Herpes viruses and duodenal ulcer disease

Antibodies to herpes simplex virus and Epstein-Barr virus were sought in the sera of 33 patients with endoscopically proved duodenal ulcer and 33 healthy controls. Neither the prevalence nor the antibody levels to both viruses were significantly different between the two groups. These results suggest that herpes viruses may not play a role in the pathogenesis of duodenal ulcer disease.     

Helicobacter pylori in duodenal ulcer disease and its eradication

Antral biopsy specimens were processed for Helicobacter pylori by Gram staining, rapid urease test (RUT) and culture from 25 patients with symptoms of duodenal ulcer, amongst whom the positivity rate was 84%. Follow up of 16 patients after appropriate therapy showed complete regression of the disease in 87.5% of cases whereas in 12.5% of cases a decrease in the extent of duodenal ulceration was noted.     

Psychological correlates of gastric and duodenal ulcer disease

Psychological correlates of gastric and duodenal ulcer disease were assessed in a group of somewhat older patients with ulcer disease identified by endoscopy. Associations between both ulcer types and symptom measures (anxiety and depression) seemed only to reflect severity or chronicity of gastrointestinal symptoms or the impending endoscopy procedure. Associations with 'trait' psychological indices may be of causal significance. Duodenal ulcer patients had higher 'introversion' and 'psychoticism' scores (on the EPQ) than controls, while gastric ulcer patients had higher psychoticism scores and 'trait anxiety' scores. These findings could not be attributed to confounding variables. When the two ulcer groups were compared, the gastric ulcer group had significantly higher neuroticism, psychoticism and hostility scores which were not attributable to confounding variables. The higher depression scores in gastric ulcer patients, however, simply reflected the greater chronicity of their physical symptoms. The groups did not differ significantly on measures of trait anxiety, tension, introversion or Type A behaviour.     

Russel bodies in the duodenal mucosa in ulcer disease]

A total of 103 specimens of the duodenum mucosa incised during the resection of the stomach in different variants of the course of peptic ulcer were studied. It was shown that Russell's bodies (RB) in the mucosa's layer proper were formed by cellular elements analogous to immunoglobulinocytes of the lymph nodes and spleen of the laboratory animals which had been subjected to an experimental stimulation of immunogenesis. Peculiar patterns of contacts of RB with the mast cells and possible significance of these contacts are discussed. On the basis of the data obtained the conclusion was drawn that elimination of the RB substrate in the duodenum mucosa was realized in two directions: a) centripetal by penetration of the substrate into the lymphatic and blood vessels; and b) centrifugal, by its evacuation into the lumen of the alimentary canal.     

Roxatidine in duodenal ulcer

Roxatidine acetate is a new H2-receptor antagonist. A randomized double-blind clinical trial in fifty-three patients with endoscopically proven duodenal ulcers > 5 mm in diameter was undertaken to compare safety and efficacy of roxatidine with that of ranitidine. Twenty-six patients received roxatidine (75 mg bid) while 27 patients received ranitidine (150 mg bid) for 4 weeks. One patient in each group did not come for follow up. Roxatidine and ranitidine had comparable ulcer healing rates (22/25 vs 22/26); roxatidine, however, resulted in greater reduction in the number and severity of night time pain episodes (p < 0.05). No adverse event was reported during 4 weeks of treatment with roxatidine. Thus roxatidine achieves the primary therapeutic goal of relief of pain better than ranitidine.     

The occurrence of gastric and duodenal auto-antibodies in peptic ulcer disease

The possible relationship between peptic ulcer and the occurrence of auto-antibodies was investigated by means of an enzyme-linked immunosorbent assay (ELISA). Sera from 24 patients with active duodenal ulcer were analysed using cells and subcellular fractions from pig gastric acid duodenal mucosa for binding of immunoglobulins. Four sera (17%) reacted with a homogenate from duodenal mucosa. Nine sera (38%) were found to contain auto-antibodies against gastric mucosal cells. The cell-reactive auto-antibodies were shown to bind preferentially to parietal cells and chief cells. In these cells the antigens were identified as H, K-ATPase and pepsinogen respectively. Six sera were positive against purified H,K-ATPase; 12 sera were positive against pepsinogen, and only one of these sera reacted with both H,K-ATPase and pepsinogen. The results show that auto-antibodies are formed in a large fraction of patients (18/24; 75%) with peptic ulcer disease. The present study further demonstrates that enrichment of antigenic structures is required for obtaining a satisfactory sensitivity in the assay.     

Reflux gastritis in duodenal ulcer

The results of a comprehensive examination of 44 patients with duodenal ulcer are analyzed. Reflux gastritis was detected in almost 50% of the patients. X-ray method, gastroduodenoscopy, and radiologic method for measuring the duodenal reflux in gastric contents portions were employed to diagnose duodenogastric reflux and reflux gastritis. The radiologic method was found the most informative. Reflux gastritis was finally diagnosed after histologic examination of gastric mucosa biopsy specimens. Increased count of IgE cells in these specimens may be considered as the marker of reflux gastritis. The authors come to a conclusion that reflux gastritis degree should be taken into consideration when choosing a method for conservative and radical treatment of duodenal ulcers.     

Campylobacter pyloridis in duodenal ulcer

A morphologic study of antral gastric and duodenal mucosa was carried out in patients with duodenal ulcers. Peptic ulcers were in the phase of exacerbation in 55 patients, and that of remission, in 10. Campylobacter pyloridis (CP) were detected in 83% of the cases by histologic investigation of gastric and duodenal mucosa biopsy specimens obtained from patients with duodenal ulcers. CP were more common and numerous during exacerbation rather than remission of peptic ulcers. Bacterial dissemination in gastric and duodenal mucosa was greater in patients with a long history of ulcers, which might possibly indicate pathogenetic involvement of CP in ulcerogenesis. CP are recovered more commonly in individuals with normal or reduced gastric juice acidity as compared to those showing hypersecretion. Although conventional antiulcer treatment reduces CP dissemination, the bacteria are not eliminated in most cases, which might be a cause of peptic ulcer relapses.     

Perforated duodenal ulcer in a tropical African population.

Duodenal ulcer is common in tropical African countries. In many cases, the patients are first seen as cases of gastric outlet obstruction because, in this environment, people present at the hospital in late stages of disease. Perforated duodenal ulcer in this environment, however, has received very little attention in the literature because previously it was rarely seen. It is not unlikely that some cases of severe gastric outlet obstruction from chronic duodenal ulcer are due to unrecognized perforated duodenal ulcers that have healed.     

The role of stressful life events in duodenal ulcer recurrence: A prospective study

This study prospectively assessed whether stressful life events (LE) were predictive of duodenal ulcer (DU) recurrence during remission of disease. We administered Paykel's Interview for Recent Life Events to 80 patients to assess events that occurred 12 months prior to the first interview and again 6 to 12 months later for LE that occurred during the interval. Upper gastrointestinal endoscopy detected DU recurrence in 11 patients. Prospective data analysis showed no significant difference in LE between relapsing and relapse-free groups, whereas retrospective analysis showed significantly more LE (p > .03) among relapsing patients. LE seems to have played a marginal role in DU recurrence.     

A questionnaire study for 128 patients with Gaucher disease

Gaucher disease is an uncommon autosomal recessive disorder characterized by lysosomal storage of glucosyl ceramide, a material released during cell degradation. Patients with Gaucher disease often have significant hematologic, bone structural, and visceral problems which sometimes greatly affect their health and life style. Based on some extraordinary scientific discoveries over the past 45 years, a treatment system has evolved which consists of administration of an enzyme, which destroys the lysosome-stored material and to some extent restores the patients to good health. There are still some problems for these patients; however, and the purpose of the study is to define some of the clinical, sociologic, and psychologic problems with a specially designed questionnaire. Questionnaire data was collected for 128 patients from two institutions with complete anonymity, and the information compared against data from a National Health Interview Survey. The results show that many of the patients still have fairly extensive problems, which could possibly be helped by some alterations in treatment protocols.