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Biomedical subjects

E Goldin

Publications and source records attributed to E Goldin.

At least 109 records · Page 6Linked to original sources
PubMed1988

Giant duodenal ulcer: the hepatic intra-arterial chemotherapy variant.

Giant duodenal ulcers are extensive ulcers, more than 2.5 cm in diameter, that involve a large portion of the duodenal bulb. These atypical duodenal ulcers create serious problems to the patient and the physician, are frequently complicated by bleeding and penetration, and have a high mortality rate. Most of the reported cases were classified as a severe variant of the common peptic ulcer disease, others were associated with the Zollinger Ellison syndrome. We report here four patients with giant duodenal ulcers but with a different and definitive aetiology: hepatic intra-arterial chemotherapy infusion for liver metastase or primary hepatocellular carcinoma.

Adult↗
PubMed1988

Comparison of misoprostol and ranitidine in the treatment of duodenal ulcer.

The efficacy of misoprostol (a synthetic analogue of prostaglandin E1) and ranitidine in the treatment of duodenal ulcer was evaluated. Seventy-one patients with endoscopically proven duodenal ulcer were randomized in a double-blind manner in one of two groups that received two daily doses of 400 micrograms misoprostol or 150 mg ranitidine. Ulcer healing was assessed endoscopically after 4 weeks of treatment; in subjects who had not healed treatment was continued and endoscopy was repeated after another 4 weeks. The mean age, sex distribution and tobacco, alcohol and caffein consumption were similar in both groups. In the misoprostol-treated group, healing of the ulcer was observed in 74.8% of patients at 4 weeks and in 86.5% at 8 weeks; in the ranitidine group (n = 34), the healing rate was 91.2 and 100%, respectively. The differences between healing rates in the two groups were not statistically significant. In the misoprostol group (n = 37), 27% of patients experienced diarrhea; of these, two were withdrawn from the trial due to this side effect. These results, which are part of a multicenter international study, suggest that misoprostol at a daily dose of 800 micrograms is as effective as 300 mg/day ranitidine in the treatment of duodenal ulcer.

Adult↗
PubMed1988

Esophageal involvement in pemphigus vulgaris.

Eight patients with pemphigus vulgaris were examined endoscopically for esophageal involvement. Most of them (seven of eight) had gastrointestinal symptoms of various types. Four of the patients had microscopical evidence of pemphigus vulgaris involving the esophagus. Three patients were found to have other diseases in their upper gastrointestinal tract accounting for their symptoms. There was no correlation between patients symptoms and macroscopic and microscopic findings. In patients with pemphigus vulgaris, endoscopy should be performed whenever gastrointestinal complaints appear, because the approaches to therapy could differ, according to the endoscopic findings.

Aged↗
PubMed1988

Burkitt's lymphoma in an old patient with diarrhea: ileoscopic diagnosis.

A 61-yr-old man with Burkitt's lymphoma who presented with 6 months of diarrhea was found, at ileoscopy, to have inflammation of the mucosal narrow lumen, deep linear ulcerations, and a "cobblestone" appearance of the terminal ileum. Endoscopic biopsies were diagnostic of Burkitt's lymphoma, and no laparotomy was necessary. Presentation with diarrhea and the age of the patient were unusual, and the endoscopic features and diagnosis of the disease in the terminal ileum made by ileoscopy have not been previously reported.

Age Factors↗
PubMed1987

Cytoprotective doses of arbacet with minimal antisecretory properties are not effective in duodenal ulcer healing.

The efficacy of arbacet (a synthetic analog of prostaglandin E2) in definite cytoprotective but minimal antisecretory dose was evaluated in the treatment of duodenal ulcer. One hundred five patients with endoscopically proven duodenal ulcer were randomized in a double-blind manner to receive four times daily either arbacet 25 micrograms or placebo. Ulcer healing was assessed endoscopically after two and four weeks of treatment. The mean age, sex distribution, and tobacco and alcohol consumption were similar in the two treatment groups. The ulcers of 16 patients in both the placebo and the arbacet-treated group healed after 14 days of treatment. At the end of the study, healing of the ulcer was observed in 69.2% of the arbacet-treated patients and in 60.4% of patients in the placebo treated group. (Difference was not statistically significant). We conclude that cytoprotective doses of arbacet with minimal antisecretory properties are not effective in duodenal ulcer healing.

Adolescent↗
PubMed1987

Arachidonic acid oxidation by brain and placenta preparations from normal and placental insufficient fetal rabbit.

Cytosolic (100,000 g) fractions of fetal rabbit brain and placenta tissue convert [1-14C]arachidonic acid into several oxidation products identified with the lipoxygenase [12-hydroxyeicosatetraenoic acid (12-HETE) and 15-HETE] and cyclooxygenase [prostaglandin E2 (PGE2)] pathways. Formation of 12-HETE and 15-HETE by fetal brain is time-dependent, reaching a plateau after 40 min and is linear with protein concentration. An apparent affinity constant of 0.06 mM and a Vmax of 0.1 mumol/h/g wet weight are presumably responsible for the excessive accumulation of 12-HETE and 15-HETE in comparison to PGE2 (Km = 0.5 mM). The latter is synthesized by the placenta particulate fraction but almost exclusively by the brain cytosol. Compared to brain, the activity of the placenta tissue is exceedingly higher and in addition to 12-HETE and 15-HETE there is a substantial formation of 12-L-hydroxyheptadecatrienic acid. Formation of 12-HETE and 15-HETE at 21 days is as effective as at 31 days gestation and is strongly inhibited by nordihydroguaiaretic acid (93%), BW755c (99%), and AA861 (84%) but not by indomethacin. Placenta and brain tissues of intrauterine growth retarded fetuses after ligation of placental blood vessels fail to convert arachidonic acid into other eicosanoids. Loss of enzymatic activity also observed in normal tissue after prolonged storage cannot be restored by the addition of several SH agents, ascorbate, or ferric iron.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1987

Endoscopic insertion of endoprostheses in the treatment of postoperative cutaneous biliary fistula.

We report a case in which a large, postoperative, biliary cutaneous fistula was successfully treated by means of endoscopic insertion of two endoprostheses into the common bile duct. Twenty-four hours after the procedure, bile flow from the cutaneous fistula ceased completely. The endoprostheses were removed after 6 weeks, and no evidence of leak from the biliary tract was seen on a retrograde cholangiogram. For the treatment of postoperative biliary leaks, insertion of endoprostheses is a good and safe alternative to surgery.

Biliary Fistula↗
PubMed1986

Role of endogenous gastric prostanoids in the pathogenesis and therapy of duodenal ulcer.

Synthesis of prostaglandin E2 and 6-keto prostaglandin F1 alpha by cultured antral and fundic gastric mucosa obtained from 86 patients with active duodenal ulcer who were not receiving medication was 50% lower (p less than 0.01) than their respective synthesis by cultured gastric mucosa in normal subjects. Antral and fundic prostanoid synthesis in patients receiving chronic therapy with nonsteroidal antiinflammatory drugs was almost completely inhibited. The decreased synthesis of antral and fundic prostaglandin E2 and 6-keto prostaglandin F1 alpha in duodenal ulcer patients was not affected following ulcer healing achieved after 4 wk of therapy with placebo, arbacet, misoprostol, sucralfate, and pirenzepine. In contrast, following 4 wk of therapy with ranitidine, both antral and fundic prostaglandin E2 synthesis were significantly increased when compared with their respective synthesis before therapy. These results confirm that gastric prostanoid synthesis is decreased in patients with active duodenal ulcer and in subjects treated with nonsteroidal antiinflammatory drugs, suggesting that decreased endogenous prostanoid synthesis may contribute to the pathogenesis of mucosal damage. The induction of endogenous prostanoids by ranitidine may contribute to its therapeutic effect.

6-Ketoprostaglandin F1 alpha↗
PubMed1986

Intussusception in intestinal lymphoma: the role of colonoscopy.

Intussusception is a well known complication and sometimes the presenting symptom of intestinal lymphoma. The final diagnosis in most patients is made by surgery. We report a 12 year old boy with intussusception in whom the diagnosis was established by colonoscopy and surgery was avoided.

Child↗
PubMed1985

Should we worry about gastric cancer in duodenal ulcer patients?

In three patients with active duodenal ulcer, carcinoma of the stomach was detected early during routine endoscopic examination. In all patients subtotal gastrectomy was performed, and pathological examination of the resected stomach revealed carcinoma confined to the mucosa. We review evidence for and against any association between gastric carcinoma and peptic ulcer disease.

Adenocarcinoma↗