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Biomedical subjects

I Katzka

Publications and source records attributed to I Katzka.

At least 19 recordsLinked to original sources
PubMed1989

Is operation always necessary for enterovesical fistulas in Crohn's disease?

We have followed 11 patients with Crohn's disease and enterovesical fistulas prospectively for up to 21 years. Seven patients underwent resection for complications other than the fistula; the fistula had been present up to 5 years in this group. Four patients have being followed medically for 1-21 years since a fistula was recognized. In no patient of either group has renal impairment developed. We suggest that enterovesical fistula by itself is not an indication for surgical intervention.

Adult↗
PubMed1983

Proliferative defects in ulcerative colitis patients.

The proliferative characteristics of epithelial cells in rectal biopsies from a group of 18 patients (ages 18-72) with ulcerative colitis spanning several months to over 20 years duration were examined, using an in vitro 3HTdR labeling technique. Although the labeling indices for patients with inflammatory bowel disease did not differ significantly from that of control (8.9 +/- 3.6 vs 7.7 +/- 3.9), the number of labeled cells/individual crypt column was higher among some crypts in ulcerative colitis patients. A normal proliferative pattern was demonstrated in crypts of 5/18 patients (27.8%) with DNA synthesis confined to the lower two-thirds of the crypt and the lower third the major zone of proliferation. Thirteen patients (72.2%) showed extension of the proliferative compartment to the surface of the glands, while retaining the lower third of the gland as the predominant proliferative zone (Stage I abnormality). Of these 13, seven had an additional abnormality, namely, a shift of the major zone of proliferation to the middle third of the crypt (Stage II abnormality), a pattern first reported in the colorectal mucosa of patients with a history of colon cancer. Precancerous lesions, including incompletely differentiated epithelium and lateral crypt budding, were recognized in all of these cases, suggesting that the Stage II abnormality is a proliferative parameter forecasting neoplastic transformation.

Adolescent↗
PubMed1983

Macroamylase in the pleural fluid of a patient with lymphoma.

A patient with a macroamylase in pleural fluid is described. A diagnosis of recurrent pleural effusion due to chronic relapsing pancreatitis had been made on the basis of hyperamylasemia, high pleural fluid amylase, and abdominal pain. The amylase in the pleural fluid as well as the serum was ultimately characterized as a macroamylase on electrophoresis and chromatography. A diagnosis of lymphoma subsequently became obvious. The pathogenesis of the macroamylase in the pleural effusion and the association of macroamylasemia with malignant disease is discussed.

Amylases↗
PubMed1983

Assessment of colorectal cancer risk in patients with ulcerative colitis: experience from a private practice.

The cumulative risk of developing colon cancer in patients with ulcerative colitis has been stated to increase 10%-20% for every decade of duration of disease after 10 yr. We reviewed the clinical course of 673 patients with inflammatory bowel disease restricted to the colon who were seen by the authors since 1955. A subset of 258 patients with a diagnosis of ulcerative colitis established before 1970 and followed by the authors was studied by both the classical life table and a generalized approach to estimate the risk of colorectal carcinoma. Only nine instances of colorectal carcinoma occurred. Using the former method and eliminating 3 patients referred with known colorectal carcinoma, the actuarial risk for developing this complication for all patients, regardless of extent of disease, was computed to be only 6.6% at 26 yr and 11.4% at 32 yr following the onset of ulcerative colitis. The cumulative probability of colorectal carcinoma among patients with universal colitis at 26 yr was 19.7% by the generalized method and 11.6% using the standard life table. The generalized approach consistently gave higher risk estimates due to a smaller number of patients in the denominator of the risk calculation. Using an alternative method, we calculated cancer risk from the date first seen for patients with universal extent and a history of greater than or equal to 10 yr of disease (means = 17.4 yr). The magnitude of the resulting colorectal carcinoma risk was even less than previously reported in hospitalized patients. This method is more suited for colorectal carcinoma risk assessment of a large series of ulcerative colitis patients seen in private practice and the results should modify the fear of cancer development in these patients.

Actuarial Analysis↗
PubMed1981

Splenic pseudocyst associated with hypersplenism.

A patient with hypersplenism, who was found to have a splenic pseudocyst containing an organized hematoma, is described. There are only two patients with splenic pseudocyst and hypersplenism and an additional two patients with splenic cysts and hypersplenism reported in the world literature. The hypersplenism associated with splenic cysts and pseudocysts is explained on the basis of an expansion of the plasma volume and the total blood volume, an increased destruction of red blood cells and a pooling of blood in the enlarged spleen. The combined use of ultrasonography and computerized tomography has increased the accuracy of noninvasive diagnosis and made more invasive examinations unnecessary. When the ultrasound is technically unsuccessful or when it shows a mixed echo pattern, one should resort to computerized tomography with which it is possible, almost invariably, to differentiate between cysts and neoplasms.

Adult↗
PubMed1981

Giant pseudopolyps in Crohn's colitis. A nonoperative approach.

Six patients with Crohn's disease had colonic intraluminal multilobulated masses detected on barium enema. Four had Crohn's colitis and two ileocolitis. The mean duration of disease was four and eight tenths years. Three patients underwent surgery and three had colonoscopy with multiple biopsies and cytology. Pseudopolypoid inflammatory tissue was found in each case. One patient died after a prolonged postoperative course due to sepsis and abscess formation. No surgery was performed in three patients and follow-up colonoscopic examinations at four and a half years revealed no change in these findings. The presence of an intraluminal colonic mass in Crohn's colitis may mimic a neoplasm. If surveillance with x-ray, endoscopic biopsies and cytology reveals pseudopolypoid inflammatory tissue then surgery is not mandatory. Pseudopolypoid inflammatory tissue has never been associated with carcinoma.

Adult↗
PubMed1979

Management of toxic megacolon: the significance of early recognition in medical management.

Twenty-seven patients with acute toxic dilatation of the colon (TM) as a complication of inflammatory disease of the colon are reported. To emphasize the importance of early recognition and therapy, we separated the patients into two groups: 19 were receiving care by the authors (series A) before the development of TM, and eight were seen in consultation after its onset (series B), TM subsided with medical therapy in 13 episodes among 19 patients in series A and two of eight B. The others underwent surgical therapy. There were no deaths in either group. The differences in management and mortality from other reports suggest a program of surveillance and therapy for this life-threatening situation.

Adolescent↗
PubMed1979

Meat bolus impaction of the lower esophagus associated with a paraesophageal hernia. Successful noninvasive treatment with intravenous glucagon.

Ferrucci and Long recently reported the relief of esophageal food impaction with the use of intravenous glucagon in three patients. Our first experience in using this new procedure was very successful and gratifying. The essence and purpose of this brief communication is to record and further substantiate the efficacy of a new treatment modality.

Esophagogastric Junction↗
PubMed1977

Cancer in chronic ulcerative colitis. Diagnostic role of segmental colonic lavage.

Saline colonic lavage in 74 patients with chronic ulcerative colitis was performed utilizing a commercially available dental irrigating unit through a polyethylene catheter in the biopsy channel of a colonoscope or through a sigmoidoscope via a lavage-aspirating double-lumen probe. Six patients were found with colonic carcinoma. Two diagnoses of malignancy were established by cytologic smears and cell block alone. Two patients had positive mucosal biopsies and cell block. One patient with a hepatic flexure carcinoma and a second patient with a malignancy proximal to the left colon stricture were missed by these techniques. Considering the established proclivity for carcinoma in these patients, it is felt that segmental lavage in areas of stricutre, grossly dostorted mucosa, or endoscopically inaccessible areas represents a valuable adjunct in the diagnosis of carcinoma in chronic ulcerative colitis.

Adenocarcinoma↗
PubMed1975

The response of the local immunoglobulin system to malignant lesions of the stomach. A new diagnostic test.

The response of the local secretory immunoglobulin system to tumor antigens was studied in 71 patients suspected of harboring a gastric malignancy. Gastric aspirates were obtained by fiberoptic endoscopy and measured on single radial immunodiffusion plates (Behring Diagnostics). Patients with malignant neoplasms of the stomach were divided into Type I and Type II lesions, based on the extent and stage of the disease. Secretory IgA titers were elevated in all patients with a Type I malignant tumor confirmed by histologic examination; mean 6.1 mg/100 (SD +/- 3.7 mg/100). This leads us to believe that the host's response to malignant cells of the gastrointestinal system is an altered and elevated secretion of IgA. Evaluation of local immunoglobulin titers may be of value when used in conjunction with other diagnostic modalities in determining the nature of gastrointestinal lesions, particularly when the lesion is not metastatic or massively involving the gastric wall.

Adult↗