[Diagnosis of duodenal diseases by endoscopy (author's transl)].
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IgA, IgM and IgC content in blood serum and gastric juice were determined in 89 patients with different gastric and duodenal diseases (57 with duodenal ulcers, 13 with gastric ulcers 8 with chronic atrophic gastritis, 9 with superficial chronic gastritis and gastroduodenitis and two with gastric cancer). Immunoglobulin was established in gastric juice (over 0,3 mg/100 ml) in 49 per cent of all the patients examined with gastric and duodenal diseases. No correlation was found between serum immunoglobulin level and their presence in the gastric juice. No correlation exists between the volume of the basal secretion and the presence or absence of immunoglobulins in the gastric juice. Immunoglobulins were established more often in the gastric juice with lower secretion of hydrochloric acid (in chronic atrophic gastritis and gastric ulcer), while in cases of higher secretion they are more frequently absent. A certain parallelism was established between the changes of hydrochloric acid output and JgA secretion in the gastric juice after stimulation of gastric secretion by Pentagastrin or histamine.
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The content of gastrin, beta-endorphin, insulin, C-peptide in 129 patients with chronic gastric and duodenal diseases was studied by standard radioimmunoassay during the acute phase of the disease and after routine treatment. It is concluded that normalization of the hormonal homeostasis is one the criteria of treatment efficacy.
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Duodenal tumors are rare but duodenal inflammatory disease occurs frequently. In most cases it can be accurately diagnosed without angiography but in the occasional case that presents a diagnostic problem, angiography is required. Seven cases of duodenal inflammatory disease are reviewed. Careful attention to the shape and direction of vascular displacement and to separate evaluation of pancreatic and duodenal arteries accurately distinguished duodenal from pancreatic disease. This distinction can significantly influence subsequent therapy.
Data are given on the condition of the thoracic spine of 465 patients with certain gastric and duodenal diseases. Degenerative-dystrophic lesions (spondylosis deformans and intervertebral osteochondrosis) of the thoracic spine together with osteoarthritis deformans of the costovertebral and costotransverse articulations lead to neurodystrophy of the gastric and duodenal mucosa through chronic stimulation by osteophytes of the thoracic sympathetic ganglia. Disorders of gastric and duodenal motor activity are also important. The attendant reflux gastritis is stipulated by reflux of the intestinal contents into the gastric lumen. Condition of the stomach and duodenum can be improved by relieving changes in the spine.
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The exact pathogenic mechanisms involved in Campylobacter pylori associated gastro-duodenal inflammation are unclear. C. pylori adheres to gastric type epithelium and colonisation is associated with a number of ultrastructural abnormalities. Other factors thought important include the marked bacterial urease activity, enzymatic degradation of the mucous layer and possible toxins. The induced inflammatory reaction will also contribute to tissue damage and a breakdown of normal defense mechanisms.
OBJECTIVE: Previous erosive oesophagitis studies have excluded patients with peptic ulcers or taking aspirin, and conflicting results have been reported concerning the influence of. We aimed to study the possible correlation between erosive oesophageal and gastro-duodenal diseases in patients with or without erosive oesophagitis who are taking low-dose aspirin, or simple analgesics, or those infected with. METHODS: Endoscopic oesophageal and gastro-duodenal lesions were graded in 287 patients with reflux oesophagitis, median age 57 years, including 168 with oesophageal erosions, 131 infected with, 45 patients taking aspirin 75 mg daily, and 65 patients taking simple analgesics containing paracetamol/codeine. RESULTS: The grades of oesophageal erosions correlated positively with the duodenal scores (r = 0.15; P = 0.01) in the study group as a whole (n = 287), and in patients (n = 131) with (r = 0.169; P = 0.05). Eighty of 168 patients with erosive oesophagitis had (48%), compared with 51 of 119 patients (43%) with non-erosive oesophageal disease (P = 0.47). Oesophageal scores were highest in the aspirin group (P = 0.04; Kruskal-Wallis test), with grades > or =3 being found in 36% of patients on aspirin, 22% on simple analgesics, and in 18% of other patients. CONCLUSIONS: The degree of oesophageal damage correlates positively with that in the duodenal mucosa, although the overall prevalence of erosive oesophagitis is not influenced by. Also, patients taking aspirin have a greater degree of oesophageal damage. These indicate the presence of a common process mediating both oesophageal and duodenal diseases in at least some patients with these disorders.
One of the newest conceptions on the causes of gastritis, duodenitis, peptic and duodenal ulcers states that an infectious factor--Helicobacter pylori is responsible. The purpose of the this study was to estimate the frequency of Helicobacter pylori among children and the correlation between its presence and gastritis, duodenitis, peptic and duodenal ulcers and biliary reflux. Helicobacter pylori infection seems to be a serious etiopathogenic factor of stomach and duodenal diseases among children. Inflammatory changes of the gastric mucosa, as well as peptic and duodenal ulcers more frequent in children with H. pylori.