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PubMed1995

Lansoprazole capsules and amoxicillin oral suspension in the treatment of peptic ulcer disease.

BACKGROUND: Lansoprazole is a potent antisecretory drug also possessing anti-Helicobacter pylori activity in vitro. It is a candidate drug for combination regimens with antibiotics for treating H. pylori infections. METHODS: In a semiblind study, 65 patients with duodenal and/or gastric ulcer and pathologic 14C urea breath test results were treated with either 60 mg lansoprazole every morning only for 14 days or combined with 500 mg amoxicillin oral suspension four times daily between meals, given for 11 days. Endoscopy and breath test were repeated after 6 weeks and 6 months. Patients with unhealed ulcers were withdrawn. RESULTS: Eradication of H. pylori infection was attained in 46% of patients receiving lansoprazole and amoxicillin but in no patient receiving lansoprazole alone. Ulcers healed significantly more often in those who were H. pylori-negative (18 of 19 (95%)) than in those who were H. pylori-positive (20 of 41 (49%)). Adverse events, particularly stomatitis/sore throat and diarrhea, occurred significantly more often when amoxicillin was combined with lansoprazole. CONCLUSIONS: Lansoprazole eradicated H. pylori infection only when combined with amoxicillin. Eradication rates in this study are hardly acceptable, and further studies are necessary to define optimal doses and duration of treatment. Using amoxicillin as an oral suspension may not be of any substantial benefit and may cause stomatitis and sore throat.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMedDate not supplied

Arthroscopic treatment of adhesive capsulitis.

Although conservative management with or without manipulation performed with the patient under anesthesia is the generally accepted treatment strategy for adhesive capsulitis, considerable interest is being shown in arthroscopic surgical procedures for this disorder. This study reviews the outcome of patients who underwent an arthroscopic release of the inferior capsule, reproducing in a controlled fashion the traumatic disruption of the inferior capsule commonly caused by manipulation with the patient under anesthesia. The outcome of 24 patients (26 shoulders) was assessed with an average follow-up of 13.5 months. A total of 88% of patients were very satisfied with the procedure, and no operative complications occurred. A return to normal or near normal shoulder function in 76% or more of the study group for forward flexion, abduction, and external rotation was demonstrated. A total of 50% of patients still had some restriction in internal rotation. The Constant Scoring system, also used to assess clinical shoulder function, revealed 87% of patients had achieved an excellent or good result when compared with the contralateral normal shoulder score. Our results suggest that arthroscopic capsular release is a safe and effective treatment for adhesive capsulitis, with patterns of recovery that compare favorably to other treatment modalities.

Adult↗
PubMed1989

Omeprazole and cimetidine in the treatment of ulcers of the body of the stomach: a double blind comparative trial. Danish Omeprazole Study Group.

OBJECTIVE: To see whether omeprazole was superior to cimetidine in healing ulcers of the body of the stomach. DESIGN: Double blind randomised parallel group study of omeprazole versus cimetidine for six weeks with assessment of healing at end of every second week. SETTING: Outpatient referrals in 11 centres in Denmark. PATIENTS: One hundred sixty one patients who satisfied the following criteria: age 18-79; one or more ulcers of body of stomach (that is, at or above the angulus) seen endoscopically within four days before study treatment; no H2 receptor antagonists taken within previous two weeks; no history of gastric surgery and no complications needing surgery; no concurrent treatment or disease that might confound assessment; oral contraception or an intrauterine device being used by women of childbearing age. INTERVENTIONS: Omeprazole 30 mg daily (one capsule in the morning) or cimetidine 1 g daily (one 200 mg tablet thrice daily, two tablets at bedtime) for six weeks. Inactive capsules and tablets provided so that all patients took same number of capsules and tablets daily. Compliance monitored by pill counts. END POINT: Endoscopic evidence of accelerated healing of type I gastric ulcers after four weeks of omeprazole. MEASUREMENTS AND MAIN RESULTS: Pain recorded on diary cards and patients assessed after two, four, and six weeks of treatment for clinical state and by endoscopy and biopsy and repeat laboratory tests. Twenty eight patients withdrawn during trial for violations of protocol. At two weeks healing rates were identical in the two treatment groups (omeprazole 41% (30/73 patients); cimetidine 41% (30/73]. At four weeks cumulative healing rates were 77% (53/69 patients) in the omeprazole treatment group and 58% (41/71) in the cimetidine treatment group (95% confidence interval of difference between groups 4% to 34%). By six weeks the cumulative healing rates in the two treatment groups differed by only 6% (60/68 patients (88%) given omeprazole; 53/65 (82%) given cimetidine). Log rank analysis with ulcer size used as covariable showed a significant difference in healing times in favour of omeprazole. There was no difference in the occurrence of pain relief between the two treatment groups. No serious clinical or biochemical side effects of treatment were noted. CONCLUSIONS: Omeprazole 30 mg daily accelerates healing of ulcers in the body of the stomach as compared with cimetidine 1 g daily. This effect is more pronounced in ulcers greater than 12 mm diameter.

Aged↗
PubMed1980

Arthroscopic examination of experimentally induced pathologic conditions of the rabbit temporomandibular joint.

Because of the difficulty in diagnosing and treating diseases of the temporomandibular joint, there seems to be a need for a simple, safe technique of examination. The purpose of this study was to examine the usefulness of the arthroscope in diagnosing pathologic conditions of the temporomandibular joint. Various pathologic conditions were produced in the mandibular joints of rabbits. These included steroid-induced arthropathy, chronic inflammatory changes in the synovium, acute inflammatory disease, and gross damage to the condyle and disk. The joints were then visualized with the arthroscope and photographed. Biopsy specimens of what appeared to be the involved areas of the condylar surface and joint capsule were taken for histologic study. The arthroscopic findings were correlated with the biopsy findings and histologic sections of the entire joint.

Animals↗
PubMed1998

Endoscopy of the gastroduodenal mucosa after carprofen, meloxicam and ketoprofen administration in dogs.

Endoscopy was undertaken to examine the gastroduodenal mucosa of 24 healthy dogs after seven days and again after 28 days of oral non-steroidal anti-inflammatory drug (NSAID) administration. The dogs were divided into four groups. One group received ketoprofen (1 mg/kg every 24 hours), one group carprofen (2 mg/kg every 12 hours for seven days followed by 2 mg/kg every 24 hours), a third group meloxicam suspension (0.2 mg/kg every 24 hours), and the last group gelatin (one capsule every 24 hours). Serum biochemical and complete blood count parameters did not change significantly after NSAID administration. Gastroduodenal lesions were observed in 17 dogs, but in all cases these were mild to moderate. The dogs receiving gelatin or carprofen showed the fewest and the least severe lesions, although there was no statistically significant difference between the three test drugs and the control group (P < or = 0.05). None of the dogs showed any clinical signs related to the gastrointestinal lesions.

Animals↗
PubMedDate not supplied

The arthroscopic management of osteochondritis dissecans of the adolescent elbow.

The management of avascular necrosis of the capitellum of the adolescent elbow continues to be a dilemma. This article is a critical retrospective analysis of 12 pediatric patients (mean age at surgery 14.5 years) who underwent arthroscopic debridement alone followed by early range of motion. Follow-up at a mean of 3.2 years (range, 2.0 to 5.7 years) indicated that the average flexion contracture improved from 23 degrees preoperatively to 10 degrees postoperatively. All patients had remodeling of the capitellum by plain radiographs; however, five patients had associated enlargement of the radial head. Eleven patients had minimal mechanical symptoms after the procedure and were highly satisfied. One patient had substantial enlargement of the radial head with continued loss of supination and mechanical symptoms requiring radial head resection 2 years after the index procedure. Five patients had a triangular avulsion fragment present off the lateral capsule. A statistically significant worse subjective outcome was associated with the presence of this fragment (P < .005). There were no complications.

Adolescent↗
PubMed2005

Retrieval of ureteral calculus using a new method of endoscopic assistance in a cat.

A 9-year-old female spayed domestic short-haired cat presented with ureteral obstruction due to a ureteral calculus 4 cm distal to the renal pelvis. Preoperative creatinine was 844 mmol/L. A novel approach to this condition was utilised whereby a flexible endoscope was passed through a hole made in the renal capsule into the renal pelvis and ureter. The calculus was visualised, and the endoscope was removed. A 1.4 mm flexible grasping forceps was introduced into the proximal ureter through the same hole in the renal capsule and the calculus was removed. The creatinine dropped to 282 micromol/L within 2 weeks of surgery. The cat died of apparently unrelated causes several months after surgery.

Animals↗
PubMedDate not supplied

Transnasal endoscopic approach to expose the medial rectus from the annulus of Zinn to the penetration of Tenon's capsule.

Conventional strabismus surgery employs a conjunctival incision to gain access to Tenon's space where a wide variety of procedures are routinely performed on the tendon and anterior aspect of the extraocular muscles. Recently, transnasal endoscopic surgical techniques have gained acceptance as effective means of decompressing the medial wall and floor of the orbit in patients with thyroid-related orbitopathy. The orbital surface of the medial rectus and inferior rectus are exposed from the annulus of Zinn to a position close to where the muscles penetrate Tenon's capsule. In theory, this technique also provides the exposure necessary to locate and retrieve a "lost" medial rectus when the usual sub-Tenon's approach fails to recover the muscle. Cadaver studies demonstrate the feasibility of exposure and suture placement in the stump of a lost medial rectus with passage of the suture through Tenon's capsule to transmit the force of the muscle to the globe, provided that the lost muscle is retrieved before severe contracture develops.

Endoscopy↗
PubMed2006

Placement of the Bravo wireless pH monitoring capsule onto the gastric wall under endoscopic guidance.

BACKGROUND: The Bravo system was designed mainly to monitor esophageal pH, and there have been no reports on gastric pH monitoring using this system. OBJECTIVE: To place the Bravo capsule on the gastric wall and monitor gastric pH. DESIGN: Experimental clinical trial with the cooperation of volunteers. SETTING: Academic medical center. PATIENTS: Eleven volunteers (9 men, 2 women; mean age 38 years; 3 had symptoms of GERD). INTERVENTIONS: The Bravo system was introduced into the esophagus and stomach along a thin endoscope and capsules were attached, one each to the esophageal and gastric walls under direct vision through the endoscope. Esophageal and gastric pHs were simultaneously monitored. RESULTS: The 2 capsules were successfully placed in 10 of the 11 subjects, and both esophageal and gastric pHs were monitored for 48 hours in 9 subjects. Mild to moderate precordial pain was observed in 7 subjects, but no other complications or side effects were observed in this study. The gastric pH of 10 subjects increased after meals and returned to baseline pH 2 hours later. Decrease of esophageal pH was observed 1 hour after a meal in the symptomatic subjects and corresponded to the time when gastric pH decreased secondary to the increase of pH with meals. CONCLUSIONS: The Bravo capsule is easily placed on the gastric wall under endoscopic assistance and enables long ambulatory monitoring of gastric pH.

Adult↗
PubMed1996

Arthroscopic management of trapeziometacarpal joint arthritis of the thumb.

Open partial trapeziectomy and interpositional arthroplasty have proven to be effective in ameliorating the symptoms of carpometacarpal joint arthritis of the thumb. Surgical technique of arthroscopic partial resection of the trapezium and interpositional arthroplasty is described. Thirty-three interpositional arthroplasties were carried out arthroscopically. Autogenous tendon graft. Gortex (WL Gore & Associates, Inc. Flagstaff, AZ) and fascia lata allograft were used as interpositional material; 87.8% of patients got relief from pain. Average postoperative pinch strength was 11 lbs. No ligament reconstruction was required because the capsule was left intact. The procedures were done on an outpatient basis and all patients were discharged the same day. There were no complications associated with radial sensory nerve.

Aged↗
PubMed1988

Chronic flunixin meglumine therapy in foals.

Effects of a therapeutic dose of flunixin meglumine on gastric mucosa of horse foals were determined by endoscopy, double-contrast radiography, and gross and histologic examinations. Foals were administered 1.1 mg of flunixin meglumine/kg of body weight, PO/day for 30 days in an encapsulated form that was divided into 2 doses/day (group 1; n = 3) or by IM injection once a day (group 2; n = 7). Three control foals (group 3; n = 3) were administered capsules (n = 1) containing dextrose powder or IM injections (n = 2) of vehicle solution without flunixin meglumine. All 3 groups-1 foals given flunixin meglumine PO developed oral ulcers. Group-2 foals given flunixin meglumine IM did not develop oral ulcers. One control foal (group 3) developed 1 oral ulcer that healed during the study. Endoscopic examination revealed linear crease-like mucosal lesions in the glandular portion of the stomach in 2 group-2 foals. Radiographic evidence of gastric ulcers was observed in only 1 gastrogram of a group-1 foal. Foals were euthanatized, and necropsy revealed erosions and/or ulcers of the glandular portion of the stomach. Oral ulcers were observed in all 3 group-1 foals. Erosions of the glandular portion of the stomach developed in all 10 foals given flunixin meglumine, but did not develop in group-3 foals. Ulceration of the glandular portion of the stomach was present in 1 group-2 foal.

Administration, Oral↗
PubMedDate not supplied

[Critical assessment of indications for arthroscopic lateral release and medial tightening of the knee joint].

UNLABELLED: Based on the results of a retrospective study of 50 patients with mild lateral tracking and lateral compression of the patella (32 patients) and recurrent patellofemoral dislocation (18 patients), we present the technique, the results, the complications and the indications for the endoscopic lateral retinacular release and medial drawing tight of the capsule. The average age of the patients was 28.8 years (range: 10-53). At time of follow-up (m = 51 months) the patients were examined clinically as well as radiologically. The results were scored according to a score by Crosby and Insall. 73% of the patients with mild lateral tracking and lateral compression (lateral release) were satisfied with the operative results (visual analogue scale), as well as 66.6% of the patients with recurrent patellofemoral dislocation (lateral release and medial drawing tight of the capsule). Only 40% of the patients with patellofemoral arthritis (lateral release) reported about an improvement of this procedure. The score showed significantly good results but didn't raise the differences in between the groups of different indications. 28% of the patients showed an abnormal lateral tracking of the patella in active motion, the passive patella-glide-test (Hughston) raised a patella-hypermobility to the lateral side in 36% of the cases and to the medial side in 76%. X-rays of both knees showed an increased lateral patellofemoral angle of 10.8 degrees and an increased sulcus angle of 144 degrees. There was no progression in osteoarthritis in the operated side of the patellofemoral joint found. Complications revealed in a high number of hemarthrosis right after the operation, in 2 cases an open revision was necessary. CLINICAL RELEVANCE: According to our results patients with patella compression syndrome without patellofemoral arthritis and patients with recurrent luxation or subluxation of the patella are good candidates for endoscopic lateral release and eventually medial drawing tight of the capsule. In a young population the endoscopic lateral release is a relatively simple surgical procedure making an open technique in failed cases possible.

Adolescent↗
PubMed2003

Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis.

BACKGROUND AND STUDY AIMS: It is still difficult to visualize changes in the small intestine. Wireless capsule enteroscopy is a new method that promises to provide new insights into the small intestine. In a prospective study, the diagnostic yield of wireless enteroscopy was therefore compared with computed tomography (CT) enteroclysis. PATIENTS AND METHODS: Twenty-two patients with suspected small-bowel pathology underwent CT enteroclysis and wireless capsule enteroscopy examinations, conducted by two independent blinded investigators. The results of the two investigations (diagnoses and the number, extent, and location of lesions detected) were compared by a third investigator. RESULTS: The patients included in the study had obscure gastrointestinal bleeding (n = 8), Crohn's disease (n = 8), unexplained diarrhea (n = 5), or suspected carcinoid tumor (n = 1). Pathological lesions were detected using capsule enteroscopy in 13 patients (59 %) and using CT enteroclysis in eight (36 %; P = 0.12). In seven patients (one case each of colonic Crohn's disease, diverticulitis, Meckel's diverticulum, carcinoid tumor, mesothelioma, colonic polyps, and irritable bowel syndrome), no pathological changes were found in the small intestine using either method. The diagnosis was established by wireless capsule enteroscopy in four patients with obscure bleeding, whereas CT enteroclysis was positive in only one patient ( P = 0.1). Crohn's disease was found in two patients with unexplained diarrhea. Small-bowel lesions were identified in six patients with known Crohn's disease using capsule enteroscopy or CT enteroclysis. The only side effect of wireless capsule enteroscopy observed was abdominal pain in one patient with Crohn's disease. There were no serious side effects with CT enteroclysis. CONCLUSIONS: Wireless capsule enteroscopy detects more small-bowel lesions than CT enteroclysis in patients with obscure gastrointestinal bleeding and Crohn's disease.

Adolescent↗
PubMed2004

Frictional resistance characteristics of a capsule inside the intestine for microendoscope design.

The design of the capsule body for a self-propelled endoscope is important from the frictional resistance point of view. The motivation of this work was to gain a better understanding of the effect of capsule shape on the frictional resistance of the capsule inside a small intestine. Special experimental set-ups were built to investigate the frictional resistance of the capsule and the viscoelastic deformation characteristics of the small intestine specimen of a pig. Tests were performed with capsules of various shapes and dimensions. Experimental data showed that a smooth cylindrical capsule geometry resulted in the least frictional resistance due to the shape and relatively small surface area. Also, it was found that the variation of frictional resistance of the capsule was closely related to the local change in the viscoelastic property of the intestine due to the heterogeneity of the internal structure of the intestine.

Animals↗
PubMed1993

[Cervical lymph node metastases].

The investigative procedure of clinically diagnosed cervical lymph node metastases is discussed. Cervical lymph node metastases can be the first manifestation of a carcinoma. The corresponding primary tumor is diagnosed in the ENT area (mouth, pharynx, larynx) in 80% of the cases and in bronchi or esophagus in 10%; therefore, a detailed ENT examination and an upper panendoscopy must be undertaken. Wedge excisions of lymph node metastases are contraindicated, since they produce an artificial rupture of capsule and open the door to extranodal tumor growth. Excision of cervical lymph nodes, which are clinically related to a cervical lymph node metastasis, should only be carried out within the framework of a diagnostic and therapeutic concept.

Bronchial Neoplasms↗
PubMed1997

[Does axillary liposuction modify histologic study of excised lymph nodes?].

OBJECTIVE: To determine the pathological features of lymph nodes removed by axillary liposuction. METHODS: A prospective study of 34 axillary dissections performed from July 1995 to September 1996 in patients with breast cancer N0. After lipolysis, the fat was drained from the axillary cavity by means of liposuction (Karman nozzle ch.8; suction pressure of 1 Bar). The remaining nodes were removed by an endoscopic dissection in conservative treatments. The remaining nodes were removed during modified radical mastectomy in non-conservative treatments. Lymph nodes were fixed in formol and examined by the pathologist. RESULTS: An average of 15 lymph nodes (8-35) were removed. 502 lymph nodes were examined: 458 (91%) were not involved and 44 (9%) were involved, including 21 (4%) with rupture of the capsule. No pathological traumatism was seen. CONCLUSION: Axillary liposuction did not alter the pathological features of lymph nodes in our study.

Adult↗
PubMed1979

Hysteroscopic removal of a Heyman radium capsule.

This case report demonstrates the use of the hysteroscope for the localization and removal of a missing Heyman radium capsule in a patient with endometrial carcinoma. There has been much recent interest in the use of the hysteroscope for therapeutic purposes in clinical gynecology. This case report emphasizes the value of this instrument in patient care.

Adenocarcinoma↗