of two cases.

We report two female patients with neurogenic tumors of the digestive tract. In the first patient, the tumor of 10 cm diameter originated in the stomach and at preoperative CT imitated a peripancreatic cyst. In the second patient, the tumor of 6 cm diameter originated in the duodenum.

[Endoscopic ultrasonography in the preoperative localization of a pancreatic tumor producing insulin (insulinoma)].

Pancreatic endocrine tumors include insulinomas, gastrinomas and some other less frequent neoplasms produce different GI hormones. Preoperative localization of the tumor in patients with evident clinical and biochemical features is usually difficult to obtain in conventional imaging methods. This is due to typically small size of these tumors.

Cardiovascular status after postural change in compensated cirrhosis: an argument for vasodilatory concept.

It seems that hypervolemia and vasodilatation coincide in compensated cirrhosis, but neither rank nor importance of these factors has been fully clarified in adaptive response to postural change. We studied, with gated equilibrium radionuclide angiography and thoracic electrical bioimpedance the hemodynamic status of 19 patients with compensated cirrhosis and 18 healthy subjects in upright and supine positions. In the upright position, the cirrhotic patients were hypotensive and had decreased peripheral vascular resistance despite increased cardiac output.

Short-term effects of variceal sclerotherapy on portal hypertensive gastropathy.

Background And Study Aims: Obliteration of esophageal varices may modify the mucosal perfusion of the stomach. The relationship between short-term injection variceal sclerotherapy (IVS) and the evolution of portal hypertensive gastropathy (PHG) is insufficiently recognized.

Patients And Methods: Forty-one cirrhotic patients were treated with hemostatic or secondary preventive IVS.

Effect of propranolol on portosystemic collateral circulation estimated by per-rectal portal scintigraphy with technetium-99m pertechnetate.

Background/aims: Propranolol is widely used in the prevention of variceal bleeding. However, in certain patients with cirrhosis, the portal hypotensive effect of propranolol cannot be obtained. An explanation for portal unresponsiveness to propranolol could be an increase in portocollateral vascular resistance mediated by this drug.

[Per-rectal scintigraphy of the portal system with pertechnetate TC-99M: clinically useful examination of patients with chronic liver disease.Part I].

Per-rectal portal scintigraphy with Tc-99m pertechnetate is a method to evaluate portosystemic shunting (shunt index) in inferior mesenteric vein. In this study the shunt index was estimated in patients with chronic liver disease in relation to the severity of liver injury, portal hypertension and incidence of oesophageal varices. Shunt index was elevated in patients with non-cirrhotic liver disease as compared with healthy normals (34 +/- 6% vs 8 +/- 2%; p < 0.

[Per-rectal scintigraphy of the portal system with pertechnetate TC-99M: effect of propranolol on portosystemic collateral circulation in patients with cirrhosis. Part II].

Propranolol can reduce portal hypertension, therefore is recommended in prevention of variceal bleeding in patients with liver cirrhosis. However, in certain patients with cirrhosis portal hypotensive effect of propranolol cannot be obtained, and the reason of this finding is unknown. In 28 patients with cirrhosis the effect of seven days administration of propranolol on collateral blood flow from inferior mesenteric vein was examined by means of per-rectal portal scintigraphy.

Portal shunting in inferior mesenteric vein in cirrhosis: correlation with hemorrhage from esophageal varices.

Objective: Certain patients with portal hypertension develop large esophageal varices, whereas others have small varices, or none. Our objective in this study was to determine whether this variability depends upon the amount of blood derived by peripheral portosystemic collaterals.

Methods: Esophagogastroscopy to determine presence and size of esophageal varices, and pre-rectal portal scintigraphy to assess portosystemic shunt index (PSI) in inferior mesenteric vein were performed in 45 cirrhotics and 17 patients with pre-cirrhotic liver disease.

[Cystic hepatic malignant tumors].

Non-parasitic hepatic cysts are common finding at abdominal sonography and in vast majority they are benign lesions. We report two cases of cystic liver neoplasms, namely the biliary cystadenocarcinoma and malignant hemangioendothelioma. In both cases, despite slow development of the tumour the presence of cyst considerably delayed diagnosis and hindered surgical treatment.

[Angiomatosis of the liver].

Cavernous haemangioma of the liver is the most frequently observed benign hepatic tumour. Polyangiomatosis is a great rarity, and in view of the similarity to metastatic tumours, it is a serious diagnostic problem. In the paper three cases are described of polyangiomatosis of the liver diagnosed on the basis of abdominal ultrasonography.

[Evolution of cutaneous changes observed in cirrhosis patients before and after liver transplantation].

Unlabelled: In 11 patients with liver cirrhosis a prospective study concerning the evolution of skin changes before and after liver transplantation was performed. Etiology of the disease was: alcoholic in 5 cases, post-inflammatory in 4 cases and primary biliary cirrhosis in 2. Evolution of: nevi spiders, erythema palmar, changes in nails, Hippocrates fingers, discoloration of legs, bilateral Dupuytren's disease and gynecomastia (in man) were estimated.

Clinical utility of quantitative assessment of liver haemodynamics in cirrhosis provided by dynamic hepatoscintigraphy.

Interrelationships between quantitative assessment of portal (%Qp) and arterial (%Qa) components of hepatic blood supply obtained by dynamic hepatoscintigraphy, and clinical variables characterizing the severity of liver cirrhosis and portal hypertension were studied in 25 cirrhotic patients. The variables, clinical state, size of oesophageal varices, ascites accumulation, sonographic stigmata of portal hypertension, liver mass and elimination rate of lidocaine and antipyrine were studied. The %Qa rose in proportion to the severity of liver injury estimated from the Child-Turcotte and McCormick grading scores.