摘要:

PURPOSE:This paper compares the positive predictive value of an immunochemical fecal occult blood test for colorectal neoplasms between the stool specimens obtained during the digital rectal examination and those obtained during the routine screening.METHODS:In a medical check‐up, 1,688 subjects received both an immunochemical fecal occult blood test and a colonoscopy. Fecal occult blood was tested by two methods: digital rectal examination and routine screening. The positivity rate of an immunochemical fecal occult blood test and the positive predictive value for colorectal cancer and large adenomatous polyp were determined by these two methods.RESULTS:The positivity rate and the positive predictive value were 5.4 percent and 19.8 percent (4.4 percent for cancer and 15.4 percent for adenomatous polyp) in the digital rectal examination method and 3.5 percent and 27.1 percent (6.8 percent for cancer and 20.3 percent for adenomatous polyp) in the routine screening method, respectively. These figures indicate a significant difference in the positivity rate (P<0.01) and the positive predictive value (P<0.05) between these two methods.CONCLUSIONS:These findings indicate that the stool obtained by routine screening has a better positive predictive value than stool collected during the digital rectal examination.

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PURPOSE:The interactions of blood‐borne colorectal carcinoma cells with vascular endothelium are important during hematogenous formation of distant metastases. To adhere to the vessel wall, circulating carcinoma cells that come into contact with the microvasculature must resist the tractive forces of the flow of plasma and other circulating cells that tend to detach them from the wall.METHODS:Hydrodynamic adhesion assays have been introduced to mimic the microcirculation and investigate cell adhesion under flow conditions. Different aspects of colorectal cancer cell adhesion during hematogenous formation of distant metastases are summarized and discussed in this review.RESULTS:Adhesion of colorectal carcinoma cells to endothelial cells and extracellular matrix is influenced by the presence of fluid flow. Shear forces alone are able to induce signal transduction events in these cells that result in cell activation and modification of adhesive behavior.CONCLUSIONS:Consideration of fluid dynamics of circulating colorectal cancer cell movement in the microcirculation leads to new knowledge ofin vivoprocesses that are involved in tumor cell adhesion to the vessel wall in host organs. Shear forces have been found to influence adhesive properties of colorectal carcinoma cells to endothelial cells and underlying subendothelial extracellular matrix. Understanding the complex processes involved in tumor cell adhesion may result in the development of novel therapeutic strategies.

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;Mesenteric panniculitis is a rare disease characterized by nonspecific inflammation of the fat tissue of the mesentery. We present an extremely rare case of mesenteric panniculitis of the sigmoid colon, complicated by occlusion of the inferior mesenteric vein. A 75‐year‐old male presented with a one‐month history of abdominal distention and abdominal mass without pain. Physical examination revealed a firm mass in the lower abdomen. Barium enema study demonstrated rugged mucosa and a serrated contour in the rectosigmoid colon. Computed tomography showed that the mass arose from the mesentery, which surrounded the mesenteric vessels. The density of the mass was slightly higher than that of fatty tissue. Based on these radiologic findings, the patient was diagnosed as having mesenteric panniculitis of the rectosigmoid colon. Colonoscopy showed narrowing with edematous mucosa in the rectosigmoid colon, whereas marked dilated vessels were noted in the proximal portion of the sigmoid colon. Angiography showed occlusion of the inferior mesenteric vein, with venous flow returningviaa collateral vein. The patient was observed without medication because his condition was satisfactory. His symptoms subsequently disappeared during a period of several weeks. The mass in the lower abdomen gradually diminished in size, disappearing three months later. Computed tomography and barium enema showed improvement of the lesion. The favorable outcome of the present case was probably because of formation of a collateral vein. The present case suggests that aggressive therapy for mesenteric panniculitis should be avoided, because the outcome of this disorder is good, even when there is obstruction of vessels.

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PURPOSE:Endometriosis of the rectovaginal septum can harbor different types of secondary tumors that may involve the rectal wall and protrude into its lumen, thus making diagnosis difficult. Extrauterine low‐grade endometrial stromal sarcoma may rarely arise in endometriosis. The purpose of this article was to present the third case of this association.METHOD:This was a clinicopathologic study.RESULTS:A 42‐year‐old female presented with abdominal pain and fever. Laparotomy revealed a large pelvic mass involving the rectovaginal septum and the colonic wall and which protruded into the lumen forming endoluminal polypoid masses. Concomitant peritoneal nodules and a metastatic paracolic lymph node were also found. Histopathologically, primary endometriotic foci were found in close relationship with an endometrial stromal sarcoma which invaded the rectal wall. The female genital tract had no endometriotic lesions. The patient was treated by surgery and subsequent chemotherapy and was alive and well 20 months later.CONCLUSIONS:Endometriosis and its possible malignant changes should be taken into account in the differential endoscopic diagnosis of rectal masses in females.

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;Cecal volvulus is a rare cause of intestinal obstruction after major abdominal surgery. A case of cecal volvulus occurring in the early postoperative period after left colon resection for malignancy is presented. Clinical evaluation and plain abdominal radiographs suggesting cecal volvulus prompted laparotomy and correction. Delay in diagnosis results in high mortality, and treatment depends largely on the viability of the involved intestine. This report describes the second case of cecal volvulus complicating a left colectomy. It was treated by detorsion and reperitonealization cecopexy.

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

&NA;Gasless hand‐assisted surgery, an alternative technique for colorectal cancer, is described. The abdomen is lifted by two metal disks especially designed for this procedure. The gasless condition evokes no hazard from pneumoperitoneum, and the procedure is greatly simplified by the hand assistance.

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:2001

数据来源: OVID