12 research outputs found
Jejunogastric intussusception presented with hematemesis: a case presentation and review of the literature
BACKGROUND: Jejunogastric intussusception (JGI) is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. To avoid mortality early diagnosis and prompt surgical intervention is mandatory. CASE PRESENTATION: A young man presented with epigastric pain and bilous vomiting followed by hematemesis,10 years after vagotomy and gastrojejunostomy for a bleeding duodenal ulcer. Emergency endoscopy showed JGI and the CT scan of the abdomen was compatible with this diagnosis. At laparotomy a retrograde type II, JGI was confirmed and managed by reduction of JGI without intestinal resection. Postoperative recovery was uneventful. CONCLUSIONS: JGI is a rare condition and less than 200 cases have been published since its first description in 1914. The clinical picture is almost diagnostic. Endoscopy performed by someone familiar with this rare entity is certainly diagnostic and CT-Scan of the abdomen could also help. There is no medical treatment for acute JGI and the correct treatment is surgical intervention as soon as possible
Role of soluble triggering receptor expressed on myelold cells in inflammatory bowel disease
AIM: To investigate the probable role of soluble triggering receptor
expressed on myeloid cells-1 (sTREM-1) in the pathogenesis of
inflammatory bowel disease (IBD).
METHODS: Fifty-eight patients were enrolled; nineteen healthy volunteers
served as controls; 8 patients were diagnosed with Crohn’s disease, and
31 with ulcerative colitis. Clinical and endoscopic activity indexes of
patients with Crohn’s disease and ulcerative colitis respectively were
estimated. Upon admission blood was sampled; sTREM-1 and TNF alpha were
measured by an immunoassay and malondialdehyde (MDA) by the
thiobarbitourate assay, after passage through an HPLC system.
RESULTS: Median SE of TNFa of controls, patients with Crohn’s disease
and patients with ulcerative colitis were 6.02 +/- 3.94, 7.98 +/- 5.08
(P = NS vs controls), and 8.45 +/- 4.15 ng/L (P = 0.018 vs controls)
respectively. Respective values of sTREM-1 were 53.31 +/- 32.93, 735.10
+/- 197.17 (P = 0.008 vs controls) and 435.82 +/- 279.71 ng/L (P = 0.049
vs controls). sTREM-1 was positively correlated with Crohn’s disease
activity index and clinical and endoscopic activity indexes of
ulcerative colitis (P = 0.002, 0.001 and 0.009, respectively). sTREM-1
of patients with ulcerative colitis was positively correlated with TNF
alpha (P = 0.001).
CONCLUSION: sTREM-1 seems to behave as a novel mediator in IBD in
correlation with the degree of the :inflammatory reaction of the
intestinal mucosa. 2006 The WIG Press. All rights reserved
Can soluble triggering receptor expressed on myeloid cells (sTREM-1) be considered an anti-inflammatory mediator in the pathogenesis of peptic ulcer disease?
Soluble triggering receptor expressed on myeloid cells (sTREM-1) is a
novel mediator involved in the pathogenesis of peptic ulcer disease. To
investigate the potential role of sTREM-1 in the anti-inflammatory
response in chronic gastritis, sTREM-1 was compared with other
anti-inflammatory mediators of gastritis. Forty patients with dyspepsia
were enrolled: 20 with peptic ulcer and 20 controls without any
macroscopic abnormalities. All patients were examined by endoscopy;
gastric juice was aspirated and biopsy specimens were collected from the
antrum and corpus of the stomach. sTREM-1, interleukin (IL)-8, and IL-10
were estimated by enzyme immunoassays. Median sTREM-1 in patient
controls and in patients with peptic ulcer disease was 3.91 and 44.27
pg/ml, respectively (P=0.006). Respective values of IL-8 were 1856.97
and 2030.66 pg/ml (P=0.023); those of IL-10 were 16.92 and 18.43 pg/ml
(NS). The odds ratio for the presence of peptic ulcer in the event of a
concentration of sTREM-1 higher than 15 pg/ml was 23.22 (95% CI,
2.58-208.62; P=0.002). A positive correlation was found between the
ratios of IL-8/sTREM-1 and IL-8/IL-10 (r (s), + 0.365; P=0.021). In
conclusion, sTREM-1 is an independent factor for the generation of
peptic ulcer disease and might behave as an anti-inflammatory mediator
in chronic gastritis
Retinol-binding protein, acute phase reactants and Helicobacter pylori infection in patients with gastric adenocarcinoma
AIM: To determine the serum levels of c-reactive protein (CRP),
transferrin (TRF), a2-macroglobulin (A2M), ceruloplasmin (CER), a1-acid
glycoprotein (AAG), prealbumin (P-ALB) and retinol-binding protein (RBP)
in gastric carcinoma patients and to explore their possible correlation
with underlying Helicobacter pylori (H pylori) infection.
METHODS: We measured the serum levels of CRP, TRF, A2M, CER, AAG, P-ALB,
and RBP in 153 preoperative patients (93 males; mean age: 63.1 +/- 11.3
years) with non-cardia gastric adenocarcinoma and 19 healthy subjects.
RESULTS: The levels of CRP, CER, RBP, and AAG in cancer patients were
significantly higher than those in healthy controls (P < 0.0001), while
no difference was found regarding the TRF, P-ALB, and A2M levels. Cancer
patients with H pylori infection had significantly lower RBP values
compared to non-infected ones (P < 0.0001) and also higher values of CRP
and AAG (P = 0.09 and P = 0.08, respectively).
CONCLUSION: High serum levels of CRP, CER and AAG in cancer patients do
not seem to be related to H pylori infection. Retinol-binding protein
seems to discriminate between infected and non-infected patients with
gastric carcinoma. Further studies are needed to explore if it is
directly involved in the pathogenesis of the disease or is merely an
epiphenomenon. (C) 2005 The WJG Press and Elsevier Inc. All rights
reserved