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Biomedical subjects

G L Kratzer

Publications and source records attributed to G L Kratzer.

At least 19 recordsLinked to original sources
PubMed1995

Observations of aggressive, small, flat, and depressed colon cancer. Report of three cases.

Three cases of small, flat, and depressed colon cancers are reported. One lesion is less than 1 cm in diameter with lymphatic invasion in the submucosa; the other measures 0.8 cm in the longest dimension and penetrates through the muscular layers to the subserosa. The third one, 1.2 cm in diameter, has had liver metastasis. The endoscopic appearances of two lesions with a resected specimen are presented in color to demonstrate some difficulties in visualizing these lesions for endoscopists. The biologic aggressiveness of these three lesions appears due to their rapid growth, which is expressed by a high mitotic rate of the cancer cells. Their histogenesis is considered to derive from (1) flat adenoma, from (2) serrated adenoma, and (3) from hyperplastic epithelium (or de novo in origin), respectively.

Adenocarcinoma↗
PubMed1992

Fast-growing cancer of the colon and rectum.

Recently, the existence of a flat, colorectal cancer has been proposed. This cancer is completely different in appearance from ordinary polyp cancer and is believed to invade deeply into the submucosa, even in its early stages. Its characteristics are quite different from cancers that follow the adenoma-cancer sequence, and it requires a greater search to detect. The authors observed four cases of fast-growing cancer that were relatively flat in appearance, contained no adenomatous component, and were invasive, even in their early stages.

Adult↗
PubMed1991

Gardner syndrome: study and follow-up of a family.

A study is in progress of a family (Family P) with Gardner syndrome (familial adenomatous polyposis with extraintestinal manifestations-FAPG). Occult bone lesions of the jaws and ocular fundus lesions were found in a number of affected and at-risk relatives. In some, these "markers" were found early in life before the appearance of colonic polyps. Family P is remarkable for differences in expression of the gene manifested by differences in the age-at-onset of polyps of the colon, in number and size of polyps, and in occurrence of desmoids. These differences may explain why some at-risk relatives wisely followed medical surveillance plans while others, who lacked symptoms, failed to do so. Others without medical guidance undertook their own independent "treatment." As knowledge about extracolonic lesions has increased and surgical treatment for FAPG improved from the time the first affected member of Family P received her diagnosis in 1953, the outlook for survival has also improved. Family communication and that among professionals treating families with FAPG may be improved as worldwide Polyposis Registries increase in number. The risk of postsurgical extraintestinal complications is reason enough to urge life-long medical surveillance for all at-risk relatives.

Adenomatous Polyposis Coli↗
PubMed1980

Low anterior resection for rectal cancer: technique and results.

The records of 113 consecutive patients who underwent low anterior resection for rectal cancer are reviewed. The patients with a single-layer anastomosis appeared relatively free of complications. The two-layer technique resulted in a 4.4 percent incidence of anastomotic problems. In this limited study, cancers less than 12 cm above the anus, especially those in the Dukes' C category, were more apt to show recurrent or residual tumor. The excessive residual tumor rate of 13 percent in this study indicates that the Miles' resection should have been used more frequently. The distance of normal bowel transected below the lesion was not the only factor in prognosis. The 5 year survival rate of 60 percent should be improved.

Carcinoma↗
PubMed1976

Miles' resection for cancer of the rectum.

Miles' resection is the optimal surgical operation for cancer involving the lowermost third of the rectum, although some surgeons question the wisdom of subjecting the patient to permanent colostomy and use fulguration as the alternative. In the author's series of 100 patients, the five-year survival rate was 41.6%. The operative mortality rate was 4%. The median distance of the cancer above the dentate line was 3 cm and the average distance was 4.6 cm. Fifty patients had Dukes' C lesions. Of the 100 patients, 95 had adenocarcinoma, 3 had squamous-cell carcinoma, 1 had a cloacogenic lesion, and 1 had melanocarcinoma. Complications were surprisingly few. Eleven patients had perineal recurrence. The relatively poor survival rate is attributed to anatomic limitations for radical surgical measures and to the spread of cancer cells by the time of operation. Regular check-up examinations are most effective in the prevention of rectal cancer.

Adenocarcinoma↗
PubMed1975

Outpatient anorectal surgery.

Fulguration of polyps, rectal biopsy and the Barron method of removing hemorrhoids require no anesthesia. Anal fissures, warts, small fistulas and hemorrhoids can be removed with a minimal amount of anesthesia. Pilonidal cysts or abscesses can also be incised and drained in this manner. Extensive fistulas, unusually large hemorrhoids with generalized prolapse of mucosa and disorders involving poor-risk patients should be managed in the hospital.

Abscess↗