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At least 1,171 records · Page 65Linked to original sources
PubMed1988

Treatment of Campylobacter pylori gastritis: a pilot study using pirenzepine dihydrochloride (Gastrozepin) and three formulations of colloidal bismuth subcitrate (De-Nol).

Antral biopsies were obtained to detect Campylobacter pylori infection in 382 patients referred for gastroscopy. One hundred and seventy four patients (46%) were infected. Infection was strongly associated with histological gastritis (p less than 0.001), but there was no association between histological antral gastritis and the appearance of the gastric antrum during gastroscopy. Because it has been suggested that the lower relapse rate for duodenal ulcer following colloidal bismuth subcitrate (CBS) is due to suppression of C pylori we investigated different formulations and dosing of CBS for their efficacy in clearing C pylori. Seventy four infected patients were prospectively assigned to therapy with pirenzepine (11 patients) or one of four regimens of CBS; one swallow tablet 4 times a day (11 patients); two swallow tablets twice daily (16 patients); two buffered swallow tablets twice daily (14 patients); or two chew tablets twice daily (22 patients). All patients treated with pirenzepine and one CBS swallow tablet 4 times a day were still infected after treatment. Infection was not detected in 16 patients taking twice daily doses of CBS; 8 (50%), 3 (21%) and 5 (23%) patients taking two standard, buffered or chew tabs twice daily respectively. Improvement of histological gastritis was observed only in those patients apparently cleared of C pylori (p less than 0.01) and this was due to a decrease in polymorphonuclear leukocytes. Nine patients apparently cleared of the infection were rebiopsied 44-137 days following treatment and 6 (66%) were found again to be infected. This study suggests that suppression of C pylori may vary with the formulation and dosing of CBS.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMedDate not supplied

[Weakened condition of gastric mucosa barrier and hypersthenic dyspepsia].

Many patients, who suffer of heartburn or non ulcerous dyspepsia, seem to have a normal gastric mucosa (gastroscopy or histology). Potential difference is a measurement of the efficacity of mucosal barrier, and it drops when healthy volunteers ingest aspirin. By this method it is shown that patients with non ulcerous dyspepsia have a weakness of gastric mucosal barrier. Compare to controls or irritable bowel syndrome, basal potential difference is lower and time to return to basal value after aspirin is longer. This test shows that a trouble of the mucosal barrier exists even if the mucosa seems to be normal at gastroscopy and histology.

Aspirin↗
PubMed1985

Gastric carcinoids with minimal or no macroscopic lesion in patients with pernicious anemia.

In a series of 44 patients with pernicious anemia examined by gastroscopy, three cases of gastric carcinoids were found. During the same ten-year period about 11,000 gastroscopies were performed on patients not suffering from pernicious anemia, and only one case of gastric carcinoid was detected. In two of the cases no endoscopic lesion was seen and the carcinoid was detectable only at histological examination, while in one case an unusual combination of carcinoid tumor and tubular adenoma in the same polyp was found. Most of the carcinoids arose in atrophic body mucosa, but in one case the mucosa around the carcinoid showed antral properties. One patient had slightly elevated values of pancreatic polypeptide, while no hormonal activity was found in others. No growth or spread of the carcinoid was observed during follow-up. It is suggested that the same pathogenetic factors may operate in the genesis of gastric carcinoid and gastric carcinoma in patients with pernicious anemia.

Adenoma↗
PubMed1983

Tolerance of two ampicillin esters: a comparison of pivampicillin and bacampicillin.

The tolerability of tablets containing the ampicillin esters, pivampicillin and bacampicillin were compared clinically in 138 patients and by gastroscopy in 2 healthy volunteers. The clinical study showed no difference in tolerability, 26% of patients taking pivampicillin and 23% of those taking bacampicillin reported side-effects. Both preparations were equally effective clinically: 94% of patients taking pivampicillin and 91% of those taking bacampicillin were cured or improved. Gastroscopy showed that the pivampicillin tablets disintegrated more rapidly (10 minutes) than bacampicillin tablets (36 minutes). After disintegration, the pivampicillin tablets covered a larger area of the gastric mucosa than did tablets of bacampicillin.

Adolescent↗
PubMed1983

Gastric banding, a surgical method of treating morbid obesity: preliminary report.

Gross overweight in 15 patients was treated by a new method called gastric banding. The operative procedure is described. The technique is simpler than other procedures such as gastric bypass and gastroplasty. Gastric banding involves no opening of the gastrointestinal tract, which helps to minimize operative risk and complication rate. Operation resulted in an average weight loss of 36.5 kg (29.5 per cent) over six months, and is considered highly effective. Each patient was submitted, postoperatively, to a thorough check-up which included clinical examination, X-ray, gastroscopy and an extensive battery of laboratory tests. The fact that the artificial stoma and the gastric mucosa of upper and lower compartments can be inspected on gastroscopy is an added advantage. The series seems to indicate that gastric banding is a promising surgical method of treating extreme overweight.

Adult↗
PubMed1978

Gastric bezoars--spontaneous resolution.

Six cases of gastric phytobezoars were seen on fiberoptic gastroscopy over a period of four years during which time 1,400 gastroscopies were done. Four of these cases showed complete resolution of bezoars on repeat endoscopy during a follow-up period ranging from two weeks to one year. Our experience shows that, in the absence of gastric outlet obstruction, small bowel obstruction or other serious problems due to bezoars, they may not need surgical or aggressive medical treatment.

Adult↗
PubMed1980

No influence of age and gastric acid secretion on serum vitamin B12 concentration.

Serum vitamin B12 concentration, parietal cell antibodies (PCA), peak acid output vitamin B12 resorption capacity were determined in 76 patients (age 23 to 82 years). Gastroscopy was performed on all of these patients; guided biopsy was taken from 70 of them. No influence of the inflammatory changes in the gastric mucosa, sex or the presence of PCA on the serum vitamin B12 concentration were demonstrable in our patients, who all revealed a vitamin B12 resorption in the normal range. In particular we were unable to confirm the observation of Döscherholmen et al. (5) of a fall in serum vitamin B12 concentration with increasing age or decreasing PAO. Hence the estimation of the serum vitamin B12 concentration cannot be used as a screening test for selecting those patients suffering from chronic atrophic gastritis and achlorhydria, who should be monitored by gastroscopy and biopsy because of an increased risk of gastric cancer.

Achlorhydria↗
PubMed1995

[Endoscopic and surgical therapy of hemorrhagic duodenal and stomach ulcer].

The aim of this prospective clinical study was to evaluate whether a combination of the endoscopic hemostasis together with fibrin sealing and consecutive conservative therapy could reduce the frequency of recurrent bleedings, thus the number of operations without adversely influencing the prognosis of the disease. 134 patients admitted to the surgical and medical hospital of the University of Ulm between 1/1990 and 1/1992 with bleeding gastroduodenal ulcers took part in this study. All patients were treated endoscopically by hypertonic saline solution plus epinephrine and fibrin sealant. If initial endoscopic hemostasis was not achieved patients were operated within 6 h after admission. Patients with successful initial endoscopic hemostasis were treated conservatively and underwent control endoscopy after 24 and 48 h. In 23 patients the initial endoscopic hemostasis was not successful, they had to be operated immediately. In 111 patients endoscopic hemostasis was achieved, 20% of these patients had acute bleeding ulcers (Forrest Ia, b), 66% showed stigmata of fresh bleedings (Forrest-IIa bleeding). Primary endoscopic hemostasis was achieved in 85.6% of all patients treated, 14.4% of patients (n = 16) developed a recurrent bleeding during the observation period verified by gastroscopy. Half of these patients had an acute bleeding at the first gastroscopy (Forrest-Ia, Forrest-Ib bleeding). Recurrent bleeding became apparent between day 1 and 6 after admission to the hospital. Two patients refused surgical intervention, the other 14 were operated immediately.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[The clinical aspects of 49 cases of early gastric cancer].

Forty-nine consecutive patients with early gastric cancer (EGC), observed from January 1978 to December 1992 in the Surgery Department of our Institute, were included in a retrospective study. The EGC prevalence in the overall cases of gastric cancer was 11%. This frequency was 8% in the period 1978-1985 and 15% in the period 1986-1992. All patients underwent gastroscopy with gastric biopsy, but only in 35 cases (72%) was a preoperative diagnosis of gastric cancer possible. In the remaining 14 cases only the histological examination of surgical specimens made possible a definitive diagnosis. A subtotal gastrectomy was carried out in 36 cases (73%), a total gastrectomy in 12 cases (25%) while only in one case (2%) was a superior polar resection carried out. The postoperative morbidity was 5% and mortality was 2%. The median survival was 61 months and, at the moment, 41 patients are alive and free from disease. Our data confirm the favourable prognosis of EGC compared to the advanced gastric cancer. We think it useful to carry out a routine gastroscopy when there are symptoms related to the upper abdomen in order to make an early diagnosis of gastric cancer.

Adult↗
PubMed1994

Acetylsalicylic acid in the prevention of early stenosis and occlusion of transjugular intrahepatic portal-systemic stent shunts: a controlled study.

Stenosis or occlusion of the transjugular intrahepatic portal-systemic stent shunt may be initiated by aggregation and activation of thrombocytes on the surface of the metallic stent material. To find effective prevention of this event, we conducted a controlled trial administering acetylsalicylic acid for 3 mo. Forty-four patients (8 women and 36 men) with portal hypertension were included in this study. The patients were randomized into a group receiving 100 mg acetylsalicylic acid/day (n = 21) or into a control group (n = 23). Treatment was started immediately after transjugular intrahepatic portal-systemic stent shunt. Three months after transjugular intrahepatic portal-systemic stent shunt, 15 patients in the acetylsalicylic acid group and 19 patients in the control group underwent clinical reevaluation, gastroscopy and recatheterization with determination of the portal-systemic pressure gradient. No variceal bleeding occurred in any patients. In four patients in the acetylsalicylic acid group, erosive gastritis was observed in gastroscopy in contrast to only one patient in the control group. Complete patency of the stent was noted in 10 of 15 patients in the acetylsalicylic acid group and in 14 of 19 patients in the control group. Transjugular intrahepatic portal-systemic stent shunt restenosis associated with a significant increase of the portal-systemic gradient occurred in five patients in the acetylsalicylic acid group, which required redilation in all and additional stent placement for expansion of the stented tract in two patients. In the control group, redilation was necessary in five patients with additional stent extension in two patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Endoscopic studies of the digestive tract as a service for family practitioners; experience in the Eindhoven area].

In May 1989 an open access endoscopy service for general practitioners (GPs) was started in the region of Eindhoven. In the four hospitals covering a population of 500,000 inhabitants, served by 200 GPs, uniform working agreements were made. We evaluated the endoscopies performed in 1990 and compared the total number of endoscopies with that of gastrointestinal X-rays. A total of 996 open access gastroscopies were performed. The most important diagnoses were: peptic ulcer (19%), oesophagitis (16%), bulbitis (9%) and carcinoma (1.5%). The diagnostic yield was 57%. A total of 509 GP-referred sigmoidoscopies were performed. The most important diagnoses were: haemorrhoids and anal fissure (28%), colitis (15%), diverticulosis (12%), neoplastic polyps (11%) and carcinoma (4%). The diagnostic yield was 77%. Compared with 1989 the total number of gastroscopies, requested by GPs and by specialists, increased by 15% of which two-thirds were requested by the GPs. In this period the reduction of barium meals was 11% which was almost exclusively due to the specialist group. Sigmoidoscopies increased by 7%, entirely due to the GP group. The number of barium enemas remained constant. Open access endoscopy resulted in an increase endoscopies with only a partial substitution of radiological examinations. The increase in endoscopic examinations in the GP group did not result in a decline in the specialist group. The total diagnostic yield was 64%.

Adolescent↗
PubMed1993

[Gastroenterologic-endoscopic studies in ambulatory practice. Spectrum of applications, trends, quality and economic aspects].

A review on spectrum, frequency and complication rate of gastroenterological endoscopy in ambulant practice is given based on data of the National Association of Public Health Insurance Physicians of Germany. The following important aspects are mentioned: 1. Endoscopy has surpassed radiology in diagnostic examinations for gastric and colonic diseases. 2. Gastroscopy is more commonly carried out by physicians, coloscopy by gastroenterologists or specialists. Hospital doctors don't contribute significantly to ambulant endoscopic examinations of stomach and colon. 3. Endoscopic examinations of the pancreas, biliary tree, laparoscopy and other techniques play an insignificant role in ambulant practice. 4. The complication rate of ambulant gastroenterological endoscopy is very low. There have been only a few malpractice cases due to complications of gastroenterological endoscopic examinations. 5. The quality of coloscopy is not yet satisfactory as measured by the relative proportions of partial and total coloscopy. 6. In the past only limited attention was given to aspects of quality assurance and quality control in endoscopy in ambulant practice. This should be changed in the future. 7. The fees for gastroscopy and coloscopy allowed by the public insurance companies don't cover the expenses and are inadequate. As a result, a negative impact on the quality of medical care can be expected.

Ambulatory Care↗
PubMed1993

[Surgical treatment of bleeding stomach and duodenal ulcer--retrospective analysis of a five-year period].

94 patients have been operated upon for haemorrhagic gastroduodenal ulcer disease in the Wenckebach-Krankenhaus during the years 1986-1990. In all but 6 patients the ulcer has been controlled by an emergency gastroscopy. 25 of these patients had to undergo emergency operation at once for persistent bleeding after gastroscopy. From the other patients, another 31 suffered rebleeding and had to be laparotomised in an emergency procedure, too. Only in 38 cases an interval-operation was possible. No one of these 38 patients died. The overall mortality-rate was 14.9% (14 patients). The mean age of our patients was 68 (26-90) years, none of the patients under 60 years died, whereas the mortality-rate of the elder was as high as 20%. The operative procedures were ulcer excision and suturing of the bleeding vessel and distal gastrectomy. There was no difference in mortality-rates between resective and non resective procedures. Our aim to operate upon the patients in an elective way could be achieved in about one third only. Many patients refused an operation after primary control of bleeding.

Adult↗
PubMed1996

Effects of intermittent feed deprivation, intermittent feed deprivation with ranitidine administration, and stall confinement with ad libitum access to hay on gastric ulceration in horses.

OBJECTIVES: To determine the effect of decreasing gastric acidity in a feed-deprivation protocol on induction of gastric ulcers, and to determine whether stall confinement may be a factor contributing to gastric ulceration in horses. ANIMALS: 8 adult horses, 4 geldings and 4 mares, 3 to 8 years old, and 7 adult horses, 5 geldings and 2 mares, 4 to 11 years old. PROCEDURE: Gastric ulceration was induced in horses by alternating 24-hour periods of feed deprivation and ad libitum access to hay, for a total of 96 hours' feed deprivation. This protocol was repeated with the horses receiving the histamine type-2 receptor (H2) antagonist ranitidine (6.6 mg/kg of body weight, PO, q 8 h). In another group of horses, severity of gastric lesions was compared after 7 days' pasture turnout and 7 days' stall confinement with ad libitum access to hay. Gastroscopy was performed after each feed-deprivation protocol was completed, and total lesion area in the gastric squamous epithelial mucosa was measured. Gastroscopy was performed at the beginning and end of 7 days' pasture turnout and 7 days' stall confinement. RESULTS: Alternating periods of feed deprivation resulted in erosion and ulceration of the gastric squamous epithelial mucosa of each horse. Concurrent treatment with ranitidine resulted in significantly (P < 0.05) less area of ulceration in the gastric squamous epithelial mucosa. After 7 days' stall confinement, 6 of 7 horses had ulceration in the gastric squamous epithelial mucosa, and 1 horse had a lesion in the glandular mucosa, whereas after 7 days' pasture turnout, 2 horses had reddening of the gastric squamous mucosa along the lesser curvature (P < 0.05). CONCLUSIONS AND CLINICAL RELEVANCE: Severe ulceration of the gastric squamous epithelial mucosa, caused by excess acidity, can develop rapidly in horses deprived of feed or not consuming feed. Suppression of gastric acidity with the histamine type-2 receptor antagonist ranitidine effectively minimized the area of ulceration caused by feed deprivation. Compared with being turned out to pasture, stall confinement alone appears to be an important factor in the development of gastric ulcers in horses, probably as a result of altered eating behavior.

Animals↗
PubMed1998

[Computerized speech recognition-based endoscopic findings].

Discrete, Hidden Markov model based speech recognition and phoneme based speech synthesis techniques were applied for gastroscopy reporting and machine control. The authors developed a special program for grammatical analysis of the sentences. Altogether 100 patient findings were grammatically analysed. The sentences were grouped according to the topographical order of the investigation: oesophagus, cardia, fundus, corpus, antrum, pylorus, bulbus, postbulbar section, and the pathological findings: erosion, ulceration, malignancy. Speech samples from 3 deep voiced male investigators were collected. The recognition rate was above 95%. A simulation program was also developed for dictation and controlling of the different equipment (monitor, printer, video, endoscope) in the gastroscopy laboratory by speech recognition. Speech synthesis was applied for the evaluation of understanding. This module artificially synthesizes the answer of the system giving backup for the understood information. With additional developments the discrete word speech 'recognition' achieved the level of routine application in medical reporting. However, ready-to-use developments need the joint activity of speech technology and endoscopy industry with end-user teams.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

[Therapy of Helicobacter pylori infection using Lactobacillus acidophilus].

INTRODUCTION: In vitro experiments with Lactobacillus acidophilus have revealed its inhibitory effect on Helicobacter pylori and its application in treatment of Helicobacter pylori positive gastritis was examined. MATERIAL AND METHODS: 15 patients have undergone gastroscopy with biopsy and by histopathological examination. Helicobacter pylori positive gastritis was detected. During a two-month period these patients took acidophilus milk (3 x 250 ml a day) prepared according to a special protocol and which contained 4 x 10(9)-1 x 10(10) live cells of Lactobacillus acidophilus at the moment of preparation. Lactobacillus acidophilus strain NAS, gained from lyophilized preparation Bio-Nate (Natren Inc. USA) was used as a test organism. Control gastroscopy was performed 2 months later. RESULTS: 14 patients have completed the examination. All of them were satisfied with the taste of acidophilus milk and could stand it well, whereas in 6 out of 14 Helicobacter pylori was eradicated. DISCUSSION: Helicobacter pylori eradication therapy is recommended in all cases of Helicobacter pylori positive gastritis associated with peptic ulcer, as well as in absence of ulcer when subjective difficulties occur. Antibiotic therapy is often unsuccessful and most often associated with risks of significant adverse effects, being the consequence of intestinal microflora disorders. The aim of using Lactobacillus acidophilus in the therapy is to reduce risks of adverse effects. In our study, by using acidophilus milk only, without other therapy, eradication of Helicobacter pylori was achieved in 6 out of 14 patients. All patients could stand the therapy well and were satisfied with the taste of the preparation. The number of examinees was small in regard to making conclusions, but the results are encouraging and show that apart from established in vitro effect. Lactobacillus acidophilus has a potential in vivo effect.

Adult↗
PubMed1962

A new direct-vision biopsy gastroscope.

Experience of 70 gastroscopies with direct-vision biopsy is favourable and indicates that this instrument will be of great assistance in certain difficult diagnostic problems of gastric pathology.

Biopsy↗
PubMed1953

Endoscopy in hernia at the esophageal hiatus.

Endoscopy is useful for confirming diagnosis of hiatal hernia as made by x-ray examination, for establishing the diagnosis when x-ray examinations do not disclose the herniation, and for observation of resultant abnormalities in the affected area. The authors' experience with gastroscopy and esophagoscopy in hiatal hernia is reported and the techniques and usual findings in these procedures are summarized.

Disclosure↗