摘要:

Percutaneous ultrasonically (US) guided fine-needle biopsy can be considered the first invasive diagnostic step for hepatic malignancies. This procedure may also be useful for benign hepatic lesions. In pancreatic tumors the success rate of this technique is lower than that obtained in hepatic masses. US-guided puncture shows low risk even though fatal and major complications, although rare, may occur.

ISSN:0257-2753    

DOI:10.1159/000171350

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Luminal and mucosal pH were measured endoscopically in patients with reflux esophagitis and antral gastritis and in control subjects. In all subjects, significant lumen-to-mucosa gradients were observed in the esophagus, stomach and acidified proximal duodenum. In the reflux patients luminal pH was lower in the fundus (mean ± SEM, control vs. reflux esophagitis: 2.01 ± 0.17 vs. 1.32 ± 0.18;p < 0.02)and antrum(3.51 ± 0.35 vs. 2.13 ± 0.24; p < 0.01) and, in the gastritis patients, in the fundus (2.01 ± 0.17 vs. 1.3 ± 0.17; p < 0.02). In both patient groups, mucosal pH was lower in the fundus (control vs. reflux vs. gastritis: 4.84 ± 0.37 vs. 3.37 ± 0.61 vs. 3.12 ± 0.6; p < 0.05) and acidified duodenal cap (6.74 ± 0.13 vs. 6.09 ± 0.24 vs. 5.73 ± 0.46; p < 0.03). Mucosal pH profiles at the various sites showed less resistance of the gradient to a highly acidic environment in both the lower esophagus and antrum than in fundus and duodenum, and this was the case in the patient and control groups. Though associated with a more acid environment, neither esophagitis nor antral gastritis exhibits a specific deficit in the ‘mucus-bicarbonate barrier’, suggesting that the pathogenesis of these disorders may depend more on abnormal ‘attack’ rather t

ISSN:0257-2753    

DOI:10.1159/000171351

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

‘Gastrospirillum hominis’ is a ‘new’ tightly coiled gram-negative bacterium carrying bundles of sheathed polar flagella. It has been rather infrequently detected in antral and, even more rarely, in fundic mucosa samples removed at endoscopy from patients investigated for Helicobacter pylori colonization. Until now, it has remained noncultivable but has successfully been maintained in laboratory mice. Its identity with similar bacteria found in the stomachs of cats, dogs, monkeys, pigs, and other animals is uncertain. It was probably already seen by early investigators in the first half of this century. Preliminary data published in case reports suggest that it is associated with more or less active chronic antral gastritis, that it is restricted to the gastric epithelium, and that it possesses a urease, thus limiting the specificity of urease tests for H. pylori. There is hitherto no solid proof that it can induce inflammation although it seems capable of invading parietal and other glandular cells and causing ultrastructural changes. Similar organisms spontaneously colonizing the stomachs of rhesus monkeys were shown to increase gastric acid se

ISSN:0257-2753    

DOI:10.1159/000171352

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Sucralfate, a basic aluminium salt of sucrose, was the first successful drug with a major cytoprotective mechanism of action. It binds bile acids and pepsin and adheres to both ulcerated and nonulcerated mucosa. Sucralfate stimulates the synthesis and release of gastric mucosal prostaglandins as well as bicarbonate and the epidermal growth factor which stimulates healing. Sucralfate is the safest drug available today in the treatment of dyspeptic symptoms and compared to ranitidine and cimetidine it has the following characteristics. (1) It effectively prevents mucosal damage by alcohol. (2) The short-term healing of duodenal ulcers is the same for sucralfate, cimetidine and ranitidine. (3) Sucralfate-treated patients have a lower recurrence rate of duodenal ulceration after healing when compared with cimetidine and the recurrence rate is not connected with the presence or absence of Campylobacter pylori.

ISSN:0257-2753    

DOI:10.1159/000171353

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

In patients with chronic liver disease (CLD), several clotting changes can be observed. The most frequent abnormality is the reduced synthesis of many clotting factors, including vitamin-K-dependent and vitamin-K-independent ones. A low platelet count is another frequent feature of patients with CLD, which, however, is not always associated with the prolongation of bleeding time. Hyperfibrinolytic syndrome is usually seen in patients with decompensated state, and may further deteriorate the clotting abnormalities and favor bleeding complications. The assessment of the clotting system may be a useful approach to evaluate liver function and predict prognosis of patients with CLD.

ISSN:0257-2753    

DOI:10.1159/000171354

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Acromegaly is a unique condition characterized by chronic growth hormone (GH) and insulin-like growth factor-1 (IGF-1) hypersecretion usually due to a pituitary adenoma. Rarely, acromegaly can result from a GH-releasing hormone carcinoid or pancreatic neoplasm which stimulates the normal pituitary to secrete GH. This review describes the interactions between acromegaly and the gastrointestinal system. In contrast to the soft tissue and skeletal changes, clinical organomegaly of the liver, kidney, and spleen is unusual in patients with acromegaly and should warrant further investigations. The prevalence of cholelithiasis is notably increased by the use of the otherwise effective GH-lowering somatostatin analog, octreotide. Patients on long-term therapy with this agent may require anticholelithogenic treatment. The frequency of malignant and premalignant polyps of the colon justify the routine screening for these lesions in newly diagnosed patients with acromegaly.

ISSN:0257-2753    

DOI:10.1159/000171355

出版商:S. Karger AG    

年代:1992

数据来源: Karger