Is colorectal carcinoma in the young a more deadly disease?

Of the 2923 cases of colorectal carcinoma treated from 1970 to 1981, only 12 (0.4%) were under the age of 30 years. Analysis of this group confirmed the higher incidence of more advanced tumours, as well as a higher frequency of predominantly mucin-secreting adenocarcinoma. Regardless of the mode of treatment, survival is particularly poor in the young patients, and, in our opinion, this is a reflection of the more aggressive behaviour of the type of carcinoma afflicting young patients.

Serum angiotensin converting enzyme in Crohn's disease, ulcerative colitis and peptic ulceration.

Serum angiotensin converting enzyme (ACE) activities were determined in patients with different types of inflammatory disease of the gastrointestinal tract, in patients with peptic ulcer, and in healthy volunteer subjects. ACE activity in serum was measured by its in vitro ability to cleave hippuric acid from the synthetic tripeptide hippuryl-L-histidyl-L-leucine. The hippuric acid so formed was quantified by high performance liquid chromatography and results are expressed as nmol hippuric acid produced/ml plasma/min. ACE activity was 27.4 +/- 7.7 (mean +/- SD, n = 37) in control subjects and was not related to age or sex. Compared to controls, patients with ulcerative colitis had similar ACE values (26.5 +/- 7.7, n = 16) while, surprisingly, there was a significant (p less than 0.01) increase in the enzyme in those with active peptic ulcers (33.8 +/- 8.8, n = 21) irrespective of whether the site of ulceration was gastric or duodenal. In a mixed group of patients with active and inactive Crohn's disease, ACE activity (24.8 +/- 7.2, n = 19) was not different from controls. However, ACE activity was significantly (p less than 0.02) depressed in active Crohn's disease (19.8 +/- 7.3, n = 8) compared to either control subjects or patients with inactive disease (28.4 +/- 6.3, n = 9). There was wide inter-patient variability in ACE levels and hence the diagnostic value of random measurements of this enzyme in Crohn's disease is limited.

Primary linitis plastica carcinoma of urinary bladder.

Primary linitis plastica type carcinoma of the urinary bladder in a sixty-one-year-old man is described. Only 2 other cases have been reported in the English medical literature.