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)

In 72 of 13,500 patients who underwent endoscopy of the upper digestive tract during an 8-year period, 99 gastric polyps were found. All the polyps were biopsied; 18 were also removed. Histological examination of the 99 polyps showed that 25 were inflammatory, 23 hyperplastic, 17 hyperplasiogenic, 10 adenomatous, 3 hamartomatous, 3 with intestinal metaplasia and 18 with normal mucosa. The histological diagnosis was changed following polypectomy in 50% of the polyps that had been removed. Dysplasia was discovered in two adenomatous polyps; no carcinoma was found. In two cases the polyps were syncronous to carcinoma; in two other cases, they were metachronous to carcinoma. Inflammatory polyps were found in association with inflammation of the upper gastrointestinal tract, such as duodenal and gastric ulcer, esophagitis, gastritis and duodenitis. No correlation was demonstrated between the symptoms and the type or location of the polyps. In 10 patients, who were under observation for an average duration of 3.5 years, 3 polyps disappeared, 1 was removed and 11 had not changed. We conclude that endoscopic polypectomy of gastric polyps may not always be indicated and should be reserved for polyps that were adenomatous, according to the biopsy, or that had grown and changed their shape in a follow-up endoscopy.
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PMID:Gastric polyps--a clinical study. 407 73

Biopsy and operative material was used to study the incidence and significance of different degrees of dysplasia in precancerous diseases and gastric cancer, its evolution and pathognomonic features, with various morphological methods. It is shown that mild and moderate dysplasia is indistinguishable from regenerative changes in gastritis, erosions and gastric ulcer, it can undergo involution or malignization. A marker of enhanced risk of gastric cancer is severe dysplasia which is often multicentric. Among pretumor diseases, most frequently severe dysplasia is found with adenoma and gastritis of the stump. Severe dysplasia in the absence of cancer in the gastrobiopsy material makes mandatory a dynamic study with biopsies taken every three months from different regions of the mucosa. The degree of dysplasia can be objectively tested by quantitating the DNA content, and its average content can be a criterion for differential diagnosis between severe dysplasia and early cancer. The histochemical, radioautographic, and electron microscopic features of dysplasia, testifying to impaired regeneration of te epithelium, cannot serve to differentiate between severe dysplasia and cancer or to assess the risk of transition of dysplasia into cancer. The main way of solving this problem is dynamic observation.
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PMID:[Dysplasia and early stomach cancer]. 409 97

Seventy-two patients with endoscopically proven gastric ulcers were entered into a prospective controlled trial to assess the efficacy of ranitidine and cimetidine in ulcer healing. All patients were biopsied on entry and at subsequent endoscopies. After exclusion of 7 patients during the first month of treatment, the remaining 65 patients, 47 males and 18 females, mean age 48.2 +/-1.5 years, at 1 month had a healing rate of 47% and 52% respectively. The non-healers continued their treatment for a further 4 weeks. This increased the healing rate to 77% and 76% respectively. If the defaulters and poor compliers are withdrawn the healing rate rises to 58% and 57% at 4 weeks and to 91% and 79% at 8 weeks respectively. There was no significant difference between the two groups as regarded initial ulcer size and severity of dyspepsia. Antacid tablet consumption during the study was comparable. The initial size of the ulcers which failed to heal after 4 weeks of treatment tended to be larger than those which healed (P less than 0.05), but smoking did not appear to influence ulcer healing. No obvious side-effects or evidence of dysplasia were found. The study shows that ranitidine is at least as effective as cimetidine in gastric ulcer healing.
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PMID:Ranitidine in the treatment of gastric ulceration. 627 19

In 1976, 121 patients with benign gastric ulcer and 13 with gastric carcinoma were diagnosed in our department by endoscopy, cytology and directed biopsies. At a 5-year follow-up, 78 of these patients were re-examined with endoscopy and biopsies. None had developed gastric cancer during the observation time. Of the 78 patients who underwent endoscopy, 16 had gastric ulcer, 2 duodenal ulcer and 27 atrophic gastritis, including 3 with moderate dysplasia of the gastric mucosa. The patients with ulcer had remarkably few symptoms. Only few data are available concerning the postulated link between gastric ulcer disease and gastric malignancy. The cancer-ex-ulcere hypothesis seems to be a medical dogma. However, well planned prospective studies with endoscopic follow-up of gastric ulcers are needed to elucidate the question properly.
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PMID:Gastric ulcer and risk of cancer. A five-year follow-up study. 648 72

In order to ascertain the role of gastric carcinoembryonic antigen (CEA) determination in detecting patients with a risk for gastric cancer, 69 subjects were studied; 23 were referred for endoscopy because of dyspepsia but without obvious macroscopic lesions, 27 with duodenal ulcer, 11 with benign gastric ulcer, 8 with gastric cancer. The following results were obtained by subdividing the material according to the histologic interpretation of the results of gastric mucosal biopsies: (1) in the presence of minor histologic abnormalities of the gastric mucosa, CEA in gastric juice was under 100 ng/ml in all but five cases; and (2) in moderate or severe chronic atrophic gastritis (associated or otherwise with intestinal metaplasia or dysplasia), and in gastric cancer, gastric CEA ranged between 224 and 3120 ng/ml in all but two cases. Although not diagnostic for gastric cancer, gastric CEA is a promising test in detecting patients at risk, including those with dysplasia of the gastric mucosa.
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PMID:Carcinoembryonic antigen in gastric juice collected during endoscopy. Value in detecting high-risk patients and gastric cancer. 664 May 4

In York between 1941 and 1949, 632 patients underwent Polya partial gastrectomy for peptic ulcer. Of 307 patients who were followed up in the York Gastric Clinic from 1971 to 1980, nine died of gastric cancer, three times the expected number. If gastrectomy was performed for gastric ulcer the risk of later development of carcinoma (7%) was significantly greater than that following operation for duodenal ulcer (1.6%) (p less than 0.001). No cancers were diagnosed in the 54 patients endoscoped. Atrophic gastritis was found in 98% of patients and intestinal metaplasia in 44%. Dysplasia was present in 35% but in no case was it severe. Although we have found that there is an increased risk of cancer developing in the gastric remnant we do not consider routine endoscopic follow up of all postgastrectomy patients to be a practical proposition.
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PMID:Endoscopic examination of the gastric remnant 31-39 years after subtotal gastrectomy for peptic ulcer. 670 18

We evaluated the changes over 1-55 months in mild gastric epithelial dysplasia (a relatively frequent, but not widely studied histological lesion) in 20 patients (11 with benign gastric ulcer, eight with chronic gastritis, and one after Billroth 2 operation), in order to ascertain whether to follow-up such patients in the future. Regression of the lesion was documented in 13 (65%), and no change in six (30%). Progression from mild to moderate dysplasia occurred in only one patient (5%). As mild dysplasia regresses or remains unchanged in most patients, at least over the short-term, specific follow-up is probably unnecessary. Nevertheless, a rational program of monitoring the associated precancerous conditions is in order.
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PMID:Is mild gastric epithelial dysplasia an indication for follow-up? 688 51

Per- and trans-endoscopic pH measurements in the upper digestive tract have provided new and interesting data. Performed by the authors on a series of 314 patients, they showed that the gastric pH is seldom acid, even in duodenal ulcer, and is always alkaline in gastric ulcer and gastric carcinoma. Gastritis may be divided into two groups, depending on whether the pH is normal or hypoacid (4.5 in the antrum, 2.5 in the fundus). Biopsies demonstrated the presence of intestinal metaplasia and epithelial dysplasia in 57.8% of 83 patients with hypoacid gastritis. The method therefore constitutes a simple and reliable means of determining markers of precancerous lesions.
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PMID:[Contribution of per- and trans-endoscopic pH measurements to the exploration of the upper digestive tract (author's transl)]. 707 21

A 54 year old man without pathologic past history but mild hypertension, obesity and gastric ulcer, presented with a syndrome of Wallenberg. He had complained for five days of progressive and diffuse headache. The neurological condition improved initially, but the patient died suddenly two weeks later. Pathological examination showed no significant alteration except for left ventricular enlargement and mild arteriosclerosis. There was a hemodissection (dissecting aneurysm) of the left vertebral artery next to the inferior oliva. It induced a lateral infarct and a limited dorsal infarct at the middle third level of medulla oblongata. Although the location of the arterial changes is usual, their nature is exceptional. The cause of the arterial hemodissection could not be ascertained: fibrous arterial dysplasia, atherosclerosis or congenital abnormalities of internal elastic layer may be discussed. But no definite conclusion can be reached.
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PMID:[Wallenberg's syndrome due to a dissecting aneurysm of the vertebral artery]. 713 26

In 50 patients with benign gastric ulcer (eight relapsing, 42 nonrelapsing) the evolution of the edge and scar histological characteristics was studied with special regard to the pressure and modification of epithelial dysplasia. The patients were endoscopically followed-up; for 1 to 74 months. Dysplasia was present in 29% of observations made in active ulcer and in 19% of patients with scarring gastric ulcer. Severe dysplasia was found only in one case. During follow-up, regression of the dysplastic changes was documented in 64% of the cases, progression from mild to moderate dysplasia in 4%, while no change was recorded in 32%. Appearance of dysplasia or progression from mild to moderate was seen in 62% of the relapsing cases, as opposed to 14% of the nonrelapsing cases (p less than 0.005). Dysplastic changes, usually mild, are relatively frequent in the mucosa both at the edge and scar of gastric ulcer, but they tend to disappear with the healing of the ulcer. Appearance or progression in severity of dysplasia during follow-up are rare, but significantly more frequent in relapsing ulcers, which therefore require more careful follow-up.
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PMID:Gastric epithelial dysplasia in relapsing and nonrelapsing gastric ulcer. 713 37


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