ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This review of the past year's literature focuses on progress in the elucidation of the pathways and mechanisms controlling gastric exocrine (ie, acid and pepsin) and endocrine (ie, gastrin, histamine, and somatostatin) secretion at central, peripheral, and intracellular levels by neural, hormonal, and paracrine agents. Molecular biological and immunocytochemical techniques coupled with physiological studies have furthered our understanding of the pathways and mechanisms regulating gastric secretions. At least three subtypes of muscarinic receptors, five subtypes of somatostatin receptors, and three subtypes of gastrin receptors have been identified, several of which participate in the regulation of acid secretion. γ-Aminobutyric acid has been identified convincingly in antral gastrin cells and tentatively in somatostatin-containing D and serotonin-containing enterochromaffin cells. Strong evidence supports the role of cholecystokinin and secretin as physiological enterogastrones. Traditionally considered hormones, these peptides may inhibit acid secretion predominantly via vagal afferent nerve fibers. Cytoskeletal and low molecular mass GTP-binding proteins may participate in the regulation of membrane trafficking in parietal and chief cells.

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The observation that a significant proportion of patients who are infected withHelicobacter pylorior who consume nonsteroidal anti-inflammatory drugs on a regular basis do not develop gastric or duodenal ulcers suggests that differences in host responses to these agents play an important role in the pathogenesis of the gastroduodenal injury. In the past year, significant progress has been made in understanding the contribution of various components of the “mucosal defense network” to resistance to injury. For example, advances have been made in understanding the mechanisms through which epithelial cells maintain their intracellular pH near neutrality in the face of significant luminal acid loads. The importance of nitric oxide and prostaglandins in the regulation of mucosal blood flow and other components of mucosal defense is becoming more clearly understood. Advances have been made in understanding the contribution of the mucosal immune system and the mediators and cytokines it produces in the responses of the mucosa to bacterial infection or ingestion of noxious substances. The role of the sensory afferent neurons in modulating mucosal defense has been the subject of a number of studies, as has been the mechanisms underlying restitution of the gastroduodenal epithelium, factors influencing healing of ulcers, and factors contributing to the adaptation of the stomach to repeated administration of nonsteroidal anti-inflammatory drugs.

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Although the past year's literature has again been dominated byHelicobacter pylori(its eradication, influence on ulcer relapse, and reinfection rate), it should be emphasized that other factors are also important in the pathogenesis of peptic ulcer disease. Several new antisecretory compounds have been introduced,eg, lansoprazole and pantoprazole, which should prove useful for the treatment of routine peptic ulcer disease as well as Zollinger-Ellison syndrome. There has been renewed interest in the management of Zollinger-Ellison syndrome owing to the availability of new technologies that allow earlier and more complete evaluation and long-term studies that provide a better understanding of the natural history of the disease.

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Surgical interventions for the treatment of stomach and duodenal pathology, like all areas of surgery, are undergoing rapid changes. These changes have been, and continue to be, driven by improvements in both surgical technology and the understanding of the disease processes themselves. The past year has seen an especially large number of exciting new developments in areas ranging from laparoscopic Nissen fundoplication to pylorus-preserving pancreaticoduodenectomy. This article highlights some of the exciting changes taking place in an area of surgery that is undergoing a dramatic transformation.

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article focuses on four areas of gastric mucosal disease that attract considerable attention because they are new or because of therapeutic implications: mucosa-associated lymphoid tissue lymphoma, gastric dysplasia, gastropathy, and lymphocytic gastritis. The main emphasis is on mucosa-associated lymphoid tissue lymphomas because their pathology has been and is being recharacterized and because some cases regress dramatically with eradication therapy forHelicobacter pylori.Molecular markers are being used to define these lesions, and future studies will probably further stratify them along lines that will better predict response to therapy. Gastric dysplasia is uncommon in North America, and therefore, when it is encountered as an isolated lesion, it generates anxiety in relation to management. Gastropathies and lymphocytic gastritis are types of gastric mucosal injury that used to be lumped together as “gastritis.” Their appearances are sufficiently different, however, and they can be linked closely with some defined clinical conditions.

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Since the advent of the pediatric endoscope, pediatric gastroenterologists have begun to expand our understanding of the pathophysiology of gastrointestinal disorders in children. The important advances reviewed in this paper will facilitate management of gastrointestinal disorders in children. New technologic breakthroughs are also highlighted. This review examines recent papers on a number of important clinical topics. Specifically, recent reports regardingHelicobacter pyloriinfection in children are highlighted. A number of papers provide important new information regarding upper gastrointestinal tract inflammatory bowel disease, which should improve the management of these patients. Finally, significant technologic advances in the areas of endoscopy, gastric emptying studies, pediatric surgery, and the removal of foreign bodies are reviewed.

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The identification ofHelicobacter pyloriin the pathogenesis of chronic gastritis, peptic ulcer, and gastric cancer has provided an enormous advance in clinical gastroenterology. Epidemiologic studies show that many of the more severe clinical manifestations ofH. pyloriinfection occur in a minority of the infected population. Thus, the interaction among the organism, environmental factors, and the host response contributes to the various forms of disease. This review considers the most recent literature in the context of the hypothesis that gastric diseases associated withH. pyloriinfection result from a failure in the host's ability to develop an appropriate mucosal immune response to this luminal antigen. A better understanding of the immunopathogenesis of this process will provide a more informed approach for the development of therapeutic intervention through mucosal immunization.

ISSN:0267-1379    

出版商:OVID    

年代:1995

数据来源: OVID