intraductal high-intensity ultrasonography and chemotherapy-impregnated plastic biliary endoprosthesis are important steps in the palliative management of extrahepatic CCs. Radiofrequency and chemo-embolization methods are also applicable for intra-hepatic CCs as palliative modes of treatment. We need more prospective randomized controlled trials to evaluate the role of the new emerging therapies for CC patients.

Among the laboratory tests investigated, including fibrinogen, CRP, ESR, and platelet counts, receiver operating characteristic (ROC) curve analysis indicated RDW to be the most significant indicator of active UC. For CD, CRP was an important marker of active disease.

MRCP is used with increasing frequency as a non-invasive alternative to ERCP and the diagnostic results of MRCP with a heavily T2-weighted TSE MR sequence and ERCP are comparable with high accuracy in various hepatobiliary pathologies.

Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylorihas been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some other nongastric diseases. Among them, coronary heart disease attracts much debate. Many studies have demonstrated a close relationship between insulin resistance and atherosclerosis. Chronic inflammation and alterations in counter-regulatory hormones are deemed responsible for the etiology of insulin resistance. We aimed to examine the effect of H. pylori on insulin resistance. Sixty-three patients were enrolled in the study. Patients were divided into two groups according to H. pylori presence. HOMA-IR (homeostasis model assessment of insulin resistance) level was used to assess insülin resistance. Thirty-six patients were H. pylori positive and 27 were H. pylori negative. There was no difference between the two groups with regard to age, gender, or body mass index. HOMA-IR level was 1.73+/- 1.1 in the H. pylori-negative group, whereas it was 2.56 +/- 1.54 in the H. pylori-positive group (P < 0.05). This study provides the first direct evidence for an association between chronic H. pylori infection and insulin resistance.

Case 1An 82-year-old man was admitted to the hospital because of pain in the right lower quadrant of the abdomen for 3 d. Standard laboratory tests, serum levels of CA 19-9 and carcino-embryonic antigen (CEA) were within normal ranges. Ultrasonography (USG) and computerized tomography (CT) demonstrated a well demarcated, elliptical 7 cm × 5 cm cystic mass with parietal calcifications in the right lower quadrant of the abdomen. There was an indentation in the cecum by colonoscopy. Surgical exploration revealed the mass to be an AM. Simple appendectomy was performed. Pathological examination revealed a mucinous cystadenoma with dimensions of 8 cm × 6 cm × 5.5 cm. AM restricted to the appendix and cecum was free of the disease. The patient's postoperative course was unremarkable, and he was discharged home on the 4th postoperative day. Case 2A 65-year-old woman was referred to the emergency de- CASE REPORT AbstractThe mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitis-like symptoms. Sometimes, patients with mucocele can present with confusing symptoms. Preoperative suspicion and diagnosis of appendiceal mucocele are important. Ultrasonography and computed tomography are useful tools for the diagnosis of appendiceal mucocele. It may be also recognised by colonoscopy as a smooth submucosal lesion of the cecum. Optimal management of the mucocele could be achieved through accurate preoperative diagnosis. Preoperative diagnosis is a major component for minimizing intra-operative and post-operative complications. We herein report five cases and discuss the diagnostic methods and surgical treatment.