So-called clinically primary tuberculous pericarditis.
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Biomedical subjects
Publications and source records attributed to T Yao.
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We evaluated a 72-year-old woman who was experiencing dysphagia. Esophageal leiomyosarcoma was diagnosed by barium meal study, upper gastrointestinal endoscopy, endoscopic ultrasonography (EUS), by computed tomography (CT). A barium meal study and esophagoscopy performed 3 months before the diagnosis of esophageal leiomyosarcoma showed no abnormalities. Therefore, the tumor appeared to have grown rapidly during the 3-month period.
Push-type jejunal endoscopy using a long forward-viewing duodenofiberscope was performed in two patients with primary jejunal carcinoma. Patient 1, a 48-year-old female, complained of nausea, vomiting, and weight loss, whereas patient 2, a 65-year-old female, presented epigastric pain. The lesion was located in the upper portion of the jejunum, and diagnosis was made by a double-contrast X-ray study of the small intestine in both patients. Endoscopic examinations revealed a reddish, nodular polypoid lesion with an annular constriction and an irregular central ulceration. Endoscopic biopsy confirmed a diagnosis of adenocarcinoma in both patients. Push-type jejunal endoscopy is valuable for an accurate preoperative diagnosis of primary jejunal carcinoma.
Operative intestinal fiberscopy, in which the duodenal fiberscope was introduced during laparotomy for colectomy in familial polyposis via the enterotomy opening, permitted the demonstration of small intestinal polyps in six of seven consecutive cases. Four of the six patients had adenomatous polyps in the proximal jejunum, including one patient with the concomitant presence of ileal adenomas. Polyposis due to lymphoid hyperplasia in the terminal ileum was found in three patients. Preoperative upper gastrointestinal surveys revealed adenomas in the duodenums of all seven patients, adenomas in the gastric antrum in three, and multiple hamartomas in the gastric corpus in two. Thus, in familial polyposis or Gardner's syndrome, more or less the entire gastrointestinal tract seems to be involved and the term "gastrointestinal polyposis" seems to describe these conditions.
BACKGROUND: Crohn's colitis, frequently accompanied by stenosis or narrowing, can be difficult to assess through conventional methods. We evaluated the usefulness of virtual computed tomographic colonography (CTC) for the detection of colonic lesions due to Crohn's disease. METHODS: Forty-two lesions in 33 patients with Crohn's disease were examined by CTC and barium enema (BE). Twenty-two patients also were examined by colonoscopy (CS). The visualization ability of CTC was compared with those of the other two methods. RESULTS: In the visualization of elevated lesions, there was no significant difference between CTC and BE (18 of 20, p = 0.487) or between CTC and CS (15 of 16, p = 0.99); however, ulcerative lesions were less often visualized by CTC. However, CTC enabled identification of serious lesions in the colon proximal to the stenosis in nine patients and was superior to BE and CS in terms of its ability to visualize the proximal site of the stenosis (p = 0.003). CONCLUSION: CTC is clinically useful for the evaluation of Crohn's colitis, especially those with stenotic lesions.
BACKGROUND: To clarify the radiographic characteristics of intractable gastric ulcers with H2-receptor antagonists. METHODS: The radiographic findings at the time of starting treatment were compared between 42 patients with gastric ulcers that did not heal within eight weeks of starting treatment with H2-receptor antagonists (the intractable group) and 58 patients whose ulcers healed within the eight-week period (the tractable group). RESULTS: The following radiographic findings in the intractable group were observed at a significantly higher incidence than those in the tractable group and included: an ulcer located on the angle, linear ulcers, a greater depth, an uneven mound surrounding an ulcer, prominent folds' convergence, an overhanging gastric mucosa, an irregular ulcer base, a shortening of the lesser curvature and a U-shaped deformity of the angle. A multiple logistic regression analysis showed that the following three factors had a significant and independent delaying effect on healing: a U-shaped deformity of the angle, an uneven mound surrounding an ulcer and prominent folds' convergence. The relative risk of these factors were 12.7, 14.4 and 12.5, respectively. CONCLUSIONS: Intractable gastric ulcer with H2-receptor antagonists can be predicted based on the characteristic radiographic findings at the start of treatment.
Coimmobilized glucose oxidase and anti-T4 antiserum are employed in the construction of a biosensor for thyroxine measurements. The resulting enzyme-immunosensor yields an amplified response to T4 with a detection limit of 15 nM.
Endoscopic and biopsy findings of the esophagus, stomach, duodenum, and colorectum were studied in 37 patients with amyloidosis involving the gastrointestinal tract. Endoscopic examinations revealed fine granular appearance, polypoid protrusions, erosions, ulcerations, and mucosal friability in many cases. These findings were most marked and noticed most often in the second portion of the duodenum. The frequency of amyloid deposition in the biopsy specimens was as follows; 100% in the duodenum, 95% in the stomach, 91% in the colorectum, and 72% in the esophagus. The degree of amyloid deposition in the duodenum, which was the highest of the entire gastrointestinal tract, significantly correlated with the frequency of endoscopic findings such as fine granular appearance and polypoid protrusions. Therefore, the two endoscopic findings described above are characteristic of this disease and may reflect amyloid deposition in the mucosa or submucosa of the alimentary tract. Our results indicate that for a diagnosis of amyloidosis, it is important to examine the upper gastrointestinal tract, especially the duodenum, using endoscopy and biopsy techniques.
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