[The structure and function of gastric and duodenal mucosa].
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Biomedical subjects
Publications and source records attributed to J Aguirre García.
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We informed four cases of primary sclerosing cholangitis associated with chronic ulcerative colitis, diagnosed in the Gastroenterology Department, Hospital de Especialidades del CM Siglo XXI Mexico City, during 1987 to 1988. The mean age was 30.2 years and the evolution of colitis was 6.6 years. Two patients were females and two males, all presented active colitis and three presented hepatic symptoms. The laboratory abnormalities were hypertransaminasemia, increased alkaline phosphatase and hyperbilirubinemia. In three patients endoscopic retrograde cholangiopancreatography was done, in all cases diagnosis was established by histology. The frequency of primary sclerosing cholangitis associated with chronic ulcerative colitis was 13.3%.
We present five patients with AIDS and enteropathy in whom the chronic diarrheal syndrome disappeared with a gluten-free diet. We hypothesize on the interrelations between celiac disease and enteropathy in AIDS, and propose that in similar cases, it may be a useful therapeutic alternative.
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Cancer of the ampula of Vater occurs in 10% of cases of jaundice caused by malignant neoplasms. Endoscopy with biopsy and citological study helps to establish the diagnosis in most instances, utilizing a duodeno fibroscope JFB-2. Fourteen patients, ten men and four women, were studied in a five year period in the Service of Endoscopy in the General Hospital of National Medical Center of the Mexican Institute of Social Security. All the patients presented with obstructive jaundice and only in four was papilary carcinoma suspected from the clinical and radiological studies. Direct biopsy was performed in all patients and brush biopsy for citology in 9. In all 14 patients a malignant lesion was observed macroscopically in the ampula of Vater projecting in to the duodenum. In thirteen of fourteen the lesion was diagnosed microscopically as adenocarcinoma and in eight of nine citologically. The utilization of this methodology facilitates the early diagnosis of the lesion in this way improves considerably the prognosis.
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In 25 patients with acute leukemia that presented chantes in liver function tests, 29 liver biopsies were done by percutaneous needle or peritoneoscopy and directed needle, to determine the nature of the lesion. In one case leukemic infiltration was found; 16 patients showed nonspecific lesions, one, granulomatous hepatitis, one, viral hepatitis; one showed no changes in the biopsy. In these twenty cases the treatment was not modified, the survival time was from 15 to 57 months (median 25 months), and 14 an still in remission. Five patients (20%) showed drug-induced hepatitis; in these it was necessary to modify to chemotherapy, the survival time in four cases was 2 to 9.6 months (median 4.8 months) and one is still in remission after 36 months of treatment. It is concluded that hepatic biopsy may be very useful in evaluating the undesirable effects of treatment of acute leukemia and in making therapeutic decisions. The risks of this procedure and the contraindications are similar in patients with acute leukemia and those with other diseases.
Liver biopsy was taken from 20 patients with chronic and acute alcoholism. The patients had been hospitalized for diverse reasons, had no clinical manifestations of alcoholic hepatitis nor cirrhosis, but did have abnormal liver function tests. The most common abnormal test results were low serum albumin, polyclonal gamma-globulin elevation, and S G O T and Alk P rise. In all patients one or more types of hepatic lesiones were found: steatosis (15), polynuclear and mononuclear infiltrates (15), and portal (7), interstitial (13), or centriobular (8) fibrosis. Two patients had cirrhosis. None had hepatic cell necrosis. These findings justify a motivated search for liver damage in patients with alcoholism who have slight alterations in liver function tests, even in the absence of clinical manifestations of liver disease.
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A review of the discovery of the GB viruses (GB virus-A, GB virus-B and GB virus-C) is presented, and the relationship between the GB virus-C and the hepatitis G virus (HGV) is mentioned. The GB virus-A and GB virus-B apparently do not cause liver disease in human. The GB virus C, HGV or GBV-C/HGV is transmitted parenterally, usually through blood transfusions or contaminated needles causing chronical infection. The prevalence of GBV-C/HGV infection among volunteer blood donors is less than 1%, and in patients with C or B hepatitis is more than 10%; the pathogenicity of this agent is not well defined.