ABSTRACT
Dystrophic epidermolysis bullosa is an inherited disorder with frequent oesophageal stricture formation. There is no satisfactory medical treatment of dysphagia however; endoluminal balloon dilation is a novel method with satisfactory results. Intrafamilial cases of dystrophic epidermolysis bullosa manifest variable clinical presentations. We report two sisters with dystrophic epidermolysis bullosa simultaneously presenting with dysphagia. Fluoroscopically guided endoscopic balloon dilation revealed almost complete resolution of dysphagia in both patients. Our cases represented a striking similarity in their clinical picture and response to treatment. Balloon dilation in these cases is a safe and effective approach.
Subject(s)
Catheterization , Epidermolysis Bullosa Dystrophica/complications , Esophageal Stenosis/etiology , Esophageal Stenosis/therapy , Esophagoscopy , Fluoroscopy , Siblings , Adult , Deglutition Disorders/diagnostic imaging , Deglutition Disorders/etiology , Deglutition Disorders/therapy , Epidermolysis Bullosa Dystrophica/diagnostic imaging , Epidermolysis Bullosa Dystrophica/pathology , Esophageal Stenosis/diagnostic imaging , Esophageal Stenosis/pathology , Female , Genetic Predisposition to Disease , HumansABSTRACT
PURPOSE: A randomized, double-blind, controlled study was conducted to investigate the efficacy of oral calcium dobesilate therapy in treating acute attacks of internal hemorrhoids. METHODS: Twenty-nine well-documented adult patients with first- or second-degree internal hemorrhoids were treated with calcium dobesilate for two weeks, while16 patients received only a high-fiber diet to serve as control. Both symptoms and anoscopic inflammation were scored on a scale from 0 to 2 before (T0) and two weeks after treatment (T2). RESULTS: A success rate of 86.21 percent with cessation of bleeding plus lack of severe anitis anoscopically at two weeks were achieved with calcium dobesilate. The pretreatment symptom score of 2 fell significantly to 0.45 +/- 0.13, and the pretreatment anitis score of 1.69 +/- 0.09 fell to 0.55 +/- 0.12 at T2 (P = 0.0001 for both comparisons). The symptom and anoscopic inflammation scores obtained with calcium dobesilate treatment were also significantly better than those with diet only (P = 0.0017 and P = 0.0013, respectively). CONCLUSION: Together with recommendations about diet and bowel discipline, oral calcium dobesilate treatment provides an efficient, fast, and safe symptomatic relief from acute symptoms of hemorrhoidal disease. This symptomatic healing is associated with a significant improvement in the anoscopically observed inflammation.
Subject(s)
Calcium Dobesilate/therapeutic use , Hemorrhoids/drug therapy , Hemostatics/therapeutic use , Acute Disease , Adult , Double-Blind Method , Female , Hemorrhoids/diet therapy , Humans , Male , Middle AgedABSTRACT
Helicobacter pylori is regarded as an important pathogen playing a key role in the pathogenesis of peptic ulcer. Different studies about the mode of transmission of the microorganism report conflicting results about dental plaque as the source of H. pylori infection. In the present study we aimed to detect the presence of H. pylori in dental plaque of Turkish patients by polymerase chain reaction (PCR) and if any to do typing by restriction fragment length polymorphism (RFLP) analysis. Fifty dyspeptic patients, to whom upper gastrointestinal endoscopy was performed, were included in the study. Dental plaques were obtained before endoscopic examination. Both dental plaque and gastric biopsy samples were amplified with Ure A and Cag A gene primers. There were no positive dental plaque samples even in the 23 patients whose gastric biopsy specimens were positive. Our findings showed that there is not a correlation between dental presentation of the microorganism and H. pylori gastritis.
Subject(s)
Dental Plaque/microbiology , Gastric Mucosa/microbiology , Helicobacter pylori/isolation & purification , Adult , Aged , Biopsy, Needle , Dyspepsia/microbiology , Female , Gastroesophageal Reflux/microbiology , Humans , Male , Middle Aged , Peptic Ulcer/microbiology , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , TurkeySubject(s)
Foreign-Body Migration , Surgical Sponges , Cholecystectomy , Female , Humans , Middle Aged , Stomach , Time FactorsABSTRACT
Bile duct varices, also named the "pseudo-cholangio- carcinoma sign<" are frequently encountered by ERCP in portal hypertension cases due to cavernous transformation of the portal vein. There is a documentation that, in three cases, this sign disappeared after placement of a transjugular intrahepatic portosystemic shunt.
Subject(s)
Bile Duct Neoplasms/diagnosis , Bile Ducts, Intrahepatic/blood supply , Cholangiocarcinoma/diagnosis , Portasystemic Shunt, Surgical , Varicose Veins/diagnosis , Adult , Bile Ducts, Intrahepatic/diagnostic imaging , Diagnosis, Differential , Female , Humans , Hypertension, Portal/diagnosis , Hypertension, Portal/surgery , Jugular Veins , Male , Middle Aged , Postoperative Period , Radiography , Stents , Ultrasonography , Varicose Veins/surgeryABSTRACT
Endoscopic biliary drainage is an effective and harmless method for biliary obstructions of malign origin. Percutaneous biliary external drainage (PBED) could be attempted if endoscopic drainage is unsuccessful. The percutaneous route has some unwanted effect. We have PBED into internal endoprotheses in 8 malign patients successfully without any complications.
Subject(s)
Bile Ducts/surgery , Cholestasis/surgery , Drainage/methods , Endoscopy , Prostheses and Implants , Catheterization , Cholecystostomy , Cholestasis/diagnostic imaging , Humans , RadiographyABSTRACT
Agarose and polyacrylamide gel electrophoresis of a total alpaca (Lama pacos) DNA, digested with several restriction enzymes, revealed the presence of two tandemly organized repetitive DNA sequences, named Satellite I and Satellite II. Three Xhol-monomers from Satellite I DNA and two BspRI-monomers from Satellite II DNA were sequenced. As determined by dot hybridization analysis, the total alpaca DNA consists of 3.4% and 1.3% Satellites I and II, respectively. Computer search revealed no homology to any primate, rodent or mammalian sequences published in the Gen Bank Release 48.0 (February 1987) and the EMBL Bank Release 10 (December 1986).
