Surgical treatment of villous tumors of the large intestine

During a period of 10 years 487 patients were under observation, in whom 528 glandular-villous and villous tumors of the rectum and colon were recognized. Malignancy was 11-12% in the colon and 26.3% in the rectum. Endoscopic removal of villous tumors was conducted in 78.9%, transanal excision in 6.5%, and resection of segments of the large intestine in 13.7% of patients. Large villous tumors of the large intestine must be managed by operations of a more radical character.     

Growth rate of malignant tumors of the large intestine

The rates of colonic tumor growth were studied on the basis of evaluation of the case histories of 19 cancer patients in whom dynamic endocolonoscopy had been carried out. In some cases, malignant tumors appeared in the colon within 12 months after previous colonoscopy. Tumors were under 2.0 cm in size and were not accompanied by any clinical symptoms. Repeated endoscopic examinations performed within a period of 1-3 years detected large tumors which caused the constriction of colonic lumen. Clinical symptoms developed in such patients approximately 1-4 months prior to tumor detection. It is concluded that although the rates of growth of colonic malignancies are rather high, tumorigenesis is preceded by a long-term stage of preclinical disease.     

Diagnosis and treatment of soft tissue tumors

Alterations in [Hb], which are mediated through changes in arterial oxygen content, and alterations in BV, which are mediated through changes in cardiac output (Q), have a significant effect on both VO2max and aerobic performance. If BV is held constant, a decrease in [Hb] (anaemia) causes a decrease in VO2max and aerobic performance, while an increase in [Hb] (blood doping) causes an increase in VO2max and aerobic performance. If [Hb] is held constant, an increase in BV can cause and increase in both VO2max and aerobic performance, while a decrease in BV can cause a decrease in VO2max and aerobic performance. In addition, an increase in BV can compensate for moderate reductions in [Hb] through increase in Q, allowing VO2max to remain unchanged or even increase. Also, a large portion of the difference in the enhanced cardiovascular function of endurance athletes is due to their high BV and the resultant enhancement of diastolic function. Hence, optimizing both [Hb] and BV is a very important consideration for endurance performance.     

Kinetics of populations of enterocytes of experimental tumors of the large intestine in rats

To determine whether somatostatin, an inhibitor of glucagon and growth hormone secretion, might be useful as an adjunct to insulin the management of diabetic hyperglycaemia, seven insulin-requiring diabetic men were given somatostatin (100 microgram/h, IV) continuously for 3 days after their diabetes had been treated intensively by diet and insulin on a metabolic ward. During infusion of somatostatin and despite reduction in average insulin dose exceeding 50%, there was improvement in diabetic control as assessed by postprandial hyperglycaemia, 24-h glycosuria and the average daily serum glucose level and its fluctuation; when somatostatin was discontinued, but insulin doses held constant, diabetic control rapidly worsened. No adverse effects were observed. These results indicate that somatostatin plus insulin can be a more effective regimen than insulin alone in controlling diabetic hyperglycaemia. A longer acting and more selective somatostatin preparation may prove useful as an adjunct to insulin in the management of diabetes.     

Immediate and long-term results of the treatment in cancer of the large intestine

Operative treatment of 200 patients with carcinoma of the rectum is analysed. Planned operations were conducted on 101 patients, postoperative mortality was 7.8%. Surgery was undertaken in 93 patients with acute intestinal obstruction, postoperative mortality was 15.05%. Changes of the policy of treatment of patients with acute intestinal obstruction reduced postoperative mortality. Five-year survival was 67.1%.     

Lipomas of the large intestine

The incidence of lipomas of the colon is difficult to evaluate due to lack of symptoms. They are often discovered by chance during endoscopic or radiological examination and sometimes display only obstructive symptoms. A barium enema may be useful for the preoperative diagnosis of lipoma of the colon. The difficulty of obtaining a clear preoperative diagnosis influences the type of surgical treatment undertaken. Thus, a resection is often preferred to the simple removal of the lipoma by colotomy or endoscopy.     

Malignant tumors of the small intestine

Primary malignant tumors of the small intestine are uncommon. The average annual incidence rate over a period of 30 years in Saskatchewan was 0.7 and 0.6 per 100,000 for male and females, respectively. The 209 patients who comprise the series represent 1.6% of the total number who had gastrointestinal cancers over the same period. The distribution of the tumors by site and histologic type is described. Both carcinoid and adenocarcinomatous tumors of the small intestine are associated with a high incidence of primary malignant neoplasms in other sites (17.0 and 20.3%, respectively). One patient with Peutz-Jeghers syndrome is of interest because of the malignant change which occurred in more than one of the small bowel polyps and because of consequent liver metastases. The reason for the poor prognosis in noncarcinoid small bowel malignant neoplasms is probably due to late diagnosis. The five-year disease-free survival in these tumors was 22.5%. Malignant carcinoids had a better overall five-year survival rate of 64%. For those confined to the bowel wall, the five-year survival rate was 73%, compared to 59% for those extending to nodes or metastasizing to distant organs.     

Features of the treatment of complications after surgery in benign tumors of the lung

Complications have occurred in 30 (9.4%) of 318 patients, operated on for benign pulmonary tumor. In 5 patients rethoracotomy was conducted for haemothorax within 1-2 days, not influencing the duration of treatment. All the patients are alive.     

Diagnosis and treatment of bone tumors complicated by pathological fractures

The article elucidates certain questions of modern methods of diagnosis and treatment of tumors of long tubular bones complicated by pathological fractures. The methods were used for the treatment of 41 patients. The authors emphasize the importance of such methods as radio- and angiography, punctional and trepanobiopsy, measurement of the intraosseous pressure. The efficiency of the ultrasound resection in association with cryodestruction for the treatment of the diseases mentioned is reported.     

Ultrasonography as a primary diagnostic tool in patients with inflammatory disease and tumors of the small intestine and large bowel

PURPOSE: The administration of two GnRH analogues (buserelin and leuprolide acetate) in long and short protocols was evaluated prospectively. In the long protocol, the analogues were given from day 1 of the cycle for at least 14 days and then hMG administration was started, while in the short protocol the analogues were initiated from cycle day 1, adding hMG from day 3. The patients were divided into four groups according to the protocol used: Group I, buserelin-long; Group II, buserelin-short; Group III, leuprolide-long; and Group IV, leuprolide-short. Serum E2 levels on the day of hCG injection and the number of follicles observed, oocytes retrieved, and embryos obtained, as well as implantation rates, were significantly higher (P < 0.001) in the long protocols than in the short ones. RESULTS: Pregnancy rates were similar in all groups, although a trend for better results was observed in buserelin-long compared to buserelin-short. There were no differences in the results achieved with buserelin or leuprolide. CONCLUSION: The administration of GnRH analogues (buserelin and leuprolide acetate) in long protocols induced a more intense ovarian response and was associated with significantly higher implantation rates and also a trend for higher pregnancy rates, although this difference was not statistically significant.