Cellular retinol-binding protein (CRBP) in human colorectal adenocarcinoma.
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Adenocarcinoma↗
Biomedical subjects
G Ekelund
Publications and source records attributed to G Ekelund.
Preoperative short-term radiotherapy in rectal carcinoma. A preliminary report of a prospective randomized study.
Between 1980 and 1983, 373 patients with clinically resectable rectal adenocarcinoma entered a prospective randomized study aimed to evaluate the effect of short-term preoperative radiotherapy. Protocol violations were identified in 21 instances. Of the remaining 352 patients, 182 were randomized to surgical treatment only (S-group). Immediately, before surgery, 170 patients were irradiated to the pelvic region with 25 Gy (2500 rad) during a 5-day period (RT-group). Of these patients, 59% underwent abdominoperineal excision, 38% anterior resection, and 3% laparotomy only. At surgery distant metastases were discovered in 32 patients (9%). There were no significant differences between the groups in the distribution of age, sex, operative methods, and tumor stage according to the original Dukes' classification. During the follow-up time, ranging between 6 months and 3 years, tumor recurrence occurred in 35 patients, 19 in the S-group and 16 in the RT-group. Fifteen patients in the S-group had pelvic recurrence compared to 10 patients in the RT-group. Distant metastases occurred in six and eight patients, respectively. Two patients in each group had both pelvic and distant recurrence. There was no correlation between tumor recurrence and type of operation. Median time interval from diagnosis to pelvic recurrence was 10 months in the S-group and 16 months in the RT-group. Postoperative complications in the form of wound sepsis were slightly more common in the RT-group. In summary, the applied treatment regimen, is well-tolerated and apparently does not affect the Dukes' stage of the tumor. Although there is no statistically significant difference, there is a trend of less pelvic recurrence in patients receiving preoperative radiotherapy.
Adenocarcinoma↗
The feasibility of large scale population screening.
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Aged↗
Pre- and post-operative complications in Crohn's disease with special reference to duration of preoperative disease history.
In an analysis of a consecutive series of 133 patients with a diagnosis of Crohn's disease established preoperatively and in which early surgical intervention was the prevailing policy, the median time between diagnosis and operation was short. For patients with predominantly small-bowel disease it was 4 months and for patients with predominantly colonic involvement 8 months. The frequencies of preoperative and early postoperative complications were low compared with those in other reports. Local complications, such as intra-abdominal fistulae and abscesses, were preoperatively seen in only 4% of the patients. Arthritis, iritis, or erythema nodosum was not seen in patients with predominantly small-bowel disease. The early postoperative death rate was 1.5%, the late mortality rate related to Crohn's disease 2.3%. In conclusion, early resectional surgery seems to be justified as one form of treatment for Crohn's disease in that it diminishes the rate of serious complications. The risk of recurrence is, however, not influenced by early surgical intervention.
Crohn Disease↗
Is CEA analysis of value in screening for recurrences after surgery for colorectal carcinoma?
The progress of 139 patients operated upon for cure of colorectal carcinoma, was followed postoperatively with a standardized protocol. A CEA test was performed for comparison with other parameters. Median observation time was four years. When an upper limit for CEA of 7.5 micrograms/1 was allowed, sensitivity was found to be 78 per cent, specificity 91 per cent, and predictive value of an elevated CEA concentration, 83 per cent. In general, CEA measurement traced recurrence six months before clinical diagnosis. In only a few cases was recurrence first heralded by an abnormality in other blood chemistry test results. CEA may thus be used in postoperative screening for recurrence even though most recurrences, when detected, are not curable.
Alanine Transaminase↗
Metabolic epidemiology of colon cancer: dietary pattern and fecal sterol concentrations of three populations.
The nutrient intake, fecal neutral sterol concentration, and bile acid concentration of populations with a varied risk for colon cancer development were investigated. High-risk populations in the metropolitan New York area and Malmo, Sweden, were compared with an intermediate-risk population in Umea, Sweden. The mean daily intake of protein and fat was comparable in all groups, but the total daily fiber intake was higher in Umea, as was the total daily stool output. There was no difference in the total fiber intake and stool output between Malmo and metropolitan New York. The fecal secondary bile acid concentration was lower in Umea than in the other two areas; no difference was observed between Malmo and metropolitan New York. These results suggest that high fiber intake may be considered protective against colon cancer even in a population with a high risk intake. A high dietary fiber intake may limit colon cancer risk by increasing stool bulk, and thus diluting and/or binding tumor promoters.
Adult↗
Double contrast examination in carcinoma of the colon and rectum. A prospective clinical series.
During a 9-month period, 2 590 patients were referred for radiographic examination of the large bowel. All but 55 of these examinations were performed according to the double contrast examination method. The patients were followed prospectively from 40 to 48 months. Carcinoma of the colon or rectum was disclosed in 96 patients and other malignant lesions in 7 others. The carcinomas in 93 patients were diagnosed at the primary DCE. During the follow-up period, carcinoma of the colon was revealed in another 10 patients, the malignancy having been obfuscated by diverticulitis in 3 patients and considered polyps in 6 others. The accuracy of the double contrast method was calculated at 99.3 per cent.
Adenoma↗
Recurrence rate after surgical treatment of Crohn's disease.
In an unselected series of 207 consecutive patients with Crohn's disease diagnosed between 1958 and 1974, 170 underwent a resection of all the macroscopically involved bowel ('radically' resected). Two patients died during the first postoperative month. The crude recurrence rate for the surviving 168 patients was 49%. The cumulative recurrence rate, calculated by the actuarial method, was 53% at 15 years. Age, sex, length of preoperative disease history, localization of the lesions in the bowel, and primary surgical procedures performed had no influence on the recurrence rate. However, the histopathological appearance of the resection margins seemed to influence the prognosis, since the presence of ulcers and/or granulomas was correlated with a significantly increased recurrence rate.
Actuarial Analysis↗
Crohn's disease in a defined population course and results of surgical treatment. I. Small bowel disease.
In a total, unselected series of 207 patients with Crohn's disease diagnosed between 1958 and 1974, 87 of the 182 patients operated upon during the investigated period were, at a comprehensive reevaluation, found to have the disease predominantly or exclusively confined to the small bowel. In five of these cases wide-spread lesions were present. The frequency of preoperative sequelae or complications was low. Postoperative complications were comparatively few with only one death. The calculated recurrence rate at 15 years was 43%. In spite of the fact that some patients needed repeated resections, the outcome of surgery as assessed at the end of the observation time was good in most cases.
Adolescent↗
Crohn's disease in a defined population course and results of surgical treatment. Part II. Large bowel disease.
In a total consecutive series of 182 patients operated upon for Crohn's disease, 95 (52%) had the lesions predominantly or exclusively confined to the colon. A "radical" operation was performed in 88 of these 95 patients. The general policy was to spare the rectum, if possible. It was found that when the rectum was primarily involved the lesions did not disappear after subtotal colectomy. Ileorectal anastomosis was only successful in 9 of 22 cases. In all these nine cases the rectum was uninvolved preoperatively. The overall mortality rate related to Crohn's disease was 6% and the overall recurrence rate 62%. All patients with an anastomosis between a disease-free small intestine and a diseased colon developed recurrence in the ileum. Therefore, a thorough preoperative examination of the whole colon is essential.
Adolescent↗
The value of intensive follow-up after curative resection for colorectal carcinoma.
A previous study undertaken by this department showed follow-up to be of little value in tracing curable recurrences in patients with colorectal cancer who had curative operations. The aim of the present investigation was to determine if more intensified follow-up would result in earlier diagnosis of recurrences and thus lead to earlier and more effective treatment. Altogether 599 patients with colorectal cancer were treated between 1973 and 1977. The 363 (61 per cent) patients who were operated upon for cure entered the study and were followed up until December 1979. The same incidence of recurrence was seen in both series, but, with the more detailed protocol, they were more frequently detected before symptoms developed. However, the rate of curative reoperation for recurrence was not changed and only few patients survived after such reoperations. The conclusion is that the previous protocol is as efficient as the detailed one while no effective treatment of disseminated disease exists.
Adult↗
The double contrast examination in inflammatory large bowel disease. A prospective clinical, radiographic, and pathologic study.
In a prospective clinical series of 2371 consecutive patients referred for double contrast examination (DCE) of the large bowel, 154 had clinical and/or radiographic signs of inflammatory disease. The patients were followed up from May 1976 until May 1981. At the time of interpretation of the roentgenograms, the radiologist was unaware of clinical and laboratory findings. In 31 patients, organ specimens were studied histologically and in 101 other multiple endoscopic biopsies were available. Basing on the clinical observations and the pathology reports, the accuracy of the DCE was calculated at 99%; the predictive value of a positive DCE at 92, and that of a negative DCE at 99%.
Adolescent↗
Carcinoma of the anal canal.
A 20-year retrospective study of all anal canal carcinomas in the city of Malmö has been performed. The series consists of 29 patients, 23 women and 6 men, with a mean age of 66 years. Eight patients had non-keratinizing squamous cell carcinoma, 7 had keratinizing squamous cell carcinoma, 12 had basaloid squamous cell carcinoma, and 2 patients had mucoepidermoid carcinoma. Two of four patients operated on for curative purposes with local excision survived 5 years, as did seven of nine patients operated on curatively with abdominoperineal resection. In discussing the results, an overview of the literature is presented. It is concluded that adjuvant combined chemotherapy and radiotherapy appears to result in a higher survival rate for patients with tumours growing at or above the dentate line.
Aged↗
Single dose doxycycline prophylaxis and peroperative bacteriological culture in elective colorectal surgery.
A prospective study was performed on 196 consecutive patients undergoing elective colonic surgery to evaluate the prophylactic effect of a single dose of doxycycline. The patients were randomized into four groups: group I 200 mg i.v. preoperatively, group III 600 mg i.v. preoperatively, group III 600 mg i.v. postoperatively, and group IV 200 mg i.v. preoperatively and 200 mg i.v. daily 3 days postoperatively. The rate of septic complications for the different groups were: I 13 per cent, II 7 per cent, III 20 per cent, and IV 19 per cent. There was no statistically significant difference in occurrence of septic complications between the groups. The degree of bacterial contamination during operation was estimated by culture from wound irrigation fluid and from cotton swabs. Bacteria were recovered from the irrigation fluid in 97 per cent, while culture from cotton swabs proved to be much less sensitive. A high number of bacteria in the irrigation fluid was significantly correlated to a high complication rate. It is suggested that direct plating from irrigation fluid can be used for defining a high risk group of patients in colonic surgery.
Aged↗
Early diagnosis of metachronous colorectal carcinoma.
The frequency of metachronous colorectal tumours in a prospective 20-year series of patients with colorectal cancer is reported. Thirty-one patients, that is 2.1% of the patients operated on for cure, had metachronous carcinomas, and 5.4% had metachronous polyps. One-third of the metachronous carcinomas were diagnosed at scheduled postoperative control examinations, and the others because of their symptoms or at autopsy. The reported metachronous carcinomas are considered to represent failures of follow-up only and not to indicate their true incidence, since their natural course has been arrested by removal of adenomas whenever found. Several of the metachronous tumours were judged to be overlooked synchronous ones, and therefore a thorough postoperative examination of the remaining large bowel is advocated. The finding of subsequent tumours in this series indicates that continuous follow-up is worthwhile.
Adult↗
[Solitary ulcer of the rectum--a diagnostic and therapeutic problem].
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Adult↗
Jejunal endocrine tumor composed of somatostatin and gastrin cells and associated with duodenal ulcer disease.
A case of malignant endocrine tumour of the jejunum, associated with severe duodenal ulcer is described. The tumour and a local metastasis were examined by immunohistochemistry and found to contain abundant somatostatin-immunoreactive cells together with less numerous cells displaying gastrin immunoreactivity. This is to our knowledge the first case of intestinal somatostatinoma. The presence of gastrin cells in the tumour may explain the ulcer diathesis.
Duodenal Ulcer↗
Cecal tumor-inverted appendix.
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Appendix↗