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- Elzuki, A, et al.
(författare)
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Alpha1-antitrypsin deficiency (PiZ) may be a risk factor for duodenal ulcer in patients with Helicobacter pylori infection
- 2000
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Ingår i: Scandinavian Journal of Gastroenterology. - 0036-5521. ; 35:1, s. 32-35
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Tidskriftsartikel (refereegranskat)abstract
- Abstract BACKGROUND: Most individuals with Helicobacter pylori infection in Western countries have no evidence of peptic ulcer disease (PUD). We therefore assessed the PiZ deficiency variant of the major plasma protease inhibitor alpha1-antitrypsin (alpha1AT) as a risk factor for PUD in H. pylori-infected individuals. METHODS: The cohort comprised 100 patients with endoscopically or surgically proven PUD (30 patients with duodenal ulcer (DU) and 70 patients with gastric ulcer (GU)) and 162 age- and sex-matched controls with PUD-negative endoscopic findings and no history of PUD. Plasma samples were screened for alpha1AT deficiency (PiZ) with an enzyme-linked immunosorbent assay (ELISA) and phenotyped by isoelectric focusing. H. pylori infection was evaluated with an IgG ELISA technique. RESULTS: Among the 262 patients 17 (6.5%) were positive for the PiZ alpha1AT deficiency, a frequency of the same magnitude as in the Swedish general population (4.7%). Of the PiZ carriers 76% (13 of 17) had H. pylori antibodies compared with 61% (151 of 245) of the non-PiZ carriers (NS). The prevalence of DU tended to be higher in H. pylori-positive PiZ carriers than in non-PiZ carriers (15.4%, 4 of 26 versus 0 of 4). Furthermore, among patients with DU a high PiZ allele frequency (13.3%, 4 of 30) was found compared with the general population (4.7%) (odds ratio (OR), 3.2; 95% confidence interval (CI), 1.09-8.94; P = 0.02). All DU patients carrying the PiZ allele were positive for H. pylori. In addition, four of five PiZ carriers with H. pylori infection and PUD had DU. CONCLUSIONS: The PiZ allele may be a contributing factor in the development of DU in H. pylori-positive individuals.
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| 2. |
- Fork, Thomas, et al.
(författare)
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Enteroskopikapseln- sväljbart engångsinstrument för videoundersökning av tunntarmen
- 2002
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Ingår i: Läkartidningen. - 0023-7205. ; 99:48, s. 6-4842
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Forskningsöversikt (refereegranskat)abstract
- Since 1,5 years wireless enteroscopy with the GivenM2A-capsule has been tested clinically. Wireless capsule-enteroscopy (WCE) has already contributed significantly to the understanding of patients with obscure intestinal symptoms. Series of occult bleeders show that WCE detects lesions in 60%, whereas enterography only in 15%, and push-enteroscopy in 25%. Lesions detected are angiodysplasia in 55%, ulcerations in 14%, aphtoid lesions and erosions in 11%, tumours in 8%. Active bleeding was seen in 43%. In patients with Crohn’s disease further information on extent of disease and type of lesions is gained, mainly seen as erosions in 64%. WCE in hereditary polyposis disclosed more and bigger lesions, and in celiac enteropathy villous atrophy and scalloping of the mucous membrane is readily identified. Software to locate the capsule in the gastrointestinal tract is recently launched together with a graphic display of capsule track and transit times. Soon displays for motility and pressure will follow. Capsule adaptation for screening for Barrett’s esophagus and colon cancer might come true.
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| 6. |
- Lindström, Eva, et al.
(författare)
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Pin within a bile duct stone.
- 2002
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Ingår i: Gastrointestinal Endoscopy. - : Elsevier BV. - 1097-6779 .- 0016-5107. ; 55:7, s. 912-912
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Petersson, Ulf, et al.
(författare)
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Enzyme leakage, trypsinogen activation, and inflammatory response in endoscopic retrograde cholangiopancreatography-induced pancreatitis.
- 2002
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Ingår i: Pancreas. - 0885-3177. ; 24:4, s. 321-328
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP)-induced pancreatitis (EIP) provides an opportunity to study different pathophysiologic events early in the course of acute pancreatitis. AIMS: To investigate whether the leakage of pancreatic proenzymes (anionic trypsinogen), pancreatic protease activation (carboxypeptidase B activation peptide), cytokine response (interleukin [IL]-1 receptor antagonist, IL-6, and soluble tumor necrosis factor receptor-I) and neutrophil activation (neutrophil gelatinase-associated lipocalin and polymorphonuclear elastase) differ between patients with and without EIP. A second aim was to clarify the temporal relation between these different events. METHODOLOGY: Ninety-nine nonconsecutive patients undergoing ERCP were investigated in the study. RESULTS: Fourteen of 99 patients undergoing ERCP developed mild EIP. Six hours after the investigation the concentration of anionic trypsinogen was significantly higher in patients with EIP than in patients without EIP. The day after ERCP, higher concentrations of anionic trypsinogen, carboxypeptidase B activation peptide, IL-6, and polymorphonuclear elastase were recorded in the EIP group. No significant differences in IL-1 receptor antagonist, soluble tumor necrosis factor receptor-I or neutrophil gelatinase-associated lipocalin were found between the groups in this study. CONCLUSION: Mild EIP was accompanied by early leakage of proenzymes and later activation of trypsinogen/proteases. A significant cytokine response and neutrophil activation were recorded the day after ERCP, but further studies are needed to determine the temporal relation between these different pathophysiologic events.
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| 10. |
- Toth, Ervin
(författare)
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Chromoendoscopy with particular reference to a modified endoscopic Congo red test
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chromoendoscopy, endoscopic tissue staining, is an adjunctive method using chemical agents applied to the mucosal surface in order to aid gastrointestinal endoscopic diagnosis and therapy. Acid producing mucosa in the GI tract may be visualized endoscopically by Congo red staining in combination with stimulation of gastric acid production. Congo red is a reactive indicator dye that changes color from red to dark blue/black at a pH of less than three. We have modified the conventional Congo red test, and characterized a rapid approach, modified endoscopic Congo red test (MCRT). In this test, within five minutes after pentagastrin injection, the Congo red coated normal, acid producing fundal mucosa turns to a blue/black color. The two shortcomings in the original method, the time of dose-response and the dose of acid stimulant pentagastrin, are circumvented by our modification. The dose-response delay was reduced by 63% from 10-20 minutes to around five minutes, and the dose/kg of pentagastrin by 30 times, giving it intravenously instead of intra-muscularly. MCRT was applied in 589 examinations in order to study gastric mucosa in subjects with both non-operated and resected stomachs. MCRT was found to be a rapid, inexpensive and well-tolerated method to visualize acid producing mucosa during routine gastroscopic examination. MCRT increases the diagnostic accuracy of routine gastroscopy in detecting chronic atrophic fundal gastritis (sensitivity from 0.25 to 1.0 and specificity from 0.88 to 0.95, respectively). This is a rapid and accurate method (accuracy 0.98) to detect hypo/achlorhydria during gastroscopic examination. Morphological and functional information provided by MCRT may influence the clinical managements of patients. Future outcome studies should more precisely define the potential indications and the clinical benefit of MCRT.
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