RESUMEN
OBJECTIVE: The purpose of this study was to determine the prevalence of the different types of gastric polyps in the Daniel Alcides Carrión Hospital between the years of 2014 and 2016, and also define the endoscopic and histopathological characteristics of the lesions. MATERIALS AND METHODS: 7559 endoscopic reports were reviewed, in which 148 gastric polyps were found. The patients age and sex as well as the localization, number, size and macroscopic and microscopic aspects of the polyps were recorded. RESULTS: The prevalence of gastric polyps was 1.9%; 74.3% of these were found in women with an average age of 61.5 years. 59.4% of the gastric polyps found were singular, and the majority were located on the body and antrum of the stomach. 74.29% of the polyps were less than 1 cm in diameter and 83.64% of these were sessile when seen macroscopically. According to the histological type, it was found that the majority of gastric polyps were hyperplasic (76.4%), followed by fundic gland polyps (17.5%) and gastric adenomas (6.1%). It was also found that multiple gastric polyps were associated with fundic gland polyps while singular polyps were most likely hyperplastic or adenomas. CONCLUSION: The prevalence of fundic gland polyps has increased, while the other types of polyps have maintained their estimated prevalence.
Asunto(s)
Pólipos Adenomatosos/epidemiología , Neoplasias Gástricas/epidemiología , Adenoma/epidemiología , Adenoma/patología , Adenoma/cirugía , Pólipos Adenomatosos/patología , Pólipos Adenomatosos/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fundus Gástrico/patología , Gastroscopía , Humanos , Hiperplasia , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugía , Adulto JovenRESUMEN
Objetivos: El propósito de este estudio fue determinar la prevalencia y las características endoscópicas e histopatológicas de los distintos tipos de pólipos gástricos en el Hospital Daniel Alcides Carrión entre los años 2014-2016. Materiales y métodos: Se revisó 7559 reportes endoscópicos, donde se encontró 148 pólipos gástricos y se consignó datos de edad, sexo, localización, número de lesiones, tamaño, y aspectos macroscópicos y microscópicos de la lesión. Resultados: La prevalencia de pólipos gástricos fue 1,9%; el 74,3% de estos se presentaron en mujeres donde la edad promedio fue de 61,5 años. El 59,46% de los pólipos gástricos fueron únicos, la mayoría localizándose en el antro y cuerpo del estómago. El 74,29% de pólipos fueron menores de 1 cm en diámetro y el 83,64% tenían un aspecto macroscópico sésil. Con respecto al tipo histológico, se encontró que la mayoría de los pólipos gástricos en esta población son hiperplásicos (76,4%), seguidos por los de glándulas fúndicas (17,5%) y la minoría fueron adenomas (6,1%). Cabe resaltar que los pólipos múltiples fueron en su gran mayoría de tipo de glándulas fúndicas mientras que en los demás tipos histológicos predominó el pólipo único. Conclusión: La prevalencia de pólipos de glándulas fúndicas ha aumentado, mientras los otros tipos de pólipos han mantenido su prevalencia esperada.
Objective: The purpose of this study was to determine the prevalence of the different types of gastric polyps in the Daniel Alcides Carrión Hospital between the years of 2014 and 2016, and also define the endoscopic and histopathological characteristics of the lesions. Materials and methods: 7559 endoscopic reports were reviewed, in which 148 gastric polyps were found. The patients' age and sex as well as the localization, number, size and macroscopic and microscopic aspects of the polyps were recorded. Results: The prevalence of gastric polyps was 1.9%; 74.3% of these were found in women with an average age of 61.5 years. 59.4% of the gastric polyps found were singular, and the majority were located on the body and antrum of the stomach. 74.29% of the polyps were less than 1 cm in diameter and 83.64% of these were sessile when seen macroscopically. According to the histological type, it was found that the majority of gastric polyps were hyperplasic (76.4%), followed by fundic gland polyps (17.5%) and gastric adenomas (6.1%). It was also found that multiple gastric polyps were associated with fundic gland polyps while singular polyps were most likely hyperplastic or adenomas. Conclusion: The prevalence of fundic gland polyps has increased, while the other types of polyps have maintained their estimated prevalence.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Neoplasias Gástricas/epidemiología , Pólipos Adenomatosos/epidemiología , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/patología , Adenoma/cirugía , Adenoma/patología , Adenoma/epidemiología , Prevalencia , Estudios Retrospectivos , Gastroscopía , Pólipos Adenomatosos/cirugía , Pólipos Adenomatosos/patología , Fundus Gástrico/patología , HiperplasiaRESUMEN
BACKGROUND: The prevalence of gastric polyps varies around the world reflecting regional associations. We describe demographic features of patients with gastric polyp diagnosis treated between 1980 and 2016 at a referral center in Mexico City and analyzed trends of polyp subtype. MATERIALS AND METHODS: We conducted a blind review of archival slides of gastric biopsies with polyp diagnosis from the years 1980, 1990, 2000, 2010, and 2016. Initial diagnosis; patient's gender, age and symptoms; and number and location of lesions were recorded. Blind slide review and trend analysis were performed. RESULTS: In 3887 gastric biopsies, 192 patients (4.93%) with epithelial polyps were identified. The median age of patients was 58 years; 73% were female. Polyps were single in 143/192 cases (74.4%), almost 67% in the oxyntic mucosa, and 85% were associated with dyspepsia. The prevalence was 0.5%, 1.6%, 1.9%, 4.6%, and 9.6% for the years 1980, 1990, 2000, 2010, and 2016, respectively, resulting in a rising trend in the prevalence of epithelial polyps of 380% in 46 years. Fundic gland polyps (FGPs) had a global frequency of 66.6% (128/192). They were identified for the first time in the third period of the study, with a frequency of 28.6% (6/21), 66.6% (35/53), and 78.3% (87/111) for the years 2000, 2010, and 2016, respectively. Contrary, hyperplastic polyps (HPs) decreased 20%. A relative prevalence of 3.29%, 0.97%, and 0.15% was observed for FGP, HP, and gastric adenoma, respectively. DISCUSSION: The 1400% change of FGP explains the increased prevalence of gastric polyps. Chronic treatment with proton pump inhibitors and Helicobacter pylori eradication are possible explanations.
Asunto(s)
Adenoma/epidemiología , Fundus Gástrico/patología , Pólipos/epidemiología , Neoplasias Gástricas/epidemiología , Adenoma/diagnóstico , Adenoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Dispepsia/epidemiología , Dispepsia/etiología , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Pólipos/diagnóstico , Pólipos/patología , Prevalencia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patología , Adulto JovenRESUMEN
Hemorragia digestiva alta (HDA) é uma emergência clínica exteriorizada através de melena, hematêmese, além de alterações hemodinâmicas decorrentes de perda volêmica. Existem vários diagnósticos etiológicos causadores de hemorragias digestivas altas; dentre eles, uma causa rara é lesão de Dieulafoy, sendo relacionada acerca de 2% dos casos de HDA. Neste relato, descreveremos um caso de lesão de Dieulafoy, evidenciando a relevância desta lesão como um importante diagnóstico diferencial nas causas de hemorragia digestiva alta. O procedimento diagnóstico e o manejo atual são fundamentados pela endoscopia digestiva alta. A hemostasia endoscópica é realizada, utilizando técnicas como eletrocoagulação, injeções com adrenalina e hemoclips.
Upper gastrointestinal bleeding (UGBI) is a clinical emergency externalized through melena, hematemesis and hemodynamic changes due to volume loss. There are a lot of etiological diagnosis of gastroduodenal hemorrhages, including Dieulafoy which is a rare cause related about 2% of the UGBI cases. In this report we describe a case of Dieulafoy lesion highlighting the importance of this lesion as a rare and important differential diagnosis in cases of upper gastrointestinal bleeding. The current diagnostic and management is justified by endoscopy. Endoscopic hemostasis is performed using techniques such as electrocoagulation, injections of adrenaline and hemo-clips.
Asunto(s)
Humanos , Masculino , Adulto , Arteriolas/anomalías , Hematemesis , Melena , Endoscopía del Sistema Digestivo , Tracto Gastrointestinal Superior , Fundus Gástrico/patología , Hemorragia Gastrointestinal , Hemorragia Gastrointestinal/etiologíaRESUMEN
Scientific literature, although limited in this area, supports the hypothesis that asthma, by means of selective leukocyte trafficking between the various mucosal and glandular sites of the body, can have the same pathophysiological effects on the stomach as the airways. This study aimed to determine if asthma, in the absence and presence of various asthma therapies (Hydrocortisone and Modul8TM), imparted any morphological alteration on the stomach parietal and chief cells. The BALB/c murine asthmatic mouse model was the model of choice in this study. The asthma induction protocol as well as the asthma therapies were proved to be effective with the aid of bronchial lavage fluid leukocyte quantification. Fundic and pyloric biopsies were extracted at termination and assessed by means of transmission electron, scanning electron and light microscopy. The extracted fundic and pyloric biopsies revealed asthma alone induced parietal cell hypertrophy (increase in parietal cell size P < 0.000100 in both stomach regions) and chief cell hyper functioning. The use of Hydrocortisone and Modul8TM, as a therapy to correct the perceived gastric alterations were dismal; only in the case of fundic parietal cells were both treatments able to compensate for the hypertrophic effect caused by asthma, while in the pylorus parietal cell asthma- induced hypertrophy was only compensated for by Modul8TM.
La literatura científica, aunque limitada en esta área, apoya la hipótesis de que el asma, por medio del tráfico selectivo de leucocitos entre los diferentes sitios y la mucosa glandular del cuerpo, puede tener los mismos efectos fisiopatológicos en el estómago y las vías respiratorias. Este estudio tuvo como objetivo determinar si el asma, en ausencia y presencia de diversos tratamientos para el asma (hidrocortisona y Modul8 TM), generó alguna alteración morfológica en las céluals parietales y principales del estómago. El modelo murino BALB/c del ratón asmático fue el modelo de elección en este estudio. El protocolo de inducción de asma, así como el tratamiento del asma demostró ser eficaz con la ayuda de lavado bronquial y cuantificación leucocitaria del fluido. Biopsias de las regiones fúndica y pilórica fueron extraídas y evaluadas por medio de microscopía electrónica de transmisión, de barrido y de luz. Las biopsias extraídas de la región fúndica y pilórica revelaron que el asma solamente induce hipertrofia de las células parietales (aumento del tamaño de las células parietales P <0,00001 en ambas regiones del estómago) e hiperfuncionamiento de las células principales. El uso de hidrocortisona y Modul8 TM, como una terapia para corregir las alteraciones gástricas fue disimil, sólo en el caso de las células parietales fúndicas ambos tratamientos fueron capaces de compensar el efecto hipertrófico causado por el asma, mientras que en la célula parietal pílorica la hipertrofia inducida por el asma solamente se vio compensada por Modul8TM.
Asunto(s)
Animales , Femenino , Ratas , Asma/patología , Estómago/patología , Estómago/ultraestructura , Antiasmáticos , Modelos Animales de Enfermedad , Fundus Gástrico/patología , Fundus Gástrico/ultraestructura , Hipertrofia , Leucocitos , Ratones Endogámicos BALB C , Microscopía Electrónica , Nebulizadores y Vaporizadores , Células Parietales Gástricas , Píloro/patología , Píloro/ultraestructuraRESUMEN
INTRODUCTION: There is epidemiologic evidence that suggest the relation between the histological type and location of gastric adenocarcinoma. Knowing that there is a predominance of Helicobacter pylori infection in the antral region and this is considered an environmental factor; make us suppose that there is a relation among intestinal type and distal location. OBJECTIVE: The aim of this study is to investigate the relation among histological type and location of gastric cancer, using the Lauren classification and the Japanese Gastric Cancer Association classification. METHOD: During the period between January 1st 2007 and December 31th 2010, 460 patients with the proven diagnostic of adenocarcinoma were admitted for surgical treatment at the gastric cancer specialized ward of Rebagliati National Hospital, Lima, Peru. RESULTS: Female was more frequent in diffuse type (39% vs. 33%; p: 0,153), the mean age among intestinal type is greater than diffuse type (70,7 vs. 62,6 años; p<0,001). There is association among poorly differentiated with upper location (22% vs. 12,7%; p = 0,009), signet cell with middle location (50% vs. 32,5%; p: 0,006), tubular type with distal location (57,6% vs. 42,8%; p: 0,002), intestinal type with distal location (58,3% vs. 44,1%; p: 0,004), and diffuse type with upper location (19,3% vs. 12,5%; p: 0,049). CONCLUSION: Adenocarcinomas histologically differentiated or intestinal type are associated with distal location. Poorly differentiated type and signet ring cell type are associated with upper and middle location respectively.
Asunto(s)
Adenocarcinoma/patología , Neoplasias Gástricas/patología , Adenocarcinoma/clasificación , Adenocarcinoma/epidemiología , Adenocarcinoma Mucinoso/epidemiología , Adenocarcinoma Mucinoso/patología , Adenocarcinoma Papilar/epidemiología , Adenocarcinoma Papilar/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células en Anillo de Sello/epidemiología , Carcinoma de Células en Anillo de Sello/patología , Cardias/patología , Femenino , Fundus Gástrico/patología , Hospitales Públicos/estadística & datos numéricos , Hospitales Urbanos/estadística & datos numéricos , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Perú/epidemiología , Antro Pilórico/patología , Neoplasias Gástricas/clasificación , Neoplasias Gástricas/epidemiologíaRESUMEN
BACKGROUND & AIMS: Fundic gland polyps (FGPs), the most common type of gastric polyps, have been associated with prolonged proton pump inhibitor therapy and an increased risk of colon cancer. The presence of FGPs has been inversely correlated with Helicobacter pylori infection. We evaluated the prevalence of H pylori-associated gastritis, colonic polyps, and carcinomas in subjects with and without FGPs. METHODS: We analyzed data collected from community-based endoscopy centers in 36 states (plus Washington DC and Puerto Rico) on patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy between April 2007 and March 2008. Of the 103,385 patients who underwent EGD during this time period, gastric biopsy samples were collected from 78,801 and colonic biopsies from 26,017. Slides of samples from Helicobacter-infected FGPs and FGPs with dysplasia were reviewed. RESULTS: FGPs were detected in 6081 patients (67.8% women). Helicobacter infection was present in less than 0.5% patients with FGPs and 13.0% of those without FGPs (odds ratio [OR], 29.05; 95% confidence interval [CI], 20.4-41.4; P < .0001). Colonic adenomas were detected in 42.3% of women with FGPs and 33.8% of those without (OR, 1.43; 95% CI, 1.26-1.63; P < .001); there was no significant difference in colonic adenomas between men with and without FGPs. CONCLUSIONS: Women had a higher prevalence of FGPs. FGPs were associated with gastroesophageal reflux disease symptoms, gastric heterotopia, hyperplastic colonic polyps (only in men), and colonic adenomas (only in women, especially those over 60 years of age). The presence of FGPs was inversely correlated with H pylori infection, active gastritis, and gastric neoplasia.
Asunto(s)
Fundus Gástrico/patología , Mucosa Gástrica/patología , Gastritis/complicaciones , Neoplasias Gastrointestinales/epidemiología , Infecciones por Helicobacter/complicaciones , Pólipos/complicaciones , Pólipos/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Niño , Colon/patología , Colonoscopía , District of Columbia , Endoscopía Gastrointestinal , Femenino , Fundus Gástrico/microbiología , Helicobacter pylori/aislamiento & purificación , Histocitoquímica , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Puerto Rico , Adulto JovenRESUMEN
AIM: To evaluate gastrointestinal motility during 5-fluorouracil (5-FU)-induced intestinal mucositis. MATERIALS AND METHODS: Wistar rats received 5-FU (150 mg kg(-1), i.p.) or saline. After the 1st, 3rd, 5th, 15th and 30th day, sections of duodenum, jejunum and ileum were removed for assessment of epithelial damage, apoptotic and mitotic indexes, MPO activity and GSH concentration. In order to study gastrointestinal motility, on the 3rd or 15th day after 5-FU treatment, gastric emptying in vivo was measured by scintilographic method, and stomach or duodenal smooth muscle contractions induced by CCh were evaluated in vitro. RESULTS: On the third day of treatment, 5-FU induced a significant villi shortening, an increase in crypt depth and intestinal MPO activity and a decrease in villus/crypt ratio and GSH concentration. On the first day after 5-FU there was an increase in the apoptosis index and a decrease in the mitosis index in all intestinal segments. After the 15th day of 5-FU treatment, a complete reversion of all these parameters was observed. There was a delay in gastric emptying in vivo and a significant increase in gastric fundus and duodenum smooth muscle contraction, after both the 3rd and 15th day. CONCLUSION: 5-FU-induced gastrointestinal dysmotility outlasts intestinal mucositis.
Asunto(s)
Antimetabolitos Antineoplásicos/toxicidad , Fluorouracilo/toxicidad , Motilidad Gastrointestinal/efectos de los fármacos , Enfermedades Intestinales/fisiopatología , Mucositis/fisiopatología , Animales , Apoptosis/efectos de los fármacos , Carbacol/farmacología , Vaciamiento Gástrico/efectos de los fármacos , Fundus Gástrico/patología , Glutatión/análisis , Enfermedades Intestinales/inducido químicamente , Intestino Delgado/patología , Masculino , Índice Mitótico , Mucositis/inducido químicamente , Peroxidasa/análisis , Distribución Aleatoria , Ratas , Ratas Wistar , Factores de TiempoRESUMEN
The gastric inflammatory fibroid polyp (GIFP) is a rare benign tumor that is localized mainly in the antrum and presents endoscopically as a submucosal mass. The usual reported presenting size ranges among 1 and 5 cm. In this case report we present the largest GIFP published in the literature in a very uncommon localization, this is a 9.1 x 6.3 cm lesion in the gastric fundus.
Asunto(s)
Leiomioma/patología , Pólipos/patología , Gastropatías/patología , Complicaciones de la Diabetes/patología , Fundus Gástrico/patología , Mucosa Gástrica/patología , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Regression of intestinal metaplasia to cardiac mucosa in patients with Barrett's (BE) esophagus could alter the natural history of BE. OBJECTIVE: To determine the regression of intestinal metaplasia to cardiac mucosa in patients followed more than 5 years after operation, by repeated endoscopy with biopsy. MATERIAL AND METHODS: This prospective study included 78 patients with BE submitted to combined vagotomy, antrectomy (an antireflux procedure), and Roux-en-Y gastrointestinal reconstruction with more than 60 months follow up. Patients were divided in 3 groups: (1) 31 with short-segment BE (< or =30 mm length); (2) 42 with long-segment BE (31 to 99 mm length); and (3) 5 with extra-long-segment BE (> or =100 mm). Each patient had at least three endoscopic procedures with multiple biopsies during a mean follow up of 95 months (range, 60-220 months). Acid and duodenal reflux were also evaluated. RESULTS: Sixty-four percent of patients with short segment BE had regression to cardiac mucosa at a mean of 40 months after operation. Sixty-two percent of patients with long segment BE had regression to cardiac mucosa at a mean of 47 months postoperatively. No regression occurred in the 5 patients with extra-long segment BE. In 20% of patients, regression to fundic mucosa occurred between 78 to 94 months after surgery. One patient progressed to low grade dysplasia, but no patient progressed to high-grade dysplasia or adenocarcinoma. Acid and duodenal reflux studies demonstrated that in asymptomatic patients, reflux was abolished; 90% of the patients had a Visick grade of 1 or 2. CONCLUSIONS: Vagotomy and antrectomy combined with duodenal bile diversion abolish acid and duodenal reflux into the distal esophagus in patients with BE, which is accompanied by a regression of BE from intestinal to cardiac or fundic mucosa in about 60% of patients. This regression is time dependent and varies directly with the length of BE. The potential for an antineoplastic effect, especially in young patients with long segment BE, suggests that this operation may become an attractive option as a definitive surgical treatment. Patients with short segment BE submitted to this procedure behave similar to patients submitted to Nissen fundoplication, and therefore in these patients, we do not advocate this complex operation.
Asunto(s)
Esófago de Barrett/cirugía , Cardias/patología , Duodeno/cirugía , Gastrectomía , Fundus Gástrico/patología , Intestinos/patología , Vagotomía , Adolescente , Adulto , Anciano , Anastomosis en-Y de Roux , Esófago de Barrett/complicaciones , Esófago de Barrett/patología , Femenino , Gastrectomía/métodos , Reflujo Gastroesofágico/etiología , Reflujo Gastroesofágico/fisiopatología , Humanos , Estudios Longitudinales , Masculino , Metaplasia , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Inducción de RemisiónRESUMEN
Se presentan 18 pacientes tratados con gastrectomía total ampliada por presentar cáncer de cardias y fondo del estómago, en el Hospital «Manuel Fajardo¼ en el período de enero de 1995 a enero de 2003. Mostramos los resultados obtenidos con la gastrectomía total ampliada con respecto a la supervivencia y a la presencia de complicaciones, en especial las dehiscencias de anastomosis. El 88,8(por ciento) de los pacientes era del sexo masculino y el 50(por ciento) estaba en la sexta década de la vida. Todos eran fumadores. Las lesiones del tipo adenocarcinoma estaban localizadas en el cardias en el 34,5(por ciento) de los casos, mientras en el resto se extendían al fondo del estómago (65,5(por ciento). En el 78,8(por ciento) la anastomosis fue manual; la técnica en Y de Roux se utilizó en el 44,5(por ciento) y la anastomosis término-lateral con la modificación de Warren en el 55,5(por ciento). No ocurrieron dehiscencias. La mortalidad quirúrgica fue del 5,5(por ciento). La supervivencia a los 3 años fue del 33,3(AU)
Asunto(s)
Humanos , Masculino , Adulto , Gastrectomía/métodos , Neoplasias Gástricas , Cardias/patología , Fundus Gástrico/patologíaRESUMEN
Se presentan 18 pacientes tratados con gastrectomía total ampliada por presentar cáncer de cardias y fondo del estómago, en el Hospital Manuel Fajardo en el período de enero de 1995 a enero de 2003. Mostramos los resultados obtenidos con la gastrectomía total ampliada con respecto a la supervivencia y a la presencia de complicaciones, en especial las dehiscencias de anastomosis. El 88,8 por ciento de los pacientes era del sexo masculino y el 50 por ciento estaba en la sexta década de la vida. Todos eran fumadores. Las lesiones del tipo adenocarcinoma estaban localizadas en el cardias en el 34,5 por ciento de los casos, mientras en el resto se extendían al fondo del estómago (65,5por ciento). En el 78,8 por ciento la anastomosis fue manual; la técnica en Y de Roux se utilizó en el 44,5 por ciento y la anastomosis término-lateral con la modificación de Warren en el 55,5 por ciento. No ocurrieron dehiscencias. La mortalidad quirúrgica fue del 5,5 por ciento. La supervivencia a los 3 años fue del 33,3(AU)
18 patients treaties are presented with total gastrectomía enlarged to present cardias cancer and bottom of the stomach, in the Hospital Manuel Fajardo in the period of January of 1995 to January of 2003. We show the results obtained with the total gastrectomía enlarged with regard to the survival and to the presence of complications, especially the anastomosis dehiscencias. 88,8 percent of the patients was of the masculine sex and 50 percent it was in the sixth decade of the life. All were smoking. The lesions of the type adenocarcinoma were located in the cardias by 34,5 percent of the cases, while in the rest they extended to the bottom of the stomach (65,5 percent). By 78,8 percent the anastomosis was manual; the technique in AND of Roux it was used in 44,5 percent and the term-lateral anastomosis with the modification of Warren by 55,5 percent. They didn't happen dehiscencias. The surgical mortality was of 5,5 percent. The survival to the 3 years was of the 33,3(AU)
Asunto(s)
Humanos , Masculino , Adulto , Neoplasias Gástricas/diagnóstico , Cardias/patología , Gastrectomía/métodos , Fundus Gástrico/patología , SobrevidaRESUMEN
Background: The mucosa distal to the endoscopic mucosal change zone can have easily diagnosed early alterations, in patients with chronic gastroesophageal reflux. Aim: To determine the type of mucosa existent in the zone distal to the squamous-columnar junction in patients with chronic gastroesophageal reflux without intestinal metaplasia. Patients and methods: One hundred thirty four controls and 208 patients with chronic gastroesophageal reflux lasting two years were studied. Forty three of these patients had a normal endoscopy, 54 had an erosive esophagitis and 111 had a short columnar epithelium covering the distal esophagus, without intestinal metaplasia. In all subjects, four biopsies were obtained from a zone distal to the squamous-columnar junction and two from the distal gastric antrum. Results: In 59 percent of control subjects, fundic mucosa was present in the zone distal to the squamous-columnar junction. Cardial mucosa was present in the rest. In patients with chronic gastroesophageal reflux, cardial mucosa was predominant. Helicobacter pylorii infection decreased along with increasing extension of cardial mucosa covering the distal esophagus. Conclusions: In patients with chronic gastroesophageal reflux there is a metaplasia of fundic mucosa towards cardial mucosa. On the other hand, Helicobacter pylorii infection decreases gradually
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Helicobacter pylori/aislamiento & purificación , Mucosa Gástrica/patología , Reflujo Gastroesofágico/patología , Cardias/patología , Infecciones por Helicobacter/epidemiología , Fundus Gástrico/patología , Unión Esofagogástrica/patologíaRESUMEN
BACKGROUND: The mucosa distal to the endoscopic mucosal change zone can have easily diagnosed early alterations, in patients with chronic gastroesophageal reflux. AIM: To determine the type of mucosa existent in the zone distal to the squamous-columnar junction in patients with chronic gastroesophageal reflux without intestinal metaplasia. PATIENTS AND METHODS: One hundred thirty four controls and 208 patients with chronic gastroesophageal reflux lasting two years were studied. Forty three of these patients had a normal endoscopy, 54 had an erosive esophagitis and 111 had a short columnar epithelium covering the distal esophagus, without intestinal metaplasia. In all subjects, four biopsies were obtained from a zone distal to the squamous-columnar junction and two from the distal gastric antrum. RESULTS: In 59% of control subjects, fundic mucosa was present in the zone distal to the squamous-columnar junction. Cardial mucosa was present in the rest. In patient with chronic gastroesophageal reflux, cardial mucosa was predominant. Helicobacter pylorii infection decreased along with increasing extension of cardial mucosa covering the distal esophagus. CONCLUSIONS: In patients with chronic gastroesophageal reflux there is a metaplasia of fundic mucosa towards cardial mucosa. On the other hand, Helicobacter pylorii infection decreases gradually.
Asunto(s)
Esófago de Barrett/etiología , Mucosa Gástrica/patología , Reflujo Gastroesofágico/patología , Infecciones por Helicobacter/patología , Helicobacter pylori , Adolescente , Adulto , Anciano , Biopsia , Cardias/microbiología , Cardias/patología , Estudios de Casos y Controles , Enfermedad Crónica , Endoscopios Gastrointestinales , Femenino , Fundus Gástrico/microbiología , Fundus Gástrico/patología , Mucosa Gástrica/microbiología , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/microbiología , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
The effect of electrolytic lesion of the median raphe nucleus was measured on behavioral and physiological parameters related to stress 24 h after the lesion. In of the elevated plus-maze the lesion decreased the percentage of open arm entries and tended to shorten the time spent on the open arms indicating as increase in anxiety. In contrast, the lesion markedly increased the time spent in the bright (aversive) compartment of the light-dark box and decrease in attempts to cross from the dark toward the bright compartment, an anxiolyic effect. With the exception of plasma prolactin level, which was lowered by the lesion, the physiological measures used in the present study indicate that the lesioned animals are under stress. Thus, death rate and weight loss after the surgery were higher in lesioned than in control animals. In addition, lesioned animals showed higher plasma corticoster- one levels, a high incidence of gastric ulcers in the fundus and a depressed immune response to the mitogen concavaline A. These results highlight the importance of the median raphe nucleus in the regulation of stress and anxiety. They also show that behavioral and physiological measures of stress may be dissociated.
Asunto(s)
Animales , Masculino , Ratas , Ansiedad , Conducta Animal , Núcleos del Rafe/patología , Estrés Fisiológico/metabolismo , Corticoesteroides/sangre , Concanavalina A/farmacología , Oscuridad , Electrodos , Fundus Gástrico/patología , Iluminación , Linfopenia , Mortalidad , Prolactina/sangre , Ratas Wistar , Úlcera Gástrica , Pérdida de PesoRESUMEN
The effect of electrolytic lesion of the median raphe nucleus was measured on behavioral and physiological parameters related to stress 24 h after the lesion. In of the elevated plus-maze the lesion decreased the percentage of open arm entries and tended to shorten the time spent on the open arms indicating as increase in anxiety. In contrast, the lesion markedly increased the time spent in the bright (aversive) compartment of the light-dark box and decrease in attempts to cross from the dark toward the bright compartment, an anxiolyic effect. With the exception of plasma prolactin level, which was lowered by the lesion, the physiological measures used in the present study indicate that the lesioned animals are under stress. Thus, death rate and weight loss after the surgery were higher in lesioned than in control animals. In addition, lesioned animals showed higher plasma corticoster- one levels, a high incidence of gastric ulcers in the fundus and a depressed immune response to the mitogen concavaline A. These results highlight the importance of the median raphe nucleus in the regulation of stress and anxiety. They also show that behavioral and physiological measures of stress may be dissociated. (AU)
Asunto(s)
Animales , Masculino , Ratas , RESEARCH SUPPORT, NON-U.S. GOVT , Núcleos del Rafe/patología , Conducta Animal , Estrés Fisiológico/metabolismo , Ansiedad , Electrodos , Iluminación , Oscuridad , Mortalidad , Pérdida de Peso , Corticoesteroides/sangre , Prolactina/sangre , Úlcera Gástrica , Fundus Gástrico/patología , Concanavalina A/farmacología , Linfopenia , Ratas WistarRESUMEN
It is generally agreed that Helicobacter pylori (Hp) plays a key role in alterating regulatory factors affecting cellular proliferation during the disease process. During chronic superficial gastritis there is, in case of moderate/severe activity, a foveolar-superficial expansion of immature muco-peptic cells. In the present experience this phenomenon has been evaluated in the surrounding areas of 22 body-fundic gastric ulcer (BFGU). The 72.7% of BFGU were Hp positive. The expansion was detectable in 68.7% of Hp positive BFGU. The expansion process involves the substitution of mature cells with immature one determining a reduction of the efficacy of the mucosa barrier in association with an increment of aggressive factors (mucosal pepsins). This phenomenon in relation with host genetic susceptibility may favor peptic ulcer.
Asunto(s)
Mucosa Gástrica/patología , Infecciones por Helicobacter/patología , Helicobacter pylori , Úlcera Gástrica/patología , División Celular , Distribución de Chi-Cuadrado , Femenino , Fundus Gástrico/metabolismo , Fundus Gástrico/patología , Mucosa Gástrica/microbiología , Infecciones por Helicobacter/microbiología , Humanos , Masculino , Persona de Mediana Edad , Úlcera Gástrica/microbiologíaRESUMEN
It is generally agreed that Helicobacter pylori (Hp) plays a key role in alterating regulatory factors affecting cellular proliferation during the disease process. During chronic superficial gastritis there is, in case of moderate/severe activity, a foveolar-superficial expansion of immature muco-peptic cells. In the present experience this phenomenon has been evaluated in the surrounding areas of 22 body-fundic gastric ulcer (BFGU). The 72.7 percent of BFGU were Hp positive. The expansion was detectable in 68.7 percent of Hp positive BFGU. The expansion process involves the substitution of mature cells with immature one determining a reduction of the efficacy of the mucosa barrier in association with an increment of aggresive factors (mucosal pepsins). This phenomenon in relation with host genetic susceptibility may favor peptic ulcer. (AU)
Asunto(s)
Persona de Mediana Edad , Femenino , Humanos , Úlcera Gástrica/patología , Mucosa Gástrica/patología , Infecciones por Helicobacter/patología , Helicobacter pylori , Fundus Gástrico/patología , Fundus Gástrico/metabolismo , Distribución de Chi-Cuadrado , Susceptibilidad a Enfermedades , División CelularRESUMEN
It is generally agreed that Helicobacter pylori (Hp) plays a key role in alterating regulatory factors affecting cellular proliferation during the disease process. During chronic superficial gastritis there is, in case of moderate/severe activity, a foveolar-superficial expansion of immature muco-peptic cells. In the present experience this phenomenon has been evaluated in the surrounding areas of 22 body-fundic gastric ulcer (BFGU). The 72.7 percent of BFGU were Hp positive. The expansion was detectable in 68.7 percent of Hp positive BFGU. The expansion process involves the substitution of mature cells with immature one determining a reduction of the efficacy of the mucosa barrier in association with an increment of aggresive factors (mucosal pepsins). This phenomenon in relation with host genetic susceptibility may favor peptic ulcer.