Browsing by Author "GUZMAN, S"

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    ACCURACY OF THE 1ST ENDOSCOPIC PROCEDURE IN THE DIFFERENTIAL-DIAGNOSIS OF GASTRIC-LESIONS
    (1982) LLANOS, O; GUZMAN, S; DUARTE, I
    The accuracy of endoscopy and directed biopsy in the differential diagnosis of gastric lesions was evaluated by comparing the diagnoses of 1 endoscopic procedure (endoscopy and multiple directed biopsies) with the definitive diagnoses in 333 patients. The overall endoscopic and bioptic accuracy rate for all patients amounted to 98.8%. Separate accuracy rates of endoscopy alone and biopsy were 86.5 and 94.9%, respectively. The reliability of endoscopy was similar in the diagnosis of malignant and benign lesions (86 and 89%). Endoscopic biopsy was correct in 99.1% of benign lesions and in 86% of malignancies. False negative rates were 3.9% for endoscopy and 4.0% for biopsy. False positive rate was 5.5% for endoscopy alone and 2.1% for biopsy. One endoscopic procedure is a highly reliable method in the differential diagnosis of benign and malignant gastric lesions.
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    CATABOLISM OF CHYLOMICRON REMNANTS IN PATIENTS WITH PREVIOUS ACUTE-PANCREATITIS
    (1990) ROLLAN, A; GUZMAN, S; PIMENTEL, F; NERVI, F
    A recent study reports that patients with previous acute pancreatitis commonly have an abnormal clearance of serum triglycerides after an oral fat load. This observation supports the hypothesis that patients with previous acute pancreatitis and normal fasting serum triglyceride levels may have a preexistent abnormality in the metabolism of chylomicrons. To test this hypothesis, the catabolism of chylomicrons and their remnants was studied in a series of 7 patients who had sustained an attack of pancreatitis (2, gallstone related; 2, alcohol ingestion; 1, hydatid cyst; and 3, no associated pathological condition) at least 18 mo earlier. All the patients had previously had abnormal oral-fat tolerance test results. These patients were compared with a series of 6 healthy volunteers. Chylomicrons were endogenously labeled with an oral dose of retinyl palmitate, and their plasma elimination half-life was calculated. The retinyl palmitate absorption rate constants were similar in control and pancreatitis patients. The chylomicron t1/2 were 2.3 .+-. 0.8 (SD) h and 3.9 .+-. 1.8 h in the control and pancreatitis groups, respectively (p = 0.07). The chylomicron remnant t1/2 was 2.7 .+-. 1.1 h in the control groups and 5.2 .+-. 2.4 h in the pancreatitis group (p < 0.05). This study support the hypothesis that subjects with previous acute pancreatitis may have an abnormality in the catabolism of chylomicron particles. This abnormality may represent a preexistent genetic condition expressed in either the apoprotein composition of chylomicrons or in the hepatic apolipoprotein E-receptor activity.
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    INTESTINAL METAPLASIA OF THE GASTRIC-MUCOSA IN AUTOPSIES OF CHILEAN ADULTS
    (1984) DUARTE, I; FONK, ML; LLANOS, O; GUZMAN, S
    The frequency and characteristics of intestinal metaplasia of the stomach were studied in autopsy material of 68 Chilean adults, with ages ranging from 30-79 yr. Metaplasia was found in 76.5%, which is in agreement with the high frequency of metaplasia reported from other geographic areas of high incidence for gastric cancer. Of those stomachs with metaplasia, 90.4% had involvement of the lesser curvature, 88.5% of the antral region and only 3.8% did not show the condition in those 2 areas. The metaplasia extended to less than 1/2 of the length of the mucosa in 85.6% of the sections with this change, showing that it is mainly a patchy and multifocal condition. In subjects older than 50 yr, intestinal metaplasia was more extended and severe, and involved with a relative higher frequency the greater curvature and both anterior and posterior walls of the stomach.
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    MALIGNANT PAPILLOMATOSIS OF THE COMMON BILE-DUCT - A CASE DIAGNOSED BY ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
    (1991) GUZMAN, S; MARTINEZ, J; FORADORI, G; VIAL, T; DUARTE, I
    Bile duct papillomatosis is a rare entity with a high risk of malignant change. We report the case of a 60-year-old man with malignant papillomatosis of the distal common bile duct and a separate carcinoma of ampulla of Vater. The patient had previously undergone surgery for acute cholecystitis and common bile duct calculi. Three months later the patient developed jaundice and fever. An endoscopic retrograde cholangiopancreatography demonstrated multiple filling defects adherent to the wall of the distal common bile duct. Pancreatoduodenectomy was performed with complete resection of the extrahepatic bile duct. Histologic examination showed a multicentric papillary adenocarcinoma of the common bile duct associated with an adenocarcinoma of the ampulla of Vater. The resection margins were free of tumor.