Assuntos
Adenocarcinoma/diagnóstico , Mesotelioma/diagnóstico , Segunda Neoplasia Primária/diagnóstico , Neoplasias do Colo Sigmoide/diagnóstico , Adenocarcinoma/cirurgia , Idoso , Colo Sigmoide/patologia , Colo Sigmoide/cirurgia , Diagnóstico Diferencial , Evolução Fatal , Humanos , Masculino , Mesotelioma/cirurgia , Segunda Neoplasia Primária/cirurgia , Neoplasias do Colo Sigmoide/cirurgiaRESUMO
OBJECTIVES: The present day clinical significance and natural history of Barrett's esophageal ulcer are compared with those reported originally by Barrett. METHODS: Records of patients with Barrett's ulcers followed by the Gastroenterology Service at the Medical College of Wisconsin were reviewed to assess the natural history of the ulcers in patients with Barrett's esophagus. RESULTS: The histories of 14 patients with ulcers in Barrett's esophagus were reviewed. Average follow-up was 5 yr. Ulcers occurred in both short and long segment Barrett's and responded poorly to therapy. Dysplasia occurred in eight patients, and carcinoma developed in two. CONCLUSIONS: Barrett's ulcers occur today and are difficult to manage, as they were 45 yr ago. Complications today, especially dysplasia and carcinoma, are different than those reported by Barrett (life-threatening hemorrhage, esophageal perforation, and stenosis.)
Assuntos
Esôfago de Barrett , Antiulcerosos/uso terapêutico , Esôfago de Barrett/tratamento farmacológico , Esôfago de Barrett/epidemiologia , Esôfago de Barrett/microbiologia , Esôfago de Barrett/patologia , Esôfago/patologia , Feminino , Seguimentos , Infecções por Helicobacter/diagnóstico , Helicobacter pylori , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/uso terapêutico , Fatores de TempoRESUMO
Twenty-seven canine hearts instrumented with ultrasonic dimension crystals underwent simultaneous determination of stroke work and myocardial oxygen consumption during incremental volume loading on right heart bypass before and 30 minutes after 2 hours of cardioplegic arrest at 10 degrees C. Three cardioplegic solutions were used: Hematocrit values were 17.0% (group I), 8.2% (group II), and 0% (group III). In all groups the slope of the linear stroke work versus end-diastolic volume relationship, a measure of contractility, was unchanged after ischemic arrest. However, the myocardial oxygen consumption for basal metabolism was increased an average of 25.5% after arrest with plasma (group III). Since the plasma concentration in all three groups was identical, and the oxygen available to the hearts during ischemia was the same in groups II and III, the efficacy of blood-based cardioplegic solutions cannot be attributed to a plasma component or to the greater oxygen-carrying capacity of the red blood cell. Future studies should attempt to identify the salutory entity of the red cell responsible for preservation of myocardial oxygen consumption efficiency.
