Increased prevalence of colorectal adenomas in women with breast cancer.

Background: The frequency of colorectal adenomas and carcinomas was investigated in a large cohort of women with breast cancer in comparison with matched controls, since data on the occurrence of second tumors in women with breast cancer is controversial.

Design: In a cohort study, 188 consecutive women (median age 57 years) with primary breast cancer and 376 age-matched women who served as controls were examined by total colonoscopy. Breast cancer patients and controls were compared for the frequency of colorectal adenomas and carcinomas.

Screening for p53 and K-ras mutations in whole-gut lavage in chronic inflammatory bowel disease.

Objectives: Molecular screening for frequently mutated genes may increase the likelihood of identifying cancer risk groups, such as patients with longstanding inflammatory bowel disease. This study investigated the prevalence and time course of p53 and K-ras mutations in colonic lavage fluid of patients with inflammatory bowel disease.

Methods: Colonic lavage fluid from 190 patients with ulcerative colitis (73), Crohn's disease (58) or controls (49 non-tumour, 10 colorectal cancer) was studied by oligomer-specific hybridization for K-ras mutations and single-strand conformation polymorphism (SSCP) for p53 mutations.

Cross-sectional imaging findings in congenital intestinal lymphangiectasia.

A 37-year-old woman presented with an 18 month history of recurrent severe abdominal pain, recurrent diarrhea since her second year of life, and mild peripheral edema. CT and more clearly MRI revealed signs of small bowel and mesenterial edema with partial tubular appearance, which correlated well with the histopathologic findings shown in duodenal biopsy. This is the first report of MR findings in congenital intestinal lymphangiectasia with correlation with other imaging modalities.

Dysplasia of the submucous nerve plexus in slow-transit constipation of adults.

Aim: A clinicopathological entity, intestinal neuronal dysplasia type B (IND) has been described in children with severe constipation. The present study was designed to evaluate whether IND could be identified in adult patients with idiopathic slow-transit constipation.

Methods: Rectal biopsies were taken from 27 constipated patients with documented slow colonic transit and 23 controls and stained for S100 protein, acetylcholine esterase and lactate dehydrogenase.

Endothelial cell autoantibodies are a marker of disease susceptibility in inflammatory bowel disease but apparently not linked to persistent measles virus infection.

Intestinal vasculitis caused by persistent measles virus infection of intestinal endothelial cells was described in Crohn's disease. Furthermore, endothelial cell autoantibodies have been demonstrated in inflammatory bowel disease (IBD). Autoantibodies against intestinal endothelial cells were visualized by indirect immunofluorescence in patients with IBD, in their healthy first-degree relatives, in patients with infectious enterocolitis, and in healthy, unrelated controls.

Clinical long-term follow-up results in intestinal neuronal dysplasia (IND).

Commonly available information on intestinal neuronal dysplasia (IND) is sparse. Especially well documented long-term courses are lacking. The aim of this study was to correlate defecation as a clinical parameter of the long-term course in malformations of the enteric nervous system with the morphological diagnosis.

Accuracy of 13C-urea breath test in clinical use for diagnosis of Helicobacter pylori infection.

Unlabelled: The 13C-urea breath test (UBT) is a noninvasive test for diagnosis of Helicobacter pylori infection of gastric mucosa. The aim of this prospective study was to assess the accuracy of a simple UBT in clinical routine use.

Methods: The study population comprised of 100 patients (49 f, 51 m) requiring diagnostic upper GI endoscopy.

Influence of age on 13C-urea breath test results in children.

Background: The 13C-urea breath test for diagnosis of Helicobacter pylori infection has not been validated in infants and young children. The influence of age on the test results was studied by conventional validation against invasive methods and by mathematical estimation in a large pediatric population.

Methods: The breath test was performed in 1499 children aged 2 months to 18 years.

Secondary ischaemia in experimental free flaps--treatment by long acting prostacyclin analogues.

Secondary postoperative ischaemia due to venous occlusion is the most detrimental insult to free microvascular flaps. In an experimental rat free flap model the efficacy of long acting prostacyclin analogues iloprost (Ilomedin) and cicaprost in venous occlusion induced postoperative ischaemia was studied. Free, microvascular groin flaps were transplanted to the neck and the draining veins were temporarily occluded on the first postoperative day for a total of 20 min.

Prevalence and clinical outcome of hepatitis C infection in children who underwent cardiac surgery before the implementation of blood-donor screening.

Background And Methods: There are few data on the prevalence and clinical outcome of hepatitis C infection in children. We studied 458 children who underwent cardiac surgery in Munich, Germany, before 1991, when blood-donor screening for hepatitis C was introduced in Germany. Their mean age at first operation was 2.

Unfractioned heparin in the therapy of patients with highly active inflammatory bowel disease.

Objective: Unfractioned heparin reportedly improves severe ulcerative colitis and Crohn's disease, but most of the few observations made have been published as abstracts. This prospective study evaluated whether heparin results in improvement of disease activity in patients with highly active, refractory ulcerative colitis or Crohn's disease.

Methods: Thirteen patients with ulcerative colitis and four patients with Crohn's disease received continuous intravenous heparin, aiming at a partial thromboplastin time of about 60 s for 2 wk.

Molecular screening of patients with long standing extensive ulcerative colitis: detection of p53 and Ki-ras mutations by single strand conformation polymorphism analysis and differential hybridisation in colonic lavage fluid.

Background: In patients with long standing ulcerative colitis at risk of developing malignancy, mutations of the p53 and Ki-ras gene were investigated in lavage solution obtained at surveillance colonoscopy.

Methods: DNA was isolated from 31 consecutive patients with total or subtotal ulcerative colitis and a disease duration of between seven and 26 years. Twenty seven control patients showed no macroscopic or microscopic inflammation on colonoscopy.

MPO-ANCA-Positive crescentic glomerulonephritis: a distinct entity of scleroderma renal disease?

Scleroderma renal crisis is characterized by intimal thickening of the afferent glomerular arterioles resulting in hypertension and fibrinoid necrosis of the capillary tuff. We report a 67-year-old man with long-standing systemic sclerosis who developed normotensive progressive renal failure, proteinuria, and a nephritic urinary sediment with serum myeloperoxidase-antineutrophil cytoplasmatic antibodies (MPO-ANCA). Renal biopsy showed pauci-immune crescentic glomerulonephritis but none of the typical vascular changes of scleroderma renal crisis.

[ARDS and Wegener granulomatosis].

Unlabelled: Wegener's granulomatosis is a distinct clinicopathologic entity characterized by granulomatous vasculitis of the upper and lower respiratory tract and glomerulonephritis. This disease can present as a clinical picture which resembles sepsis and adult respiratory distress syndrome (ARDS). Wegener's disease requires immunosuppression which can have detrimental consequences when used in sepsis.

[Hyperplastic polyps of the colon. An inhomogeneous group of pathologic-anatomic changes].

A total of 334 hyperplastic polyps of the colon of 266 patients were examined under epidemiologically, morphometrically and histochemically. Of these, 62 cases (23%) were associated with adenomas, 18 cases (7%) with carcinomas. Hyperplastic polyps are not entirely homogeneous, pathologically and -anatomically: Carcinoma-associated hyperplastic polyps are larger in diameter, the size and width of their crypts is greater, and they have a higher percentage of goblet cells with a higher amount of sialomucins as shown by HID/AB stain.

n-3 fatty acids only delay early relapse of ulcerative colitis in remission.

Relapse prevention by dietary n-3 fatty acids (5.1 g/day) was studied in a double-blind, placebo-controlled trial of 64 patients with ulcerative colitis in remission and off steroids. 5-ASA compounds were stopped three months after randomization and clinical disease activity monitored for two years.

Diagnostic value of histology in non-erosive gastro-oesophageal reflux disease.

Background: In the absence of oesophageal erosions longterm pH monitoring is the present gold standard for diagnosing gastro-oesophageal reflux disease (GORD). This method, however, is invasive, time consuming, expensive, and not generally available.

Aims: As histological changes have been described in GORD, this study looked at the possibility of whether the diagnosis of non-erosive reflux disease could be made by histological examination routinely during endoscopy.

Rectal suction biopsy: can it be sufficient to diagnose neuronal intestinal dysplasia?

Rectal suction biopsy is the diagnostic procedure of choice in aganglionosis even if only mucosal tissue is obtained. In neuronal intestinal dysplasia it is essential to include parts of the submucous layer. Therefore some biopsies are unsuitable because they lack submucous tissue.

Unconjugated secondary bile acids in the serum of patients with colorectal adenomas.

A positive association between deoxcholic acid (DCA) in the serum and colorectal adenomas, the precursors of colorectal cancer has recently been found, which supported the hypothesis of a pathogenic role of DCA in colonic carcinogenesis. This approach was based on the hypothesis that DCA formed in the colon is absorbed into the portal venous blood and exhibits a constant spillover to the systemic circulation. To further substantiate this hypothesis this study investigated whether in the serum of adenoma patients DCA was higher in the unconjugated fraction, which originates directly from the colon.

[Experimental studies of the no-reflow phenomenon with prostacyclin].

The no-reflow phenomenon is a dreaded complication in free tissue transplantations. After a critical period of warm ischemia, insufficient reflow is observed after vessel anastomosis and opening of the artery. In an experimental study in 72 rats, groin flaps were harvested with the nutrient superficial epigastric vessels and transplanted to the neck using a microvascular technique with anastomoses to the carotid artery and jugular vein.

[Increasing the survival rate of endangered free microvascular tissue transplants using a prostacyclin derivative].

Free flap transplantations and replantations of extremities are threatened by venous occlusion due to haematomas, contusions, and secondary healing of the surrounding tissues. In an experimental investigation in 18 Sprague-Dawley-rats, the influence of the Prostacyclin analogue Iloprost on temporary ischemia by venous occlusion was tested. Free groin flaps were transplanted to the neck of these animals with microanastomoses of the nutrient superficial epigastric vessels to the carotid artery and the jugular vein.