摘要:

&NA;Anal manometry, with microtransducer technique, was performed in 55 patients after restorative proctocolectomy. Forty‐two patients were followed regularly from before surgery until 12 months after surgery, and 23 patients until 24 months of function. Postoperatively, sphincter function was severely impaired. At 12 months, the mean height was less than 60 percent, mean area less than 50 percent, and mean length less than 90 percent of the preoperative values of the high pressure zone. There was no improvement between 12 and 24 months. Mean maximal squeeze pressure was restored at 12 months. Rectoanal inhibitory reflex was constantly present preoperatively, but in only 4 of 30 patients, postoperatively. Those patients with preoperative resting pressure 100 cm H2O or greater had significantly higher resting tones at 12 months than those with less than 100 cm H2O. Patients with 5 or fewer bowel movements every 24 hours had significantly higher resting tones than those with more than 6 movements every 24 hours (66vs.45 cm H2O). Patients with deferral 60 minutes or greater had significantly higher resting pressures than those with deferral less than 30 minutes (65vs.44 cm H2O). No correlation was found between resting pressure and state of continence.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;Through recent research, the trace element, germanium, was found to have an anticancer effect. The purpose of this research was to determine the effect of germanium on 1, 2‐dimethylhydrazine‐induced intestinal cancer in rats. Ninety‐six 8‐week‐old Sprague‐Dawley male rats were divided into 4 groups, with 24 rats in each group. All received dimethylhydrazine, 20 mg/kg body weight, subcutaneously, once a week for 20 weeks. Except for one control group, the other three groups were subdivided into six groups and administered three different kinds of germanium (inorganic germanium, organic germanium, and natural organic germanium) one month before and during dimethylhydrazine treatment, and during dimethylhydrazine treatment, respectively. Twenty‐four weeks after carcinogen exposure, all surviving animals were sacrificed and examined for intestinal tumors. The number and location of the tumors were recorded and the pathology examined. The incidence of intestinal cancer in the control group (dimethylhydrazine only) was 91 percent; in groups provided with inorganic germanium one month before and during dimethylhydrazine treatment, and during dimethylhydrazine treatment only, it was 91 and 78 percent; in groups provided with organic germanium one month before and during dimethylhydrazine treatment, and during dimethylhydrazine treatment only, it was 64 and 64 percent; in groups provided with natural organic germanium one month before and during dimethylhydrazine treatment and during dimethylhydrazine treatment only, it was 50 and 45 percent. From these results, the authors conclude that natural organic germanium has the best prevention effect for intestinal cancer in this animal model(P<0.01), followed by organic germanium(P<0.05). Inorganic germanium has no effect. However, there is no difference in the cancer prevention effect of germanium provided one month before and during dimethylhydrazine treatment, and during dimethylhydrazine treatment only.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;Patients with a primary family history of colon cancer were recommended to have full colonoscopy for screening. The results of 125 such patients who also were asymptomatic, had no prior history of neoplasms, and had negative fecal occult blood, showed 15 patients (12 percent) with neoplasms. Only 6 (5.2 percent) had neoplasms that were detectable only by colonoscopy(i.e.,above 55 cm). These results suggest that colonoscopy may not be necessary to screen patients with a primary history of colon cancer.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;To clarify the presence of depressed adenomas in the human large intestine, a prospective study was performed from January 1986 to December 1987. During these two years, 997 colonoscopies were conducted in patients, bdexcluding cases of familial adenomatosis coli. Of 32 small, depressed lesions biopsied, seven were depressed adenomas, demonstrating that depressed adenomas do exist in the colon and rectum, and can be detected endoscopically. Resembling a sucker, they are easily detected through inflation and deflation.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;Twentyfive patients with invasive adenocarcinoma of the rectum were treated by preoperative external irradiation (35 Gy), local excision, and peroperative placement of a plastic tube loop in the tumor bed for perioperative brachytherapy (20 or 25 Gy. Patients treated were too frail for radical resection (14 patients or had refused a permanent colostomy (11 patients. With a mean follow‐up of 40.5 months, there have been 5 patients with local relapse, 3 of whom had salvage abdominoperineal resections: 2 have no evidence of disease and 1 has developed distant metastatic disease. The 20 patients with local control have normally functioning sphincters; 1 has developed distant metastic disease. This combined approach was designed to expand the curative role of local resection in carcinoma of the rectum. The surgical techniques are thoroughly described and the potential role and indications of this approach are discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;Local recurrence is the most serious complication of anterior resection for rectal cancer, usually occurring during the first two years after surgery. Over a five‐year period, from 1981 to 1986, 183 patients underwent anterior resection for rectal carcinoma at the Surgery Ward of the University of Ferrara. Patients were followed for two years postoperatively. All operations were performed with staplers and classified according to Dukes, with 43 cases of Dukes' A; 83 cases of Dukes' B; and 57 cases of Dukes' C. In the first 24 months after surgery, the tumor recurred locally in 44 of the 183 patients (24 percent. Dukes' stage, grading distal resection margin, and histopathologic differentiation of the distal rectal ring left in the stapler after anastomosis were assessed to determine a prognostic indicator for the recurrence of the tumor. The stage:recurrence ratio was as follows: A, 1 (2 percent); B, 21 (25 percent); and C, 22 (39 percent). The grading:recurrence ratio was: G1, 13:51 (25 percent); G2, 24:110 (22 percent); and G3, 7:22 (32 percent). The ratio between distal rectal resection margin and recurrence was: 0 to 2 cm, 15:27 (56 percent); 2 to 4 cm, 16:74 (22 percent); and over 4 cm, 13:82 (15 percent). Histopathologic examination of the distal rectal ring was negative for all patients. These data confirm the direct relationship between class and local recurrence and indicate histologic grade and distal resection margin as significant prognostic parameters only when interpreted in the light of staging.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;Immunoperoxidase staining of LICR‐LON M8, a mouse monoclonal antibody reactive with epithelial membrane antigen, showed a strong reaction with colorectal cancer. This finding prompted an immunoscintigraphic study of colorectal cancer patients using this antibody. Sixteen patients had external gamma scintigraphy after intravenous injection of indium 111‐labeled M8. Positive scans were obtained in 11 of the 13 patients with primary colorectal cancers, and 2 of the 3 patients with recurrent tumors. The high indium 111 background in the liver prevented the detection of hepatic metastases in 5 patients. Twelve patients had samples taken of tumor, normal colon, and venous blood at the time of surgery. The ratio of labeled antibody uptake in tumor to that of blood was 5.1 (±3.6 S.D.), which was significantly different(P=0.001) to that of the similar ratio for normal colon (2.0±1.6 S.D.). The tumor to normal colon uptake ratio was 2.6 (±1.3 S.D.). These results suggest a specific uptake of indium 111‐labeled M8 by colorectal cancer.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;In a prospective study of 35 patients undergoing surgery for colorectal cancer, the mitogenic activity of plasma was measured using 3T3 Swiss fibroblasts as target cells. Transfused patients exhibited a 100 percent increase in mitogenic activity over preoperative values compared with no significant change in nontransfused patients. Samples were taken from blood during 28 days of storage following donation, and mitogenic activity measured. The mitogenic activity increased with storage time, the principal changes occurring from the end of the second week. The increased mitogenic activity in patients following transfusion and in stored blood may be a factor in the mediation of the deleterious effect of transfusion on recurrence in colorectal cancer and perhaps “fresh” blood, if required, should be used.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;Undiagnosed abdominal emergencies account for 10 percent of all fatalities among patients with spinal cord injuries. A large number of these emergencies involve the lower gastrointestinal tract. The purpose of this study is to bring attention to the occult nature of colorectal disease in spinal cord patients and to highlight the subtle, but characteristic, symptoms and signs that develop in these patients. The authors identified 13 spinal cord patients in whom a lesion developed in either the appendix, colon, rectum, or anus. The average age of all patients was 36.2 years. Trauma and multiple sclerosis were the most common etiology of spinal cord injury. The most common presenting symptoms were abdominal distention, vomiting, and constipation. The average delay in diagnosis of the colorectal disease was 35.8 hours. An 84% morbidity and 22% mortality were observed. This study indicates that any deviation from the normal lifestyle of the spinal cord patient should alert one to the possibility of visceral inflammation. Furthermore, close attention to the signs of autonomic dysreflexia or changes in spasticity, along with a thorough evaluation of the ill‐appearing spinal cord patient, may uncover occult colonic or rectal disease.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

&NA;Four homosexual male patients with giant anal carcinomas, ranging from 10 to 17 cm in diameter, are presented. These patients were not candidates for abdominoperineal resection because of fixation to adjacent structures. Common symptoms included pain, sepsis, anemia, incontinence, and weight loss. Diverting colostomy was performed in all patients. Two of the four patients were treated by wide local excision of the tumors for palliation. Two patients were treated with chemotherapy and radiation therapy. Three of the four patients died within 12 months. The authors conclude that diverting colostomy and wide local excision of giant anal cancers offer effective palliation of local wound problems in selected cases.

ISSN:0012-3706    

出版商:OVID    

年代:1990

数据来源: OVID