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

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

Based on own experience and on the published literature we report about indications and efficiency of endosonography (EUS) in gastric tumors. The following conclusions can be drawn at the present time. Submucous tumors can be clearly differentiated from extragastric compressions. Although the endosonographic aspect does not allow to formulate an etiologic diagnosis, EUS findings can give hints regarding the nature of the submucous tumor (e.g. leiomyoma, lipoma, cyst). In 75% of cases malignant submucous tumors can be visualized and a correct preoperative staging can be performed. EUS is of special importance in the description of gastric carcinoma. The pT stage can be correctly determined preoperatively in about 80% (69-92%) of cases. Accompanying inflammation in early gastric cancer can lead to overstaging. The sensitivity for local lymph node metastases reaches about 77% (50-88%). Gastric non-Hodgkin lymphomas can be excellently visualized with EUS. The sensitivity amounts to 90-100% and in about 90% of cases the extent of the tumor can be correctly determined preoperatively. The response to radio-chemotherapy of gastric non-Hodgkin lymphomas can be monitored easily with the method. At the present time EUS is the most sensitive imaging tool in visualizing and staging of gastric tumors. Its main advantage is the exact demonstration of intramural and paragastric alterations. However, despite the use of high ultrasonic frequencies and the excellent demonstration of even tiny details with EUS, biopsies for histologic evaluation are still mandatory, especially when dealing with gastric ulcer.
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PMID:[Endosonography of stomach tumors]. 147 65

A case of occult gastrointestinal bleeding due to jejunal metastases of a primary lung carcinoma in a 53-year-old man is reported. When after healing of a large gastric ulcer melena persisted, a subsequently performed double contrast enema of the small bowel revealed evidence of several jejunal tumors. This was confirmed by angiography of the superior mesenteric artery and computed tomography of the abdomen. After resection of the tumor-bearing jejunal loop, histological evaluation revealed metastases secondary to a large-cell bronchogenic carcinoma which had been resected 1 year previously.
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PMID:A rare source of occult gastrointestinal bleeding: jejunal filiae secondary to metastatic lung carcinoma. 301 40

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

The authors present data of the clinical X-ray and morphological diagnostics of malignant gastric ulcers revealed in 96 patients. The total number of patients with gastric ulcer operated upon was 642. The morphological findings may serve the only reliable criterium of malignancy. Results of the operative treatment of such a malignant ulcer of the stomach are dependent on the spread of malignant invasion in the gastric wall. Treatment of patients with the involved mucosa only gave 5-year survival in 89.5%. Spread of the malignant invasion throughout the whole thickness of the gastric wall--50.0%. In patients with metastases into lymph nodes (independent of the invasion into the gastric wall) 5-year survival made up 29.4%.
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PMID:[Malignant stomach ulcer]. 367 28

The content of T- and B-lymphocytes was studied in the blood of 72 patients with gastric ulcer and carcinoma. The amount of complete T- and B-lymphocytes and incomplete B-lymphocytes was found to dramatically decrease in patients with peptic ulcer and gastric carcinoma with distant metastases. The authors believe that the data obtained could be used in addition to others when choosing the specific treatment of patients with gastric carcinoma in the postoperative period.
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PMID:[Lymphocyte count in the blood of stomach cancer patients]. 697 17

Conventional transcutaneous ultrasound examinations are often compromised by intervening pulmonary or bowel gas and have limited resolution. Ultrasonic probes of frequencies greater than 5 MHz, which enhance resolution, cannot be used successfully on the skin surface, because they do not penetrate deeply enough to view intraabdominal organs in most adults. To overcome these problems, we tested an ultrasonic endoscope which had a 10-MHz, 64-element linear assay, generated real-time images at resolutions of less than 1 mm, and was an integral part of a 35-mm-long and 13-mm-wide endoscopic rigid tip. Thirty-two studies were performed in 15 healthy subjects, 4 patients with pancreatic cancer and 6 patients with chronic pancreatitis, and 1 patient each with a gastric ulcer and a suspected pancreatic abscess. We demonstrated that this procedure is safe, provides high resolution real-time ultrasound visualization of the heart, aorta, spleen, pancreas, liver, gallbladder, kidneys, and gastrointestinal mucosa and can detect moderate-sized pancreatic tumors and hepatic metastases less than 1 cm in diameter. Because endoscopic visualization of gastrointestinal mucosa and ultrasound examination of extraluminal organs can be obtained during a single procedure, rapid differentiation among mucosal and intramural disease of the hollow gut and disease of extraluminal organs should be possible with this diagnostic technique.
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PMID:Human endoscopic ultrasonography. 710 13

A retrospective analysis of 3052 gastroscopies made by our Digestive Endoscopy Department from 1974 to 1979 was carried out. 14 Early Gastric Cancers out of a total of 157 gastric carcinomas were diagnosed (8.9%), with an EGC: Gastroscopies ratio = 1:218. From the macroscopic point of view 8 were found to belong to type III, 5 to type II, and 1 to type I. The main location was the lesser curvature (angulus-antrum). With regard to the degree of infiltration, 2 were found to belong to stage 0a, 8 to stage 0b, and 5 to stage I. The endoscopic observation gave reason to suspect the presence of a malignant lesion in 6 of the 14 cases. The bioptic examination proved positive in 10 cases, while in 4 the diagnosis was made on the operatory piece. The importance of multiple bioptic samples is again confirmed. Cytology performed by brushing showed malignant tumoral cells in 4 cases, and again in 4 cases the radiological examination led to suspicion of degenerated gastric ulcer. 13 patients were subjected to surgery during which no metastases to the locoregional lymphonodes were found; the patients are all alive. We started gastric carcinoma screening by selecting the patients on the basis of a worksheet covering epidemiological, clinical, biohumoural and instrumental parameters, since the prognosis for the disease is directly proportional to the earliness of its diagnosis.
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PMID:[Early gastric cancer: a retrospective study of our cases (1974-1979)]. 726 Dec 3

Under study were 3877 case reports of gastric cancer patients of different age groups. It was noted that the duration of complaints in all age groups is nearly the same, but the diagnostic period in younger patients (18-35 years of age), as a rule, is considerably prolonged due to a supposed non-oncological lesion. Also, young patients show a larger area of invasion and earlier metastases. The recognition of gastric ulcer in due course by an aimed roentgenological examination, using also pneumogastrography, is shown to be effective enough.
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PMID:[Clinico-roentgenological characteristics of stomach cancer in young and old patients]. 745 24

A critical evaluation has been made of the available evidence in man of the effects of prolonged low acid states on the structure and function of the stomach. Various human models have been examined. 1. Ageing does not affect acid output from the normal male stomach, and there may be an increase in women. With progressive atrophy of the corpus mucosa, which is more frequent and rapid in patients with gastric ulcer, there is an associated loss of secretory function. Chronic gastritis and atrophy are the most important age-related changes, which in many cultures are hypothesized to develop via a prior Helicobacter pylori-related gastritis. However, H. pylori colonization of the mucosa decreases with increasing grades of gastric atrophy probably because intestinal metaplasia provides a hostile environment. Atrophy and intestinal metaplasia are associated with precancerous lesions and gastric cancer. Apparent hyperplasia of the gastric argyrophil endocrine cells is a common and spontaneous phenomenon in patients with atrophic gastritis, which in part may be related to the preferential loss of nonendocrine cells. 2. Pernicious anemia is associated with a complete lack of acid production, marked hypergastrinemia, and endocrine cell hyperplasia in the majority of patients. ECL-cell carcinoids and gastric cancer occur with a prevalence of 3-7%, and endoscopic surveillance in routine clinical practice is not warranted. 3. Gastric ECL-cell carcinoids are rare events that have been described in association with two diseases in man, pernicious anemia and Zollinger-Ellison syndrome as part of multiple endocrine neoplasia syndrome type I, and usually relate to marked hypergastrinemia and the presence of chronic atrophic gastritis with gastric antibodies or a genetic defect rather than the presence or absence of acid. Regression or disappearance of ECL-cell carcinoids, either spontaneously or after removal of the gastrin drive, has been recorded. Lymph node, and rarely hepatic, metastases are documented but death in these cases has been anecdotal. 4. Therapy with H2 antagonists may result in up to a twofold rise in serum gastrin levels but in man no endocrine cell hyperplasia has been recorded. However, the data for H2 antagonists on these aspects are very limited. There is no drug-related risk of gastric or esophageal cancer, although the incidence of the latter may be raised. Long-term treatment with omeprazole is associated with a two- to fourfold increase in gastrin levels over baseline values in one third of patients and apparent endocrine cell hyperplasia in 7% of cases overall.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pathophysiological effects of long-term acid suppression in man. 785 87


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