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

This is the report of the presence of a benign gastric ulcer in a patient with achlorhydria and documented pernicious anemia. The pernicious anemia was established by a Histalog-fast achlorhydria, a Schilling test of 2.1% excretion of tagges vitamin B12 in a 24-hr urine, and reticulocytosis after administration of cyanocobalamine. Following Histalog (1.5 mg per kg of body weight), the gastric volume was 40 ml, there was no acid, and the pH was 8.1. The ulcer demonstrated by gastroscopy was confirmed at gastrectomy. Histological examination of the ulcer and the remainder of the stomach showed no malignancy. The principal conclusion of this paper is that the patient did not have an acid-produced ulcer, but that bile regurgitation coupled with alcohol ingestion produced the lesion. Surgical investigation of the ulcer seemed mandatory because of the known increased incidence of gastric carcinoma in patients with pernicious anemia.
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PMID:Benign gastric ulcer in a patient with pernicious anemia. 115 91

Forty-nine patients undergoing elective or emergent gastric surgery have been included in this study. Gastric needle aspiration was performed at the time of surgery in each case, followed by qualitative aerobic and anaerobic bacteriologic analysis. In 18 patients undergoing elective operation for chronic nonobstructing duodenal ulcer a gastric microflora was present in only three patients and no postoperative wound infections were observed. In 29 of 31 patients, in the other groups of patients with bleeding or obstructing duodenal ulcer or in those with gastric ulcer or malignancy, intragastric micro-organisms were present. Six of the 7 postoperative wound infections which developed in these groups of patients were due to one of the same bacteria isolated at the time of original needle aspiration. It appears that the endogenous intragastric microflora is a significant factor in the development of postoperative wound sepsis following gastric resection, in those groups of patients with a compromise of their normal gastric antibacterial inhibitory mechanisms.
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PMID:Intragastric microbial colonization in common disease states of the stomach and duodenum. 119 Aug 60

About 5--10% of the gastric carcinomas develop from a gastric ulcer (ulcerocancer). This process, however, is, referred to gastric ulcers, too rare to indicate a prophylactic resection of the stomach on account of the danger of the development of cancer. Careful diagnostics and following control with X-ray examination and gastroscopy are, however, necessary in every gastric ulcer. The retrogression of the complaints neither proves healing of the ulcer nor benignity of the ulcer. Compared with the ulcerocarcinoma the differential diagnosis of the gastric ulcer is easy when locally advanced, patelliform carcinomas are in question. It is difficult in small carcinomas and especially in the carcinoma of the mucous membrane of type III. Individual radiologic and endoscopic signs and especially their combination are useful for the differentiation, but they may be misleading. A carcinomatous ulcer may radiologically and endoscopically look like a peptic ulcer and may apparently also fully heal. Therefore, a certain differential diagnosis is only possible with the help of an aimed biopsy of the stomach or the cytodiagnostics. The two methods serve further propagation. They should be used in every case, when an apparantly benign ulcer does not reveal a clear retrogression under effective treatment with carbenoxolone within four weeks. The examination of the gastric juice may be used for the differential diagnosis.
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PMID:[Stomach ulcer and stomach cancer]. 120 73

The course reviews the present status in the field of Vagotomy with reference to pathophysiology, gastrin release, anatomy, neural changes in the antrum, acid secretion, GI hormones, gastric motility, pepsin concentration, mucus production, O2 tension in the gastric mucosa, changes in the numbers of parietal cells, glucose tolerance, indications, diagnosis, necessity for drainage, acute complications, exclusion of malignancy in gastric ulcer; technique, intraoperative tests, results with TV, SV with antrectomy, recurrences, SPV and pyroplasty (controlled study), training. Nonresecting surgery of GDU is possible if vagotomy (SPV) and drainage (pyloroplasty) are correctly combined.
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PMID:[Vagotomy (author's transl)]. 120 35

Of 701 patients with gastric ulcers admitted to hospital within the period 1955-64, 180 died within a five-year period calculated from the time of admission. Causes of death were established at autopsy in 66%, and otherwise were derived from death certificates. The mortality in our series is grouped after the sex and age of the patients, and the causes of death are compared with the corresponding sex and age groups of the Copenhagen population. Mortality was significantly higher than expected in both men and women, particularly high in the first year after actual admission, but falling thereafter to about the same level as the expected mortality. Gastric ulcer itself was the most usual cause of death, but other disease was also significant. Thus mortality from suicide was significantly higher than expected in women. That there is a relationship between operation and suicide seems unlikely--all concerned had psychiatric histories. In men, pulmonary disease involved a significantly higher mortality than expected, and some connection between ulcer disease and pulmonary disease seems possible. If patients dying from cancer of the stomach within a two-year period are excluded, mortality from this disease was not significantly higher than expected. Thus the study gives no support to that theory that benign gastric ulcers are prone to malignant degeneration.
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PMID:Causes of death in patients with gastric ulcers. 121 Oct 40

A controlled prospective study was undertaken to determine if fluids which bathe malignancies may contain carcinoembryonic antigen (CEA) earlier in the course of gastrointestinal cancer than does plasma of the same patient and may offer a better means for diagnosis. CEA titers were normal (less than 2.5 ng per ml) in the plasma of 42 healthy volunteers. Normal CEA levels were also found in the plasma and in the colonic mucus of 14, the gastric juice of 18, duodenal drainage of 10, and bile of 11 normal control subjects. The colonic mucus of 3 patients with ulcerative colitis, gastric secretions of 5 benign gastric ulcer patients, bile specimens from 11 normal control subjects and from 5 gallstone patients contained CEA at concentrations below 2.5 ng per ml. Positive CEA titers were found in the fluids bathing tumors of all 23 patients with colonic carcinoma, 9 of 17 patients with gastric carcinoma, and all 6 patients with pancreatic carcinoma. In contrast, positive CEA titers were found in the plasma of only 16 of 23 patients with colon carcinoma, 6 of 17 patients with gastric carcinoma, and 4 of 6 patients with pancreatic carcinoma. Among 46 patients with gastrointestinal malignancies, CEA was detected in significant concentrations in the plasma of 26 patients and in fluids bathing tumors of 38 patients. These results indicate a significant association of adenocarcinoma of the colon with CEA-positive colonic mucus (P less than 0.01) and suggest the usefulness of assaying CEA in fluids bathing tumors for the detection of gastrointestinal malignancies.
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PMID:CEA levels in fluids bathing gastrointestinal tumors. 125 36

A total of 36 patients with advanced non-small-cell lung cancer (NSCLC) were treated with a combination of 5-day continuous i.v. infusion of cisplatin (25 mg/m2 daily), bolus infusion of vindesine (3 mg/m2) on days 1 and 8, and s.c. injection of recombinant human granulocyte-colony-stimulating factor (2 micrograms/kg daily) on days 6-21. Treatment was repeated every 3-4 weeks. Responding patients with stage IIIA or IIIB disease received chest radiation therapy (50-60 Gy) after this treatment. One complete response and 23 partial responses were observed, for an overall response rate of 66.7% (24/36; 95% confidence limits, 51.3%-82.1%). The median duration of response was 5.7 months and the median overall survival was 10.1 months. WHO grade 3 or 4 leukopenia and neutropenia occurred in 22 (61%) and 27 (75%) patients, respectively, but the mean duration of leukopenia (< 2,000/mm3) and neutropenia (< 1,000/mm3) was 3.4 and 3.5 days, respectively, and there was no instance of life-threatening infection. Thrombocytopenia and anemia of grade 3 or 4 occurred in 28% and 36% of our subjects, respectively. Grade 2 nausea and vomiting occurred in 47% of the patients. Elevated serum creatinine levels (> 1.5 mg/dl) were observed in 3 (8%) of the 36 patients. One patient died of acute renal failure induced by hemorrhage of a gastric ulcer. This regimen is effective in the treatment of NSCLC and further studies of this combination are warranted.
Cancer Chemother Pharmacol 1992
PMID:Phase II study of cisplatin as a 5-day continuous infusion with vindesine plus recombinant human granulocyte-colony-stimulating factor in the treatment of advanced non-small-cell lung cancer. 128 May 37

The authors analyse the specific features of the clinical picture, diagnosis, pathomorphological changes and surgical treatment in 52 patients with gastric ulcer which underwent malignant degeneration. It is noted that malignancy occurs most frequently in close vicinity to the ulcerative defect and rarely in the mucosa beyond the ulcer. The morphostructural reorganizations are determined to a certain degree by the peculiarities of extension of the tumor along the mucosa and the organ as a whole. The authors discuss the principles of the choice of the method for treatment according to the findings of pathomorphological examination of biopsy material and the results of emergency intraoperative examination. Even if the merest suspicion of malignancy of the ulcer arises, the operation should be conducted with observance of all oncological principles. Postoperative mortality was 3.8%, complications occurred in 7.7% of cases. Five-year survival was 84.6% in the absence of metastases and the presence of carcinoma cells within the limits of the mucosa and 12.5% among cases in which metastases were found during the operation. Attention is drawn to the principles of regular medical surveillance over patients receiving nonoperative treatment for gastric ulcer.
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PMID:[The surgical treatment of malignant stomach ulcers]. 143 65

The relation of atrophic gastritis, other gastric lesions and lifestyle factors to stomach cancer risk was prospectively studied among 3,914 subjects who underwent gastroscopic examination and responded to a questionnaire survey at the Aichi Cancer Center Hospital. During 4.4 years of follow-up on average, 45 incident cases of stomach cancer were identified at least three months after the initial examination. If the baseline endoscopic findings indicated the presence of atrophic gastritis, the risk of developing stomach cancer was increased 5.73-fold, compared with no indication at the baseline. The risk further increased with advancing degree of atrophy and increasing extension of atrophy on the lesser curvature. These trends in the relative risks were statistically significant (P = 0.027 and P = 0.041, respectively). The risk of developing stomach cancer was statistically significantly increased among subjects with gastric polyps, but not among those with gastric ulcer. Stomach cancer cases tended to consume more cigarettes, alcohol, rice, pickles and salted fish gut/cod roe and less fruits and vegetables and to have more family histories of stomach cancer than noncases, although these differences were not statistically significant. The results of the present study provide additional evidence on the relation between atrophic gastritis and stomach cancer and suggest a need for intensive follow-up of patients with atrophic gastritis and gastric polyps.
Jpn J Cancer Res 1992 Nov
PMID:A prospective study of atrophic gastritis and stomach cancer risk. 148 28

A 10-year experience with 2,441 patients over 65 years of age undergoing operations for non-upper gastrointestinal tracts was reviewed to evaluate both the incidence of postoperative upper gastrointestinal bleeding and the clinical risk factors associated with the complication. A total of 18 (0.7%, 7 males and 11 females) patients had overt postoperative upper gastrointestinal bleeding of non-variceal origin documented by endoscopic findings or blood transfusions. Of these, the complication developed in 10 (1.5%) of 646 patients after an operation for biliary or pancreatic disease, 1 (1.5%) of 64 for aneurysmal or obstructive arterial disease, 5 (1.1%) of 43 for colorectal cancer and 2 (0.3%) of 916 for hernia. The incidences of bleeding after an operation for obstructive jaundice (3.8%), for biliary or pancreatic malignancy (4.5%), and of unavoidable diversion colostomy for colorectal anastomosis (3.1%) were significantly higher than for non-jaundice (0.6%), for non-malignancy (1.1%) and of postoperative upper gastrointestinal bleeding in the present study. The origins of bleeding were gastric ulcer in 11, acute gastric mucosal lesion in 4, duodenal ulcer in 1 and other in 2. All cases of bleeding were treated and met success in hemostasis using H2-blockers. Of these, however, 5 patients died of multiple organ failure despite discontinued hemorrhage, prophylactic use of H2-blockers showed a decrease in occurrence of postoperative upper gastrointestinal bleeding in the present study.
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PMID:[Post operative upper gastrointestinal bleeding in the aged]. 149 79


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