[Diagnosis of duodenal diseases by endoscopy (author's transl)].
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IgA, IgM and IgC content in blood serum and gastric juice were determined in 89 patients with different gastric and duodenal diseases (57 with duodenal ulcers, 13 with gastric ulcers 8 with chronic atrophic gastritis, 9 with superficial chronic gastritis and gastroduodenitis and two with gastric cancer). Immunoglobulin was established in gastric juice (over 0,3 mg/100 ml) in 49 per cent of all the patients examined with gastric and duodenal diseases. No correlation was found between serum immunoglobulin level and their presence in the gastric juice. No correlation exists between the volume of the basal secretion and the presence or absence of immunoglobulins in the gastric juice. Immunoglobulins were established more often in the gastric juice with lower secretion of hydrochloric acid (in chronic atrophic gastritis and gastric ulcer), while in cases of higher secretion they are more frequently absent. A certain parallelism was established between the changes of hydrochloric acid output and JgA secretion in the gastric juice after stimulation of gastric secretion by Pentagastrin or histamine.
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The content of gastrin, beta-endorphin, insulin, C-peptide in 129 patients with chronic gastric and duodenal diseases was studied by standard radioimmunoassay during the acute phase of the disease and after routine treatment. It is concluded that normalization of the hormonal homeostasis is one the criteria of treatment efficacy.
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The purpose of the study was to define duodenal epithelial function in duodenal diseases and to assess the potentialities of correction of detected dysfunctions. The electrical properties (EPs) of the duodenal epithelium were explored in patients with primary chronic duodenitis, duodenal peptic ulcer (DPU) on an exacerbation and in the late postoperative period after selective proximal vagotomy. Mucosal biopsy specimens were obtained at fibrogastroduodenoscopy with biopsy forceps and placed in a sign-alternating field with the parameters, adequate bioelectric epitheliocytic characteristics: 28 V at a voltage sign change rate of 1 Hz, and a current strength of 200 microA. Bioelectrical cell reactions (nuclear fluctuation amplitude) were recorded by light microscopy using a MOB-1A ocular micrometer at minutes 10, 30, and 60 of the onset of electrical field action. A significant reduction was found in the amplitude of duodenal epithelial nuclear fluctuations in the examinees, which was most pronounced in DPU on an exacerbation. Duodenal epithelial EPs were shown to undergo regular changes during therapy and may serve as an additional test in evaluating the efficiency of therapy.
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The electrokinetic properties of erythrocytes of the duodenal and buccal epitheliums were studied in patients with chronic duodenitis and with duodenal ulcer at exacerbation in the remote period after selective proximal vagotomy; the diagnostic value of the studied parameters was demonstrated, the presence of correlation bonds between them was shown.
Duodenal tumors are rare but duodenal inflammatory disease occurs frequently. In most cases it can be accurately diagnosed without angiography but in the occasional case that presents a diagnostic problem, angiography is required. Seven cases of duodenal inflammatory disease are reviewed. Careful attention to the shape and direction of vascular displacement and to separate evaluation of pancreatic and duodenal arteries accurately distinguished duodenal from pancreatic disease. This distinction can significantly influence subsequent therapy.
Data are given on the condition of the thoracic spine of 465 patients with certain gastric and duodenal diseases. Degenerative-dystrophic lesions (spondylosis deformans and intervertebral osteochondrosis) of the thoracic spine together with osteoarthritis deformans of the costovertebral and costotransverse articulations lead to neurodystrophy of the gastric and duodenal mucosa through chronic stimulation by osteophytes of the thoracic sympathetic ganglia. Disorders of gastric and duodenal motor activity are also important. The attendant reflux gastritis is stipulated by reflux of the intestinal contents into the gastric lumen. Condition of the stomach and duodenum can be improved by relieving changes in the spine.
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