Scandinavian journal of gastroenterology. Supplement
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Scand. J. Gastroenterol. Suppl. · Jan 1993
Randomized Controlled Trial Comparative Study Clinical TrialPrognostic impact of blood transfusions on disease-free survival in colorectal carcinoma.
Blood transfusions have been indicated as having an adverse effect on the prognosis of patients treated surgically for cancer. We carried out a randomized trial to investigate whether a predeposit autologous blood transfusion program improved prognosis in patients with colorectal cancer as compared to the current practice of allogeneic transfusion. ⋯ We found that the risk of recurrence was significantly increased for patients transfused with allogeneic, or with autologous, or with both types of blood, compared with those patients who did not require transfusions; relative recurrence rates were 2.3 (p = 0.001), 1.8 (p = 0.044) and 2.5 (p = 0.009), respectively; these three rates did not differ significantly from each other. We conclude that it is not the blood transfusions themselves, but the circumstances that necessitate the transfusions that are the real determinants of prognosis.
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During the past 30 years much interest has been focused on gastric acid as a possible causative factor in functional dyspepsia. The similarities to duodenal ulcer with regard to the symptoms, previous reports of a high risk of subsequent ulcer development, and a growing number of clinical therapeutic trials showing a significant advantage for acid-reducing drugs over placebo--although challenged by many investigators--have all contributed to a common notion that the gastric acid may play an equally important pathogenic role in functional dyspepsia as in peptic ulcer disease. ⋯ Those dyspeptic individuals who benefit from antacids purchased over the counter usually do not have functional dyspepsia but rather organic diseases such as esophagitis or peptic ulcer. The association or pathophysiologic parallelism between functional dyspepsia and peptic ulcer implied by the results of some studies of functional dyspepsia in the past might be explained by unintended inclusion of overlooked or subclinical cases of peptic ulcer disease in those studies.
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Scand. J. Gastroenterol. Suppl. · Jan 1989
Changes in the intracellular calcium ion concentration in the gastric mucosa in a rat ischemia-reperfusion model.
To investigate the role of the intracellular calcium ion in the development of acute gastric mucosal lesions, phosphorylase a activity was measured as an index of the intracellular calcium ion concentration ([Ca2+]i), using Lowry's method, in the rat ischemia-reperfusion model. [Ca2+]i increased significantly at the end of the ischemic state without acute mucosal lesions (AGML). After reinfusion, [Ca2+]i showed a slight increase and AGML developed. Continual intravenous infusion of the calcium channel blocker, diltiazem (1 mg/kg/hr), inhibited the increase in [Ca2+]i in the ischemic state and reduced the development of AGML after reinfusion. These results suggest that the increase in [Ca2+]i in the ischemic state plays an important role in the development of AGML.
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Scand. J. Gastroenterol. Suppl. · Jan 1989
Role of free radicals and lipid peroxidation in gastric mucosal injury induced by ischemia-reperfusion in rats.
Ischemia and reperfusion are of the greatest importance in the pathology of many diseases. We investigated the roles of oxygen-derived free radicals and lipid peroxidation in gastric mucosal injury, such as spotty and linear hemorrhagic erosions, induced in rats by ischemia-reperfusion. The gastric mucosal injury and the increase in thiobarbituric acid (TBA) reactants in the gastric mucosa induced by ischemia-reperfusion were significantly inhibited by treatment with SOD and catalase. These results suggest that oxygen-derived free radicals and lipid peroxidation play important roles in the pathogenesis of acute gastric mucosal lesions induced by ischemia-reperfusion.
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'Gastro-esophageal reflux' is the passage of gastric content into the esophagus. Resulting typical symptoms are denoted as 'reflux like dyspepsia'. 'Reflux esophagitis' is the endoscopic or microscopic evidence of damage to the esophageal mucosa. ⋯ Esophageal acid exposure increases during the day with a peak in the evening and little reflux after midnight. Treatment should probably be concentrated to evening time and not so much to night time.