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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results from the dispensary follow-up and prophylactic treatment of 175 patients with gastric ulcer in the course of 3 to 7 years (62% of the patients 5 from to 7 years) are reported. Two thirds of the patients are enlisted in the dispensary system during the first year after the disease onset. The ulcer disappears in 53.57 per cent by the end of the third month from the beginning of the treatment and in 81.43 per cent during the first 6 months. By the end of the first year, the ulcer was not closed in 8.57 per cent of the patients, hence 14.85 per cent of them underwent an operation. Control examinations and prophylactic treatment were conducted at least twice a year (in spring and autumn) in the course of three months. Recidivations occur rarely in the systematically treated patients, as well as hemorrhage and perforation of the ulcer as compared with the control group without a systematic prophylactic treatment. During the follow up, malignant degeneration of the ulcer was found in 9 patients (5.14%), 7 out of them were operated (5 at a relatively early period with a survival of 5 years in 60%). In more than the half of the patients with malignant degeneration, the duration of the gastric ulcer was over 6 years. Both the gigantic and the ulcers with small dimensions could have a malignant degeneration. Cancer degenerated ulcer are more frequently localized in the horizontal part of the lesser and greater stomach curvatures and subcardially. With a view to the timely diagnosis of cancer degeneration of the ulcer, the patients are advised to keep the control examinations under dispensary conditions--clinically, at the laboratory and endoscopically-biopsy at least two times a year.
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PMID:[Dispensary observation and treatment of stomach ulcer patients]. 43 48

During the last years bile acids have gained more and more clinical importance. They play a decisive part in intestinal fat resorption. Increased bile acid content in the colon will result in diarrhea. By determination of serum bile acids the liver function can be judged exactly. It seems probable that bile acids take part in the pathogenesis of gastritis gastric ulcer and colonic cancer. By administration of chenodeoxycholic acid and ursodeoxycholic acid dissolution of cholesterol stones within the gall bladder is possible.
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PMID:[Clinical significance of bile acids]. 45 69

229 stomachs resected for duodenal and gastric ulcer and carcinoma were examined with special regard to the morphological and histochemical pattern of intestinal metaplasia (IM). The results of qualitative and semiquantitative studies were analysed statistically. Whereas duodenal and gastric ulcer cases are best discriminated by the presence or absence of IM, the strongest discriminating factor between carcinoma and gastric ulcer is the content of goblet cells in metaplastic crypts. Metaplastic crypts lined exclusively with goblet cells producing sulfated acid glycoproteins could be identified in more than one third of the cancer cases. The increase in goblet cells coincides with a loss of the more differentiated cells in the metaplastic glands, such as enterocytes, APUD cells, or Paneth cells. This "enterocoli metaplasia" seems to be specific for cancer bearing mucosa and occurs more often in cancer of intestinal type; it may represent a form of a derepressive dedifferentiation. The significance of enterocoli metaplasia as a premalignant lesion remains to be elucidated.
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PMID:Loss of differentiation in intestinal metaplasia in cancerous stomachs. A comparative morphologic study. 46 Dec 32

In histological examination of gastrectomy specimens from patients with duodenal ulcer, gastric ulcer, and early and advanced cancer, both chronic atrophic gastritis and intestinal metaplasia were identified in 54% of the cases with duodenal ulcer. At 90 to 100%, respectively, these mucosal changes were approximately twice as frequent with gastric ulcer and early and advanced gastric cancer. Mild dysplasia occurred in 54% of the cases with duodenal ulcer; occurred somewhat more frequently with gastric ulcer, in 75% of the cases; and in almost all cases with early and advanced gastric cancer, at 90% and 100%, respectively. Whereas 27% of the cases with duodenal ulcer, 62% with gastric ulcer, and 90% and 95% of the respective cases with early and advanced gastric cancer showed moderate dysplasia, only severe dysplasia in early gastric cancer (40%) and advanced gastric (81%) was clearly more frequent in comparison to duodenal ulcer (9%) and gastric ulcer (12%). In the cases with duodenal ulcer chronic atrophic gastritis and intestinal metaplasia were limited mostly to the antrum; with gastric ulcer and cancerous stomach disorders, they also occurred in other stomach sections. Mild and moderate dysplasia conformed to the same distribution pattern. Severe dysplasia, which was only detected in two ulcer cases, was not only substantially more frequent in cases with early and advanced gastric cancer, but also showed a clear topographic relationship to cancer localization in the stomach.
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PMID:Gastritis, intestinal metaplasia and dysplasia versus benign ulcer in stomach and duodenum and gastric carcinoma -- a histotopographical study. 46 Dec 33

Because of the higher risk of cancer in the gastric stump, an increased incidence of pre-cancerous conditions should be exspected also in the resected stomach. Therefore, a combined endoscopic and bioptic study was performed in order to investigate the incidence of dysplasias in the gastric stump after resection for benign conditions. Among 101 patients with gastric resection, 2 cases were excluded from this study because of preceeding gastric cancer and one because of cancer of the gastric stump. In 43 of the remaining 98 patients, a Billroth-I-resection (gastroduodenostomy) had been carried out. In the remaining 55 patients with a Billroth-II-resection (gastroenterostomy) 9 had an additional enteroanastomosis of Braun whereas in the residual 46 patients this enteroanastomosis was lacking. This distinction was made because of a facultative or obligatory bile reflux. The average age of the B-I-group was 68 years, of the B-II-group with enteroanastomosis 69 years, and the B-II-group without enteroanastomosis 62 years. A non-operated group matched for age served as control group. Biopsy particles from the anastomotic region were gained by endoscopy and cut in step sections. The classification of dysplasias (degree I-III) followed the criteria given by Nagayo as modified by Grundmann. Inflammatory reactive changes were separated from these. A few changes could not be classified definitely and were listed as unclassified dysplasia. While dysplastic changes of low degree were quite numerous in every group, the dysplasias of higher degree were only found in a small number of cases. In the 46 cases with B-II-resection without Braun's enteroanastomosis, there were 5 dysplasia II and 3 dysplasia II. In the 9 cases with B-II-resection and with Braun's enteroanastomosis, there was 1 dysplasia I and no dysplasia III. In the 43 patient with B-I-resection only 2 dysplasia II and no dysplasia III were found. In the control group of 98 patients matched for age there were only 5 cases with dysplasia I and 1 case with dysplasia III. Patients with higher degrees of dysplasia showed a higher age and a longer interval after operation. There was also a correlation between higher degrees of dysplasia and severe atrophic changes in the mucosa. Correlating the degree of dysplasia with the reason for gastric resection, most of the dysplastic changes occurred in patients resected for gastric ulcer, whereas cases resected for duodenal ulcer showed only 2 dysplasias I. The discussion refers to the few data about dysplasia of the gastric stump available from the literature. Atrophic and increased regenerative changes obviously play a role in the pathogenesis of these dysplastic changes. As a causative factor the role of bile reflux is discussed. A further diagnostic and therapeutic regimen for the different forms of dysplasia is proposed.
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PMID:Incidence of epithelial dysplasia after partial gastric resection. 46 Dec 34

It is generally accepted that the bile acids are responsible for pathologies as a result of deficiency or by toxic action. Quantitative deficiency is difficult to evaluate but the normal pool of bile acids is generally considered to be between 2 and4 grams. Daily loss and replacement by synthesis is thought to be between 500 and 700 mg. There is experimental evidence to demonstrate the toxic action of certain bile acids on metabolic structures and processes. There is no doubt that alterations in the metabolism of bile acids give rise to certain pathologic aspects in some diseases of the gastrointestinal tract or the hepatobiliary system. There are other conditions, on the other hand, in which the study of these acids may reveal significant physiopathologic implications. The first group includes terminal ileopathy, blind loop syndrome, gastric ulcer, gastritis, cholestasis, cirrhosis of the liver, and cholelithiasis. In the second group are such diverse conditions as acute pancreatitis, cancer of the colon, endocrine disturbances, some hyperlipidemias, and others. Much of the present day understanding of the physiopathology of the bile acids will probably have to be revised in the nex few years, in view of the rapid advances being made in this field.
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PMID:[Bile acids II. Physiopathologic and clinical aspects (author's transl)]. 47 Apr 97

One hundred and thirty-four lymph nodes from forty-seven patients with renal adenocarcinoma and the same number of regional nodes from sixty-one patients with gastric ulcer were ewwuated histologically by using the standardized reporting system introduced by Cottier, Turk & Sobin (1973). Special attention was focused on the morphologic features which correlate with the immunological responses of these lymph nodes. The cellular elements of the antibody response were found to be active more often in the ulcer series than in the cancer series. On the other hand, the constituents of the cell-mediated immune system were depressed more often in the nodes draining renal carcinomas. The significance of the different immune responses evoked by these two diseases is discussed and the conclusion is drawn that there is some degree of derangement of both humoral and cell-mediated immune systems in the regional lymph nodes of renal adenocarcinoma. The applicability of the reporting system used in assessing the morphology of human lymph nodes is to be emphasized.
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PMID:Morphology of the lymph nodes draining renal adenocarcinoma in relation to immunological functions. 48 69

The primary aim of the Japan--Hawaii Cancer Study was to identify factors that could explain the changes in cancer risk experienced by Japanese who migrated to Hawaii. Many investigations were conducted in this long-term prospective study since its inception in 1971. Among the findings that relate to gastrointestinal carcinoma were the following: 1) Bowel transit time does not appear to be related to the occurrence of large bowel cancer or to any of the benign conditions with which it is associated; 2) adenomatous and hyperplastic polyps, as well as diverticula, are much more prevalent among autopsy specimens from Japanese who had lived in Hawaii than of those in Japan; 3) adenomatous polyps and diverticula are positively associated with atherosclerosis in the necropsy population in Hawaii; 4) although the incidence of the diffuse histopathologic type of gastric cancer does not differ appreciably among the Japanese in Hawaii and Japan, the migrants have a significantly lower incidence of the intestinal type of stomach cancer; and 5) case-control studies indicated that the two conditions frequently associated with gastric carcinoma, i.e., gastric ulcer and intestinal metaplasia of the stomach, are associated with high salt intakes and adherence to the traditional Japanese diet.
Natl Cancer Inst Monogr 1977 Dec
PMID:Gastrointestinal carcinoma in the Japanese of Hawaii: a status report. 61 38

A long-term follow-up gastrocamera photographic study of 481 patients with gastric ulcer was conducted at intervals of 3 weeks to 6 months. It showed that gastric ulcers could remain healed for 2 months to 6 years of observation, yet, recurrence of ulceration occurred in 79% including 18% with multiple occurences. Gastric polyp developed in 8 patients whose initial gastrophotography showed no such lesion in the original study. Furthermore, 7 cancers of the stomach developed at sites away from the initial benign ulcer foci. Six of these cases proved to be mucosal cancer and one was an advanced cancer. In 5 of 7 cases of malignancy, the cancer occurred distal to the initial ulcer foci and anaplastic adenocarcinoma was seen in 3 of these. The others were well differentiated adenocarcinomas. No correlation was found among histopathological type of cancer, depth of malignant invasion, location of the new growth or gastric juice acidity in these 7 cases of malignancy. It is concluded that a thorough and routine gastroscopic examination is indicated for all sorts of gastric disorders whether they are initial or follow-up cases.
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PMID:Follow-up endoscopic study of gastric mucosal changes secondary to gastric ulcer. 63 Oct 93

Four cases of endoscopically proven gastroduodenal fistulae (double pyloric canal) are presented, and ten case reports in the literature are reviewed. The fistula develops from a penetrating gastric ulcer. Presumably, the ulcer becomes adherent to adjacent duodenum and penetrates further to establish a fistulous connection, which ultimately becomes lined with mucosa, creating a second pyloric canal. Fistulae between the lesser curve of the antrum and superior fornix of the duodenal bulb were the commonest (9 out of 14). Fistulae also form between the lesser curve of the body of the stomach and the duodenal bulb or fourth part of the duodenum. Gastro-gastric fistula and a fistula into the inferior fornix of the duodenal bulb from a pyloric ulcer have been described. In two of the four cases in this series fistulae had formed from the greater curve of the antrum to the inferior fornix of the duodenal bulb, an entity not previously described. Radiologic appearances may be confused with an antral carcinoma, an ulcerating carcinoma, Crohn's disease, or lymphoma. The presence of previous ulceration and evidence of scarring should aid in avoiding confusion with malignancy. The term gastroduodenal fistula is suggested to describe double pyloric canal.
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PMID:Gastroduodenal fistulae and double pyloric canal. 66 55


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