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Biomedical subjects

F T Fork

Publications and source records attributed to F T Fork.

At least 37 records · Page 2Linked to original sources
PubMed1995

Endoluminal ultrasound and low-field magnetic resonance imaging are superior to clinical examination in the preoperative staging of rectal cancer.

OBJECTIVE: To compare digital examination, endoluminal ultrasound (ELU), and plain magnetic resonance imaging (MRI), with histopathological findings in the preoperative staging of rectal cancer. DESIGN: A prospective comparative study. SETTING: University hospital, Sweden. SUBJECTS: 35 patients with rectal cancer who presented during the period February 1987 to February 1991. RESULTS: The digital examination of 19 patients could be assessed and was correct in 13 (68%). ELU was done in 34 patients; the accuracy was 88%. Extension of tumour was overestimated in two and underestimated in two. MRI was done for 35 patients with an accuracy of 66%; in 12 patients extension was underestimated. The diagnostic accuracy of the assessment of lymph node involvement was 71% with ELU, and 72% with MRI. CONCLUSION: These findings indicate that MRI seems to underestimate the extension of rectal tumours, but both ELU and MRI can be helpful in selecting patients with advanced tumours for whom preoperative adjuvant treatment is being considered. ELU is superior in staging tumours confined to the rectal wall, and could be of value in the selection of patients whose tumours were suitable for local excision. None of these techniques, however, can reliably identify the extent of lymph node involvement.

Aged↗
PubMed1995

Chronic atrophic fundic gastritis diagnosed by a modified Congo red test.

BACKGROUND AND STUDY AIMS: Chronic atrophic fundic gastritis (CAFG) is associated with several diseases, such as gastric cancer, gastric ulcer, pernicious anemia, and bacterial overgrowth. In spite of recent technical improvements, the gastroscopic diagnosis of CAFG remains uncertain. Congo red chromogastroscopy is capable of visualizing acid-producing normal fundic mucosa, but has hitherto not been suitable for routine use. The aim of our study was to establish a reliable endoscopic technique with which to diagnose CAFG. PATIENTS AND METHODS: This prospective study comprises 124 consecutive patients (71 women, 53 min) with a mean age of 65 years (range 36-92). Macroscopic evaluation of the gastric fundic mucosa in routine endoscopy using video techniques was compared with evaluation by means of a modified endoscopic Congo red test (MCRT). In routine gastroscopy, CAFG was recognized by the thin, friable mucosa, with a marked visible vascular pattern and fold atrophy. With MCRT, the diagnosis of CAFG was made within five minutes' observation when no red-to-blue color shift in the fundic mucosa could be induced by 0.2 mu g/kg intravenous pentagastrin. The results were then compared with the histological examination of biopsies from the fundic mucosa. RESULTS: CAFG was confirmed by histology in 40 of 124 cases. The diagnostic sensitivity of MCRT was 1.0 (40/40), with a positive predictive value of 0.90, whereas the values for macroscopic gastroscopic evaluation were 0.25 (10/40) and 0.50, respectively. CONCLUSIONS: We conclude that MCRT is a sensitive, fast, and cost-effective method of identifying patients with CAFG, and well suited for use in routine gastroscopy.

Adolescent↗
PubMed1989

Esophageal and jejunal motor function after total gastrectomy and Roux-Y esophagojejunostomy.

Emptying and peristaltic activity of the esophagus and proximal jejunum were studied using scintigraphy and fluoroscopy documented on videotape in 11 patients after total gastrectomy and Roux-Y loop reconstruction. Impaired esophageal motor function, as judged by both methods, was seen in five patients who were all 50 years of age or older. This was in contrast to the findings in a group of healthy control subjects, all over 50 years of age, in whom esophageal function appeared normal on scintigraphy in five of seven. Disturbed jejunal function, as judged by radiography, was found in eight patients, whereas the emptying rate according to scintigraphy was judged normal in all but two patients. Five of the patients complained of various adverse alimentary tract symptoms, but the scintigraphic and radiographic findings did not correlate with these symptoms.

Adult↗
PubMed1988

The postcholecystectomy syndrome: bile ducts as pain trigger zone.

Sixty-five non-icteric patients presumed to have the postcholecystectomy syndrome (PCS) were followed up for 4-13 years after their first endoscopic retrograde cholangiopancreatography (ERCP) examination, which gave normal findings. All patients, however, experienced severe pain on injection of only 1-2 ml of contrast medium over 5-10 sec into the common bile duct (CBD). Thirty-four of the 65 patients were found to have true PCS on long-term follow-up studies, whereas 31 of them had other diseases. A second ERCP also showed normal results, and the injection-related pain was preceded by an abnormal pressure rise in the CBD at manometry. The CBD acted like a pain trigger zone, and the pain reaction might be diagnostic in everyday clinical practice. In conclusion, ultrasonography is an adequate diagnostic method in non-obstructive PCS. Medical treatment is often successful. ERCP and interventional treatment should be reserved for patients with obstructive symptoms and for patients in whom all medical treatment has failed.

Biliary Dyskinesia↗
PubMed1987

The Kock continent ileostomy--radiology of dysfunctions.

Some patients who have undergone coloproctectomy due to colitis or polyposis with a continent ileostomy constructed ad modum Kock reveal postoperative, secondary abnormalities and dysfunction. The radiological appearance of the pouch in six such patients who complained of incontinence and/or difficulties to catheterize is reported and the findings are correlated with the findings at subsequent surgery and/or endoscopy. It can be concluded that radiology can contribute substantially to the morphodynamic assessment of patients with dysfunction of a Kock ileostomy whereas endoscopy easily depicts mucosal lesions.

Adult↗
PubMed1987

Granulated wheat-fibres as a diet additive preceding colon cleansing for colonography.

Granulated wheat-fibres were tested as an additive to normal food before colon radiography in 52 out of 177 consecutive out-patients. The cleansing day food was prohibited. The results show no adverse effect of fibres on cleansing. Thus patients with organic and functional disturbances of the large bowel already treated with fibres do not have to stop this medication during days preceeding colon radiography. This means simple patient management and indicates that a routine use of fibres before colon cleansing in the old persons ought to be beneficial.

Adolescent↗
PubMed1986

Juxtapapillary choledochoduodenal fistula following choledochal exploration and diagnosed by early duodenoscopy.

In 86 patients who had undergone common-duct exploration at surgery for benign biliary disease, duodenoscopy was performed within 4 weeks after the operation. Choledochoduodenal fistula, apparently iatrogenic, was then found in eight patients (9.3%). All eight were among the 35 patients in whom a rigid probe had been passed to the duodenum, giving a fistula incidence of 23% in this group. Four of the eight patients consented to repeat duodenoscopy, which showed healing of fistula within a year in three cases. No patient with choledochoduodenal fistula experienced postoperative biliary symptoms.

Adult↗
PubMed1985

Villous adenomas in the duodenum.

Five patients with villous adenomas in the duodenum are described. In one patient malignant degeneration had occurred at the time of diagnosis. This patient was treated with a pancreaticoduodenal resection and is doing well 2 years postoperatively. The other four patients all had a duodenotomy and a local excision of the tumour. One patient had a recurrence with malignant degeneration within 1 year. The other three patients are doing well without signs of recurrence 1-4 years postoperatively. It is concluded that duodenal villous adenomas are potentially malignant. The strategy of surgical treatment is discussed.

Adenocarcinoma↗
PubMed1985

Primary gastric lymphoma versus gastric cancer. An endoscopic and radiographic study of differential diagnostic possibilities.

Eighteen patients with primary gastric malignant lymphoma were compared retrospectively with an age- and sex-matched group of patients with gastric cancer. It was found that a correct preoperative diagnosis was established in 8 out of 18 lymphoma patients (44%). Of the remaining patients eight were preoperatively diagnosed as cancers and two as benign ulcers. Malignancy was not suggested by biopsy or cytology in a total of six lymphoma patients. There was no difference as regards the size of the gastric lesion between the groups. A diffuse involvement of the stomach was found only in lymphoma patients. Furthermore, lymphoma patients often showed superficial stellate ulcers and a sharp margin between the lesion and the normal mucosa. It is suggested that these findings should make the investigator aware of the possibility of a gastric lymphoma. When this diagnosis is considered, great importance should be attached to obtaining large biopsies which possibly allow a correct preoperative diagnosis more often.

Adult↗
PubMed1985

Herniography of femoral, obturator and perineal hernias.

Positive contrast herniography was used in the workup of 550 patients with unclear groin pain. The majority of these patients had rather characteristic hernias of indirect, direct or femoral type. However, now and then diagnostic problems arose. A femoral hernia may look like a direct, indirect or even obturator hernia. There is also a variety of multilocular femoral hernias and other types. A femoral hernia may be present together with other hernias in the ipsilateral or contralateral groin. Obturator hernias are usually small but are always confined to the obturator canal laterally in the obturator foramen. Abnormalities in the pouch of Douglas may include a deep rectogenital pouch, diverticula and true herniations. These uncommon herniographic findings are described and discussed.

Adult↗
PubMed1985

Herniography in anterior abdominal wall hernia.

The clinical diagnosis of anterior abdominal wall hernia is difficult in patients with a negative or inconclusive physical examination. These hernias are often of an interparietal type which hampers their detection. Herniography may contribute to the clinical workup in patients with Spigelian, incisional, and umbilical hernias. As the clinical presentation may be spurious, herniography should be used on wide indications. The herniographic appearance and differential diagnosis of these hernias are reported. The additional use of ultrasonography in this setting is illustrated and discussed.

Abdominal Neoplasms↗
PubMed1985

Defecography.

Defecography is a technique of examining the rectum and anal canal in which the patient is studied while sitting down rather than recumbent and recordings are obtained both at rest and during straining. The authors describe their findings in 83 patients with dyschezia. Defecation was normal in 28 patients. Prolapse of the anal mucosa was seen in 13 patients and internal procidentia in 23, 12 of whom also had intussusception manifested as rectal prolapse. A deep rectogenital fossa associated with an enterocele was seen in 16 patients; 13 had a proctocele, while fecal retention was seen in 5. Descent of the pelvic floor and changes in the angle between the rectum and anal canal were assessed. The authors recommend defecography as a more physiological means of assessing rectal dysfunction.

Adult↗