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

Patients with abdominal pain and no definite diagnosis referred for endoscopy were studied to define discriminating features in the history, and the value of a stool occult blood test, in predicting the presence of upper gastrointestinal disease. Endoscopy was performed in 116 patients; pathology was seen in 32 (duodenal ulcer 17, gastric carcinoma 4, gastric ulcer 3, miscellaneous 8) and no pathology was seen in 84 patients. Features that predicted upper gastrointestinal pathology were, in descending order of rank: a positive pointing sign, a positive stool Fecult test, a history of vomiting, loss of weight, and alcohol intake. Using these discriminating features together it was possible to correctly predict 95% of patients with abnormal endoscopy and 82% of patients with a normal endoscopy. The history and the stool occult blood test are useful predictors of the presence of upper gastrointestinal pathology and may aid rational selection of patients for endoscopy.
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PMID:Value of the history and stool occult blood test in selection of patients for upper endoscopy in Zimbabwe. 164 46

From May 1978 to December 1989, 54 patients with pancreatic carcinoma underwent electron beam intraoperative radiotherapy (IORT). Three died of preoperative complications within a month. In 19 patients, liver metastasis and/or peritoneal dissemination became obvious at laparotomy. They therefore underwent IORT with palliative intent. Relief of pain was obtained in 12 of the 14 patients with pain (85.7%), although three of them were treated in combination with splanchnic nerve block. Thirty-two patients with localized carcinoma underwent IORT with curative intent (total tumor resection in 6, partial resection in 6, and no tumor resection in 20). With additional IORT treatment, their survival was significantly (p less than 0.05 during the 18th month) longer than that of 40 patients without IORT (total tumor resection in 13, partial resection in 9, and no tumor resection in 18). Among the patients without tumor resection, the 20 patients who underwent IORT survived significantly (p less than 0.05 during the 7th month) longer than the 18 patients who did not. Twelve patients who underwent total pancreatectomy died earlier than the 23 patients treated with IORT in combination with partial tumor resection or no tumor resection (not significant). In 26 patients with partial tumor resection or no tumor resection, either additional external irradiation or IORT using a small field within a large field significantly (p less than 0.05 during the 7th and 8th month) improved survival compared with IORT using a single field. Of the 20 patients without tumor resection, relief from pain was obtained in 18 of 19 patients with pain (94.7%), although two of them were treated in combination with splanchnic nerve block. In terms of adverse effects possibly caused by IORT in 26 patients who survived longer than 6 months, gastrointestinal problems were serious in several (gastric ulcer in 2, duodenal stenosis in 1, gastric ulcer and duodenal stenosis in 1, and duodenal perforation and duodenal ulcer in 1). In conclusion, our experience suggests that IORT can relieve patients of serious pain and improve survival in patients with localized pancreatic carcinoma.
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PMID:[Intraoperative radiation therapy of carcinoma of the pancreas]. 168 93

Helicobacter pylori infection has been associated with gastritis, duodenal ulcer, gastric ulcer, and the epidemic form of gastric carcinoma. Eradication of H. pylori infection has proven to be difficult. Recently, combinations of antimicrobial drugs have been shown to eradicate greater than 50% of infections; however, the results have proven variable, and the factors influencing effectiveness of therapy are unclear. In the present study, the effectiveness of a triple therapy for eradication of H. pylori infection was evaluated. Triple therapy consisted of 2 g tetracycline, 750 mg metronidazole, and five or eight tablets of bismuth subsalicylate daily in 93 patients (70 with duodenal ulcer, 17 with gastric ulcer, and 6 with simple H. pylori gastritis). Combinations of a sensitive urea breath test, serology, culture, and histology were used to confirm the presence of infection, eradication, or relapse. Eradication was defined as inability to show H. pylori greater than or equal to 1 month after ending therapy. The overall eradication rate was 87%. The factors evaluated for their effect on predicting eradication included age, gender, type of disease, duration of therapy, amount of bismuth subsalicylate [five or eight Pepto-Bismol tablets daily (Procter & Gamble, Cincinnati, OH)], and compliance with the prescribed medications. Stepwise regression showed that compliance was the most important factor predicting success; the success rate was 96% for patients who took greater than 60% of the prescribed medications and 69% for patients who took less. For those taking greater than 60% of the prescribed therapy, the eradication rates were similar (a) for patients receiving therapy for 14 days or when tetracycline and bismuth subsalicylate were taken for an additional 14 days; (b) for patients with duodenal ulcer, gastric ulcer, and simple H. pylori gastritis; and (c) whether five or eight bismuth subsalicylate tablets were taken. It is concluded that triple therapy is effective for eradication of H. pylori and that future studies need to take compliance into account for comparisons between regimens.
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PMID:Factors influencing the eradication of Helicobacter pylori with triple therapy. 173 20

The main results of two-decade co-operation between Tartu University, Estonia, and the University of Helsinki, Oulu and Tampere in Finland on immunology of chronic gastritis are presented. These results include data on cell-mediated and humoral immunity to autoantigens from gastric antrum and corpus mucosa in chronic gastritis, gastric ulcer, gastric carcinoma and other gastric diseases, as well as in random samples from two populations.
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PMID:Autoimmune reactions to gastric mucosa in chronic gastritis: a review. 175 18

A new monoclonal antibody has been developed which is capable of detecting structures in gastric mucus glycoproteins expressed in the fetus and in adult gastric mucosa in conditions such as gastric carcinoma. Cancer associated monoclonal antibodies were selected by testing them against various mucous glycoprotein samples from the alimentary tract, including salivary glycoproteins from both secretory and non-secretory subjects, and cancerous and normal gastric juice glycoproteins. They were tested against 1000 samples of gastric juice from an unselected population. Immunochemical characterisation suggested that the glycoproteins picked up by P4 and i11 include one of the compounds reacting with rabbit anti-fetal sulphoglycoprotein antigen serum. On the basis of a clinical trial and immunohistological evaluation further evidence was obtained of P4 as the most promising antibody for further experimentation. A total of 302 gastric juice specimens from patients with various gastric symptoms were analysed using the enzyme linked immunosorbent assay technique and P4 antibody. Of 10 gastric cancers, nine had P4 in the gastric juice. A positive correlation was found between gastric ulcer and the appearance of P4. Duodenal ulcers were not correlated to P4. Atrophic gastritis and P4 coincided less frequently. Raised P4 values were found in between 3% and 9% of subjects, depending on the population. Cancer cases showed high P4 values, which allows adjustment of the lower limit of a positive result to high level whereby a considerable number of non-cancerous P4 positives are omitted.
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PMID:Gastric cancer associated structure in mucus glycoproteins shown as a clinically useful marker. 148 73

Helicobacter pylori is a microaerophilic, Gram-negative, spiral rod, the role of which in different gastric diseases has been investigated worldwide since the beginning of the 1980s. H. pylori has been shown to be the causative agent in active chronic gastritis, and it is regularly found in patients endoscopied for duodenal ulcer. The bacterium is also frequently isolated from persons with gastric ulcer, gastric carcinoma and non-ulcer dyspepsia. Apart from cultivation of the bacterium, other diagnostic procedures include various staining methods and urease tests of gastric biopsy samples. The application of non-invasive diagnostic methods, serology and urea breath tests, is rapidly increasing. H. pylori is susceptible to several antimicrobials in vitro, but eradication of the bacterium from the gastric mucosa is not always achieved. The best results until now have been obtained with the combined use of bismuth salts and two antibiotics. In active chronic gastritis and duodenal ulcer patients, eradication of the bacteria has resulted in healing of the disease with permanent decrease of circulating antibodies and negative urease tests. H. pylori has been found worldwide and the infection shows an age-dependent increase. Man, apparently, is the reservoir of the bacterium, but the exact mechanisms of interhuman transmission are still not defined.
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PMID:Helicobacter pylori and associated gastroduodenal diseases. Review article. 185 43

Helicobacter pylori attracted widespread interest from gastroenterologists because of its potential aetiologic role in disorders of the upper gastrointestinal tract. Based on extensive microbiological studies, Campylobacter pylori was renamed Helicobacter pylori, and the organism represents a new genus of bacteria. It is generally accepted that H. pylori causes chronic, non-specific gastritis (type B gastritis). The inflammatory response occurs even though the bacterium does not penetrate the gastric epithelium; it is found on the surface of and adjacent to the epithelium. The clinical significance of histological gastritis is unknown. The bacterium is often found in asymptomatic subjects. In Caucasian adults, the prevalence of infection increases with increasing age. Higher rates of infection are found in blacks and Hispanics than would be expected for their age. Whether these different rates are the result of racial or socioeconomic factors is not known. It is theorized, but not proven, that high rates of infection with H. pylori at an early age may explain the high incidence of gastric carcinoma found in Hispanic populations. H. pylori is found in almost every patient with duodenal ulcer disease, although no direct evidence for a causal relationship exists. Indirect evidence is based on the findings that if H. pylori infection is eradicated, ulcer recurrence is less likely (up to one year of follow-up). A small percentage of patients have a relapse despite eradication of the organism, suggesting a role for other factors in duodenal ulcer disease. The role of H. pylori in gastric ulcer disease is unknown. Seventy to eighty per cent of patients with gastric ulcer have evidence of H. pylori infection, and preliminary data seem to support the existence of two distinct aetiologic groups: those with gastric ulcers related to H. pylori infection and those with gastric ulcers related to use of non-steroidal anti-inflammatory drugs. The role of H. pylori in non-ulcer dyspepsia is unknown. Some clinicians believe that H. pylori causes non-ulcer dyspepsia and treat these patients for H. pylori infection. However, the data supporting this practice are poor. Treatment is only recommended for patients with resistant duodenal ulcers and patients who have frequent relapses of duodenal ulcers and who are willing to take triple-drug therapy (bismuth compounds, metronidazole, tetracycline) for the infection. As 95% of patients with duodenal ulcer have evidence of H. pylori infection, there is probably little need to confirm the diagnosis of H. pylori infection.
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PMID:Helicobacter pylori: review of research findings. 188 32

Within the past decade, there has been an explosion of investigative activity and publications about Helicobacter pylori (H. pylori). Its role in gastroduodenal disease is becoming greater with definite etiologic association in chronic type B gastritis and a probable role in duodenal ulcer, a probable role in gastric ulcer, and possibly a factor in the development of interstitial type gastric carcinoma. Epidemiologic studies have shown H. pylori to be worldwide in distribution with higher prevalence rates and earlier initial infection rates in developing countries compared with industrialized nations. Person-to-person transmission appears to occur via the fecal-oral route. Pathogenesis of H. pylori-associated diseases remains unclear. We are, however, gaining insights into the role that H. pylori extracellular products play in damage to mucin and gastric epithelial cells as well as other gastroduodenal physiologic processes. Antimicrobial treatment, when effective, produces remission of mucosal pathologic changes and reduces duodenal recurrence rates. A major as yet unsolved problem is that there is no completely effective treatment regimen that consistently eradicates H. pylori in infected patients. Concepts of pathogenesis and future directions of research are discussed.
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PMID:Helicobacter pylori: current perspectives. 194 Jan 86

The aim of this work was to study the relationship between intestinal metaplasia and dysplasia in gastric ulcers and their tissue repair in 223 patients with 236 gastric ulcers found endoscopically and treated with H2 blockers. The average duration of follow-up for the men was 32.4 months (range, 12-87 months) and for the women 42.5 months (range, 12-88 months). In 112 patients (50.2%) with 118 gastric ulcers, intestinal metaplasia in the different types was observed. The data obtained allow us to state that severe dysplasia and gastric cancer can occur only in a restricted number of patients with intestinal metaplasia in gastric ulcers and/or gastric ulcer tissue repair (two in our study, more than 60 yr old), and only in the forms with sulphomucins, more precisely type III. In relation to the fact that gastric ulcers rarely become carcinoma, the intestinal metaplasia frequently observed should not be considered "precancerous", as such, but could become so in the presence of several factors which, excluding age, did not emerge from our study.
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PMID:Intestinal metaplasia and dysplasia in gastric ulcer and its tissue repair. 197 92

One hundred and fifty-five patients aged 75 years and over with gastrointestinal haemorrhage were studied and compared with a series of patients aged under 75 years. The mortality in patients with gastric ulcer or gastric carcinoma was not affected by age. However, the mortality in patients with duodenal ulcer was greater in the over-75s (8/31 deaths in the over-75s, 4/77 deaths in the under-75s, P = 0.01). There was no reluctance to operate on the over-75s. These results can be used to help construct future trials to improve treatment.
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PMID:Causes and mortality in patients aged over 75 years with gastrointestinal haemorrhage. 186 62


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