[Esophageal involvement in progressive systemic sclerosis]. / El compromiso del esófago en la esclerosis sistemica progresiva.

The authors present 17 patients with progressive systemic sclerosis studied at the Hospital Nacional de Gastroenterología "Dr. Carlos Bonorino Udaondo" (Buenos Aires), in the period between 1976-1980. Clinical, radiological, endoscopical and manometrical studies of the digestive tract was performed, showing frequent compromise in this collagen disease.

[Alkaline gastritis. Gastric reoperations]. / Gastritis alcalina. Reoperaciones gástricas.

The authors present 23 cases (1.6%) of reoperated patients with alkaline gastritis syndrome at Dr. Bonorino Udaondo National Gastroenterology Hospital. Over 1400 surgical operations performed in order to treat the gastroduodenal ulcer disease; 19 patients showed an evident syndrome of alkaline gastritis and the rest of cases had a mixed syndrome, because of another syndromes. The initial operation was a gastric resection Billroth II type in 22 cases and the rest are had a vagotomy with a gastroenterostomy. In all the cases, clinical, radiological, laboratory, endoscopy and histopathology aspects as well as Kay and Hollander test were studied. The modified surgical operations were: Soupault-Bucaille with isoperistaltic loop (7 cases), with anisoperistaltic loop Poth type (1 case), reoperations with the Y en Roux technique (14 cases), desgastroenterostomy, closing of the jejunal and gastric drainage and pyloroplasty (1 case). It was fulfilled with a vagotomy. The 50% of the cases have to 8 years after the operation; another were reexamined at 100 and 15 years being without symptoms.

[Evaluation of esophageal involvement by pHmetry in patients with progressive systemic sclerosis]. / Evaluación del compromiso esofágico mediante pHmetría en pacientes con esclerosis sistémica progresiva.

The authors studied 16 patients with progressive systemic sclerosis to whom it was performed ph-metry, acid clearance and oesophageal electromanometry, compared the results with a control group of 20 patients. The oesophageal basal ph showed significative difference (p greater than 0.001) at the same as acid clearance (p greater than 0.01). It was not found correlation between the manometric alterations and acid clearance changes. (F 5%); at same as the last one and the clinical evolution period. (r = 0.16). Gastroesophageal reflux was positive in all the patients. The authors considered that intra-esophageal ph-metry and acid clearance was two methods with high sensibility to evaluate the oesophageal deterioration in systemic disease.

[Botulinum toxin is effective in the short-term treatment of esophageal achalasia. Preliminary results of a randomized trial]. / La toxina botulínica es efectiva en el tratamiento a corto plazo de acalasia esofágica. Resultados preliminares de un estudio randomizado.

UNLABELLED: Botulinum toxin (BoTox) is a potent inhibitor of the release of acetylcholine from terminal nerves and has been used successfully in spastic disorders of skeletal muscle. Its used for the treatment of disorders of gastrointestinal smooth muscle has recently been explored. In this study we evaluated the efficacy of transendoscopic injection of BoTox in 13 symptomatic patients with achalasia G II (Siewert classification) without previous treatment of an ongoing randomized-controlled trial. Patients were blindly randomized to administrate: a) 8OU of BoTox were injected in four quadrants (1 ml in each quadrant-20 U/ml) (n = 8), b) normal saline solution as placebo injected in the same way (n = 5). Patients who did not respond were retreated in an open design with the same schedule of BoTox. BoTox or placebo were injected directly into the lower esophageal sphincter (LES), located by manometric and endoscopic procedures, via sclerotherapy injector. Response to treatment was assessed by changes in symptoms score, weight, LES pressure, barium esophagograms and endoscopy. All determinations were repeated at basal and after 7-30-60 and 90 days of treatment. Post treatment response was considered positive if at one month, 3 of 4 parameters were improved. No evidence of response to BoTox were assessed in 3 patients. At 90 days, 10 patients remain well and data are as follows: (mean +/- SD) symptoms score: (Pre: 3.23 +/- 0.44) (Post: 1.31 +/- 0.95); LES pressure (mmHg) (Pre: 53, 15 +/- 66.31 +/- 7.49); % reduction of esophageal diameter 55% (p < 0.0001) (pair T-test). Relaxation of LES did not change after treatment. There were no side effects related to BoTox injection. CONCLUSIONS: Endoscopic intrasphincteric BoTox injection is safe, simple and effective in the short term treatment for achalasia. Further studies are necessary for evaluation of long term effects.

[Osteoarthropathies of inflammatory diseases of the colon]. / Osteo-artropatías de las enfermedades inflamatorias del colon.

Fifteen patients suffering from inflamatory diseases of the colon (14 nonspecific ulcerous recto colitis and 1 Crohn disease) were complicated with involvement of large joints and spine (ankylosing spondelytis). The clinic, radiology, pathology, seriology and evolution of ankylosing spondylitis were considered in relation-ship with inflamatory disease of colon.

[Clinico-manometric correlation in esophageal involvement of progressive systemic sclerosis]. / Correlación clínico-manométrica en el compromiso esofágico de la esclerosis sistémica progresiva.

The esophageal response studied in the systemic illness has been developed clearly in the body of the esophagus as well as in the lower esophageal sphincter, showing important alterations in the peristalsis and a significant fall of lower esophageal sphincter pressure, proving conditions such as those in which gastro-esophageal reflux is produced. The authors studied the esophageal motility in 10 patients with progressive systemic sclerosis by electromanometry by means of an open-tipped catheters system. They found that the pressure of the inferior esophageal sphincter was altered in the 100 per cent of the cases; in 50% of the patients there was a lack of peristaltic waves and in the remaining 50% the middle pressure was less than in normal subjects. It was observed dysquinethic waves in 40% of the cases. The intensity of the epidermic compromise is no related with alterations in the esophageal functioning.

[Pyoderma gangrenosum in Crohn's diseases of the colon]. / Pioderma gangrenoso en enfermedades de Crohn del colon.

A case of much less frequent association of the pyoderma gangrenosum and granulomatous disease of the colon (Crohn's disease of the colon) is presented. A literature review is made about the association of the same with other gastrointestinal affections. It is brought up to date the possible atiopathogenical mechanisms and therapeutical effects.

[Esophageal involvement in progressive systemic sclerosis]. / Compromiso esofágico en la esclerosis sistémica progresiva.

Systemic sclerosis is a collagen disease with high frequency of oesophageal affection, specially if we use manometry as an evaluation method that has a high rate of clinic complication in high rate of patients. The aim of the study was to evaluate the prevalence of the oesophageal affection through the clinical, radiological, endoscopical and manometrical studies and to compare the results with other authors. Between January 1978 and February 1993, we evaluated 101 patients with different clinical types of scleroderma 89 females and 12 males with ages between 16-83 (mean: 49, 19 years). In order to determine systemic sclerosis diagnosis following Masi Rodman criterion's we found from 101 cases 83 had dysphagia (82.2%) motor 66 (65%) organic 17 (34.7%) GER was seem in 41 cases (40.5%). According to Heitz's radiological classification: I: 26 patients (25%) II: 58 patients (52.4%) III: 19 patients (18.8%) IV: 17 patients (16.9%). In reference to Neschis manometric classification we found II 88 (76%) III 77 (76%) In accordance with endoscopical classification we found I: 16 (15.8%); II: 49 (48.5%); III: 19 (18.8%); IV: 17 (16.9%); Although this motor and organic oesophageal alterations have an evident diagnostic value, they have also been referred in another metabolic and collagen diseases but with lesser frequency than was found in the systemic sclerosis by us.

[Achalasia and esophageal cancer]. / Acalasia y cáncer de esófago.

During the period included between January 1970 and December 1990, we studied 242 patients with manometric and radiological diagnosis of esophageal achalasia. Eight of these patients (3.3%) developed during the evolution of their disease an esophageal carcinoma. Eight cases showed histologic type of epidermoid carcinoma: 3 differentiated, 3 semi-differentiated and 2 anaplastic. Therapy for achalasia was: one patient, Heller myotomy, 4 patients, dilatations with bougies in numerous opportunities, and the other two patients receive no treatment for achalasia. Two patients reported tracheobronchial fistulas as complication of carcinoma. Treatment received for carcinoma included: three patients, radiotherapy (4000 rads); one patient, chemotherapy; one patient, chemotherapy and radiotherapy, one resection surgery and two patients feeding gastrostomy. All of the eight patients died within the year of diagnosis of epidermoid carcinoma.

[Helicobacter pylori detection by polymerase chain reaction in gastric juice and its correlation with the histology (Giemsa)]. / Detección del Helicobacter pylori por reacción en cadena de polimerasa en jugo gástrico y su correlación con la histología (GIEMSA).

HP infection is involved in the pathogenesis of several gastroduodenal diseases, as type B chronic gastritis, duodenal and gastric ulcer, MALT lymphoma and gastric cancer. The recent availability of molecular techniques, specifically the PCR, allow us to detect very low amounts of the bacterium. The aim of the study is to evaluate the presence of HP in gastric juice by PCR technique and to correlate this findings with histology (Giemsa) of gastric mucosa. Gastric juice PCR positive findings were found in 10/31 (32.3%) HP positive patients at histology. We concluded that HP in gastric juice is possible to detect by molecular techniques. In our study 32.3% of the patients showed the presence of HP in gastric juice.

[A new method for detection and erradication of Helicobacter pylori infection by stool antigens test]. / Nuevo mètodo para detecciòn de infecciòn y erradicaciòn del Helicobacter pylori (Hp) por determinaciòn de antìgenos en materia fecal.

Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests.

El compromiso del esofago en la esclerosis sistemica progresiva. / Esophageal involvement in progressive systemic sclerosis

Se presentan 17 pacientes portadores de esclerosis sistemica progresiva estudiados durante los anos 1976-1980 en el Hospital Nacional de Gastroenterologia Dr. Bonorino Udaondo. Se realizaron estudios clinicos, radiologicos, endoscopicos y manometricos del tubo digestivo,evidenciando el frecuente compromiso del mismo en esta colagenopatia. Se comparan nuestros hallazgos gastrointestinales con estadisticas similares de otros autores

El higado en las enfermedades del colageno. / The liver in collagen diseases

Se hace un repaso de las alteraciones de funcion y estructura hepatica que se descubren en pacientes portadores de lupus eritematoso sistemico, esclerosis sistemica progresiva, artritis reumatoide y angeites por hipersensibilidad. Se esbozan posibilidades etiopatogenicas y se discute el papel probable de los virus de la hepatites. Finalmente, se resumen las drogas usualmente usadas en la terapia de las colagenosis, que de por si pueden producir lesion hepatica

Pioderma gangrenoso en enfermedades de Crohn del colon. / Pyoderma gangrenosum in Crohn's diseases of the colon

Se presenta un caso de la infrecuente asociacion de pioderma gangrenoso y enfermedad granulomatosa del colon (enfermedad de Crohn).Se realiza una revision de la literatura acerca de las asociaciones del mismo con otras afecciones gastrointestinales. Se actualizan los probables mecanismos etiopatogenicos y resultados terapeuticos

Osteo-artropatias de las enfermedades inflamatorias del colon. / Osteoarthropathies of inflammatory diseases of the colon

Se presentan 15 pacientes portadores de enfermedades inflamatorias del colon (14 rectocolitis ulcerosas inespecificas y 1 enfermedad de Crohn) que se complicaron con afectacion de grandes articulaciones y columna vertebral (espondilitis anquilosante). Se comenta la incidencia de estas manifestaciones, la clinica, la radiologia, la patologia, la serologia y evolucion con relacion a la enfermedad inflamatoria