ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Gastric secretion is finely regulated by neural, hormonal, and paracrine pathways. During ingestion of a meal, the pathways can be activated by stimuli originating in the brain or stimuli originating in the stomach, such as mechanical stimulation (eg, distension) or chemical stimulation (eg, protein). The main secretagogues active at the level of the parietal cell are acetylcholine (neurotransmitter), gastrin (hormone), and histamine (paracrine agent); the main inhibitor is somatostatin (paracrine agent). The release of these four agents by neural, hormonal, and paracrine mechanisms and the interactions among them determine the rate of acid secretion in response to physiological stimuli. The two main intracellular signaling pathways involve cyclic adenosine monophosphate and calcium. A third pathway, involving accumulation of guanosine 3',5'-cyclic monophosphate, is receiving increased attention. Progress has been made in characterizing the intracellular events that occur between generation of second messengers and incorporation of tubulovesicle-rich H+K+-ATPase into the apical membrane of the parietal cell and exocytosis of pepsinogen from the chief cell.

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Although there are now clear associations between ulcer disease and infection with Helicobacter pylori or use of nonsteroidal anti-inflammatory drugs (NSAIDs), it remains unclear how these factors affect the ability of the gastroduodenal mucosa to resist injury (ie, mucosal defense). Progress has been made in understanding the factors that regulate mucus and bicarbonate secretion in the upper gastrointestinal tract, and the influence of antiulcer drugs (eg, lansoprazole, omeprazole) on these factors. The discovery of two isoforms of the enzyme responsible for prostaglandin synthesis has resulted in a reappraisal of the role of this class of mediators in mucosal defense, and an evaluation of the theory that selective inhibitors of the inducible form of this enzyme will be “Gl safe.” The most active area of research in mucosal defense over the past year was concerned with factors influencing mucosal repair. A number of growth factors have been identified as playing key roles in the ulcer healing process. Moreover, the role of these factors in improving the quality of ulcer healing has been carefully examined.

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The literature in the year under review was once again dominated by Helicobacter pylori. The organism has clearly emerged as the permissive factor in the pathogenesis of peptic ulcer disease, although there are reports of a lower than expected H. pylori colonization rate in duodenal ulcer subjects from the United States. Many controversial issues were addressed, but the indications for treatment, the role of the organism in nonulcer dyspepsia, the organism's role in gastric physiology, and the optimal treatment regimens remain largely undecided.

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The surgical management of diseases of the stomach and duodenum has undergone rapid change. Laparoscopy is at the forefront, having influenced the management of disorders ranging from gastroesophageal reflux to peptic ulcer disease. However, the impact of outcome analysis has also been instrumental. It must be remembered that these new techniques are based on principles that underlie the open methods, and they must ultimately be compared with them for validation. More critical evaluation of other advances in gastroduodenal surgery is evident. This helps assure that change does not occur to the detriment of patients and that new indications for operative therapy do not inappropriately arise from technologic advances. This article reviews the most recent of these changes in general surgery.

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This review covers progress made over the past year in the area of endoscopic therapy for gastrointestinal hemorrhage including peptic ulcer bleeding, gastric varices, and gastric antral ectasia. The role of endoscopic mucosal resection as a diagnostic and therapeutic tool is discussed. Also covered is the literature concerning percutaneous endoscopic gastrostomy, particularly relating to patient outcome after the procedure. Finally, there is a brief review of the literature regarding the current and possible future clinical uses of endoscopic ultrasonography.

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Major themes to emerge from recent literature in the area of gastroduodenal motility include significant progress in the development of noninvasive tests of gastric function and an emphasis both on the importance of regional motor specialization within the stomach and of the complex interactions between the stomach and the rest of the gastrointestinal tract. In the clinical arena, nonulcer dyspepsia continues to attract intense interest, and dysmotility and altered gut perception and sensation continue to be major areas of research activity. Available data suggest, however, that dyspepsia is unlikely to be explained by a single pathophysiologic mechanism but more likely reflects an interaction between a variety of abnormalities at a number of levels.

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This review covers progress made over the past few years in the area of gastroesophageal reflux, cyclic vomiting, intestinal pseudo-obstruction, drugs, and hormones that affect motility in children. Studies such as those reviewed not only improve our understanding of such disorders but also enhance the quality of life for children affected by them.

ISSN:0267-1379    

出版商:OVID    

年代:1997

数据来源: OVID