[Methimazole hepatitis].
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Biomedical subjects
Publications and source records attributed to A Piñero Madrona.
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BACKGROUND: The experience in detection of sentinel lymph node in melanoma using preoperative scintigraphy and intraoperative gamma probe is referred. PATIENTS AND METHODS: We studied 60 patients with stage I-II melanoma who underwent sentinel lymph node biopsy performed using 99m-Tc-labelled sulphur colloid as radioactive tracer. A preoperative scintigraphy was performed and intraoperative gamma probe was used to localize the sentinel node in all cases. Scintigraphy results, effectiveness of intraoperative detection (technical efficacy), pathological results, and follow-up have been studied. RESULTS: Preoperative detection was 98.3% and the mean basin detected was 1.17. There were multiple basins especially when melanomas were on the trunk. Technical efficacy was 98.4% and intraoperative detection was more difficult in parotid gland region. HMB-45 immunohistochemical staining was essential in pathological studies, in whom 10% were positives. Lymphadenectomy could be avoided in 90% of the patients. Recurrences were not detected during follow-up and metastases were found only in non biopsied cases. Sentinel node biopsy morbidity was significative lesser than that of lymphadenectomy. CONCLUSIONS: Preoperative scintigraphy and intraoperative gamma probe use to localize sentinel node in melanoma have a high efficacy. They can reveal multiple basins and they allow a more selective surgical approach and a minimal dissection.
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OBJECTIVE: To analyse the need for operation for pyloric stenosis caused by duodenal ulcer over a period of 24 years (1976-1999). DESIGN: Retrospective study. SETTING: University hospital, Spain. SUBJECTS: 156 patients operated on for peptic pyloric stenosis. MAIN OUTCOME MEASURES: The number of patients operated on yearly were grouped into 4-year periods for statistical comparison. RESULTS: The number of cases operated on each year steadily decreased between 1976 and 1999. In the 1988-1991 period there was a significant reduction (p <0.05), which continued over the next two 4-year periods, particularly the last (p <0.01). CONCLUSION: Although we cannot use this study to establish a direct relation between the decrease in the indication for operations for peptic pyloric stenosis and the use of H2 antagonists, proton pump inhibitors, or treatment to eradicate Helicobacter pylori, we did find a significance difference between the years before and after the introduction of these drugs.
Currently, the vena cava superior syndrome (VCSS) is mainly of oncologic origin. We report here four cases of this syndrome caused by intrathoracic multinodular goiter. All patients had compressive symptoms, particularly of the oesophagus and trachea. Axial CT was the imaging technique that delineated the intrathoracic multinodular goiter compressing brachiocephalic vessels. Surgery (total thyroidectomy) was used and all compressive symptoms resolved.
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Idiopathic intestinal invagination is a relatively frequent process in children in comparison with cases of intestinal obstruction/subocclusion by invagination secondary to a tumor in adults which is unusual and more often observed in patients over the age of 60 years. Two clinical cases of intestinal obstruction in young adult males due to intestinal invagination by a tumor of the small intestine are presented. One case was due to a submucosal lipoma which lead to ileo-ileal intussusception and an ileo-cecal invagination by a terminal ileum lymphoma. The clinical and diagnostic aspects of this infrequent disease are discussed.
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The formation of an aortoenteric fistula is an infrequent cause of intestinal bleeding which carries out a bad prognosis. The causes may be diverse and the clinical picture is, occasionally, very unspecific with a high index of suspicion being fundamental in the management of this type of patients. Four cases of aortoenteric fistula which the authors believe to be clearly demonstrative are presented. One of these cases may currently be considered as very rare in Spain due to the etiology of the same. The authors emphasize the importance of exhaustive exploration by oral endoscopy which is able to diagnosis the localization of the bleeding in 80% of the cases. However they also underline the need for laparotomy, particularly in carriers of aortic vascular grafts which are currently the most important risk group, since confirmation of diagnosis by imaging methods may be delayed.