Endoscopy and gastroenterology.
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Biomedical subjects
Publications and source records attributed to H H Rubio.
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Chronic nonspecific bulbitis (CNB), the number of G-cells in the antrum and the level of serum gastrin were unrelated in a group of 24 patients. Gastrin may be produced by cells outside the antrum or by a few but hyperactive antral G-cells.
Approximately 90% of correctly indicated endoscopic polypectomies for early colorectal cancer, whether invasive or not, are curative, provided strict criteria are adopted in the pathological evaluation of the resected specimen. Unrestricted time surveillance is mandatory since benign (more frequent) or malignant relapses appear in 30-40% of the patients.
We presented and studied the endoscopic diagnosis of the duodenal ulcer, duodenal tumors and duodenal bleeding. Duodenal Ulcer is classified according as location, form and evolutive stage. Duodenal tumors are divided in polyps, primitive tumors, pancreas anomaly and lymphoma. Duodenal bleeding can be diagnosed according its cause (inflammatory, tumors vascular and traumatic). It is emphasized the importance of the indications and methods of the enteroscopy. We show our experience in 313 duodenal ulcers cases and 98 enteroscopic diagnosis.
Two epidermoid, identical but independent tumors of the middle esophagus, arising in columnar lined esophagus (Barrett's esophagus or endobrachyesophagus) are reported. Both were diagnosed endoscopically and resected. The upper tumor involved only the mucosa, the aboral one the mucosa and submucosa.
The result of 25 transjugular liver biopsies are described. The indications of this technique were: Abnormal blood clotting 65%. Failure of previous percutaneous biopsy 15%. Requirements of suprahepatic venography and or manometry. Perforation of the hepatic capsule was evident in three patients when contrast medium injected after the biopsy escaped under the capsule but without evidence of bleeding. The transjugular liver biopsy is not easy but safe and preferable technique in the management of selected patients.
The prospective investigation here presented tries to show the histologic changes produced in the endoscopic mucosal erythema zone of the gastric stump, which is the largest exposition and reactivity site to which the duodenal-biliary reflux damages. 56 clinically asynthomatic patients have been studied through directed biopsy. The observed results are: great prevailing of chronic gastritis and a high percentage of intestinal metaplasia which, in both cases are in close correlation with the age of the patient and not with his surgical age. There is not any relation either with age or intensity in the different degrees of dysplasia. We came to the conclusion that the erythema does not constitute by it self a histologic perfile different from the rest of the remaining gastric stump.
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Gastric Cancer comprises two basic types: Advanced Gastric Cancer (A.G.C.) and Early Gastric Cancer (E.G.C.). A.G.C. extends beyond the proper muscle layer with a 5 to 17%, five years survival rate after surgery. E.G.C. does not extend beyond the submucosa (with or without metastasis to regional lymph nodes) and has a 80 - 95% five years survival rate. Intermediate Gastric Cancer, PM G.C. (Gastric cancer of the proper muscle layer) does not surpass the proper muscle layer and offers a five years life expectance of near 60% after adequate surgical treatment, with peculiar features in radiology, endoscopy and evolutivity. We report a case of PM G.C., "depressed" and "protruded". The proper muscle layer was invaded by the depressed lesion". Both lesions were continguous.
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The diagnosis of CND cannot be improved by electron microscopy. The normal duodenal cap and CND have similar ultrastructural appearances on guided endoscopic biopsy.
A case of primary gastric plasmacytome is presented. The difficulties of the endoscopic diagnosis, including the citology and the biopsy, are emphasised.
"Bulbitis" was classified by fiberoptic endoscopy in: superficial, erosive and pseudopolypoid. Endoscopic diagnosis of "bulbitis" is reliable, as good agreement was obtained in 100 cases tabulated according to histological grading. Erosive "bulbitis" implies a severe histopathological compromise.
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