Histopathological insights into hair loss in Cronkhite-Canada syndrome: diffuse anagen-telogen conversion precedes clinical hair loss progression.

Cronkhite-Canada syndrome (CCS) is a rare disorder characterised by gastrointestinal polyposis and ectodermal changes, represented by extensive alopecia. Detailed histopathological investigations of alopecic lesions in two female CCS patients with severe hair loss revealed a marked increase in telogen hair follicles with no sign of loss or of the minaturisation or atrophy of hair follicle structures and the absence of inflammatory change, despite severe inflammation in the gastrointestinal tract. These findings suggested that hair regrowth can be expected without systemic corticosteroids, if they are not necessary for treatment of the gastrointestinal tract, and that anagen-telogen transition is an early event preceding clinical hair loss in CCS.

The use of infliximab in the prevention of postsurgical recurrence in polysurgery Crohn's disease patients: a pilot open-labeled prospective study.

PURPOSE: Crohn's disease (CD) commonly recurs after surgery, and a number of patients need repeated surgery, especially smokers and those with repeated surgeries or penetrating disease. Whether infliximab prevents postsurgical recurrence in high-risk CD remains unknown. In the present pilot open-labeled study, we investigated the safety and efficacy of scheduled infliximab, which was started early after surgery, in maintaining remission of CD patients who have undergone multiple surgeries due to penetrating disease. METHODS: Eleven patients (nine male, two female; age range, 26-48 years) who had undergone repeated surgeries (median, 4; range, 2-5) for penetrating disease were enrolled. Two to 4 weeks after surgery, the patients were started on intravenous infliximab (5 mg/kg) at an 8-week interval. The primary end points were the proportion of patients in clinical remission at the end of the study, the rate of endoscopic/radiologic remission at 24 months, and the rate of adverse effects. RESULTS: One patient dropped out due to non-compliance, and ten patients were eligible for analysis. Clinical remission was maintained in six of ten patients (60.0%) at the end of the study. At 24 months, four out of ten patients were in endoscopic or radiological remission (40.0%). Two patients experienced adverse effects (18.2%), one of whom elected to withdraw from the study. CONCLUSION: The findings of no major safety concern and possible clinical benefit in our study suggest that further investigation of infliximab as a treatment for prevention of postsurgical recurrence in high-risk CD is warranted.

The use of water-soluble contrast enema without pretreatment for the diagnosis of colon disease.

Conventional colonoscopy and barium enema are the main examinations for colonic lesions, but each of them has different limitations according to the condition of the patient. It has been reported that preparations for these examinations also caused complications, such as colonic perforation leading to fatality. To avoid these complications, colonic enema with water-soluble contrast medium (Gatrografin) has been performed as a screening method for those suspected to have obstructive colonic diseases, or those in whom it was difficult to be form colonoscopy and barium enema because of their poor condition. There are few reports about water-soluble contrast enema (WSCE). We retrospectively examined 121 cases of WSCE performed from January 2004 to December 2005 and assessed the acceptability of examination and its ability to detect colonic lesions. We divided our patients into five groups according to the reason for performing WSCE. In all cases, we were able to perform WSCE without complications and assess colonic lesions. In 58 cases, we compared the results of WSCE with those of barium enema or colonoscopy, or both In 8 cases we missed small colonic polyps and erosions, but we missed only one large polyp 3 cm in diameter, which we detected retrospectively. In conclusion, WSCE is safe and useful for the diagnosis of colonic disease, and may be one of the choices of colonic examination especially for those who are suspected to have obstructive colonic diseases or hemorrhagic lesions as well as for those in whom it is difficult to perform barium enema or colonoscopy.

Sporadic gastric neurofibroma underneath early cancer: MDCT gastrography and histological findings.

We report the case of a sporadic gastric submucosal neurofibroma underneath a T1 stage cancer. A 61-year-old man underwent gastroscopy because of epigastralgia and was diagnosed as having T1 stage gastric cancer by an experienced gastroenterologist. Subsequently performed computed tomography (CT) showed poorly circumscribed wall thickening underneath the converged folds on three-dimensional images. On a dynamic enhancement study, the thickened wall was seen to be enhanced gradually from the arterial phase to the equilibrium phase. Based on these findings, we diagnosed stage T2 cancer. Total gastrectomy was performed, and the surgically removed specimen revealed that the wall thickening was caused by a submucosal neurofibroma and that cancer existed in this neurofibroma, invading the submucosa. This patient had no family history of neurofibromatosis, and so the lesion was diagnosed as early gastric cancer with a sporadic submucosal neurofibroma. Coexistence of gastric cancer and a submucosal tumor is rare, but such a case is one of the pitfalls of a CT diagnosis of T stage gastric cancer.

A novel apoptosis-inducing monoclonal antibody (anti-LHK) against a cell surface antigen on colon cancer cells.

BACKGROUND: Apoptosis is a crucial element in the behavior of mammalian cells in many different situations. We here report the establishment of a novel monoclonal antibody (anti-LHK mAb) that has apoptosis-inducing activity against colon cancer Colo205 cells. METHODS: The mechanism of anti-LHK mAb-induced cell death was assessed by microscopic morphology, Annexin V/Hoechst 33528 staining, and detection of DNA fragmentation. The molecular weight of LHK antigen was determined by Western blotting. Growth inhibition of Colo205 cells induced by anti-LHK mAb was determined by in vitro and in vivo studies. RESULTS: Anti-LHK reacted with a 70-kDa antigen and completely blocked the proliferation of Colo205 cells bearing LHK in vitro in a manner characteristic of apoptosis. Strikingly, anti-LHK mAb suppressed tumor growth in a murine peritoneal dissemination model. CONCLUSIONS: LHK antigen, which is restricted to epithelial cells, may be a novel death receptor that plays a critical role in controlling the growth, invasion, and metastasis of human colon cancer cells.