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Biomedical subjects

G Smok

Publications and source records attributed to G Smok.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Benign polypoid lesions of the gallbladder. Their relation to gallbladder adenocarcinoma].

Out of 12,153 cholecystectomies performed over a period of 10 years, 114 polypoid lesions were found in 81 removed gallbladders (0.7%). 225 adenocarcinomas of the gallbladder were found in the same population (1.85%). The mean age of patients with polypoid lesions was 46 years, with a male to female ratio of 1:2.7. 94% of lesions measured less than 10 mm and only 9.6% were adenomas. Among these, dysplastic alterations were found in all and one had evidence of early adenocarcinoma. The mean age of patients with adenocarcinoma was 62 years with a male to female ratio of 1:6. Residual adenomas were found in 2 cases and multiple adenomas coexisted in another case. Thus, polypoid lesions of the gallbladder are less frequent than adenocarcinoma. Only adenomas show a potential to evolve to malignant lesions, but their low incidence makes them an unimportant precursor of gallbladder carcinoma.

Adenocarcinoma↗
PubMed1992

[Clinical course characteristics of gastric cancer 1958-1990].

The clinical, surgical and histopathologic characteristics of patients with gastric cancer were compared among 3 consecutive periods from 1958 to 1990. A significant increase in the frequency of location at the upper third of the stomach, a greater proportion of resectable lesions, an increasing tendency towards extended total gastrectomy and a significant increase in the frequency of undifferentiated or diffuse carcinoma were observed. A change in pathogenetic factors along the years may be involved in the differences described.

Adult↗
PubMed1992

[Transvenous hepatic biopsy in patients with blood coagulation disorders].

Severe clotting defects represent the main contraindication to percutaneous liver biopsy. A transvenous liver puncture technique has been developed for patients suffering from blood coagulation disorders. This approach was attempted in 17 of 148 consecutive patients (12%) in whom a needle liver biopsy was indicated. Hepatic tissue samplings were successfully obtained in 16 subjects. The mean size of the specimens was 7 mm. The clinical diagnosis or therapy were modified in 7 patients when the histopathology report was available. No complications related to the procedure occurred. Our early experience suggests that transvenous liver biopsy is indicated in one/ninth of cases in whom hepatic tissue sample is required for diagnosis. This technique is safe, and it has a high success rate to provide liver tissue samples.

Adult↗
PubMed1992

[A cooperative study on early and intermediate gastric cancer: clinical, diagnostic and therapeutic aspects].

A cooperative study involving 13 hospitals in Chile allowed the analysis of 353 patients with gastric cancer in early stages. 82 cancers were located at the mucosal level, 151 at the submucosa and 120 reached the muscular layer. There were no differences in age and sex among these groups. Compared to early stage, patients with intermediate stage had a greater incidence of bleeding, anemia and undernutrition and exhibited lower body weight. Endoscopy had a higher diagnostic yield compared to radiological study. The diagnosis was confirmed by biopsy in 95% of patients. Total or subtotal gastrectomy was performed according to the location of the lesion, with a low operative mortality rate. Early gastric cancer accounts for 8 to 10% of all patients with gastric cancer undergoing surgical treatment.

Adult↗
PubMed1992

[Microscopic colitis and collagenous colitis. An entity not yet reported in Chile].

Collagenous and microscopic colitis have been described as causes for abundant watery diarrhea with a normal radiologic and endoscopic aspect of the colonic mucosa. Microscopic colitis is characterized by diffuse intraepithelial lymphocytic infiltration and collagenous colitis by thickening of subepithelial collagen layer greater than 15 microns with or without inflammatory changes of the mucosa. Here are reported 5 patients with microscopic colitis and 4 with collagenous colitis. The mean age was 52 years (range 40 to 68) with an equal sex distribution. Diarrhea was of longstanding duration without weight loss, anemia or hypoalbuminemia. Occasionally the volume of diarrhea was over 1 L a day. One patient had steatorrhea that proved resistant to a gluten free diet. Endoscopic and radiologic findings were normal in every patient and the diagnosis was based on typical histology. Azulfidine therapy was successful in 7 patients and prednisone in another. Colonic biopsy should be performed in every patient with chronic diarrhea.

Adult↗
PubMed1992

[Peptic ulcer and endoscopic signs of portal hypertension in patients with primary biliary cirrhosis].

BACKGROUND: Controversies exist on the prevalence of peptic ulcer and on the relationship between the presence of portal hypertension associated lesions in the upper gastrointestinal tract and the histological and functional stages of primary biliary cirrhosis AIM: To evaluate the prevalence of peptic ulcer and endoscopic signs of portal hypertension in subjects with primary biliary cirrhosis. PATIENTS AND METHODS: A retrospective study based on upper gastrointestinal endoscopies in 36 patients with primary biliary cirrhosis and 45 subjects with chronic active hepatitis. SETTING: Gastroenterology Center, Hospital Clínico, University of Chile, Santiago. MAIN RESULTS: No differences were demonstrated between the two groups for the prevalence of peptic ulcer (11% in primary biliary cirrhosis vs 13% in chronic active hepatitis). Esophageal varices were found in 5 of 16 patients (31%) in prefibrotic stages of primary biliary cirrhosis compared with 10 of 20 (50%) in whom fibrosis or cirrhosis were noted; NS. Endoscopic signs suggesting hypertensive gastropathy were present in 2 patients with early primary biliary cirrhosis (13%) and in 5 (25%) in advanced stages. CONCLUSIONS: Peptic ulcer is not more prevalent in patients with primary biliary cirrhosis than in those suffering from chronic active hepatitis. Esophageal varices and endoscopic stigmata of portal hypertension induced changes in gastric mucosa can be observed in early stages of primary biliary cirrhosis.

Endoscopy, Gastrointestinal↗
PubMed1991

[Prevalence of gallbladder neoplasms in cholecystectomies].

The prevalence of gallbladder cancer in 10,468 cholecystectomy patients was studied: 3.4% of the female and only 1.32% of the male population had gallbladder cancer (p < 0.001). The female population had 2.7 times more cholelithiasis, and 7.9 times more cancer than the male population. Cancer incidence increases progressively with age, specially after the 5th decade.

Adult↗
PubMed1991

[Incipient and intermediate gastric cancer II. Anatomo-pathological and surgical aspects. Cooperative study in 13 hospitals].

Anatomic and surgical characteristics of 233 pts with early, and 120 with intermediate gastric cancer, from 13 hospitals in Chile are analyzed. 63% had depressed or excavated lesions. Most of the tumors were located in the inferior or middle third, while only 17% of the early carcinomas were found in the superior third of the stomach, specially in the lesser curvature. 5% had residual tumor in the gastric remanent. Histologically, tubular adenocarcinoma was the most common finding. According to Lauren's classification intestinal carcinoma was more frequent than the diffuse type. Surgeons underestimated lymphatic node involvement (macroscopic appreciation) in up to 58% of the cases when compared to the pathologists observation (microscopic appreciation). This was specially true in muscular carcinomas. The incidence of lymphatic metastases was 6% in mucous, 12% in submucous and 57% in muscular carcinoma. The need of complete lymph node dissection of all the lymphatic barriers is emphasized.

Carcinoma↗
PubMed1990

[Ductal epithelial lesions and pancreatic adenocarcinoma].

Epithelial alterations in pancreatic ducts may have a premalignant nature. We compared the incidence of different lesions in 49 pancreatic cancer specimens compared to 100 controls. Simple hyperplasia, mucosecretory metaplasia and pyloric metaplasia were evenly distributed among groups. In contrast, papillary hyperplasia, intestinal metaplasia and dysplasia were significantly more frequent in pancreas with carcinoma. Therefore, these lesions may have a precancerous nature.

Adenocarcinoma↗
PubMed1990

[Primary biliary cirrhosis. The experience in 33 consecutive cases].

Primary biliary cirrhosis is a chronic, progressive and often fatal cholestatic liver disease. We report clinical characteristics and follow up in 33 consecutive patients studied at a single university hospital during the last 10 years. 31 were female (94%) and the mean age was 51 +/- 2 years. At diagnosis, itching was present in 26 cases (78%). Association with autoimmune mediated diseases was frequent. Liver function tests showed marked cholestasis (alkaline phosphatase levels of 439 +/- 58 IU/l, range 90-1335). High antimitochondrial antibody titers and elevation of IgM levels were shown in all cases. According to liver biopsy findings, the diagnosis of primary biliary cirrhosis was an early one during the prospective phase of the study and was made in 8 +/- 1.4% of liver biopsies performed during this period. After a follow up of 27 +/- 5 months, 10 patients have died (30%). Our experience suggests that primary biliary cirrhosis is not an uncommon cause of chronic liver diseases in Chile.

Adult↗
PubMed1990

[Fungal infections in 2 cases of fulminant hepatitis].

Infectious complications are highly prevalent in patients with fulminating hepatitis. We report 2 female patients, aged 42 and 80 years old, with fulminating hepatitis caused by virus B and virus non-A non B, who died 20 and 25 days after initiation of the disease. Post mortem examinations showed severe C albicans infection of the gastrointestinal tract. A literature review is included.

Adult↗
PubMed1990

[Dieulafoy's vascular malformation as a cause of massive and recurrent gastric hemorrhage].

We demonstrated a Dieulafoy-type vascular malformation in 10 patients with upper gastrointestinal bleeding. Most patients had a history of prior bleeding and were older than 60 years of age. A mean of 2.6 endoscopic examinations had been performed, and a mean of 2500 ml of blood transfused per patient. A localized resection of the lesion was performed in 9 patients and a partial gastrectomy in the remaining. Surgery was performed as an emergency in 5 patients. The lesion was a small, 2 to 5 mm, erosion localized in the subcardial region. The vascular nature of the lesion was confirmed by histologic study in all cases. Postoperative course was uneventful in all patients and no recurrences have been observed.

Acute Disease↗
PubMed1989

[Potential difference of the gastric mucosa in gastroduodenal disease. Relation with endoscopical and histologic findings].

Most studies of gastric transmucosal potential difference concern acute damage. We studied this phenomenon in 168 patients with different pathologic processes: erosive gastritis, duodenal and prepyloric ulcer, atrophic gastritis, gastric ulcer and normal controls. Ag-AgCl electrodes and Agar-KCl bridges were used to record potential differences. Biopsies were taken from gastric antrum and body and potential differences were related to endoscopic and histologic findings. Maximal values of -29.2 + 2 and -22.2 + 1.6 for body and antrum, respectively, were found in normals. Lowest values (-19.4 + 1.4 and -14.3 + 1.5, respectively) were found in gastric ulcer, with intermediate values for the other conditions. Normal histologic findings were associated to potentials of -31 + 2 and -20 + 3.1 whereas lower values were recorded in patients with moderate or severe atrophic changes. Our findings suggest a relation between mucosal atrophy and lower transmucosal potential differences.

Adolescent↗
PubMed1989

[Esophageal potential difference in patients with peptic ulcer and gastritis].

A potential difference is generated by the active transport of electrolytes through low permeability epithelium such as the gastric and esophageal mucosa. A decrease in this potential has been proposed as an indicator of mucosal damage. We measured potential difference in 151 patients undergoing endoscopy for duodenal ulcer, gastritis or as a control group. Mean for the whole group was -18 + 0.5 mV, range -4 to -37. No differences were found among groups. Due to the ample variation in potential difference both at the gastric and esophageal levels, its determination was of no use in localizing the boundary between gastric and esophageal mucosa.

Adolescent↗
PubMed1989

Histological analysis of liver parenchyma and choledochal wall, and external diameter and intraluminal pressure of the common bile duct in controls and patients with common bile duct stones with and without acute suppurative cholangitis.

The purpose of this prospective controlled study was to determine the changes in intraluminal pressure and diameter of the common bile duct in a total of 121 bile patients with choledocholithiasis, and the consequences of these alterations for choledochal mucosa and liver histology. In fact, the reflux of bacteria from the obstructed biliary tract into the bloodstream is responsible for producing the clinical syndrome of acute suppurative cholangitis. Group I (26 patients) served as controls, Group II (50) had choledocholithiasis with clear green bile, and Group III (45) were patients with acute suppurative cholangitis with pus in the biliary tract. Ultrasonography revealed gallstones in all the patients. The external diameter of the common bile duct in patients with choledocholithiasis and acute suppurative cholangitis was significantly greater than in those of the other groups. Patients with acute suppurative cholangitis also had a higher intraluminal pressure than those of Groups I or II.

Acute Disease↗
PubMed1987

Type IV gastric ulcer: a new hypothesis.

In 1965 Johnson proposed his classification for gastric ulcer, which was subsequently adopted by the majority of surgeons. However, for many years we have observed the high frequency of subcardial or juxtacardial ulcers near the esophagogastric junction, which has not been reported elsewhere. In this article we describe the characteristics of this type of gastric ulcer and propose to designate it as a type IV gastric ulcer. This nomenclature is based on its clinical and pathophysiologic features. The anatomically "high" gastric ulcer has an incidence of 27.4%; its main features include a frequent association with the type O blood group; a low basal and stimulated acid output, a high incidence of upper gastrointestinal bleeding, a slower emptying of fluids, and a high percentage of deep penetrating ulcer.

Blood Group Antigens↗