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At least 1,513 records · Page 84Linked to original sources
PubMed1986

[Surgical therapy of stenosing duodenal ulcer--results of an uncontrolled comparative study].

In an uncontrolled trial on 77 patients we investigated the results of different surgical procedures in stenosis secondary to duodenal ulcer. The assignment to a procedure was dependent on the preference of the surgeon. The follow-up investigation after a mean observation time of 40-42 months was performed without knowledge of the surgical procedure. The postoperative mortality was 6.6% after resection, 0% after vagotomy and drainage. Postoperative sequelae were lowest in highly selective vagotomy + gastroduodenostomy (Visick I in 15 out of 17). After resection only 15 out of 33 had Visick I. The worst result was obtained after selective vagotomy and pyloric dilatation (4 out of 9 Visick IV). This procedure has been given up.

Adolescent↗
PubMed1989

Deleterious effect of sodium fluoride on gastrointestinal tract.

1. The effect of sodium fluoride (NaF) on gastrointestinal tracts of rats was investigated. 2. Blood flow rate in rat stomach mucosa was only 30% of the initial rate during 30-60 min after a single oral dose (300 mg/kg) of NaF. 3. The addition of NaF (final NaF concentration: 50 and 100 ppm) in vitro gave the reduction of 10 and 28%, respectively, of initial free calcium ion levels in rat blood. 4. These results indicate that oral ingestion of excess amount of NaF caused dilatation of blood vessel and greatly decreased blood flow rate to accumulate the circulating blood in the mucosa of gastrointestinal tract to cause redness.

Animals↗
PubMed1988

Ciliated metaplasia in the gastric mucosa. In an American patient.

We report the first case of ciliated gastric metaplasia found in a Caucasian American patient. Cilia were found in cystically dilated glands underneath a gastric adenoma. The rarity of ciliated metaplasia among Caucasians and its high frequency among the Japanese suggests a difference in the gastric mucosa in the two populations.

Adenoma↗
PubMed1998

Mediation by 5_hydroxytryptamine of the femoral vasoconstriction induced by acid challenge of the rat gastric mucosa.

1. Gastric mucosal barrier disruption in the presence of luminal acid causes femoral vasoconstriction via a pathway that appears to be stimulated by messengers generated in the injured gastric mucosa. This study was undertaken to analyse the gastric factors that are responsible for the femoral vasoconstrictor response. 2. Gastric mucosal barrier disruption in the presence of luminal acid was induced by perfusing the stomach of urethane-anaesthetized rats with ethanol (15 %) in 0.01-0.15 M HCl. Blood flow in the left gastric and right femoral artery was estimated by the ultrasonic transit time shift technique. 3. Gastric perfusion of ethanol in HCl caused loss of H+ ions from the gastric lumen, decreased the HCO3- concentration in hepatic portal vein blood, induced macroscopic histological damage to the gastric mucosa, dilated the left gastric artery and constricted the femoral artery. These responses were related to the HCl concentration in the ethanol-containing perfusion medium. 4. The femoral vasoconstriction was also seen when, instead of ethanol, taurocholate (20 mM) was used to disrupt the gastric mucosal barrier in the presence of 0.15 M HCl. 5. The femoral vasoconstriction evoked by gastric perfusion of ethanol in HCl was left unaltered by pharmacological blockade of gastrin and histamine receptors. In contrast, the 5-hydroxytryptamine 5-HT1/2 receptor antagonist methiothepin, but not the 5-HT2A receptor antagonist ketanserin or the 5-HT3 receptor antagonist granisetron, inhibited the ability of both 5-hydroxytryptamine and gastric acid back-diffusion to constrict the femoral artery. 6. Gastric acid back-diffusion caused release of 5-hydroxytryptamine into the gastric lumen, which was related to the HCl concentration in the ethanol-containing perfusion medium. 7. These data show that femoral vasoconstriction evoked by gastric mucosal barrier disruption depends on back-diffusion of acid into the mucosa. The acid-induced damage results in release of 5-hydroxytryptamine from the gastric mucosa, and the pathway leading to constriction of the femoral artery involves 5-hydroxytryptamine acting via 5-HT1/2 receptors as a messenger molecule.

Animals↗
PubMed2003

[Hepatobiliogastroscintigraphy in assessment of the hepatobiliary system in primary cancer of the liver].

Primary cancer of the liver is characterized not only by laboratory evidence for cytolytic (87.5% cases), cholestatic (100% cases) syndromes, high levels of oncomarkers (CA-19-9, 50%; CEA, 68.75%; alpha FP, 43.75%) and activation of hemostasis system but, as shown at hepatobiligastroscintigraphy with 99m-Tc-brommeside, by at least 2-fold decline in absorptive and excretory function of hepatic polygonal cells (in 75% cases), at least a 5-fold decline in secretory function of the gallbladder (in 100% cases), cholestasis (in 100% cases) manifesting as a 3.8-fold reduction, on the average, of the ratio of secretory function of the gallbladder to that of the intrahepatic bile ducts, dilation of the latter (in 50% cases), Oddi's sphincter hypotonicity (in 50% cases). None of the patients showed duodenogastric reflux.

Adult↗
PubMedDate not supplied

The present state and future of endoscopic surgery.

The present state and future of endoscopic surgery is analyzed on the basis of our own experience with endoscopic methods applied in clinical practice. Data were obtained from 73,572 diagnostic endoscopies and 1975 surgical procedures performed between 1972 and 1994. A significant role of endoscopic procedures was observed in stomach and duodenum surgery, bile duct and pancreatic surgery and colorectal surgery. We performed 9100 ERCP, 1200 endoscopic sphincterotomies, 61 bile duct prosthesis placement, 1086 cholangioscopies, 61,105 gastroscopies, 422 endoscopic hemostasis of the upper GI tract, and 376 curative polypectomies. We introduced sphincter Oddi manometry, endoscopic ultrasonography and minimal invasive methods to surgical practice in the treatment of oesophageal, gastric and rectal strictures such as balloon dilation and laser recanalization. Modern endoscopic methods used together with ultrasonography, radiology and computer techniques create progress in surgery.

Catheterization↗
PubMedDate not supplied

EEA stapler in oesophagogastrectomies.

A retrospective study was conducted to evaluate the use of the EEA circular stapler in the construction of oesophagogastric anastomoses. Eighty five consecutive patients were subjected to oesophageal resections. There were 58 males and 27 females. The age ranged between 38 and 77 (mean 62) years and between 49 and 84 (mean 69) years respectively. In the first 19 patients the surgical approach was carried out via a Lewis' procedure and in the remaining 66 via a low left thoracotomy. The overall hospital mortality was 20%. Leakage related to mortality was found to be 4.7%. Mean operative time was estimated at a rate of 168 min (range: 120-360) and mean blood loss 434 ml (range: 250-1200). The mean postoperative stay was 15.3 days (range: 9-41). Benign anastomotic strictures occurred in 22% of the operated patients, all of whom responded well to dilation. By the aid of the EEA stapler, high and safe anastomoses can be carried out via a low left thoracotomy with acceptable morbidity and mortality.

Adult↗
PubMed1998

The watermelon stomach: clinical presentation, diagnosis, and treatment.

The watermelon stomach syndrome is an increasingly recognized cause of persistent acute or occult gastrointestinal bleeding, typically in elderly women. This disorder often presents with severe iron deficiency anemia, and a variety of associated conditions including autoimmune disease, cirrhosis, achlorhydria, and hypochlorhydria. Diagnosis is made by the characteristic endoscopic appearance of visible linear watermelon-like vascular stripes in the antrum. Histology confirms the vascular nature of this disorder, showing dilated and thrombosed capillaries in the lamina propria, associated with reactive fibromuscular hyperplasia. The optimum treatment of choice is not known. Several treatment options, including surgical antrectomy, and endoscopic photocoagulation with Nd:Yag laser, heater probe therapy, and bipolar electrocautery, have yielded excellent results. Pharmacological agents have also been used to treat selected numbers of patients, most of which comprise a small number of case reports.

Adult↗
PubMed1994

The effect of distension of the stomach on coronary blood flow in anaesthetized pigs.

The present study was undertaken in anaesthetized pigs to determine whether distension of the stomach reflexly affects coronary blood flow. Experiments were performed on 17 pigs anaesthetized with ketamine and sodium pentobarbitone and artificially ventilated. Coronary blood flow was measured with an electromagnetic flowmeter positioned around the origin of the left circumflex coronary artery. The stomach was distended by injecting 0.8l warm Ringer solution into a balloon positioned within the stomach (mean gastric transmural pressure of about 13 mm Hg). Changes in aortic blood pressure and heart rate were prevented by a pressurized reservoir connected to the left femoral artery and by atrial pacing respectively. Distension of the stomach always caused a decrease in mean coronary blood flow. In five pigs, the magnitude of the decrease in coronary blood flow was graded by step increments in the gastric distending volume from 0.6l to 1l. The response of coronary blood flow was not affected by the administration of atropine (12 pigs), while it was abolished by the administration of bretylium tosylate (eight pigs) and by bilateral vagotomy (eight pigs; four cervical, four subdiaphragmatic vagotomy). These results show that innocuous distension of the stomach in anaesthetized pigs reflexly decreases coronary blood flow. This reflex response is mediated by sympathetic effects and its afferent limb involves the vagal nerves.

Anesthesia, Intravenous↗
PubMed1991

[Subacute arsenic poisoning].

A cas is reported of a 23-year-old man who voluntarily took a massive dose of arsenic (at least 8 g). In spite of the ingested amount and the acute nature of the poisoning, the patient survived 8 days. Gastrointestinal, neurologic and cardiac features were predominant including nausea, vomiting, choleroid diarrhoea, encephalopathy, peripheral neuropathy, and finally a fatal toxic cardiomyopathy. Metabolic acidosis, moderate cytolysis and an anticoagulant effect were also observed. This unique characteristic was partly due to a circulating anticoagulant with prothrombinase activity, as well as direct antivitamin K activity. Postmortem examination revealed: a congestive oesophagitis; a necrosing gastritis involving all the stomach wall; diffuse hepatic steatosis; skin lesions with vascular congestion and dermoepidermal detachment; discrete subepicardial congestive lesions. Arsenic was found in all tissues.

Acute Disease↗
PubMed2003

Endoscopy-guided balloon dilatation of oesophageal strictures in children.

The aim of the study is to evaluate the indications, safety, and efficacy of endoscopy guided balloon dilatation (EGBD) in the treatment of strictures of the oesophagus in children. Between 1998 and 2002, 12 infants and children with oesophageal strictures were treated with EGBD in our institute. Median age was 4.1 years (range, 2 months-11 years). Of 12 patients, four had oesophageal strictures, following repair of oesophageal atresia; six had short-segment caustic strictures; and two had anastomotic strictures after oesophageal replacement (colon, 1; stomach, 1). All patients had previously failed to respond to conventional bouginage (mean, 6 sessions; range 2-14). All patients underwent contrast studies before EGBD. EGBD was performed using flexible endoscopy and fluoroscopic screening under general anaesthesia. The mean number of EGBD procedures per patient was six (range 4-10). The functional results were complete in ten and temporary in two patients. There has been no morbidity or mortality. EGBD is safe and effective for treating oesophageal anastomotic and short-segment caustic strictures.

Journal Article↗
PubMed1983

Gastric blood flow responses to autonomic nerve stimulation and related pharmacological studies in rats.

The effects of autonomic nerve stimulation on rat gastric blood flow (GBF) were studied using a cross thermocouple method. Stimulation of the periarterial nerve bundles along the left gastric artery produced a decrease in GBF which was antagonized by phenoxybenzamine (0.05 mg kg-1 i.v.), but not by propranolol (1 mg kg-1 i.v.). Stimulation of the vagus nerves elicited an increase in GBF, within a latency of 20 s, which was not apparently affected by atropine (0.15 and 1.5 mg kg-1 i.v.) but was completely blocked by hexamethonium (10 mg kg-1 i.v.). The GBF increase due to acetylcholine (0.25 micrograms rat-1 i.a.), was markedly blocked by atropine (0.15 mg kg-1 i.v.). Vagal stimulation also produced both the cholinergic excitation and non-cholinergic inhibition of gastric motility. The vagally induced GBF increase was little affected by any pretreatment with phentolamine, propranolol, indomethacin or aprotinin. These results suggest that sympathetic nerve stimulation creases GBF through alpha-adrenoceptors and parasympathetic nerve stimulation increases GBF through a non-cholinergic mechanism in rats and that the GBF increase may result from a primary dilator effect of vagal stimulation on the blood vessels because of the immediate initiation of the response.

Animals↗
PubMed1981

Sonography of hypertensive portal venous system: correlation with arterial portography.

Sixteen patients with portal hypertension and bleeding from gastroesophageal varices were studied prospectively by sonography and arterial portography. Sonography was able to demonstrate anechoic venous structures in characteristic sites in the upper abdomen corresponding with portosystemic collateral veins seen with arterial portography. Of four patients with sonographic visualization of a dilated umbilical vein, three were seen with angiography. Two patients had periportal collateral veins seen with both methods. Of 10 patients with retrograde opacification of the left gastric vein, nine were seen with sonography. Although all 16 patients had endoscopic proof of gastroesophageal varices, only 12 were demonstrated by angiography. Of these 12 patients, 10 had sonographic visualization of varices alone the gastroesophageal junction and lesser curvature of the stomach. One patient with opacification of a gastrorenal communication also had left upper quadrant venous abnormalities at sonography. Sonography is useful in the noninvasive identification of portosystemic collateral vessels in patients with portal hypertension.

Adult↗
PubMedDate not supplied

[Vagotomy and drainage adapted for ulcerous stenosis].

The authors have retrospectively studied 56 patients with duodenal ulcer stenosis treated by vagotomy and gastric drainage. They found that there are several types of stenosis needing different drainage and vagotomy procedures. So, they propose an operative policy based on the result of a intra-operative exploration adapting the gastric drainage to the type of stenosis and vagotomy to the selected drainage. If the ideal is to preserve pylorus, then to perform a H.S.V. with dilatation or duodenoplasty, nevertheless, according to the authors, there are still indications for T.V. and drainage.

Adult↗
PubMed1996

[Endoscopic treatment of anastomosis insufficiency and perforation in the esophagus with fibrin glue].

The incidence of anastomotic dehiscence following oesophageal or gastric resection reported in European studies varies between 3.5 and 25%. The outcome of these patients is usually not explained nor is there a relevant number of studies concerning the treatment of this situation. Oesophageal perforation is rare but is commonly combined with high morbidity and mortality. Operative treatment mostly means major surgical procedures. In our institution endoscopic treatment of these defects has been established since 1985. Following the endoscopic diagnosis, the extent of the defect becomes radiologically documented by filling the cavity with contrast media. This also shows any contact to intraoperatively placed drainages. The lesions and abscess cavities are then endoscopically flushed with saline solution on a daily basis analogously to an internal drainage until surfaces are cleansed. Developing granulation tissue and cleansed surfaces are then covered with fibrin tissue adhesive to support shrinking of the defect. During the last 9 years, we treated 46 cases of anastomotic dehiscence and 9 oesophageal perforations applying this regimen. About 50% of the patients showed signs of sepsis at the beginning of their course. The defects were between 1 and 400 ml in size. In a median number of 4 (1-19) endoscopies a median of 8 (1-81) ml of fibrin tissue adhesive was applied. The average costs for fibrin tissue adhesive were about US $720. Close to 80% of the lesions could be healed, only 14% of the patients developed oesophageal stenosis with a consecutive need of dilatation. We therefore conclude that this method is helpful in treating patients with oesophageal lesions, especially if they are in reduced general condition and are at high risk for operative interventions.

Esophageal Neoplasms↗
PubMed1996

Distribution of peptide-containing nerve fibres in achalasia of the oesophagus.

In this study the innervation of the normal human oesophagus was compared with samples taken from 12 patients undergoing Heller's cardiomyotomy for achalasia. The distribution of all nerve fibres in the oesophageal wall was revealed by immunoreactivity to neuron specific enolase and subpopulations of nerve fibres were revealed by immunoreactivity to vasoactive intestinal peptide, neuropeptide Y, enkephalin and substance P. In healthy oesophagus, many nerve fibres immunoreactive for vasoactive intestinal peptide and neuropeptide Y were present in the circular and longitudinal muscle layers of the oesophageal wall and in the cardia of the stomach, whereas fibres immunoreactive for enkephalin and substance P were uncommon. Neuropeptide Y-reactive fibres were commonly seen around blood vessels. In the myenteric plexus cell bodies reactive for vasoactive intestinal peptide and neuropeptide Y were prevalent, as were varicose and non-varicose fibres. In contrast, samples from patients with achalasia revealed few nerve fibres immunoreactive for vasoactive intestinal peptide or neuropeptide Y in either circular or longitudinal muscle, suggesting damage to the inhibitory motor neurons to the muscle layers. Very few fibres were found that were reactive for neuron-specific enolase, indicating that other fibre population (e.g. excitatory cholinergic motor neurons) are also damaged in achalasia. These abnormalities were observed in biopsies from both the constricted and dilated portions of the oesophagus, but the pattern of innervation in the gastric cardia was normal. Myenteric ganglion cells were seen in the oesophagus in only two patients and varicose nerve fibres in the myenteric plexus were uncommon. Neuropeptide Y-reactive perivascular nerve fibres were still found in achalasia as well as non-varicose nerve fibres in the myenteric plexus. These findings indicate damage to all intrinsic neurons in the oesophageal wall in achalasia; however, extrinsic nerve fibres appear to be intact.

Adult↗
PubMed1992

Five types of pyloric cells in the antral mucosa of the stomach.

Only one type of pyloric cells in the exocrine antral glands is usually described in the literature. The review of 100 gastrectomy specimens revealed 5 types of pyloric cells: one composed of "ordinary" pyloric cells (i.e. cuboidal cells with ill-defined borders, pale, bubbly cytoplasm with an inconspicuous cytoplasmic network). The second type was characterized by pyloric cells with a small, regular vacuole, usually in a subnuclear position. The vacuole in such cells was negative for mucous stains. The third type of pyloric cells had a large intracytoplasmatic vacuole. Cells with this characteristic were found in cystically dilated pyloric glands. The vacuoles in such cells were usually negative for mucous stains although a rim of PAS or alcian blue positive substance was found in some vacuoles. The fourth type of pyloric cells had eosinophilic granules in the cytoplasm. These granules were proven to contain lysozyme. The fifth type had a non-vacuolated, homogeneous ("glassy") cytoplasm which was weakly positive for PAS but negative for acid mucins or mannosides. While the significance of the various types of pyloric cells herein described remains unclear, their easy identification in H & E stained preparations would permit more elaborated studies with histochemistry, immunohistochemistry and/or transmission electron microscopy in the future.

Cytoplasm↗