Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-three patients presenting with dyspepsia were examined with the Olympus Fiber-gastroscope. An endoscopic diagnosis was made in each case and multiple gastric biopsies were obtained for histological and ultrastructural assessment. The endoscopic, histological and ultrastructural findings were compared with each other. Of 33 patients endoscoped, 29 were found to have endoscopic evidence of various types of gastritis and all of these latter had histological evidence of some form of gastritis. Histological confirmation of specific types of endoscopically diagnosed gastritis, however, was only found in 3/9 cases of chronic atrophic gastritis (CAG), 10/14 cases of chronic (superficial) gastritis (CG) and in none of six cases of acute gastritis (AG), indicating that endoscopic diagnosis of specific types of gastritis is relatively inaccurate. Endoscopic diagnosis should thus be restricted to presence or absence of gastritis, leaving the specific typing to histological assessment of the gastric biopsies. Multiple gastric biopsies should be obtained even though the gastric mucosa appears normal endoscopically, since histological evidence of gastritis was found in three out of four cases with endoscopically normal gastric mucosa. Comparison of histological diagnosis with electron microscopy showed that generally there is good correlation between the severity of the histological changes and the ultrastructural grade of damage as defined in this study. It would appear that E.M. examination of the gastric biopsies will not significantly increase the diagnostic accuracy of light microscopy, although it has elucidated the various cellular changes which characterize chronic gastritis. The rough surface contours, the large gastric pit and the increasing number of surface microvilli, seen by scanning E.M., aid the grading of the disease process. Some of these changes are reflected in observations made by transmission E.M. where in addition the basal intercellular edema of the mucosal layer and the appearance of electron-dense mucosal lining cells are observed. The latter, which are the counterpart of "intestinal metaplasia", possess mucus granules which resemble those of gastric mucosal lining cells or intestinal goblet cells, or both.
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PMID:Endoscopic, histological and ultrastructural correlations in chronic gastritis. 44 29

Patients with ventricular ulcer (n = 109) were examined endoscopically and bioptically concerning the frequency of an at the same time existing gastritis. It was shown that stomachs with ulcer practically without any exception, i.e. in 96 per cent, had a pangastritis. In the endoscopic comparative group without focal lesions (n = 231) a gradually less pronouncedly expressed gastritis is present than in patients with ulcer. Patients with gastric ulcer and such persons with endoscopical negative dyspepsia (endoscopic comparative group) have common the more pronounced appearance of the gastritis in the antrum (antritis) than in the corpus. Gastric ulcers appeared in males at the age from 30 to 49 years twice as often as in females. The latter showed an approximately linear increase of the frequency of corpus ulcers between 20 and 69 years. In antrum ulcers like in duodenal ulcers the males dominate at the age from 20 to 59 years, whereas the females prevail in the 7th decennium.
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PMID:[Gastritis and stomach ulcer]. 54 72

Eighteen patients with dyspepsia and vomiting which followed surgery for peptic ulcer have completed a study to examine the role of diverting bile from the stomach by a Roux-en-Y procedure. Bile regurgitation and mild epigastric pain relieved by vomiting were abolished. Measurements of bile acids in the fasting gastric aspirate were useful in predicting the outcome of surgery; good results were obtained when initially there was reflex into the stomach of more than 120 mumol/hour of bile acids. A wider group of patients than those selected in previous series may benefit from this operation, as good results can be obtained in patients with dyspepsia relieved by alkali and without achlorhydria or gastritis. Endoscopy was repeated one year after Roux-en-Y operation. Erythema of the mucosa was improved, but gastritis did not improve.
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PMID:Selection of patients for bile diversion surgery: use of bile acid measurement in fasting gastric aspirates. 63 35

The occurrence of gastritis in antral and body mucosa is compared in an Icelandic and a Danish group of patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. In all 93 Icelandic and 88 Danish patients were examined. All signs of antral gastritis were more frequent in Icelandic than in Danish patients, but only the incidence of superficial inflammation and decreased mucus content in surface and crypt epithelium differed significantly. In body mucosa pseudopyloric metaplasia was more frequent in Iceland and occurred equally freqeuntly in all three diseases. A statistically significant correlation was found between macroscopic gastritis and occurrence of antral superficial inflammation and between smoking and superficial inflammation and decreased mucus content in the pyloric biopsy specimen. The presence of histological gastritis was not correlated to the intake of alcohol and salicylic acid, nor to the presence of pain at the time of investigation.
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PMID:A prospective comparative study of clinical and pathological characteristics in Icelandic and Danish patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. II. Histological results. 67 62

Esophageal, fundal, antral, and duodenal mucosal biopsies from 10 patients with heartburn were compared with biopsies from 18 patients with dyspepsia but without heartburn or radiographic or endoscopic evidence of peptic ulcer disease, gastric retention, or esophageal stricture. There was a highly significnt correlation between heartburn and antral gastritis and duodentitis (P less than 0.01). It is suggested that histologic reflux changes are determined by the severity of reflux and reparative potential of the esophageal mucosa. Heartburn, on the other hand, is more related to the nature of the refluxed fluid. The fluid most likely to induce heartburn is one containing duodenal fluid, which is also believed to be an important cause of antral gastritis.
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PMID:The association of heartburn with gastritis. 85 59

Eighty-four patients who had undergone different types of operation for duodenal ulcer have been studied by endoscopy and gastric biopsy. Half suffered from dyspepsia and vomiting but the other half had no symptoms and acted as controls. Endoscopic and histological abnormalities were found in both groups of patients. However, certain findings occurred more commonly in those with symptoms; severe and extensive hyperaemia, bile staining of the gastric mucus, and bile reflux seen on endoscopy were all significantly more common in those with symptoms than in those without. Active gastritis in the proximal stomach was also more common in those with symptoms. Gastritis of the stoma and antrum was found in 89% of all patients; as it was unconnected with symptoms it can be regarded as a "normal" finding. The incidences of contact bleeding, erosions, and oedema were not significantly different in the two groups.
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PMID:Symptomatic significance of gastric mucosal changes after surgery for peptic ulcer. 86 89

Chronic erosive gastritis (C.E.G.) is a gastric mucosal lesionwith characteristic radiological and endoscopic appearances. Pyloric gland hyperplasia is seen on histological examination of biopsy specimens. C.E.G. is uncommonly reported in the English literature. In reviewing 3,800 upper gastro-intestinal endoscopies from 1971--1976, 108 patients were diagnosed as having typical features of chronic erosive gastritis, an incidence of 2.8%. There was a significant association with duodenal ulceration and an overall male predominance. The lesion can also co-exist with gastric ulceration and has been observed as an incidental finding in patients examined urgently for upper gastro-intestinal bleeding. In this context C.E.G. should be distinguished from acute mucosal erosions. Symptoms may relate to the accompanying peptic ulceration, although dyspepsia epigastric pain, fullness and nausea may possibly occur with C.E.G. alone.
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PMID:Chronic erosive (verrucous) gastritis. A study of 108 patients. 89 82

Iceland (IS) and Denmark (DK) are ethnically, culturally, and economically closely related Nordic countries, but gastric cancer is much more frequent in Iceland, and other differences in the occurrence rates of gastric diseases are also suspected. Therefore a cooperative study was initiated comparing Icelandic and Danish patients with gastric ulcer (GU), duodenal ulcer (DU), and X-ray negative dyspepsia (XND) as regards clinical features, external factors of possible importance for gastritis and cancer, gastroscopic appearance, and histological gastric mucosal changes. The project lasted one year and comprised 93 Icelandic and 88 Danish patients. A large number of comparisons showed a high degree of similarity between Icelandic and Danish patients. Significant differences were found in tobacco consumption (DK greater than IS), duration of symptoms in XND (IS greater than DK), whereas the positon ratio of GU (IS less than DK) and acetylsalicylic acid consumption (DK greater than IS) showed non-significant trends. Significant difference was found between the occurrence of diffuse macroscopic changes of the gastric mucosa (IS greater than DK), which corresponds to the histological differences to be described in a subsequent article.
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PMID:A prospective comparative study of clinical and histological characteristics in Icelandic and Danish patients with gastric ulcer, duodenal ulcer, and X-ray negative dyspepsia. I. Design and clinical features. 92 8

A number of drugs are available that act fairly specifically as "mild" analgesics, although this description by no means implies that their clinical effectiveness is limited to the relief of slight pain and trivial disability. They are effective by mouth and their action is mediated peripherally. Among the possible mechanisms of action, the inhibition of prostaglandin synthesis is currently regarded as most likely to be relevant. Some centrally acting drugs of the narcotic analgesic type, such as codeine and dextropropoxyphene are effective orally; they are usable in the same way as other mild analgesics and may be preferable for some types of pain. Many problems arise in the assessment and comparison of mild analgesics, both experimentally and clinically. Subjective assessments may be made on a pain scale by the patient himself, or by a trained observer. Individual variations are all-important, and the limitations of controlled trials need to be remembered. Alternative drugs and mixtures have little advantage over aspirin, but specific drug tolerance, in the long term, varies from patient to patient. Gastric irritation is most likely to occur with aspirin in the presence of chronic dyspepsia or acute precipitating causes such as alchoholic gastritis. Allergy also occurs in some susceptible individuals. The risk of renal damage with phenacetin is increasingly appreciated, and the possibility of hepatic damage from paracetamol is now recognised. Other side-effects and interactions are summarized in the review, and some notes are given on therapeutic and non-therapeutic use.
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PMID:Simple analgesics. 110

This study has investigated the possible association between duodenogastric reflux, gastritis, and symptoms in 35 patients with or without dyspepsia one to 15 years after gastric surgery. Five patients were excluded because of biliary disease, hiatus hernia, or recurrent ulceration. The remaining 30 were assessed by a symptomatic score, measurement, of bilirubin and sodium concentrations in samples of fasting gastric juice, endoscopy, gastric biopsy, and the presence of radiological reflux. In 15 patients with a symptom score of less than the median, gastric bilirubin levels were less than 1 mg/100 ml in 80%; severe endoscopic changes were seen in only one patient and reflux was not observed. In contrast, in patients with a symptom score in excess of the median fluoroscopic and biochemical reflux was seen in 69 and 80% respectively and severe mucosal hyperaemia in half. There was a significant correlation between symptoms, gastric hyperaemia, and duodenal reflus ( P smaller than 0-02).
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PMID:Duodenogastric reflux: a cause of gastric mucosal hyperaemia and symptoms after operations for peptic ulceration. 114 Jun 22


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