[Complete and sustained remission of liver metastases from neuroendocrine tumor with somatostatin analogue therapy].

Somatostatin analogues represent a major treatment modality in the therapy of neuroendocrine tumors. Their efficacy is well documented in the inhibition of hormone secretion; however, novel data seem to underline their effectiveness in tumor regression, as well. In this report authors present a case of type 1 neuroendocrine tumors of the stomach associated with liver metastases.

Effect of proton-pump inhibitor therapy on serum chromogranin a level.

Background: The neuroendocrine marker, chromogranin A (CgA) increases during medium- or long-term proton-pump inhibitor (PPI) treatment.

Aims: To analyze the effect of ultra-short-term and diverse dose of PPI therapy on serum CgA and gastrin levels and evaluate the effect of PPI treatment cessation.

Patients And Methods: Fasting serum CgA and gastrin were determined in newly diagnosed gastroesophageal reflux disease (GERD) patients (n = 54) treated with diverse doses of PPI during a 28-day period, in patients treated with PPIs for at least 6 months (n = 42), and in subjects where PPI treatment could be stopped (n = 11).

[Carcinoid tumors].

The authors review the most important clinical aspects of carcinoid tumors. Carcinoid tumors originating in neuroendocrine cells are rare, usually slowly-growing neoplasms, however, they may present as aggressive and rapidly progressing tumors. Epidemiologic data indicates that their prevalence is gradually increasing, which may be explained, at least in part, by the development and wider use of advanced diagnostic methods.

[Novel aspects in the pathogenesis of gastroesophageal reflux disease].

Unlabelled: In addition to lower esophageal sphincter (LES) relaxations and decreased LES tone, increased intra-abdominal pressure can also play role in the pathogenesis of gastroesophageal reflux disease (GERD),.

Aim: To analyze the correlation between occupation-related increased intra-abdominal pressure or straining (experienced for years) and the prevalence of GERD symptoms.

Methods: Reflux symptoms were analyzed through a questionnaire among professional singers, wind players and glassblowers in comparison with controls.

Gastroesophageal reflux disease: work-related disease?

Background: An occupation-related susceptibility of professional singers to experience gastroesophageal reflux has been suggested.

Aims: To investigate the prevalence of gastroesophageal reflux symptoms in a series of professional opera choristers, wind players, glassblowers and water polo players in comparison with a sample of general population.

Subjects And Methods: A total of 202 professional opera choristers from well-known choirs in different Hungarian regions, 71 professional wind players, 43 glassblowers, 54 water polo players were identified and 115 control subjects were compared prospectively.

Peptic esophageal stricture: medical treatment.

Peptic esophageal stricture as a consequence of gastroesophageal reflux disease is the most frequent among benign esophageal strictures. The incidence is low and has been decreasing since the 1990s with a parallel increase in proton pump inhibitor use. Dysphagia is a common symptom: accurate diagnostic procedures (barium esophagogram, upper endoscopy with biopsies) have to be performed to exclude malignant causes first.

Diagnosis and recognition of early esophageal neoplasia.

Barrett's esophagus (BE) is the precursor lesion of esophageal adenocarcinoma, a malignancy with increasing incidence in Western countries. Malignant transformation of Barrett's metaplasia is a multistep process in which intestinal metaplasia progresses through low-grade and high-grade dysplasia into eventually invasive cancer. Several risk factors for the development of BE have been identified.

Comparison of the effects of 1,25 dihydroxyvitamin D and 25 hydroxyvitamin D on bone pathology and disease activity in Crohn's disease patients.

Background: Vitamin D is essential for osteopenia therapy in Crohn's disease (CD). The active form of vitamin-D (aVD) is the 1,25(OH)2D. There are no data available whether aVD or plain vitamin-D (pVD) has any advantage in managing osteoporosis in CD or has any effect on the activity of the disease itself.

Increased p53 expression in the malignant transformation of Barrett's esophagus is accompanied by an upward shift of the proliferative compartment.

Neoplastic progression in Barrett's esophagus (BE) occurs by a multistep process associated with early molecular and morphological changes. This study evaluated cell proliferation and p53 expression and their correlation in the development and progression of esophageal adenocarcinoma. PCNA and p53 expressions were analyzed in biopsy samples by immunohistochemistry including patients with reflux esophagitis, BE, BE with concomitant esophagitis, Barrett's dysplasia, esophageal adenocarcinoma and a control group without any histological changes.

[Bowel gases].

Abdominal bloating is one of the most common symptoms in patients with different gastrointestinal disorders. The majority of patients usually attribute this complaint to increased intestinal gas volume. Recent experimental studies using the gas challenge test help us to better understand the gas dynamics and tolerance in humans.

[Novel therapeutic approaches in the treatment of irritable bowel syndrome].

The treatment of irritable bowel syndrome due to the heterogeneous clinical symptoms and coexisting psychiatric disorders is still controversial. Although several agents with different mechanisms of action are widely used in clinical practice, there are only few drugs available with strong evidence of their efficacy, safety and tolerability at present. The etiology of irritable bowel syndrome is considered to be multifactorial: experimental and clinical research on visceral hypersensitivity, motility and brain-gut axis involving its neurotransmitters and receptors created the foundation of novel therapeutic approaches.

Alterations of glutathione S-transferase and matrix metalloproteinase-9 expressions are early events in esophageal carcinogenesis.

Aim: To investigate the role of glutathione S-transferase (GST) and matrix metalloproteinase-9 (MMP-9) expressions in the development and progression of reflux esophagitis-Barrett's metaplasia-dysplasia-adenocarcinoma sequence in the esophagus.

Methods: GST and MMP-9 expressions were analyzed in 51 paraffin-embedded tissue samples by immunohistochemistry including patients with reflux esophagitis (n = 7), Barrett's metaplasia (n = 14), Barrett and esophagitis (n = 8), Barrett and dysplasia (n = 7), esophageal adenocarcinoma (n = 8) and a control group without any histological changes (n = 7). Immunostaining was determined semiquantitatively.

Hepatitis C virus infection in a resident elderly population: a 10-year follow-up study.

Background: The natural history of hepatitis C virus infection in the elderly is poorly known.

Objective: To assess the mortality rate, the progression of liver disease, the hepatitis C virus carrier state and the co-morbidity in a cohort of 35 out of 1,063 anti-hepatitis C virus positive elderly people prospectively followed-up from 1992 to 2002.

Methods: Liver function tests, hepatitis C virus-RNA analysis, hepatitis C virus genotyping and abdominal ultrasonography were assessed at the beginning of the study, and then, liver function tests and ultrasonography were performed annually during the first 5 years of the follow-up.

[Is the successful eradication of Helicobacter pylori sufficient for the healing of peptic ulcer?].

Helicobacter pylori has a major role in the pathogenesis of peptic ulcer disease. Cure of the infection is essential in ulcer healing, but an additional PPI therapy after completing eradication treatment is widespread in clinical practice. In the present work clinical studies evaluating peptic ulcer healing followed or not by PPI treatment after eradication therapy were analyzed.

[Gaucher's disease: pathogenesis, diagnosis and therapy].

Gaucher's disease is the most common lysosomal storage disorder. Gene defect leads to deficiency or decreased activity of glucocerebrosidase followed by the accumulation of glucosylceramide. Most frequently hepatosplenomegaly, anemia, skeletal and hematological abnormalities are present.

[Osteoporosis associated with inflammatory bowel diseases].

Inflammatory bowel diseases, most frequently Crohn's disease, are frequently accompanied by decreased bone mineral content (30-70%). The osteopenia is not explained by the side effects of treatment or the secondary malabsorption. There must be a common pathological pathway in the background.