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Thrombus in the left atrial appendage
ARTICLES
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Rhodes JM. Unifying hypothesis for inflammatory bowel disease and associated colon cancer: sticking the pieces together with sugar. Lancet 1996; 347: 40–44. Satsangi J, Parkes M, Louis E, et al. Two stage genome-wide search in inflammatory bowel disease provides evidence for susceptibility loci on chromosomes 3, 7 and 12. Nat Genet 1996; 14: 199–202. Pokorny RM, Hofmeister A, Galandiuk S, Dietz AB, Cohen ND, Neibergs HL. Crohn’s disease and ulcerative colitis are associated with the DNA repair gene MLH1. Ann Surg 1997; 225: 718–23. Gyde SN, Prior P, Allan RN, et al. Colorectal cancer in ulcerative colitis: a cohort study of primary referrals from three centres. Gut 1988; 29: 206–17. Fonager K, Sorensen HT, Mellemkjaer L, Olsen JH, Olsen J. Risk of colorectal cancer in relatives of patients with inflammatory bowel disease. Cancer Causes Control 1998; 9: 389–92. Han SW, Barton JR, Welfare MR. No apparent increase of colon cancer in relatives of ulcerative colitis patients. Am J Gastroenterol 1999; 94: 2323–24. Riegler G, Carratu R, Tartaglione M, Morace F, Manzione R, Arimoli A. Prevalence and relative risk of malignancy in relatives of inflammatory bowel disease patients and control subjects. J Clin Gastroenterol 1998; 27: 211–14. Karlen P, Lofberg R, Brostrom O, Leijonmarck CE, Hellers G, Persson PG. Increased risk of cancer in ulcerative colitis: a populationbased cohort study. Am J Gastroenterol 1999; 94: 1047–52. Persson PK, Karlen P, Bernell O, et al. Crohn’s disease and cancer: a population-based cohort study. Gastroenterology 1994; 107: 1675–79.
16 Swedish National Board of Health and Welfare. Swedish Hospital Discharge Register 1987–1996, quality and contents. Stockholm: Centre for Epidemiology, 1998. 17 WHO. Manual of the international classification of diseases, injuries and causes of death. 7th revision. Geneva: WHO, 1955. 18 Lennard-Jones J. Definition and diagnosis of Crohn’s disease. In: Skandia International Symposia: regional enteritis. Stockholm: Nordiska Bokhandelns Förlag, 1971: 105–12. 19 Garland CF, Lilienfeld AM, Mendeloff AI, Markowitz JA, Terrell KB, Garland FC. Incidence rates of ulcerative colitis and Crohn’s disease in fifteen areas of the United States. Gastroenterology 1981; 81: 1115–24. 20 Lunde AS, Lundeborg S, Lettenstrom GS, Thygesen L, Huebner J. The person-number systems of Sweden, Norway, Denmark, and Israel. Vital Health Stat 2 1980; 2: 1–59. 21 Mattsson B, Wallgren A. Completeness of the Swedish Cancer Register: non-notified cancer cases recorded on death certificates in 1978. Acta Radiol Oncol 1984; 23: 305–13. 22 Breslow NE, Day NE. Statistical methods in cancer research. Vol II: the design and analysis of cohort studies. Lyon: IARC Sci Publ 1987; 1–406. 23 Lynch HT, de la Chapelle A. Genetic susceptibility to non-polyposis colorectal cancer. J Med Genet 1999; 36: 801–18. 24 Tomeo CA, Colditz GA, Willett WC, et al. Harvard report on cancer prevention. Volume 3: prevention of colon cancer in the United States. Cancer Causes Control 1999; 10: 167–80. 25 Sondergaard JO, Bulow S, Lynge E. Cancer incidence among parents of patients with colorectal cancer. Int J Cancer 1991; 47: 202–06.
Clinical picture: Thrombus in the left atrial appendage Andrea V Brasch, Shaul Atar, Robert J Siegel
An 83-year-old woman with rheumatic mitral stenosis underwent mitral valve replacement. Intraoperative transoesophageal echocardiography revealed a large, echodense structure in the left atrial appendage (figure A, arrow, LA=left atrium and LV=left ventricle). Intra-atrial thrombus was confirmed by pathological examination of the removed appendage (figure B). Note the corrugated surface of the left atrial appendage, which corresponds to the imprint in the thrombus. Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048 (Andrea V Brasch MD, Shaul Atar MD, Robert J Siegel MD)
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THE LANCET • Vol 357 • January 27, 2001
For personal use only. Reproduce with permission from The Lancet Publishing Group.
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10
11
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Rhodes JM. Unifying hypothesis for inflammatory bowel disease and associated colon cancer: sticking the pieces together with sugar. Lancet 1996; 347: 40–44. Satsangi J, Parkes M, Louis E, et al. Two stage genome-wide search in inflammatory bowel disease provides evidence for susceptibility loci on chromosomes 3, 7 and 12. Nat Genet 1996; 14: 199–202. Pokorny RM, Hofmeister A, Galandiuk S, Dietz AB, Cohen ND, Neibergs HL. Crohn’s disease and ulcerative colitis are associated with the DNA repair gene MLH1. Ann Surg 1997; 225: 718–23. Gyde SN, Prior P, Allan RN, et al. Colorectal cancer in ulcerative colitis: a cohort study of primary referrals from three centres. Gut 1988; 29: 206–17. Fonager K, Sorensen HT, Mellemkjaer L, Olsen JH, Olsen J. Risk of colorectal cancer in relatives of patients with inflammatory bowel disease. Cancer Causes Control 1998; 9: 389–92. Han SW, Barton JR, Welfare MR. No apparent increase of colon cancer in relatives of ulcerative colitis patients. Am J Gastroenterol 1999; 94: 2323–24. Riegler G, Carratu R, Tartaglione M, Morace F, Manzione R, Arimoli A. Prevalence and relative risk of malignancy in relatives of inflammatory bowel disease patients and control subjects. J Clin Gastroenterol 1998; 27: 211–14. Karlen P, Lofberg R, Brostrom O, Leijonmarck CE, Hellers G, Persson PG. Increased risk of cancer in ulcerative colitis: a populationbased cohort study. Am J Gastroenterol 1999; 94: 1047–52. Persson PK, Karlen P, Bernell O, et al. Crohn’s disease and cancer: a population-based cohort study. Gastroenterology 1994; 107: 1675–79.
16 Swedish National Board of Health and Welfare. Swedish Hospital Discharge Register 1987–1996, quality and contents. Stockholm: Centre for Epidemiology, 1998. 17 WHO. Manual of the international classification of diseases, injuries and causes of death. 7th revision. Geneva: WHO, 1955. 18 Lennard-Jones J. Definition and diagnosis of Crohn’s disease. In: Skandia International Symposia: regional enteritis. Stockholm: Nordiska Bokhandelns Förlag, 1971: 105–12. 19 Garland CF, Lilienfeld AM, Mendeloff AI, Markowitz JA, Terrell KB, Garland FC. Incidence rates of ulcerative colitis and Crohn’s disease in fifteen areas of the United States. Gastroenterology 1981; 81: 1115–24. 20 Lunde AS, Lundeborg S, Lettenstrom GS, Thygesen L, Huebner J. The person-number systems of Sweden, Norway, Denmark, and Israel. Vital Health Stat 2 1980; 2: 1–59. 21 Mattsson B, Wallgren A. Completeness of the Swedish Cancer Register: non-notified cancer cases recorded on death certificates in 1978. Acta Radiol Oncol 1984; 23: 305–13. 22 Breslow NE, Day NE. Statistical methods in cancer research. Vol II: the design and analysis of cohort studies. Lyon: IARC Sci Publ 1987; 1–406. 23 Lynch HT, de la Chapelle A. Genetic susceptibility to non-polyposis colorectal cancer. J Med Genet 1999; 36: 801–18. 24 Tomeo CA, Colditz GA, Willett WC, et al. Harvard report on cancer prevention. Volume 3: prevention of colon cancer in the United States. Cancer Causes Control 1999; 10: 167–80. 25 Sondergaard JO, Bulow S, Lynge E. Cancer incidence among parents of patients with colorectal cancer. Int J Cancer 1991; 47: 202–06.
Clinical picture: Thrombus in the left atrial appendage Andrea V Brasch, Shaul Atar, Robert J Siegel
An 83-year-old woman with rheumatic mitral stenosis underwent mitral valve replacement. Intraoperative transoesophageal echocardiography revealed a large, echodense structure in the left atrial appendage (figure A, arrow, LA=left atrium and LV=left ventricle). Intra-atrial thrombus was confirmed by pathological examination of the removed appendage (figure B). Note the corrugated surface of the left atrial appendage, which corresponds to the imprint in the thrombus. Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048 (Andrea V Brasch MD, Shaul Atar MD, Robert J Siegel MD)
266
THE LANCET • Vol 357 • January 27, 2001
For personal use only. Reproduce with permission from The Lancet Publishing Group.