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Biomedical subjects

H J Nord

Publications and source records attributed to H J Nord.

At least 19 recordsLinked to original sources
PubMed1995

Significance of solitary and multiple esophageal ulcers in patients with AIDS.

We endoscopically evaluated odynophagia and/or dysphagia in 23 patients with acquired immunodeficiency syndrome (AIDS). Eleven patients (48%) were found to have esophageal ulcers. Seven of them had deep, sharply demarcated, well-circumscribed ulcer craters with raised edges; in two the ulcer extended to the muscularis propria. Ulcers were single in four patients, multiple in six, and unspecified in one. Biopsies were nondiagnostic. In eight patients, mycobacterial, viral, and fungal cultures were negative. Specific infections diagnosed in three patients were treated with appropriate agents. Ulcers were treated symptomatically, and seven patients received therapy for suspected viral etiology. Symptoms remained unchanged in five patients, improved in three, and resolved in two. Fifty-five percent of patients died within 3.6 months (mean) of diagnosis. Large solitary and multiple esophageal ulcers are common in AIDS patients with odynophagia and dysphagia.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Niacin-induced hepatotoxicity: unusual presentations.

We report four cases of niacin-induced hepatotoxicity. All four patients were using sustained-release niacin preparations. When they stopped taking niacin, symptoms and laboratory abnormalities resolved. Two of the patients had focal fatty infiltration of the liver on imaging studies, a presentation of niacin hepatotoxicity not previously described. One patient had a coagulopathy even though aminotransferase levels were only mildly elevated. We recommend that patients using sustained-release preparations of niacin have periodic monitoring of liver enzymes and that the preparation be discontinued if any abnormalities develop.

Adult↗
PubMed1994

Endoscopic diagnosis and treatment of esophageal cancer.

Esophageal carcinoma is one of the deadliest malignant tumors. This article reviews its epidemiology, etiology, and clinical and endoscopic presentation, as well as methods for proper staging to identify the patients who will not benefit from surgery and require palliative therapy. The various treatment options are discussed in detail with an emphasis on the latest endoscopic palliative measures.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

Non 0-1 Vibrio cholerae septicemia and culture negative neutrocytic ascites in a patient with chronic liver disease.

Non 0-1 Vibrio cholerae infection is often associated with ingestion of contaminated seafood and its common presentation is gastroenteritis. Septicemia may be found in immunocompromised hosts resulting in mortality approaching 50%. A case is reported of non 0-1 Vibrio cholerae infection presenting with septicemia in a patient with neutrocytic ascites suggestive of spontaneous bacterial peritonitis.

Adult↗
PubMed1992

Endoscopic orientation within the duodenal bulb.

Laparotomy performed for bleeding duodenal ulcer after diagnostic/therapeutic endoscopy revealed a disparity in location of the lesion on several occasions at our institution. The position of the duodenal lesion is important in assessing bleeding potential. Twenty consecutive patients underwent upper gastrointestinal endoscopy by a staff and trainee gastroenterologist to evaluate the ability to determine the true posterior position of the duodenal bulb. Documentation of the posterior bulb location was verified by pooled colored fluid with the patient in a supine position. True posterior location was chosen only 30% of the time by an experienced gastroenterologist. This observation may have clinical implications in assessing the patient's bleeding potential and in the use of coaptive coagulation for control of ulcer bleeding.

Duodenal Ulcer↗
PubMed1989

Pancreatic abscess: analysis of a high risk subgroup.

Over the past ten years, 21 cases of pancreatic abscess were diagnosed at our university teaching hospital. On the basis of the findings from CT scan, sonography, and exploratory laparotomy, five patients were determined to have poorly localized disease and 16 patients were felt to have well localized purulent fluid collection. The five patients with poorly localized disease had an overall mortality rate of 80%, an average of 5.2 Ranson criteria, and 80% required partial pancreatic resection. Of the 16 patients with well localized disease there was a mortality rate of 20%, an average of 3.3 Ranson criteria, and only 6% required resection. All five patients who had pancreatic resection died. These data suggest the following conclusions: 1. Patients with pancreatic abscess which is poorly localized have a greater severity of pancreatitis as indicated by a higher average number of Ranson criteria. 2. Patients with a poorly localized phlegmonous abscess more often require pancreatic resection, which is associated with a higher mortality. 3. The high mortality rate seen with patients with a poorly localized phlegmonous pancreatic slough designates this group as a high risk subset of all pancreatic abscess patients.

Abscess↗
PubMed1989

A new objective measurement of esophageal lumen patency.

This study was performed to develop a system to measure dysphagia in an objective fashion, test its correlation with subjective estimates of dysphagia, and encourage the use of a standardized measure of esophageal stenosis. Thirty-five patients with mechanical dysphagia underwent subjective estimates of dysphagia using a dysphagia scale graded from 0 to 5, as well as a diet scale. Lumen diameter was measured endoscopically, using the open or closed biopsy forceps as a measuring guide. Patients were then given barium capsules or tablets of increasing diameter under fluoroscopy, in the upright position. Pills were given sequentially until a pill failed to traverse the esophagus in less than 20 s. The diameter of the pill failing to traverse the esophagus within 20 s correlated strongly with the endoscopically measured diameter by Spearmans rank correlation (Rs = 0.85). The weakest correlation was between endoscopically measured diameter and the dysphagia scale (Rs = 0.48). The diameter of the pill failing to traverse the esophagus within 20 s is an excellent estimate of esophageal lumen diameter. Pill size correlates much better with esophageal lumen diameter than dysphagia or diet scales. This new dysphagia assessment system should simplify standardization of the grading of dysphagia.

Barium Sulfate↗
PubMed1988

Granular cell tumor of the esophagus: natural history, diagnosis, and therapy.

Five cases of granular cell tumor of the esophagus are reported. In four cases, the tumor was an asymptomatic, incidental finding. In one case, a larger granular cell tumor presented with dysphagia and required local surgical excision. Long-term follow-up in three cases revealed no evidence of tumor progression. Esophageal granular cell tumors are benign lesions which can frequently be diagnosed by endoscopic biopsy. Asymptomatic, smaller lesions require observation only. Larger, symptomatic lesions can be treated with local surgical excision.

Esophageal Neoplasms↗
PubMed1988

Treatment of pharyngoesophageal stenosis by polyvinyl prosthesis.

Many authors have objected to the use of esophageal stents in the palliative management of lesions obstructing the cervical esophagus, especially when the prosthesis must lie within 2 cm of the cricopharyngeus muscle (CPM). Ten patients with stenosis of the cervical esophagus by lesions within 2 cm of or involving the CPM were considered for prosthesis placement. The prosthesis was successfully placed in eight patients, five of whom had a tracheoesophageal fistula (TEF). A prosthesis could not be placed in two patients, and two patients complained of a minimal but tolerable foreign body sensation. Six prostheses were custom-made. The necessity to place a prosthesis within 2 cm of or even immediately proximal to the CPM should not be considered an absolute contraindication to esophageal prosthesis placement in selected patients. Foreign body sensation may be absent or minimal, and stent migration is common.

Aged↗