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11. |
Clinical Results and Prognostic Factors of Radiologically Node-Positive Gastric Carcinoma |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 140-143
Yosuke,
Adachi Ikuo,
Sakino Takashi,
Matsumata Yasunori,
Iso Rinken,
Yoh Seigo,
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摘要:
Lymph node metastasis determined by histologic examination is an important prognostic indicator in gastric carcinoma. However, prognostic value of lymph node metastasis detected by computed tomography (CT) is unknown. The aim of this study was to evaluate clinical results and prognostic factors of patients with radiologically node-positive gastric carcinoma.The study included 78 patients with primary gastric carcinoma and lymph node metastasis confirmed by CT. The level of lymph node metastasis was simply graded as follows: level I included perigastric nodes; level II included intermediate nodes along the left gastric, common hepatic, and celiac arteries; and level III included distant nodes along the hepatoduodenal ligament, pancreas, spleen, and abdominal aorta.Sixty patients (79%) had stage IV tumors showing one or more of the following: level III lymph node metastasis in 37, pancreatic invasion in 27, peritoneal dissemination in 23, and liver metastasis in 19. Overall 1- and 5-year survival rates were 29% and 6%, respectively, and the 1-year survival rate was significantly influenced by the level of lymph node metastasis on CT (55% for level I, 27% for level II, 7% for level III,P< 0.01). In patients with gastrectomy, prognostic factors were tumor size (<10 cm versus >10 cm,P< 0.01), gross type (localized versus infiltrative,P< 0.01), histologic type (well differentiated versus poorly differentiated,P< 0.01), and curability of the disease (curative versus noncurative,P< 0.01).Our study indicates that prognosis of patients with radiologically node-positive gastric carcinoma is poor because of high frequency of extensive tumor spreads. Patients having only positive level I nodes on CT are candidates for curative gastrectomy, which may offer long-term survival.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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12. |
Heterotopic Pancreas: A Difficult Diagnosis |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 144-147
Cheng-Yuan,
Hsia Chew-Wun,
Wu Win-Yiu,
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摘要:
Heterotopic pancreas is a rare disease. We evaluated 17 patients treated surgically at our hospital. Epigastric pain (77%), abdominal fullness (30%), and tarry stools (24%) were the three most frequent symptoms and signs. The lesions were diagnosed as gastroduodenal tumors by gastroduodenoscopy (67%) or upper gastrointestinal series (71%). Among these, only one gastric submucosal tumor was considered to be heterotopic pancreas preoperatively. Three patients were found to have gastric tumor by abdominal ultrasound. Computed tomography, small-intestinal series, barium enema, endoscopic retrograde cholangiopancreatography, angiography, and cholescintigraphy did not help in disclosing lesion. In about half of the patients, the lesions were located at the stomach. Tumor size varied from 1 to 3 cm. Surgical excision relieved symptoms. These findings indicated heterotopic pancreas is still a difficult disease for diagnosis, regardless of the improvements of diagnostic tools and techniques.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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13. |
Factors Predicting Progression to Cirrhosis and Hepatocellular Carcinoma in Patients With Transfusion-Associated Hepatitis C Virus Infection |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 148-152
Chisa,
Murakami Keisuke,
Hino Masaaki,
Korenaga Muneko,
Okazaki Michiari,
Okuda Kazuhiko,
Nukui Kiwamu,
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摘要:
The clinical progression of chronic hepatitis C is not uniform throughout the entire period of infection and is more rapid in patients with advanced histologic disease. Our study was designed to identify factors contributing to progression to cirrhosis and hepatocellular carcinoma by taking the entire period of infection into consideration. Two hundred thirteen patients with transfusion-associated hepatitis type C chronic liver disease were included in this study. They did not have either a history of antiviral therapy or any other potential causes of chronic liver disease except for transfusion. Hepatitis C virus genotype 1b was detected in 144 (68%) patients, followed by 2a in 51 (24%), 2b in 11 (5%), 1a in 4 (2%), and coinfection with 1b and 2a in 3 (1%). The log-rank test in the Kaplan-Meier method revealed that the cumulative percentage of cirrhosis-free or hepatocellular carcinoma-free patients became significantly lower as the transfusion age went up. Patient age at the time of transfusion was the only independent factor related to disease progression in multivariate analysis using Cox's proportional hazards model. Thus age at transfusion should be taken into consideration in designing the optimal follow-up schedule and therapy in patients with posttransfusion-associated chronic hepatitis C.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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14. |
Detection of Serum p53 Antibodies in Mucosal Colorectal Cancer and Negative Conversion After Endoscopic Resection |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 153-154
Akihiko,
Takeda Kazuaki,
Nakajima Hideaki,
Shimada Hideo,
Imazeki Wataru,
Takayama Hideki,
Hayashi Seiji,
Yoshimura Takao,
Suzuki Takenori,
Ochiai Kaichi,
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ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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15. |
Gallbladder Carcinoma Producing Alpha-Fetoprotein |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 155-158
Matthew,
St. Laurent Robert,
Esterl Glenn,
Halff K.,
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摘要:
Alpha-feto protein (AFP) is a clinically useful marker for hepatocellular carcinoma, hepatoblastoma, and nonseminomatous testicular tumors. Elevated serum AFP can also occur with tumors of the gastrointestinal tract, pancreas, lung, kidney, and urachus. Serum AFP can also be minimally elevated in nonmalignant conditions including acute and chronic hepatitis, cirrhosis, and pregnancy.Reports of gallbladder carcinoma that elaborate AFP are extremely rare, and almost all represent papillary carcinomas. Until now, there have been only two reports in the world literature that describe undifferentiated gallbladder carcinoma with elevated serum AFP. The authors present one case of undifferentiated gallbladder carcinoma and another case of poorly differentiated gallbladder carcinoma with increased serum AFP. In both cases, serum AFP was particularly useful in documenting metastatic recurrence of gallbladder carcinoma.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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16. |
Markedly Elevated CA125 in Hepatic CirrhosisTwo Case Illustrations and Review of the Literature |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 159-161
John,
DiBaise Jeremiah,
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摘要:
CA125 is the most widely used tumor marker presently available for use in patients with epithelial ovarian cancer. Although elevated in a high percentage of patients with ovarian cancer, serum CA125 levels have also been detected in patients with numerous benign and malignant nongynecologic disorders, including various diseases of the liver. Despite this well-publicized fact, it has become apparent that the association between CA125 elevation, particularly the degree of elevation, and liver disease may not be as widely recognized as one would suspect. When marked CA125 elevations occur, diagnostic confusion is common. We describe two cases illustrative of this point. Both cases involve middle-aged women who presented with massive ascites and due to markedly elevated serum CA125 levels underwent exploratory laparotomy with hysterectomy and/or bilateral salpingo-oopherectomy before their referral to our center. Because preservation of a woman's reproductive organs is a significant concern, it is imperative that both primary care physicians and specialists are aware of such associations and the proper use of tumor markers.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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17. |
Cholestatic Jaundice in Two Patients with Primary AmyloidosisUltrastructural Findings of the Liver |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 162-166
Masaki,
Iwai Yasutaka,
Ishii Takahiro,
Mori Yoshinori,
Harada Yoshihiro,
Kitagawa Motomu,
Kashiwadani Ongyoku,
Ou Takeshi,
Okanoue Kei,
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摘要:
Two patients with primary amyloidosis (amyloid light chain case) and severe cholestatic jaundice are described. Liver biopsy in the preterminal stage demonstrated amyloid deposits in the perisinusoidal space and in portal tracts, and hepatocytes were atrophic because of compression by amyloid fibrils. Ultrastructural findings showed amyloid fibrils not only in Disse's space but also in the sinusoids, and thehepatocytemicrovilli facing the amyloid fibrils were spicular. There were aggregates of lysosomal granules in the vicinity of bile canaliculi and some bile canaliculi were dilated with loss of microvilli. Amyloid fibrils in the portal tract compressed bile ductules, causing wide intercellular space and separated basement membranes from their epitheliums. These findings suggested disturbance in transporting not only of essential materials from sinusoids to hepatocytes but also of secretory vesicles into bile canaliculi and leakage of bile juice from small bile ductules in preterminal stage of primary amyloidosis.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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18. |
Primary Leiomyosarcoma of the Greater Omentum |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 167-170
Jiro,
Ishida Hideaki,
Ishida Kei,
Konno Tomoya,
Komatsuda Kimihiko,
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摘要:
We report a case of primary greater omental leiomyosarcoma successfully resected by omentectomy. Palpation of a painless abdominal mass at physical examination motivated medical imaging examination. Ultrasound visualized accurately the internal structure of the lesion but failed to determine the site of origin. Computed tomography and angiography determined the greater omental origin of the tumor before surgery. A review of the literature is also presented.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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19. |
Duodenal Ulceration Into the Cystic Artery With Massive Hemorrhage |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 171-174
Takeshi,
Iwamura Ryoji,
Uchino Shinya,
Oshikata Takashi,
Shimozono Etuji,
Kubota Kiyokazu,
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摘要:
This is a case presentation of a unique cause of intestinal bleeding. A duodenal ulcer eroded into the superficial branch of the cystic artery, causing massive intestinal hemorrhage. The patient, a 76-year-old woman, presented with left upper abdominal and left back pain secondary to cystic lesions in the pancreas body and tail. Stress after operation and complication of leakage of pancreatic juice after distal pancreatectomy with splenectomy and diclofenac sodium administration may have caused a deep peptic ulcer to erode the cystic artery. We performed a transfixing ligation of the bleeding vessel, serosal suture of ulcer of the gallbladder, and simple closure of the duodenal ulcer with covering greater omentum. There were no serious complications after the operation, and the patient made an uneventful recovery.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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20. |
A Case of Acute Phlegmonous Gastritis Successfully Treated With Antibiotics |
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Journal of Clinical Gastroenterology,
Volume 28,
Issue 2,
1999,
Page 175-177
Yuji,
Iwakiri Teppei,
Kabemura Daisuke,
Yasuda Hiroaki,
Okabe Akira,
Soejima Toshirou,
Miyagahara Kenichiro,
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摘要:
Acute phlegmonous gastritis is a rare disorder in which bacterial infection occurs in the gastric wall. Gastrectomy involving the affected area has been thought to be an effective form of treatment. The authors report a case of a 32-year-old woman who had severe upper abdominal pain without signs of peritoneal irritation. Endoscopy showed edematous and reddened gastric mucosa with a mass lesion in the gastric antrum. Endoscopic ultrasonography showed thickening of the antral wall and a low-echoic mass in the gastric antrum, thought to represent a fluid collection. White pus was aspirated from the mass. Localized type of acute phlegmonous gastritis with a gastric abscess was diagnosed. Culture of the pus showedStreptococcus pneumoniae.Through early diagnosis without laparotomy, the patient's gastritis was successfully treated with antibiotics alone.
ISSN:0192-0790
出版商:OVID
年代:1999
数据来源: OVID
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