摘要:

In a group of 94 duodenal ulcer patients consecutively studied and followed-up for 1 year, subjects with maximal acid output (M.A.O.) above 60 mmol/hour (mostly heavy-smoking men), were found to relapse more frequently than those with lower M.A.O. values (72.2% versus 27.6%;p<0.0005). A significantly higher relapse rate was also detected in patients treated with maintenance dosages of effective antisecretory drugs (cimetidine, ranitidine, pirenzepine) and presenting M.A.O. over 60 mmol/hour. It is yet to be established whether an alternative therapeutic regime may prove effective in preventing ulcer recurrence in patients with gastric hypersecretion.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Only rarely has lymphoma been associated with ulcerative colitis. We report a 25-year-old man with an 8-year history of ulcerative colitis, who developed diffuse large cell lymphoma (histiocytic) of the colon. We review 17 previously reported cases and discuss the risk of lymphoma, diagnostic clues, prognosis, and the evidence for a relationship between ulcerative colitis and lymphoma.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Conflicting reports have appeared concerning the role ofClostridium difficiletoxin in chronic inflammatory bowel disease. Therefore, we prospectively evaluated the incidence ofC. difficiletoxin in 44 children with inflammatory bowel disease of variable clinical severity over a 1-year period. Only 3/128 stool specimens provided by these patients were found to be toxin-positive. These three stool specimens were from three different patients with Crohn's disease of moderate severity who had no recent hospitalization or antibiotic exposure. None received vancomycin therapy and their stools became toxin-negative over 3 weeks with no apparent change in the patients' clinical condition. No patient with severe disease or recent exposure to antibiotics or sulfasalazine was found to have toxin-positive stools. Routine screening for C. difficile toxin in children with inflammatory bowel disease appears unwarranted.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The rectoanal inhibitory reflex and rectal sensitivity were evaluated in 13 patients with idiopathic chronic constipation and in 13 control subjects. A double balloon probe was used to stimulate and record the rectoanal inhibitory reflex and rectal sensitivity. The results showed a linear relationship between relaxation amplitude and the logarithm of rectal distending volume, and between relaxation duration and the logarithm of rectal distending volume, with a significant reduction of relaxation amplitude in the patient group.The rectal sensitivity thresholds were significantly increased in patients compared with controls. In 10 additional patients with chronic constipation, motility and sensitivity parameters were evaluated before and after 28 days of high-fiber diet. After diet, the values of relaxation amplitude were significantly increased, returning within normal range, but sensitivity parameters did not change.In conclusion, it appears that in adult chronic idiopathic constipation, anorectal motility and rectal sensitivity are altered, and that only motor abnormalities are corrected by a high-fiber diet.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A 21-year-old schizophrenic man developed ulcerative colitis. Because he might have needed steroids, we reviewed the literature on the use of steroids in patients with psychiatric disorders. The pathogenesis of psychiatric symptoms during steroid therapy is unknown. Development of psychiatric complications in patients receiving steroids is probably dose-dependent. The type of psychiatric manifestations is variable, ranging from affective through schizophremiform syndromes. It is unclear whether a history of psychiatric disorders increases the risk for psychiatric problems from steroids. In the majority of patients psychiatric complications remit when the dose of steroids is reduced or discontinued, or when appropriate pharmacotherapy and psychotherapy are administered. Preliminary studies suggest that lithium may prevent development of steroid psychosis.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

We report cirrhosis and alpha 1-antitrypsin deficiency in two patients over 50 years of age who had an initial diagnosis of cryptogenic cirrhosis. Serum alpha 1-antitrypsin levels were in the homozygous range and a liver biopsy demonstrated cirrhosis with periodic acid-Schiff-positive, diastase-resistant globules in both. Red intracytoplasmic inclusion globules seen on trichrome staining in the first patient, and a decreased alpha-1 fraction on serum protein electrophoresis in the second suggested the diagnosis. We propose that the diagnosis of alpha 1-antitrypsin deficiency be considered in all patients, regardless of age, and that trichrome staining be part of the routine histologic evaluation in all patients with cirrhosis of uncertain etiology.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

We report a case of esophageal cast, a rare entity, and a review of the literature. We also theorize about the possible mechanism of injury due to vomiting, which was common in most previously reported patients. We assume a close association may occur between the Mallory-Weiss syndrome and production of an esophageal cast. Other causes of esophageal casts are presented.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Achalasia occurs rarely in infancy. We report a case of infantile achalasia associated with deficient tear production. This presentation, as well as the few extremely rare related reports, may suggest a common autonomic system pathophysiology.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

We report extensive colonic hemangiomatosis in two young adults. In the first, the hemangioma contiguously involved the entire colon. In the second, a large venous angioma affected the bladder, rectosigmoid, and descending colon. Venous angioma, a variant of hemangioma, is frequently confused with cavernous hemangioma because of their similar histologic appearance. The angiographic features, however, may enable a more accurate preoperative diagnosis and prevent unwarranted biopsy. We review and put into perspective pertinent previous reports of cavernous and venous angioma.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Jejunal varices were a cause of recurrent gastrointestinal hemorrhage in an 18-year-old man with common variable immunodeficiency and nodular lymphoid hyperplasia of the small intestine. Despite numerous procedures, including upper gastrointestinal endoscopy, colonoscopy, arteriography, and exploratory laparotomy no active bleeding site was identified until superior mesenteric angiography demonstrated thrombosis of the superior mesenteric vein with an extensive collateral circulation through mesenteric varices. At laparotomy, mesenteric lymph nodes up to 4 cm in diameter seemed to be compressing the superior mesenteric vein. Histological examination of a node revealed reactive hyperplasia with prominent germinal centers. After resection of varices in a 20-cm length of proximal jejunum, there has been delayed, but complete resolution of bleeding in a 17-month follow-up.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID