[The effect of atmospheric conditions on the occurrence of peptic ulcer hemorrhage]. / Utjecaj atmosferskih uvjeta na ucestalost krvarenja iz peptickog ulkusa.

The influence of atmospheric factors on the frequency of bleeding from the peptic ulcer was studied within the period from April 1, 1984, to March 31, 1989, consequently through 1826 days. The average daily atmospheric pressure, the average daily temperature and the relative humidity have been examined. There were 1102 cases of bleeding peptic ulcer, 537 bleeding gastric ulcers and 565 bleeding duodenal ulcers. During the study period there were 454 days with bleeding form ventricular ulcer and 465 days with bleeding from duodenal ulcer. There was 793 days with bleeding form either lesion. The discriminatory analysis demonstrated that the atmospheric pressure is the variable that discriminates the days with bleeding and the days prior to bleeding from the days without bleeding. The relative humidity occurs as the relevant discriminatory variable in the days prior to bleeding for the duodenal ulcer group and for the entire group. The centroids of the discriminatory function demonstrate that the days with ulcer bleeding are characterized by the fall of atmospheric pressure. The factor analysis of meterological variables clearly shows the correlation of the atmospheric pressure and the bleeding regardless to the localisation of bleeding ulcer, where the greatest number of bleedings is correlated with lower atmospheric pressure. We conclude that the incidence of bleeding form the peptic ulcer of the stomach and duodenum correlates in great measure with low atmospheric pressure in the days prior to bleeding and in the days of bleeding, as well as with fall of atmospheric pressure in the days of bleeding with respect to previous day.(ABSTRACT TRUNCATED AT 250 WORDS)

Prophylactic administration of ranitidine after sclerotherapy of esophageal varices.

The present trial was carried out to determine the usefulness of H2-receptor antagonist drug therapy for the prevention of esophageal bleeding and esophageal varices in patients who underwent sclerotherapy. According to randomization, out of the 58 patients, 28 received, along with the usual standard therapy, ranitidine and 30 received placebo. Ranitidine, 50 mg, was administered intravenously over a period of 3 days every 8 hours, and then 150 mg of ranitidine was given per os in the evening for one month. For improvement of hemostasis and during the elective sclerotherapies, 1% polidocanol was used as the sclerosant. During each puncture, 2 ml was injected. Injections were paravasal and intravasal. After sclerotherapy, endoscopic examinations were carried out on the third day and one month later. Necrosis was noted in 42% of the patients and esophageal mucosal inflammation in 26%. Esophageal ulcers did not occur. There was no statistically significant difference between the two groups in terms of age, sex ratio, cause of liver cirrhosis, and the Child's classification. The size of the esophageal varices had no effect on the development of esophageal mucosal changes in correlation with the quantity of sclerosant. The comparison of the two groups of patients, sclerosed for hemorrhage and sclerosed electively, showed no statistically significant difference regarding esophageal mucosal changes. No differences between the ranitidine and placebo groups of patients were observed in this indication. It can be concluded that esophageal mucosal changes probably arise as a consequence of the sclerosant, its concentration, quantity and mode of application.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship between tissue and serum concentrations of carcinoembryonic antigen (CEA) in gastric and colonic carcinomas.

A relationship between tissue and serum concentrations of carcinoembryonic antigen (CEA) as determined by monoclonal enzymo-immunoassay (EIA) was studied in 47 patients with gastric carcinoma and 46 patients with colorectal carcinoma. The values were then compared to those obtained in a control group of 64 healthy subjects. On the basis of results, an increase in tissue CEA is not paralleled by a simultaneous increase in serum CEA. Serum CEA depends on tumor mass and points to the process extension. There is no specific tissue CEA threshold above which the serum CEA concentration should unavoidably increase. A relationship between tissue and serum CEA concentrations according to the degree of differentiation, studied in colorectal carcinomas, revealed significantly lower values of tissue CEA concentration in poorly differentiated carcinomas, whereas serum CEA concentrations did not show any such difference. The present study has suggested that, having identified both tissue and serum CEA concentrations in colorectal carcinoma, the tumor, its size and differentiation could be readily and quite closely defined at the time of measurements.

[Tissue carcinoembryonic antigen: a screening test for increased cell proliferation?]. / Tkivni karcinoembrionalni antigen (CEA): test probiranja pojacane stanicne proliferacije?

A relationship between the tissue and serum concentrations of carcinoembryonic antigen (CEA) as determined by the enzymoimmunoassay (EIA) was studied in 46 patients with colorectal carcinoma and 47 patients with gastric carcinoma. The values were then compared to those obtained in the control group of 64 healthy subjects. Serum CEA concentrations were measured in all of them, whereas tissue CEA concentration was determined in the rectal and gastric mucosa homogenates in 30 and 34 subjects, respectively. As expected, no differences were observed in the levels of serum CEA concentrations in either of the healthy subject subgroups. The serum CEA concentrations were found to be at the normal level of 2.5 ng/ml. In both subgroups of healthy subjects, the tissue CEA concentration was found to significantly differ, but the same was in colorectal and gastric carcinomas as compared to the normal rectal and gastric mucosa. When the process extent according to Dukes' classification in 22 patients with colorectal carcinoma operated on was compared to the relationship between the tissue and serum CEA concentrations, the serum CEA concentration of CEA was shown to depend on the tumor mass, regardless of the level of the specific tissue CEA concentration. Unusually high values of tissue CEA concentration, along with normal serum CEA concentration, were observed in 3 healthy subjects. A relationship between the tissue and serum CEA concentrations according to the degree of differentiation, studied in colorectal carcinomas, revealed significantly lower values of tissue CEA concentration in poorly differentiated carcinomas (P less than 0.01), whereas serum CEA concentrations did not show any such difference.