Gastric outlet obstruction secondary to a gallstone (Bouveret's syndrome)
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Biomedical subjects
Publications and source records attributed to N M Patel.
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A patient with chronic gastric volvulus is reported and the related literature reviewed. The clinical presentation, diagnosis, and treatment are discussed. Features of acute and chronic volvulus are compared.
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In the last 12 months, two patients with severe reflux esophagitis intractable to conventional medical therapy were treated with surgical implantation of Angelchik prosthesis. Both patients improved. The cases are discussed and literature reviewed.
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The case of a patient with agnogenic myeloid metaplasia and myelofibrosis engrafted upon a longstanding treated case of polycythemia rubra vera and presenting with ascites due to peritoneal implants of myeloid tissue is presented. Comments on the differential diagnosis of ascites in general, and especially in myelofibrosis, are entered. The specific simple methodology for the confirmation of this diagnosis through microscopic examination of the sediment of the ascitic fluid for the detection of megakaryocytes and erythroblasts is presented. Radiotherapy in moderate amounts offers a very effective and long-lasting form of this entity.
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The effects of 5-hydroxytryptamine (5HT) and noradrenaline (NA) have been studied on rat anococcygeus muscle. 1. 5HT and NA produced a dose-dependent contraction of rat anococcygeus muscle. Cyproheptadine (1.0 X 10(-6) M), a specific 5HT receptor blocker, failed to inhibit the responses to either 5HT or NA. 2. However, phentolamine, a specific alpha receptor antagonist competitively blocked the responses to 5HT and NA. 3. The responses to 5HT were inhibited in the reserpinized (5 mg/kg i.p. 24 h) and 6-hydroxydopamine (6-OHDA) pre-treated preparations. 6-OHDA produced a leftward shift of the dose-response curve of NA. Reserpine pre-treatment potentiated lower doses of NA and the threshold dose of NA was significantly decreased. 4. Nialamide (2.2 x 10(-6) M), the mono-amine oxidase inhibitor produced a significant leftward shift of the dose-response curve of both 5HT and NA. Pyrogallol (2.3 x 10(-5) M), the catechol-o-methyl transferase inhibitor also potentiated the responses to both 5HT and NA, but the potentiation was significant at lower doses of 5HT and NA. 5. Our data suggest that 5HT- and NA-induced contractions in rat anococcygeus muscle are mediated through common alpha adrenoceptors. 5HT actions are probably indirect, mediated through the release of NA.
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Histamine, 2-(2-pyridyl)ethylamine (PEA), a specific H1 receptor agonist, and 4-methylhistamine (4-MH), a specific H2 receptor agonist, produced a dose-dependent contraction of estrogen-primed guinea pig uterus and taenia coli. Mepyramine (10(-7) M), a specific H1 receptor antagonist, competitively blocked the responses to histamine and PEA in both the preparations. Metiamide (10(-6) M), a specific H2 receptor antagonist, inhibited the responses to histamine and 4-MH in the guinea pig uterus and taenia coli. Our data suggest the presence of both H1 and H2 receptors in the guinea pig uterus and taenia coli. Both receptors appear to be excitatory in nature.
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