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Biomedical subjects

N Krasner

Publications and source records attributed to N Krasner.

At least 55 records · Page 3Linked to original sources
PubMed1985

Advances in gastrointestinal endoscopy and laser therapy; the way ahead.

Modern flexible fibreoptics enable gastroenterologists to visualise and treat many lesions and conditions in the upper gastrointestinal tract and colon. Therapeutic endoscopy is forming a larger proportion of many unit's workload and the newer techniques to stop or prevent rebleeding are the subject of much research and development. Developments in the fields of operative endoscopy, small intestinal endoscopy, and endoscopic ultrasound are also progressing rapidly. The place of video-endoscopy is still to be established but potentially has several advantages over fibreoptic endoscopy. Laser therapy has been well established as a means of treating gastrointestinal haemorrhage from peptic ulcers, and has potential use in the treatment of angiomatous lesions. It is increasingly being used both for palliation and 'cure' of malignancy and neoplasia in the gastrointestinal tract. The use of such lasers depends upon thermal damage, but newer types of non-thermal laser therapy, using pulsed lasers, or dye lasers with prior tumour sensitisation are rapidly going to be applied to the treatment of gastrointestinal disease.

Aged↗
PubMed1984

Is there a place in the United Kingdom for intensive antacid treatment for chronic peptic ulceration?

Sixty nine patients with chronic duodenal or juxtapyloric ulceration were studied in a prospective double blind randomised trial to compare the efficacy of antacid and placebo at high (30 ml seven times daily) and low (10 ml as required) doses. After four weeks ulcers had healed in 12 out of 18 patients (67%) receiving "low dose" antacid compared with in six out of 17 patients (35%) receiving low dose placebo; ulcers had also healed in six out of 19 patients (32%) receiving "high dose" antacid compared with in two out of 15 patients (13%) receiving high dose placebo. Overall, the effect of antacid was superior to that of placebo in healing ulcers (p less than 0.05) and the effect of low dose treatment was superior to that of high dose treatment (p less than 0.01). There were no significant differences between antacid and placebo at eight weeks. Antacid was better than placebo in relieving pain, but the difference was not significant. Poor compliance and high incidence of diarrhoea made high dose antacid an impractical treatment. Low dose antacid was associated with a significantly better rate of healing than high dose antacid and was far better tolerated. This low dosage of antacid should be considered to be an active treatment in trials of ulcer healing.

Adolescent↗
PubMed1984

Acute pancreatitis and Cushing's syndrome.

A case of acute necrotizing pancreatitis in a 53-year-old man with an ectopic adrenocorticotrophin (ACTH) producing bronchial carcinoma is described. The aetiology of acute pancreatitis in relation to steroid therapy and malignancy is discussed and it is suggested that excess endogenous steroid production may also cause acute pancreatitis.

ACTH Syndrome, Ectopic↗
PubMed1984

Alcohol problems in pregnancy and childhood--where do we go from here?

The awareness of potential damage to the foetus caused by maternal drinking during pregnancy creates the need for a planned programme of education for young women of childbearing age. Prevention of foetal damage might best be achieved by commencing the education process with schoolchildren and adolescents but preconception and antenatal clinics must necessarily be 'foci of attention'. Thought must be directed to the content of the material presented and efforts made to tailor the information for target groups. A prime need is the proper instruction of all those who will be involved as educators to ensure a balanced approach. Primary prevention must be the mainstay of our efforts in the management of obstetric, neonatal and developmental problems resulting from alcohol consumption during pregnancy.

Adolescent↗
PubMed1983

Injection sclerotherapy for oesophageal varices in the elderly.

Thirty-seven patients admitted consecutively to the Gastroenterology Unit with haemorrhage from oesophageal varices were treated by injection sclerotherapy. The patients were subdivided according to age at presentation (below 65, over 65 years). The mortality and morbidity of the two groups, over the period of follow-up (mean 5.1 months) were compared. The risk of rebleeding was higher in the elderly (0.23 overall) than in the young (0.11 overall) and was reflected in the higher mortality, four of 14 elderly patients and four of 23 younger patients. A further three elderly patients succumbed to intercurrent illness during the same period. In three of the surviving elderly, complete resolution of varices was noted. Complications of sclerotherapy occurred in eight out of 51 injections in the elderly and six out of 97 in the young but were usually well tolerated. This study suggests that injection sclerotherapy is useful in the treatment of bleeding oesophageal varices in the elderly and suggests recommendations for improved survival.

Adult↗
PubMed1983

Benign mesenchymoma of the stomach.

Benign mesenchymoma is a mixed tumour of mesenchymal derivatives composed of a mixture of two or more mesenchymal elements in addition to fibrous tissue. Two cases of this tumour of the stomach are reported. As far as can be ascertained, there has been no previous report of gastric mesenchymoma.

Aged↗
PubMed1982

Extensive gastrointestinal damage following a saline emetic.

A 27-year old female received about 1 kg of salt in about 600 ml of water as an emetic after a self-poisoning attempt. Vomiting did not occur and massive necrosis of gastric, duodenal, and jejunal mucosa resulted in a severe and prolonged illness which required 31 weeks of continuous hospital care and 31 laparotomies over a period of 16 months. The dangers of salt emesis are emphasized.

Adult↗
PubMed1979

Hepatocellular carcinoma in primary biliary cirrhosis: report of four cases.

Of 98 patients dying with primary biliary cirrhosis only four developed hepatocellular carcinoma. It is suggested that the development of hepatocellular carcinoma is uncommon in this type of chronic liver disease because of its known female preponderance, and the fact that cirrhosis develops late in the course of the illness.

Carcinoma, Hepatocellular↗
PubMed1978

Hepatocellular carcinoma in Great Britain: influence of age, sex, HBsAg status, and aetiology of underlying cirrhosis.

An analysis of 294 patients who died with cirrhosis showed that 24% had developed hepatocellular carcinoma. Haemochromatosis and HBsAg positive chronic active hepatitis were high risk groups (36% and 42% respectively) and the frequency was lowest in primary biliary cirrhosis and HBsAg negative chronic active hepatitis (3% and 11% respectively). Those with hepatocellular carcinoma showed a striking male preponderance (11:1) and further analysis has shown that the proportion developing this tumour in each group was closely related to the proportion of males in that group (r=0.97). Age was the only other significant factor, malignant change occurring more commonly in those over the age of 50 years than those below (30% and 7% respectively, P less than 0.005). The indluence of HBsAg was largely accounted for by the known predisposition of males to carry HBsAg. The group of patients who had developed this tumour without cirrhosis were younger (mean age 39 years) and had a lower male to female ratio of 1.1:1 and the place of contraceptive-related tumour within this group is dicussed.

Adult↗
PubMed1978

Red blood cell transketolase activity and the effect of thiamine supplementation in patients with chronic liver disease.

Biochemical evidence of thiamine deficiency was found in 58% of patients with chronic liver disease, the incidence being higher in alcoholic than in non-alcoholic patients. Daily supplementation with high doses of thiamine hydrochloride (200 mg/day) for one week restored levels of thiamine pyrophosphate (TPP), the active co-enzyme form of thiamine, to normal in all cases. Such supplementation also stimulated synthesis of the TPP dependent enzyme transketolase. Because of the essential role of TPP as a co-factor in intermediary metabolism, it is concluded that high doses of thiamine should be included in the routine nutritional management of patients with severe chronic liver disease.

Ascorbic Acid↗
PubMed1977

Changing pattern of alcoholic liver disease in Great Britain: relation to sex and signs of autoimmunity.

A survey of 293 patients with alcoholic liver disease showed that women, particularly those aged under 45, had a significantly higher incidence of alcoholic hepatitis, with or without superimposed cirrhosis, than men. The long-term prognosis for both women who continued to drink and those who stopped drinking was worse than that for men. Autoantibodies were more common in women, which suggested that immune mechanisms may play a part in the pathogenesis and progression of alcoholic liver disease in women.

Adult↗
PubMed1976

Histocompatibility antigens, autoantibodies, and immunoglobulins in alcoholic liver disease.

Determination of histocompatibility antigens in 63 patients with alcoholic liver disease showed that HLA-B8 was more prevalent in patients with cirrhosis than in controls, but among those with fatty liver and minimal fibrosis the prevalence of this antigen was normal. Another noticeable difference was the absence of HLAA28 in the cirrhotic group. In the total series of 219 patients the prevalence of antinuclear and smooth muscle antibodies was raised; they were especially prevalent in patients with cirrhosis. Raised serum IgA and IgG concentrations were also common (found in 50% and 37% respectively) and were again significantly associated with cirrhosis. In contrast, serum IgM levels, which were raised in 46% of cases, were not significantly related to the presence of cirrhosis but correlated significantly with the degree of portacaval shunting. These results support recent evidence suggesting that immune responses may be implicated in alcohol-induced liver damage, particularly in its progression to cirrhosis.

Adult↗
PubMed1976

Ethanol oxidizing enzyme activites in liver disease.

1 The activites of hepatic alcohol dehydrogenase, catalase and the reduced nicotinamide adenine dinucleotide phosphate (NADPH) dependent ethanol oxidizing system were determined in liver biopsies from nine patients with liver disease and seven control subjects with non evidence of liver disease. 2 Alcohol dehydrogenase and catalase activites were significantly lower in the patients with liver disease. 3 The activity of the NADPH dependent ethanol oxidizing system was significantly greater in the patients with liver disease, when its activity was expressed in terms of mg protein or g wet weight liver. 4 It is suggested that the greater activity of the NADPH dependent system may compensate for the low alcohol dehydrogenase activites found in patients with liver disease and maintain normal rates of ethanol metabolism.

Alcohol Oxidoreductases↗