Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

N-Methyl-N-nitro-N'-nitrosoguanidine (MNNG) is a gastric carcinogen in several animal species and has been used in a number of systems to dissect the co-carcinogenic potential of various compounds in the induction of gastric adenocarcinoma. Recent epidemiological evidence suggests that Helicobacter pylori may play a role as a co-carcinogen in the etiology of this tumor in humans and we have been interested in developing an animal model to study this possibility. A related organism, H. mustelae, naturally colonizes the ferret stomach and causes persistent chronic gastritis. The pathology elicited by H. mustelae in ferrets has many similarities with the human disease including different stages of multifocal atrophic gastritis which underlie the gastric ulcer and gastric carcinoma syndrome. There is little evidence, however, demonstrating the susceptibility of ferrets toward chemical carcinogenesis. We have consequently undertaken a study to ascertain whether 10 6-month-old female ferrets given a single oral dose of MNNG (50-100 mg/kg) would develop adenocarcinoma of the stomach. Five age-matched unmanipulated control animals were included for comparative purposes. All 15 ferrets were infected with H. mustelae. Nine of 10 ferrets dosed with MNNG developed gastric adenocarcinoma (29-55 months after dosing), while none of the five historical control ferrets examined an average of 63 months after the initiation of the study developed gastric tumors. By comparison, we have not observed gastric adenocarcinoma, nor has it been reported, in > 10 years of observation of untreated ferrets naturally infected with H. mustelae. The H. mustelae-infected ferret, with demonstrated susceptibility to a gastric carcinogen, plus the recent availability of specific pathogen-free ferrets, should now allow longitudinal studies in vivo to probe the role of Helicobacter in the development of gastric cancer.
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PMID:MNNG-induced gastric carcinoma in ferrets infected with Helicobacter mustelae. 840 24

During a time when gastric cancer in the United States appears to be decreasing in incidence and occurring primarily in older individuals, a 12-year review of our experience (1977 to 1989) has identified a disproportionate number of gastric cancers in the young black population. In this series of 97 patients with gastric adenocarcinoma, the mean age at diagnosis was 58 years (range, 22 to 84 years). There were 54 men (56%) and 43 women; 78 (80%) were black, 17 (18%) were white, one was American Indian, and one was Mexican. Fifty-two patients (54%) had stage IV disease at the time of presentation. Fifty-two patients (54%) were less than 60 years old at diagnosis; 45 (86%) of these were black men. We do not know the reason for this unusual age distribution, but a combination of environmental factors or an unusually susceptible population may be involved. Identification of a gastric ulcer in this cohort warrants careful follow-up and appropriate treatment.
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PMID:Gastric carcinoma among younger individuals in Mississippi. 845 69

From October 1991 to July 1992, endoscopic ultrasound examination (EUS) was performed preoperatively in 30 patients with gastrointestinal disease with a new forward-view fiber optic gastroscope with a 5 and 7.5 MHz curved-array linear transducer mounted directly behind the lens. Before EUS examination, endoscopy with biopsy had established the diagnosis of gastric disease in 22 cases: 16 adenocarcinoma, 4 lymphoma, 1 carcinoid tumor and 1 gastric metastasis of a chorionic tumor. In the 8 other cases, endoscopic diagnosis with non productive biopsy was gastric ulcer (1 case), submucosal tumor (5 cases), and large fold gastritis (2 cases). EUS established a correct diagnosis in 6 of these 8 cases (2 leiomyoma, 1 lipoma, 1 lymphoma, 2 gastric linitis). Correct preoperative TN staging was accomplished by EUS in 83.3% and correct preoperative staging for N was accomplished by EUS in 90%. This study shows that EUS a curved-array transducer is useful in preoperative TN staging of gastric tumors.
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PMID:[Electronic sectorial ultrasound endoscopy in benign and malignant tumoral pathology of the stomach. Results in 30 patients]. 846 67

Gastric malignancy was the cause of bleeding in 35 of a consecutive series of 2260 cases (1.5%) treated with upper gastrointestinal haemorrhage. Fifteen patients came to emergency surgery (43%). In 13 of 30 early endoscopies performed the lesion was thought to be benign (43%) and seven of these cases came to emergency surgery. Two patients died after 15 emergency operations (13%) compared with 15 deaths after 109 emergency operations (14%) for benign gastric ulcer during the same period of study. A total of four patients with malignant ulceration died after surgery in 33 cases (12%), two after 15 emergency operations and two after 18 elective procedures. The only significant predictors of urgent surgery for malignant ulcer were shock on admission and active bleeding or visible vessel on endoscopy. Resection of gastric malignancy was performed in 29 patients during initial admission and in four cases at a subsequent admission giving a final resection rate of 91%. Of the 28 patients with adenocarcinoma, 19 had localized disease (Stage I or II) (68%). Nine patients were treated by total gastrectomy, five at an initial elective procedure and four at a second procedure.
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PMID:Management of acute bleeding gastric malignancy. 849 15

As for precancerous lesion of the stomach detail analysis of endoscopic follow-up cases and histopathological investigations brought some new informations on its carcinogenesis. In this paper recent several reports were introduced and discussed on new opinion of precancerous conditions such as adenoma, intestinal metaplasia, gastric ulcer, remnant stomach and H. pylori. Gastric adenoma was considered to be neoplastic because of high incidence of carcinoma in situ. The stomach coexisted with adenoma showed high percentage of new arising tumor in same stomach and therefore, we can say that these are thought to be high risk group for well differentiated adenocarcinoma. Concerning the relation between intestinal metaplasia and gastric cancer we have never obtained final conclusion. However, it is likely that incomplete type of intestinal metaplasia appeared to be coexistent with gastric cancer, especially intestinal type carcinoma, which was thought to be paracancerous lesions. Recent advance of molecular biology has indicated new knowledge on gastric carcinogenesis, suggestive of multistep pathways. According to their reports, genomic instanbility appeared frequently in gastric adenoma and intestinal metaplasia as well as gastric carcinoma. Gastric carcinogenesis for ulcer, remnant stomach and H. pylori was also discussed. In near future the mechanism of gastric carcinogenesis is expected to be solved from view point of genetic events.
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PMID:[New concepts on precancerous lesions of the stomach]. 860 11

Non-invasive diagnosis of gastric adenocarcinoma (GAC) is usually difficult due to the low sensitivity and specificity of serologic markers,including pepsinogens and gastrin. For the improvement of the diagnostic values of these markers, a "recursive partitioning and amalgamation" algorithm was employed to construct a decision protocol. A total of 636 subjects including 161 healthy subjects, 163 patients with GAC, 196 with gastric ulcer and 116 with duodenal ulcer were enrolled. Serum levels of gastrin, pepsinogen I, pepsinogen II, and the ratio of pepsinogen I / pepsinogen II were determined for each of the subjects. The proposed "decision tree" classifies subjects into five subgroups with different risks of GAC and peptic ulcer, based on the information of age, serum pepsinogen and gastrin levels. Using this novel analysis system, an expected probability of GAC or ulcers could be obtained. Patients with an age > 62 years and a serum level of pepsinogen I < or = 33 ng/ml were strongly indicated for further confirmatory tests of GAC. This treestructured analysis is also helpful in clarifying the interactions between various serologic markers and demographic factors.
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PMID:A novel tree-structured analysis for non-invasive diagnosis of gastric adenocarcinoma. 866 56

The possibility of using [18F] FDG PET for assessment of tumor extension in primary gastric non-Hodgkin's lymphoma (NHL) was studied in 8 patients (6 high-grade and 2 low-grade, one of the MALT type) and in a control group of 7 patients (5 patients with NHL without clinical signs of gastric involvement, 1 patient with NHL and benign gastric ulcer and 1 patient with adenocarcinoma of the stomach). All patients with gastric NHL and the two with benign gastric ulcer and adenocarcinoma, respectively, underwent endoscopy including multiple biopsies for histopathological diagnosis. All patients with high-grade and one of the two with low-grade NHL and the patient with adenocarcinoma displayed high gastric uptake of [18F] FDG corresponding to the pathological findings at endoscopy and/or CT. No pathological tracer uptake was seen in the patient with low-grade gastric NHL of the MALT type. In 6/8 patients with gastric NHL, [18F] FDG PET demonstrated larger tumor extension in the stomach than was found at endoscopy, and there was high tracer uptake in the stomach in two patients who were evaluated as normal on CT. [18F] FDG PET correctly excluded gastric NHL in the patient with a benign gastric ulcer and in the patients with NHL without clinical signs of gastric involvement. Although the experience is as yet limited, [18F] FDG PET affords a novel possibility for evaluation of gastric NHL and would seem valuable as a complement to endoscopy and CT in selected patients, where the technique can yield additional information decisive for the choice of therapy.
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PMID:[18F] FDG PET in gastric non-Hodgkin's lymphoma. 940 47

Over a 5-year period, 6 patients with potentially resectable (cT2) pancreatic adenocarcinoma underwent exclusive radiotherapy. Surgery was ruled out because of the patients' age (> 75 years) in 5 cases and for contraindication for anesthesia in the remaining one. Four patients underwent intraluminal brachytherapy (50 Gy) with linear 192Ir sources; the remaining two underwent concomitant radiochemotherapy (39.6 and 50.4 Gy respectively) followed by a boost dose (50 and 20 Gy respectively) of intraluminal brachytherapy. All patients completed the treatment without relevant acute side-effects. One patient undergoing combined treatment showed gastric ulcer 8 months after treatment. Two patients showed local progression of the disease and two distant metastases. In one of the two patients with local progression, digestive by-pass was required. All patients died. Median survival was of 14 months. Actuarial survival at 1, 2 and 3 years was 66%, 33% and 16% respectively. No patient showed pain during follow-up. The fairly good quality of life observed in these patients undergoing conservative treatment and the rate of survival, comparable with that of surgical series, suggest that irradiation should be considered in those patients in whom radical surgery in contraindicated.
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PMID:Organ preservation in the management of pancreatic cancer. 944 55

Helicobacter pylori infection is a common infection in Singapore affecting about 31% of the population. The seroprevalence of H. pylori infection increases with age from 3% in children below 5 years to 71% in adults above 65 years. Amongst the races, Chinese and Indians had similar rates of seropositivity (34.3% and 33.6%) while in Malays it was significantly lower (13.7%; P < 0.05). H. pylori infection is associated with peptic ulcer disease (both duodenal and gastric ulcer) as well as gastric cancer [adenocarcinoma, early gastric cancer and mucosa-associated lymphoma of T cell type (MALT) lymphoma]. Its role in non-ulcer dyspepsia is controversial. H. pylori was found in 31% of non-ulcer dyspepsia patients in Singapore compared with 28% in normal healthy controls. Gastric emptying test using indigestible solids shows that gastroparesis per se, H. pylori in the presence of gastroparesis (but not H. pylori alone) are related to dyspeptic symptom. H. pylori plays a synergistic role with non-steroidal anti-inflammatory drugs (NSAIDs) in causing bleeding in gastric ulcer but not in duodenal ulcer. Invasive and non-invasive methods are available for diagnosis of H. pylori and should be used to establish the aetiology of gastro-duodenal disease. Currently two groups of therapeutic regimes with eradication rates of 90% are available: bismuth containing regimes and proton-pump inhibitors based regimes. Triple therapy for one week (using three drugs effective against H. pylori) is currently the treatment of choice.
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PMID:Helicobacter pylori infection--current status in Singapore. 949 71

Proton pump inhibitors (PPIs) are drugs which irreversibly inhibit proton pump (H+/K+ ATPase) function and are the most potent gastric acid-suppressing agents in clinical use. There is now a substantial body of evidence showing improved efficacy of PPIs over the histamine H2 receptor antagonists and other drugs in acid-related disorders. Omeprazole 20 mg/day, lansoprazole 30 mg/day, pantoprazole 40 mg/day or rabeprazole 20 mg/day for 2 to 4 weeks are more effective than standard doses of H2-receptor antagonists in healing duodenal and gastric ulcers. Patients with gastric ulcers should receive standard doses of PPIs as for duodenal ulcers but for a longer time period (4 to 8 weeks). There is no conclusive evidence to support the use of a particular PPI over another for either duodenal or gastric ulcer healing. For Helicobacter pylori-positive duodenal ulceration, a combination of a PPI and 2 antibacterials will eradicate H. pylori in over 90% of cases and significantly reduce ulcer recurrence. Patients with H. pylori-positive gastric ulcers should be managed similarly. PPIs also have efficacy advantages over ranitidine and misoprostol and are better tolerated than misoprostol in patients taking nonsteroidal anti-inflammatory drugs (NSAIDs). In endoscopically proven gastro-oesophageal reflux disease, standard daily doses of the PPIs are more effective than H2-receptor antagonists for healing, and patients should receive a 4 to 8 week course of treatment. For severe reflux, with ulceration and/or stricture formation, a higher dose regimen (omeprazole 40 mg, lansoprazole 60 mg, pantoprazole 80 mg or rabeprazole 40 mg daily) appears to yield better healing rates. There is little evidence that PPIs lead to resolution of Barrett's oesophagus or a reduction of subsequent adenocarcinoma development, but PPIs are indicated in healing of any associated ulceration. In Zollinger-Ellison syndrome, PPIs have become the treatment of choice for the management of gastric acid hypersecretion.
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PMID:Proton pump inhibitors. Pharmacology and rationale for use in gastrointestinal disorders. 977 9


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