摘要:

&NA;In an unselected population of 108 patients with ulcerative colitis in an ongoing endoscopic cancer surveillance program, high‐grade dysplasia was diagnosed in 3, low‐grade dysplasia in 11, and mucosal changes indefinite for dysplasia in 11 patients. The abnormal biopsy specimens from these 25 patients and samples from other parts of the large bowel obtained at the same examination were investigated by flow cytometric DNA analysis. One hundred thirty‐six of 160 samples (85 percent) gave evaluable DNA histograms and, accordingly, 23 patients were retrospectively investigated. Six patients (26 percent) showed aneuploidy (abnormal DNA stemlines) and 1 had possible aneuploidy. All 3 patients with high‐grade dysplasia showed aneuploidy (or possible aneuploidy) preceding or coexisting with the severe dysplastic changes. In 1 of these patients, the presence of aneuploidy preceded two diploid carcinomas. One patient was found to have had aneuploidy for seven years without evident malignant transformation. Further prospective studies are necessary to determine the value of DNA analysis in relation to morphologic examination in surveillance of patients with ulcerative colitis.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Conventional treatment for colonic obstruction due to cancer or benign anastomotic stricutres in high‐risk patients or unresectable cases in some form of colostomy. This procedure has the negative aspects of requiring a general anesthetic and leaves the infirm patient with a stoma that they cannot easily attend to. Ablation of tumor by Nd‐Yag laser has been available for several years, with passage of the laser fiber through a colonoscope. To evaluate the role of laser photocoagulation in the palliation of colorectal tumors or benign strictures, the authors summarized their initial experience, trying to define the indications, various methods of treatment, and complication rate in these patients. This technique is difficult to perform and has the added risk of intestinal perforation but does obviate anesthetic and surgical risks. Seven patients with recurrent metastatic colorectal obstruction, three patients with benign colonic strictures, and two patients with large villous tumors were treated with Nd‐Yag laser passed via the colonoscope. The mean age was 71 years (range, 52 to 86 years). Five patients received sedatives only, six patients received epidural anesthetic, and one had a general anesthetic. The average total energy used was 3702 joules on noncontact fibers, and the average number of pulses was 126. Distance of the lesion from the anal margin ranged from 0.5 to 30 cm. Ten of twelve tumors were within 15 cm of the dentate line. In the most distal lesions, manual debulking with biopsy forceps facilitated the laser treatment. Symptomatic relief was achieved in all patients. One patient required a colostomy one month after treatment because of incontinence. Another patient needed a resection of a benign stricture after three laser treatments. Other than one case of microperforation, treated conservatively with antibiotics, no other complications occurred and there was no mortality. The authors believed that the Nd‐Yag laser plays a specific role in the treatment of high‐risk patients.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Vascular disorders of the colorectum are considered rare in Taiwan, however, recently the authors encountered five cases of ischemic colitis, all in men over 50 years of age. Cases one and five involved stricture, case two was secondary to obstructive colon cancer, and case three was of the gangrenous type presenting with peritonitis due to colonic perforation. Case four was of the transient type with acute massive lower gastrointestinal bleeding secondary to traumatic shock. All five patients were treated successfully by resection.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Two cases of colorectal lymphoma are presented. Preoperative histologic diagnosis is difficult and examination of the fresh specimen using immunocytochemical and gene rearrangement techniques are necessary to establish the precise nature of the lesion. Surgical excision is the mainstay of treatment for localized lymphoma of the colorectum and chemotherapy for malignant lymphomatous polyposis.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;T. Kennedy Dalziel, the son of a farmer, was born in Scotland at Merkland, Penpont, Dumfriesshire. He received his early education at a private school in Dumfries and studied medicine at Edinburgh University, graduating in 1883. He continued his medical studies in Berlin and Vienna, where he specialized in experimental surgery and pathology. In 1885 he began his practice in Glasgow, and in 1889 he joined the surgical staff of the Western Infirmary. In 1891 he joined the staff of the Royal Hospital for Sick Children.In his early years, Dalziel did considerable lecturing, first as Lecturer on Anatomy at the Western Medical School, and later as Professor of Medical Jurisprudence and of Surgery in Anderson's College. At the beginning of World War I he was called to represent Scotland on the Advisory Council to the Diretor‐General of the Royal Army Medical Corps. For his services, the king conferred on him the honor of knighthood.His successes and the public position he attained were the result of an unusual combination of qualities—charm, kindliness, extraordinary teaching skills, and marvelous manipulative dexterity. He was considered the best technical surgeon in the West of Scotland. His contributions to the medical literature were considerable, dealing mainly with abdominal surgery. His writings, including this “classic” paper, demonstrate a concise grasp of a new disease entity,chronic interstitial enteritis, later to become known as Crohn's disease. It is generally believed that Dalziel was the first to “draw attention to this condition”. T. Kennedy Dalziel died on February 10, 1924, in his 64th year.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID