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Biomedical subjects

K Geboes

Publications and source records attributed to K Geboes.

At least 289 records · Page 16Linked to original sources
PubMed1975

Sexual impotence in man.

An analysis as to etiology and complaints of 486 cases of male sexual impotence was performed and is presented. Psychological factors are dominant in 68%. Physico-organic or iatrogenic causes accounted for deviations in 26% of the patients examined. Educational factors took an important part mainly in ejaculation disturbances. Primary anejaculation as a consequence of educational flaws occurred in 15% of the patients. Erection disturbances were often the consequence of physico-organic affections. The loss of libido was a real complaint in 19% of the patients.

Adult↗
PubMedDate not supplied

Palliative Nd:YAG laser therapy for cancer of the esophagus and gastroesophageal junction: impact on the quality of remaining life.

Endoscopic laser therapy (ELT) for palliation of cancer of the esophagus and the gastroesophageal junction was evaluated in 31 patients with far advanced disease. Initial technical success (94%) and initial improvement of symptoms (81%) were comparable to data reported previously. Complications were bleeding (6%), sepsis (6%), and tracheoesophageal fistula (6%). This analysis, however, addressed the impact of ELT on the remaining life of the patients. In 9 patients (29%) ELT was the only palliative alternative, and in 7 of these patients a fair functional success was achieved. In 13/21 (63%) of the patients with good initial functional result palliation could be preserved by repeated ELT until death from cachexia. Eight patients, however, were intubated in the follow-up period because of failure to keep the esophagus open. The dysphagia-free interval was only 4 weeks, and repeated ELT became progressively more difficult because of increased tumor load and increasing debility of the patient. 32% of the patients experienced ELT as more difficult than repeated dilations. Our data also suggest that duration of palliation after ELT alone lasts longer than palliation after dilation followed by ELT. Results of ELT were best in patients with recurrent cancer at the esophagogastric or esophagojejunal anastomosis.

Adult↗
PubMedDate not supplied

Whipple's disease: endoscopic aspects before and after therapy.

This report describes the utility and the advantages of endoscopy in diagnosing and following the course of Whipple's disease. Sixteen patients, diagnosed over a period of 22 years, were identified via pathology records and retrospectively reviewed. Five patients were diagnosed before 1980 by means of peroral suction biopsy of the small intestine. The 11 patients diagnosed after 1980 all had upper gastrointestinal endoscopy and endoscopic small intestinal biopsies. Gross endoscopic lesions were observed in 9 of the 11 patients and disappeared in 5 of 6 treated patients at 6 months. These lesions include erosions, yellow plaques, and a pale yellow shaggy mucosa. The latter two lesions are macroscopically suggestive of Whipple's disease. After endoscopic "healing," periodic acid-Schiff-positive macrophages remained present in the endoscopic biopsies for years. The patients were followed for a median period of 4 years and 5 months. All patients were treated with antibiotics (eight tetracycline alone, four tetracycline + streptomycin + penicillin, and four trimethoprim). Five patients (four of the tetracycline alone group, none of the trimethoprim group) relapsed 2 to 11 years after the initial treatment.

Adult↗
PubMedDate not supplied

The natural history of esophageal Crohn's disease: three patterns of evolution.

We carried out a clinical and endoscopic follow-up study of 14 patients with Crohn's disease of the esophagus. The diagnosis was based on the combination of endoscopic and histologic examinations with exclusion of all other possible causes. All patients had other gastrointestinal localizations of Crohn's disease, including oral and anal disease, and the majority also had serious extra-intestinal manifestations. Complete healing of the lesions was accomplished with corticosteroids in 9/14 patients after 2 to 4 weeks. During a total follow-up of 83 years for the 14 patients, 26 "flare-ups" of intestinal and systemic symptoms having a Crohn's disease activity index greater than 200 were diagnosed, on which occasions UGI endoscopy was performed before adjusting therapy. Three patterns of evolution could be distinguished: (1) in eight patients (total 17 flare-ups), neither endoscopic esophageal lesions nor UGI symptoms were apparent during follow-up. (2) Three patients (1 flare-up each) had persistent lesions despite corticosteroid therapy. (3) Three patients (6 flare-ups, 2 each) had relapse of both symptoms and esophageal lesions on each endoscopy, although these lesions had completely disappeared initially.

Adolescent↗
PubMedDate not supplied

CT diagnosis of primary torsion of greater omentum.

The etiology of primary volvulus of the omentum in the absence of other intraabdominal pathology remains obscure. Abdominal pain and tenderness are always present. Computed tomography demonstrates an abdominal mass composed of fatty and fibrous folds. Characteristic for a torsion is the concentric distribution of the fibrous folds at the site of torsion.

Female↗
PubMedDate not supplied

CT findings in nonmucosal eosinophilic gastroenteritis.

A 22-year-old patient with eosinophilic gastroenteritis with predominantly submucosal and muscular involvement is presented. The benefits of CT, using water as an orally administered contrast agent, are stressed, because CT enabled the authors to suggest a full thickness biopsy, after mucosal biopsies had remained repeatedly negative.

Adult↗
PubMedDate not supplied

Valvular colonic sphincter substitutes. An experimental study in dogs.

Three types of colonic sphincter substitutes were placed at an abdominal colostomy in dogs. Simple valve construction (8) was based on orthograde intussusception of the colon over 3.5 cm. In calibrated valves (6) the intraluminal pressure was increased by reducing the diameter of the overlying muscle coat. Reverse smooth muscle plasties (5) and simple colostomies (5) served as controls. Immediately after construction highest pressure (50 +/- 8.9 mm Hg) was obtained in calibrated valves. After 1 month the pressure dropped to 20 mm Hg, but remained stable thereafter. Although valvular constructions cannot maintain high pressure, they may be useful as substitutes for the internal anal sphincter by filling up the lumen so that the action of a surrounding striated muscle ring becomes more effective.

Animals↗
PubMedDate not supplied

Dysplasia in the gastrointestinal tract.

Epithelial dysplasia is an unequivocal neoplastic transformation which can be recognized with routine morphology. It is the morphological expression of one of the early steps of carcinogenesis. Its diagnosis depends upon the recognition of cytological and architectural abnormalities. A dysplastic lesion can, according to the severity of these abnormalities, be subdivided into different degrees. The presence of dysplasia in endoscopic biopsies may indicate a precursor lesion but it may also be a marker of malignancy. New techniques looking for molecular alterations can help to make a more reliable diagnosis of dysplasia.

Biopsy↗
PubMedDate not supplied

Different gastritis features are linked to different gastric neoplasms.

OBJECTIVES: Helicobacter pylori infection induces gastritis, which may evolve to carcinoma or lymphoma. Whether duration of infection and inflammation pattern determine the outcome of the neoplastic process is not known. The aim of this study was to investigate the features of the gastritis associated with neoplasia. METHODS: Gastritis found in association with carcinoma (100 cases) and lymphoma (45 cases) were graded using the Sydney system. RESULTS: In particular in the antrum, gastric carcinomas, in particular of the intestinal type, were associated with a chronic (94%, n = 34/36) atrophic (92%, n = 33/36) gastritis and intestinal metaplasia (81%, n = 29/36). In diffuse type carcinomas inflammation was either absent or mild. An active (64%, n = 16/25), chronic gastritis (100%, n = 25/25) with lymphoid hyperplasia (72%, n = 18/25) was found in marginal zone cell lymphoma. CONCLUSIONS: Our study shows that the (pre)atrophic phases of inflammation are associated with gastric carcinomas. In contrast the active phase of inflammation, characterized by severe activity as well as severe chronicity, is found next to marginal zone cell lymphoma.

Adult↗
PubMedDate not supplied

Sweet's syndrome in a patient with Crohn's disease.

Crohn's disease is rarely associated with Sweet's syndrome. We report a 32-year old woman who presented with diarrhea, fever and disseminated erythematous plaques on the arms and the trunk. After colonoscopy with biopsies, Crohn's disease was diagnosed. Skin biopsy showed a dense infiltration of neutrophilic polymorphonuclear leukocytes, establishing also the diagnosis of Sweet's syndrome. Crohn's disease is one of several systemic diseases that may underlie Sweet's syndrome. Treatment with methylprednisolone resulted in a rapid improvement of both gastro-intestinal symptoms and skin lesions.

Adult↗
PubMedDate not supplied

Barrett's esophagus: the metaplasia-dysplasia-carcinoma sequence: morphological aspects.

In the gastrointestinal tract, epithelial dysplasia is defined as an "unequivocal neoplastic transformation, confined within the boundaries of the basement membrane" or "the presence of unequivocally neoplastic cells that replace a variable proportion of the normal epithelium". It can be recognized by microscopy because of cytological and architectural changes. Reactive changes or equivocal changes should thus not be called "dysplasia". As dysplasia is confined within the basement membrane, it is a noninvasive neoplastic transformation. In the lower esophagus lined by columnar epithelium (Barrett's esophagus) dysplasia is classified as negative, indefinite or positive. Positive lesions are subdivided into low-grade and high-grade dysplasia according to the severity of the lesions. Carcinoma in situ (intraepithelial carcinoma) is included in the category of high-grade dysplasia. The presence of dysplasia can be recognized on biopsies and on cytological preparations. Several techniques have been introduced with the purpose to improve the diagnostic yield. These include special stains for the assessment of mucin, enzymehistochemistry and immunohistochemistry for tumor markers such as CEA and CA 19-9 and molecular techniques. Mucin histochemistry, enzymehistochemistry and immunohistochemistry for traditional markers have limited practical value. The nuclear presence of abnormal products such as mutant p53 can be identified using immunohistochemistry and appropriate antibodies. Flow cytometry can identify aneuploid cell populations and Fluorescent In Situ Hybridization (FISH) can identify chromosomal gains and losses. These techniques provide additional information but they identify other phenomena which do not necessarily appear at the same moment as dysplasia during the process of carcinogenesis. Application of these techniques can however certainly help to support a diagnosis of dysplasia while negative results do not necessarily disproof such a diagnosis. The temporal course of the progression of dysplasia and the development of carcinoma is not well known and seems to be variable. Low-grade dysplasia may persist for long periods. A direct progression towards carcinoma has been noted although more often an increase in the severity of the dysplasia, before the development of carcinoma, was seen during the observation period. High-grade dysplasia can also persist for many months, sometimes even years without obvious evolution but it can also progress rapidly to carcinoma.

Barrett Esophagus↗
PubMedDate not supplied

Ulcerative colitis and malignancy.

Ulcerative colitis is associated with an increased risk for colorectal cancer. The increase is approximately six to ten times the expected in the general population. Disease duration and extension are the major risk factors. Concomitant primary sclerosing cholangitis is an additional independent risk factor. The relative risk is approximately 14.8 for patients with pancolitis while it is 1.7 for patients with disease restricted to the rectum. The risk increases rapidly after 20 years of disease evolution. Active treatment might decrease the risk. The increased cancer risk is a major problem for longterm management of patients with ulcerative colitis. It is the rationale for various surveillance programs and the search for dysplasia. Two major types of dysplasia must be distinguished in ulcerative colitis: sporadic adenomas and ulcerative colitis-associated dysplasia. Sporadic adenomas can be treated by simple polypectomy. The diagnosis of dypsplasia relies mainly on microscopic analysis of biopsy samples. Additional techniques, including flow cytometry and the search for DNA abnormalities and immunohistochemistry or molecular techniques looking for genetic defects can help to improve the diagnostic yield.

Colitis, Ulcerative↗