摘要:

Conventional oral pancreatic enzyme preparations are largely inactivated by gastric acid. To circumvent this, preparations containing pancreatic enzymes in the form of microspheres encoated by a pH-sensitive membrane have been introduced. We compared the therapeutic efficacy of two such preparations, Pancrease (mean ± 2SD, lipase activity/capsule 4933 ± 140 units) and Cotazym-S (lipase activity/capsule 5712 ± 152 units), with a conventional pancreatic enzyme preparation, Pancreatin (lipase content/tablet 684 ± 52 units) in seven men with pancreatic insufficiency secondary to alcoholism. In each patient, we collected stool for 72 hours for total lipid determinations without pancreatic enzyme therapy, and on various pancreatic enzyme preparations. At the end of the study, we asked patients which oral pancreatic enzyme preparation they preferred. Fecal fat excretion was significantly reduced with Pancrease and Cotazym-S as compared to the untreated state (p < 0.0005). Pancrease and Cotazym-S were equally effective in reducing fecal fat excretion. There was a trend towards greater reduction of fecal fat excretion with the pH-sensitive enteric coated preparations than with a weak conventional pancreatic enzyme preparation with low lipase content. The difference, however, was not statistically significant. The frequency of bowel movements per day was similar on treatment with both pH-sensitive enteric coated preparations. Our patients preferred encapsulated enteric coated preparations to the tablets of conventional pancreatic enzyme preparation for palatability and the smaller number of capsules to be taken with each meal.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

An important role for Candida in gastric and duodenal ulcer disease is being increasingly recognized. Causative factors implicated include the frequent use of cimetidine, and immunosuppressive or antibiotic therapy. Concerning cimetidine, there is no clear-cut evidence that the drug depresses cell mediated immunity; on the contrary, there is evidence that delayed hypersensitivity is enhanced. Acid reduction is the alternate and more likely explanation for any role of cimetidine in gastric and duodenal candidiasis. We report a patient with a duodenal ulcer, which repeatedly bled and failed to heal in hospital on standard antacid and cimetidine therapy. Candida was identified in the ulcer and treated, using mycostatin suspension, resulting in complete healing. We feel that Candida involvement of duodenal ulcers may be more common than is generally recognized, and may be the cause for nonhealing in certain patients already on optimum therapy.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

A unique case of granulomatous gastritis of unknown etiology is reported. The patient, a 43-year-old Haitian woman, suffered a gastric perforation from a disease process limited to the stomach. The stomach was markedly enlarged and edematous with transmural, serpiginous granulomatous tracks throughout the gastric wall, but most numerous in the fundic region. Accompanying acute and chronic inflammatory infiltrates were scant. No microorganisms, parasites, foreign body particles, or other known granulogenic materials could be identified. Clinical and pathologic features also differed markedly from granulomatous gastritis seen in sarcoidosis, Crohn's disease, or isolated granulomatous gastritis as defined by Fahmi et al.10Infection by a parasite for which man is not the definitive host seems the most likely etiology.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

We report a patient with abdominal pain, diarrhea, and edema of the small intestine all of which disappeared after resection of an ovarian mucinous cystadenoma of borderline malignancy. Preoperatively, the serum gastrin level was high and it decreased to normal afterwards; subsequent immunohistochemical studies of the tumor revealed cytoplasmic hormone granules containing gastrin-like immunoreactivity. We believe that the symptoms in our patient were the result of an ectopic ovarian gastrin-producing tumor.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

In a 28-year-old man with a long history of esophageal reflux, two polypoid lesions in a columnar-lined (Barrett) esophagus proved to be adenopapillary cancer. Despite extensive preoperative endoscopic evaluation, no other malignant foci were found until after complete postoperative dissection of the esophageal specimen, when two more small flat lesions were diagnosed as adenocarcinoma. Dysplastic changes of specialized columnar epithelium and junctional epithelium were mild, except around the tumors. In the preoperative assessment of patients with a columnar-lined esophagus, physicians should be aware of the possibility of multifocal development of tumors either exophytic or superficial spreading, and multiple biopsies should be taken from normal-looking areas.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Three days after laminectomy, toxic shock syndrome (TSS) presented as acute diarrhea, rash, and fever in a 62-year-old postmenopausal woman. Forty-eight hours later, the full syndrome of TSS developed. Exploration of a benign-appearing wound revealed an occult Staphylococcus aureus infection. This report and literature review underscore the need to consider TSS in the differential diagnosis of acute diarrhea regardless of age, sex, race, and menstrual status, particularly when there has been recent soft tissue infection, injury, or surgery of any type.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

In most instances, patients with an acute abdomen and pneumoperitoneum have a perforated hollow viscus as the underlying cause. Clinicians must not forget, however, some of the less common causes of free air in the abdomen. We describe pneumoperitoneum from a vaginoperitoneal fistula, developing after hysterectomy, well known to gynecologists, but rarely noted in the medical literature.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Multiple endocrine neoplasia, type IIB (MEN 2b), is omprised of medullary carcinoma of the thyroid, pheohromocytoma, diffuse ganglioneuromatosis of the gasrointestinal tract, and skeletal abnormalities. Alimentary ract manifestations, especially enlargement of the lips and ongue by proliferative neural tissue, are often the earliest lues to the presence of the syndrome. A patient is presented ere who illustrates the chronicity and diversity of symptoms haracteristic of MEN 2b. It is important to recognize the ypical oral manifestations of this syndrome so that the hyroid gland can be evaluated before the development of isseminated medullary carcinoma.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Hepatic portal vein gas (HPVG) usually occurs in conjunction with an abdominal catastrophe such as bowel infarction or necrotizing enterocolitis. We describe this finding after air contrast barium enema in a patient with stable chronic ulcerative colitis who had no symptoms, morbidity, or sequelae, and discuss the diagnostic and therapeutic implications of HPVG.

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1983

数据来源: OVID