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

Prophylactic use of misoprostol has been found to cause a 15-fold reduction in the rate of gastric ulcer among symptomatic nonsteroidal anti-inflammatory drug users with osteoarthritis. Using data from a variety of sources, we performed a decision analytic-based evaluation of direct medical costs in these patients to determine whether routine prophylactic use of this medication is a preferred strategy over no prophylaxis. The base-case analysis revealed that misoprostol is cost-reducing for the initial 3 months of prophylaxis when the compliance rate is 60%, the silent ulcer rate is 40%, and the medication is priced below $1.74/d (expected costs per patient of approximately $300). The model is highly sensitive to changes in these parameters. Changing the rates of hospitalization and operation have less effect. Reliable estimates of misoprostol's economic impact after the initial 3 months of treatment are impossible to develop with current data. Nonmedical direct costs, patients' out-of-pocket costs, and indirect economic effects, such as work loss, were not considered in the model. All would enhance the economic benefit of the medication. Health care policy makers and payers must consider trade-offs between the clinical and economic implications of preventive medical interventions, such as misoprostol, especially as the call intensifies for more efficient allocation of health care resources.
Arch Intern Med 1989 Sep
PMID:Economic effects of prophylactic use of misoprostol to prevent gastric ulcer in patients taking nonsteroidal anti-inflammatory drugs. 250 6

Effects of irsogladine maleate (IM), in combination with histamine H2-receptor antagonists or a muscarinic receptor antagonist, on the formation of stress ulcer were investigated in rats. The ED50 of IM and that of cimetidine for suppressing stress ulceration were remarkably reduced when these drugs were used in combination. ED50s in this case were less than the theoretical values calculated on the basis of additive action, thereby suggesting the synergistic effect of IM and cimetidine. The synergistic effect of IM and ranitidine or famotidine in suppressing stress ulceration was also observed, while IM and pirenzepine did not always produce a synergistic effect. In addition, for acetic acid-induced gastric ulcers, combined administration of IM and cimetidine also markedly potentiated ulcer healing. The marked synergistic potentiation of IM and histamine H2-receptor antagonists may be due to compensatory coordination of both drugs on the gastric secretion and mucosal microcirculation. These results suggest that the combination of IM and histamine H2-receptor antagonists may be beneficial in clinical gastric ulcer therapy.
Nihon Yakurigaku Zasshi 1989 Sep
PMID:[Synergistic effect of irsogladine maleate and histamine H2-receptor antagonists on experimental gastric ulcers in rats]. 257 21

Various blood flow disturbances in intraabdominal digestive organs were studied clinically and experimentally from a viewpoint of vascular surgery. Acute gastric mucosal lesion may occur due to ischemia and reperfusion injury of the gastric mucosa. Bleeding from stomach ulcer may be rarely caused by consumption coagulopathy along with aortic aneurysm. Heparin therapy was successful to interrupt it. Gastrectomy is not indicated for such condition but aneurysm should be repaired. Portal vein reconstruction for the radical resection of hepatic, biliary and pancreatic cancers should be carefully made, because early or late stenosis occurs frequently, and they may connect to early or late morbidities or mortalities. On the other hand, resection and replacement of the suprarenal vena cava invaded by the retroperitoneal malignant tumor may be safely carried out. For the acute mesenteric arterial occlusion, early diagnosis and arterial reconstruction are essential to save catastrophe. Positive Doppler sound on the vasa recta seems to be the most reliable parameter for assessing bowel viability. Approach from the proximal large arteries is recommended for uncontrollable intraperitoneal bleeding.
Nihon Geka Gakkai Zasshi 1989 Sep
PMID:[Blood flow disturbance in digestive organs--a viewpoint of vascular surgery]. 258 8

Glycyrrhetinic acid (Ia) and eighteen related derivatives were examined for antiulcer activity using stress-induced gastric lesions (restraint plus water immersion at 25 degrees C) in mice and rats as screening tests. Among the compounds tested, dihemiphthalate derivatives of 18 alpha- or 18 beta-olean-12-ene-3 beta,30-diol (IV, IIId), 18 beta-olean-9(11)12-diene-3 beta,30-diol (VIc), and olean-11,13(18)-diene-3 beta,30-diol (VIIc) showed potent inhibition of gastric lesion formation at a dose of 12 or 25 mg/kg (p.o.); carbenoxolone sodium (Ib) significantly suppressed the lesion formation at a dose of 500 mg/kg (p.o.). Further evaluation of the antiulcer activity was carried out mainly for compound IIId. Compound IIId (p.o.) prevented the formation of indomethacin-induced or 0.6 N HCl-induced gastric lesions; the latter antiulcer effect was noted even in the combined treatment with indomethacin, suggesting that the effect occurs independently of endogenous prostaglandins. In contrast, compound IIId had no preventive effect against Shay rat ulcer when intragastrically (i.g.) administered; further, no antisecretory effect was seen by i.g. application in pylorus-ligated rats. Administration of compound IIId for 2 weeks accelerated the healing rate of acetic acid-induced gastric ulcer in rats. No significant change in urine excretion was observed after its consecutive administration for 3 d. These results suggest that dihemiphthalate derivatives (IIId, IV, VIc, VIIc) may produce a strong antiulcer activity, probably by strengthening some gastric mucosal defensive mechanism.
Chem Pharm Bull (Tokyo) 1989 Sep
PMID:Antiulcer activities of glycyrrhetinic acid derivatives in experimental gastric lesion models. 260

Numerous studies have indicated a role of epidermal growth factor in the maintenance of the gastrointestinal mucosa. In the present study epidermal growth factor concentrations in saliva and gastric juice of patients with gastric or duodenal ulcer or gastritis are compared with those of healthy controls. For this purpose a novel ELISA system has been developed and shown to be sensitive and specific. It is demonstrated that gastric juice and saliva of patients with gastric ulcer contain less epidermal growth factor than the samples of healthy controls (p less than 0.01). Epidermal growth factor concentrations and outputs (product of epidermal growth factor concentration and the volume secreted in 15 min) in the gastric juice of patients with duodenal ulcer do not differ from those of healthy controls.
J Clin Chem Clin Biochem 1989 Sep
PMID:Gastric ulcer is accompanied by a decrease of epidermal growth factor in gastric juice and saliva. 260 19

The mucosal superoxide dismutase (SOD) activities were serially examined on the acute gastric mucosal lesion (AGML) induced by water-immersion restraint stress to rats for six hours. The mucosal SOD activities gradually increased in proportion to the time up to 3 hours after the restraint stress. But it decreased 6 hours after when severe damage had been established in the mucosa. On the other hand, the mucosal SOD activities of the margins of human gastric ulcer showed to be higher on the healing stage than on the active stage. And the SOD activities of the intractable ulcer were lower than those of the curable ulcer. These results indicate that the mucosal SOD may play some important roles both on the protecting process information of AGML and on the healing process in gastric ulcer.
Rinsho Byori 1989 Sep
PMID:[Changes in mucosal superoxide dismutase activities of gastric lesions]. 260 64

Ultrasonography was performed for 15 patients with gastric ulcers, after tap water ingestion using 5-MHz and/or 7.5-MHz transducers. Sonographic signs of gastric ulcer were classified as gastric wall edema associated with ulcer crater (six cases) and gastric wall edema only (nine cases). The latter nine included two cases of perforation of gastric ulcers that were depicted as gastric wall edema associated with fluid collection. Ultrasonography proved useful for detecting benign ulcerations and can be used to supplement follow-up examinations, but it cannot replace endoscopy and contrast radiography.
J Ultrasound Med 1989 Sep
PMID:Ultrasonography of benign gastric ulcers. Characteristic features and sequential follow-ups. 267 74

Dysfunction of the sphincter of Oddi (SOD) is an uncommon condition which must be considered in cases of persistent pain in the upper abdomen following uncomplicated cholecystectomy, when disease in other organs, such as gastric ulcer, esophagitis and pancreatitis has been eliminated. The pathogenesis is not fully elucidated, but it is assumed that the cholecystectomy in some cases induces an increased tendency to spasm in the sphincter of Oddi (SO), and, perhaps in connection with an increased sensitivity to pressure elevations in the biliary tree, results in attacks of pain. Whether fibrosis (stenosis) of the SO due to instrumentation or passage of stones is part of the etiology is obscure. Endoscopic retrograde cholangiopancreaticography with papillary manometry should be performed in all cases where SOD is suspected. An elevated basal pressure in SO seems to be the best indicator of SOD. In cases unresponsive to conservative treatment, endoscopic sphincterotomy may be considered. This treatment is not finally evaluated, but apparently the effect is good, especially in patients with elevated basal pressure in SO. It is emphasized that the knowledge of the behavior and regulation of SO is incomplete and that this should be remembered when criteria for SOD are applied.
Ugeskr Laeger 1989 Sep 25
PMID:[Oddi's sphincter dysfunction]. 267 55

The safety and efficacy of a new endoscopic microwave hemostatic device (Microtaze) was compared with BICAP and heater probe using previously established canine models of endoscopic hemostasis. Parameters evaluated included (a) depth of injury, (b) efficacy of hemostasis (bleeding gastric ulcer model), and (c) strength of coaptive bonding (mesenteric artery model). Depth of injury was graded histologically 1 wk after coagulation as the percentage of lesions showing gastric full-thickness damage for each probe. In depth-of-injury studies probes were applied at maximum force (established endoscopically with a specially designed force gauge) and at maximum power settings (50 W Microtaze, 30 J heater probe, dial setting 10 BICAP) to determine safety. There was no significant difference in the percentage of external muscle layer damage: 85%, 74%, and 86% for Microtaze, heater probe, and BICAP, respectively. Hemostasis was achieved 100% of the time in endoscopically induced bleeding gastric ulcers in heparinized dogs. Canine mesenteric arteries measuring 1-2 mm in diameter were isolated at laparotomy and coaptively sealed, and the bond strength was measured by application of hydrostatic pressure. Bursting pressures were not significantly different for Microtaze, heater probe, or BICAP probes (1062 +/- 77 mmHg, 863 +/- 85 mmHg, and 1154 +/- 139 mmHg, respectively). In conclusion, microwave energy may be applied endoscopically to produce hemostasis with similar safety and efficacy to BICAP and heater probe.
Gastroenterology 1989 Sep
PMID:Microwave energy compared with heater probe and BICAP in canine models of peptic ulcer hemorrhage. 275 28

In view of the low incidence of hypertrophic pyloric stenosis, we present a case of this pathology in a male aged 74. Stenosis was of the diffuse type, associated with gastric ulcer and chronic atrophic gastritis. The patient was admitted to our Service with upper digestive tract hemorrhage after deterioration of the ulcer.
Endoscopy 1989 Sep
PMID:Hypertrophic pyloric stenosis in the adult. 279 14


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