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Biomedical subjects

K Geboes

Publications and source records attributed to K Geboes.

At least 235 records · Page 13Linked to original sources
PubMed1984

A new and effective technique of Yag laser photocoagulation for severe upper gastrointestinal bleeding.

A new technique of treating acute severe upper gastrointestinal haemorrhage was evaluated. The technique consisted of epinephrine injections in the bleeding lesion combined with YAG laser radiation in short pulses, applied until the bleeding vessel was completely closed. This new treatment modality was tried in 54 consecutive patients with severe upper gastrointestinal bleeding from a spurting artery, or an ulcer with a non-bleeding visible vessel in the floor of the ulcer crater at endoscopy. Permanent haemostasis was achieved in 87% of the 54 patients. Emergency surgery was needed in 13%. The mortality rate was only 10%. No complications occurred. It is concluded that this new technique of treating severe upper gastrointestinal bleeding from a spurting artery, or an ulcer with a visible vessel results in a significant improvement of the success rate (permanent haemostasis) and a marked reduction in the mortality rate.

Adolescent↗
PubMed1984

Natural history of recurrent Crohn's disease at the ileocolonic anastomosis after curative surgery.

An endoscopical and histological study was carried out in 114 patients, treated by 'curative' resection of the terminal ileum and part of the colon for Crohn's disease, in order to study the natural history of recurrent Crohn's disease. The recurrence rate of Crohn's disease in patients examined within one year of the operation was 72%. This figure did not differ significantly from that in patients examined one to three years or three to 10 years after surgery (79% and 77% respectively). Recurrence was located in the neoterminal ileum and at the anastomosis in 88% of the patients. Early endoscopic signs of recurrence were small aphthous ulcers in the neoterminal ileum. Ileal biopsies at this stage showed an important inflammatory cell infiltrate of the lamina propria with numerous eosinophils and fusion and blunting of the villi. More advanced lesions observed in patients examined one to three years after surgery, consisted of larger, often serpiginous ulcerations and nodular thickening of folds. In patients examined three to 10 years after the operation, the anastomosis was frequently stenosed and rigid, with large ulcers extending from the stenosis into the colon. Mucosal granulomas may be found in normal appearing mucosa as well as in the obviously inflamed mucosa surrounding the ulcers. These studies suggest that recurrence of Crohn's disease almost always develops in the first year after the operation. Significant endoscopic lesions may be present without clinical symptoms, particularly in the earlier stages of the disease.

Adolescent↗
PubMed1984

Primary gastric actinomycosis: a case report and review of the literature.

A case of primary gastric actinomycosis presenting as a bleeding gastric tumor is reported. The diagnosis of this infection of the stomach is difficult and may often be established only by histological examination. If the disease is recognized, the prognosis is good because antibiotic treatment is very effective. Recent literature findings are reviewed and clinical and endoscopic features are compared.

Actinomycosis↗
PubMed1984

Cystadenoma of the common bile duct demonstrated by endoscopic retrograde cholangiography: an uncommon cause of extrahepatic obstruction.

Obstructive jaundice may rarely be caused by a benign tumor of the biliary tract. We describe a patient in whom the diagnosis of cystadenoma of the common bile duct was established. Complete resection of the tumor could be carried out. The clinical, radiological, and histological features of this neoplasm are reviewed.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1983

Immunohistochemical demonstration of lysozyme in pseudopyloric glands in chronic cholecystitis.

Gallbladders of 12 cases with chronic cholecystitis showing pseudopyloric glands (PPG) and of 18 cases with acute cholecystitis or chronic cholecystitis but without PPG were examined by the peroxidase - antiperoxidase (PAP) method using rabbit antibody against human lysozyme (LM). LM-immunoreactivity was detected in the cytoplasm of PPG and, to a lesser extent, in the pits of epithelial crypts that gave rise to PPG. No LM was found in normal gallbladders; in cases of cholecystitis without PPG, LM-immunoreactivity was restricted to infiltrating inflammatory cells. The presence of LM in PPG suggests that PPG represent functional metaplastic areas, involved in the non-specific defence mechanisms through participation of LM.

Cholecystitis↗
PubMed1983

Lymphocytes and Langerhans cells in the human oesophageal epithelium.

Using monoclonal antibodies on fresh frozen endoscopically obtained oesophageal biopsies the distribution of Langerhans cells, B lymphocytes, and various subpopulations of T lymphocytes was studied in the normal human oesophageal mucosa and in oesophagitis. Identification of the lymphocytes was carried out by an immunoperoxidase technique using OKT3 (antihuman T cell antibody), OKT4 (antihuman helper T cell antibody), OKT8 (antihuman cytotoxic T cell) and OKT10 (antihuman null cell antibody). Identification of the Langerhans cells was carried out using an ATPase stain and OKIa (Ia like antigen) and OKT6 (antihuman thymocyte). In the normal oesophageal epithelium cytotoxic T lymphocytes are found as well as Ia positive Langerhans cells. Helper T lymphocytes and B lymphocytes are present mainly in the lamina propria. In oesophagitis an increase in Langerhans cells and cytotoxic T lymphocytes within the epithelium is found. From these findings it can be concluded that the oesophagus contains a reticuloepithelial system as well as a lymphocytic population which are a part of the gut-associated lymphoid tissue.

Adult↗
PubMed1983

Presence of alpha-1-antitrypsin in pancreatic carcinoma. Report of four cases in association with hepatic storage of the protease inhibitor.

Among 13 patients with accumulation of alpha-1-antitrypsin (AAT) globules in periportal hepatocytes, 4 were found to have a pancreatic malignant tumor. Three tumors presented features of well-differentiated adenocarcinoma, the fourth was a poorly differentiated carcinoma displaying a glandular differentiation in its lymph node metastases. AAT immunoreactivity was detected in tumor cells from all 4 cases in either the primary or metastatic site. Two tumors contained Grimelius-positive cells; most of them were also positive for AAT. In addition, AAT immunoreactivity was observed in cells from normal large excretory ducts of the pancreas. AAT-positive tumor cells were negative on staining for other normal plasma (e.g. albumin and fibrinogen) or tissue-associated proteins (e.g. alpha-fetoprotein and human chorionic gonadotrophin). The findings appear to suggest: the pancreas adenocarcinoma as an additional malignant tumor with AAT positivity; a possible malignant proliferation of AAT containing cells in the pancreas ducts; a possible association between AAT accumulation in the liver and pancreatic adenocarcinoma.

Adenocarcinoma↗
PubMed1983

Immunoreactivity of alpha-1-antitrypsin in the human colon.

Alpha-1-antitrypsin (AAT) was detected by an indirect immunofluorescent technique and a peroxidase antiperoxidase technique in the human colon. It was present along the luminal border, in Paneth cells, in occasional epithelial cells and in macrophages. In idiopathic inflammatory bowel diseases an increased number of AAT positive macrophages can be seen. Although AAT is scarcely present in the human it might play a role in a local defence mechanism and thus in the pathogenesis of inflammatory bowel diseases.

Adenocarcinoma↗
PubMed1983

Immunohistochemical identification of lysozyme in pseudopyloric gland metaplasia in Crohn's disease.

Using an immunoperoxidase technique lysozyme (LZM) was identified in the ileum of patients with Crohn's disease in inflammatory cells of the lamina propria, in Paneth cells and in pseudopyloric gland metaplasia. These observations demonstrate a further analogy of pseudopyloric gland metaplasia with true pyloric glands, and may offer an additional explanation for the raised concentration of serum-LZM in patients with Crohn's disease.

Crohn Disease↗
PubMed1983

Neodymium-Yag laser photocoagulation for haemostasis of gastrointestinal non-variceal haemorrhage.

Neodymium-Yag laser treatment in 130 patients with upper gastrointestinal bleeding, including spurting arterial bleeding, active oozing or fresh stigmata of bleeding (fresh clot or non-bleeding vessel), permitted overall initial haemostasis in 95% of the patients. Total laser failures (rebleeds) amounted to 22%. Considering only the ulcers with vessels in 36 patients, initial control of haemorrhage was achieved in 83%, but the total failure rate amounted to 50%. A controlled randomized study in 129 patients with oozing bleeding and patients with stigmata of bleeding showed a significant (p less than 0.001) reduction of duration and of the recurrence rate of bleeding and a significant decrease (p less than 0.05) of operative indications. Mortality rates however were not lowered by laser therapy. Complications of lasertherapy did not occur. One hundred thirty-eight gastrointestinal angiomas were treated by Yag laser photocoagulation in 32 patients without complications. Although the results of Yag laser treatment of gastrointestinal bleeding seem promising, endoscopic laser techniques should be improved to optimise the results and to improve the prognosis of life-threatening gastrointestinal bleedings.

Gastrointestinal Hemorrhage↗
PubMed1983

Case report: fourteen-year follow-up of an apudoma of the bile ducts at the hilum of the liver.

A patient presented with a sclerosing tumor at the bifurcation of the main hepatic ducts and was followed for 14 yr after the initial symptoms. Palliative surgery was performed in 1968, followed by a remission of 10 yr. A reintervention in 1979 showed an impressive fibrotic mass that could be extirpated. The patient is again in complete remission for almost 3 yr. A tumor biopsy specimen, obtained at the second intervention, showed an apudoma-type tumor. This was confirmed by a positive Grimelius stain and by immunohistochemical investigation.

Adult↗
PubMed1982

Yersinia enteritis.

Y. enterocolitica has been shown to be a fairly common human pathogen in many countries. The clinical picture produced by Y. enterocolitica infections is quite variable. An acute abdominal disease (acute gastroenteritis or colitis, or a pseudoappendicitis due to acute terminal ileitis) and, less commonly, erythema nodosum and arthritis are the most important manifestations of the disease. On radiologic examination mucosal lesions of the terminal ileum are found in most patients with gastrointestinal symptoms. The colon is less frequently involved. The most typical lesions consist of shallow, small, round ulcers characteristic of the disease. Microscopic examination may suggest yersiniosis but does not show pathogenic signs. Y. enterocolitica can be detected by stool cultures or by serologic examinations. The disease is usually mild. If specific therapy is indicated the disease usually responds well to antibiotic therapy.

Anti-Bacterial Agents↗
PubMed1982

Acute infective colitis caused by endemic pathogens in western Europe: endoscopic features.

In a 4-year period 45 patients were admitted to our gastroenterological u nit with acute infective colitis. The endemic pathogens responsible for the colitis were Yersinia enterocolitica (46%), Campylobacter fetus jejuni (20%), common Salmonellae (13%), less virulent strains of Shigella (9%), Entamoeba hystolytica (7%) and Cytomegalovirus (4%). These microorganisms caused very severe disease in 18% of the patients, who were mostly predisposed. While Salmonella- and amoebic colitis always mimicked ulcerative colitis by the presence of diffuse lesions, the other pathogens caused focal colitis, thus necessitating differential diagnosis vis a vis Crohn's colitis. Two patients (4%) died of complications, while 93% of the patients were cured by proper antimicrobial therapy. In the same period 12 patients were admitted with an acute attack of inflammatory bowel disease due to an intercurrent infection with the same pathogens. In most of these patients clinical remission of IBD was achieved by treating the intercurrent infection. These data indicate that in the presence of an acute attack of colitis an infective etiologic agent must always be sought, and that an attack of chronic idiopathic inflammatory bowel disease may be caused by an intercurrent infection.

Adolescent↗
PubMed1982

Morphological identification of alpha-I-antitrypsin in the human small intestine.

Alpha-I-antitrypsin immunoreactivity was demonstrated by immunofluorescence in epithelial cells of the normal human small intestine. Its presence was also confirmed in biopsies of patients with Crohn's disease. Specific fluorescence was observed in only four out of 14 adult patients with coeliac disease. These results implicate the human small intestinal epithelium as a possible source of alpha-I-antitrypsin. The absence of positive cells may have implications in the aetiology of coeliac disease.

Adult↗
PubMed1982

Alpha-1-antitrypsin immunoreactivity in gastric carcinoid.

Alpha-1-antitrypsin (AAT) was demonstrated in tumour cells in three out of five cases of gastric carcinoma showing the histological characteristics of carcinoid tumour. It was also detected in normal stomach mucosa, but was not found in 10 cases of adenocarcinoma of intestinal or mucous cell type. The AAT-positive tumour cells were argyrophilic, PAS-positive and were negative for pancreatic and gastric hormones. These findings suggest a possible malignant proliferation of alpha-1-antitrypsin-containing cells in the stomach.

Adenocarcinoma↗