Morphine potentiated the ulcerogenic activity of indometacin in a dose-dependent manner when administered subcutaneously (2.5–7.5 mg/kg). However, in the case of intracerebroventricular administration, morphine failed to exert any potentiating action. Atropine (0.5 mg/kg, s.c.) and cimetidine (12.5–25 mg/kg, s.c.) decreased the ulcerogenic activity of indometacin, and the combination of indometacin/morphine in about the same degree. However, the reduced ulcerogenic activity of indometacin after atropine or cimetidine treatment could still be enhanced by morphine if it was added to the combination of indometacin/atropine or indometacin/cimetidine. Since the potentiating action of morphine was completely blocked by naloxone (1 mg/kg), this action of morphine might be mediated via opiate receptors.

Twenty patients with rectal adenocarcinoma were endoscopically biopsied and given short-term cytostatic therapy [5-fluorouracil (5-FU) (600 mg/m(2)) and Ca-folinate (60 mg/m(2)) for 2 days]. Seven days later, the tumor was resected or a second biopsy was performed. Apoptotic and mitotic indices as well as (mutant) p53 and bcl(2) expression were determined in the tumor tissue before and after the short-term chemotherapy. The patients were treated thereafter with long-term, intermittent 5-FU administration and followed up clinically for 7-26 months. Six patients showed progression of the disease and died, whereas 14 improved or showed no tumor progression. Significant increase of the apoptotic index and nonsignificant decrease of the mitotic index after the short-term cytostatic treatment were seen in the tumor tissue of responder cases. Nonresponders showed no change in both mitotic activity and apoptotic activity. Both survivors and deceased showed high mutant p53 expression, and the changes after short-term 5-FU treatment were not significant. Expression of bcl(2) was present in only 5 cases, with the postchemotherapy changes being not significant. These findings suggest that apoptotic response to short-term cytostatic therapy may be an additional predictive factor in rectal adenocarcinoma.

Approximately 30 % of primary extranodal lymphomas occur in the gastrointestinal tract. Most of these present as single le− sions, although gastrointestinal polyposis occurs in some 10 % of cases, including conditions such as multiple lymphoma− tous polyposis (MLP) and immunoproli− ferative small−intestinal disease (IPSID) [1]. MLP is a rare intestinal malignancy characterized by the presence of numer− ous gastrointestinal polypoid lesions of malignant lymphoma. It is a non−Hodg− kin s B−cell lymphoma that is the gastro− intestinal counterpart of mantle−cell lym− phoma [2]. The polyps range from a few millimeters to several centimeters in size and involve the small and large bowel in 80 ± 90 % of cases and the stomach or duo− denum in 50 % of cases [3]. The condition often shows extra−abdominal dissemina− tion, especially to peripheral lymph nodes.A 68−year−old man presented with a his− tory of abdominal pain, occult lower gas− trointestinal bleeding, loss of weight, sideropenic anemia, and fever. Colonosco− py revealed a large number of different− sized polyps (Figure 1). Abdominal ultra− sonography showed enlarged retroperito− neal lymph nodes. Chest and abdominal computed tomography (CT) also demon− strated lymphoid dissemination. Gastros− copy and CT enteroclysis did not show polypoid lesions. Histopathological ex− amination of the large−bowel polyps confirmed lymphocytes with irregular nuclei. Immunohistochemistry (DAKO/ LSAB+DAB) of tissue samples showed CD20, CD5, CD43, and cyclinD1 positivity, and CD79−alpha, CD3, and cytokeratin ne− gativity (Figure 2). Mantle−cell lymphoma was diagnosed on the basis of these data.The patient underwent four cycles of che− motherapy with a protocol using cyclo− phosphamide, hydroxydaunomycin, On− covin (vincristine), and prednisone (CHOP) plus rituximab (Mabthera). The control colonoscopy showed that the polyps had disappeared. At the time of writing, the patient had been asympto− matic and without any abnormal labora− tory values for a 12−month follow−up period.This case represents a rare form of colonic polyposis. Combined chemotherapy was successful and the change in the endo− scopic appearance was spectacular. In the management of such rare cases, we re− commend careful follow−up of patients by gastroenterologists and oncologists. In case of relapse, repeated chemotherapy or bone−marrow transplantation is needed.

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