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Biomedical subjects

J C Mangla

Publications and source records attributed to J C Mangla.

At least 19 recordsLinked to original sources
PubMed1979

Ileovesical fistula. Failure of T.P.N. role of oral 14C PEG (polyethylene glycol) and charcoal in diagnosis.

A patient with regional enteritis presenting with symptoms of fecaluria and pneumaturia is presented. Most of the established technics such as upper gastrointestinal series, cystography, cystoscopy and colonoscopy failed to demonstrate the fistula in this patient. 14C PEG as a nonabsorbable marker was given by mouth and a seven-fold increase in the counts at the fourth hour of urine collection confirmed the presence of an ileovesical fistula. This increase in counts was not seen when 14C PEG test was repeated after closure of this fistula surgically and was also not seen in a similar disease control patient and a healthy normal volunteer. Total parenteral nutrition with intralipids, Freamine II and glucose given in a peripheral vein for 45 days failed to close this fistula.

Administration, Oral↗
PubMed1979

Pancreatic pseudocyst involving the spleen.

A case of pseudocyst of the tail of the pancreas involving the spleen is presented. Diagnosis of splenic involvement by pseudocyst was made by angiography followed by immediate (elective) surgical intervention with distal pancreatectomy and splenectomy without pre- or postoperative complications.

Adult↗
PubMed1978

Crohn's disease in Barrett's esophagus.

A patient with regional ileitis (Crohn's disease) developed a benign esophageal stricture. He had no history of heartburn or other symptoms of reflux esophagitis. The diagnosis of Crohn's disease was suspected but could not be proved preoperatively. The surgically resected esophagus showed the gross and microscopic features of Crohn's disease. Barrett's esophageal mucosa was also found in the resected esophagus. Postoperatively, the patient developed a fistula at the esophagogastrostomy site. Crohn's esophagitis has been reported in 15 patients but none had Barrett's esophagus. We believe our patient reported here is the first case with Crohn's disease and Barrett's esophagus.

Crohn Disease↗
PubMed1978

Superior mesenteric artery compression syndrome.

An attempt was made to search the medical records of the University Hospital and five affiliated hospitals at Rochester, NY for the last 10 years. Seventeen patients with superior mesenteric artery compression syndrome were found. The prevalence of this disease in a chronic-care hospital (0.965/1,000 admisssions) is significantly higher than that in acute general hospitals (0.0108-0.0520/1,000 admissions) by Chi square statistic (P less than 0.001). This syndrome should be suspected in patients with chronic wasting diseases who are bedridden and have lost weight after which they develop frequent vomiting or aspirations. On reviewing 146 cases from the literature after 1963, duodenojejunostomy was considered to be the best procedure for severe cases. The same good results were not achieved after gastrojejunostomy and lysis of the ligament of Treitz. Gastrojejunostomy provided adequate decompression of the stomach but was inadequate for releasing duodenal obstruction. Some patients after division of the ligament of Treitz had difficulty in downward displacement of the duodenum and the symptoms of obstruction persisted necessitating duodenojejunostomy. This paper demonstrates that in two patients gastrojejunostomy failed to relieve the obstruction. One of them had to be reoperated on and a duodenojejunostomy was performed with relief of obstructive symptoms.

Adolescent↗
PubMed1977

Endoscopic diagnosis of Barrett's esophagus.

Four cases of Barrett's esophagus are presented. Diagnosis was confirmed by multiple serial biopsies of the esophagus. There are many features on endoscopic examination which suggest the diagnosis of this anomaly. These features are described in detail along with endoscopic pictures.

Aged↗
PubMed1977

Hepatoma presenting as lower gastrointestinal bleeding.

A 61-year old white male, known to have alcoholic cirrhosis, presented with massive fresh bleeding per rectum. Various investigations failed to ascertain the cause of bleeding. Hepatoma of the liver was revealed by selective hepatic and superior mesenteric angiography. Massive lower gastrointestinal bleeding occurred again one month later and was rapidly followed by death from hepatic coma. An extensive hepatoma infiltrating the adjacent hepatic flexure of the colon was found at autopsy, the colonic infiltration explaining the lower gastrointestinal hemorrhage.

Carcinoma, Hepatocellular↗
PubMed1976

Diagnosis of Barrett's esophagus by pertechnetate radionuclide.

In Barrett's esophagus the normal stratified squamous epithelium of esophagus is replaced by columnar epithelium and other charcteristics of gastric mucosa. Barrett's esophagus has an increased tendency to bleed and is more prone to undergo malignant change. There are many procedures used to diagnose this entity, but only by serial and multiple esophageal mucosal biopsies can the diagnosis be confirmed. Harper et al (2) demonstrated an early and intense uptake of 99m Tc pertechnetate by the stomach in animals. Since the Barrett's esophagus is lined by gastric mucosa, pertechnetate scintigraphy was used as a screening procedure. The criteria for a postive scan was an area of increased uptake of technetium extending above the normal dense uptake of stomach configuration. Pertechnetate scintigraphy was performed in 4 patients with Barrett's esophagus and 6 controls with only one false negative result. Thus pertechnetate scintigraphy is a rapid, safe, and atraumatic screening procedure.

Betazole↗
PubMed1976

Benign hepatic tumors and oral contraceptive pills.

In order to consider possible environmental factors related to the development of benign hepatic tumors, all reports of this disorder in the case records of five different hospitals in Rochester, New York, during the past 10 years were reviewed. Seven patients with benign hepatic tumors of the liver and two with peliosis hepatis were identified. Among the seven with a benign hepatic tumor, four were women currently receiving oral contraceptives; one had been receiving this medication in the past, and two had no history of exposure to any steroid whatsoever. The two patients with peliosis hepatis were receiving long-term androgenic anabolic steroids. Dilated, thin-walled vessels and vascular spaces were a more prominent feature of the tumor seen in four patients receiving oral contraceptive pills. It is emphasized in this report that benign hepatic tumors do occur in men and in patients with cirrhotic liver without the use of any kind of steroids.

Adult↗
PubMed1976

An evaluation of the Nissen fundoplication.

The characteristic radiological findings which follow a Nissen fundoplication are reviewed. The esophagus may be narrowed but is intrinsically normal. A pseudotumor at the medial aspect of the fundus is generally present. The history and radiographic findings can normally differentiate this defect from neoplasm or a nonoperated hiatal hernia. Postoperative clinical evaluation has shown this procedure to be very valuable in the amelioration of symptoms.

Esophageal Diseases↗
PubMed1976

Liver tests, HB-Ag and HB-Ab in asymptomatic drug addicts.

One hundred eighty-eight asymptomatic addicts were studied to determine the frequency of a history of hepatitis (previous episodes of jaundice), abnormalities of liver tests (serum bilirubin, alkaline phosphatase, serum albumin, serum glutamic oxalacetic transaminase) and incidence of HB-Ag and HB-Ab. Seventy-four were white and 114 were nonwhite. A history of hepatitis was obtained in only 38%. One hundred and fifty-two of the 188 addicts (81%) had one or more abnormal liver tests. The bilirubin was abnormal in 5%, akkaline phosphatase in 28% and serum glutamic oxalacetic transaminase in 55%. HB-Ag was positive in 2.6% using radioimmunoassay and HB-Ab was found in 66%. There was a higher incidence of elevated serum glutamic oxalacetic transaminase, HB-Ab and history of hepatitis among white, compared to nonwhite addicts.

Adolescent↗
PubMed1976

Pepsin secretion, pepsinogen, and gastrin in "Barrett's esophagus." Clinical and morphological characteristics.

Four cases of Barrett's esophagus are presented. Three cases presented with significant esophageal bleeding and one case presented with high esophageal stricture. Gastrointestinal panendoscopy was done in each case and multiple biopsies were taken. The biopsies were utilized for histomorphology, pepsinogen agar gel electrophoresis, and tissue gastrin assays. Tissue gastrin levels in esophageal mucosa were elevated in 2 cases when compared to controls with and without hiatus hernia. Pepsin and acid secretory studies were done by isolating the esophagus. Barrett's esophagus was shown to produce pepsin by both chemical studies (2 cases) and agar gel electrophoresis at pH 5.7 (3 cases), and was also shown to produce acid. The mucosa contained either cathepsin or cathepsin and pepsinogens in all cases. Nissen's fundoplication was performed in all of the patients. Of 3 patients who were bleeding, 2 who consented for this operation stopped bleeding after the operation. It is to be noted that the usual clinical treatment of antacids, bedrest, and raising the head end of the bed failed in all of the patients. The follow-up of 9 months to 3 years postoperatively has shown persistence of Barrett's mucosa with no evidence for any reversion to normal esophageal type.

Electrophoresis, Agar Gel↗
PubMed1975

A new technique of endoscopic esophageal biopsy using multipurpose biopsy tube in the diagnosis of reflux esophagitis.

A very easily performed new technique of simultaneous introduction of Rubin's multipurpose biopsy tube and gastrofiberscope in the diagnosis of reflux esophagitis is described. This technique will obviate the need of taking multiple biopsies and adds the advantage of direct observation of abnormal mucosa. As the biopsy is obtained under direct vision, there is no need of x-ray or manometric localization and one can avoid inadvertently biopsying a varix or a friable ulcer.

Biopsy↗