10 Years endoscopic diagnosis of early gastric cancer in Europe

Summary In two different inquiries concerning the diagnosis of gastric cancer and especially early gastric cancer (E.G.C.) (comprising the years 1968–1977) we collected all over Europe 872,376 gastroscopies with 2832 E.G.C. (0.3%). For 739,360 gastroscopies a total of 39,953 gastric cancers was reported of which 2475 were E.G.C. (6.2%). One E.G.C. was found in 308 gastroscopies. The ulcerating types (IIc and III) were the most frequent ones. The antrum, including angulus and pylorus, and the Magenstraße may be considered as zones of predilection. 94% of all patients with an E.G.C. have had complaints for several months or years before. Gastro-intestinal bleeding is found in 11.4% of the patients over the age of 40.40% of E.G.C. were found in women. 60% in men. E.G.C. is the most frequent from the 6th to the 8th decade of age. Diagnosis of cancer is made by biopsy and/or cytology. The accuracy of diagnosis correlates with the number of biopsy particles from the lesion. A previous, carefully done X-ray examination increases the efficiency of gastroscopy in finding an E.G.C.     

胃粘膜相关淋巴组织淋巴瘤临床与内镜表现特征

目的 探讨胃粘膜相关淋巴组织（MALT）淋巴瘤临床和内镜表现特征及其内在联系。方法 总结1985年－1999年我院经手术及病理证实的32例胃MALT淋巴瘤患者临床和内镜资料。结果 32例患者平均就诊时间为15.6月,平均年龄51.3岁,30－39岁及60－69岁为发病高峰,男女比例1.9:1。患者症状不具有特异性,腹痛是其最常见表现。病变累及胃窦12例,胃体8例,多部位者12例。内镜下表现为弥漫型10例,溃疡型16例,结节型6例。各型症状、体 征无显著差异。弥漫型病灶在累及浆膜层前已发生淋巴结转移。内镜确诊率62.5%。32例均为B细胞淋巴瘤,其中27例伴幽门螺杆菌（Hp）感染(84.4%)。结论 胃MALT淋巴瘤发病年龄呈双峰现象,男性居多,起病隐袭,症状、体征不具有特异性。内镜下病变范围广、病灶多发是其特点,各型临床表现无显著差异,但弥漫型容易发生周围淋巴结转移。内镜下多块取检、深取检以及及时做免疫组化检查可提高内镜诊断准确率。Hp感染可能与胃MALT淋巴瘤的发生有关。     

Percutaneous endoscopic gastrostomy feeding in AIDS*

Reduced energy intake is the most important reason for weight loss in advanced human immunodeficiency virus (HIV) infection. From January 1989 to August 1995 enteral feeding via a percutaneous endoscopic gastrostomy tube (PEG) was offered to all human immunodeficiency virus(HIV)/AIDS patients attending Fairfield Hospital, Melbourne who were unable to maintain 85% ideal body weight. A total of 71 patients received enteral feeding (1000–2000 kcal/day) for a median period of 161 days (range 4–644 days). Fifty-one (72%) patients gained 5.8 ± 4.4kg (range 0.4 - 19.2kg). Nine gained 10 kg or more. The median time to maximum weight was 74 days after PEG insertion. Those who gained weight had a longer median survival, but this difference was not statistically significant (210 vs 109 days, P=0.07). The only predictor of weight gain was a CD4 count greater than 100/μL. Patients who gained weight reported improved quality of life and increased independence. However, early complications, especially wound infection, were common. Although these data have been gathered retrospectively, our experience suggests that enteral feeding can maintain or improve nutritional status and may improve quality of life in advanced HIV infection.     

Percutaneous endoscopic gastrostomy: a nonoperative technique for feeding gastrostomy

Feeding gastrostomy is a useful means of providing nutrition in patients unable to swallow. Percutaneous endoscopic gastrostomy provides a means for creating a feeding gastrostomy without the necessity for laparotomy. It adds a new tool to the armamentarium of the therapeutic endoscopist.