Background-Aims. Early prediction of the severity of acute pancreatitis would lead to prompt intensive treatment resulting in improvement of the outcome. The present study investigated the use of C-reactive protein (CRP), interleukin IL-8 and tumor necrosis factor-α (TNF-α) as prognosticators of the severity of the disease. Methods. Twenty-six patients with acute pancreatitis were studied. Patients with APACHE II score of 9 or more formed the severe group, while the mild group consisted of patients with APACHE II score of less than 9. Serum samples for measurement of CRP, IL-8 and TNF-α were collected on the day of admission and additionally on the 2nd, 3rd and 7th days. Results. Significantly higher levels of IL-8 were found in patients with severe acute pancreatitis compared to those with mild disease especially at the 2nd and 3rd days (P = .001 and P = .014, resp.). No significant difference for CRP and TNF-α was observed between the two groups. The optimal cut-offs for IL-8 in order to discriminate severe from mild disease at the 2nd and 3rd days were 25.4 pg/mL and 14.5 pg/mL, respectively. Conclusions. IL-8 in early phase of acute pancreatitis is superior marker compared to CRP and TNF-α for distinguishing patients with severe disease.
Background-aim: Gastrointestinal stromal tumours (GIST) are the most common mesenchymal neoplasms of the gastrointestinal tract, yet extremely rare since they account for less than 1% of all GI tumours, which may arise virtually in any part of the gastrointestinal tract. GISTs are typically defined as a group of heterogeneous gastrointestinal mesenchymal neoplasms that are characterized by the expression of c-KIT receptor tyrosine kinase (called CD117 antigen) and often also the CD34 antigen. There is an equal gender distribution, with a peak incidence between the fifth and sixth decade of life. Twenty percent of GISTs are asymptomatic. Clinical symptoms are non-specific including abdominal pain, ileus and weight loss, while the most common symptom at presentation is GI bleeding. Due to the non-specific presenting symptoms, diagnosis of GIST is often delayed. Useful diagnostic tools include imaging, endoscopy and histological examinations. GISTs are prone to metastasize. Prognostic factors include tumour size, mitotic activity and tumour location. The optimal treatment is radical surgery, while treatment with tyrosine kinase inhibitor imatinib has significantly improved the outcome of the disease. In the current study, we present five cases of GISTs treated in our department during the period 2007-2009, followed by a brief review of the literature. Material-Methods:The records of five patients diagnosed with GIST over the last two years in our department were retrospectively reviewed. They concerned four male and one female, with a median age at diagnosis of 64 years (age range 52-75 years with the exception of a 28-year old male patient). Two presented with upper GI bleeding resulting from duodenal GIST and one with upper GI bleeding due to a large GIST located in the stomach. Another patient presented with a painful abdominal mass en-Y oesophagojejunal anastomosis for the GIST of the stomach. To date, none of the above-mentioned patients has exhibited any sign of relapse.
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