PurposeTo compare anthropometric data (body mass index [BMI]) in patients without lithiasis to patients with symptomatic simple cholelithiasis or choledocholithiasis.MethodsWe retrospectively reviewed data from 147 patients undergoing laparoscopic cholecystectomy between 2001–2015. Complete growth data from 98 patients was compared with anthropometric data from the population of the Czech Republic and a control group (BMI of 100 consecutive patients without biliary stones in abdominal ultrasound who were admitted to a surgical department for suspected appendicitis).ResultsThe BMI of 75 children with simple cholelithiasis and 23 with choledocholithiasis was compared to the standard Czech pediatric population and to the control group. The median age (simple cholelithiasis and choledocholithiasis) was 16 years, and 35 patients (24%) had a family history of gallstones. Types of lithiasis included multiple (n = 120), solitary (n = 11), and sludge (n = 10). Five cases had polyps and one had gallbladder dysplasia. Patients with simple cholelithiasis had significantly higher BMI compared to the control group without cholelithiasis (p<0.0001) and the standard Czech population (p = 0.03). Patients with choledocholithiasis had a mean BMI significantly higher than that of the general population (p = 0.001) and the control group (p = 0.0001). Patients with choledocholithiasis had significantly higher BMI than those with simple cholelithiasis (p = 0.03).ConclusionPatients with cholelithiasis had significantly higher BMI than the general population, and patients with choledocholithiasis had significantly higher BMI than patients with simple lithiasis. Elevated BMI is a risk factor for developing choledocholithiasis. ERCP and early laparoscopic cholecystectomy in patients with choledocholithiasis offer equivalent outcomes in patients with simple cholelithiasis.

Background Memantine, currently available for the treatment of Alzheimer's disease, is an uncompetitive antagonist of the N-methyl-D-aspartate type of glutamate receptors. Under normal physiologic conditions, these unstimulated receptor ion channels are blocked by magnesium ions, which are displaced after agonist-induced depolarization. In humans, memantine administration is associated with different gastrointestinal dysmotility side effects (vomiting, diarrhoea, constipation, motor-mediated abdominal pain), thus limiting its clinical use. Mechanism of these motility disorders has not been clarified yet. Pigs can be used in various preclinical experiments due to their relatively very similar gastrointestinal functions compared to humans. The aim of this study was to evaluate the impact of a single and repeated doses of memantine on porcine gastric myoelectric activity evaluated by means of electrogastrography (EGG). Methods Six adult female experimental pigs (Sus scrofa f. domestica, mean weight 41.7±5.0 kg) entered the study for two times. The first EGG was recorded after a single intragastric dose of memantine (20 mg). In the second part, EGG was accomplished after 7-day intragastric administration (20 mg per day). All EGG recordings were performed under general anaesthesia. Basal (15 minutes) and study recordings (120 minutes) were accomplished using an EGG stand (MMS, Enschede, the Netherlands). Running spectral analysis based on Fourier transform was used. Results were expressed as dominant frequency of gastric slow waves (DF) and power analysis (areas of amplitudes).

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Časný karcinom žaludku je definován histopatologicky jako nádor, jehož lokální růst je omezen na sliznici a submukózu. Koncepce časného karcinomu byla rozpracována již v 60. letech v Japonsku a v současnosti je široce akceptována. Je potřeba si uvědomit, že termín časný karcinom zahrnuje léze bez i s metastatickým postižením spádových lymfatických uzlin. Společnou charakteristikou je příznivější prognóza ve srovnání s pokročilým onemocněním. Úkolem endoskopisty je v první řadě nádor (prekancerózy) diagnostikovat (identifikovat) a biopticky ověřit. Po úspěšné identifikaci musí následovat jejich klasifikace vedoucí k volbě adekvátního přístupu, který zahrnuje dispenzarizaci prekanceróz, v případě nádoru pak endoskopickou léčbu (resekci) nebo léčbu chirurgickou (s nebo bez chemoterapie). Způsob léčby je určován především charakterem léze dle rizika či průkazu postižení lymfatických uzlin.Klíčová slova: gastroskopie, časný karcinom, karcinom žaludku, endoskopická resekce. Early gastric cancerEarly gastric cancer is defined histopathologically as a tumour with limited local progression to the mucosa and submucosa. The concept of early cancer was developed in the 1960s in Japan and is now widely accepted. The term of early gastric cancer included cases with/without metastatic lymph node involvement. However, a common characteristic is a favourable prognosis of the disease. The task of the endoscopist is primarily to diagnose (identify) the tumour (precancerous lesions) and to verify it by biopsy. Successful identification must be followed by its correct classification, leading to the choice of an adequate approach, which includes surveillance, endoscopic treatment (resection) or surgical treatment (with or without chemotherapy). The method of treatment is determined primarily by the nature or risk of lymph node involvement.

Introduction: To date, there is not generally accepted and universal indicator of activity, and functional integrity of the small intestine in patients with coeliac disease. The aim of our study was to investigate whether serum concentrations of the non-essential amino acids citrulline and ornithine might have this function. Methods: We examined serum citrulline and ornithine concentrations in a subgroup of patients with proven coeliac disease and healthy controls (blood donors). Results: A total of 94 patients with coeliac disease (29 men, mean age 53 ± 18 years; 65 women, mean age 44 ± 14 years) and 35 healthy controls (blood donors) in whom coeliac disease was serologically excluded (10 men, mean age 51 ± 14 years; 25 women, mean age 46 ± 12 years) were included in the study. Significantly lower concentrations of serum ornithine were found in patients with coeliac disease (mean 65 ± 3 μmol/L; median 63 μmol/L, IQR 34 μmol/L, p < 0.001). No statistically nor clinically significant differences were found in the citrulline concentrations between the study and control group. Conclusions: Serum ornithine (but not citrulline) may be useful for assessing the functional status of the small intestine in uncomplicated coeliac disease. Further studies involving more detailed analysis of dietary and metabolic changes in patients will be needed to reach definitive conclusions.

An unusual case of AA amyloidosis is presented. Pharmacotherapy of rheumatoid arthritis induced its 5-year clinical remission, yet despite this, the patient developed AA amyloidosis. Amyloidosis involved the stomach, duodenum and kidneys. AA amyloidosis did not impair the renal functions significantly. This case emphasized the importance of non-targeted bio­psies of macroscopically normal mucosa of the stomach and duodenum that made it possible to dia­gnose amyloidosis. The patient remained without any gastrointestinal symptoms even during the subsequent follow-up. Key words: AA amyloidosis – gastroscopy – non-targeted bio­psies

Summary: Pancreatobiliary stent migration is not a common complication, mostly without serious consequences, but sometimes causing intestinal perforation. The authors describe migration of the DB stent into the sigmoid with subsequent completely asymptomatic perforation of the bowel wall. Due to the patient’s clinical condition and age, the perforation was successfully treated endoscopically. Key words: biliary stent – ERCP – migration – complications – perforation