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Biomedical subjects

S Bülow

Publications and source records attributed to S Bülow.

135 records · Page 8Linked to original sources
PubMedDate not supplied

Diagnosis of familial adenomatous polyposis.

Familial adenomatous polyposis (FAP) includes early development of up to thousands of colorectal adenomas and of colorectal adenocarcinoma in all untreated cases. Moreover, a variety of extracolonic manifestations are seen. Proctosigmoidoscopy is used for screening; when adenomas are found, the diagnostic evaluation includes colonoscopy and gastroduodenoscopy. Screening of first degree relatives should start at the age of 10 years, using proctosigmoidoscopy at regular intervals. The recent detection of a specific FAP gene at chromosome 5 and of congenital retinal pigmentations will allow an early preclinical diagnosis in the future. A centralized registration of FAP has resulted in an improved prognosis, and the establishment of international groups will contribute to increased research of this disease.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

Colorectal cancer in patients less than 40 years of age in Denmark, 1943-1967.

A retrospective review of all the 951 patients less than 40 years of age with colorectal cancer in Denmark 1943-67 is described. The annual incidence in Denmark of colorectal cancer in this age group is 1.4/100,000. These patients do not differ from other patients with colorectal cancer with regard to sex ratio, tumor localization, extent of tumor growth, histologic type, frequency of intestinal obstruction and perforation. Of these patients 53 per cent were subjected to radical operation. The five-year crude survival rate was 32 per cent for all patients and 65 per cent in cases of radical operation. The operative mortality was 9 per cent. The extent of tumor growth according to Dukes' classification and the presence of intestinal obstruction and/or perforation were the only factors found to influence the prognosis. The survival rates correspond to rate given in the literature in respect of colorectal cancer, regardless of age. It is concluded that colorectal cancer in young patients differs in no respect from the disease in older patients.

Adolescent↗
PubMedDate not supplied

Cumulative risk of developing polyps or malignancy at the ileal pouch-anal anastomosis in patients with familial adenomatous polyposis.

Restorative proctocolectomy with an ileal pouch-anal anastomosis is performed in an increasing number of patients with familial adenomatous polyposis (FAP). Two techniques are currently used to construct an ileal pouch-anal anastomosis: (1) a double-stapled anastomosis between the pouch and the anal canal and (2) mucosectomy with a hand-sewn ileoanal anastomosis at the dentate line. Although this procedure is thought to abolish the risk of colorectal adenoma, an increasing number of case reports have been published concerning the development of adenoma at the anastomotic site. The purpose of this study was to evaluate the overall cumulative risk of developing adenomatous polyps after ileal pouch-anal anastomosis and to compare the cumulative risk after either anastomotic technique. A total of 126 consecutive FAP patients undergoing a restorative proctocolectomy were identified from polyposis registries in The Netherlands, Denmark, Italy, Germany, and New York. Life-table analysis was used to calculate the cumulative risk of developing polyps in 97 patients with at least 1 year of endoscopic follow-up (median 66 months, range 12 to 188 months). A double-stapled anastomosis was used in 35 patients, whereas in 62 patients a hand-sewn anastomosis with a mucosectomy was performed. In 13 patients polyps developed at the anastomotic site, four with severe and four with moderate dysplasia. None of the patients developed a carcinoma at the anastomotic site. The cumulative risk of developing a polyp at the anastomotic site was 8% (95% confidence interval 2% to 14%) at 3.5 years and 18% (95% confidence interval 8% to 28%) at 7 years, respectively. The risk of developing a polyp at the anastomotic site within 7 years was 31% for patients with a double-stapled vs. 10% for patients with a hand-sewn anastomosis with mucosectomy (P = 0.03 [log-rank test]). Because FAP patients undergoing a restorative proctocolectomy with either a double-stapled or hand-sewn anastomosis have a substantial risk of developing adenomatous polyps at the anastomotic site, lifelong endoscopic surveillance is mandatory in both groups.

Adenoma↗
PubMedDate not supplied

Tubocutaneous fistula. Case report.

A 40-year-old woman with Crohn's disease had a cutaneous fistula discharging only during menstruation. Surgical exploration showed a tubocutaneous fistula. Such fistula is extremely rare without prior surgery of the reproductive organs. Discharge during menstruation was the salient feature in most reported tubocutaneous fistulas. Resection of the fistula and salpingectomy is the treatment of choice.

Abdominal Muscles↗
PubMedDate not supplied

The establishment of an HNPCC register.

Guidelines for the establishment of an HNPCC-register are presented. The aims of a register are discussed. Steps in identification of families and persons at risk are suggested, and possible sources of family and pedigree data are mentioned. The role of a register in surveillance, information of family members and medical colleagues, research and international collaboration are discussed.

Colorectal Neoplasms, Hereditary Nonpolyposis↗