20 research outputs found
α-Fetoprotein and human chorionic gonadotrophin-β as prognostic markers in neuroendocrine tumour patients
Serum chromogranin A is the most useful general and prognostic tumour marker available for neuroendocrine tumour (NET) patients. The role of other tumour markers is less clear. In order to determine the diagnostic and prognostic value of serum α-fetoprotein (AFP) and human chorionic gonadotrophin-β (hCGβ) in NETs, a database containing biochemical, histological, and survival data on 360 NET patients was constructed. This data was statistically assessed, using Statistical Package for the Social Sciences, to determine the utility of commonly measured tumour markers with particular emphasis on AFP and hCGβ. α-Fetoprotein and hCGβ were raised in 9.5 and 12.3% of patients respectively and jointly raised in 9.1% of patients in whom it was measured. α-Fetoprotein levels associated strongly and positively with tumour grade, serum CgA and hCGβ levels, and worse survival. Human chorionic gonadotrophin-β levels also associated strongly and positively with serum CgA and AFP levels, and worsening survival. α-Fetoprotein and hCGβ are elevated in high-grade NETs, with a rapidly progressive course and poorer survival. They also correlate with chromogranin-A, which is known to be a marker of tumour burden and to have prognostic value. Thus AFP and hCGβ are clinically important in NETs and when elevated are poor prognostic markers
Use of the pylorus for preventing ileostomy complications - An experimental canine study
PURPOSE: Conventional ileostomy, as it is well known, presents with
persistent watery diarrhea, among other complications. The present-day
modified methods of conventional ileostomy cannot effectively prevent
these unpleasant consequences. The purpose of this study was to try to
use the sphincter mechanism of the pylorus in ileostomy in dogs
experimentally to prevent the above symptoms. METHOD: Following a highly
selective vagotomy, the antrum with the pylorous and a 3-cm segment of
the duodenum were separated from the gastrointestinal tract along with
its vasculature and innervation, and the distal duodenal end was closed.
Then, the terminal loop of ileum (before an ileostomy was performed) was
dissected, and the distal segment was anastomosed with the proximal end
of duodenum; the proximal segment of this loop was anastomosed with the
stump of the antrum. The gastrointestinal continuity was established by
anastomosis of the gastric stump to the first loop of the jejunum.
RESULTS: After the procedure, the sphincter mechanism of the pylorus was
preserved, and bowel movements became solid and infrequent, so a
colostomy bag could be applied consistently. CONCLUSIONS: Similarity of
anatomy and physiology of the alimentary tract in dogs and humans favors
possible application of this procedure to humans, with better results
than with conventional ileostomy
Successful octreotide treatment of chylous pleural effusion and lymphedema in the yellow nail syndrome
Acute pancreatitis after long-term therapy with mesalazine, and hyperamylasaemia associated with azathioprine in a patient with ulcerative colitis
Carcinoid tumors of the duodenum and the ampulla of Vater:current diagnostic and therapeutic approach in a series of 8 patients. Case series
AbstractAimTo describe the specific characteristics of duodenal/perivaterian carcinoids and to analyze the diagnostic/therapeutic approach.Material and methodsEight patients were included in our study. Symptoms on admission included dyspepsia, upper gastrointestinal (GI) bleeding and anemia. All patients underwent upper GI endoscopy and gastrointestinal peptides (gastrin) and neuroendocrine markers (Chromogranin-A, CgA) measurement. Imaging studies were performed in all patients, including OCTREOSCAN, while in patients with ACs MRCP or ERCP was also performed, when necessary. Definite diagnosis was confirmed by histopathologic examination.ResultsPolypoid masses (carcinoids) were revealed at duodenal bulb and ampulla of Vater, in 5 and 3 patients, respectively. Serum gastrin was moderately increased in 4 patients, while in one patient it was more than 1000 pg/ml. Serum CgA was moderately increased in one patient, in whom OCTREOSCAN detected a solitary hepatic metastasis. Two patients with DC, of less than 1 cm of diameter, were treated by endoscopic polypectomy, while all the other patients underwent surgery. The patient with hepatic metastasis and positive OCTREOSCAN received also Octreotide LAR, resulting in stabilization of disease. No recurrence or metastases were observed during follow-up (range : 1.5–9.6 years).ConclusionsIn DC tumors <1 cm endoscopic excision with close follow-up is an adequate treatment, while in tumors >1 cm and in AC, surgical resection is the treatment of choice. In metastatic tumors, resection of the primary lesion with administration of somatostatin analogues may stabilize the disease and improve patient’s quality of life
Carcinoid tumors of the duodenum and the ampulla of Vater: Current diagnostic and therapeutic approach in a series of 8 patients. Case series
Aim: To describe the specific characteristics of duodenal/perivaterian
carcinoids and to analyze the diagnostic/therapeutic approach.
Material and methods: Eight patients were included in our study.
Symptoms on admission included dyspepsia, upper gastrointestinal (GI)
bleeding and anemia. All patients underwent upper GI endoscopy and
gastrointestinal peptides (gastrin) and neuroendocrine markers
(Chromogranin-A, CgA) measurement. Imaging studies were performed in all
patients, including OCTREOSCAN, while in patients with ACs MRCP or ERCP
was also performed, when necessary. Definite diagnosis was confirmed by
histopathologic examination.
Results: Polypoid masses (carcinoids) were revealed at duodenal bulb and
ampulla of Vater, in 5 and 3 patients, respectively. Serum gastrin was
moderately increased in 4 patients, while in one patient it was more
than 1000 pg/ml. Serum CgA was moderately increased in one patient, in
whom OCTREOSCAN detected a solitary hepatic metastasis. Two patients
with DC, of less than 1 cm of diameter, were treated by endoscopic
polypectomy, while all the other patients underwent surgery. The patient
with hepatic metastasis and positive OCTREOSCAN received also Octreotide
LAR, resulting in stabilization of disease. No recurrence or metastases
were observed during follow-up (range : 1.5-9.6 years).
Conclusions: In DC tumors < 1 cm endoscopic excision with close
follow-up is an adequate treatment, while in tumors > 1 cm and in AC,
surgical resection is the treatment of choice. In metastatic tumors,
resection of the primary lesion with administration of somatostatin
analogues may stabilize the disease and improve patient’s quality of
life. (C) 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All
rights reserved