Small bowel adenocarcinoma presenting as a first manifestation of Crohn's disease: report of a case, and a literature review.

Small bowel Crohn's disease has been related to an increased incidence of small bowel adenocarcinoma, but the total number of reported cases is small. We present an interesting case of a young male patient with nephrolithiasis in childhood, an atypical intermittent history of diarrhoea also since his childhood, who developed obstructive ileus and underwent an urgent operation. The operation revealed a stenosis of the ileum owing to a mass, which proved to be a small bowel adenocarcinoma.

The true value of serum elastase-1 in endoscopic retrograde cholangiopancreatography (ERCP).

BACKGROUND: The routine use of serum elastase-1 in patients, pre- and post-endoscopic retrograde cholangiopancreatography (ERCP), has been strongly supported but not sufficiently correlated with diagnosis, patient outcome/prognosis, or routine markers such as serum amylase. The value of serum elastase-1 post-ERCP, as far as clinical diagnosis and prognosis is concerned, was tested and compared with serum amylase in terms of sensitivity, specificity, positive prognostic value (PPV), and negative prognostic value (NPV). METHODS: In a prospective study of 38 consecutive patients undergoing ERCP, we assessed the following biochemical parameters 24 h before ERCP and 2 and 18 h after ERCP: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (gamma-GT), alkaline phosphatase (ALP), amylase (AMS), lactate dehydrogenase (LDH), and pancreatic elastase-1.

CT colonoscopy for obstructive sigmoid endometriosis: a new technique for an old problem.

Endometriosis of the sigmoid colon is a pathologic entity which is infrequently reported. A 29-year-old woman was admitted to the hospital because of abdominal pain, constipation, and menstrual rectal bleeding. Endometriosis was suspected, and CT (virtual) colonoscopy showed severe stenosis of the orthosigmoid canal due to a submucosal mass.

Alarming atrioventricular block and mitral valve prolapse in the Kearns-Sayre syndrome.

Kearns-Sayre syndrome (KSS) is a multisystem mitochondrial disorder characterized by the invariant triad: onset before 20, progressive external ophthalmoplegia and pigmentary retinal degeneration, plus at least one of the following: complete (or not) heart block, cereberal dysfunction and CSF protein above 100 mg/dl. Autopsies from patients with KSS revealed widespread tissue distribution mtDNA deletions. These deletions result in significantly lower activities of the enzymes of the respiratory chain.

Reduced serum insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 levels in adults with inflammatory bowel disease.

In the present study, the changes in circulating IGF-1 and its binding protein IGFBP-3 were determined in adult patients with active inflammatory bowel disease (IBD) in order to assess the effect of this inflammatory condition on the IGF system. IGF-1 and IGFBP-3, as well as interleukin-6 (IL-6) were measured in serum obtained from 22 consecutive newly diagnosed patients (mean age 41.3 years) with active IBD, including 10 patients with Crohn's disease (CD), and 12 with ulcerative colitis (UC).

High CA 19-9 levels in benign biliary tract diseases. Report of four cases and review of the literature.

For years, CA 19-9 has been proposed as a marker for epithelial-type gastrointestinal cancers, even though it is well known that its diagnostic specificity is low. Here we describe cases of extremely high CA 19-9 levels in benign biliary tract diseases. The first case involved a 77-year-old male patient with choledocholithiasis and jaundice who was found to have CA 19-9 levels of 98,628 UI/ml.

Manometric study in Kearns-Sayre syndrome.

Although swallowing difficulties have been described in patients with Kearns-Sayre syndrome (KSS), the spectrum of manometric characteristics of dysphagia is not yet well known. Moreover, it is conceivable that a combination of various degrees of swallowing difficulties with different patterns in manometric studies exist, each playing a major role in the prognosis, natural history, and quality of life of KSS patients. An 18-year-old girl diagnosed at the age of 5 years with KSS (muscle biopsy) was admitted to our department with an upper respiratory tract infection and dysphagia.

Severe hypomagnesemia and hypoparathyroidism in Kearns-Sayre syndrome.

Kearns-Sayre syndrome (KSS) is a multisystem mitochondrial disorder characterized by the invariant triad: onset before 20, progressive external ophthalmoplegia and pigmentary retinal degeneration, plus at least one of the following: complete heart block, cerebellar dysfunction and CSF protein >100 mg/dl. Autopsies from patients with KSS revealed widespread tissue distribution of mitochondrial (mt) DNA deletions. These deletions result in significantly lower activities of the enzymes of the respiratory chain.

Skin lesion's treatment with alfa interferon in a patient with B-CLL.

Treatment with recombinant alfa-2b-interferon in a patient with advanced B-CLL resulting in complete remission of skin lesions after one month therapy is reported in this paper. Interferon was administered subcutaneously three times weekly. Six months later while the treatment continued, the disease remained stable.