Higher incidence of Gastrospirillum sp. in swine with gastric ulcer of the pars oesophagea

Gastric ulcer in swine is characterized by an area of acid-peptic digestion, occurs usually in the pars oesophagea of the stomach, and has unknown etiopathogenesis. The present work was carried out to investigate the prevalence of the newly described spiral-shaped microorganism Gastrospirillum sp. ("Gastrospirillum suis") in stomachs of abattoir pigs with and without gastric ulcer. Stomachs were removed from 32 consecutive pigs presenting apparently normal mucosa and from 32 additional consecutive pigs presenting frank, chronic gastric ulcer of the pars oesophagea. Fragments of antral, oxyntic, cardiac and pars oesophagea regions were taken from each stomach and processed for histology and for identification of Gastrospirillum sp. in tissue sections. The microorganisms were identified mainly in the mucous layer and in gastric foveolas of the antral and oxyntic mucosa. Forty pigs (62.5%) were positive for Gastrospirillum sp.; among them, 27 (67.5%) had gastric ulcer, and 13 (32.5%) had no ulcer. Twenty-four pigs (37.5%) were negative for Gastrospirillum sp.; among them, five (20.8%) presented with gastric ulcer, and 19 (79.2%) had no ulcer. There was a significant difference between pigs with and without gastric ulcer in regard to the presence of Gastrospirillum sp. (P < 0.01). The spiral-shaped microorganism Gastrospirillum sp. that inhabits the stomach of pigs should be considered a possible factor connected with the etiopathogenesis of swine gastric ulcer.     

Effect of ingestion of C1Na and proteins on the Na concentration in the renal papilla of the rat

A case of benign lymphoid hyperplasia of the stomach misdiagnosed as ulcerating gastric carcinoma is presented. The similarities in the clinical, roentgenologic and and gastroscopic features as well as in the gross appearance of the two lesions are described and the features which help differentiation are highlighted. The pathologic picture suggested that the lesion possibly arose as a peptic ulcer and the clinical history further supports such a possibility.     

Ticlopidine, diarrhea and lymphocytic colitis

Perforation into the heart is a rare ulcer complication in a hiatal hernia. Because of the massive bleeding, medical help is often in vain. The case of a 73-year-old patient reported by our department confirms this. Endoscopic treatment was not possible because of the extraordinary amount of blood in the stomach, and the high intraoperative blood loss was lethal. If gastric ulcers occur in upper regions of the stomach, the possibility of the presence of an paraesophageal hernia and elective surgical treatment must be considered.     

The individualized choice of the method of operation in the planned surgery of gastric and duodenal peptic ulcers

A working classification of gastroduodenal ulcers was developed by the authors on the basis of surgical treatment of 1838 patients with ulcer disease of the stomach and duodenum. When used in combination with the complex examination of the patients it allows to individually choose the operative method. The indications and contraindications for different kinds of surgery are given. Specific features of the postoperative management are described.     

A case of esophageal cancer required jejunal reconstruction because of a gastric ulcer scar

Recently, with increase of number of esophagectomy for esophageal cancer, the cases having the lesion in the organs for esophageal substitute have been increasing. The case of esophageal cancer, required reconstruction using the pedicled jejunum, because of impaired submucosal blood perfusion of the stomach caused by a ulcer scar, was reported. The patient was a 72-year-old female, with the ulcerative and infiltrative cancer lesion in the anterior wall of the mid-thoracic esophagus. Barium swallow revealed shortening of the lesser curvature and indentation of the greater curvature of the stomach. Endoscopy showed the lesion occupying anterior two thirds of the esophageal wall circumferentialy from 30 to 34 cm from the incisor tooth. The lineal scar of ulcer on the lesser curvature of the body of the stomach was also found. Following esophagectomy through right thoracotomy, the stomach was mobilized for reconstruction by dividing left gastric artery and short gastric artery, but the stomach oral to the ulcer scar became ischemic and bleeding was not found at the tip of the stomach. Therefore, reconstruction was performed using the pedicled jejunum through antesternal route. The gastric cardia is rich in the vascular network in the submucosal layer. The ulcer or ulcer scar of this region can cause ischemia in the tip of the gastric tube for esophageal substitute. Care should be taken to detect the ulcer lesion at the stomach preoperatively. In the case with the ulcer lesion blood supply to the tip of the gastric tube should be critically evaluated.     

Celiacography in the diagnosis of stomach cancer

Selective celiacography after the Seldinger technic was performed in 24 patients with stomach pathology (cancer, ulcer, leiomyoma, cicatricial deformation of the stomach). Angiographic symptoms in gastric cancer are found to be mostly similar with those in ulcer and an inflammatory process. Celiacography fails to form an adequately precise judgement on the degree of gastric cancer local speed.     

An epidemiological analysis of peptic ulcer morbidity among the servicemen in the enlisted service of the Armed Forces of Ukraine

Data are submitted from a time-related analysis of peptic ulcer incidence among enlisted men of the Armed Forces of Ukraine. Peptic ulcer in the Armed Forces of Ukraine has been shown to be a major illness associated with substantial labour resource losses that total in certain years 28.3 percent of the digestive diseases-related unfitness for work, with the specific weight of ulcer of the stomach not exceeding 0.08 percent, that of duodenal ulcer--0.23 percent in general morbidity patterns.     

The clinical prognosis of the complication of peptic ulcer by acute hemorrhage

Clinical parameters have been studied in 45 peptic ulcer patients without and 47 ones with acute hemorrhage. Factors of acute hemorrhage risk in ulcer patients have been specified (old age, long history of the disease, previous hemorrhages, duodenal ulcer localization at the back and upper walls and gastric ulcer localization at the middle and upper thirds of the lesser curvature of the stomach, size of ulcer, penetration). Combined existence of the factors is conducive to acute hemorrhage.     

Histological changes in the canine stomach following massive electron beam irradiation

The histologic changes induced by irradiation of the stomachs of dogs were examined one hour to nine months after irradiation. The irradiated area of the stomach progressed to ulcer formation by way of hyperemia and erosion; on the other hand, there were simultaneous signs of recovery. Regenerating epithelium appeared during the first week and migrated from the surface adjacent to the ulcer to the center of the ulcer. Subsequently the muscularis mucosae extended, and then the submucous coat was repaired. Regeneration of the nerve fibers around the muscularis mucosae seemed to reach its maximum three weeks after irradiation. These proliferating nerves degenerated with deepening of the radiation ulcer, but they were unexpectedly radioresistant and protrude from the surface of the ulcer into the necrotic surrounding tissues. It is concluded that the effect of irradiation on the alleviation of the pain of stomach cancer is not due to the degeneration of the nerves but to elimination of the stimulation of nerves on account of the radiation effect on the cancer cells themselves.     

The drug prophylaxis of peptic ulcer exacerbations

453 patients with ulcer located in the duodenal bulb and pyloric part of the stomach in the presence of Helicobacter pylori were examined before and followed up after hospital treatment of the ulcer. The authors findings support the importance of maintenance with current antisecretory drugs and on-demand therapy as well as of combined antibacterial therapy against Helicobacter pylori. Adequate chemotherapy in the ulcer exacerbation was able to reduce the number of recurrences and complications.     

Physiopathology of Helicobacter pylori infection

The gastric juice of Helicobacter pylori-infected individuals contains substantially higher levels of phospholipase A2 (PLA2) than that of individuals who are not infected. We present a new theory for how this H. pylori-induced PLA2 activity in gastric juice may play a major role in the development of peptic ulcer disease. When activated at neutral pH (pH 6.5-7.0), PLA2 may damage the surfactant-like, phospholipid-rich layer which constitutes an important part of the mucus barrier. Pepsin and other proteases, activated at low pH (pH 1.0-3.5), may then denature and cleave PLA2-exposed proteins. Peptic ulcers therefore tend to develop in regions exposed to changing luminal pH, such as the duodenal bulb when acid production is high or normal, or in the stomach when acid secretion is low.     

Guidelines to assist national authorities with regard to the formulation of transplant policies and laws

The peptic ulcer of stomach and duodenum are the more often occuring complications of steroid treatment in children with chronic glomerulonephrite. Dinamic investigation has shown that the using of beta-carotin oily solution in therapy of this complications increases the efficiency of traditional treatment. It has been shown that beta-carotene administration speeds the reparation of stomach and duodenum ulcers, saves adequate serum concentration of beta-carotene and retinol. The data obtained demonstrate that beta-carotene administration in the complex therapy of chronic glomerulonephrite patient with gastroenteropathy should be recommended.     

Gastric acidity in a double ulcer (of the stomach and duodenum)

Gastric salt-acid secretion was studied in three comparative patient groups with gastric ulcer, endoscopically confirmed, combination of gastric and duodenal ulcers. In the patients with double localization of the ulcer (stomach and duodenum) - hyperacidity was determined after pentagastrin stimulation. Acid-salt secretion was higher than that of the patients with gastric ulcer and was close to the secretion of those with duodenal ulcer, being but with a high standard deviation, necessitates consideration to be given to each concrete case of treatment. No discrepancy in the volume of gastric secretion before meals was established, thus impugning the role of pylor stasis in the genesis of secondary gastric ulceration. The incidence of atrophic gastritis in case of gastric and double ulcer is almost identical, hence attention is paid to the duodeno-gastric reflux as an eventual cause for damaging gastric mucosa with its successive ulceration in the patients with duodenal ulcer of many years. That is the reason, drugs enhancing the resistance of gastric mucosa as well as methoclopramid intake are proposed additionally to the drugs, neutralizing or blocking the gastric acid-salt secretion.     

Laboratory medicine in ulcer disease

The role of laboratory medicine in ulcer disease is poorly defined. However there is increasing evidence of the clinical usefulness of some laboratory tests that investigate secretory functions and defensive properties of the stomach, gastrointestinal hormones and Helicobacter pylori infection. These tests may modify the clinical management of patients with peptic ulcer by identifying H. pylori positive subjects, patients with high acid output, patients who do not respond to antisecretory therapy, and patients with high gastrin levels in whom Zollinger-Ellison syndrome may be suspected. Here we review the clinical value of laboratory tests in ulcer disease, particularly as concerns the cost/benefit ratio. The relative merits of these tests are described giving an indication of their possible role in the diagnostic algorithm.     

Comparative results of surgical treatment for perforating and bleeding pyloroduodenal ulcers

Results of treatment of 1309 patients with perforated and bleeding pyloroduodenal ulcers for 20-years period have been analysed. Resection of the stomach performed in 85 cases resulted in high postoperative lethality which made up in bleeding ulcers 14.8%. Drainage operations of the stomach with excision or suturing of ulcer combined with bilateral truncal vagotomy was performed in 60 patients, postoperative lethality rate being 8.4%. 128 patients underwent selective proximal vagotomy together with pyloro- and duodenoplasty, lethality rate being 1.6%. Combined vagotomy (posterior truncal and anterior sero-muscular) with excision of ulcer, transversal pyloroplasty and duodenoplasty was carried out in 1036 patients (postoperative lethality--2.4%). Excellent and good functional results were achieved in 79.6% of the patients.     

Ultrastructural aspects of lesions caused by Mycobacterium spp in AIDS]

Anchusa strigosa Banks et Sol (Boraginaceae) root extracts (ASRE) were prepared by soaking the dry material in boiling water. The clear soluble extract was dried and found to be 0.238 g/g dry roots. A gastric ulcer was induced in fastened animals by oral ingestion of ethanol. Administration of 0.080 g of ASRE prior to ethanol ingestion protected the stomach of the rat from ulcer formation. The ulcer index values, expressed as a percentage of total stomach surface area affected by the ulcer, were lowered from 34.0+/-4.0 to 6.0+/-0.7 and 32.5+/-9.4 to 2.2+/-1.4 by the morphometric and the planimetric methods, respectively. Treatment of the induced ulcer in guinea pigs was achieved by oral administration of ASRE at the therapeutic dose of extract of 0.286 g/kg body weight/day for 24 days. The intraperitoneal LD50 of ASRE in mice was 0.080 g extract/kg body weight. Replacing water intake by ASRE at 75 ml of variable extract concentrations of 2.865, 3.57 and 4.284 g/l per animal per day for 90 days showed no histopathological changes in all organs of the rat. However, a clear depression effect on the central nervous system and anemia were observed particularly with extract of 3.57 g/l or more.     

Goal attainment and life satisfaction: variables under study

AIM: The study of clinical running of gastric or duodenal ulcer in associated coronary heart disease (CHD). MATERIALS AND METHODS: 209 CHD patients with gastric ulcer (GU) or duodenal ulcer (DU) were examined clinically plus histological examination of gastric or duodenal mucosa biopsies was made. RESULTS: In CHD patients GU occurred more frequently (56%) than DU. The lesions involved more frequently lesser curvature of the stomach and pyloric part of the stomach. Males developed ulcers 3.5 times more frequently than females. Ulcers tended to a painless course without season exacerbations. The disease manifested first with gastric bleeding in 52% of the patients. GU and DU ran with frequent recurrences and long-term exacerbations (76% of patients) which coincided in time with CHD exacerbations. 68% of patients developed exacerbations within 10 days after myocardial infarction or aortocoronary bypass operation. Helicobacter pylori was present as a resolving factor in arising ulcer in 26% of patients. Microcirculatory disorders, reduced blood flow speed in gastric or duodenal mucosa, hypocoagulation syndrome, dyslipidemia provoked exacerbations in 62% of patients. Examinations of biopsies from gastric and duodenal mucosa showed marked dystrophic changes in the mucosa, its connective tissue basis in the vessels in the presence of mild inflammation at ulcer site. CONCLUSION: The onset of ulcers and erosions in the mucosa of the gastrointestinal tract in CHD may be due to circulatory disorders in gastric mucosa. The main factors of aggression are hypoxia, hypoxia-induced trophic defects in gastric and duodenal mucosa, circulatory disorders.     

Evaluation of a new chromogenic substrate assay for the measurement of the prothrombin time

Since the ingestion studies by Marshall and Morris, Helicobacter pylori has been known to cause both acute and chronic infection in the human stomach activating both the cellular and the humoral immune system. It is of little or no value to evaluate the causative relationship of an infectious agent using Koch's criteria. The more recent criteria for causative relationships used in the science of epidemiology are more useful. These criteria include: (i) the characteristic of the association which is fulfilled for most cases of both duodenal and gastric ulcer; (ii) the temporal relationship which is fulfilled for duodenal ulcer and has not been investigated for gastric ulcer; (iii) the biological gradient which has been fulfilled for duodenal ulcer in a few studies but not investigated for gastric ulcer; (iv) the biological plausibility which is easily fulfilled for both duodenal and gastric ulcer; (v) the effect of an intervention which has been fulfilled for duodenal ulcer and in a few studies for gastric ulcer; and (vi) the coherence of these data with what is known about the disease which is fulfilled for both duodenal and gastric ulcer. Even though there is no need for all criteria to be fulfilled, further studies are necessary to confirm the temporal relationship between H. pylori and peptic ulcer, and the biological gradient of H. pylori in relation to the gastric ulcer. Even so, there is a strong indication that most of the peptic ulcers, apart from those caused by non-steroid anti-inflammatory drugs and Zollinger-Ellison-like syndromes, are caused by H. pylori infection.     

The etiological and pathogenetic characteristics of duodenal peptic ulcer in adolescents

Studied by endoscopy were 100 adolescents with diagnosed duodenal ulcer, as were 100 essentially healthy subjects and 90 ones of the same age presenting with primary chronic gastroduodenitis together with 60 adults who had duodenal ulcer. The following items were etiologic risk factors for duodenal ulcer, if combined, in the above adolescent series: Frequent episodes nervous of tension, hereditary predisposition and helicobacteriosis. In juveniles with duodenal ulcer, secretion and motility of the stomach appeared to be subjected to changes to a higher degree than it was in adult subjects with duodenal ulcer, while functions of the psychovegetative and immune systems were found to be less changeable in the former. In adolescents presenting with duodenal ulcer and primary chronic gastroduodenitis, the etiologic risk factors and pathogenetic changes were found out to be identical.     

Role of gastric acid in the aetiology of dyspeptic disease and dyspepsia

The main diseases associated with dyspepsia are peptic ulcer disease, gastro-oesophageal reflux disease and non-ulcer dyspepsia. Increased gastric acid secretion is a characteristic of most duodenal ulcer patients and of a small minority of non-ulcer dyspepsia and gastro-oesophageal reflux disease patients. Although acid secretion is normal in most gastro-oesophageal reflux disease patients, the condition is mainly the result of excess exposure of the distal oesophagus to acid refluxing from the stomach. Increased mucosal sensitivity to acid is involved in the aetiology of dyspeptic symptoms in the majority of patients with peptic ulcer disease and gastro-oesophageal reflux disease, and in a minority of non-ulcer dyspepsia subjects. Gastric acid, therefore, plays an important role in both the aetiology of dyspeptic diseases and in the aetiology of dyspeptic symptoms.