Methotrexate therapy for primary biliary cirrhosis.

Objective: Preliminary data suggested possible benefits of methotrexate in primary biliary cirrhosis. We assessed the effectiveness of methotrexate use in primary biliary cirrhosis and its tolerance in patients with this disease.

Methods: A total of 110 primary biliary cirrhosis patients began methotrexate 15 mg/wk; for most, ursodeoxycholic acid was added during the study.

A carcinoid tumor associated with chylous ascites and elevated tumor markers.

The case is reported of a 74-year-old woman with a carcinoid tumor associated with chylous ascites and elevated tumor markers, CEA, and CA-125. In addition, the novel use of chromogranin-A quantitative assay from peripheral blood and ascetic fluid is discussed. The patient's clinical course and beneficial response to chemotherapy is also discussed and previous similar cases reported in the English-language literature are reviewed.

The role of the fecal stream in Crohn's disease: an historical and analytic review.

Since 1939, a series of clinical reports and laboratory investigations have suggested that the intestinal fecal stream may play a significant part in the pathogenesis of Crohn's disease (CD). The beneficial effect of exclusion of the stream by ileostomy was followed by improvement in patients with CD of the ileum and colon despite little change in the histopathology of the excluded loop, even to the point of allowing restoration of intestinal continuity in some patients. End ileostomy lowers the risk of recurrence of CD compared with anastomotic operations.