Duodenal Peptic Ulcer Research Articles

Pacemaker shifting in the right atrium during vagus nerve stimulation in dogs

Dalargin injected subcutaneously at a dose of 10 micrograms/kg decreased 4-5 fold ulcer manifestations in rats with cysteamine-induced duodenal ulcers. Intracerebroventricular dose of 2 micrograms diminished the manifestations to a lesser extent Dalargin only at a dose exceeding 500 micrograms intraperitoneally decreased significantly the in vivo binding of 3H-D-Ala2, D-Leu5-enkephalin with brain opiate receptors. We believe that Dalargin injected peripherally in small doses does not penetrate the blood-brain barrier and that its antiulcer activity is due to the interaction with peripheral opioid receptors. It seems possible that the disturbances in the central/peripheral ratio of the opioid activity plays an important role in the pathogenesis of duodenal peptic ulcer.

Early gastric cancer in Italy. Clinical and pathological observations on 80 cases.

Of 542 gastric cancer patients operated in the period between 1976 and 1982, we found early gastric cancer (EGC) in 80 cases (15.3%). Patients with EGC did not show specific symptoms if compared with patients affected by gastric or duodenal peptic ulcer, gallstones, functional disorders of the upper gastrointestinal tract, or advanced gastric cancer (AGC). Single-contrast radiology showed a low sensitivity, especially in the depressed lesions. In contrast, endoscopy alone diagnosed 64 EGCs (80.0%) as malignant lesions. The five-year overall survival rate of the EGC patients was 85.9% and that of AGC patients was 43.8%. From a pathological point of view, our results confirm the usefulness of the studies on EGC for the comprehension of gastric carcinogenesis. The clinical relevance of EGC is linked to the good prognosis; however, the absence of clear symptoms and lack of alternative diagnostic methods to the endoscopy cast some doubts on the feasibility of mass detection programs.

Changes in the interleukin-1 and interleukin-2 generation in duodenal ulcer patients during cimetidine treatment

The effect of cimetidine treatment on the generation of interleukin-1 (IL-1) and interleukin-2 (IL-2) was studied in 11 duodenal ulcer patients. The results obtained were compared with those for untreated healthy subjects. The drug was administered intravenously in a dose of 200 mg four times a day for 8 days. The investigations were performed before, during and 1 wk after cimetidine therapy. IL-1 generation was determined by the ability of supernatants from 2-day cultured adherent cells stimulated by lipopolysaccharide to enhance proliferation of PHA-stimulated mice thymocytes. IL-2 generation was determined by the ability of supernatants from 2-day cultured, PHA-stimulated mononuclear cells to proliferate autologous 17-day cultured T cells. In all ulcer patients IL-1 generation diminished during cimetidine treatment ( P < 0.005). It continued to decrease in 4 subjects and increased in the other 7 ones following drug withdrawal. All the values were higher than those in healthy controls. IL-2 activity in ulcer patients was similar to that in healthy subjects and it increased significantly in all ulcer patients following the onset of the treatment ( P < 0.005) and decreased nearly to the initial values 1 wk after termination of the treatment ( P < 0.005). The present studies indicate that cimetidine, a selective histamine H 2-receptor antagonist, deeply changes mechanisms of immunoregulation in patients with duodenal peptic ulcer.

Fistulation to the pancreatic duct complicating duodenal peptic ulcer

A previously unreported complication of peptic ulcer disease is described—fistula formation between the duodenum and the pancreatic duct. Symptoms that initially were typical for ulcer disease changed abruptly in intensity, character, and timing when fistulation occurred. Diagnosis of this complication was elusive. Symptoms resolved completely after alimentary diversion by a Billroth II hemigastrectomy combined with truncal vagectomy.

Physical illness in severe depressives and psychiatric alcoholics in Gothenburg, Sweden

The entire middle-aged male urban population of a Swedish city, as defined by a census in November 1969, was assessed for any mental hospital hospitalization during a 3-year period (1978–1980), as well as for any general hospital hospitalization during a 10-year period (1970–1979) within the catchment area. Inpatients of the mental hospital population belonging to the cohort and put in the categories ‘Psychiatric alcoholic spectrum’ and ‘Severe depression’ were studied for diagnoses of physical illness during any general hospital hospitalization. The psychiatric alcoholic spectrum was associated positively with infections, injuries, alcohol intoxication, pancreatitis, liver cirrhosis, arthritis/rheumatic diseases and duodenal peptic ulcer; and negatively with malignant neoplasms, myocardial infarction, gallstone disease and urolithiasis. Severe depression was associated positively with infections, myocardial infarction, asthma and alcohol intoxication. A nosologic taxonomy, aimed at explaining the epidemiological associations recorded, is suggested.

Gastric outlet obstruction in peptic ulcer disease: An indication for surgery

Eighty-seven patients with duodenal peptic ulcer disease and gastric outlet obstruction were reviewed retrospectively. All patients were initially treated with standard medical regimens. Gastric outlet obstruction persisted in 49 patients (56 percent) for more than 5 days, necessitating operative intervention. Obstruction relented in the other 38 patients (44 percent), and they were discharged from the hospital. However, late follow-up on the entire cohort revealed that 98 percent of patients with chronic ulcer disease and 64 percent of patients with acute disease ultimately required an operation.

Pap Smears: Physicians Must Disclose Risk of Refusal

In 1972 the California Supreme Court helped set the standard for informed consent in the landmark case of Cobbs v. Grant. That case involved a middleaged gentleman who was operated on for an intractable peptic duodenal ulcer. He suffered complications which included loss of his spleen, a subsequent gastric ulcer, and a 50% gastrectomy. None of these well-recognized potential risks of ulcer surgery had been disclosed to him. The court determined that physicians must disclose the following information to patients, in lay terms, before performing procedures on them:a description of the procedure and its success rates;risks of death or serious bodily harm;alternatives, and the dangers inherent in each; andmajor problems of recuperation.

FIVE YEARS‘ EXPERIENCE WITH PROXIMAL GASTRIC (HIGHLY SELECTIVE) VAGOTOMY

In the five-year period 1972 to 1976 the author's preferred treatment for patients with chronic duodenal or prepyloric peptic ulcer requiring surgery was proximal gastric vagotomy. In spite of this preference, only two-thirds of such patients were so treated. Most patients with bleeding and stenosis were treated by bilateral truncal vagotomy and drainage, and a few by Pólya gastrectomy. Proximal gastric vagotomy proved to be a safe elective operation without mortality and with a proven ulcer recurrence rate so far of 6%. Compared with those who had bilateral truncal vagotomy and drainage, the proximal gastric vagotomy patients complained less often of diarrhoea but more often of weight loss and reflux. Two patients have had persistent postprandial non-peptic pain, thought possibly due to upper gastric ischaemia.

Gastric and Duodenal Peptic Ulcer Disease in a Well-Defined Population

In a necropsy series from Malmö of 2,218 subjects above 20 years of age, and composing 88.2% of all Malmö residents above 20 who died during the period of investigation, the frequency of gastric and duodenal peptic ulcer disease (ulcer, scar or surgically treated peptic ulcer) was studied. The total frequency of peptic ulcer disease was 17.9% (20.9% in men and 14.7% in women). The condition was most common (25.4%) in men in the 50-59 year age group, after which the frequency declined. In women a constant high frequency (15-16%) was seen in all age groups above 60 years. Gastric ulcer (ulcer or scar) was found in 10.7% and duodenal ulcer in 5.5%. 16.1% of subjects with peptic ulcer disease had been subjected to surgical treatment, 22.8% of the men and 5.8% of the women.

Cimetidine Therapy in Zollinger-Ellison Syndrome

THE ZOLLINGER-ELLISON syndrome is associated with hypersecretion of gastric acid, usually owing to gastrin-secreting pancreatic tumors. Hemorrhage or perforation are complications of the malignant peptic ulcer diathesis. The recommended treatment is total gastrectomy. This case of Zollinger-Ellison syndrome is reported to illustrate an alternative treatment for patients unable to tolerate total gastrectomy. Report of a Case A 72-year-old man underwent gastroenterostomy and vagotomy in 1972 for a bleeding duodenal peptic ulcer. Intermittent episodes of epigastric pain for the next four years were treated with antacids. He was admitted on May 17, 1976, with epigastric pain, weakness, and melena, but no diarrhea; hemoglobin level was 6 gm/dl. A large duodenal ulcer was demonstrated radiographically. The basal acid output was 17 mEq/hr, and maximal acid output was 35 mEq/hr. Fasting serum gastrin level was 433 and 600 pg/ml on two occasions (normal, less than 170 pg/ml. Following a bolus of secretin (2

Duodenal ulcer associated with incomplete duodenal diaphragm

Peptic duodenal ulcer associated with congenital incomplete duodenal diaphragm has not been described in children. An etiologic correlation of the ulcer with the diaphragm may be possible.

Effect of synthetic 15-methyl analog of prostaglandin E2 on gastric secretion and peptic ulcer formation.

Abstract In conscious cats with chronic gastric and pancreatic fistulas, a synthetic 15-methyl analog of prostaglandin E 2 , 15/S/15-methyl-E 2 -methyl ester, caused a dose-related inhibition of maximal gastric acid and pepsin response to pentagastrin and histamine. The administration of 1.0 μg per kilogram-hour of 15-Me-PGE 2 produced complete inhibition of acid secretion induced by pentagastrin and about 80 per cent inhibition of secretion induced by histamine. Gastric secretion in response to peptone meal (measured by intragastric titration) reached a level similar to that induced by histamine. 15-Me-PGE 2 caused profound decrease of acid response to a meal. The inhibitory action of the analog occurred after either intravenous or intraduodenal administration. The compound prevented the formation of duodenal peptic ulcer induced by 36-hour intravenous infusion of pentagastrin or histamine, but did not affect pancreatic response to exogenous secretin or duodenal acidification. The antisecretory and anti-ulcer action of the compound is likely to be a direct one on the parietal cell and it could prove of value in the treatment of peptic ulcer.

"Pseudotumor effect" in hypotonic duodenography. Report of 2 cases.

Two cases of “pseudotumor effect” in hypotonic duodenography are shown. Misdiagnosis of granulomatous enteritis of the duodenum (without involvement of the terminal ileum) and acute peptic duodenal ulcer are attributed to the “pseudotumor effect.” Distension of the C-loop in hypotonic duodenography can sometimes result in a disproportionate and misleading exaggeration of an abnormality. The importance of correlation between hypotonic duodenography and the routine gastrointestinal study is stressed.

Psychosomatic Specificity: Experimental Study and Results

Franz Alexander, the founder and first director of the Institute for Psychoanalysis in Chicago, started the Specificity Project in the year 1951, and was the team leader until 1956. Then he left and was followed by Thomas French, and later by George Pollock, who now, three years after the termination of the project, reports about its design, progress, and quantitative findings. As a presentation of this often-discussed and controversial project, the present volume is the first one to be published. It will be followed by further details about the case study by teams of experts in different medical specialties. The diseases studied are bronchial asthma, rheumatoid arthritis, ulcerative colitis, essential hypertension, neurodermatitis, thyrotoxicosis, duodenal peptic ulcer. Statistical analysis seems to indicate that one can indeed differentiate between certain specific diseases, purely on the basis of the psychological patterns associated with each one of them.

INCREASED CEREBROSPINAL-FLUID PROTEIN SECONDARY TO HYPERCALCEMIA OF THE MILK-ALKALI SYNDROME.

ALTHOUGH Central-nervous-system dysfunction may dominate the clinical picture of diseases associated with hypercalcemia, it is not generally appreciated that striking elevation of the cerebrospinal-fluid protein may be present. Case Report A 46-year-old man entered the Salt Lake County General Hospital on July 31, 1964, because of weakness. Ten years previously a duodenal peptic ulcer had been diagnosed. Since that time he had ingested up to 5 quarts of milk and 1/2 pound of calcium carbonate daily. Two years before admission weakness, ataxia, lethargy and impaired mentation developed. During the month before admission constipation, thirst and polyuria were noted. Physical examination . . .

Duodenal ulcer with malignant degeneration.

Excerpt Malignant degeneration of a chronic peptic duodenal ulcer is rarely observed, as compared with malignant changes in a peptic ulcer of the stomach. According to Ewing (1), only 10 cases were...

Duodenal and Jejunal Peptic Ulcer: Technic of Resection

Duodenal and Jejunal Peptic Ulcer: Technic of Resection

Duodenal and Jejunal Peptic Ulcer.

Duodenal and Jejunal Peptic Ulcer.

Duodenal and Jejunal Peptic Ulcer: Tecknic of Resection

Duodenal and Jejunal Peptic Ulcer: Tecknic of Resection