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)

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

A small fraction of pancreatic cysts are neoplastic rather than inflammatory in origin. Failure to recognize the true nature of a neoplastic cyst will lead to an incorrect treatment strategy. This is a report of eight patients whose cystic neoplasms were misdiagnosed and maltreated. Five of the eight tumors proved to be malignant. Five were drained by anastomosis to a viscus and one by aspiration; drainage was recommended for the other two. Treatment by drainage led to complications (persistent painful gastric ulcer, infection in the cysts), growth of new cysts, no cures, but missed opportunities to cure cancer. Three patients with no metastases at first operation had metastatic spread to the liver, omentum, or lungs at reoperation. In three of the five cases initially treated by cystenterostomy (including one cancer), subsequent resection was possible and probably curative. One cystadenocarcinoma was watched for 3 years before apparently curative resection. Guidelines based on serum and cyst amylase levels, morphologic appearance, angiography, pancreatography, and biopsy are given for the purpose of differentiating inflammatory cysts from neoplastic cysts of the pancreas. Confusion of these entities should not occur, but errors can often be corrected.
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PMID:Cystic tumors mistaken for pancreatic pseudocysts. 356 76

In addition to housekeeping cyclooxygenase (COX)-1, which is constitutively expressed in many body cells, an inducible COX-2 has been described and cloned. Induction or presence of COX-2 has been reported not only in isolated cells, but also in cells in various tissues, as well as in both physiological and pathophysiological states, including acute exudative inflammation, proliferative inflammation, animal arthritis, rheumatoid arthritis, angiogenesis, bone absorption, gastric ulcer, colon cancer, hyperalgesia, Alzheimer's disease and certain states of the kidney, brain and female reproductive organs. This review article introduces results from recent works in these fields. COX-1- or COX-2-knockout mice may provide many clues on the roles of COX-2, but may simultaneously cause unnecessary confusion in the recognition of the roles of COX-2, and this is discussed. Recently the roles of COX-2 in exudative inflammation and the anti-inflammatory effects of selective COX-2 inhibitors have been questioned. This is discussed in the text. Prostanoids mediate signals to adjacent cells to provide fine regulation of cellular function. Because of the short duration of the expression of COX-2 gene and protein, COX-2 must play some roles different from those of COX-1 gene and protein in vivo. It is not yet possible to identify all the roles of COX-2, but in some tissues, such as the kidney, the brain and others, COX-2 may be expressed constitutively, whereas the prostaglandin generation by COX-2 may replace that by COX-1 in some states (or vice-versa). Precise analyses of the expression of COX-2 may disclose fine modulation of cellular and organ functions by PGs. Several selective or preferential COX-2 inhibitors have been developed and were shown to be effective in clinical trials. Most were reported to be free of adverse gastrointestinal effects, but it should be noted that in the healing process of gastric ulcers and in sodium-restricted states, adverse effects of selective COX-2 inhibitors could be expected. Soon, with more detailed knowledge of the delicate roles of COX-2 in vivo, effective and safe application of COX-2 inhibitors should be realized.
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PMID:Cyclooxygenase-2: its rich diversity of roles and possible application of its selective inhibitors. 1102 54