Hepato Gastroenterol
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Hepato Gastroenterol · Nov 1998
Clinical TrialBiochemical modulation of doxorubicin by high-dose tamoxifen in the treatment of advanced hepatocellular carcinoma.
In vitro data have indicated that tamoxifen (> 2.5 uM) significantly enhances the cytotoxic effect of doxorubicin in hepatocellular carcinoma (HCC) cells. This clinical study was conducted to examine whether tamoxifen, at a dose sufficient to result in a plasma concentration of more than 2.5 uM, may improve the therapeutic efficacy of doxorubicin in patients with advanced HCC. ⋯ High dose tamoxifen appears to be an effective biochemical modulator of doxorubicin in the treatment of HCC. Prospective randomized phase III studies comparing doxorubicin alone versus doxorubicin plus high-dose tamoxifen are needed.
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Hepato Gastroenterol · Nov 1998
ReviewObservations on the etiology and pathogenesis of intraductal papillary-mucinous neoplasms of the pancreas.
During the last two decades, intraductal papillary-mucinous neoplasms have been recognised as a group that should be distinguished from ductal adenocarcinomas. The literature for these tumors is confusing with the use of many different terms such as mucinous duct ectasia and, sometimes, there is a failure to distinguish them from mucinous cystic tumors. The recognition and apparently increasing incidence of these neoplasms is perhaps entirely attributable to improved diagnostic and imaging methods such as endoscopic retrograde pancreatography and computerized tomography. Experimental, molecular, and epidemiologic data suggest that the etiology of IPMN overlaps that of solid ductal adenocarcinomas.
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Hepato Gastroenterol · Nov 1998
Case ReportsTraumatic biliary stricture successfully treated by percutaneous transhepatic bile duct dilatation: a case report.
A 24 year-old woman complained of obstructive jaundice 24 days after blunt abdominal trauma due to a traffic accident. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a stricture, 15 mm in length, at the common bile duct associated with upper bile duct dilatation. ⋯ Following the confirmation of satisfactory dilatation of the stricture, the catheter was removed. There was no recurrence of jaundice 16 months later in a follow-up study.
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Hepato Gastroenterol · Nov 1998
Comparative StudyOxygen desaturation during sedation for colonoscopy in elderly patients.
Conscious sedation increases the tolerance of patients to endoscopic examination, but arterial oxygen desaturation during endoscopy has often been reported. Elderly patients are considered to be at special risk. However, sedation-induced changes in cardiovascular function in the elderly have not been well investigated. Therefore, this study examined the effects of sedation on pulse rate, systolic blood pressure, and arterial oxygen saturation in elderly patients. ⋯ Midazolam increases the tolerance of elderly patients to endoscopy, but it significantly lowers the level of arterial oxygen saturation and increases the incidence of desaturation. Continuous monitoring is especially valuable during endoscopy in the elderly.
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Hepato Gastroenterol · Nov 1998
Spontaneous gastroduodenal perforation in cancer patients receiving chemotherapy.
Spontaneous gastroduodenal perforation is a rare and lethal complication in cancer patients receiving chemotherapy. ⋯ High index with suspicion of the disease with early treatment may improve survival of cancer patients with spontaneous gastroduodenal perforation.