ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Sex and racial predilection, social history, and histology were analyzed in a biopsy-proven adenocarcinoma of the lower esophagus/esophagogastric junction collected over a 5-year period in two teaching institutions with different patient populations. Adenocarcinoma occurred in 11% of patients with biopsy-proven esophageal cancer. The disease occurred only in males at one center, and in a 7:1 ratio of males to females at the other center. Clear racial predilection was seen, since 12 of 13 patients with adenocarcinoma of the esophagus were white, whereas less than 20% of patients with squamous carcinoma of the esophagus were white. The finding of Barrett's epithelium in eight of the 13 cases strongly supports the theory that in white males, Barrett's epithelium is a precursor lesion of adenocarcinoma of the esophagus/esophagogastric junction.

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The clinical and investigative features of eight patients with attacks of epigastric pain believed due to a hypertensive lower esophageal sphincter (LES) are described. Radionuclide esophageal transit studies were normal in all but one patient. Two patients had positive acid perfusion studies. Only three had an abnormal baseline esophageal manometry, but after small intravenous doses of pentagastrin all subjects experienced their presenting pain coincident with increases in LES pressure ranging from 75 to 140 mmHg. Five patients eventually required surgical myotomy of the LES, but pain relief which was immediate and complete in all proved permanent in only one. Two of the operated patients continued to experience severe attacks of pain refractory to medical therapy. The diagnosis of a hypertensive LES is best made by pentagastrin stimulation of the sphincter, but cutting the sphincter may not cure the patient.

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

We evaluated long-term treatment with either ranitidine (R) or sucralfate (S) in the prevention of duodenal ulcer recurrences. Fifty-nine patients with healed ulcers were randomly allocated to maintenance treatment with 150 mg R nightly or 2 g/day S. By using a life table analysis, the calculated probable remission rates at 4, 8, and 12 months were 90, 85, and 53% with R, respectively, and 62, 62, and 53% with S, respectively. These differences were not significant at any interval. In both groups ulcer relapse was independent of sex, smoking habit, and alcohol and coffee consumption, whereas a history longer than 5 years was significantly related to a higher probability of recurrence. No relevant clinical or biochemical side effects were encountered with either drug, but compliance rate was higher in the R group. R and S are equally effective in preventing duodenal ulcer relapse over a 1-year period of maintenance treatment, although R proved to be more effective in preventing early relapse.

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Spiral organisms were found in close apposition to the jejunal mucosa in a patient with idiopathic intestinal pseudoob-struction. Such organisms are generally not found in the jejunum and their presence in this patient was considered to be related to intestinal stasis, and possibly to diarrhea.

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Two hundred twenty-two patients with colon cancer, diagnosed in the past 5 years, were grouped by age into the sixth, seventh, and eighth decades. Examination showed an increased incidence of right-sided colon cancer by decade and a simultaneous fall in the incidence of rectosigmoid lesions. A trend toward a more favorable Dukes' pattern was evident with each rise in decade. We suggest that the shift in site of colon and rectal cancer toward the right is directly related to age and is a feature of the “aging gut.”

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Forty cases of nongangrenous ischemic colitis were studied to find the different clinical features between stricturing form and transient form. Clinical and laboratory findings were compared between two groups, 15 cases of stricturing form and 25 of transient form, which were diagnosed by follow-up barium enema radiography. The following four items, of the nine studied, were significantly different between the two groups; namely, patients of stricturing form were older in age, had longer time intervals from the onset of disease to disappearance of subjective symptoms and to normalization of white blood cell count and/or erythrocyte sedimentation rate, and showed an increase in l-h erythrocyte sedimentation rate on day 5 or earlier of the disease. Our observations indicate that the age and l-h erythrocyte sedimentation rate might be useful indicators to differentiate the stricturing and transient forms early after the onset of the disease.

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

We report two studies on possible risk factors for postoperative recurrence of Crohn's disease and an extensive literature review. In our retrospective study, 90 patients who had undergone curative resection and anastomosis 1 to 22 years (average 9.3 years) previously were examined. The recurrence rate, calculated by actuarial methods, was 62.2% after 10 years and 86.4% after 15 years. The site of recurrence was clearly related to the initial location of disease (p < 0.001). However, of the various clinical, pathological, and surgical factors studied, only the preoperative history correlated directly with recurrence (p < 0.05).The prospective study evaluated the influence on recurrence of microscopic lesions at grossly free margins of ileocecal resection. Twenty-two consecutive patients, operated on for Crohn's disease of the terminal ileum from 6 to 34 months previously (average 24 months), were studied. From the histological grading previously established, recurrence was independent of involvement at both proximal and distal section lines. Therefore, we recommend conservative resection to obtain only grossly uninvolved margins.

ISSN:0192-0790    

出版商:OVID    

年代:1986

数据来源: OVID