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Objective To investigate the effects of systematically nursing intervention on performing upper gastrointestinal longitudinal endoscopic ultrasonography. Methods From July 2006 to August 2008, 80 patients with upper gastrointestinal disease were divided into the experimental group and the control group, with 40 patients in each group. The experimental group received mental nursing before endoscopy examination, to comfort and encourage them to eliminate the psychological tension, instructing patients to relax, turning off lights to reduce the horror resulted from seeing insertion of large visual endoscopic ultrasonography into their mouths. While the control group received standard care of gastrointestinal endoscopic examination. The horror, nausea, abrasion of laryngopharynx and repeated operation were compared in the two groups using x2 test. Results The incidence of abnormal conditions in the experimental group was lower than those of the control group. Conclusions Nursing intervention can elevate the success rate of exami-nation, reduce the suffering of patients and ensure the smooth conduct of examination.
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PURPOSE: Performing laparoscopic surgery for upper gastrointestinal disease has gradually been increasing. The aim of this study is to review the initial experience with laparoscopic surgery for treating upper gastrointestinal diseases. METHODS: We retrospectively studied a total of 76 patients who underwent laparoscopic surgery for upper gastrointestinal disease from April 2003 to December 2008. The clinical features and surgical outcomes were analyzed. RESULTS: The types of upper gastrointestinal diseases that were treated by laparoscopic surgery were early gastric cancer (n=45), advanced gastric cancer (n=6), gastric submucosal tumor (n=14), duodenal ulcer stricture (n=5), duodenal ulcer perforation (n=2), superior mesenteric artery syndrome (n=2), gastroesophageal reflux (n=1) and dysphagia due to parkinsonism (n=1). There were 11 operative morbidities (14.5%), including 1 operative mortality (1.3%). CONCLUSION: Although this study shows the narrow range of indications for performing this laparoscopic procedure and the surgical experience is rather limited, laparoscopic surgery was applied for treating various upper gastrointestinal diseases. Based on this experience, surgeons should make efforts to improve the surgical outcomes.
Subject(s)
Humans , Constriction, Pathologic , Deglutition Disorders , Duodenal Ulcer , Gastroesophageal Reflux , Gastrointestinal Diseases , Laparoscopy , Parkinsonian Disorders , Retrospective Studies , Stomach Neoplasms , Superior Mesenteric Artery SyndromeABSTRACT
Endoscopic ultrasonography has been widely used in the diagnosis of digestive system disease,and has great important diagnostic significance in the differential diagnosis of the upper gastrointestinal mucosa or submucosal lesions,as well as to distinguish the gastrointestinal intracavitary and extracavitary lesions.At the same time,EUS can more accurately judge the depth of tumor invasion and the surrounding lymph node metastasis,which has great value in the preoperative TNM staging of esophageal cancer and gastriccancer,the judgment of resectability and the prognosis.We summarized the result of EUS in the upper gastrointestinal disease in our hospital.
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BACKGROUND/AIMS: Although previous reports suggested that pepsinogen (PG) I/II ratio was the index of gastric atrophy, PG I/II ratio was also related to other factors such as Helicobacter pylori (H. pylori) infection, various gastrointestinal diseases, and aging. The aim of this study was to evaluate the relationship between serum PG I/II ratio and age or upper gastro-intestinal diseases according to H. pylori infection status. METHODS: A total of 529 individuals (307 male; mean age, 57.2 years) were divided into 4 groups (94 gastric ulcers, 35 duodenal ulcers, 105 reflux esophagitis, and 295 atrophic gastritis) according to endoscopic diagnosis. H. pylori infection was determined by H. pylori IgG antibody (ELISA) and PG was measured by latex immunoassay. RESULTS: H. pylori infected patients showed markedly increased serum PG II levels (24.0+/-14.7 ng/mL vs. 13.8+/-16.6 ng/mL, p<0.001) and low PG I/II ratio (3.9+/-2.0 vs. 6.0+/-2.5, p<0.001) than non-infected subjects. In H. pylori infected patients, mean PG I/II ratios in the gastric ulcer and atrophic gastritis group were significantly lower than those of the duodenal ulcer and reflux esophagitis group (p<0.001, ANOVA, Turkey's multiples comparison test). The mean ratio of open type atrophic gastritis was lower than that of close type atrophic gastritis (3.0+/-1.4 vs. 3.8+/-1.7, p<0.005). PG I/II ratio gradually decreased with age in H. pylori-infected patients with atrophic gastritis (R(2)=0.9, p=0.005, linear regression analysis). CONCLUSION: Serum PG I/II ratio reflects H. pylori infection and gastric atrophy. In the presence of H. pylori infection, gastric atrophy progresses with age.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Age Factors , Diagnosis, Differential , Duodenal Ulcer/microbiology , Esophagitis, Peptic/microbiology , Gastritis, Atrophic/microbiology , Gastrointestinal Diseases/diagnosis , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Pepsinogen A/blood , Pepsinogen C/blood , Stomach Ulcer/microbiologyABSTRACT
BACKGROUND/AIMS: Although previous reports suggested that pepsinogen (PG) I/II ratio was the index of gastric atrophy, PG I/II ratio was also related to other factors such as Helicobacter pylori (H. pylori) infection, various gastrointestinal diseases, and aging. The aim of this study was to evaluate the relationship between serum PG I/II ratio and age or upper gastro-intestinal diseases according to H. pylori infection status. METHODS: A total of 529 individuals (307 male; mean age, 57.2 years) were divided into 4 groups (94 gastric ulcers, 35 duodenal ulcers, 105 reflux esophagitis, and 295 atrophic gastritis) according to endoscopic diagnosis. H. pylori infection was determined by H. pylori IgG antibody (ELISA) and PG was measured by latex immunoassay. RESULTS: H. pylori infected patients showed markedly increased serum PG II levels (24.0+/-14.7 ng/mL vs. 13.8+/-16.6 ng/mL, p<0.001) and low PG I/II ratio (3.9+/-2.0 vs. 6.0+/-2.5, p<0.001) than non-infected subjects. In H. pylori infected patients, mean PG I/II ratios in the gastric ulcer and atrophic gastritis group were significantly lower than those of the duodenal ulcer and reflux esophagitis group (p<0.001, ANOVA, Turkey's multiples comparison test). The mean ratio of open type atrophic gastritis was lower than that of close type atrophic gastritis (3.0+/-1.4 vs. 3.8+/-1.7, p<0.005). PG I/II ratio gradually decreased with age in H. pylori-infected patients with atrophic gastritis (R(2)=0.9, p=0.005, linear regression analysis). CONCLUSION: Serum PG I/II ratio reflects H. pylori infection and gastric atrophy. In the presence of H. pylori infection, gastric atrophy progresses with age.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Age Factors , Diagnosis, Differential , Duodenal Ulcer/microbiology , Esophagitis, Peptic/microbiology , Gastritis, Atrophic/microbiology , Gastrointestinal Diseases/diagnosis , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Pepsinogen A/blood , Pepsinogen C/blood , Stomach Ulcer/microbiologyABSTRACT
Ghrelin, a novel gastrointestinal peptide with 28 amino acids, is secreted from the A-like cells of the gastric fundus. This peptide hormone does not only promote the release of growth hormone, but also stimulates food intake, gastric motility and cardiac output. Increased plasma ghrelin level has been reported in patients with upper gastrointestinal (GI) disease or in their disease animal model, suggesting its important role in the pathogenesis of upper GI disease.
Subject(s)
Humans , Appetite/physiology , Cysteamine/metabolism , Dyspepsia/etiology , Eating , Gastrointestinal Diseases/etiology , Ghrelin/physiology , Peptic Ulcer/etiologyABSTRACT
Objective To evaluate the value of electronic video endoscopy for adults in upper gastrointestinal disease in children. Methods Results of video endoscopy for adults performed on 128 children with abdominal pain, upper gastrointestinal hemorrhage, accidental foreign bodies, and esophageal stenosis were analyzed retrospectively. Results The total positive detection rate was 100%. The incidence rates of chronic superficial gastritis and/or duodenitis, peptic ulcer, and foreign bodies were 64.84%, 25.78%, and 8.59%, respectively. Only 1 case of esophageal stenosis was found. Conclusion Video endoscopy for adults, also safe for children, is of significant value in the etiological diagnosis of upper gastrointestinal disease in children.
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PURPOSE: In H. pylori infection serum pepsinogen l/ll ratio decreases and pepsinogen ll level is increased. Increased serum pepsinogen ll level correlates with pathologic severity of gastritis. We assayed serum pepsinogen l, ll levels and pepsinogen l/ll ratio to evaluate the relationship between the serum pepsinogen level and upper gastrointestinal diseases. METHODS: One hundred and sixty-five children who had undergone upper gastrodudenal endoscopic examination with CLO test and silver stain were included. Pepsinogen l and ll levels were detected in serum by radioimmunoassay. RESULTS: Age distributions were: 3 patients below 5 years, 55 patients between 6 and 10 and 107 over 11. Thirty-two (19%) were H. pylori positive, and 133 (81%) were negative. Pepsinogen l increased in H. pylori positive children (P<0.01). Pepsinogen ll were higher in the H. pylori positive patients compared to Helicobactor negative group (P<0.001). Pepsinogen l and II were significantly higher (P<0.01 in pepsinogene l: P<0.01 in ll) in children with nodular gastritis with Helicobactor positive than any other disease including H. pylori negative without duodenal ulcer. Pepsinogen l/ll ratio was lower in children with nodular gastritis with H. pylori positive (P<0.001) than in children with any other disease including Helicobacter negative. CONCLUSION: These results suggest that serum pepsinogen levels are inportnat in pathogenesis of upper gastrointestinal disease in children with H. pylori infection.