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Biomedical subjects

J Banai

Publications and source records attributed to J Banai.

At least 19 recordsLinked to original sources

Esophageal intramural metastasis from adenocarcinoma of the gastroesophageal junction.

Among a total of 143 patients examined for diagnosis of adenocarcinoma of the cardia, intramural esophageal metastases were verified in six patients (4.19 %). In each case the diagnosis was confirmed by histological examination. The histological structure of the primary tumors and metastases was the same. Metastases were detected by endoscopic ultrasound examination in three cases. All the cardia tumors proved to be well advanced. As well as endoscopic identification of the primary tumor, thorough examination of the proximal part of the esophagus is of great importance.

Adenocarcinoma↗

[Siewert-Stein classification of adenocarcinoma of the esophagogastric junction].

Nowadays the terminology used for the definition of adenocarcinomas at the oesophagogastric junction is "cardiac carcinoma", which can be easily misunderstood. This definition of adenocarcinomas of the oesophagogastric junction does not allow correct comparison of diagnosis (endoscopic, radiological and pathologic), epidemiology and surgical therapy in national and international aspects, because different tumours can develope in the same area, and all called cardia tumors. Siewert and Stein recommended a classification to solve this problem. The classification of the tumours is morphological/topographical. Type I is adenocarcinoma of the distal part of the oesophagus. Type II is adenocarcinoma of the real cardia and type III is subcardial gastric adenocarcinoma. At classification, we always consider results of endoscopy (ortograde and retroflexed view of the oesophago-gastric junction), the x-rays of the oesophagus and stomach, findings at the operation and pathohistologic results. Between 1/1/1974 and 31/12/2000, a total number of 50,878 upper panendoscopic examinations were performed at the Endoscopic Laboratory of the Surgical Department. Adenocarcinoma of the cardia was diagnosed in 488 patients. According to the Siewert-Stein classification, type I tumour was found in 123 (25.2%), type II in 240 (49.18%), and type III was present in 125 (25.61%) patients. The importance of this classification is it enables unified pre-operative assessment and it can also help to decide the type of the surgical intervention. In our patients with type I cancer--depending of the size of the tumour--distal 2/3 oesophagectomy with the resection of the proximal lesser curve of the stomach or total gastrectomy were performed. In the first group oesophago-jejuno-gastrostomy, in case of total gastrectomy Roux-en-Y loop anastomosis was created. In patients with types II and III cancers total gastrectomy was performed. In every patient lymphadenectomy was performed. We suggest the use of this new classification in clinical, gastroenterology--with special regard to the endoscopy--and pathology.

Adenocarcinoma↗

[Endoscopic diagnosis of gastrointestinal bleeding of unknown origin].

In recent years push enteroscopy has become the most important method in the examination of patients with obscure gastrointestinal bleeding. We summarise our experiences with 148 enteroscopies performed on 140 patients with bleeding of unknown origin. The source of bleeding could be identified in 81 patients (57.86%). The most common lesions were small bowel tumors (13.57%) and vascular malformations (12.86%). Several patients (22.86%) referred for enteroscopy had lesions in the esophagus, stomach and proximal duodenum that were missed at upper endoscopy. The authors conclude that push enteroscopy has a major role in the evaluation of patients with obscure gastrointestinal bleeding. Enteroscopy should be the first diagnostic step after negative esophago-gastroduodenoscopy and negative colonoscopy. Enteroscopy seems to be superior to other diagnostic methods. It is well tolerable and is not time consuming.

Adolescent↗

[Thrombophilia in ulcerative colitis].

The authors report a combined occurrence of thrombophilia and colitis ulcerosa and provide an analysis of relevant references in earlier works. It is likely intertwinning of the two disease's symptoms, the chronic cause of the condition and the underlying molecular biology variations cannot be traced back to a single cause. Further research is required to establish whether the protein-C anomaly exhibited in the presented case is general in this condition or an individual occurrence. The publication emphasises that in future cases it will be advisable to perform tests capable of proving or refuting the abnormality of protein-C.

Adult↗

[Pharmacologic therapy of Crohn's disease and ulcerative colitis].

Important progress has been made in recent years in the understanding of pathogenesis of Crohn's disease and ulcerative colitis, but the cause of IBD remains obscure, so curative therapy is still lacking. Current treatment strategies as sulphasalazine, mesalasine, glucocorticosteroids are mainly anti-inflammatory. In the past years the greatest advances have been characterised by the more widespread use of topically acting steroids, immunosuppressants and by the introduction of immunomodulatory agents as cytokines and anticytokines. The author summarises the standard therapy and new possibilities of medical treatment for IBD and suggests some algorythms for clinical practice.

Acute Disease↗

[Diagnostic problems of Wilson disease].

A family (three siblings) of Wilson's-disease is described. The authors review the pathogenesis, diagnostics, pathology and treatment of Wilson's-disease. The diagnostic difficulties are emphasised. The variety of liver lesions are demonstrated in the different grades of the disease. The importance of the early diagnosis is stressed.

Adolescent↗

Tissue concentrations and correlations of prostaglandins in healthy and inflamed human esophageal and jejunal mucosa.

The PGE2, PGF2 alpha, PGI2, and TXB2 content in biopsies of healthy esophageal mucosa and inflamed mucosa and from subjects with chronic esophagitis was measured and statistically analyzed. No significant differences were found between the tissue concentrations of prostaglandins in the inflamed and the healthy mucosa, except for elevated PGI2 content in the inflamed esophageal mucosa in comparison to healthy mucosa. The prostaglandin content of jejunal mucosa was unchanged in jejunitis and in atrophy compared to findings in healthy subjects. Regression analysis revealed a significant negative correlation between the PGF2 alpha and PGI2 content in both inflamed esophageal and inflamed jejunal mucosa. In healthy mucosa, no correlation was found between the tissue concentrations of these two prostaglandins, either in the esophagus or in the jejunum. These results suggest the redistribution of cyclic endoperoxide metabolism under certain pathological conditions.

Analysis of Variance↗

[Endoscopic study of the small intestine].

The author summarises the possibilities of small bowel endoscopy. In case of haemorrhage of unknown origin, enteroscopy may be helpful. Sonde type fiber- or video-enteroscopes can be used. This procedure is time-consuming and needs an experienced team. In case of life-threatening bleeding intraoperative enteroscopy is recommended. "Push" enteroscopy is the best, rapid method in the diagnostics of suspected diffuse intestinal diseases or circumscript lesions of the proximal small bowel. Adult or pediatric colonoscopies or jejunoscopes are available for this investigation. Endoscopic biopsy specimens are suitable for histological examination and for enzyme assay as well. Aspiration of jejunal fluid for bacteriological culture is a way for revealing of bacterial overgrowth. The author emphasises the importance of the deep duodenoscopy made by an upper panendoscope in the diagnostics of villous atrophy.

Diagnosis, Differential↗

Intraoperative colonoscopy.

The authors performed intraoperative colonoscopy in 31 patients. This examination is done if preoperative colonoscopy was not performed or incomplete, and intraoperative difficulty occurs. In addition, it is indicated to localize non-palpable lesions, to perform polypectomy (if unsuccessful preoperatively but manageable intraoperatively), to define the site of endoscopic polypectomy, in certain instances to determine the resection plane, and after resection of constrictive tumours to look over the proximal intestinal section, to detect the synchronous lesions. It is emphasized that by their method the opening of the lumen becomes avoidable thus resulting in a decreased postoperative morbidity and mortality.

Colonoscopy↗

[Gallstone ileus after endoscopic sphincterotomy].

The authors report on a case of gallstone ileus developed after endoscopic sphincterotomy (EST). The patient had to be operated and recovered uneventfully after enterotomy. Emphasis is placed on the importance of patient's observation after EST so this rare complication could be revealed in time.

Aged↗

[Tomato skin in the common bile duct after endoscopic sphincterotomy].

Lithotomy and endoscopic sphincterotomy were carried out in a 83-year-old woman because of choledocholithiasis. One year later calculi and tomato skins were found in the common bile duct. Significance is attributed to the tomato skins in the development of calculi. The attention is drawn to the observation that operative interventions performed through the Vater's papilla, spontaneous or iatrogenic choledochoduodenal fistulas create favourable conditions for foreign material to get into the choledochus and this may cause lithogenesis.

Aged↗

[A rapid test for the analysis of lactase and sucrase activity in the jejunum (a comparative study)].

Jejunal lactase and sucrase activities were demonstrated in biopsy specimens obtained endoscopically using a rapid test which had been developed previously. The results were compared with enzyme activities determined by Dahlquist's method. The data suggest that the rapid test is suitable for the demonstration about the presence of lactase and sucrase, and the results are correlated with enzyme activities measured by assay. The main advantage of the test, that it is rapid, simple and cheap, no special equipments are necessary, so it can be used in every endoscopic department.

Adolescent↗

Measurement and demonstration of lactase and sucrase activities in jejunal mucosa.

Jejunal lactase and sucrase activities were demonstrated on endoscopically obtained biopsy specimens by a rapid test which had been developed earlier. The results were compared with enzyme activities found by Dahlquist's method. The data suggest that the rapid test is suitable for the semiquantitative determination of lactase and sucrase, and the results correlate with enzyme activities measured by the Dahlquist assay. The main advantage of the test is that it is rapid, simple, and cheap, and because no special equipment is necessary, it can be used in any endoscopic department.

Adolescent↗