Respiratory symptoms and pulmonary functional changes in patients with irritable bowel syndrome.

OBJECTIVE: Scientific evidence of functional interface between the immune and sensory motor systems of the gut and respiratory systems has been reported. In recent studies excess prevalence of bronchial hyper-responsiveness has been shown among patients with irritable bowel syndrome (IBS). The purpose of our study was to investigate the possible relationship between IBS and asthma. METHODS: One hundred thirty-three patients with IBS (108 women, 25 men) and 137 control subjects (105 women, 32 men) were included in this study. Both for IBS and the control group, the mean ages were 41.64+/-9.45 yr and 39.94+/-10.62 yr, respectively. Patients more than 50 yr old, with any organic GI disease, acute respiratory system infection, current or ex-smokers, and patients using drugs affecting smooth muscle and autonomic nervous system were not included in the study. Respiratory symptoms were questioned and pulmonary function tests were performed for every subject. RESULTS: There were 45 (33.8%) and eight (5.8%) subjects with respiratory symptoms in IBS and control groups, respectively (p < 0.0001). Twenty-one (15.8%) patients from the IBS group and two (1.45%) patients from the control group had the diagnosis of asthma according to history, clinical, and PFT findings. There was no statistical difference between two groups with respect to percentage of forced vital capacity and forced expiratory volume in 1 s-to-forced vital capacity. The difference between the two groups in forced expiratory volume in 1 s, flow after 50% of the vital capacity has been exhaled, peak expiratory flow rate, and maximal mid-expiratory flow rate was statistically significant (p < 0.01). CONCLUSION: We found that the prevalence of asthma was more common in the IBS group than in controls. Our finding supports the speculation that asthma and IBS may share common pathophysiological processes.

Endoscopic retrograde cholangiopancreatography in the diagnosis and management of choledochal cysts.

Choledochal cysts are an uncommon anomaly of the biliary system manifested by cystic dilatation of the extra or intrahepatic biliary tree or both. It is most frequently found in Orientals and in females. Endoscopic retrograde cholangiopancreatography is a valuable imaging technique in the diagnosis of choledochal cysts in adults. Additionally, in selected cases, a choledochocele may be effectively managed by endoscopic sphincterotomy. We present clinical and endoscopic findings of six adult patients with choledochal cysts. Clinical symptoms were characterized by abdominal pain, jaundice and cholangitis. Associated hepatobiliary pathologic findings included cholelithiasis, recurrent acute pancreatitis, gallbladder carcinoma, Cystolithiasis, choledocholithiasis, biliary stricture and hepatic abscess.

Hepatitis C virus genotypes in patients with hepatocellular carcinoma.

OBJECTIVES: Epidemiological studies have suggested a strong association between chronic hepatitis C virus (HCV) infection and the development of hepatocellular carcinoma (HCC). It has also been suggested that there is a relationship between HCV genotypes and the development of cirrhosis and HCC. To investigate the possible role of HCV genotypes in the development of HCC, we studied HCV genotypes in 22 HCV-seropositive patients with histologically proven cirrhosis of the liver and HCC. METHODS: Anti-HCV antibodies were detected by second-generation enzyme-linked immunosorbent assay (ELISA). Serum HCV-RNA was detected by nested reverse transcription-polymerase chain reaction (RT-PCR) using primers derived from the highly conserved 5'-untranslated region. The HCV genotype was determined by nested RT-PCR using type-specific primers derived from the core region. RESULTS: Anti-HCV and HCV-RNA were detected in all patients with HCC. HCV genotyping was achieved in all of them. All patients had genotype 1b HCV. CONCLUSION: These findings suggest that HCV remains in replication and genotype 1b HCV is the predominant type in our HCV-seropositive patients with HCC.