Long-term enteral nutrition in patients with quiescent CD has a clear suppressive effect on clinical and endoscopic disease activities and the mucosal inflammatory cytokine levels.

No abstract

ObjectivesThe aim of the study was to compare the diagnostic performance of early-phase 123I-metaiodobenzylguanidine (MIBG) scintigraphy with that of delayed-phase imaging in Lewy body disease (LBD).MethodsA retrospective cohort study of 123I-MIBG scintigraphy was carried out in 192 patients who were suspected of having LBD. Clinical diagnosis was obtained using the UK Parkinson’s Disease Brain Bank Criteria in some cases or the third report of the Dementia with Lewy bodies Consortium in others. The participants consisted of 81 patients with LBD and 111 nondiseased patients. An injection of 111 MBq of 123I-MIBG was used. Planar images were obtained in an early phase and again in a delayed phase and the heart to mediastinum count ratio was calculated for both phases. Diagnostic performance was compared using a receiver-operator characteristic analysis. The cutoff value was chosen to maximize the Youden index. The sensitivity and specificity of each phase were calculated from the optimal cutoff value.ResultsThe heart to mediastinum ratio of the LBD group (median 1.8 and 1.45 for early and delayed phases, respectively) was significantly lower than that of the nondiseased group (median 2.93 and 3.18 for early and delayed phases, respectively). The area under the receiver-operating characteristic curve was not significantly different between the early and delayed phases (0.871 vs. 0.893; P=0.0914). Sensitivity and specificity were 80.2 and 91% for early-phase imaging (cutoff value at 2.28) and 81.5 and 95.5% (cutoff value at 1.91) for delayed-phase imaging, respectively.ConclusionThe diagnostic performance of 123I-MIBG scintigraphy was not significantly different between early-phase and delayed-phase imaging.

A 52-year-old woman with a history of two parturitions presented with lower abdominal pain. Multi-detector CT of the abdomen showed discontinuity of the sigmoid colon near the broad ligament on the left side. We assigned a provisional diagnosis of an internal hernia progressing through a defect in the broad ligament. SILS revealed a total broad ligament defect on the left side but no signs of ischemic, necrotic bowel. We successfully repaired the broad ligament defect with suturing. At the 2-month follow-up, the patient remained well with no signs of recurrence. This case appears to be the first report of a broad ligament hernia successfully diagnosed and repaired by SILS.