Abstract:
GOALS:The current study presents 1 tertiary endoscopy center's 20-year experience using endoscopic therapy to treat patients with symptomatic primary sclerosing cholangitis (PSC). BACKGROUND:Endoscopic therapy for patients with PSC and dominant strictures has been used for more than 20 years, but there is concern that instrumenting a sclerotic biliary tree induces risks that outweigh anticipated benefits. STUDY:In this retrospective chart review, 117 patients with PSC were identified using ICD-9 codes. Patients had a mean age of 47 years (range: 15 to 86 y). Mean duration of follow-up was 8 years (range: 2 to 20 y). Of the 117 identified patients, 106 underwent endoscopic retrograde cholangiopancreatography on one or more occasions (for a total of 317 endoscopic retrograde cholangiopancreatographies), and a subset of 84 patients received endoscopic therapy for treatment of dominant strictures and/or deteriorating clinical status. Actual survival for endoscopically treated patients was compared with predicted survival using the Mayo Clinic natural history model for PSC. RESULTS:Our chart review revealed 23 recognized complications among the 317 procedures performed (7.3%), and no procedure-related deaths. Observed patient survival at years 3 and 4 was significantly higher than that predicted by the Mayo Clinic natural history model for PSC (P=0.021). CONCLUSIONS:Patients with PSC who have a deteriorating clinical course benefited from endoscopic therapy to provide drainage of bile ducts, removal of stones, and/or temporary relief from obstructions, with acceptable procedure-related complications and higher than expected 3-year and 4-year survival.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Gluck M,Cantone NR,Brandabur JJ,Patterson DJ,Bredfeldt JE,Kozarek RAdoi
10.1097/MCG.0b013e3181646713subject
Has Abstractpub_date
2008-10-01 00:00:00pages
1032-9issue
9eissn
0192-0790issn
1539-2031journal_volume
42pub_type
杂志文章abstract::A 34-year-old man with acquired immunodeficiency syndrome (AIDS) developed pneumatosis cystoides intestinalis associated with an intestinal infection with Cryptosporidium organisms. The pneumatosis resolved upon treatment of the cryptosporidiosis with paromomycin and clofazimine. Four other cases of benign pneumatosis...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199606000-00015
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Duodenal intraepithelial lymphocytosis (D-IEL) is an early marker for celiac disease (CD). However, the majority of cases are due to non-CD-related conditions. GOALS:To identify the predictors of CD when presented with D-IEL. METHODS:A total of 215 adult patients with D-IEL had undergone prospective and sy...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000184
更新日期:2015-07-01 00:00:00
abstract::The advent of new diagnostic and therapeutic modalities for Helicobacter pylori allows any physician to offer curative antibiotic regimens to patients with peptic ulcer disease and gastritis. This article describes new management strategies and discusses the advantages of each. In the old strategy, endoscopy was perfo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract:GOALS:To review the published experience with acute pancreatitis in childhood. STUDY:Computerized search of the English medical literature since 1965 using MEDLINE. RESULTS:Details of 589 patients were reviewed. Mean age was 9.2 +/- 2.4 years (range: 1 week to 21 years). Male to female ratio was 1.2. Etiologies inclu...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200308000-00015
更新日期:2003-08-01 00:00:00
abstract::Markedly elevated alpha-fetoprotein levels in the range of >1,000 ng/mL are highly suspicious for the presence of hepatocellular carcinoma. This report describes three patients with cirrhosis and replicating hepatitis B virus infection who presented with initial serum alpha-fetoprotein levels of >1,000 ng/mL without c...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/00004836-200305000-00017
更新日期:2003-05-01 00:00:00
abstract::Disposable biopsy forceps have recently been introduced into the field of endoscopy. We have analyzed biopsy size and histologic interpretation of samples obtained with the disposable forceps and compared them to those obtained with reusable forceps. In the 18 patients studied, 49 samples were collected with the reusa...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract::Cardiac and circulatory failure are the main causes of hypoxic hepatitis. In a prospective study of 142 cases of hypoxic hepatitis collected during a 10-year period, we encountered two cases resulting from extreme arterial hypoxemia without congestive heart failure, cor pulmonale, or circulatory failure. Both patients...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199706000-00013
更新日期:1997-06-01 00:00:00
abstract::Diverticular disease of the colon is quite common in developed countries, and its prevalence increases with age. Although present in perhaps two thirds of the elderly population, the large majority of patients will remain entirely asymptomatic. Nonetheless, an estimated 20% of those affected may manifest clinical illn...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199910000-00004
更新日期:1999-10-01 00:00:00
abstract::We review acid rebound, the seemingly paradoxical increase in acid secretion resulting from administration of an antacid. Primarily a laboratory observation, the demonstration of the phenomenon was a major contributing factor to the swift, and possibly unjustified, fall from grace of calcium carbonate in the therapy o...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1097/00004836-199207000-00010
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198610000-00024
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Pancreatic cancer (PC) is one of the leading causes of cancer death in Western countries. An increased risk for PC is known in a number of hereditary tumor syndromes. In selected individuals at high risk of developing PC, surveillance of the pancreas might be able to detect premalignant lesions and early inv...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181981123
更新日期:2009-10-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000000797
更新日期:2017-04-01 00:00:00
abstract::The fear of cancer has evoked calls for intensive surveillance programs in Barrett's esophagus. Two evolving issues are fueling this fire: (a) the rising risk of adenocarcinoma of the esophagus over the past 20 years and (b) the coincidental increase in the recognized prevalence of Barrett's esophagus in the general p...
journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:10.1097/00004836-199609000-00002
更新日期:1996-09-01 00:00:00
abstract:GOALS:We investigated the prognosis of Crohn's disease (CD) in Korean patients with jejunal involvement. BACKGROUND:Although jejunal involvement is considered a poor prognostic factor of CD in whites, it has never been validated in Asian populations. METHODS:We retrospectively reviewed the medical records of 1403 Kor...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3182705f9e
更新日期:2013-05-01 00:00:00
abstract::We compared eleven patients in whom symptoms of Crohn's disease appeared at age greater than or equal to 65 with a younger group in whom symptoms had appeared earlier. Only 64% of the older patients were initially recognized as having Crohn's disease, as compared with 96% of the younger patients even though clinical c...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198908000-00013
更新日期:1989-08-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200111000-00004
更新日期:2001-11-01 00:00:00
abstract::Islet cell carcinoma frequently produces more than one chemical product, although its clinical expression is usually restricted to a single hormone. We describe an unusual patient who presented with full-blown metastasizing gastrinoma. He was treated with cimetidine for five years and then streptozotocin therapy, whic...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199010000-00018
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:The clinical effect of probiotics on irritable bowel syndrome (IBS) is still controversial. AIMS:We aimed to evaluate the effects of a probiotic mixture on IBS symptoms and the composition of fecal microbiota in patients with diarrhea-dominant IBS (D-IBS). METHODS:Fifty patients with D-IBS were randomized ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,随机对照试验
doi:10.1097/MCG.0b013e31823712b1
更新日期:2012-03-01 00:00:00
abstract::Granular cell myoblastoma, a rare, but generally benign tumor, is being encountered with increasing frequency in the digestive tract. Seventy-two cases have been described in the esophagus; we report two additional cases. A follow-up, available in 13 patients (including ours), reveals a low likelihood of malignant tra...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198404000-00003
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200010000-00006
更新日期:2000-10-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:
更新日期:1994-07-01 00:00:00
abstract::Helicobacter pylori infects only human gastric epithelium, causes gastritis, and is strongly associated with gastroduodenal ulceration and gastric cancer. Colonization of the stomach with H. pylori is accompanied in the acute stage by an increased number of neutrophils in the lamina propria, indicative of gastric infl...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199800001-00021
更新日期:1998-01-01 00:00:00
abstract::The prevalence of hepatitis C virus (HCV)-RNA positivity among hemodialysis patients varies between 10 and 70%. Few previous surveys revealed high frequency of seroconversion of HCV-RNA-negative patients over the years of hemodialysis. Only few studies reported HCV genotype variability. We evaluated all 65 patients on...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199901000-00005
更新日期:1999-01-01 00:00:00
abstract::A 45-year-old woman receiving continuous infusions of 5-fluoro-2'-deoxy-uridine into the hepatic artery through a surgically implanted intraarterial catheter for hepatic metastases from adenocarcinoma of the colon, developed acute epigastric pain and anemia. Endoscopy demonstrated a duodenal ulcer with a portion of th...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198808000-00016
更新日期:1988-08-01 00:00:00
abstract::Crohn's disease is believed to have an immunologic basis. The importance of the CD4 cell in particular has been supported by several reports of patients whose symptoms of Crohn's disease resolved after a decline in CD4 count associated with human immunodeficiency virus (HIV) infection. A patient with known Crohn's dis...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199709000-00013
更新日期:1997-09-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200609000-00016
更新日期:2006-09-01 00:00:00
abstract::In a double-blind placebo-controlled study, we examined the effect of calcitonin on gastric emptying, and on serum concentrations of gastrin, insulin, glucose, calcium, and phosphorus after a mixed solid-liquid meal in 11 healthy men. Synthetic salmon calcitonin was administered as a 415 pmol i.v. bolus injection foll...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-199002000-00007
更新日期:1990-02-01 00:00:00
abstract::Hepatitis C RNA testing has been used extensively to assess the efficacy of antiviral therapy and has increasingly become an integral part of clinical management of patients with chronic hepatitis C. A variety of commercially available hepatitis C virus (HCV) RNA tests are used to detect HCV RNA qualitatively or quant...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200107000-00011
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Diverticular disease (DD) is a common gastrointestinal inflammatory disorder associated with an enteric neuropathy. Although enteric glial cells (EGCs) are essential regulators of intestinal inflammation and motility functions, their contribution to the pathophysiology of DD remains unclear. Therefore, we an...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001011
更新日期:2019-07-01 00:00:00