摘要:

&NA;Paradoxical contraction of the puborectalis muscle during simulated defecation straining (anismus) has been cited as a cause of constipation. The functional specificity of this phenomenon was evaluated in 79 patients, 50 with constipation, 21 with idiopathic perineal pain, and eight with solitary rectal ulcer syndrome. Electromyogram evidence of paradoxical puborectalis contraction was observed in 38 (76 percent), ten (48 percent), and four (50 percent) of these patients, respectively. All patients with solitary rectal ulcer syndrome had difficulty defecating; defecation was normal in all patients with perineal pain. These observations suggest that paradoxical contraction of the puborectalis muscle is not a specific finding, and that it is not the sole cause of constipation in patients with anismus.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Subjects undergoing proctocolectomy with ileoanal anastomosis of either a J‐shaped or a S‐shaped ileal reservoir were studied with respect to functional status. Both subjective and objective measures were used. The S‐pouch subjects appeared to have better early functional results, but no differences were found between groups evaluated at least one year from ileostomy closure. While virtually all subjects preferred restorative proctocolectomy to their previous loop ileostomy, there was a relatively high frequency of bowel‐related symptoms, worries about bowel activity, and associated behavioral changes. The actual significance of these symptoms is difficult to determine at present. Further assessment of the quality of life in individuals with restorative proctocolectomy in comparison with subjects undergoing alternative surgical treatments is recommended.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Twenty‐two patients with pulmonary metastases from adenocarcinoma of the colon and rectum had sputum samples examined for cytology. All patients had lesions demonstrated on chest roentgenography and eight patients also underwent bronchoscopy. Three or more sputum samples were examined for eight patients, two samples for seven patients, and seven patients had one sample only examined. In five of 22 patients, the sputum samples were reported to be unsatisfactory for cytodiagnosis. Of the remaining 17, nine patients had at least one positive result for metastatic adenocarcinoma and in two additional cases the sample showed atypical cells. The result was therefore positive or atypical in 11 of 17 patients (65 percent). The positive cytology rate reported (79 percent for multiple pulmonary metastases) represents an improvement compared with previously published work. In this study 14 patients had either one or two samples collected for cytology and it is likely that the positivity rate would have been higher if three samples had been collected.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Thirty patients who had curative surgery for sigmoid and rectal carcinoma were studied by immunoscintigraphy using a new monoclonal antibody: B72.3 radiolabeled with Iodine‐131 (I‐131) or Indium‐111 (In‐111). Results were compared with other conventional diagnostic procedures such as computed tomography, ultrasound, endoscopy, and tumor markers. Seven patients had local recurrences and/or distant metastases. Immunoscintigraphy identified all local recurrences (five cases) that were confirmed by CT and was able to localize three of five liver metastases (two false‐negatives). Furthermore, immunoscintigraphy also recorded a false‐positive. Preliminary use of B72.3 shows good potential for the evaluation and detection of neoplastic sites.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Patients with a personal history of rectal cancer are considered at high risk for metachronous large‐bowel primaries. Since a malignant growth was the main reason for performing a colostomy in patients followed at the centers of the authors' association (AISTOM), a correct follow‐up approach for these patients is very important. A multicentric clinical trial was thus carried out to evaluate the efficacy of transstomal endoscopic exploration (TEE) of the residual colon, and data collection began on May 31, 1984. Nine hundred fifty‐seven patients were submitted to TEE after curative abdominoperineal resection (Miles) for rectal cancer. The male‐female ratio was 1.3;89.6 percent of the patients were over 50 years of age. A family history of large‐bowel cancer was present in 18 percent, and in 23 percent of the patients the cancer was associated with synchronous adenomas. Only 31 percent of the patients had colonoscopy or double‐contrast barium enema x‐ray beyond the neoplastic area before the surgery. TEE was done in 96.8 percent of the patients; in 3.3 percent the examination was not possible, mainly for stenosis of the stoma (in 2.3 percent). In 82 percent of the patients a complete large‐bowel exploration was possible: a new large, bowel cancer was found in 22 patients (2.2 percent) and an adenoma in 183 patients (19.1 percent). These results show that, because it is safe, practical, and effective, endoscopy plays an important role in the follow‐up of ostomates.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;A significant association was found between colorectal cancer, especially of the right colon, and concomitant gallstones. This was noted especially in female patients and in those over the age of 65. The existence of such an association is of advantage in terms of secondary prevention of colorectal cancer. The possible screening methods are discussed for those gallstone patients at risk.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;A 20‐year‐old woman presented with an acute perianal abscess. Tuberculous culture was positive and a chest radiograph demonstrated miliary spread. Tuberculosis still should be considered as an etiologic factor in acute anorectal sepsis.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Colonogastric fistula, more commonly called “gastrocolic,” is a rare complication of Crohn's colitis. The 17th incidence of this fistula is reported. Fecal halitosis is a prominent symptom. Barium enema is the most accurate diagnostic tool. Colonoscopy plays a role in delineating surgical therapy. The stomach resection is described. Because of its pathogenesis, the authors prefer to call this “colonogastric” fistula, rather than gastrocolic fistula.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Free perforation of a primary, benign, gastrococlic fistula is extremely rare; perforation of a gastrojejunocolic fistula has not been reported previously in the English medical literature. Experience with two such cases is presented and the surgical management of this condition is emphasized.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Angiosarcoma of the colon with epithelioid and histiocytoid features, a malignant counterpart of epithelioid hemangioendothelioma, was observed in a 72‐year‐old man. The disease first manifested as a right cervical mass, with the histologic appearance of malignant, undifferentiated, large‐cell epithelioid neoplasm. Light microscopy of the colonic tumor disclosed angiosarcoma, with active erythrophagocytosis and positive immunoperoxidase reactions to lysozyme, alpha‐1‐antitrypsin, and alpha‐1‐antichymotrypsin. Ultrastructural features of the tumor cells were those of intermediate betwen endothelial and histiocytic cells. The disease took a rapid fatal course with recurrence, peritoneal dissemination, and massive peritoneal hemorrhage. The cause remains unknown.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID