ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicale recorded esophageal alkaline exposure time (AET) in 52 patients with gastroesophageal reflux and in 20 control subjects to determine whether esophageal pH monitoring can measure reflux of bile acids and trypsin from the duodenum. Patients underwent a further 16-h study (divided into 2-h periods) in which AET was correlated with bile acid and trypsin concentrations in esophageal aspirates. Patients had greater nocturnal AET than controls (22.7 versus 0.9%, p = 0.005). Patients with a stricture had a greater AET than patients with erosive esophagitis (25.2 versus 13%, p < 0.05). There was no relationship between esophageal bile acid concentrations and AET, and total bile acid concentrations were similar regardless of whether a 2-h period contained alkaline episodes. Esophageal bile acid concentrations were no different, in patients with a normal esophagus, esophagitis, stricuture, or Barrett's esophagus. Trypsin was found in only 5% of aspirates, and could not be predicted by AET. We conclude that measurement of AET is not useful in the clinical evaluation of duodenoesophageal bile reflux, and bile acids and trypsin are not important in the pathogenesis of reflux esophagitis.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalucralfate and ranitidine were compared in the treatment of gastric ulcer (GU) in this multicenter randomized double-blind study. Sixty-four patients with endoscopically diagnosed GU initially included in the trial were randomly assigned to treatment with sucralfate, 2 g b.i.d. (morning and evening on an empty stomach), or ranitidine, 150 mg b.i.d. Nine patients were subsequently excluded for various reasons. The remaining 55 were examined endoscopically after 4 and, if unhealed, 8 weeks. At 4 weeks, 54.2% (13 of 24) of the sucralfate group had a healed ulcer, in comparison to 45.2% (14 of 31) of the ranitidine group (NS). At 8 weeks, cumulative healing rates were 87.5% (21 of 24) and 84% (26 of 31), respectively (NS). No differences were found in the healing effects of the drugs on smokers and nonsmokers or in side effects. These results suggest that both drugs are equally effective in the short-term treatment of GU.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalhe activity of nucleolar organizer regions (NORs) in chromosomes of peripheral blood lymphocyte cultures from 20 healthy subjects and 32 patients with celiac disease (CD) (nine untreated patients, nine treated but with dietary lapses, and 14 treated with gluten-free diet (GFD) and normal small bowel histology) was studied. Furthermore, three female patients diagnosed with small bowel non-Hodgkin's lymphoma (NHL) complicating CD were studied. Silver (Ag)-staining technique was used to visualize positive NORs. In each individual, 20 metaphases were analyzed to determine the number of NORs per cell. The average of Ag-NOR+ per cell, expressed as X ± SD, was found to be higher in the CD group (6.62 ± 0.65) compared with controls (5.70 ± 0.81) (p < 0.001). This increase was evident in both groups of chromosomes analyzed (D and G). No differences were found among the three groups, but all of them were found to be statistically different compared to controls (p < 0.001). The NHL complicating CD patients showed a statistically increased frequency of Ag-NORs (7.20 ± 0.39) with respect to CD patients (p < 0.02) and controls (p < 0.001). These findings show an increase of the transcriptional activity of rDNA in CD that could be related to the high incidence of malignancy in this pathology. Longitudinal studies of CD patients should be performed to confirm this evidence.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicaluality of life with inflammatory bowel disease has not been well examined. Recently, a questionnaire to determine subjective health status for patients with inflammatory bowel disease has been developed and verified. To examine the quality of life in a group of “well” outpatients with inflammatory bowel disease, we developed a self-administered form of this questionnaire containing 36 questions identifiable to five dimensions: systemic symptoms, bowel symptoms, functional impairment, social impairment, and emotional function. We identified outpatients with inflammatory bowel disease through the local chapter of the Ileitis and Colitis Foundation and distributed 396 questionnaires, by mail, with 182 being returned completed (46% response rate). Forty-eight age- and sex-matched controls filled out and returned an identical questionnaire. Response options for each question were framed on a seven-point scale in which 7 represented best function and 1 represented worst function. Male-to-female ratio and mean age were similar to those of controls for the inflammatory bowel disease group. In each dimension, as well as globally, the quality of life of patients with inflammatory bowel disease was significantly worse than that for their age- and sex-matched controls. In conclusion, this survey demonstrates that inflammatory bowel disease adversely affects quality of life in a highly motivated group of “well” outpatients when compared to an age- and sex-matched population.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalhe mechanism by which Mg(OH)2acts as a laxative is unknown. To explore the mechanism, six volunteers more than 55 years old, with normal bowel habits, were enrolled in a dose-response, randomized, placebo-controlled, double-blind, crossover design study. Each subject was studied for four inpatient periods of 5 days each on a metabolic ward with 9 days off of all medication between studies. In the hospital, all patients were on a diet fixed in calories, fluid volume, Na+, fiber, and Ca2+. At 8 p.m. on each study day, each subject took 45 ml containing either placebo or 1,200, 2,400, or 3,600 mg of Mg(OH)2plus 240 ml of water. On the fourth and fifth hospital days of each period, 24-h stool output was quantified and analyses performed. Compared to placebo, Mg(OH)2caused the following dose-dependent results: (a) increased number of bowel movements; (b) increased percentage of stool Mg2+; and (e) increased total stool 24-h prostaglandin E2(PGE2), with mean 24-h excretions as follow: placebo, 95 ± 18 pg/24 h; 1,200 mg Mg(OH)2, 260 ± 100; 2,400 mg Mg(OH)2, 357 ± 117; and 3,600 mg Mg(OH)2, 525 ± 196. There was a significant correlation between stool PGE2excretion and stool water consistent with a causative relationship. However, the concentration of stool prostaglandin was lower than the concentration found to alter intestinal electrolyte transport in vitro. In summary, the laxative effect of Mg(OH)2is associated with increased output of stool PGE2. The contribution of the stool PGE2to the laxative effect of Mg(OH)2is unknown.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicale studied the immunogenicity of the standard schedule of recombinant hepatitis B vaccine (20 μmUg per dose at months 0, 1, and 6) in 21 anti-human immunodeficiency virus (HIV)-positive persons. Relatively low titers of anti-HBs developed in only five subjects (23.8%) 1 month after the third dose; all five had T4 cell counts greater than 700 cells/mm and none of the 11 subjects with a T4 cell count below this value responded. Five of the 16 nonresponders to the vaccine later had acquired immunodeficiency syndrome (AIDS)-related complex (two) and AIDS (three), while none of the responders did. Our results show that anti-HIV–positive persons are poor responders to the recombinant hepatitis B vaccine, and that the absence of a response is an indicator of a more severe immune deficiency and of a poor prognosis. An optimal regimen of hepatitis B vaccination in HIV-infected persons is still to be established.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalorty patients with cirrhosis of the liver and tense ascites were randomized to receive either aldactone 400 mg/day and furosemid 80 mg/day (n = 20) or repeated large volume paracentesis (LVP) and infusion of low molecular weight dextran (n = 20). Both treatment groups were similar in clinical and laboratory parameters. Complete mobilization of the ascitic fluid was achieved in all receiving LVP and dextran therapy within 1 week of the treatment, in contrast to the minimal mobilization of the ascitic fluid in patients receiving diuretics even after 2 weeks of therapy. Renal function, the clinical parameters of systemic hemodynamics, serum electrolytes, and hepatic function remained stable in patients receiving LVP and dextran and were similar to those in the diuretictreated patients. We found no deterioration of these functions in the nonedematous patients treated by LVP and dextran even though the protective effect of edema against LVP was lacking in them. Plasma volume estimation in six nonedematous cirrhotic patients treated by LVP and dextran did not reveal any hypovolemia after complete mobilization of ascites. The frequency of complications and death were similar in the two groups. Dextran infusion is a safe, effective, and low-cost replacement therapy in patients with cirrhotic ascites treated by LVP.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicalemorrhage from varices in a hiatal hernia sac was controlled by a Sengstaken-Blakemore tube. There is little data available regarding the safety and effectiveness of balloon tamponade in patients with hiatal hernia. Therefore we review the available literature and discuss balloon tamponade in patients with a hiatal hernia.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgicale report a patient with concurrent superficial carcinomas of the esophagus and stomach. The tumors occurred in a 68-year-old woman. The esophageal tumor was an intramucosal squamous cell carcinoma, and the gastric tumor an intramucosal adenocarcinoma, type III in the Japanese classification of early gastric cancer. This is the first reported case of associated superficial esophageal and gastric cancers originating from a Western country. Such an association may be more frequent than realized, and therefore it is important to examine both the stomach and esophagus if a patient has one of these tumors.

ISSN:0192-0790    

出版商:OVID    

年代:1992

数据来源: OVID