[Analysis of disturbances of oesophageal phase of swallowing in patients with amyotrophic lateral sclerosis (ALS)]. / Analiza zaburzen fazy przelykowej polykania u chorych na stwardnienie boczne zanikowe (SLA).

BACKGROUND: The occurrence of the disturbances of oropharyngeal phases of swallowing in Amyotrophic Lateral Sclerosis (ALS) patients has been well documented. THE AIM OF STUDY: Assessment of the oesophageal manometry for detection of the oesophageal phase of swallowing in ALS patients. MATERIAL AND METHODS: The study was carried out in 12 dysphagic ALS patients and 10 sex- and age- matched healthy volunteers. RESULTS: The mean upper oesophageal contractile: amplitude, duration and velocity during the wet and dry swallows in ALS individuals were statistically differ as compared to control subjects. The abnormalities of vocal folds function was also found in the fiberoscopy examination of larynx in all ALS patients. CONCLUSIONS: This study reveal the occurrence of disturbances of the oesophageal phase of swallowing in ALS patients with dysphagia.

[Genetic aspects of colorectal carcinogenesis]. / Genetyczne aspekty karcynogenezy w jelicie grubym.

Colorectal cancer (CRC) is one of the most common forms of cancer and the second leading cause of death in Poland. Most cases of CRC are sporadic but a small percentage occurs in heritable syndromes such as dominant autosomal adenomatous and hamartomatous polyposis syndromes and hereditary nonpolyposis colorectal cancers. In a majority of cases CRCs are thought to develop in a step wise progression from normal epithelium through polyp form to carcinoma. Many genetic changes are observed in this process like inactivation of the tumor suppressor genes as well as the activation of specific oncogenes. Molecular biological studies have shown mutations of p53, Apc, k-ras and/or changes in proteins like APC and DNA microsatellite instability or loss of heterozygosity. For several years now great progress in this field and new concepts of screening strategies and therapeutic options have been made (gene therapy).

Case presentation of gastrinoma combined with gastric carcinoid with the longest survival record -- Zollinger-Ellison syndrome: pathophysiology, diagnosis and therapy.

BACKGROUND: Zollinger-Ellison syndrome is a very rare disease caused by tumor with gastrin producing cells accompanied by hypergastrinemia leading to gastric hypersecretion and peptic ulcers and their complications. CASE STUDY: Female case of gastrinoma (Zollinger-Ellison syndrome; Z-E) with a record of 38 yrs of survival. Acute gastro-duodenal ulcers started at 28 yr of age and Z-E was diagnosed by using gastrin assays. Basal and maximal acid outputs and ratio of basal/maximal outputs were away over normal limits. Because of ulcer recurrence and complications, patient was subjected to several gastric surgeries but refused total gastrectomy. She was also treated with many H2-receptor (R) antagonists and proton-pump inhibitors (PPI), each new drug being initially highly effective but then showing declining efficacy except when PPI, lansoprazole was used. The gastrin level rose in the course of disease from initial high value of 2000 pg/mL to the extreme 4500 ng/mL at present. During the last 2 yrs, metastasis mainly to liver developed and they were successfully treated by synthetic octapeptide derivative of somatostatin and, as a result, metastatis partly reduced and plasma gastrin drasticly decreased. Biopsy taken from liver metastasis showed the presence of typical gastrinoma cells with gastrin and chromogranin, while that from oxyntic mucosa revealed the ECL-cell hyperplasia with carcinoid tumors and unexpected gastric atrophy. CONCLUSIONS: This phenomenal case described in this article might be the new proven evidence needed by gastroenterologists to overturn the traditional treatment using total gastrectomy as a treatment of choice to the partial gastrectomy combined with proton pump inhibitors.