G.E.N最新文献

Anorectal manometry is a non invasive, safe and useful procedure for exploring anorectal function in several disease. The anorectal studies made in our service the last five years in children, were reviewed. There were made 234 procedures in patients 21 year old or less 93.25% of the studies could be finished and 72.64% of the patients were from other hospitals or centers. The age average was 5.62 +/- 4.72 years and the main indication was constipation (78.20%). We didn't find any statistical difference in the manometrical findings of the internal anal sphincter between the patients with only constipation, only encopresis, constipation plus encopresis and normal values. The main manometrical diagnostic in the constipated patient without Hirschsprung disease was "Normal Study" even though between 30 and 55% of the studies showed "inspecific motor dysfunction". The patients with anorectal malformations had a main internal and pressure statistically lower (Z = 3.29 p = 0.03) and "Non concluyent Study" percentage higher (Z03.44 p = 0.02) than the constipated ones. The main external anal pressure was not different between groups. In 43 patients the manometrical study showed "Suggestive of Hirschsprung Disease". We recovered the histological reports in 55.88% with aganglionosis in the 91.66%. There were no statistical differences in the other manometrical parameters. Our finding agree with the ones reported in the specialized literature and support the anorectal manometry as an useful tool for exploring the anal sphincter integrity in anorectal malformations.

We studied the effect of Cisapride (10 mg vo every 8 hours) on the characteristics of the evacuations, orocoecal transit time and motility trough rectoanal manometry in patients diagnosed with chronic constipation. The patients (N = 51) received placebo and/or drug in a controlled, randomized, double blind, crossed study during two treatment phases of 30 days each. The end of each phase was followed by a clinical evaluation, a rectoanal manometry and hydrogen breath test. Cisapride increased the rhythm of ecacuations (5.53 days +/- 3.11 vs 1.59 days +/- 1.15 p < 0.05) improved the frequency of evacuations and diminished the consistency of the feces (p < 0.05), shortened the orocoecal transit time (271.57 min +/- 9.87 vs 201.18 min +/- 29.30 p < 0.05) and improved the parameters of the rectoanal manometry readings such as the pressure of internal anal sphincter (58.14 mmHg 7.33 vs 53.90 mmHg 5.19 p < 0.05), and its relaxation percentage (73.41% +/- 15.30 vs 66.84% +/- 11.83 p < 0.05). Side effects associated with Cisapride were not significant. It is concluded that Cisapride improves intestinal motility in chronic constipation.

Among the Gastric Lymphoma' chief features are the varied endoscopic appearances and the difficulty for its conventional bioptic diagnosis. In order to focusing on this problem we analyzed 15 years of experience on this matter at the "Luis Razetti" Oncological Institute. 10 cases were morphologicaly classified as follow: a) Exophytic type 5/50%. The most difficult morphology for its endoscopic diagnosis was the infiltrative type, in its large gastric folds category 2/20%, yielding a 33% of bening diagnosis. Histopathologicaly a 66% of bening diagnosis was obtained and a 33% of uncertain diagnosis. The exophytic type in its erosive protruding mass category was the second most difficult morphology fot both endoscopic and histopathologic diagnosis. When the last two categories were associated with ulceration, the malignant diagnosis increased. 40 of the cases were operated on without preoperative histological diagnosis. All the cases were operated on without preoperative histological diagnosis. All the cases corresponded with Large cells diffuse type of Non Hodgkin's Lymphoma, a diagnosis reached in only one opportunity by endoscopic biopsy. No correlation between tumoral morphology and intraparietal growth was found. 3 patients survived for more than 1 years. It can be concluded that video endoscopic methods could help to improve the endoscopic knowledge in gastric lymphoma diagnosis, while polipectomy snare biopsy, dye methods like Indigo Carmin and special techniques like mucosectomy could help to improve the histologic diagnosis, because conventional biopsy provides small and superficial samples.

The tumor response in solid neoplasias can be evaluated through volumetric measurements. The advance of the technology and the appearance of new therapeutic alternatives as: hyperthermia, immunotherapy, photodynamic therapy have originated discrepancy with the volumetric measurement of the tumor because the tumor mass can increase or remain in the same size but with tissue modification and increase of the inflammatory and necrotic reaction. There are also other types of morphometric measurement, for the evaluation of the amount of hypoxic cells in the tumor tissue through indirect methods that measure the metabolic level of the tumor tissue; one of this morphometric measurement quantitates apoptosis by light microscopy as tumor regression response. This technique could facilitate experimental studies because of the use of peripheral tumoral tissue obtained with thin needles directed through image equipment.

Preoperative evaluation of the depth of invasion in the rectal wall as well as the presence of regional metastatic nodes are considered important factors in order to decide surgical treatment as well as prognosis in cases of cancer of the rectum. This investigation was carried out in order to establish how usefull transrectal ultrasound was for the pre-operative evaluation of cancer of the rectum. We studied 78 patients with different ano rectal pathology, among them 40 patients with confirmed ADC of the rectum that were completely studied and had ultra sonographic as well as surgical and pathological staging using TNM classification. Confiability indicators of transrectal ultrasound when compared with pathology findings, showed a sensibility of 100% in T1-T2 and T4; in T3 lesions sensibility was 76%. Specificity was between 94% and 100% in all stages. We believe that trans-rectal ultrasound is a usefull, precise and reliable diagnostic tool, for staging purposes of rectal carcinoma.

Analysis was made of 436 specimens of appendectomy in the Caracas University Hospital during the year 1.990. Ages of the patients ranged between 9 months and 79 years (average age: 21 years). 236 were males and 200 females. The pathology found most frequently was the acute inflammatory processes, followed by secondary reactive changes to other entities, many of which were unspecified (e.g. pelvic inflammatory disease) and other specific (such as infestation by parasites) less frequently were found tumoral processes such as mucocele, carcinoid tumor and those which involved another portion of the digestive apparatus and which secondarily affect the appendix.

Evaluated the acceptability of a nutrition formula consisting of pumpkin-rice chicken and oils; in a marginal community to children between the ages of 7 months to 5 years old when acute diarrhea was present. The acceptability was also evaluated in the mothers, who indicated that they liked food very little. Nevertheless, they admitted that they would give the product to their children. During the period of study 26 cases of diarrhea were reported of the 26 children, 6 children consumed all the food offered, 16 children showed variable acceptance and only 4 children reject the food completely. By age-groups, the acceptability was 75.69% for children between the ages of 7 months to one year. 72.90% acceptability for ages between 13 months to 2 years and 78.28% for ages between 25 months to 5 years old. The total acceptability was 75.66%. All cases presented marked decreased in diarrhea and an increased in the consistency of the feces with the third dose.