Assuntos
Patologia/história , Sociedades Médicas/história , História do Século XX , Medicare/história , Medicare/legislação & jurisprudência , Patologia/legislação & jurisprudência , Patologia/normas , Sociedades Médicas/legislação & jurisprudência , Sociedades Médicas/normas , Governo Estadual , Estados UnidosRESUMO
Technology is the outcome of man's use of tools and reason to change the environment to his benefit. New technology creates opportunities for some and threats for others. New technology will be dramatically influenced by the political, social, economic, and ethical milieu in which it develops. An overriding concern in the near future may be cost. Cost-benefit analysis/cost-effectiveness analysis can be a helpful planning tool but should not be used exclusively to plan for technological change. Knowledge of the humanities as well as a science will be essential if we are to make the decisions needed as we approach the 21st century.
Assuntos
Avaliação da Tecnologia Biomédica , Análise Custo-Benefício , Órgãos Governamentais , História Antiga , Tecnologia/história , Avaliação da Tecnologia Biomédica/economia , Estados UnidosRESUMO
Two patients developed adenocarcinoma of the gastric stump 20 to 30 years following gastric resection for benign peptic ulcer disease. The bulk of the medical literature supports a small but definite increased incidence with a latency period of 20 years or more. The risk is greatest following operations that lead to greater reflux of bile and pancreatic juices into the gastric remnant. The diagnosis may be inapparent by upper gastrointestinal tract roentgenograms, and changes may not even be obvious at endoscopy. Five-year survival rates are low (2% to 4%). Because the prognosis is poor once the disease is diagnosed, the high-risk patient should be considered for intermittent endoscopic surveillance.
Assuntos
Adenocarcinoma/etiologia , Gastrectomia/efeitos adversos , Neoplasias Gástricas/etiologia , Úlcera Gástrica/cirurgia , Adenocarcinoma/diagnóstico , Fatores Etários , Idoso , Endoscopia , Humanos , Jejuno/cirurgia , Masculino , Prognóstico , Neoplasias Gástricas/diagnóstico , Fatores de TempoRESUMO
Amyloid tumors of the gastrointestinal tract are exceedingly rare. Two cases are presented, one in the stomach of a patient who appeared to have systemic amyloidosis and one in the colon which appears to be isolated. The treatment was surgical excision. Extensive diagnostic work-up is required to evaluate the many various possible causes of amyloidosis.
Assuntos
Amiloidose/patologia , Doenças do Colo/patologia , Gastropatias/patologia , Idoso , Amiloidose/diagnóstico , Amiloidose/cirurgia , Colectomia , Doenças do Colo/diagnóstico , Doenças do Colo/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Gastropatias/diagnóstico , Gastropatias/cirurgiaRESUMO
Plasma cell infiltrates in the thyroid are rare. They may represent several processes, such as localized plasmacytoma, multiple myeloma, or plasma cell granuloma (PCG). It may be difficult to distinguish these disorders on the basis of morphologic features in sections stained with hematoxylin-eosin. All may be composed of mature plasma cells, without admixed macrophages or lymphocytes, that infiltrate the thyroid and adjacent connective tissue. The identification of the uncommon, but benign, PCG is facilitated by immunohistochemical staining to demonstrate an admixture of plasma cells with cytoplasmic kappa and lambda light chains. The polyclonal nature of the plasma cell infiltrate distinguishes PCG from neoplastic plasma cell proliferation.
