Morbidity after abdomino-perineal resection.
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Biomedical subjects
Publications and source records attributed to R S Berardi.
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This study has reviewed extramammary Paget's disease. The etiopathogenesis of this interesting clinical entity, although still speculative, may entail more than one process. An attempt has been made to update the natural history of this disease so that its treatment may be facilitated.
A review of goblet cell carcinoid of the appendix was undertaken. This interesting tumor appears to lie somewhere between an ordinary carcinoid and a well differentiated adenocarcinoma of the appendix in regard to its biologic behavior. The histologic features of the goblet cell carcinoid of the appendix are distinctive enough to facilitate a diagnosis, although the histogenesis remains controversial and unsettled. The prognosis is generally good in a patient treated by simple appendectomy, the treatment of choice in the majority of patients.
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Squamous cell carcinoma of the colon and rectum is a relatively rare entity. Although much of this disease entity remains enigmatic, treatment tenets are the same as those accepted for adenocarcinoma of the colon and rectum. Although prognosis of squamous cell carcinoma of the colon and rectum appears to be worse than that of adenocarcinoma, an aggressive approach to this neoplasm is indicated in order to improve survival rates.
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A case of a myxomatous variant of an inflammatory pseudotumor of the lung is reported with clinicopathologic findings including its ultrastructure. The pathologic features of inflammatory pseudotumor of the lung are compared with similar tumors arising elsewhere and bear a close resemblance to granulation tissue, which suggests that inflammatory pseudotumors represent a reparative process rather than a neoplastic process. Recognition of this entity is imperative for a correct diagnosis and in order to differentiate it from malignant neoplasm, since only conservative management is necessary for its treatment.
A case of giant localized pseudopolyp causing partial large-bowel obstruction and occurring in granulomatous colitis is reported. This represented the first manifestation of the patient's disease. The role of surgery in certain patients is discussed.
Stercoraceous perforation of the colon is seen infrequently clinically, but the mortality of this entity remains high. Early diagnosis and treatment are essential if mortality is to be reduced. Emphasis is placed on the potential prevention of this entity. The case presented involves four confined stercoraceous perforations of the colon which were treated by resection and colostomy and from which the patient made a complete recovery.
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Barrett's esophagus remains an interesting but incompletely understood entity. Although most authors contend that it is of acquired origin, evidence is presented to substantiate either an acquired or a congenital origin. The possibility exists that Barrett's esophagus may be acquired in some instances and congenital in others. The most characteristic, albeit not exclusive, histologic features of Barrett's esophagus are defined by the presence of three types of columnar epithelium: an atrophic gastric fundic type of epithelium, a junctional type of epithelium and a specialized columnar epithelium. Reversion of columnar epithelium to squamous epithelium after successful antireflux operation demands further confirmation and study. Dysplastic, metaplastic and adenomatous changes in Barrett's esophagus do occur and must be observed carefully with endoscopy during the follow-up period. The possible relationship between these changes and malignant degeneration requires further study. Although the clinical presentation of benign complications occurring in a Barrett's esophagus simulates those occurring with reflux peptic esophagitis, distinctive roentgenographic and endoscopic features suggest the diagnosis. Treatment of the complications of Barrett's esophagus is essentially surgical, although cimetidine has been shown to be effective for healing of Barrett's ulcer. The need remains for further definition and clarification of the natural history of Barrett's esophagus so that its management can be based upon more definitive grounds.
Although congenital paraduodenal hernias are infrequently encountered clinically, a surgeon must have knowledge of their production and anatomic relationships in order to properly manage these patients.
Anomalies of midgut rotation in the adult are uncommon clinical entities. Knowledge of the normal embryologic development of midgut rotation and the pathologic dispositions of each anomaly is indispensible to manage properly such anomalies.
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