1/628. Clinical value of protein-bound fucose in patients with carcinoma and other diseases. Protein-bound fucose content in sera from normal persons and patients with various malignant and non-malignant diseases was measured and statistically analyzed. Normal serum gave a mean value of 6.84 /- 0.13 mg/100 ml, and rarely exceeded 9 mg/100 ml. Although no significant difference was found between sexes, there was a tendency of fucose content to decrease in older persons. It was noted that more than 90% of cancer-bearing patients have significantly higher level than critical value (9 mg/100 ml), while only 8.7% of patients with benign tumor showed positive result. These results were not limited to special organs but in common to all cases studied. The elevation of serum fucose content in malignant tumor was well correlated with its stages of progression, though the levels were less significant in early and in rather locally restricted breast and thyroid cancer. Serial postoperative follow-up study showed that the levels in serum fucose content was a useful parameter for judging the effectiveness of therapy and the prognosis of the patient. The fucose content in malignant tumor tissue and metastasized lymph node appeared to be significantly elevated than that in normal tissue. The practical usage and limitation of the fucose value in various diseases, together with a possible source of serum fucose were discussed. ( info) |
2/628. Endoluminal surgery. The development of laparoscopic surgery has provided minimally invasive surgeons with advanced laparoscopic instrumentation and high definition imaging. The resulting surgical expertise and technology has now been extended to gastric endoluminal surgery. Laboratory and clinical investigations have been initiated for various applications of this new form of surgery. Endoluminal gastric wall excision surgery is the most widely utilized and includes the removal of superficial gastric malignancies, benign gastric wall leiomyomas, and gastric polyps. Clinical experience has increased, and the initial results have been satisfactory. Pancreaticocystogastrostomy can be successfully performed using intraluminal surgery, but gastric wall bleeding and lack of fusion of the stomach to the cyst wall have complicated some cases. There are case reports of foreign body removal and intraluminal surgical procedures for patients with bleeding gastric ulcers. Of primary importance at this stage of development is the surgeon's familiarity with appropriate indications for gastric endoluminal surgery and the access devices currently available. Future considerations include the application of this approach to patients with gastroesophageal reflux disease, occult gastrointestinal bleeding, intractable bleeding from a duodenal ulcer, and multiinstitutional trials of gastric excision procedures. ( info) |
3/628. Sessile polypoid gastric heterotopia of rectum: a report of 2 cases and review of the literature. OBJECTIVE: The term heterotopia, a term derived from Greek, implies "other place." It refers to the finding of normal tissues at foreign sites. Heterotopic gastric tissue rarely involves the large bowel. We report 2 cases of this rare entity. DATA SOURCES: case reports of 2 patients with sessile polypoid lesion in the rectum, with a review of the available literature, using both medline and relevant bibliographies of published articles. RESULTS: Biopsies of the rectal lesions in our 2 cases revealed the presence of gastric tissue. Only 27 other such cases have been reported in the English literature. CONCLUSIONS: patients with rectal gastric heterotopia usually present with bleeding, but other presentations and complications are possible. Endoscopic or surgical excision is the treatment of choice, although the lesions also respond to histamine 2 receptor blockers. ( info) |
4/628. Spontaneous gastrointestinal perforation in patients with lymphoma receiving chemotherapy and steroids. Report of three cases. Spontaneous gastrointestinal perforations in three patients with lymphoma were considered to be treatment-related conditions. All three were diagnosed as having malignant lymphoma by histological examination, and treated with chemotherapy and steroids. Four to 14 days after the start of chemotherapy, they complained of abdominal pain and plain roentgenograms revealed pneumoperitoneum. The interval between the onset of peritonitis and operation was almost 24 h. Emergency operations were carried out; one patient with a jejunal perforation underwent resection of the jejunum, another with a gastric perforation received a simple closure with omental patch, and the third with a gastric perforation underwent gastrectomy. Two patients recovered from the surgery, while the gastrectomy patient died due to sepsis. The favorable outcome of the surgical intervention is attributed to early diagnosis, prompt exploration, and selective operative procedures. We recommended a simple closure with omental patch for gastroduodenal perforation. Resection and primary anastomosis are possible only in the small bowel. ( info) |
5/628. A case of gastric pseudoterranoviasis in a 43-year-old man in korea. A case of Pseudoterranova decipiens infection was found in a 43-year-old man by gastroendoscopic examination on August 20, 1996. On August 6, 1996, he visited a local clinic, complaining of epigastric pain two days after eating raw marine fishes. Although the symptoms were relieved soon, endoscopic examination was done for differential diagnosis. A white, live nematode larva was removed from the fundus of the stomach. The larva was 38.3 x 1.0 mm in size and had a cecum reaching to the mid-level of the ventriculus. A lot of transverse striations were regularly arranged on the cuticle of its body surface, but the boring tooth and mucron were not observed at both ends of the worm. The worm was identified as the 4th stage larva of P. decipiens. ( info) |
6/628. splenosis presenting as an ulcerated gastric mass: endoscopic and endoscopic ultrasonographic imaging. A case of an ulcerated gastric wall mass ultimately found to be splenosis is presented in which the index patient had endoscopic and endoscopic ultrasonographic evaluation prior to resection. Although no visual features identified this mass as a splenic implant preoperatively, the lesion appeared to be atypical for leiomyoma, which led to surgical intervention. The role of endoscopic ultrasonography in assessing isolated gastric masses is discussed. ( info) |
| BACKGROUND: Isolated gastric tuberculosis is extremely rare, especially in the subcardiac region, where the low pH, high motility and absence of lymphoid tissue result in an unfavourable environment for the development of tuberculous lesions. methods AND RESULTS: Here we present a case of isolated gastric tuberculosis in the gastric cardia with no evidence of pulmonary involvement. Our patient was a young man with vague gastrointestinal symptoms and no previous history of tuberculosis. His condition was first detected on upper endoscopy as a raised subcardiac ulcer similar in appearance to a submucosal tumour. An endoscopic forceps biopsy showed the presence of caseating granulomata and acid-fast bacilli. The lesion resolved completely with 12 months of oral anti-tuberculosis therapy. CONCLUSIONS: This case illustrates the need for a high index of suspicion in order to diagnose this rare condition, as it can present in patients with no particular risk factors or symptoms. Once diagnosed, a complete cure can often be achieved with a course of oral anti-tuberculosis medication, with surgery being reserved for severely symptomatic or refractory lesions. ( info) |
8/628. Mucin-producing biliary papillomatosis associated with gastrobiliary fistula. We report a case of mucin-producing biliary papillomatosis in a 78-year-old woman. Abdominal ultrasound (US) and computed tomography (CT) showed wall thickening and dilatation of the intrahepatic bile duct (IHBD), as well as a nodular lesion, 1.2 cm in diameter, in the left branch of the IHBD. Gastric endoscopy revealed excretion of bile-containing mucin on the anterior wall of the body of the stomach. Endoscopic ultrasonography (EUS) showed gastrobiliary fistula and discharge of mucin into the stomach. Needle biopsy of the biliary tumor revealed papillary proliferation, but no malignant cells were recognized histologically. Therefore this patient was diagnosed as having mucin-producing biliary papillomatosis forming gastrobiliary fistula. She did not present with obstructive jaundice, probably because of the fistula. She is alive, without obstructive jaundice, 16 months after the diagnosis without having had surgery. This is, to our knowledge, the first reported case of biliary papillomatosis forming gastrobiliary fistula and with the patient free of obstructive jaundice. ( info) |
9/628. Treatment of protein-losing gastropathy with atropine. Protein loss from the gastric mucosa with hypertrophic gastric folds and hypoalbuminemia has been associated with low, normal and elevated gastric acid output. A case of protein-losing gastropathy with slightly elevated gastric acid output is described. Associated findings were hypertrophic gastric folds, hypoalbuminemia, hyperlipidemia, lymphadenopathy, edema, ascites and venous thrombosis. Oral administration of atropine resulted in a cessation of gastrointestinal protein loss and correction of hypoalbuminemia. ( info) |
10/628. Gastric tuberculosis: unusual presentations in two patients. We report two cases of gastric tuberculosis (TB) in Nigerians. The first case concerns an elderly man initially thought to have abdominal malignancy but was subsequently found to have extensive and complicated gastric TB coexisting with chronic peptic ulcer disease. The second case involved the extremely rare condition of gastro-bronchial fistula in a young woman. In contrast to previously reported cases, it was of tuberculous origin and pulmonary symptoms were minimal. Both cases were radiologically evident. ( info) |