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Inherited liver diseases affecting the adult. 影响成人的遗传性肝病。
The Gastroenterologist Pub Date : 1996-12-01
B Y Tung, K V Kowdley
{"title":"Inherited liver diseases affecting the adult.","authors":"B Y Tung,&nbsp;K V Kowdley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A variety of different inherited disorders may cause liver disease in adults. Recent advances in molecular genetics have improved our understanding of these diseases, such as the isolation and characterization of the genes responsible for Wilson disease, alpha1-antitrypsin deficiency, and cystic fibrosis. A candidate gene responsible for hereditary hemochromatosis has also recently been cloned. These scientific advances have important implications in the diagnosis, treatment, and screening of patients with genetic diseases and their families. We review the most common inherited liver diseases affecting adults, with emphasis on the clinical implications of recent molecular advances.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 4","pages":"245-61"},"PeriodicalIF":0.0,"publicationDate":"1996-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19920383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pancreatic fistulas: etiology, consequences, and treatment. 胰瘘:病因、后果和治疗。
The Gastroenterologist Pub Date : 1996-12-01
R A Kozarek, L W Traverso
{"title":"Pancreatic fistulas: etiology, consequences, and treatment.","authors":"R A Kozarek,&nbsp;L W Traverso","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pancreatic fistulas can be internal or external and the consequence of acute or chronic pancreatitis, malignancy, or trauma (to include pancreatic surgery, pseudocyst drainage, and percutaneous biopsy). Contingent on the presence of concomitant pseudocyst, downstream ductal obstruction, or a disconnected duct syndrome, treatment may include maneuvers to decrease pancreatic secretion (NPO, hyperalimentation, pancreatic enzymes, octreotide), attempts to effect serosal apposition (diuretics, thoracentesis, paracentesis), various types of percutaneous tube manipulation, or surgery. Transpapillary pancreatic duct stents have recently been used for refractory ductal leaks and may work either by direct occlusion of the fistula or by lowering the duodenal-pancreatic pressure gradient.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 4","pages":"238-44"},"PeriodicalIF":0.0,"publicationDate":"1996-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19920382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percutaneous drainage of enteric-related abscesses. 经皮肠相关脓肿引流术。
The Gastroenterologist Pub Date : 1996-12-01
A S Fulcher, M A Turner
{"title":"Percutaneous drainage of enteric-related abscesses.","authors":"A S Fulcher,&nbsp;M A Turner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Percutaneous drainage is a routinely performed radiologic procedure used in the management of abdominal abscesses. This technique has become the preferred method of treatment for most abdominal and pelvic abscesses, specifically those of enteric origin related to surgical procedures, appendicitis, diverticulitis, and Crohn disease. The well-documented safety and therapeutic efficacy of percutaneous abscess drainage (PAD) lead to the acceptance of this procedure as the primary means of managing abdominal abscesses, obviating the need for surgery in many instances. PAD may provide definitive therapy or may serve as a temporizing measure before delayed surgical treatment. Although PAD was originally reserved for treatment of unilocular, relatively superficial fluid collections, the role of PAD has evolved such that it is now used to manage complex multilocular fluid collections and abscesses that lie deep within the abdomen or pelvis. Although the standard transabdominal approach is preferred, a variety of approaches, including transgastric, transrectal, transvaginal, and transgluteal, may be used. PAD is performed using CT or sonographic guidance.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 4","pages":"276-85"},"PeriodicalIF":0.0,"publicationDate":"1996-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19920385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatitis C and autoimmunity. 丙型肝炎和自身免疫。
The Gastroenterologist Pub Date : 1996-09-01
C Wrobleski, L S Friedman
{"title":"Hepatitis C and autoimmunity.","authors":"C Wrobleski,&nbsp;L S Friedman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 3","pages":"211-5"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19858228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of common bile duct stones. 胆总管结石的处理。
The Gastroenterologist Pub Date : 1996-09-01
J M Marks, J L Ponsky
{"title":"Management of common bile duct stones.","authors":"J M Marks,&nbsp;J L Ponsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Management of common bile duct stones has changed rapidly as new developments in surgical and endoscopic equipment have become available. Prior to advanced laparoscopic surgical techniques and endoscopic sphincterotomy, common bile duct stones required open surgery, choledochotomy, and manual removal. New alternatives in the management of choledocholithiasis must be understood to allow for comprehensive management of common bile duct stones. Endoscopic and surgical techniques can also be combined for excellent results utilizing minimally invasive techniques. The appropriate choice of therapy will depend on the experience and the resources available.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 3","pages":"155-62"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19855928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Small flat adenoma: important in colon carcinogenesis? 小扁平腺瘤:在结肠癌发生中重要吗?
The Gastroenterologist Pub Date : 1996-09-01
P Shivaprasad, S Marulendra, A M Zfass
{"title":"Small flat adenoma: important in colon carcinogenesis?","authors":"P Shivaprasad,&nbsp;S Marulendra,&nbsp;A M Zfass","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The risk for development of colonic carcinoma increases with increasing size of the polyp. Endoscopists have focused attention on large polyps. Small flat adenomas are sessile polyps that measure less than 1 cm; they are nearly flat, and they have a slight depression in the center. They have a high incidence of cancer in situ. Adenomatous polyps follow the adenoma-carcinoma sequence. Small flat adenomas do not appear to follow this sequence, but they may be precursors of so called de novo colonic carcinoma. The genetics of small flat adenomas are not fully elucidated. Small flat adenomas may not be identified during standard colonoscopy due to the small size of the lesion. Chromoendoscopy may increase the rate of detection.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 3","pages":"216-8"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19858229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pancreatic infections. 胰腺感染。
The Gastroenterologist Pub Date : 1996-09-01
R N Stephan, E L Bradley
{"title":"Pancreatic infections.","authors":"R N Stephan,&nbsp;E L Bradley","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 3","pages":"163-8"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19855929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Manometric evaluation of constipation--Part I. 便秘的压力测量评估——第一部分。
The Gastroenterologist Pub Date : 1996-09-01
S S Rao
{"title":"Manometric evaluation of constipation--Part I.","authors":"S S Rao","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tests of anorectal function have evolved into clinically useful investigations, and they should no longer be regarded as esoteric tools. This transformation has led to major advances in understanding, diagnosis, and treatment of defecation disorders, such as constipation. Because constipation is a heterogeneous condition, it cannot be assessed by a single test. Judicious use of anorectal manometry, colon transit study, a test of simulated defecation, and defecography may provide invaluable pathophysiological information. Undoubtedly, examination of rectal and anal pressure activity, rectal sensation, rectoanal reflexes, and the functional morphology of the defecation unit provides more information than any other test of gastrointestinal motor function; however, there is no uniform criteria for defining manometric abnormalities. There is also an urgent need for establishing international standards for manometric techniques and for diagnosis. Nevertheless, knowledge and experience have paved the way for innovative diagnostic techniques and therapeutic approaches for patients with constipation.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 3","pages":"145-54"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19855927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inherited and congenital disorders of the exocrine pancreas. 外分泌胰腺的遗传性和先天性疾病。
The Gastroenterologist Pub Date : 1996-09-01
P R Durie
{"title":"Inherited and congenital disorders of the exocrine pancreas.","authors":"P R Durie","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The spectrum of inherited and congenital disorders of the exocrine pancreas is described. Although functional disturbances of the exocrine pancreas are less frequent in childhood than in adult life, there is a wide spectrum of causes, many of which are genetic or congenital in origin. Rarely, a disturbance of pancreatic function may arise as a result of disordered embryogenesis. More frequently, however, inherited disorders affecting multiple organs give rise to pancreatic dysfunction. Among Caucasian children, cystic fibrosis (CF) is, by far, the most common inherited disorder of disturbed pancreatic function. Examples of rarer, inherited causes of pancreatic dysfunction include Shwachman-Diamond syndrome, Johanson-Blizzard syndrome, Pearson's syndrome, pancreatic agenesis, and isolated enzyme deficiencies. Hereditary pancreatitis and several recently recognized metabolic causes of chronic pancreatitis can also produce severe pancreatic exocrine dysfunction.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 3","pages":"169-87"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19858225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatic encephalopathy. 肝性脑病。
The Gastroenterologist Pub Date : 1996-09-01
K D Mullen, R Gacad
{"title":"Hepatic encephalopathy.","authors":"K D Mullen,&nbsp;R Gacad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The syndrome of hepatic encephalopathy has mystified physicians since the time of Hippocrates, and it continues to do so. It is difficult to succinctly define, diagnose with certainty, or attempt to explore its pathogenesis. The literature on this topic is confusing and often contradictory. Nevertheless, very effective empirical therapy has been devised for this syndrome. We discuss selected aspects of diagnosis, pathogenesis, clinical manifestations, and treatment of hepatic encephalopathy. Emphasis is placed on the three-pronged clinical strategy to manage hepatic encephalopathy that encompasses both diagnostic and treatment measures. The burgeoning area of subclinical hepatic encephalopathy is discussed in more detail than in most reviews of this topic. We also propose a new term for the field-acute liver failure-associated hepatic encephalopathy (ALFA-HE)-to replace the unsatisfactory older term, fulminant hepatic failure.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"4 3","pages":"188-202"},"PeriodicalIF":0.0,"publicationDate":"1996-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19858226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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