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Biomedical subjects

N Kohrogi

Publications and source records attributed to N Kohrogi.

At least 19 recordsLinked to original sources
PubMed1995

Villous adenoma of the duodenum in a patient with familial adenomatosis coli.

A case of familial adenomatosis coli with villous adenoma of the third portion of the duodenum, which falls in the category of a Gardner's syndrome, is described. The patient, who had complained of an abdominal mass which had been diagnosed as a desmoid tumor after surgical resection, had numerous adenomatous polyps throughout the colon confirmed by colonoscopy with biopsy. Endoscopic examination of the upper gastrointestinal tract revealed fundic gland polyposis in the stomach and numerous small adenomas in the duodenum. In addition, there was a pedunculated polyp in the third portion of his duodenum, measuring 30 mm in diameter, the surface of which had a cauliflowerlike appearance. The polyp was removed with the electrocautery snare and was histologically diagnosed as villous adenoma. Our case report supports the concept that villous adenoma, which possesses a high malignant potential, may occur in the upper gastrointestinal tract in patients with familial adenomatosis coli, and careful examination of the upper gastrointestinal tract including the distal duodenum seems to be necessary in the follow-up patients with this disease.

Adenoma, Villous↗
PubMed1994

Gastrointestinal manifestations of Cowden's disease. Report of four cases.

Four patients with an established diagnosis of Cowden's disease underwent barium meal study, upper gastrointestinal endoscopy, barium enema examination, and colonoscopy. In three, the esophagus was affected by small protrusions, which were diagnosed as glycogenic acanthosis. Numerous hyperplastic polyps were found in the stomach in three patients, and in one an inflammatory fibroid polyp was also detected. Either lymphangiectasia or lymphoid polyps were found in the duodenum in two patients. In all patients, the colon showed polyps that varied in histology and included adenoma, hamartomatous polyp, and ganglioneurofibroma. In addition, jejunal lymphangiomas were found in one of the three patients in whom the small intestine could be precisely evaluated. These findings suggest that the gastrointestinal involvement in Cowden's disease is characterized by various benign lesions, especially esophageal glycogenic acanthosis, numerous gastric hyperplastic polyps, and multiple hamartomatous polyps in the rectosigmoid colon. Detection of these gastrointestinal manifestations may lead to early diagnosis of this potentially malignant disease.

Adult↗
PubMed1994

Crohn disease: early recognition and progress of aphthous lesions.

PURPOSE: To clarify the radiographic appearance of the initial change an dprogression in Crohn disease. MATERIALS AND METHODS: Between 1984 and 1992, nine patients (seven men and two women, aged 16-34 years; mean, 20 years) with Crohn disease, who had evidence of only aphthous erosions or ulcers at the initial examination, underwent repeated radiography for up to 7 years 11 months (median, 4 years). RESULTS: In all patients, the stomach, duodenum, small intestine, and colorectum were involved, and the esophagus was affected in three patients. Subsequently, four of the nine patients had lesions that progressed from aphthous lesions to overt Crohn disease, including ileitis in two patients, colitis in one, and ileocolitis in one. Time intervals between the first visit and the progression varied from 9 months to 3 years 6 months. In all eight patients who underwent nutritional treatment, regression of the lesions was recognized, but three of the lesions progressed during interruption of the nutritional diet. CONCLUSION: Crohn disease may initially appear as diffuse aphthous lesions in the gastrointestinal mucosa.

Adolescent↗
PubMed1993

Cancer in Peutz-Jeghers syndrome.

BACKGROUND: Peutz-Jeghers (P-J) syndrome has been found to be associated with an increased risk of malignant neoplasia. METHODS: The authors reviewed the clinical courses of eight patients with P-J syndrome (four male and four female patients, ranging in age from 8 to 55 years), who had been followed up for as long as 12 years. The diagnosis of this syndrome was based on the evidence of characteristic mucocutaneous pigmentations and gastrointestinal hamartomatous polyposis. RESULTS: Four cases of malignant neoplasm among the eight patients were found. In a 25-year-old woman, an extremely well-differentiated adenocarcinoma of the uterus cervix was found at the initial examination. A gastric cancer in a 32-year-old woman, duodenal cancers in a 43-year-old man, and a pancreatic cancer in a 60-year-old man also were identified 12, 10, and 5 years after the time of initial examinations, respectively. Two of these patients died of the effects of the tumor soon after. CONCLUSION: The authors' experience confirms a veritable malignant potency in P-J syndrome and suggests that an intensive follow-up of gastrointestinal and extra-gastrointestinal sites is needed in patients with this syndrome.

Adolescent↗
PubMed1993

Diagnosis of primary early gastric lymphoma. Usefulness of endoscopic mucosal resection for histologic evaluation.

BACKGROUND AND METHODS: Eight patients thought to have primary early gastric lymphoma were studied to evaluate the usefulness of endoscopic mucosal resection for the diagnosis of reactive lymphoid hyperplasia (RLH) or malignant lymphoma. RESULTS: In these patients, conventional endoscopic forceps biopsy did not provide a definite histologic diagnosis. Endoscopic ultrasonography (EUS) demonstrated that the disease was limited to the mucosa and the submucosa in all patients, without any paragastric lymph node involvement, so endoscopic mucosal resection was performed to obtain specimens large enough to include the submucosa. As a result, primary early gastric lymphoma was diagnosed in five patients, for whom subsequent gastrectomy confirmed the diagnosis. CONCLUSIONS: The authors recommend that endoscopic mucosal resection be performed in patients thought to have primary early gastric lymphoma and for whom a definite diagnosis can not be made by conventional endoscopic forceps biopsy.

Adult↗
PubMed1993

Neoplastic transformation arising in Peutz-Jeghers polyposis.

PURPOSE AND METHODS: To clarify the potential for malignancy of Peutz-Jeghers polyposis, we investigated 75 gastrointestinal polyps resected surgically or endoscopically from seven patients with this syndrome. RESULTS: There were 19 polyps in the stomach, 18 in the duodenum, 22 in the small intestine, and 16 in the large intestine, and these were histologically composed of 1 pyogenic granuloma, 1 cancer in adenoma, 2 adenomas, and 71 Peutz-Jeghers polyps. Nine of these Peutz-Jeghers polyps were accompanied by an adenomatous component, and, in addition, two of these showed a cancerous transformation with stalk invasion. A total of 12 neoplastic polyps (16 percent) were found in three relatively young patients (aged 20, 25, and 43 years), all of which were pedunculated and located either in the duodenum or in the jejunum. There was no statistical significance in size between the neoplastic polyps (mean +/- SD, 20.1 +/- 10.8 mm) and the completely hamartomatous polyps (mean +/- SD, 15.8 +/- 9.0 mm). Moreover, the configuration of these types of polyps seemed similar. CONCLUSION: Neoplastic transformation is not a rare event, and our results may indicate evidence of a hamartoma-adenoma-carcinoma sequence in Peutz-Jeghers polyposis.

Adolescent↗
PubMed1993

Minute nonpolypoid adenomas of the colon depicted with barium enema examination.

To evaluate the usefulness of barium enema examination for detection of small nonpolypoid adenomas, the barium enema study findings were reviewed in patients with flat or depressed adenomas of the colon 3-5 mm in diameter that had been initially found during colonoscopy and that had been diagnosed as adenomas at histologic analysis. Eleven of the 21 nonpolypoid adenomas were depicted on radiographs; they tended to be located on the left side of the colon. The 10 other lesions were not detected retrospectively on barium enema radiographs. The radiographic findings in the depicted lesions included smooth, round, radiolucent areas; in seven of these lesions, round or irregular barium flecks were also seen. The radiolucent areas were attributed either to slightly elevated growth of adenomas or to surrounding hyperplasia of nonneoplastic glands; the central barium fleck seemed to conform to depressed areas within adenomas. Barium enema examination can demonstrate nonpolypoid adenomas of the colon, even though colonoscopy seems superior to barium enema examination for detection of these lesions.

Adenoma↗
PubMed1993

Large intra-abdominal desmoid tumors in a patient with familial adenomatosis coli: their rapid growth detected by computerized tomography.

A case of familial adenomatosis coli with large intra-abdominal desmoid tumors is described. The patient initially complained of an abdominal mass, which was diagnosed as a desmoid tumor after surgical resection. Further examinations revealed numerous polyps of the colon which were histologically diagnosed as adenomas. Despite intensive medical therapy, the desmoid tumors rapidly increased in size and number, and resulted in abscess and cavity formation that involved the ileum. Although desmoid tumors are classically benign in nature, we consider these tumors to be a therapeutic problem in patients with familial adenomatosis coli.

Abdominal Neoplasms↗
PubMed1992

Esophageal ulcer complicated by Reiter's syndrome. A case report.

A 40-year-old woman with Reiter's syndrome had low-grade fever, a psoriasislike eruption on feet and hands, and multiple esophageal ulcers. She had keratoderma blennorrhagica, aseptic vaginitis, and ileosacral arthritis, but no ocular lesions. The patient was HLA-B27 negative. Radiographic and endoscopic examinations of the upper gastrointestinal (GI) tract showed multiple round or irregularly shaped small ulcers in the middle and distal portion of the esophagus. One month later, all esophageal ulcers disappeared spontaneously. A case like this of Reiter's syndrome with esophageal involvement has not been reported before.

Adult↗
PubMed1990

Use of tumor diameter to estimate the growth kinetics of cancer and sensitivity of screening tests.

A statistical method has been developed that is useful for studying the relationship between the growth kinetics of malignant tumors and the detection probability either through symptoms or by screening. Mathematical models that describe the distribution of pathological variables in malignant tumors, detected after various histories of screening, are derived and parameters for detection probabilities and the growth kinetics are then estimated by the maximum likelihood procedure. By this method the probabilities of detection through symptoms as well as by screening can be estimated as functions of pathological variable(s) such as tumor size. The growth rate of tumor can also be estimated from the distribution of pathological variables. The present method was applied to gastric cancer in Japan, where an annual screening program for the disease exists. The detection probability for the indirect X-ray used as the screening test was estimated to be 0.323 x (diameter)2/[1 + 0.323 x (diameter)2]. The doubling time of gastric cancer was estimated to be 2.90 months.

Cell Cycle↗
PubMed1989

Red cell folate concentrations in patients with Crohn's disease on parenteral nutrition.

To examine changes in the folate concentrations in red cell during relatively long-term total parenteral nutrition (TPN), 10 Japanese patients with Crohn's disease (7 males), the mean Crohn's disease activity index on admission being 211, were given folic acid in a dose of 400 micrograms/day (AMA-FDA formulation) or 800 micrograms/day for 6-16 weeks (mean 10.5). The red cell folate concentrations were determined before TPN and once every week or 2-4 weeks thereafter. The folate concentrations were very low even after TPN with folic acid of 400 micrograms/day. In those given 800 micrograms of daily folic acid, the folate levels tended to increase, but did not reach the normal range. We propose that folic acid over 800 micrograms/day or a double dose of AMA-FDA formulation should be prescribed for Crohn's disease treated with long-term TPN.

Adolescent↗
PubMed1988

Endoscopic diagnosis of lymphangioma of the small intestine.

In three patients with lymphangioma of the small intestine, the preoperative diagnosis of lymphangioma was made by endoscopy with biopsy and radiology. A typical endoscopic finding was an elevated polypoid tumor, yellowish-white to tan. The surface was smooth, often with white specks, and could be impressed by touching lightly with biopsy forceps. Endoscopic examination revealed satellite lesions not detected radiologically. Lymphangioma has heretofore been successfully diagnosed preoperatively by endoscopy in the duodenum. This report of accurate preoperative diagnoses of lymphangioma in the small intestine, other than the duodenum, using endoscopy, may be the first to be documented.

Aged↗
PubMed1988

Hydrogen breath test assessment of orocecal transit time: comparison with barium meal study.

Orocecal transit time was measured simultaneously by the hydrogen breath test and a barium meal study in 12 hospitalized patients, the objective being to determine whether the former test accurately represents the orocecal transit time, and to establish an adequate criterion for the transit time, based on the former test. Two definitions of orocecal transit time by the hydrogen breath test were evaluated: the time from lactulose ingestion to a sustained increase of over 5 ppm above fasting levels in the end-expiratory hydrogen concentration (definition A) and the interval to that of over 10 ppm (definition B). The orocecal transit time measured by the radiologic method was 63 +/- 9 min (mean +/- SEM), whereas that using definition A of the hydrogen breath test was 74 +/- 9 min, and that using definition B was 87 +/- 10 min. Transit times determined by both definitions closely correlated with that obtained by the radiologic method (A, r = 0.86, p less than 0.01; B, r = 0.81, p less than 0.01). Therefore, elevation of end-expiratory hydrogen concentrations seemed to coincide with cecal appearance of the head of the lactulose load. When the mean transit times were compared with findings in case of the radiologic method, definition A rather than B appeared to be more appropriate to determine orocecal transit time.

Adult↗
PubMed1985

Natural history of fundic gland polyposis in patients with familial adenomatosis coli/Gardner's syndrome.

In order to study the natural history of fundic gland polyposis, 23 patients with familial adenomatosis coli/Gardner's syndrome were examined over a follow-up period ranging from 17 mo to 13 yr (average 6 yr). Examinations included gastric radiography and endoscopy with biopsy. Fundic gland polyps were found in 10 individuals. The size and number of polyps varied considerably. During the follow-up period, there was an increase in number or size of polyps, or both, in 5 patients (aged 8-27 yr), a decrease or disappearance in 2 patients (aged 36 and 41 yr), an initial decrease or disappearance followed by a late-occurring increase in 2 patients (aged 28 and 35 yr), In addition, malignant or adenomatous changes of fundic gland polyps were not observed in any patient. Therefore, fundic gland polyposis in patients with familial adenomatosis coli/Gardner's syndrome may appear as early as 8 yr of age. In some patients there is a gradual increase in number and size of polyps, whereas in others, polyp proliferation ceases and polyps may even decrease in number and size. Our findings indicate that the fundic gland polyposis does not require prophylactic surgery and that careful periodic follow-up should suffice.

Adolescent↗