Gastric Ulcers with and without Associated Duodenal Ulcer Have Different Pathophysiology

1978 ◽  
Vol 55 (1) ◽  
pp. 97-102
Author(s):  
S. K. Lam ◽  
C. L. Lai
Keyword(s):  
Serum Gastrin ◽  
Acid Output ◽  
Distinct Group ◽  
Normal Subjects ◽  
Significant Negative Correlation ◽  
Gastric Ulcers ◽  
Fasting Serum ◽  
Duodenal Ulcers ◽  
Prepyloric Ulcer ◽  
Maximal Acid Output

1. Maximal acid output after pentagastrin stimulation, and fasting and postprandial serum gastrin concentrations were determined in 25 normal subjects, 30 patients with corpus gastric ulcers, 10 patients with prepyloric ulcers and 30 patients with both duodenal and gastric ulcers. 2. Corpus ulcers and prepyloric ulcers formed one distinct group. Maximal acid output was abnormally low in the corpus ulcer patients and no different from normal in prepyloric ulcer patients, whereas fasting serum gastrin and postprandial integrated gastrin response was abnormally high in the former and no different from the normal in the latter. Furthermore, as in the normal subjects, a significant negative correlation between maximal acid output expressed in mmol h−1 kg−1 body weight and postprandial integrated gastrin response was observed in the corpus and prepyloric ulcer patients taken as a group. 3. In complete contrast patients with both duodenal and gastric ulcers, in whom postprandial integrated gastrin response was statistically highest amongst the three types of gastric ulcers, had a significantly positive correlation between maximal acid output and the integrated gastrin response. 4. These findings suggest the operation of different pathophysiological mechanisms in gastric ulcers with and without associated duodenal ulcers.

The Relation between Functioning Parietal Cell and Gastrin Cell Masses in Two Groups of Duodenal Ulcer Patients

1976 ◽  
Vol 50 (5) ◽  
pp. 375-383 ◽  
Author(s):  
D. J. Byrnes ◽  
Shiu Kum Lam ◽  
W. Sircus
Keyword(s):  
Duodenal Ulcer ◽  
Parietal Cell ◽  
Serum Gastrin ◽  
Acid Output ◽  
Ulcer Patient ◽  
Cell Mass ◽  
Inverse Correlation ◽  
Normal Subjects ◽  
Gastrin Cell ◽  
Before And After

1. Serum gastrin concentrations before and after a standardized meal were determined in twenty-eight patients with duodenal ulcer and in ten normal control subjects. 2. In response to pentagastrin, thirteen of the duodenal ulcer subjects secreted acid within the limits of normal and fifteen secreted in excess. 3. The differences in the basal serum gastrin concentrations between the three groups, normal subjects, acid ‘normosecretors’ and hypersecretors were not statistically significant but that of the hypersecretors was suggestively low. 4. The integrated gastrin response and peak gastrin responses to meals were higher in duodenal ulcer patients with normal acid secretion than in the hypersecretors but the values for the latter were not different from normal subjects. 5. Stabilization of intragastric pH by infusion into the antrum of sodium bicarbonate during the test meal response period did not alter these differences between the two ulcer patient groups. 6. A significant inverse correlation exists between the maximal acid output and the integrated gastrin response in both normal subjects and hypersecreting duodenal ulcer patients. 7. The evidence (a) supports the existence of an inverse relationship between the functioning parietal cell and gastrin cell masses, (b) shows the gastrin response in normosecreting ulcer subjects to be inappropriately high, and (c) suggests that excessive vagotonia exerts trophic effects upon both parietal cell mass and gastrin cell mass.

Gastric ulcers differ from duodenal ulcers evaluation of basal acid output

1993 ◽  
Vol 38 (12) ◽  
pp. 2281-2286 ◽  
Author(s):  
Martin J. Collen ◽  
Michael J. Sheridan
Keyword(s):  
Acid Output ◽  
Gastric Ulcers ◽  
Duodenal Ulcers ◽  
Basal Acid Output ◽  
Basal Acid

Gastric Acid Secretion and Fasting Serum Gastrin in Patients with Duodenal Ulcer, Prepyloric Ulcer or Gastric Ulcer

1982 ◽  
Vol 14 (3) ◽  
pp. 231-235 ◽  
Author(s):  
H. Stødkilde-Jørgensen ◽  
N.A. Løvgreen ◽  
J. Ørnsholt ◽  
E. Amdrup
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Acid Secretion ◽  
Gastric Acid Secretion ◽  
Gastric Acid ◽  
Serum Gastrin ◽  
Fasting Serum ◽  
Prepyloric Ulcer

scholarly journals Giant Prepyloric Ulcer Haemorrhage: Patient Characteristics, Treatment, and Outcome in 2003–2012

Ulcers ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Margot Peetsalu ◽  
Ülle Kirsimägi ◽  
Ants Peetsalu
Keyword(s):  
Surgical Therapy ◽  
Patient Characteristics ◽  
Gastric Ulcers ◽  
Inhospital Mortality ◽  
Duodenal Ulcers ◽  
Group Iii ◽  
Group I ◽  
Prepyloric Ulcer ◽  
Ulcer Haemorrhage ◽  
Peptic Ulcer Haemorrhage

The aim of the study was to characterize patients with giant prepyloric ulcer haemorrhage, their treatment, and outcome. The data for 929 peptic ulcer haemorrhage (PUH) patients were divided into three groups according to ulcer location: group I: 165 prepyloric ulcer patients, group II: 353 gastric ulcer patients, and group III: 411 duodenal ulcer patients. Among these groups giant ulcer (ulcer diameter ≥ 2 cm) haemorrhage cases were selected for the study and the data for group I were compared with the data for groups II and III. The study shows that the proportion of giant ulcers in all prepyloric ulcers was significantly 2.2 times lower compared with the proportion of giant ulcers in all gastric ulcers and 1.5 times lower than the proportion of giant ulcers in all duodenal ulcers. The share of surgical therapy for haemorrhages from giant prepyloric ulcers did not differ from the share of surgical therapy in the case of giant gastric ulcers but was 3.5 times lower than in the case of giant duodenal ulcers. Generally, treatment for PUH from giant prepyloric ulcers was successful not involving inhospital mortality.

scholarly journals Spontaneous and Persisting Decrease in Maximal Acid Output

BMJ ◽  
1971 ◽  
Vol 2 (5757) ◽  
pp. 313-315 ◽  
Author(s):  
H. G. Desai ◽  
M. P. Zaveri ◽  
F. P. Antia
Keyword(s):  
Acid Output ◽  
Maximal Acid Output

Cimetidine Utilization in Denmark 1977–1981

1986 ◽  
Vol 14 (1) ◽  
pp. 7-14 ◽  
Author(s):  
K. Schmidt ◽  
J. Mosbech ◽  
E. Worsøe
Keyword(s):  
Geographical Variation ◽  
Application Rate ◽  
Hospital Utilization ◽  
Gastric Ulcers ◽  
Age Group ◽  
Utilization Pattern ◽  
Duodenal Ulcers ◽  
National Board ◽  
Ulcer Disease ◽  
Proxy Variables

A description of development in the utilization pattern of cimetidine (Tagamet) in Denmark is given on the basis of 19 154 granted applications for individual drug reimbursement submitted to the National Board of Health from the initial registration of cimetidine in September 1977 until general reimbursement was introduced in July 1981. The application rate per 100000 inhabitants increased steeply from 49 in 1978 to 148 in 1980 and decreased to 127 in 1981. Despite this rapid introduction, however, hospital utilization for ulcer disease was constant during this period. Half of the applications treated diagnosed duodenal ulcers and a third gastric ulcers. Only 50% of those gastric ulcers were diagnosed by endoscopy. The age-specific application rate reached a peak in the age group of 50–69 years. There was a considerable geographical variation in the rate of application. The reason for this is unknown, since the variations in the ages of patients and years of application were different in different counties, and no correlation between application rate and proxy variables for standard of health and special interest in ulcer disease between the different counties could be shown.

scholarly journals Incidence of Duodenal Ulcers and Gastric Ulcers in a Western Population: Back to Where It Started

2009 ◽  
Vol 23 (9) ◽  
pp. 604-608 ◽  
Author(s):  
Marcel JM Groenen ◽  
Ernst J Kuipers ◽  
Bettina E Hansen ◽  
Rob J Th Ouwendijk
Keyword(s):  
Gastric Ulcers ◽  
Bleeding Complications ◽  
Upper Gastrointestinal Endoscopy ◽  
Peptic Ulcers ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Treatment Regimens ◽  
H Pylori ◽  
Upper Gastrointestinal ◽  
Over Time

BACKGROUND/OBJECTIVES: As recently as 40 years ago, a decline in the incidence of peptic ulcers was observed. The discovery of Helicobacter pylori had a further major impact on the incidence of ulcer disease. Our aim was to evaluate the trends in the incidence and bleeding complications of ulcer disease in the Netherlands.METHODS: From a computerized endoscopy database of a district hospital, the data of all patients who underwent upper gastrointestinal endoscopy from 1996 to 2005 were analyzed. The incidence of duodenal and gastric ulcers, with and without complications, were compared over time.RESULTS: Overall, 20,006 upper gastrointestinal endoscopies were performed. Duodenal ulcers were diagnosed in 696 (3.5%) cases, with signs of bleeding in 158 (22.7%). Forty-five (6.5%) of these ulcers were classified as Forrest I and 113 (16.2%) as Forrest II. Gastric ulcers were diagnosed in 487 cases (2.4%), with signs of bleeding in 60 (12.3%). A Forrest 1 designation was diagnosed in 19 patients (3.9%) and Forrest 2 in 41 patients (8.4%). The incidence of gastric ulcers was stable over time, while the incidence of duodenal ulcers declined.CONCLUSIONS: The incidence of duodenal ulcer disease in the Dutch population is steadily decreasing over time. Test and treatment regimens for H pylori have possibly contributed to this decline. With a further decline in the prevalence of H pylori, the incidence of gastric ulcers is likely to exceed the incidence of duodenal ulcers in the very near future, revisiting a similar situation that was present at the beginning of the previous century.

scholarly journals Prevalence of Helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Vudumula Vijaya Lakshmi
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Normal Population ◽  
Gastric Ulcers ◽  
Upper Gastrointestinal Endoscopy ◽  
Contributing Factors ◽  
Duodenal Ulcers ◽  
Female Ratio ◽  
Ulcer Disease ◽  
H Pylori

Helicobacter pylori (H. pylori) has a role in the multifactorial etiology of peptic ulcer disease. A link between H. pylori infection and duodenal ulcer disease is now established. Other contributing factors and their interaction with the organism may initiate the ulcerative process. The fact that eradication of H. pylori infection leads to a long-term cure in the majority of duodenal ulcer patients and the fact that the prevalence of infection is higher in ulcer patients than in the normal population are cogent arguments in favor of it being the primary cause of the ulceration. This study was under taken at the Department of surgery, Narayana medical college, Nellore from January 2007 to July 2008. A total of 150 patients with duodenal ulcers, gastric ulcers, antral gastritis, gastric carcinoma and dyspepsia of any kind were studied. Maximum number of cases were in the age group of 31 years to 50 years among both sexes and number of cases gradually decreased after 50 years of age in males and females. Males were more in number and male to female ratio is (2.75:1) approximately 3:1.

Antiulcerogenic and antisecretory effects of a novel diphenylmethane derivative and antiestrogen binding site ligand

1988 ◽  
Vol 66 (8) ◽  
pp. 1139-1143 ◽  
Author(s):  
Gary B. Glavin ◽  
Lorne J. Brandes
Keyword(s):  
Binding Site ◽  
Gastric Acid ◽  
Stress Ulcer ◽  
Acid Output ◽  
Corticosterone Level ◽  
Plasma Corticosterone ◽  
Gastric Ulcers ◽  
Ulcer Formation

N,N-Diethyl-2-[4-(phenylmethyl)-phenoxy]-ethanamine hydrochloride (DPPE) is a para-diphenylmethane derivative that binds selectively and with high affinity to the microsomal antiestrogen binding site (AEBS). Recent studies with DPPE indicate that AEBS is closely related to a lower affinity non-H1, non-H2 histamine site that may be associated with calcium channels; the DPPE–AEBS site is different from that which verapamil binds, however. DPPE, but not verapamil, demonstrates antiproliferative effects in vitro and is antiestrogenic in vivo. We now show that DPPE profoundly inhibits restraint and cold stress and ethanol-induced gastric ulcer formation, accelerates ulcer healing, attenuates the stress-induced rise in plasma corticosterone level, and significantly reduces basal and H2 agonist (dimaprit)-stimulated and, to a lesser extent, bethanechol-stimulated gastric acid output in conscious rats. A nonulcerogenic but prostaglandin-depleting dose of indomethacin completely blocks the inhibitory effects of DPPE on stress ulcer formation. Conversely, verapamil only slightly attenuates dimaprit-stimulated gastric acid secretion and exacerbates ethanol-induced gastric ulcers; its anti-stress ulcer effects are only partially attenuated by indomethacin. These findings support the likelihood that the site of action of DPPE is different from that of verapamil, and that an effect on prostaglandins may, at least in part, contribute to its antiulcer and apparent cytoprotective effects.

Increased intracellular calcium and decreased activities of leucocyte Na+,K+-ATPase and Ca2+-ATPase in asthma

1999 ◽  
Vol 97 (5) ◽  
pp. 595-601 ◽  
Author(s):  
Sunil Kumar CHHABRA ◽  
Anita KHANDUJA ◽  
Deepika JAIN
Keyword(s):  
Intracellular Calcium ◽  
Acute Exacerbation ◽  
Biochemical Parameters ◽  
Venous Blood ◽  
Normal Subjects ◽  
Significant Negative Correlation ◽  
Forced Expiratory Volume ◽  
Clinical Severity ◽  
Free Calcium ◽  
Bronchial Reactivity

The present study was carried out to determine the intracellular free calcium concentration ([Ca2+]i) and the activity of its regulatory enzymes (Na+,K+-ATPase and Ca2+-ATPase) in leucocytes. Levels of plasma lysophosphatidylcholine (LPC) were also measured. Then the relationship between these parameters and the clinical severity of asthma and bronchial reactivity was studied. Patients with asthma were divided into three groups: acute asthma (subjects in acute exacerbation), uncontrolled asthma (subjects currently symptomatic) and stable asthma (subjects currently asymptomatic). A group of normal subjects was also studied. Spirometry, specific airway conductance and bronchial reactivity measurements were carried out. The following biochemical parameters were studied in venous blood: leucocyte [Ca2+]i, Na+,K+-ATPase and Ca2+-ATPase activities, and plasma LPC. Leucocyte [Ca2+]i was increased and the activities of Na+,K+-ATPase and Ca2+-ATPase were decreased in patients with asthma. Plasma levels of LPC were also increased. These changes were observed to be greatest among asthmatics in acute exacerbation of asthma, and lesser in magnitude in patients with less severe asthma. The activities of both ATPases were found to have a significant positive correlation, and [Ca2+]i and the levels of plasma LPC a significant negative correlation, with predicted forced expiratory volume in 1 s (FEV1). No significant correlation was observed between the biochemical parameters and bronchial reactivity. It is concluded that intracellular calcium homoeostasis is abnormal in asthma; specifically, the activities of Na+,K+-ATPase and Ca2+-ATPase are decreased. These abnormalities may modulate the clinical severity of asthma.

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