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Biomedical subjects

C Simmang

Publications and source records attributed to C Simmang.

11 recordsLinked to original sources
PubMed2000

Primary colonic lymphoma.

BACKGROUND AND OBJECTIVES: The colon is a rare location for gastrointestinal non-Hodgkin's lymphoma (NHL). This study was undertaken to identify risk factors, presentation, treatment, and prognosis for primary colonic lymphoma (PCL) through review of a large tertiary care hospital system experience. METHODS: A retrospective review of all patients with colonic malignancy and NHL was performed using pathology and cancer registry databases from January 1989 to December 1998. Criteria for inclusion were no evidence of extraperitoneal disease, no leukemic or lymphomatous abnormalities in the blood, and disease confined to the colon. RESULTS: Seven patients met the inclusion criteria (4 male, 3 female; 33-72 years). They represented 1.4% of all NHL, 14% of gastrointestinal NHL and 0.9% of all colonic malignancies diagnosed during this period. Three of the patients had positive serology for human immunodeficiency virus; one was taking steroids chronically for Addison disease. The most common presentation was nonspecific abdominal pain. The lack of specific symptoms delayed diagnosis from 1-12 months. All patients underwent laparotomy with resection. The most common tumor location was the cecum (5/7, 71%). Regional lymph nodes were affected in all but 1 patient. All tumors were B-cell lymphomas (5 small noncleaved cell, 2 large cell). Six of 7 patients received adjuvant chemotherapy. Of the 6 patients available for follow-up four remain alive (12, 19, 23, and 25 months after diagnosis). In both patients who died the disease recurred diffusely. CONCLUSIONS: The colon is a rare location for NHL. Immunosuppression is the most common risk factor. Patients' frequently present with non-specific abdominal pain, this leads to lengthy delays in diagnosis. Most of these tumors are located in the cecal area. Surgery is the most widely utilized form of therapy. Although adjuvant therapy is frequently utilized, its' impact on survival is unclear.

Academic Medical Centers↗
PubMed2000

Rare presentation of actinomycosis as an abdominal mass: report of a case.

PURPOSE: The purpose of this article was to report an unusual presentation of abdominal actinomycosis masquerading as a tumor. METHODS: The patient was a 54-year-old male who presented with vague abdominal discomfort and a palpable left lower quadrant mass defined on CT scan. Multiple intraoperative core biopsies were nondiagnostic, and he underwent en bloc resection of the mass and adjacent organs for a presumed tumor. RESULTS: Examination of tissue from deep within the excised specimen revealed sulfur granules diagnostic for actinomycosis. CONCLUSION: Abdominal actinomycosis is an extremely rare infection that can mimic multiple disease processes and requires accurate diagnosis for successful therapy. This novel presentation and a review of the literature are reported.

Abdomen↗
PubMed2000

Practice parameters for the treatment of sigmoid diverticulitis--supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons.

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

Diverticulitis, Colonic↗
PubMed1998

Streptococcus sanguis bacteremia and colorectal cancer.

Streptococcal bacteremia is an uncommon presentation for colorectal malignancy, yet most physicians are aware of the association between Streptococcus bovis infection and these malignancies. Many are unaware, however, that other streptococcal species are associated with colon and rectal cancers. In this case report and brief review, we highlight this association and discuss a case of Streptococcus sanguis bacteremia associated with an early invasive rectal cancer.

Adenocarcinoma↗
PubMed1997

Perianal mucinous adenocarcinoma.

BACKGROUND: Perianal mucinous adenocarcinoma is a rare variant of anal canal epithelioid tumors. Our objective in this report is to examine the clinical features, pathology, treatment, and outcome for patients with perianal mucinous adenocarcinoma. METHODS: A retrospective review identified four patients with histologically proven perianal mucinous adenocarcinoma. The medical records of these patients were reviewed for presentation, therapy, and outcome. RESULTS: Pain and bleeding were present in all cases. In three of four patients, chronic perirectal disease was present, including two abscesses and one fistula. All patients had extensive local disease at presentation. One patient presented with bilateral inguinal nodal metastases. Two patients received neoadjuvant chemotherapy and radiation, with a third patient receiving radiation alone. Two of these three patients underwent abdominoperineal resection. Three patients subsequently died (all of progression and/or recurrence) 2-48 months after diagnosis. The fourth patient (who was treated with chemotherapy and radiation followed by abdominoperineal resection) is alive and disease free at 12 months. CONCLUSIONS: Perianal mucinous adenocarcinoma is a rare disease with a poor prognosis, mostly due to its advanced nature at the time of diagnosis. Chemoradiation followed by surgery may improve outcome in selected individuals.

Adenocarcinoma↗
PubMed1994

Anal sphincter reconstruction in the elderly: does advancing age affect outcome?

PURPOSE: This study was designed to determine whether advancing age affects outcome after anal sphincter reconstruction. METHOD: Anal sphincter reconstruction, performed on patients 55 years of age and older, was reviewed to determine if functional outcome was adversely affected by advancing age. A subgroup of patients was studied with anal manometry before and after repair and with pudendal nerve terminal motor latency (PNTML) before surgery. Results were compared with a younger group of patients. RESULTS: Between July 1986 and July 1991, 14 patients, ages ranging from 55 to 81, underwent anal sphincter reconstruction using an overlapping muscle repair. Ten patients were incontinent of solid stool and four of liquid stool. Improvement was seen in 13 of 14 patients: 7 (50 percent) complete control, 3 (21 percent) incontinent to flatus, and 4 (29 percent) incontinent to liquid stools (including the patient who failed to improve). Ten patients were studied with a continuous pull-out manometric technique and PNTML: one was not improved. There was minimum change in mean maximum resting pressure (35.0-37.9 mmHg). Mean maximum squeezing pressure increased from 66 to 75 mmHg overall. Patients with complete control had a mean maximum squeezing pressure of 81 mmHg compared with 60 mmHg in patients with residual incontinence. Mean anterior anal sphincter length increased from 2.92 cm to 3.31 cm. PNTML was normal (2.0 +/- 0.2) on one or both sides in all nine patients who improved (average, 2.1). The patient who failed to improve had abnormal nerve function bilaterally (2.4, 2.7). CONCLUSION: Anal sphincter reconstruction can be performed in elderly patients with improvements in the majority of patients. Total control can be achieved by restoring maximum squeezing pressure in a patient with normal pudendal nerve function.

Adult↗
PubMed1978

Susceptibility of fetal sheep to acute decompression sickness.

Studies were conducted to determine the susceptibility of the fetus to decompression sickness. Sheep were used because fetal and maternal circulation of sheep and human placentas are dynamically similar. Seven sheep that were within three weeks of parturition were used. A Doppler ultrasonic transducer was placed around an umbilical artery of the fetus in utero and the electrical leads were exteriorized. Umbilical artery blood flow could thus be monitored together with any bubbles appearing in that part of the fetal circulation. Results of 17 dives showed that exposing the mother to a 100-fsw, 25-min standard no-decompression dive produced massive air emboli in the fetus, though no bubbles were detected in the maternal circulation either by Doppler or visual inspection. An 80-fsw dive for 40 min caused an occasional bubble to appear in the fetus. Sixty-fsw dives for 60 and 70 min, respectively, did not produce bubbles in the fetal circulation.

Animals↗