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F C Den Hartog Jager

Publications and source records attributed to F C Den Hartog Jager.

6 recordsLinked to original sources
PubMed1990

The value of screening and central registration of families with familial adenomatous polyposis. A study of 82 families in The Netherlands.

In 1984 a national registry of families with familial adenomatous polyposis was set up in The Netherlands to promote screening in those families. Eight-two families had been registered by the end of 1988. Analysis of the pedigrees showed that 204 family members at risk had not yet been screened. The diagnosis of familial adenomatous polyposis was histologically confirmed in 230 patients. These patients were subdivided into two groups. Group A comprised patients with familial adenomatous polyposis referred because they were symptomatic, and Group B relatives of these patients who were found by screening to have familial adenomatous polyposis. The authors compared these groups with respect to the occurrence of colorectal carcinoma. Fifty-four patients were found to have a colorectal carcinoma at the time of diagnosis of familial adenomatous polyposis, i.e., 49 of the 104 patients in Group A (47 percent) and five of the 126 patients in Group B (4 percent). The average age at diagnosis of the 104 patients in Group A was 35 years (range, 13 to 66 years) and that of the 126 patients in Group B was 24 years (range, 8 to 59 years). By the age of 40 years, 90 percent of the patients in group B had been diagnosed. Late onset of familial adenomatous polyposis was found in four families. Endoscopy and/or radiography of the upper digestive tract were (was) performed in 44 of the 230 patients. Nineteen patients (43 percent) were found to have polyps in the stomach or duodenum, or both. In our series, only one patient died from cancer of the upper digestive tract (ampullary carcinoma). These results show conclusively that screening leads to the early detection of familial adenomatous polyposis. The value of a national registry is proved by the finding of many at-risk family members who had not previously been screened. Screening should start between the ages of 10 and 12 and should continue up to the age of 50. In the rare cases of families with an apparently late onset of familial adenomatous polyposis, screening should be continued up to age 60. More studies are needed to determine the natural history of polyps in the upper digestive tract.

Adenomatous Polyposis Coli↗
PubMed1990

Rectosigmoid obstruction caused by ovarian cancer.

Out of a total of 379 patients with ovarian carcinoma a rectosigmoid stenosis was detected in 44 (12%). A barium enema was available in 27 cases, which revealed a severe stenosis (less than 1/2 lumen open) in 23, with an average length of 17 cm (5-40 cm). Five characteristic types of stenosis were found: solitary stenosis (n = 6), large spherical impression (n = 6), multiple stenoses (n = 4), long narrow tract (n = 6) and a total obstruction (n = 5). Desmoplastic reaction with tethering and/or parallel folds (n = 16) or fixation and/or angulation (n = 18) were frequently found, but tumour invasion was rare (n = 3). A sigmoid resection (n = 1) or colostomy (n = 3) was seldom needed, due to beneficial response to combined therapy.

Adult↗
PubMed1986

Upper intestinal and biliary tract endoprosthesis.

The endoscopic insertion of an endoprosthesis is now a standard procedure in the ultimate palliation of malignant obstructing upper gastrointestinal and biliary malignancy. The commercially available prostheses and introducing devices are adequate for the majority of upper intestinal cancers. For some stricturing lesions, especially when associated with fistula formation, individual adaptation of a tygon prosthesis with extra widening rings is often necessary. Nd: Yag laser vaporisation of mainly exophytic cancerous tissue is mainly indicated for those circumstances which are less amenable to prosthesis insertion such as total luminal obstruction, noncircumferential tumorous involvement, polypoid cancers, excessively necrotic and chronically bleeding tumors, lesions extending within 2 cm of the upper esophageal sphincter, markedly angulated cancers of the cardia with almost horizontal tube positioning and cancerous overgrowth occluding the funnel opening. Overall successful insertion occurs in over 90% of patients. Main complications are perforation 5-8% and early or late dislocation. The procedure related mortality fluctuates around 2 to 4%. Overall results with laser application are roughly comparable. The dysphagia free intervall after laser is only around 6 weeks for the majority of the patients. Transpapillary insertion of a straight Amsterdam-type prosthesis rapidly became a standard procedure for palliation of malignant jaundice. For many patients with pancreatic cancer this endoscopic approach competes favorably with corresponding surgical palliative alternatives. Disappearance of jaundice is to be expected in the vast majority of the patients. The only major unsolved problem remains late clogging with biliary sludge which necessitates insertion of new prostheses. Most problematic to breach are bifurcation tumors. Cholangitis is a major complication if one does not succeed at the first attempt to drain both liver lobes.

Biliary Tract Neoplasms↗
PubMed1986

Diagnosis and treatment of a carcinoid tumor using iodine-131 meta-iodobenzylguanidine.

Scintigraphy using I-131 meta-iodobenzylguanidine has been introduced as an effective method to detect pheochromocytomas and neuroblastomas, and the radiopharmaceutical also is applied in therapy of these tumors. The authors present a case of a metastatic gastric carcinoid tumor, another neural crest tumor, concentrating I-131 MIBG, which was documented by conventional scintigraphy and SPECT in correlation with CT scans and colloid scintigrams of the liver. Two therapeutic attempts in this patient, using I-131 MIBG, are described. The metabolic basis of this phenomenon is discussed, and the importance of I-131 MIBG imaging in the detection of neural crest tumors is underlined.

3-Iodobenzylguanidine↗