A Case of Eosinophilic Gastroenteritis with Ascites

Eosinophilic gastroenteritis is a rare disorder of unknown cause characterized by focal or diffuse eosinophilic infiltration of gastrointestinal tract, especially the stomach and duodenum. Its clinical presentation depends on which segment of gastrointestinal tract is affected and on the depth of eosinophilic infiltration in the affected segment. We present a case of a 35-year-old male with abdominal distention for six months. Laboratory testing revealed elevated eosinophil count and serum immunoglobulin E (IgE) levels. In abdominal tomography, ascites was observed, and eosinophilic infiltration was detected in duodenum biopsy samples, collected during endoscopic examination of upper gastrointestinal system. Clinical and pathologic findings of the patient responded to steroid dramatically. Even though their comorbidity is rare, eosinophilic gastroenteritis should be considered in differential diagnosis of patients with unspecified ascites

Sinteza bioulja s fenolformaldehidnim smolama u alkalnim uvjetima: fizička, kemijska i toplinska svojstva smola i svojstvo lijepljenog spoja

In the present study, bio-oil produced from vacuum pyrolysis of woody biomass has been investigated as a source of chemical feedstock. Bio-based resins were produced using the bio- oil with phenol substitutions ranging from 10 to 30 wt%. The conventional GC/MS analysis was carried out for the evaluation of the chemical composition of bio-oil. TGA, DSC and FT-IR analyses were used in order to characterize the bio-oil-phenol-formaldehyde (BPF) resins. The bonding quality of wood samples bonded with the BPF resins was investigated under different pre-treatment conditions. The highest shear strength was observed for the control samples bonded with the laboratory PF resin. As the amount of bio-oil was increased up to 30 wt%, the shear strength of the samples decreased from 12.08 to 11.76 N/mm2. The bonding performance was not negatively affected by the combination of bio-oil under dry conditions. According to TS EN 12765 standard, the relevant performance requirements for bonded samples under dry conditions must be at least 10 N/mm2. Relating to the standard, all samples bonded with BPF resins obtained the requirements for durability class C1. Under wet conditions, the bonding performance was negatively affected by the addition of bio-oil. However, the BPF resins fulfilled the durability requirements for C1, C2, and C3 specified in EN 12765 (2002).U radu je predstavljeno istraživanje mogućnosti upotrebe bioulja dobivenoga vakuumskom pirolizom drvne biomase kao izvora kemijske sirovine. Biosmole su dobivene zamjenom 10 – 30 % mase (ili težinskog udjela) fenola biouljima. Analiza kemijskog sastava bioulja provedena je GC/MS metodom. Za karakterizaciju biouljnih fenolformaldehidnih smola (BPF) primijenjene su TGA, DSC i FT-IR analiza. Kvaliteta spoja uzoraka drva slijepljenih BPF smolama ispitivana je pri različitim uvjetima predobrade. Najveća čvrstoća na smicanje postignuta je na kontrolnim uzorcima lijepljenim laboratorijskim PF smolama. S povećanjem udjela bioulja do 30 % mase (ili težinskog udjela), čvrstoća na smicanje smanjila se s 12,08 na 11,76 N/mm2. Prema normi TS EN 12765, čvrstoća na smicanje u suhim uvjetima treba biti najmanje 10 N/mm2. Kombinacija bioulja s fenolformaldehidnim smolama nije negativno utjecala na svojstva slijepljenog spoja u suhim uvjetima i svi uzorci lijepljeni BPF smolama zadovoljili su zahtjeve klase trajnosti C1. U vlažnim uvjetima dodatak bioulja negativno je utjecao na svojstva slijepljenog spoja. Međutim, BPF smole ispunile su zahtjeve trajnosti za klase C1, C2 i C3 propisane normom EN 12765 (2002)

Autoantibody frequency in celiac disease

AIM: In our study, we investigated the levels of glutamic acid decarboxylase antibody (anti-GAD), islet cell antibody (ICA), thyroperoxidase antibody (anti-TPO), thyroglobulin antibody (anti-TG), antinuclear antibodies (FANA), antibodies to double-stranded DNA (anti-ds DNA), antibody to Sjögren syndrome A antigen (anti-SSA), antibody to Sjögren syndrome B antigen (anti-SSB), Smith antibody (anti-Sm), smooth muscle antibodies (ASMA), and antimitochondrial antibody liver-kidney microsome (AMA-LKM) in patients with celiac disease as compared to healthy controls and autoimmune hypothyroid patients. MATERIALS AND METHODS: A total of 31 patients with celiac disease, 34 patients with autoimmune hypothyroidism and 29 healthy subjects were included in this study. Anti-SSA, anti-SSB, anti-Sm, anti-ds DNA, anti-GAD, anti-TPO and anti-TG were studied by Enzyme-Linked Immunosorbent Assay (ELISA), and AMA-LKM, ASMA, ANA and ICA were studied by immunofluorescence. Clinical data and the results of free thyroxine-thyroid stimulating hormone (FT4-TSH) were collected from the patients’ files by retrospective analysis. SPSS ver 13.0 was used for data analysis, and the χ(2) method was used for comparisons within groups. RESULTS: The frequency of anti-SSA, anti-SSB, anti-GAD, anti-Sm, anti-ds DNA, AMA-LKM, ASMA, ANA and ICA were not significantly different between the groups. Levels of anti-TPO and anti-TG antibodies were found to be significantly higher (<0.001) in autoimmune hypothyroid patients when compared with other groups. CONCLUSION: In previous studies, an increased frequency of autoimmune diseases of other systems has been reported in patients with celiac disease. We found that the frequency of autoimmune antibodies specific for other autoimmune diseases was not higher in celiac disease

Autoantibody frequency in celiac disease

AIM: In our study, we investigated the levels of glutamic acid decarboxylase antibody (anti-GAD), islet cell antibody (ICA), thyroperoxidase antibody (anti-TPO), thyroglobulin antibody (anti-TG), antinuclear antibodies (FANA), antibodies to double-stranded DNA (anti-ds DNA), antibody to Sjögren syndrome A antigen (anti-SSA), antibody to Sjögren syndrome B antigen (anti-SSB), Smith antibody (anti-Sm), smooth muscle antibodies (ASMA), and antimitochondrial antibody liver-kidney microsome (AMA-LKM) in patients with celiac disease as compared to healthy controls and autoimmune hypothyroid patients. MATERIALS AND METHODS: A total of 31 patients with celiac disease, 34 patients with autoimmune hypothyroidism and 29 healthy subjects were included in this study. Anti-SSA, anti-SSB, anti-Sm, anti-ds DNA, anti-GAD, anti-TPO and anti-TG were studied by Enzyme-Linked Immunosorbent Assay (ELISA), and AMA-LKM, ASMA, ANA and ICA were studied by immunofluorescence. Clinical data and the results of free thyroxine-thyroid stimulating hormone (FT4-TSH) were collected from the patients' files by retrospective analysis. SPSS ver 13.0 was used for data analysis, and the &#967;2 method was used for comparisons within groups. RESULTS: The frequency of anti-SSA, anti-SSB, anti-GAD, anti-Sm, anti-ds DNA, AMA-LKM, ASMA, ANA and ICA were not significantly different between the groups. Levels of anti-TPO and anti-TG antibodies were found to be significantly higher

Screening for Cushing’s Syndrome in Obese Patients

OBJECTIVES: The aim of this study was to examine the frequency of Cushing's syndrome (CS) in obese patients devoid of specific clinical symptoms of Cushing's syndrome. METHODS: A total of 150 obese patients (129 female, 21 male; mean age 44.41 ± 13.34 yr; mean BMI 35.76 ± 7.13) were included in the study. As a first screening step, we measured 24-h urinary free cortisol (UFC). An overnight 1-mg dexamethasone suppression test was also performed on all patients. Urinary free cortisol levels above 100 &#956;g/24 h were considered to be abnormal. Suppression of serum cortisol <1.8 &#956;g/dL after administration of 1 mg dexamethasone was the cut-off point for normal suppression. The suppression of the serum cortisol levels failed in all of the patients. RESULTS: Measured laboratory values were as follows: ACTH, median level 28 pg/ml, interquartile range (IQR) 14-59 pg/ml; fasting glucose, 100 (91-113) mg/dL; insulin, 15.7 (7.57-24.45) mU/ml; fT4, 1.17 (1.05-1.4) ng/dL; TSH, 1.70 (0.91-2.90) mIU/L; total cholesterol, 209 (170.5-250) mg/dL; LDL-c, 136 (97.7-163) mg/dL; HDL-c, 44 (37.25-50.75) mg/dL; VLDL-c, 24 (17-36) mg/dL; triglycerides, 120.5 (86-165) mg/dL. The median UFC level of the patients was 30 &#956;g/24 h (IQR 16-103). High levels of UFC (>100 &#956;g/24 h) were recorded in 37 patients (24%). Cushing's syndrome was diagnosed in 14 of the 150 patients (9.33%). Etiologic reasons for Cushing's syndrome were pituitary microadenoma (9 patients), adrenocortical adenoma (3 patients), and adrenocortical carcinoma (1 patient). CONCLUSION: A significant proportion (9.33%) of patients with simple obesity were found to have Cushing's syndrome. These findings argue that obese patients should be routinely screened for Cushing's syndrome

The Relationships of Leptin, Adiponectin Levels and Paraoxonase Activity with Metabolic and Cardiovascular Risk Factors in Females Treated with Psychiatric Drugs

OBJECTIVES: The aim of this study was to investigate serum leptin, adiponectin and paraoxonase1 levels in adult females receiving pharmacotherapy for various psychiatric disorders. METHODS: The study group consisted of 32 obese females (mean age 40.53 ± 11.00 years, mean body mass index 35.44 ± 5.33 kg/m²) who were receiving treatment for psychiatric disorders, and the control group included 22 obese females (mean age 35.95 ± 9.16 years, mean body mass index 30.78 ± 3.33 kg/m²) who were free of psychiatric disorders. Analyses were performed using a bioelectrical impedance device. Fasting blood samples were obtained for complete blood count and various biochemical tests, including determination of leptin, adiponectin and paraoxonase1 activity. RESULTS: Body mass index, waist and hip circumference, body fat percentage, fasting blood glucose, insulin, glycosylated hemoglobin, homeostasis model assesment of insulin resistance, alanine transaminase, aspartate tarnsaminase, and leptin levels were significantly higher in the study group than in controls. Although body weight was positively correlated with leptin levels in both groups, body weight was negatively correlated with adiponectin levels in the control group and positively correlated with adiponectin levels in the study group. In the study group, body mass index and hip circumference correlated positively with leptin levels, hip circumference correlated positively with adiponectin levels, and waist to hip ratio correlated positively with paraoxonase levels. In the control group, body mass index as well as waist and hip circumferences were positively correlated with leptin levels. Weight, body mass index, and hip circumference were also negatively correlated with the adiponectin/leptin ratio in the control group. CONCLUSION: This study indicates a higher risk for obesity-related disorders, particularly metabolic syndrome, diabetes and cardiovascular disease, in patients treated with psychiatric drugs

FGF-23 and vascular dysfunction in patients with stage 3 and 4 chronic kidney disease

Studies in animals show that fibroblast growth factor (FGF)-23 interferes with vascular reactivity induced by the nitric oxide (NO) system. To investigate the relationship between circulating FGF-23 levels and the response of forearm blood flow to ischemia (flow-mediated vasodilatation, FMD) and nitroglycerin, we tested 183 patients with stage 3-4 chronic kidney disease (CKD). None of them had cardiovascular complications or were taking drugs interfering with vascular function. Patients with FGF-23 levels above the median had significantly lower glomerular filtration rate, FMD, and fetuin-A levels (an anti-inflammatory molecule and potent inhibitor of calcification). They also had higher proteinuria and phosphate levels when compared to patients whose FGF-23 levels were below the median. The response to nitroglycerin was not different between the two groups. Multiple regression analysis showed that the relationship between FGF-23 and FMD was only modestly sensitive to adjustment for classical risk factors, biomarkers of bone mineral metabolism, high-sensitivity C-reactive protein, and homeostatic model assessment index. Adjustment for asymmetrical dimethyl arginine (ADMA) weakened the strength of this link; however, it remained highly significant. There was no independent association between FGF-23 and nitroglycerin. Thus, attenuation of FMD by ADMA suggests that this endogenous inhibitor of NO synthase may, in part, mediate the vascular effects of FGF-23 in patients with CKD. © 2010 International Society of Nephrology

Palliation of malignant esophageal obstruction and fistulas with self expandable metallic stents

AIM: To evaluate the efficacy of self expandable metallic stents (SEMS) in patients with malignant esophageal obstruction and fistulas