Inherited epidermolysis bullosa.
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Biomedical subjects
Publications and source records attributed to D Stevanović.
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Two brothers with the "diffuse and macular atrophic dermatosis" making a total of 4 patients are reported. The familial occurrence, numerous large "peau citréine" plaques situated on the dorsum of the upper trunk and congenital phimosis with superficial atrophy of glans penis, represent and additional features reported. The light and electron microscopic findings of the least affected site on the arm, of a "peau citréine" and of an erythemoscleroatrophic plaque, none previously studied, have been reported. Among other items, it was also found that the elastic stain-positive globe-like structures found in an unusually large number throughout the edematous upper dermis represent more advancely transformed "Civatte bodies" containing epidermal filamentous cell material.
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Fibromatoses--a subgroup within the group formed by various disorders of fibroblastic origin--have been reviewed. The existence of cases which defy an easy classification has been pointed out. The case of a patient, aged 44, in whom multiple, continuous and progressive tumours, some with considerable invagination, have kept appearing since the age of 10, has been reported.
INTRODUCTION: Gastric or duodenal peptic ulcer is the most common cause of bleeding from upper parts of the alimentary tract. Although there is a great number of these patients in the clinical practice, there are some contradictory characteristics in regard to the age of patient, localization of ulcer, the diameter of ulcer and Helicobacter pylori infection as possible risk factors in development of bleeding peptic ulcer. The aim of this work is evaluation of risk factors in our patients. MATERIAL AND METHODS: During this research we examened two groups of patients: a) first group consisted of patients with acute gastric or duodenal bleeding peptic ulcer, b) the second group consisted of patients without peptic ulcer bleeding. In both groups of patients we examined the most common risk factors for development of bleeding. This research took place in the Clinic for Surgery "Dr Dragisa Misović" in the period from January to December 1997. RESULTS: In both groups we had male predominance. Patients with bleeding peptic ulcers are statistically older when compared with the non-bleeding group (52.2 +/- 7.3:65.3 +/- 8.1). In both groups the anterior wall of the duodenum is the most common localization. In the group of bleeding ulcers we had high frequency of patients with localization of ulcers in the back wall of the duodenal bulb (20%). In this group of patients there was a high percentage of penetrating ulcers (62.5%) with active arterial bleeding (Forrest I a). Ulcers on the front wall of duodenal bulb and in small bend of stomach, as most common (over 50%), gave small peptic ulcers (under l cm) with capillary bleeding (oozing-Forrest I b) without haemodynamic complications. The presence of Helicobacter pylori infection is statistically significantly higher in the group of patients with bleeding peptic ulcers. DISCUSSION: The age of patients and localization of ulcer are very important and well known risk factors for development of bleeding peptic ulcer. However, in the last ten years Helicobacter pylori infection has become one of the most important risk factors. All Helicobacter pylori positive patients were treated with three component eradicational therapy for Helicobacter pylori. In this way we restricted the number of recurrent bleeding. CONCLUSION: In our opinion the age of patient, localization of ulcer, diameter and Helicobacter pylori infection are very important risk factors for development of bleeding peptic ulcer.
INTRODUCTION: Bleeding erosive gastritis and ulcer disease are the most common causes of bleeding from the upper parts of the alimentary tract. Over the period of the last 10 years there has been an increased number of patients where Helicobacter pylori is mentioned as the possible cause of infection. At the same time in this group of patients pH values were decreased. During our research we wanted to examine the influence of local pH value and Helicobacter pylori infection on the occurrence of bleeding erosive gastritis. MATERIAL AND METHODS: During this research we examined two groups of patients. The following parameters were examined within these two groups of patients: 1. presence of Helicobacter pylori infection; 2. histopathologic changes in mucus; 3. there were 57 patients with a bleeding form of gastritis of unknown etiology, whereas the second group consisted of 351 patients with non-bleeding form of gastritis. We examined the localization: 4. local pH. RESULTS: The presence of Helicobacter pylori infection is statistically significantly higher in the group of patients with bleeding gastritis, when compared to the non-bleeding group (72%:57%). Within the Helicobacter positive patients the most common change of mucose (over 90%) is active chronic gastritis. The presence of erosions and histopathological changes characteristic for Helicobacter pylori infection coincides with colonization of Helicobacter in the antrum. The pathogenetic action of bacteria in antrum decreases the local pH. Therefore the lowest value of local pH occurred in the group of bleeding Helicobacter pylori positive gastritis (1.72). DISCUSSION: Results of this research helped us in treatment of helicobacter pylori positive patients making a risk group for development of recurrent bleeding. We accomplished therapeutical effect in 80% of patients by using a three component eradication therapeutic protocol for helicobacter pylori. Within the group of patients who have been cured, regression of histopathological changes occurred and increase of local pH took place. In the group with persistent infection we have come across with high percentage of recurrent bleeding (37.5%). CONCLUSION: In our opinion helicobaceter pylori infection and decrease of local pH, which take place during the reaction of mucose on the presence of infection, are very aggressive factors which can cause bleeding erosions.
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