摘要:

AbstractChanges in gastric mucosal haemoglobin concentration (mucosal blood volume), mucosal haemoglobin oxygenation, mucosal blood flow and gastric arterial blood flow caused by indomethacin, an ulcerogenic agent, and anti‐ulcer agents were investigated in the stomach flap of anesthetized dogs. Indices of mucosal haemoglobin concentration and haemoglobin oxygenation, mucosal blood flow and arterial blood flow to the stomach flap were measured simultaneously. The intravenous injection of indomethacin (10 mg/kg) caused an immediate decrease in mucosal haemoglobin concentration with a gradual decrease in mucosal and arterial blood flow, and a slight decrease in mucosal haemoglobin oxygenation. The topical application of prostaglandin E2(10 μg/ml) and spizofurone (a new anti‐ulcer agent, 1 mg/ml) to the mucosa significantly increased these parameters, and remedied the decreases of these parameters caused by indomethacin. Cimetidine (20 mg/ml), pirenzepine (10 mg/ml) and proglumide (40 mg/ml) given topically did not significantly increase these parameters in the resting state or the indomethacin‐induced ischaemic state. This study indicates that: indomethacin decreases gastric haemodynamics, and that improvement occurred with application of mucosal protective agents (i.e. prostaglandin E2and spizofurone) and changes in mucosal blood concentration were closely correlated with those in mucosal blood flow and arterial blood flow, but correlated less well with those in the case of haemoglobin oxyge

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00103.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractGastric emptying of a digestible solid and liquid meal and oesophageal emptying of a solid bolus were measured with scintigraphic techniques in 45 randomly selected insulin‐dependent diabetics and in 22 control subjects. In the diabetics, the relationships between oesophageal emptying, gastric emptying, age, duration of diabetes mellitus, upper gastrointestinal symptoms, glycaemic control and the complications, autonomic neuropathy, peripheral neuropathy and retinopathy were examined. The lag period before solid food left the stomach was not significantly different in diabetics compared with control subjects, but the percentage retention of solid food at 100 min was greater (P<0.001) in the diabetic subjects. Both the early phase (percentage retention at 10 min) and the 50% emptying time for liquid gastric emptying were delayed (P<0.001) in the diabetic subjects. Of the diabetics, 58% had delayed gastric emptying of either the solid and/or the liquid meal; oesophageal emptying was delayed in 42%. Upper gastrointestinal symptoms correlated poorly with both gastric and oesophageal emptying. Oesophageal emptying, solid gastric emptying and the liquid 50% emptying time correlated with the severity of autonomic nerve dysfunction (P<0.05). The early phase of liquid emptying (retention at 10 min) was significantly slower (P15 mmol/l during the gastric emptying test and the lag period for solid emptying correlated with both the glycosylated haemoglobin and mean plasma glucose concentration

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00104.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractAeromonasspecies were found in the faeces of 15.5% of Balinese children with diarrhoea and 12.7% of children without diarrhoea. When only the strains which produce cytotoxic enterotoxin are considered, the isolation rate in the group with diarrhoea (7.1%) was more than twice that in the control group (2.8%). The predominant species wasA. hydrophila, a strain associated with environmental sources. Faecal isolates found in Bali may reflect ingestion of contaminated water and may simply be transient. Further studies are needed to clarify the importance ofAeromonasspecies as an enteric pathogen in developing countries.

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00105.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractA sensitive and specific radioimmunoassay of serum somatostatin has been developed that overcomes the problems encountered in earlier assays of peptide disintegration and the need for prior plasma extraction, which is known to result in artifactual loss of somatostatin. In 37 normal controls, a significant positive correlation between fasting serum gastrin and somatostatin concentrations, and a significant negative correlation between pentagastrin‐stimulated maximal acid output and fasting serum somatostatin levels were observed. In the majority of 134 patients with active duodenal ulcer in whom the fasting serum somatostatin levels were normal, these relationships were absent. In the remaining 25% in whom the fasting serum somatostatin levels were abnormally raised, these relationships were retained. Following a mixed meal, circulating somatostatin levels remained unchanged in controls and patients as a group. These results suggest that: (i) in the normal state, fasting levels of circulating gastrin and somatostatin are closely related, and that acid secretion may paradoxically exert an inhibitory effect on fasting somatostatin levels; (ii) hypersomatostatinaemia identifies a subgroup of patients with duodenal ulcer in whom these relationships are retained; and (iii) somatostatin may not have a significant hormonal role in the postprandial state in ma

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00106.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractClinicopathological features were studied in 41 patients with histology‐proven hepatocellular carcinoma without cirrhosis. Of these, 13 (31.7%) were positive for hepatitis B virus surface antigen (HBsAg) and 28 were negative. Twenty‐six of 28 (92.9%) HBsAg negative cases had anticore antibody (anti‐HBc) of low titres. The age of patients at the time of diagnosis of hepatocellular carcinoma was significantly younger in the HBsAg positive cases compared with the negative. The initial diagnostic clue was either abdominal mass or abdominal pain in 18 (43.9%) patients. However, the number of patients in whom hepatocellular carcinoma was detected by imaging in the absence of such clinical signs has increased recently. The tumour was encapsulated in 31 cases (75.6%) and most solitary encapsulated tumours were growing expansively. Tumours were resectable in 29 (70.7%) cases, and the prognosis of resected cases was much better than that of 12 non‐operated cases. Twenty‐one out of 29 (72.4%) resected tumours were solitary and encapsulated. However, recurrence of tumour occurred in 12 out of 28 (42.9%) cases, and it was within 2 years of resection in 11 cases. These observations and data seem to indicate that early detection and resection of tumour is very important in management, but tumour recurrence is inevitable in a considerable proportion of the patients with non‐cirrhotic hepatocellula

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00107.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractA total of 184 cases of extrahepatic portal obstruction (EHPO), mostly demonstrated by intraoperative portography and studied at 17 institutes during the period 1957–1983, were compared with 469 cases of idiopathic portal hypertension (IPH) similarly studied. Of the cases of EHPO, there were 101 males and 83 females; 93 were under 20 years of age and the average age was 25.9 years (i.e. much younger than that of IPH cases). There were two age peaks, one before age 19 years and the other at age 40–49 years. One out of three adult cases had a history of abdominal surgery, but otherwise the aetiologic factor was difficult to elicit. Bleeding was the initial symptom in the majority, and splenectomy and haematological findings of hypersplenism were less pronounced compared with IPH. Liver function tests were almost always normal. The liver appeared normal macroscopically in 69% and histologically in 35%. The changes seen in the remainder were similar to those in IPH; they were less frequent in young patients than in cases above age 20 years. Compared with IPH, the wedged hepatic venous pressure in patients with EHPO was lower and the gradient from the portal venous pressure was greater. It is concluded that extrahepatic portal obstruction is less common compared with IPH in Japan, and that there are cases particularly among adults that present clinicopathological features very similar to those of IPH. It is unclear at present whether these two disorders represent two different disease entities, or whether they represent one disorder with differences in the site of involvement along the portal vein sys

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00108.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractThirty consecutive patients with bleeding oesophageal varices secondary to schistosomal liver disease received injection sclerotherapy. These formed a part of a prospective study, to evaluate the role of sclerotherapy in the treatment of bleeding oesophageal varices due to different aetiological factors in patients seen at the Gastroenterology Unit, Riyadh Armed Forces Hospital, Saudi Arabia, between December 1980 and July 1984.Schistosomiasis is endemic in parts of Saudi Arabia. Sclerotherapy has a special place in schistosomal liver disease as liver function is well preserved in this disease. The new antischistosomal drugs are effective and may halt the progress of the disease. However, in many patients portal hypertension with bleeding oesophageal varices is found at diagnosis. Of the patients with schistosomiasis, 63.3% were Group A Child's Classification. Oesophageal varices have been eradicated in 11 cases during the mean follow‐up period of 28 months (range 3‐44 months). Four patients were referred for surgery because of bleeding gastric varices, two of whom died following operation. One patient, who was also hepatitis B surface antigen positive, died due to re‐bleeding from gastric varices. The remaining 25 patients had no recurrence of bleeding and their liver function remained satisfactory.Surgical procedures for oesophageal varices in schistosomiasis carry the risk of peri‐operative and postoperative morbidity and mortality. In contrast, complications following sclerotherapy are minor compared to surgical procedures and none of our patients had any serious sclerotherapy compli

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00109.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractDespite 20 years of widespread use, carbamazepine has rarely been implicated as causing hepatic drug reactions. The observation of eight cases of carbamazepine hepatitis during a 3‐year period afforded an unusual opportunity to describe the clinicopathological spectrum of this reaction. The eight patients (four males, four females, aged 44–83 years) presented with fever, anorexia and malaise within 12 weeks of starting carbamazepine. Clinical features included swinging fever, jaundice (six cases) and right upper quadrant abdominal pain and tenderness which frequently led to a clinical diagnosis of cholangitis; rash and eosinophilia were not present. Serum transaminase and alkaline phosphatase values variably suggested cholestasis (three patients), predominantly hepatocellular injury (one patient) or were mixed (four patients). However, in all four patients subjected to liver biopsy, the histological picture was a granulomatous hepatitis.Cessation of carbamazepine resulted in rapid resolution of symptoms with normalization of biochemical abnormalities within 4 weeks. In two patients who were rechallenged with carbamazepine, symptoms and abnormal serum biochemistry recurred within 24 h. It is suggested that carbamazepine causes hepatic drug reactions more commonly than has been previously recognized. Although the clinical and laboratory picture may suggest cholangitis, the usual histological finding is a granulomatous hepatitis. Prompt resolution can be expected in the majority of cases upon withdrawal of the d

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00110.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00111.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1986.tb00112.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY