Nutrition, survival, and AIDS.
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Biomedical subjects
Publications and source records attributed to J S Freed.
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Malignant fibrous histiocytoma (MFH) of the gastrointestinal tract is extremely rare. A case of MFH of the colon associated with neurofibromatosis is presented. MFH is a high-grade soft-tissue sarcoma of fibroblast cell origin with a strong propensity for metastasis and recurrence. Immunochemical markers help to differentiate MFH from other sarcomas. The most successful treatment of MFH is surgical extirpation. Adjuvant chemotherapy and radiotherapy have not been definitively shown to be of value.
The absorption of ranitidine from different segments of the intestinal tract was studied in a subject who had an anatomically divided small intestine. The results indicate that the drug is maximally absorbed from the small bowel rather than the stomach. Subsequent animal studies have shown that absorption of ranitidine in dogs is primarily duodenal followed by jejunal and ileal. The lack of gastric absorption, with predominantly small bowel absorption, may have investigational and therapeutic implications in a variety of gastrointestinal diseases.
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Difficulty in resection of the uncinate process of the pancreas often results in significant hemorrhage. Partial vascular occlusion of the superior mesenteric vein with resection of the lateral wall allows complete removal of all pancreatic tissue with minimal blood loss.
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Although sarcoidosis has been described affecting almost all body systems, acute cholecystitis has not previously been documented. Such a case is presented with a review of other gastrointestinal tract manifestations of the disease.
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Even in the absence of demonstrable esophagogastric varices in the cirrhotic patient, a diagnosis of variceal bleeding from unusual sites should be entertained in the differential diagnosis of massive lower gastrointestinal hemorrhage. The varices may reflect the increased pressure in the superior or inferior mesenteric systems or in the splenic system through abnormal splenocolic anastomoses. This case has the unique feature of bleeding from varices interposed between the splenic and inferior mesenteric venous systems, as opposed to the previously described cases of varices draining directly into a portosystemic conduit.
A case demonstrating the successful use of Silastic shunts for immediate limb revascularization is presented. Temporary limb revascularization may reduce the rate of amputation in combined popliteal vessel injuries. A major cause of limb loss is delay between injury and revascularization, including transport time and time spent dealing with other injuries. Repair of the popliteal vein increases the chance of successful limb salvage. Temporary Silastic shunts can alleviate time loss while others problems are dealt with and allow rapid venous, as well as arterial, revascularization. The technical ease and rapidity of shunt placement converts a catastrophic vascular emergency into a manageable problem.