RESUMO
Lately, there is a lot of interest in tumor markers, monoclonal antibodies and immunoscanning in the diagnosis and follow-up of certain cancers. The main objective of this study is to report our initial experience with the detection of specific antibodies and with the obtention of scan images. In 85.7% of patients with cancer and in 40% of patients with benign conditions, above normal values of CEA were obtained. In 85.7% of patients with cancer and in 60% of patients with benign disease, above normal values of CA 19-9 were noted. Positive scans were obtained in 83.4% of cancer patients and 13.3% negative scans; it was not useful in one case. In benign conditions 40% of the scans were positive and 60% negative. I-131 was capable of detecting tumors very clearly. The statistical analysis employed was the exact test of Fisher and the correlation was evaluated with contingency coefficients.
Assuntos
Anticorpos Monoclonais/análise , Antígenos Glicosídicos Associados a Tumores/análise , Antígeno Carcinoembrionário/análise , Neoplasias do Sistema Digestório/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Sistema Digestório/diagnóstico , Feminino , Humanos , Radioisótopos do Iodo/análise , Masculino , Pessoa de Meia-IdadeRESUMO
El conocimiento de la fisiologia del esofago y la fisiopatologia del reflujo gastroesofagico, el desarrollo de pruebas funcionales esofagicas y el diseno de procedimientos quirurgicos efectivos, ha dado como resultado un adecuado tratamiento del reflujo gastroesofagico y sus complicaciones. Revisamos la experiencia con cuatro procedimientos: 1 - Funduplicacion de Nissen. 2 - Funduplicacion parcial de Belsey.3 - Gastropexia posterior de Hill. 4- Funduplastia posterior de Guarner. Las recidivas del Nissen son del 5% y como complicacion tiene un 50% de "sindrome de bloqueo". Para el Belsey y el Hill las fallas son del 12%. La funduplastia posterior muestra resultados semejantes al Nissen, pero con un sindrome de bloqueo de 2.2%. Los procedimientos quirurgicos para el tratamiento de la estenosis peptica se dividen en dos grupos: Metodos antireflujo y resectivos. Los buenos resultados varian del 70-85%
Assuntos
Humanos , Esofagite Péptica , Junção Esofagogástrica , Refluxo Gastroesofágico , Procedimentos Cirúrgicos OperatóriosRESUMO
La etiologia de la acalasia es desconocida sin embargo, es uno de los desordenes motores del esofago que ha recibido mayor atencion en su estudio.Durante muchos anos se trato a base de dialataciones esofagicas periodicas. Durante el ultimo cuarto de siglo se ha generalizado el manejo quirurgico. En este trabajo, se hace una revision de los resultados obtenidos con el tratamiento de 145 pacientes, de los cuales 40 fueron dilatados exclusivamente y 129 fueron intervenidos quirurgicamente.Los 40 pacientes dilatados tuvieron 25% de exito. Los enfermos a quienes se les practico intervencion quirurgica como primera instancia, tuvieron un 95% de buenos resultados. Hubo 129 pacientes que fueron operados, entre los cuales 24 enfermos habian sido dilatados previamente. El porciento de exito en estos fue de 91.7%. Se concluye que el mejor tratamiento de la Acalasia es el quirurgico. Se hace una revision de los procedimientos que pueden utilizarse, analizando las ventajas y desventajas de cada uno de ellos
Assuntos
Humanos , Acalasia EsofágicaRESUMO
After major surgery some patients, especially those with an infectiouss process or sepsis, develop jaundice which has been called reactive hepatitis, toxic hepatitis, septic hepatitis or benign postoperative cholestasis; these terms do not have a very precise connotation. Eighty patients with postoperative sepsis and jaundice where studied, excluding those with liver or biliary tract disease, hepato-toxic drugs or repeated halogenated anesthetics. All of them had complete laboratory tests, cultures and percutaneous liver biopsy when it was feasible. Thirty five patients were submitted to percutaneous liver biopsy and they are the material for this paper. There was no correlation with the type and duration of the operation, postoperative complications, shock or kind of anesthesia. The main laboratory changes were leukocytosis, neutrophilia, elevation of the bilirubins mainly the direct type and increase of the alkaline phosphatase; transaminases were within normal limits. Cultures were positive in 76% of the cases predominating E. coli, Pseudomonas a. and Proteus, anaerobics were present in 22.8% of the cases. The liver biopsy showed lymphoctic infiltration, hyperplasia of the Kupffer cells, hepatic regeneration and turbid tumefaction; pericholangitis, focal necrosis, retention of pigment and steatosis were less frequent. We consider that the best denomination of these complications is benign postoperative cholestasis.