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Therapeutic procedures for submucosal tumors in the gastrointestinal tract

World Journal of Gastroenterology 2007年第24期13卷 3316-3322页

作者： laura graves ponsaing Mark Berner Hansen Department of Surgical Gastroenterology K Bispebjerg University Hospital of Copenhagen Denmark

This review is part three of three and will present an update on the therapeutic options and procedures concerning gastrointestinal (GI) submucosal tumors (SMTs). The aim of this paper is to investigate the treatments of GI SMTs and to present a case of a gastrointestinal stromal tumor (GIST). Literature searches were performed to find information on therapy for GI SMTs. Based on these searches, the optimal therapeutic procedures could be outlined. The choice of treatment of localized tumors is endoscopic resection if possible or, alternatively, laparoscopic resection or surgical resection by an open procedure. However, benign SMTs should only be excised if symptoms are present, and GISTs should be treated with particular precautions. Irresectable or recurrent GISTs may be successfully treated with the tyrosine kinase inhibitor, imatinib.

关键词： Submucosal tumor Treatment Case story Endoscopic mucosal resection Imatinib

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Classification of submucosal tumors in the gastrointestinal tract

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World Journal of Gastroenterology 2007年第24期13卷 3311-3315页

作者： laura graves ponsaing Katalin Kiss Mark Berner Hansen Department ofSurgical Gastroenterology K Bispebjerg University Hospital ofCopenhagen Denmark Department of Pathology Herlev UniversityHospital Gentofte Denmark

This review is part two of three, which will present an update on the classification of gastrointestinal submucosal tumors. Part one treats of the diagnosis and part three of the therapeutic methods regarding gastrointestinal submucosal tumors. In the past there has been some confusion as to the classification of gastrointestinal submucosal tumors. Changes in classifications have emerged due to recent advances in mainly immunohistochemistry and electron microscopy. The aim of this paper is to update the reader on the current classification. Literature searches were performed to find information related to classification of gastrointestinal submucosal tumors. Based on these searches the twelve most frequent submucosal tumor types were chosen for description of their classification. The factors that indicate whether tumors are benign or malignant are mainly size and number of mitotic counts. Gastrointestinal stromal tumors are defined mainly by their CD117 positivity. In the future, there should be no more confusion between gastrointestinal stromal tumors and other types of submucosal tumors.

关键词： Submucosal tumor Immunohistochemistry Smooth muscle derived submucosal tumors Submucosal tumors of neurogenic origin Gastrointestinal stromal tumor Malignant Benign

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Diagnostic procedures for submucosal tumors in the gastrointestinal tract

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World Journal of Gastroenterology 2007年第24期13卷 3301-3310页

作者： laura graves ponsaing Katalin Kiss Annika Loft Lise Ingemann Jensen Mark Berner Hansen Department of Surgical Gastroenterology K Bispebjerg University Hospital of Copenhagen Denmark Department of Pathology Herlev University Hospital Gentofte Denmark Department of Nuclear Medicine CopenhagenUniversity Hospital Rigshospitalet Denmark Department of Radiology Bispebjerg University Hospital of Copenhagen Denmark

This review is part one of three, which will present an update on diagnostic procedures for gastrointestinal (GI) submucosal tumors (SMTs). Part two identifies the classification and part three the therapeutic methods regarding GI SMTs. Submucosal tumors are typically asymptomatic and therefore encountered incidentally. Advances in diagnostic tools for gastrointestinal submucosal tumors have emerged over the past decade. The aim of this paper is to provide the readers with guidelines for the use of diagnostic procedures, when a submucosal tumor is suspected. Literature searches were performed to find information on diagnostics for gastrointestinal submucosal tumors. Based on the searches, the optimal diagnostic procedures and specific features of the submucosal tumors could be outlined. Standard endoscppy, capsule endoscopy and push-and-pull enteroscopy (PPE) together with barium contrast X-ray do not alone provide sufficient information, when examining submucosal tumors. Endoscopic ultrasound (EUS), computed tomography (CT), magnetic resonance imaging (MRI) and fluorodeoxyglucose-labeled positron emission tomography (FDG-PET) are recommended as supplementary tools.

关键词： Submucosal tumor Diagnosis Endoscopy Endoscopic ultrasonography Computed tomography Magnetic resonance imaging Positron emission tomography Capsule endoscopy Push-and-pull enteroscopy ponsaing LG, Kiss K, Loft A, Jensen LI, Hansen MB.

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10-minute consultation Treatment-refractory hypothyroidism

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英国医学杂志中文版 2020年第12期23卷 735-737页

作者： laura J McNally clinical fellow Catherine I Ofiaeli general practitioner Samson 0 Oyibo consultant endocrinologist Peterborough City Hospital Peterborough PE39GZUK New Queen Street Surgery Peterborough PE71 AT

A 40 year old woman complains of tiredness over the past few *** had a total thyroidectomy three years ago for graves'thyrotoxicosis and has been taking levothyroxine since *** weighs 80 kg and is taking 150 p.g daily.A blood test done in the previous week showed thyroid stimulating hormone(TSH)levels above 30 mU/L(reference range 0.4-4.5 mU/L).

关键词： stimulating graves hypothyroidism

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