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)

During the period 1971-1976, subtotal parathyroidectomy was performed on 34 patients with chronic renal failure, representing 8% of all uraemic patients treated on the Renal Ward. Preoperative treatment of renal failure was conservative therapy in 6, haemodialysis in 20 and renal transplantation in 8 patients. The operation was indicated by grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (osteoporosis, fractures, subperiosteal resorption and metastatic calcifications). The serum immunoreactive parathyroid hormone was determined in 13 cases, and the value was elevated in all. The serum calcium level was elevated in 8 out of 34 cases. Less than 500 mg of parathyroid tissue was removed in 12 cases, between 500 and 6000 mg in 19 and over 6000 mg in 3. Nodular hyperplasia was present in 11 patients, diffuse hyperplasia in 23. Postoperatively marked falls in serum parathyroid hormone and serum calcium values were observed. The bone pains, pruritus and mental disturbances were alleviated, and the general condition was favourably influenced. The operation had a lesser and more retarded effect on the radiological changes. Complete recovery was only achieved with successful renal transplant. Parathyroidectomy often had a favourable effect on the grave symptoms and may, therefore, be considered in some cases of severe hyperparathyroidism secondary to chronic renal failure.
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PMID:Parathyroidectomy in chronic renal failure. 43 13

Salicylates and nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for the treatment of painful disorders. This article reviews the efficacy, side effects, and costs of these agents and proposes a practical approach to using them in a cost-effective manner. Although there may be some differences in efficacy among available drugs, these do not appear sufficient to justify using the more expensive agents in most cases. Adverse effects, especially gastrointestinal (GI), add to the cost of using these drugs. Aspirin and all nonsalicylate NSAIDs share a risk of causing gastric ulcer, upper GI bleeding, and GI perforation. Prostaglandin inhibition by these agents may lead to reduced glomerular filtration rate and renal failure. There may be modest differences in GI and renal risks with the different agents, but these are minimal. Prophylaxis against gastric ulceration with anti-ulcer drugs has been recommended, and one agent, misoprostol, is approved for use in the United States for this purpose. Whether use of prophylaxis will increase or decrease the costs associated with NSAID therapy remains to be determined. Nonacetylated salicylates may cause less GI adverse effects and may be somewhat "renal sparing." Strategies that would reduce the cost of care for painful musculoskeletal disorders without compromising quality of care include using acetaminophen instead of an NSAID for noninflammatory disorders, trying nonacetylated salicylates as less expensive and safer alternatives to NSAIDs, using one agent at a time, allowing sufficient time to evaluate the therapeutic effect before changing agents, returning to the least expensive and/or safest drug if a trial of several in succession fails to find one that is clearly better, and reserving prophylactic use of antiulcer agents for patients who are at especially high risk and for whom anti-inflammatory effects are clearly needed.
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PMID:Cost-conscious prescribing of nonsteroidal anti-inflammatory drugs for adults with arthritis. A review and suggestions. 141 72

A 67-year-old woman was admitted to our hospital with chest pain and dyspnea which occurred suddenly after vomiting. She was well until admission except for cholelithiasis and hypertension which had been pointed out 3 years earlier. Arterial blood gas analysis showed hypoxemia without hypercapnea. Chest X-ray examination on admission revealed intra-mediastinal air with a niveau behind the heart which compressed the vasculature of the left lower lobe and a small amount of air in the regions adjacent to the trachea, left main bronchus and aortic arch. The serial chest radiographs showed pneumomediastinum, subcutaneous emphysema, pneumothorax and pleural effusion in that order within 16 hours after the onset. The diagnosis of esophageal rupture was made by CT scan of the chest performed after oral administration of Gastrografin, which demonstrated extravasation of contrast medium into the mediastinum. Surgical treatment including eversion stripping and esophagogastrostomy was performed 23 hours after the onset. Pathological examination of the removed specimens revealed a rupture of the lower portion of the esophagus originated in the gastric ulcer of the cardia. In spite of intensive care, she died 45 days after surgery because of renal failure. It was considered that the most important point in the early diagnosis of esophageal rupture was to suspect this disease based on the gastric symptoms followed by the respiratory symptoms and to demonstrate pneumomediastinum in chest X-ray. Chest CT scan performed after the oral administration of contrast medium could be an useful and non-invasive diagnostic procedure.
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PMID:[A case of esophageal rupture confirmed by chest CT: characteristic changes in chest radiographs]. 261 3

Pancreatic pseudocyst was erroneously diagnosed in three patients aged 52-57 years. Two patients had acute epigastric pain, hyperamylasemia (approximately 4,000 IU/L), and a retrogastric collection of fluid demonstrated by early ultrasonography. Laparotomy undertaken within 48 h of admission revealed the correct diagnosis in each case. One patient had perforation of a gastric ulcer into the lesser sac, and the other patient (who died) had perforation of an obstructed afferent loop 25 years after Polya partial gastrectomy. The third patient with renal failure, back pain, and marginal hyperamylasemia had a cystic mass in the lesser sac. Two internal drainage operations were performed before the correct diagnosis of epithelioid leiomyoma was established 6 years later.
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PMID:Pseudo-pseudocysts of the pancreas. 355 Jul 86

In order to evaluate its clinical usefulness, serum pepsinogen I level was measured in a prospective study in unselected patients affected by endoscopically and histologically confirmed gastric or duodenal diseases. The mean level in controls was 63 +/- 26 ng/ml (M +/- SD) with no statistical difference between males and females, while it was significantly higher in smokers than in non-smokers (respectively 69 +/- 25 and 56 +/- 25 ng/ml). On the average in gastric ulcer patients it overlapped with controls (69 +/- 34 ng/ml), but in prepyloric ulcers its value was higher (81 +/- 45 ng/ml) than that found in ulcer of the gastric corpus (66 +/- 30 ng/ml). Serum pepsinogen I level was significantly higher in duodenal ulcer patients (81 +/- 33 ng/ml), in males as compared to females and in smokers as compared to non-smokers (respectively 91 +/- 32 and 67 +/- 26 ng/ml). Higher than normal values were found in one subject affected by the Zollinger-Ellison syndrome, and in patients with severe renal failure. Low and very low levels were found after partial and total gastrectomies and in A type atrophic gastritis. In the case of duodenal ulcer, serum pepsinogen I determination showed a 16 p. 100 sensitivity and a 96 p. 100 specificity, while for atrophic gastritis it showed an 87 p. 100 sensitivity and a 100 p. 100 specificity. It is concluded that, at present, the most important clinical application seems to be its screening value in the detection of atrophic gastritis and consequently its potential use to detect populations at increased risk for gastric cancer.
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PMID:Diagnostic usefulness of serum group I pepsinogen determination. 662 12

Renal failure developed in a patient treated for worsening spastic dyspnoea, high erythrocyte sedimentation rate and enlarged peribronchial lymph nodes by the antituberculotic regimen. Renal biopsy disclosed rapidly progressive glomerulonephritis with 95% crescents, granulomatous periglomerulonephritis vasculitis and eosinophilic interstitial infiltrates. On the basis of the positivity of antineutrophil cytoplasmic antibodies (ANCA), eosinophilia and profound ventilatory impairment the diagnosis of Churg-Strauss syndrome was established. The patient was treated by plasma exchanges and combined immunosuppression with the profound effect on erythrocyte sedimentation rate, eosinophilia a negativization of ANCA and preservation of at least minimal renal function. Further therapy was complicated by steroid diabetes, repeated leucopenia and exacerbation of spastic bronchitis and eventually by the massive gastrointestinal haemorrhage from asymptomatic gastric ulcer. There were no signs of inflammation in renal autopsy specimens with prevailing glomerulosclerosis a periglomerular fibrosis. Renal impairment is rare in Churg-Strauss syndrome and it is only exceptionally the cause of renal failure.
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PMID:[The Churg-Strauss syndrome with rapidly progressive glomerulonephritis positive for antineutrophil cytoplasmic antibodies]. 829 37

The role of specific pathological findings in the upper gastrointestinal tract in chronic renal failure remains uncertain. Most of the studies were conducted in the West, and the number of subjects was small. We have tried to look at that problem in Taiwan. Endoscopy to evaluate the source of upper gastrointestinal hemorrhage was performed in 698 patients over a 37-month period; that represents 4.4% of all patients undergoing upper gastrointestinal endoscopy for miscellaneous reasons in that time span. Fifty-eight patients (8.3%) who had been hemodialyzed for chronic renal failure were selected, as were 640 control patients who did not have renal failure. Patients with renal transplant were not included. Endoscopic diagnoses, contributing factors of bleeding, and the course and outcome of the hospitalization were analyzed. chi 2 Test with or without Yates' correction and Student's t test were used as appropriate. Erosive gastritis was the most frequent source of bleeding in patients with chronic renal failure. Erosive gastritis (p < 0.005), erosive esophagitis (p < 0.001), and esophageal ulcer (p < 0.005) were significantly more common causes of bleeding in the renal failure population than in the group without renal failure. The two groups did not differ significantly (p > 0.05) in smoking, heavy alcohol intake, or use of ulcerogenic medications. The age was older (64.1 +/- 11.4 vs. 55.7 +/- 16.2 years) and the mortality rate higher (13% vs. 2%) in patients with renal failure than in those without. The differential diagnoses of upper gastrointestinal bleeding sites differ in patients with and without chronic renal failure; they are diverse. However, erosive gastritis, rather than gastric ulcer or duodenal ulcer, is the most common cause in the patients with renal failure. The mortality rate is significantly higher in these patients than in the general population.
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PMID:Investigation of upper gastrointestinal hemorrhage in chronic renal failure. 877 85

We retrospectively evaluated clinical findings and the actual status of management of 69 tuberculosis patients admitted to the Fujita Health University Hospital, a hospital without isolation wards for infectious diseases, between 1991 and 1994. The largest age group was 60s (27.5%) followed by 70s (24.6%), 80s (15.9%) and 50s (13.0%). Eight patients (11.6%) were in the 20s. Forty-nine patients were smear-positive and 22 patients were smear-negative and culture-positive. Fourteen patients (20.3%) had a past history of pulmonary tuberculosis. Twelve patients (17.4%) also had diabetes mellitus, ten patients (14.5%) had cancer, ten patients (14.5%) gastric ulcer and five patients (7.2%) renal failure. Positive skin reaction to PPD was not found in eleven patients (15.9%) and seven of these patients were quite elderly (over 70 years old). Twenty-five cases (36.2%) were classified as type II (cavitary) and 29 cases (42.0%) as type III (non-cavitary) according to the GAKKAI classification of findings on chest X-ray films for pulmonary tuberculosis. Twenty-four patients (34.8%) were not diagnosed as tuberculosis on admission by physicians in charge. Physicians in charge tended not to suspect smear-negative patients of tuberculosis. Most of the patients with cavities on their chest X-ray films were strongly suspected of tuberculosis on admission, but in some of them, tuberculosis was not considered at all. Smear-positive patients with strongly suspected tuberculosis were diagnosed with the disease within three hospital days, while it took about three weeks in patients who were not considered as tuberculosis on admission to be diagnosed as tuberculosis. In the case of smear-negative patients, it took about one month and two months respectively to diagnose the case as tuberculosis. About half (51.1%) of the smear-positive patients were admitted and treated in single-bed rooms while 44.7% were attended in multiple-bed rooms for 11 days before they were transfered to single-bed rooms. When acid-fast bacilli were detected, 57.4% of the smear-positive patients were transfered to hospitals with isolation wards for infectious diseases, while the remaining smear-positive patients were treated in single-bed rooms at the university hospital. About one-third (31.7%) of the smear-negative patients had already left the hospital when specimens were found to be culture positive for tubercle bacilli. In conclusion, it is utmost important for physicians to suspect tuberculosis for the early diagnosis of the disease.
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PMID:[Actual status of the management of tuberculosis patients in a university hospital without isolation wards for infectious diseases]. 924 73

An enzymatic, kinetic method for determining serum lipase activity was evaluated and compared to a standard manual method for use in dogs. The kinetic method was a commercial kit adapted for use on a tandem access clinical chemistry analyzer and utilized a series of coupled enzymatic reactions based on the hydrolysis of 1,2-diglyceride by lipase. The manual method was the Cherry-Crandall technique based on the titration of base against the acid formed by hydrolysis of an olive oil substrate by lipase. The correlation between the two methods was very good (r = 0.94). The reference range for 56 clinically healthy dogs assayed by the kinetic method was 90 to 527 U/L. Diseases associated with a greater than twofold elevation in serum lipase activity as determined by the kinetic method included pancreatitis, gastritis with liver disease, and oliguric renal failure with metabolic acidosis. In some cases, pancreatitis was seen with other clinical problems, such as gastroenteritis, diabetic ketoacidosis, duodenal mass, disseminated intravascular coagulation, and septic peritonitis. Diseases associated with serum lipase activity within the reference range or elevated less than twofold included gastritis, gastric ulcer, cholestasis, phenobarbital-induced hepatopathy, colitis, copper hepatopathy, abdominal hematoma, apocrine gland adenocarcinoma, and thrombocytopenia with pneumonia.
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PMID:Serum lipase determination in the dog: a comparison of a titrimetric method with an automated kinetic method. 1267 88

Cholesterol embolization syndrome is a rare but devastating complication of thrombolysis. Clinical presentations are variable, which has resulted in labeling this syndrome as the great masquerader. Almost every organ in the body may be affected, but the syndrome commonly involves the kidney, skin, central nervous system, and gastrointestinal tract. Treatment is mainly supportive, with an emphasis on reducing the risk of recurrence. The case presented is a unique one of thrombolytic-induced cholesterol embolization syndrome causing renal failure, in which the diagnosis was supported by a biopsy of a gastric ulcer.
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PMID:Cholesterol emboli-induced renal failure and gastric ulcer after thrombolytic therapy. 1575 58


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