摘要:

Cowden's disease, or multiple hamartoma syndrome, is a rare condition classified recently as a hereditary preneoplastic syndrome. Multiple orocutaneous hamartomas are associated with involvement of other organ systems, including fibrocystic breast disease and breast carcinoma, goiter, thyroid cancer, gastrointestinal polyps, and endometrial carcinoma. We describe a patient with Cowden's disease who underwent extensive gastroenterological work-up and review other cases in the literature.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 29-year-old woman with quiescent Crohn's disease developed severe myositis. Serum creatine phospho- kinase was markedly elevated, and muscle biopsy showed typical findings of dermatomyositis. The muscular symptoms promptly responded to combined treatment with corticosteroids and azathioprine. The association between inflammatory bowel disease and inflammatory myopathies is very rare. We review the clinical, pathological, and pathophysiological aspects of this association.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 51-year-old man with no history of liver disease had acute severe jaundice, with a serum level of total bilirubin of 27.4 mg/dl and an alkaline phosphatase level of 731 IU/L due to distal common bile duct compression from peripancreatic head fibrosis associated with retro- peritoneal fibrous. Other obstructive phenomena in this patient included bilateral hydronephrosis from ureteral fibrosis encasement and testicular swelling from fibrous encasement of vessels draining the scrotum. Autopsy demonstrated massive retroperitoneal fibrosis, with angulation and compression of the distal common bile duct by fibrosis covering the head of the pancreas. The intrahepatic biliary tree was dilated because of the distal choledochal obstruction, but the proximal common bile duct was not dilated due to mural fibrosis.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We report a giant splenic epithelial cyst which produced carbohydrate antigen 19–9 (CA 19–9) in a 21-year-old woman with left abdominal pain. Imaging techniques revealed a huge cyst of the spleen, and laboratory data revealed elevated serum CA 19–9 (830 U/ml; normal, < 27 U/ml). After splenectomy, serum CA 19–9 level returned to normal. A unilocular splenic cyst measuring 16×14×13 cm contained brown fluid (900 ml) with a high level of CA 19–9 (10,150,000 U/ml). The wall of the splenic cyst was composed of inner stratified epithelium with mixed squamous and columnar differentiation; immunohistochemical analysis showed that the epithelial cells of the cyst showed strong immunoreactivity to CA 19–9. The inner connective tissue of the cyst wall devoid of epithelial cells was also strongly positive for CA 19–9. We suggest that epithelial cells of our splenic epithelial cyst produced a large amount of CA 19–9 which diffused into capillaries of the connective tissue of the cyst wall and entered into systemic circulation, resulting in the elevated serum CA 19–9.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Inducing positive nitrogen balance and weight gain in patients fed exclusively parenterally was documented first by Dudrick et al. in 1968. Since that time, total parenteral nutrition (TPN) has become commonplace both in acutely ill patients and in those with severe chronic gastrointestinal disease. Clear nutritional benefits accrue, but certain complications associated with TPN have become apparent. In the following discussion we review clinical, biochemical, and pathophysiologic abnormalities of the hepatobiliary system associated with TPN, particularly hepatic dysfunction and gallbladder disease and their management.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The clinicopathologic findings in eight Mexican patients with imrnunoproliferative small intestinal disease (IPSID) are analyzed. Four of these cases have been previously reported and the remainder were found in a retrospective review of 42 lymphoproliferative disorders of the small bowel (9.5% of the cases at our institution). There were six male and two female patients with an average age of 30 years. Laparotomy with intestinal resection was performed in seven cases. Malignant lymphoma was documented in five and the early phase of IPSID in two patients. The remaining case was diagnosed by means of several endoscopic biopsies. It is concluded that although IPSID seems to be a rare disease in the mestizo population of our country, it may not be exceptional and its diagnosis has probably been overlooked.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

To determine whether risk factors of ulcerative colitis among Japanese are the same as those observed in other countries, we conducted a case-control study in Japan in 1988–90. Patients selected for the study were receiving financial aid for treatment of the disease; an equal number of population-based controls matched by age and sex were selected. Smoking decreased the risk of the disease (odds ratio = 0.30; 95% confidence interval, 0.16–0.56), and stopping smoking increased the risk (odds ratio compared with those who had never smoked = 1.44; 95% confidence interval, 0.73–2.85). In those who drank alcoholic beverages ≥ 5 days a week, disease development was less likely than in others (odds ratio = 0.49; 95% confidence interval, 0.30–0.81). In addition, difficulties in human relations at work, a family history of asthma, a medical history of surgical procedures, and personality traits such as nervousness, anxiety, and obsessive behavior were also considered risk factors. Although some findings are similar to those in former studies, a few findings are different: surgical procedures, occupational status, and a family history of the disease. To clarify whether the differences are consistent will require other case-control studies.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Pregnancy is uncommon in patients with portal hypertension, and the correct treatment for pregnant women with esophageal varices has not yet been established. There have been only a few reports on endoscopic injection sclerotherapy (EIS) during pregnancy for the control of variceal bleeding. Here we report two women with esophageal varices who underwent EIS. One was a pregnant woman with variceal hemorrhage who was saved by emergency EIS and was delivered safely. The second woman underwent prophylactic EIS for esophageal varices before becoming pregnant. This woman later gave birth uneventfully. Thus EIS appears to be a useful treatment for pregnant women with esophageal varices.

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1994

数据来源: OVID