The progression of periodontal disease is influenced by socio-economic factors. Effect modifications of socio-behavioural factors by CRP indicate that under conditions of systemic inflammation adverse SES effects may be aggravated.

Low serum IGFBP-3 levels might be associated with higher levels of periodontal disease. Neither serum IGF-I nor IGF-I/IGFBP-3 ratios were associated with periodontitis.

Dear Editors: Gastrointestinal autonomic nerve tumors (GANTs) form a subset of gastrointestinal stromal tumors (GISTs) [4]. In contrast to classical GISTs, GANTs have ultrastructurally a distinct neuroendocrine phenotype [1,4]. The nature of these ultrastructural neuroendocrine granules remains enigmatic. With the exception of a single GANT, which was described as secreting vascular endothelial growth factor and endostatin [3], there are no published reports that these tumors secrete polypeptide hormones, growth factors, or biogenic amines.In the present paper, we report a GANT found to secrete catecholamines. We are submitting this case for publication to indicate that GANTs can be functionally active.A 49-year-old man visited his primary care physician complaining of lower quadrant pain that began following a minor work-related injury of the abdomen. During the initial examination, an abdominal mass was palpated, and a subsequent computerized tomographic examination revealed a 15-cm lower abdominal mass. He was obese and had been treated for elevated blood pressure, which fluctuated between 150/105 and 163/93 mm Hg, even though he was taking antihypertensive drugs. Because of the suspicion that the tumor might be secreting catecholamines, several laboratory tests were performed, and the following abnormalities were found: urinary 5-hydroxyindolacetic acid (5-HIAA) was elevated 13.7 mg/24 h (normal, <6 mg/24 h), homovalinic acid 10.7 mg/24 (normal, <8 mg/24 h), fractionated metanephrine 281 μg/24 h (normal,<180 μg/24 h; hypertensive range, >400 μg/24 h), normetanephrine 610 μg/24 h (normal, 451 μg/24 h), and total metanephrines 891 μg/24 h (normal, 680 μg/24 h). The tumor was located in the mesentery of the small intestine and was resected in toto with a segment of the small intestine. The patient recovered completely.The tumor was multilobular and solid and measured 15×14×13 cm (Fig. 1a). Histologically, it was composed of elongated spindle cells showing moderate nuclear pleomorphism and hyperchomasia (Fig. 1b). There was an average of eight mitotic figures per ten high-power fields. Immunohistochemical stains showed that the tumor was positive for CD117, CD 34, and vimentin (Fig. 1c). Other immunohistochemical tests, including the staining with antibodies to S100, smooth muscle actin, desmin, cytokeratins, chromogranin, and synaptophysin gave negative results. Electron microscopy revealed that many cells have elongated or rounded-up filopodia-like processes containing neurosecretory granules (Fig. 1d). There were also prominent interdigitating cytoplasmic processes and rudimentary intercellular junctions. There was no evidence of smooth muscle or Schwann cell differentiation. On the basis of these morphologic data, the diagnosis of a malignant GANT was rendered. On the basis of the size (more than 10 cm in diameter) and the number of mitoses, the tumor was designated as high risk, as defined at the National Institutes of Health Consensus Conference [2]. The patient was treated with Gleevac, which he tolerated ...

Aim. The aim was to compare the periodontal status of the acromegalic patients with healthy subjects from a large population-based cohort (Study of Health in Pomerania, SHIP). Materials and Methods. We studied 32 acromegalic patients (16 females) and 128 randomly selected SHIP subjects (controls) using a 1 : 4 matching. Serum IGF-I and IGFBP-3 levels were measured using the Immulite 2500 system. Periodontitis was assessed by clinical attachment loss (CAL), probing depth (PD), and number of missing teeth. Linear and logistic regression models were used to assess differences in periodontal variables between acromegalic patients and controls. Results. IGF-I levels were comparable in acromegalic patients and controls, whereas IGFBP-3 levels were significantly higher in acromegalic patients (P = 0.004). In multivariate modelling, both groups did not differ significantly with respect to mean CAL (P = 0.12) and high tooth loss (P = 0.36). Mean PD was higher in acromegalic patients by trend (B = 0.28 (−0.00; 0.56)). Conclusion. In acromegalic patients, periodontal disease severity did not differ from their healthy SHIP controls.