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

Case report on the successful gastric ulcer treatment of a patient with primary hyperparathyroidism with the H2-receptor antagonist cimetidine. After four weeks of therapy with 0.8 g/d cimetidine stomal ulcerations were seen by x-rays and endoscopy to be healed. The patient was discharged on a regimen of 400 mg daily of oral cimetidine. Peptic ulcer did not recur after 1/2 year of treatment with this H2-receptor antagonist, although the signs of primary hyperparathyroidism were still present.
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PMID:[Successful gastric ulcer treatment of a patient with primary hyperparathyroidism with cimetidine (author's transl)]. 71 56

Among 81 patients with malignancies of the stomach, the early (cancer of the gastric mucosa) was diagnosed in 10 (12.3%) patients. Timely diagnosis of the early gastric cancer requires multiple endoscopic examinations and aimed gastric biopsies of the edges and bottom of the ulcer. The analysis of the serial histological preparations permits to detect single or small aggregations of large mucous cells looking like cricoid cells (considered by the author as a sign of malignization) and less frequently like tumour tissue, in necrotic mass or in the proper layer of the mucous membrane. It is recommended that any gastric ulcer be considered as a possible ulcerative form of cancer and that the patients be mandatorily examined in specialized institutions where the differential diagnosis between peptic ulcer and ulcerative form of cancer may be performed by the method of gastroscopy with aimed biopsy.
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PMID:[Histological evaluation of aimed gastrobiopsy in the diagnosis of early stomach cancer]. 72 63

It has been postulated that resection therapy for peptic ulcer disease will result in an increased frequency of gastric stump cancer depending on the ulcer type and type of operation (Billroth I, Billroth II, gastroenterostomy). However, an extensive review of the literature shows that after Billroth II resection for gastric ulcer without enteroanastomosis the frequency of primary gastric stump cancer is not greater than in the case of medically treated benign gastric ulcers. The frequency of cancer of the gastric stump seems lower after resection for duodenal ulcer disease. It is possible that the combination of the Billroth II resection with an enteroanastomosis decreases the frequency of cancer of the gastric remnant. Clinical and experimental studies do not allow final statements on cancer frequency after Billroth I resection or simple gastroenterostomy.
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PMID:[What is certain in the pathogenesis and incidence of primary carcinoma involving the operated stomach?]. 76 96

During the last 12 years, 1489 vagotomies were performed at the Chirurgische Poliklinik of Munich University; 1339 of them were selective proximal vagotomies (SPV). The main indication was duodenal ulcer (n = 915) and gastric ulcer (n = 188), including emergency operations for extensive bleeding. Further indications were: sliding hiatal hernia, erosive gastritis and achalasia of the cardia. The SPA was combined in all cases with a pyloroplasty based on form and function. The results are shown in detail related to mortality (elective 0.5%), recurrency (1.6%) and functional results (good 88.2%, fair 7.2%, poor 4.6%). The combined operation of SPV with pyloroplasty is, in our opinion, an operative procedure which allows non resectioning surgical treatment of GDU without selection, i.e. based on form and function.
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PMID:[Non-resecting surgery for gastroduodenal ulcer. III. Clinical results (author's transl)]. 81 6

The authors present the results of treatment with acetazolamide of gastroduodenal ulcer (356 gastric ulcer, 1.250 duodenal ulcers--859 with craters--, 24 pyloric stenosi with functional components, and 42 postgastrectomy peptic ulcers). The acetazolamide was administed in daily dosis of 25-30 mg/kg of body weight, sodium and potassium salts were added, and the liquid intake was increased (approx. 2 1 daily). A control was kept of the clinical, secretory, radiological, enzymological, and hydrolectrolytical modification. A decrease is observed of the in the carbonic anhidrase of the gastric mucosa and of the gastric secretion. There is also an increase in the gastric protection factors and a disappearance of ulcer pain. There are no significant hydroelectrolytic modifications of the blood. From a radiogical point of view, the crater of the postoperative gastric, pyloric and peptic ulcer disappears after 2 weeks of treatment, and in duodenal ulcers in 89% of the cases in 3 weeks. The method is the same time a quick, simple, an efficient therapeutic test for the differentiation of the gastric craters. The drug is well tolerated. Nevertheless a clinical, secretory and radiological control of the patients is necessary taking into account the counter-indication for the administration of acetazolamide.
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PMID:[Carbonic anhydrase inhibitors in the treatment of gastro-duodenal ulcer]. 82 86

The fundic glands of 143 stomachs resected in connection with peptic ulcer, including those localized in the stomach (70 observations) and in the duodenum (73 observations) were studied. The number of epithelial cells in the longitudinal section of the fundic gland in ulcer of the stomach was most often in the range of 100 to 149 (in 37 cases of 70), in duodenal ulcer--150 to 199 (in 36 observations of 73). In patients with duodenal ulcer, as distinct from those with gastric ulcer, the epithelial formula of the fundic gland was characterized by a lower content of non-differentiated and mucous neck cells and by a greater number of chief cells, the hyperpepsinogenic cellular shift (a rise of the content of chief cells up to 50% and more) in them was observed 4-5 times more often. The ratio index of chief and parietal cells in gastric ulcer (in 75.7% of cases) was usually in the range of 1--1.9 (tentative norm) and only in some cases (in 18.6% of observations) it was higher. In duodenal ulcer an elevated index was observed in 54.8% of cases.
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PMID:[Epithelial formula and relationship between the chief and parietal cells of fundal gastric glands in gastric and duodenal ulcer]. 88 60

An analysis has been made of 235 deaths that occurred among 1905 patients with peptic ulcer who constituted a random sample of the occurrence of ulcer disease in an area of Denmark comprising half a million inhabitants. The disease itself, according to the death certificate, was considered the primary cause of death in 10% of the cases; half of these had been operated on immediately before death. The other patients died more frequently than expected from the following causes: chronic bronchitis, pulmonary emphysema, cancer of the lung, cirrhosis of the liver, and cancer of the pancreas. Although the comorbidity with chronic bronchitis and emphysema was especially pronounced in patients with gastric ulcer, the association with liver cirrhosis and cancer of the pancreas occurred only in patients with duodenal ulcer. In women the mortality rate attributable to cardiac and vascular diseases was lower than expected. No excess coincidence of suicide was found. Berkson's fallacy is considered to be of much less importance as a possible explanation of the comorbidity found in the present study than in the majority of publications concerned with this question.
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PMID:Causes of death in duodenal and gastric ulcer. 90 79

Dyspepsia may result from over-indulgence in alcohol and food, or from anxiety and emotional problems. It may also indicate a peptic ulcer, oesophagitis or less commonly, gallstones or gastric cancer. Investigation by endoscopy or barium studies is always indicated when an organic lesion is suspected. Reassurance, tranquillizers and antispasmodics help patients with functional dyspepsia. Antacids given hourly between meals are important in the treatment of all symptomatic peptic ulcers. Cimetidine causes rapid symptomatic relief of duodenal ulcer symptoms, and most ulcers will heal with six weeks' therapy. Gastric ulcer can be treated with carbenoxolone, but this drug is avoided in the elderly and in patients with cardiac failure or hypertension. Anticholinergic drugs are of value in duodenal ulcer, especially for night pain, but they should not be used in patients over the age of 50. Special diets are of no value. For the heartburn of oesophagitis, weight reduction and a regime of regular antacid therapy remain the important measures.
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PMID:The treatment of dyspepsia. 92 13

The relationship between chronic gastritis and peptic ulcer was studied in 97 patients, 51 with duodenal ulcer and 46 with gastric ulcer. Six biopsies (three from the antrum and three from the body) were obtained under direct vision by means of an Olympus panendoscope. Chronic gastritis was classified according to the grade of inflammation (slight or moderate and intense), and to its location (antritis or pangastritis). In gastric ulcer the relationship between frequency of chronic gastritis and the site of the ulcer (antrapyloric, at the angulus, body of the stomach) was also established. Antritis was just as frequently observed in duodenal ulcer (94%) as in gastric patients (96%), but severe inflammation of the antrum was higher in G.U. (43%) than in D.U. (17%). Chronic gastritis of the gastric body was always accompanied by antritis, both in G.U. and in D.U. and was observed in 63% of the former group and 37% of the latter. Severe inflammation of the glandular portion of the stomach occurred in only one patient with D.U (2%) and in 7 with G. U (15%). In the present investigation, no relationship between between the site of gastric ulcer and the frequency of chronic gastritis was observed.
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PMID:Chronic gastritis and peptic ulcer. 93 May 40

Gastric acid responses to graded i.v. infusion of pentagastrin and Histalog were determined in peptic ulcer patients. Single-day multiple-dose tests were performed. The sensitivity to the humoral stimuli as determined by the calculated ED50's was not significantly different for duodenal ulcer patients with moderate (DUmod) or massive (DUmass) observed hypersecretion or for gastric ulcer (GU) patients: median ED50's of pentagastrin were 6.2, 6.6, and 13.1 mug/h in 18 DUmod, 22 DUmass and 7 GU patients respectively, and median ED50's of Histalog were 16.6, 25.3, and 17.1 mg/h in 14 DUmod, 10 DUmass and 6 GU patients respectively. Antrum-bulb resection significantly reduced basal acid secretion and maximal acid responses to the humoral stimuli (about 45% reduction) but did not significantly change the loss of gastric contents to the intestine or the sensitivity to the humoral stimuli (median ED50 of pentagastrin increased from 5.2 to 6.7 mug/h in 14 patients, and median ED50 of Histalog increased from 16.0 to 20.8 mg/h in 12 patients), suggesting that the intact antrum-bulb region of the ulcer patient is controlling the capacity to secrete acid, and indicating that antrum-bulb gastrin is an important trophic factor for the parietal cells in man.
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PMID:Gastric acid responses to graded i.v. infusion of pentagastrin and histalog in peptic ulcer patients before and after antrum-bulb resection. 93 94


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