摘要:

Primary gastric lymphoma comprised 20% of 119 patients with gastric malignancy seen at our hospital between 1975 and 1980, even when strict criteria were applied to exclude systemic lymphoma patients with gastric involvement. Of the 24 patients with gastric lymphoma, 16 had disease confined to the stomach and contiguous nodes. Eight with massive stomach involvement, but also evidence of distant disease were classified as “probable” primary gastric lymphoma. Symptoms, physical findings, and laboratory studies in the lymphoma patients were similar to those of carcinoma patients. Radiography was more likely to suggest benign conditions in cases with lymphoma. While endoscopy suggested malignant disease in over 80% of lymphoma patients, histologic diagnosis of lymphoma was made first by endoscopy in only 38%.Our data suggest that lymphomas are more common among gastric neoplasms than reported in the past. This cannot be accounted for by referral patterns or by improvement in diagnostic techniques. Although lymphomas appear to be more common, this is not necessarily due to a rise in their incidence. The proportionate increase in lymphomas may be due to the decline in gastric carcinoma or to a true increase in incidence.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Although recommended for patients requiring frequent dilations in whom surgery is not feasible, self-bougienage for benign esophageal stricture has not been examined critically. Thirteen patients performing self-dilations over a mean period of 4.8 years were evaluated. Dysphagia decreased in all patients and reflux symptoms were well-controlled in most patients with an antireflux regimen of elevation of the head of the bed, antacids, and cimetidine. Major complications of bleeding or perforation were not encountered, although three episodes of esophageal food impaction related to missed home dilation session did occur. Longterm self-bougienage is both safe and effective therapy for benign esophageal stricture for patients who require frequent dilations.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Granular cell myoblastoma, a rare, but generally benign tumor, is being encountered with increasing frequency in the digestive tract. Seventy-two cases have been described in the esophagus; we report two additional cases. A follow-up, available in 13 patients (including ours), reveals a low likelihood of malginant transformation or recurrence after surgical removal. Guidelines for the management of these tumors are presented.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The detection of occult blood in gastric fluid samples may be clinically important, but many current methods are too sensitive. Gastric fluid containing various concentrations of blood were subjected to analysis by four screening methods. Orthotolidine based tests (Hematest reagent tablets and Bili-Labstix) designed for urinary and fecal blood detection when applied to gastric aspirates were highly accurate, but sensitivity was so great that normal fluid yielded positive results. Guaiac slide tests (Hemoccult and Gastroccult™ slide tests) were less sensitive than the orthotolidine-based tests. The Hemoccult slide test was influenced by the low pH of gastric aspirates and neutralizing the acidity of the gastric fluid by addition of NaOH improved the sensitivity of the method. The Gastroccult™ slide test accurately determined gastric fluid pH and hemoglobin concentration > 300 μg/dl in the acid environment of gastric fluid. The Gastroccult™ slide test is a simple, rapid, and convenient method for initial evaluation of patients suspected of occult blood in gastric juice.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Improvement in Crohn's disease after drug therapy was evaluated in 38 patients with evidence of rectal disease at sigmoidoscopy in whom the rectum later appeared normal. Rectal biopsies taken before and after therapy were examined histopathologically. Cell counts of the lamina propria connective tissue cells were used to evaluate mucosal changes. The drugs apparently responsible for conversion of the rectal mocosal appearance to normal were sulfasalazine, prednisone, and 6-mercaptopurine.There was complete healing histologically in 24 patients (63%). In the other 14, healing was incomplete as evidenced by microscopic chronic inflammation, microgranulomas, or occasional lymphangiectasia. There were both complete and incomplete responses to all three drugs, but the total numbers were too small to identify significant therapeutic differences. Cell counts confirmed the elimination of acute inflammation. Despite drug therapy, histological evidence of activity persisted in one-third of the patients in whom the appearance of the rectum became normal.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The role of the anorectal band in the genesis of hemorrhoids is studied. The anorectal band is a fibroepithelial tube which is a remnant of the anorectal sinus. Seventy-six hemorrhoid patients and 32 controls were studied. Rectal neck pressure recording was done for all subjects. Two biopsies were taken from the lower rectal neck of each individual of the hemorrhoid and the control group, and were examined microscopically. Rectal neck pressure was measured in 67 patients of the hemorrhoid group after internal sphincterotomy. The mean rectal neck pressure in the hemorrhoid patients was significantly higher than the controls. Post-operative pressure measurement showed normal values. Microscopic examination of the rectal neck specimens revealed the presence of fibrous bands in the lower rectal neck submucosa of all hemorrhoid patients and in only one control subject. Evidence suggests that this fibrous band is the anorectal band which is an embryonic vestige. A new theory of the pathogenesis of hemorrhoids is presented. Evidence in support of the theory is also shown. The treatment of hemorrhoids in view of this theory is discussed.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We describe a patient with dysphagia and chest pain, whose sole esophageal manometric abnormality was an elevated lower esophageal sphincter pressure. A radionuclide esophageal emptying test showed prolongation of emptying. After bougienage and medications failed to give relief, pneumatic dilatation gave excellent subjective and objective results.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A 36-year-old woman with chief complaints of colicky right upper quadrant pain, fever, and intermittent jaundice for 3 months, proved to have Caroli's disease associated with choledocholithiasis and ascariasis of the common bile duct, documented by percutaneous transhepatic cholangiography and operation.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Oral contraceptives frequently produce mild hepatocellular dysfunction, but only rarely cause jaundice. The syndrome of oral contraceptive jaundice is usually mild, with rapid resolution upon withdrawal of the drug. We describe a patient who had a severe illness with marked jaundice after one cycle of oral contraceptives. Her symptoms progressively worsened and serum billirubin increased for almost 3 months after discontinuation of oral contraceptives. Full recovery ultimately occurred. Her severe and prolonged course demonstrates the wide spectrum of oral contraceptive jaundice.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Methylphenidate-induced hepatic injury was documented by abnormal liver function tests including a markedly elevated serum bilirubin, serum glutamic oxaloacetic transaminase, and serum glutamic pyruvic transaminase. Liver biopsy confirmed portal inflammation and hepatocellular disarray. Enzyme changes were reproducible with rechallenge of the drug (Ritalin). The drug is capable of producing hepatic injury, particularly when given in nonstandard doses intravenously.

ISSN:0192-0790    

出版商:OVID    

年代:1984

数据来源: OVID