[Crohn's disease and stromal sarcoma of the small bowel--a rare coincidence]. / Morbus Crohn und Stromasarkom des Dünndarmes - eine seltene Kombination.

We report the case of a 29-year-old female who suffers for more than 13 years from Crohn's disease. A small bowel resection had to be performed because of a complicated and insufficiently controlled course of the disease with beginning subileus. At laparotomy a leiomyosarcoma was found. This case represents the forth case in the literature of an association between chronic inflammatory bowel disease and malign mesenchymal tumors. Tumors of epithelial and lymphoreticular origin are known as a much more common complication in Crohn's disease and especially ulcerative colitis. An exact histological characterization of these sarcomas is important to define the prognosis of the disease. If recurrent subileus is poorly controlled in Crohn's disease stromal tumors with their frequent intraluminal growth have to be considered as part of the differential diagnosis.

[Calciphylaxis: ischemic tissue necrosis in chronic renal failure. Case report and review of the literature]. / Kalziphylaxie: Ischämische Hautnekrosen bei terminaler Niereninsuffizienz.Falldarstellung und Literaturüberblick.

Calciphylaxis is a rare but potentially life-threatening complication in chronic renal failure. It is characterized by ischemic tissue necrosis primarily of the skin. The typical histopathologic finding is microvascular calcification with endovascular fibrosis. Patients typically present with violaceous, mottled and painful lesions which tend to progress to non-healing ulcers and necrosis. Most frequently the lower extremities are involved in a symmetric fashion but the trunk may also be affected. Sepsis from superinfection of the lesions accounts for the high mortality of this disease which is of importance for dermatologists and nephrologists alike. 61-year-old female patient developed lesions of calciphylaxis on both calves two years after beginning hemodialysis to treat renal failure due to diabetic glomerulosclerosis. We discuss aspects of the pathogenesis of calciphylaxis, as well as diagnosis, treatment and means of prevention, and review the current literature.

Parathyroid hormone increases the concentration of insulin-like growth factor-I and transforming growth factor beta 1 in rat bone.

Intermittent treatment with parathyroid hormone (PTH) increases bone mass in experimental animals and humans. In vitro studies have suggested that the anabolic effect of PTH may be mediated by local growth factors. However, the relevance of these findings to in vivo situations remains unclear. In this study, we examined a time course of daily s.c. injections of hPTH (1-34) on the skeletal concentration of insulin-like growth factor (IGF)-I, IGF-II, and transforming growth factor beta (TGF-beta) in the proximal tail vertebrae of male rats. PTH caused a time and dose-dependent increase in the bone mineral density of the lumbar spine. This anabolic effect on bone mass was accompanied by progressive increases in bone matrix-associated IGF-I and TGF-beta 1. Increases in IGF-I and TGF-beta 1 became apparent after four and eight weeks of PTH treatment respectively and persisted through week 12. PTH had no effect on circulating IGF-I, suggesting that the increase of bone matrix IGF-I was due to the local effect of PTH on bone tissue directly rather than to an increase of circulating IGF-I. These data are consistent with the hypothesis that IGF-I and TGF-beta 1 may play a role as local mediators of the anabolic effects of PTH on bone metabolism.