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How to treat an extensive form of primary intestinal lymphangiectasia?

World Journal of Gastroenterology 2015年第23期21卷 7320-7325页

作者： rosana troskot Dragan Jurcic Ante Bilic Marija Gomercic Palcic Stanko Tezak Ivana Brajkovic Faculty of Medicine J.J.Strossmayer University of OsijekDivision of Gastroenterology and HepatologyDepartment of Internal MedicineClinical Hospital“Sveti Duh” Division of Gastroenterology and Hepatology Department of Internal Medicine“Sestre milosrdnice”University Hospital Center University of Zagreb School of Medicine Clinical Department of Nuclear Medicine and Radiation Protection University Hospital Centre Zagreb Dialysis clinic Polyclinic“Sveti Duh”II

We report a case of a 42-year-old man with a rare disorder known as primary intestinal lymphangiectasia,which is characterized by dilated intestinal lymphatics that lead to the development of protein-losing enteropathy. The patient presented with a grand mal seizure caused by malabsorption-derived electrolytes and a protein disorder. Signs of the disease, including chronic diarrhea and peripheral edema, manifested10 years ago, but a diagnosis was never made. The diagnosis was suspected because of the clinical manifestations, laboratory tests, imaging and endoscopic findings. Hyperemic and edematous mucosa of the small intestine corresponded to scattered white spots with dilated intestinal lymphatics and whitish villi in the histological specimen of the biopsied jejunal *** numerous therapeutic strategies are available,only octreotide therapy proved to be an effective means of therapeutic resolution in this patient. Although the patient had a partial remission following the use of a slow release formula of octreotide, his prognosis, clinical course, and future treatment challenges are yet to be determined.

关键词： Primary intestinal lymphangiectasia Malabsorption Seizure Treatment Diet Octreotide

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Elevated serum values of procollagen Ⅲ peptide (PIIIP)in patients with ulcerative colitis who will develop pseudopolyps

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World Journal of Gastroenterology 2003年第3期9卷 619-621页

作者： ■arko Babi Vjekoslav Jagi Zvonko Petrovi Ante Bili KapetanoviDinko Goranka Kubat rosana troskot Mira Vukeli Division of Hepatogastroenterology Department of MedicineSveti Duh General HospitalZagrcbCroatia Department of Laboratory Biochemistry Diagnosis Sveti Duh General HospitalZagtebCroatia Department of Pathology Sveti Duh General HospitalZagrebCroatia Department of Radiology Sveti Duh General HospitalZagrebCroatia

AIM: To assess the impact of procollagen Ⅲ peptide as a marker of collagenesis in the development of pseudopolyps in patients with ulcerative ***: Development of pseudopolyps was monitored in 25 patients with ulcerative colitis classified according to Powell-Tuck index as mild (n=12) or moderate (n=13) form of disease. Patients with a mild form of disease were treated with oral mesalazine medication (2-4 g/day) and local mesalazine preparation (suppository). Patients with a moderate form of disease received oral mesalazine medication (2-4 g/day), local mesalazine preparation(suppository) and local methylprednisolone at an initial dose of 60 rag/day, followed by dose tapering. How many significant variables (previously determined by analysis of variance) were elevated in the groups with and without pseudopolyp developement was observed. ROC analysis for calculation of new index was ***: Serum values of procollagen Ⅲ peptide (PⅢP), C-reactive protein (CRP) and C4 complement component (C4)were statistically significantly lower in the group of patients flee from pseudopolyp development bhan bhose who developed one or more pseudopolyps (0.45±0.12 vs 1.42±0.70,P0.05).Discrimination function analysis yielded highest standardized cannon coefficients for PⅢP (0.876), CRP (0.104), C3 (-0.534) and C4 (0.184) (P<0.036). The elevation in two of three laboratory variables (PⅢP, CRP and C4) reached sensitivity of 93 % and specificity of 90 % in the development of ***: It is proposed that an increase in two of the three laboratory parameters (PⅢP, CRP and C4) could improve the accuracy of prediction of the development of pseudopolyps. When using PⅢP, CRP and C4

关键词：原骨胶原Ⅲ 溃疡性大肠炎血清学检查假性大肠息肉作用机制

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Increased activity of Pgp multidrug transporter in patients with Helicobacter pylori infection

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World Journal of Gastroenterology 2005年第18期11卷 2720-2725页

作者： Zarko Babic Ivna Svoboda-Beusan Nastja Kucisec-Tepes Dragan Dekaris rosana troskot University Department of Medicine Department of Gastroenterology Sveti Duh General Hospital Zagreb Croatia Institute of Immunology Department of Cellular Immunology Zagreb Croatia University Department of Microbiology Sveti Duh General Hospital Zagreb Croatia Institute of Immunology Department of Cellular Immunology Zagreb Croatia

AIM: To determine whether local antibiotic resistance involves P-glycoprotein (Pgp)-mediated active drug outpumping during Helicobacter pylori ( H pylori) infection treatment with classic antibiotic therapy. METHODS: Pgp activity was determined in gastric mucosa biopsy specimens obtained from 53 patients with pathohistologically verified gastritis and microbiologically confirmed H pylori infection, and compared with the Pgp activity in 12 control subjects with normal endoscopic findings. TheH pylori positive patients were treated with short-term 7-d therapy consisting of two antibiotics (amoxicillin and azithromycin/metronidazole and clarithromycin) and a proton pump inhibitor. Pgp activity was determined by flow cytometry in the test of rhodamine dye efflux and quantified as mean fluorescence ratio (RMF).RESULTS: Upon the first cycle,H pylori was successfully eradicated in 20 patients, whereas therapy was continued in 33 patients. In the course of antibiotic therapy, RMF increased (P＜0.05) and gastric cells showed higher rhodamine dye efflux. The mean pre-treatment RMF values were also higher (P＜0.0001) in patients with multiple therapeutic failure than in those with successful H pylorieradication and control ***: Pgp might be one of the causes of therapy failure in patients with H pylori and antibiotic therapy could be chosen and followed up on the basis of the Pgp transporter local activity.

关键词： H pylori RMF Pgp

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