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  • 1
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The two-stage leukocyte adherence inhibition (LAI) test has been used to demonstrate in the serum of subjects with various colorectal cancer conditions the presence of factors able to sensitize normal leukocytes against normal intestine components. High reactivity was found in the serum from some patients with degenerating polyps but not in patients with adenocarcinoma of the bowel or controls. These data suggest that the LAI test can be of predictive value and that the host is able to develop an immune response to normal tissue components in this clinical condition.
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  • 2
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A 58-year-old man with no sign of pulmonary disease and a normal chest x-ray presented with acute pancreatitis resistant to conventional medical management and a mass in the head of the pancreas. The presumptive diagnosis was pancreatic cancer with tumor-induced pancreatitis. However, endoscopic retrograde cholangiopancreatography suggested metastatic rather than primary tumor, so that an extrapancreatic primary was actively sought. Further lung work-up demonstrated a small cell carcinoma of the lung. This case indicates that metastasis-induced acute pancreatitis can be the presenting symptom and sole manifestation of lung cancer.
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  • 3
    ISSN: 1573-2568
    Keywords: acute pancreatitis ; alcohol ; trypsin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A normal serum amylase level is found in up to 32% of patients with acute alcoholic pancreatitis. This underlines the need for more sensitive diagnostic tests in this frequent cause of pancreatitis. Animal and human studies have shown that chronic alcohol consumption leads to important modifications in trypsinogen metabolism. The present work has prospectively analyzed admission serum trypsin activity with a new biochemical test and usual markers such as amylase, lipase, and immunoreactive trypsin in 32 attacks of acute pancreatitis. Seventeen were due to alcohol and 15 to other causes, including 11 with gallstone pancreatitis. High trypsin activity (median: 235 units/liter; range: 165–853) was found in all patients with acute alcoholic pancreatitis even when the amylase level was normal on admission (3/17: 18%). Trypsin activity did not differ between nonalcoholic pancreatitis (N=15): 84 units/liter (42–98), alcoholic controls (N=15): 77 units/liter (40–122), and healthy controls (N=62): 81 units/liter (15–143). The difference was not related to the severity of disease or circulating α2-macroglobulin, α1-protease inhibitor, or immunoreactive trypsinogen levels. Lipase/amylase ratio was less discriminant than trypsin activity between alcoholic and nonalcoholic diseases. We conclude that serum trypsin activity seems specific to acute alcoholic pancreatitis and should be included in new prospective studies assessing biochemical testing of alcohol-related pancreatic diseases.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 34 (1989), S. 964-966 
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 5
    ISSN: 1573-2568
    Keywords: anemia ; angiodysplasia ; small bowel ; enteroscopy ; digestive bleeding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastrointestinal angiodysplasias are the most common cause of obscure chronic digestive blood loss. Push-enteroscopy is likely to detect and to treat vascular lesions. Push-enteroscopy was performed in 83 patients (mean age 62 years) presenting with iron deficiency anemia of obscure origin. A nonrevealing preliminary evaluation included esophagogastroduodenoscopy, colonoscopy and, in 50% of the patients, small bowel barium studies. We employed a 240-cm Olympus push-enteroscope (XSIF-100), 11.3 mm in diameter. A potential bleeding lesion was observed in 49 patients (59%). Gastrointestinal angiodysplasias were the most common lesion (33 patients). Electrocoagulation (bicap) of angiodysplasias was performed when accessible and not diffuse (〈20). If not contraindicated, hormonal treatment was proposed for patients who had at least five AD. Some patients had both treatments. Long-term follow-up (mean, 12.2 months) was obtained in 25 patients with small bowel angiodysplasias. A good outcome (neither recurrence of anemia nor blood transfusion requirements) was observed in 12 patients. The diagnostic efficacy of push-enteroscopy is high. Despite available and recommended therapeutic modalities, the long-term outcome was considered to be good in only 50% of the patients.
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  • 6
    ISSN: 1573-2568
    Keywords: esophagus ; dysphagia ; esophageal motor disorders ; achalasia ; pneumatic dilatation ; Rider-Moeller technique ; esophageal perforation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fifty-three patients suffering from dysphagia because of suspected esophageal motor disorders were treated by pneumatic dilatation using the Rider-Moeller technique. Fifteen had achalasia demonstrated by manometric studies. Forty-nine of them had remarkable clinical improvement after the procedure. During the mean period of follow-up (average 5 years, range 1–11), 75% of the patients needed a new dilatation, with a delay of two years. The results of the dilatation were excellent or good in 80% of the cases. Early complications consisted in two esophageal perforations surgically treated. There was no mortality. We did not observe late complications of the procedure. We conclude that pneumatic dilatation should be the initial procedure in the treatment of dysphagia in suspected esophageal motor disorders.
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  • 7
    ISSN: 1573-2568
    Keywords: pancreatitis ; alcohol ; selenium ; vitamin E ; vitamin A ; antioxidant
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Free radicals have been suspected to play a role in the pathogenicity of alcohol-related chronic pancreatitis. The aim of this study was to determine the status of several antioxidant parameters in these patients and examine the factors that are likely to influence them. Thirty-five subjects (23 males and 12 females, mean age 48±8 years) with disease proven by endoscopic pancreatography and 14 healthy controls (6 males and 8 females, mean age 44±7 years) were included in the study. Biochemical antioxidant parameters included: selenium, zinc, and copper levels in plasma; glutathione peroxidase in plasma and erythrocytes; plasma malondialdehyde concentrations assessed by thiobarbituric acid reactants; and serum vitamin E and A levels. Selenium and vitamin E oral intake was assessed by a five-day diet analysis. Hemoglobin (130±16 vs 143±15 g/liter), vitamin E (8±5 vs 16±9 mg/liter), vitamin A (30±11 vs 49±12µg/dl), selenium (54±20 vs 87±11µg/liter), and plasma glutathione peroxidase (903±313 vs 1326±168 units/liter) were significantly lower in patients than in controls (P〈0.05). In contrast, white blood cell count, C-reactive protein, and plasma copper levels were significantly higher in patients than in controls. Cholesterol, triglycerides, iron, ferritin, total proteins, zinc, and malondialdehyde were not different. Vitamin E was lower in patients with steatorrhea, while vitamin A was lower in patients with concomitant diabetes mellitus. Dietary intakes were not different between patients and controls. In conclusion, patients with alcohol-related chronic pancreatitis have low blood levels in many antioxidant factors. Dietary intakes of some of them (selenium and vitamin E) are adequate, however. Such deficiencies are secondary to pancreatic insufficiency and probably to increased requirements related to enhanced oxidative stress.
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  • 8
    ISSN: 1573-2568
    Keywords: GALLBLADDER STONES ; CONTACT DISSOLUTION ; METHYL TERT-BUTYL ETHER ; EUROPEAN SURVEY ; STONE RECURRENCE
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since there are now several ways to treatsymptomatic gallstone disease, one is able to selecttreatment on the basis of the patient's comfort, thepracticability, effectiveness, and side effects of the technique, and the relative costs. In order toassess the present status of contact dissolution withmethyl tert-butyl ether with regard to these aspects,the present enquiry reports the data of 21 European hospitals. Eight hundred three patients wereselected for contact litholysis of cholesterolgallbladder stones using methyl tert-butyl ether.Percutaneous transhepatic puncture of the gallbladderwas performed under x-ray or ultrasound guidance. Dissolutionrate, side effects, and treatment times of 268 patientsfrom one single center were compared to those of 535patients from the other 20 centers. Two hundred sixty-four patients were followed for fiveyears to assess stone recurrence. Physicians were askedhow they assessed the expenditure of the method, thediscomfort to the patients, and the staffing situation. Patients were asked to indicate theiracceptance on an analog scale. Puncture was successfulin 761 (94.8%) patients. Prophylactic administration ofantibiotics was not necessary. Stones were dissolved in 724 (95.1%) patients. In 315 (43.5%) sludgeremained in the gallbladder. The most severecomplication was bile leakage, which led 12 (1.6%)patients to have elective cholecystectomy. Toxicinjuries due to the ether were not reported.Methodrelated lethality amounted to 0%, 30-day-lethalityto 0.4%. Stone recurrence rate was about 40% in solitarystones and about 70% in multiple stones over five years. Patients with multiple stones developedrecurrent stones almost twice as often as those withsolitary stones. The probability of stone recurrence inpatients with sludge in the gallbladder after catheter removal was not statistically significantlydifferent from those without sludge. Seventy to 90% ofthe centers found the puncture to be simple and notdistressing for patients and the relation betweenexpenditure and therapeutic success to be acceptable. Theacceptance of contact litholysis by the patients wasexcellent. Contact litholysis when applied by anexperienced team provides real advantages in thetreatment of gallstone disease. The method is technicallysimple, well accepted by the patients, and can be easilyapplied in community hospitals. Contact litholysis maybe of particular value in patients who are not suitable for anesthesia orsurgery.
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