Ectopic Pancreas Imitating Gastrointestinal Stromal Tumor (GIST) In The Stomach.

Ectopic pancreas is a rare congenital disorder defined as pancreatic tissue lacking vascular or anatomic communication with the normal body of the pancreas. Most cases of ectopic pancreas are asymptomatic, but it may become clinically evident depending on the size, location and the pathological changes similar to those observed in case of the normal pancreas. It is often an incidental finding and can be located at different sites in the gastrointestinal tract. The most common locations are: the stomach, duodenum or the proximal part of small intestine. The risk of malignancy, bleeding and occlusion are the most serious complications. Despite the development in diagnostics, it still remains a challenge for the clinician to differentiate it from neoplasm. In this report, we described a case of 28-years old woman who presented recurrent epigastric pain. The upper gastrointestinal endoscopy revealed gastrointestinal stromal tumor on the border of the body and antrum of the back wall of great curvature of the stomach. The histopathological examination after surgery showed heterotopic pancreatic tissue. Ectopic pancreas should be considered in the differential diagnosis of gastric mass lesions.

The impact of bariatric surgery on nutritional status of patients.

INTRODUCTION: Currently, surgical treatment is considered to be the most efficient method of dealing with morbid obesity. AIM: To evaluate changes in nutritional status after surgical treatment of obesity in the early postoperative period. MATERIAL AND METHODS: The study included 50 patients (30 women and 20 men) treated surgically due to morbid obesity. During the preliminary visit and during control visits measurements of body mass, height, and waist and hip circumference were conducted. Also, analysis of body content was performed and blood was taken for biochemical analysis. Statistical analysis was conducted using the program Statistica 10. RESULTS: Six months after the surgery, in the group of women, significant reduction of average body mass, average waist circumference, average hip circumference and average body mass index (BMI) was observed. Also, significant reduction of the percentage of body fat and an increase in the percentage of fat-free body mass were observed. A significant decrease in muscle mass was also noted. Both in women and in men, 6 months after the surgery, a significant decrease in fasting glucose concentration, fasting insulin and triglycerides in blood serum was observed. CONCLUSIONS: Bariatric procedures lead to significant body mass, BMI, waist and hip circumference reduction. Loss of body mass is caused mainly by the reduction of fat tissue. Application of surgical procedures in morbid obesity treatment also allowed us to achieve improvement in insulin, glucose and lipid metabolism.

Serum ß-glucuronidase as a potential colon cancer marker: a preliminary study.

AIM: Colorectal cancer is characterized by high morbidity and mortality in developed countries. The lack of low-cost, easy-to-use screening diagnostic methods is one of the causes of late diagnosis of colorectal cancer. Beta-glucuronidase (GLU) is a lysosomal exoglycosidase involved in degradation of glycosaminoglycans of the cell membranes and extracellular matrix of normal and cancerous colon tissues. The aim of our research was to evaluate the activity of GLU in the serum of colorectal cancer and estimate its potential value in the diagnosis of colorectal cancer. MATERIAL AND METHODS: Blood samples were collected from 21 patients with colorectal adenocarcinoma and 17 healthy subjects. GLU activity was determined by the colorimetric method of Marciniak et al. by measuring the amount of p-nitrophenol released from 4-nitrophenyl-beta-D-glucuronide, at λ = 405 nm. RESULTS: We found significantly greater activity of GLU (p<0.0001) in the serum of patients with colorectal cancer, as compared to the healthy subjects. The serum GLU activity significantly differentiates patients with colorectal cancer from healthy individuals. CONCLUSIONS: Serum GLU activity has diagnostic value and may be used in the diagnosis of colon adenocarcinoma.

Dietetic recommendations after bariatric procedures in the light of the new guidelines regarding metabolic and bariatric surgery.

The frequency of obesity occurrence is constantly increasing all over the world and becoming global epidemic. Facing the lack of the efficiency of conservative treatment, patients with II and III degree of obesity are qualified for surgical treatment; however, the efficiency of surgical treatment is connected with permanent change of nutritional habits and previous lifestyle of the patient. Modification of the way of nutrition, regardless of the type of bariatric procedure, should especially include the lowering of food energetic value and change of type, consistency and size of consumed food. Nutritional treatment after bariatric procedures is multistage. It includes clear liquid diet, full liquid diet, pureed diet, mechanically altered soft diet and regular diet. Gradual expanding of the diet protects gastrointestinal tract from chemical, mechanical and thermal irritation by the food. It also should prevent nutritional deficiencies. Significant influence on the result of surgical treatment of obesity has also regular intake of food, consuming products with high nutritional value, avoiding confectionery and fat products, consuming proper amounts of protein (60-80 g/day) and vitamin-mineral supplementation.

The diagnostics of colorectal cancer.

Colorectal cancer (CRC) is one of the most frequent human malignant neoplasms. CRC has an estimated incidence of more than 1,000,000 new cases annually worldwide. Approximately one out of three people who develop CRC dies from the disease. Furthermore, CRC often affects inhabitants of industrialized countries in comparison to less developed countries. Several markers of colon cancer, including CEA, CA-19-9, TPS, TAG-72 and lysosomal hydrolases, have been identified and are now being adopted in routine clinical practice. Increased values of these markers are often the first signal of recurrence or metastases, which is useful in prediction and prognosis of clinical outcome of patients with CRC. Determination of the activity of lysosomal exoglycosidases in body fluids may bring some hope of improving diagnosis of colorectal cancer. However, it has to be remembered that currently the most effective diagnostic method of CRC is endoscopy.

The activity of N-acetyl-ß-d-hexosaminidase A and B and ß-glucuronidase in nasal polyps and hypertrophic nasal concha.

UNLABELLED: Nasal polyps and hypertrophic lower nasal conchae are common disorders of nasal cavity. The majority of etiopathogenetic theories indicate inflammatory background of polyps and hypertrophic concha. N-acetyl-ß-D-hexosaminidase and ß-glucuronidase are lysosomal exoglycosidases revealing accelerated activity in inflammatory processes. AIM: The aim of the study was to evaluate the catabolism of glycoconjugates in nasal polyps and hypertrophic nasal concha basing on the activity of N-acetyl-ß-D-hexosaminidase (HEX) and ß-glucuronidase (GLU). MATERIAL AND METHODS: Material consisted of nasal polyps taken from 40 patients during polypectomy in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and hypertrophic lower nasal conchae taken from 20 patients during mucotomy. The activity of HEX, HEX A, HEX B and GLU in supernatant of homogenates of nasal polyps and hypertrophic lower nasal concha tissues has been estimated using colorimetric method. RESULTS: Statistically significant decrease has been observed in concentration of the activity (per 1mg of tissue) of HEX (p<0.05), HEX B (p<0.001) and specific activity (per 1mg of protein) of HEX B (p<0.001) in nasal polyps tissue in comparison to hypertrophic lower nasal conchae tissue. CONCLUSIONS: Decrease in the activity and specific activity concentration of the majority of examined lysosomal exoglycosidases (increasing in inflammations) in comparison to hypertrophic lower nasal conchae suggests electrolytes disorders and questions the inflammatory background of nasal polyps.