A rare case of perforated descending colon cancer complicated with a fistula and abscess of left iliopsoas and ipsilateral obturator muscle.

Perforation of descending colon cancer combined with iliopsoas abscess and fistula formation is a rare condition and has been reported few times. A 67-year-old man came to our first aid for an acute pain in the left iliac fossa, in the flank, and in the ipsilateral thigh. Ultrasonography and computed tomography revealed a left abdominal wall, retroperitoneal, and iliopsoas abscess that also involved the ipsilateral obturator muscle. It proceeded with an exploratory laparotomy that showed a tumor of the descending colon adhered and perforated in the retroperitoneum with abscess of the iliopsoas muscle on the left-hand side, with presence of a fistula and liver metastases. A left hemicolectomy with drainage of the broad abscess was performed. Pathologic report findings determined adenocarcinoma of the resected colon.

Radioiodine and thyroid carcinoma: KI prophylaxis in children.

The Chernobyl disaster was followed by a large increase in the incidence of thyroid carcinoma in children. It has been proved that KI prophylaxis may prevent such a heavy consequence. Italy has no more nuclear power plants in activity but is surrounded by the several ones of the neighbouring countries; moreover, relevant amounts of nuclear material are still present in the territory. Therefore a nuclear risk is present in Italy as well as in other close countries and a KI prophylaxis should be organized for our children, at least for those living within 200 miles from a possible source of radioiodine pollution. Guidelines concerning KI prophylaxis exist and are internationally shared in their general outlines. Guidelines we recommend for italian children are summarized in part II ("theory"). However, to be timely and effective, KI prophylaxis must be organized long before the nuclear alarm, and the coordination of its several steps needs to be checked through a mock trial. We suggest a model of organization and describe the practical aspects of carrying out a KI prophylaxis for 82.000 subjects aged 0-18 years living in the Province of Parma (Progetto Sperimentale Parma, PSP). The main goal of PSP is to offer a controlled and reliable model of KI prophylaxis,which could be applied in any other area (previous local adjustement), whenever the central or regional Authorities will consider it necessary or desirable.

Relationships between serum IGF-1, IGFBP-2, interleukin-1beta and interleukin-6 in inflammatory bowel disease.

AIMS: To study the relationships between serum IGF-1, IGFBP-3 and IGFBP-2 and interleukin (IL)-1beta and IL-6 in inflammatory bowel disease (IBD). METHODS: Thirty-seven patients (18 males, 19 females, aged 8.8-26.1 years) with IBD (Crohn's disease, CD, n = 17, and ulcerative colitis, UC, n = 20) were studied. Patients were in relapse or remission according to established criteria. Serum IGF-1, IGFBP-3, IGFBP-2, IL-1beta and IL-6 levels were determined in patients and 15 healthy controls (aged 8.2-19.0 years). RESULTS: IGF-1 levels were lower in patients with CD in relapse compared with controls (p < 0.05). IGFBP-2 levels were higher in CD in relapse compared with other groups (all p < 0.05). In CD and UC patients (n = 37), IGF-1 levels were inversely correlated with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). IGFBP-2 levels correlated positively with ESR and IL-1beta. IL-6 levels correlated positively with ESR and CRP. IL-1beta levels were elevated in CD in relapse compared to controls (p < 0.05) and were higher in UC in relapse than in other groups (all p < 0.05). In combined CD/UC patients in relapse (n = 20), IL-1beta levels were higher (p < 0.05) in patients with recto-sigmoiditis (n = 5) than in other patients. CONCLUSIONS: IGF-1, IGFBP-2 levels were related to IL levels, disease activity and anatomical distribution, consistent with active inflammation modifying the IGF-IGFBP system, possibly relevant to disturbance of growth.