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M J Varas Lorenzo

Publications and source records attributed to M J Varas Lorenzo.

15 recordsLinked to original sources

[Zollinger-Ellison syndrome: comparative and critical review of international and national bibliography (author's transl)].

Since Zollinger and Ellison described two cases of this disease in 1955 which would later recieve their names (ZED), more than 1,000 cases have been published in the world literature up to date. In our area around 28 cases have been reported in a period of 14 years (1964--1976). The author reviews this disease, evaluating and comparing results obtained in this small series, with regard to prevalence, clinical manifestations and histopathologic lesions, against those obtained in series of large scope. Mean age was 46 years, ranging from 18 to 63 years, and the male-female ratio was 7:5. Ulcers and diarrhea were present in 100 percent and in 35 percent of the cases, respectively. The incidence of AEM-1 was 25 percent. In 85 percent of the cases the existence of a gastrinoma was demostrated, being pancreatic in 78 percent and extrapancreatic in 7 percent. In 10 percent of the cases there was a diffuse hyperplasia of the islet cells, and in one case, there was hyperplasia of the G-cells of the antrum. These results are very similar to those obtained by different authors.

Adult

[Zollinger-Ellison syndrome type II due to diffuse hyperplasia of the pancreatic islet cells (author's transl)].

A 58-year-old patient with hypergastrinemia (basal and after stimulation by means of protein food, calcium, glucagon, and secretin), acid hypersecretion, recurrent anastomotic ulcer, gastrocolonic fistula, steatorrhea, and malabsortion (hypocalcemia, hypocholesterolemia and a rather elevated 5-HIAA) is reported. The definite preoperative diagnosis of Zollinger-Ellison syndrome was established after the intravenous secretin test (75 U) which produced a significant stimulation peak 5 minutes after being injected. The possible existence of a multiple endocrine adenomatosis syndrome type I was discarded. During the operation no pancreatic or extrapancreatic macroscopic tumor was found. A total gastrectomy, transverse colectomy, splenectomy, and subtotal pancreatic resection were performed; Rosanow's techniques was used to re-established the gastrointestinal continuity. The morphological study of the excised pancreatic tissue showed a diffuse hyperplasia of the Langerhans islet cells; indirect immunofluorescence in the presence of antigastrin antibodies was faintly positive and difficult to evaluate. However, gastrin levels clearly decrease after the operation may be because the inhibitory effect of total gastrectomy or because of the partial pancreatectomy. Furthermore, the inhibitory effect of tyrocalcitonine onthe pre- and postoperative gastrin levels measured by radioimmunoassay could be verified. For the moment the importance of this test in the diagnosis of Zollinger-Ellison syndrome, and especially in the diagnosis of ZES-type II, is not known.

Calcium

[Apudomas I].

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APUD Cells

[Apudomas. II].

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Apudoma