Percutaneous transluminal biopsy of biliary strictures with a bioptome.
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Aged↗
Biomedical subjects
G Lycke
Publications and source records attributed to G Lycke.
Double contrast barium enema and flexible rectosigmoidoscopy: a reliable diagnostic combination for detection of colorectal neoplasm.
The efficiency of double contrast barium enema and flexible rectosigmoidoscopy (to 60 cm) in the assessment of patients with a positive Hemoccult II test in a randomized screening study for colorectal neoplasms was evaluated. A positive test was present in 625 patients, of whom 530 had a complete enema and rectosigmoidoscopic assessment. A carcinoma was diagnosed in 26 and an adenoma greater than or equal to 1 cm in diameter in 71. As a control, 323 patients with a negative assessment repeated the Hemoccult II test and of these 67 had a positive second test, of whom 55 underwent colonoscopy. One carcinoma (Dukes' A) and two adenomas greater than or equal to 1 cm in diameter were diagnosed. The efficiency of the assessment was also checked by rescreening the whole group 1-2 years after the first study and by continuing follow-up. It was found that two more carcinomas and one adenoma greater than or equal to 1 cm in diameter had been overlooked at the primary assessment. The sensitivity for neoplasms greater than or equal to 1 cm in diameter at the primary assessment was 72 per cent for double contrast barium enema and 86 per cent for rectosigmoidoscopy. The sensitivity for the combined methods was 94 per cent and the specificity was 99 per cent. The combination of double contrast barium enema and rectosigmoidoscopy in the primary assessment of patients with a positive Hemoccult II test gives an acceptable result and immediate retesting of those with a negative assessment is not necessary.
Adenoma↗
[Successful surgical treatment of acute massive pulmonary embolism].
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Acute Disease↗
Replacement of the esophagus by a segment of colon provided with an antireflux valve.
A method has been developed to prevent reflux of gastric contents into an interposed segment of colon substituting for the esophagus. The operative procedure includes construction of an intussusception valve at the cologastric junction. The method was used in 5 patients, who have been followed clinically for 17 to 30 months. Clinical observations including endoscopy as well as radiography and dynamic scintigraphy indicate that the addition of an antireflux valve at the distal end of the interposed segment of colon prevents gastrocolic reflux without jeopardizing the emptying of the colon transplant.
Adolescent↗
Renal function and upper urinary tract configuration following urinary diversion to a continent ileal reservoir (Kock pouch): a prospective 5 to 11-year followup after reservoir construction.
We followed 17 patients who underwent urinary diversion via a continent ileal reservoir (Kock pouch) with yearly examinations for 5 to 11 years postoperatively. The examinations involved control of renal function and configuration of the upper urinary tract. In 5 patients the upper urinary tract had become dilated during followup and in 2 of these renal scarring also had developed. All 5 patients had endured temporary outflow obstruction or reflux (stricture, overdistension of the reservoir or a defective antireflux valve). Of the patients 1 had a marked decrease in renal function before the outflow obstruction was corrected by an operation. Routine blood chemistry study was normal and hyperchloremic acidosis was not noted in any patient. After peroral loading of 6 patients with ammonium chloride significant excretion of titratable acid was found in the urine. Substitution with vitamin B12 was given to 6 patients due to subnormal values in 2 and borderline values in 4.
Follow-Up Studies↗
Perception errors with double-contrast enema after a positive guaiac test.
Between 3 and 6 of 12 colorectal neoplasms larger than 1 cm in diameter were overlooked by each of 4 radiologists in 117 individuals investigated with double-contrast enema (DCE) after a positive guaiac test. Even when the individual results of 2, 3, or 4 experienced radiologists were combined, 2 small carcinomas were overlooked due to perception errors. One of these carcinomas was diagnosed by rectosigmoidoscopy, which is an important and necessary complement to DCE. Although small carcinomas may be missed even with this combination, meticulous exploitation of the 2 methods is absolutely necessary to minimize the risk of missing a colorectal neoplasm. A drawback when 2 or more radiologists read the radiographs is the increased number of false-positive findings.
Adenoma↗
An appliance-free, sphincter-controlled bladder substitute: the urethral Kock pouch.
A modified Kock pouch was constructed in 16 patients with cancer of the bladder in whom cystoprostatectomy was indicated. Surgery entailed creation of a Kock pouch with 1 valve for prevention of reflux. The pouch then was anastomosed to the urethral stump. There was no operative mortality. Followup ranged between 3 and 9 months. Excretory urograms revealed excellent upper tract function and good evacuation of the pouch with minimal residual urine. Urodynamic studies demonstrated a volume capacity of greater than 300 ml., with pressures of less than 40 cm. water. All patients were continent during the day. Nocturnal enuresis was observed in 4 patients, 3 of whom responded favorably to I-desamino-8-D-arginine vasopressin therapy. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer.
Adult↗
Measurement of pouch volume and stoma diameter after gastroplasty.
A balloon technique has been developed for measurement of the pouch volume and stoma diameter after gastroplasty. Twenty-seven patients prospectively included in a randomized study of two types of gastroplasty operation have been investigated 6 months postoperatively. During the operation the proximal pouch was calibrated to be about 40 ml and the stoma diameter to 11 min. Six months after the operation the patients had on average reduced weight by 29 kg. Using the balloon technique, the stoma diameter was 12 +/- 1.6 (s.e.m.) mm and the pouch volume 80 +/- 11.0 ml. There was a significant correlation between the stoma diameter and weight reduction during the first 6 months postoperatively (P less than 0.01). The relationship between the stoma diameter and weight reduction followed best an exponential equation. No correlation was found between the pouch volume and weight reduction. The presented technique for measurement of pouch volume and stoma diameter after gastroplasty may be an important tool to evaluate the influence of various factors on the long-term results of surgical treatment for morbid obesity.
Body Weight↗
Diagnostic accuracy of double-contrast enema and rectosigmoidoscopy in connection with faecal occult blood testing for the detection of rectosigmoid neoplasms.
Four hundred and fifty-eight consecutive subjects with a positive faecal guaiac test when screened for early detection of colorectal neoplasms were investigated with double-contrast enemas and rectosigmoidoscopy (60 cm). The results of these two methods were compared. The radiologists and endoscopists were unaware of the result of each others' examination at the time of their own investigation. Altogether ten subjects with carcinoma in the rectosigmoid area were found. The radiologists and endoscopists each overlooked four of these ten carcinomas and only four of the carcinomas were diagnosed with both methods. Fifty-six of one hundred and seven adenomas were 1 cm or larger in diameter and located in the rectum or the sigmoid colon. Thirteen of the fifty-six adenomas were missed by double contrast enema and ten by endoscopy and only thirty-three adenomas were diagnosed with both methods. Neoplasms in the rectum and the sigmoid colon are sometimes difficult to diagnose with both radiology and endoscopy. Rectosigmoidoscopy (60 cm) should therefore be used as a complement to double contrast enemas if this method is chosen for investigation of a patient with rectal bleeding.
Adenoma↗