Diabetes mellitus, steatorrhea, cholelithiasis and a tumor distorting the duodenum prompted work-up for somatostatinoma in 52-year-old man. The responses of pancreatic B-cells but not A-cells to nutrient stimuli were inhibited, growth-hormone release was suppressed, suggesting somatostatin resistance some target tissues. Plasma somatostatin-like immunoreactivity ranged from 9000 13,000 pg per milliliter (normal: 88+/-8, mean +/- S.E.M.) distributed four molecular forms, including free...

Antibiotic-associated hemorrhagic colitis is a distinct form of antibiotic-associated in which Clostridium difficile absent. Although the cause not known, previous reports have suggested role Klebsiella oxytoca.We studied 22 consecutive patients who had suspected and were negative for C. difficile. Patients underwent diagnostic colonoscopy, among those received diagnosis colitis, stool samples cultured K. oxytoca. We isolated oxytoca strains tested them cytotoxin production using...

In patients with ulcerative colitis (UC), alterations of the intestinal microbiota, termed dysbiosis, have been postulated to contribute inflammation. Fecal microbiota transplantation (FMT) has used as effective therapy for recurrent Clostridium difficile also caused by dysbiosis. The aims present study were investigate if UC benefit from FMT and dysbiosis can be reversed.Six chronic active nonresponsive standard medical treated colonoscopic administration. Changes in colonic assessed 16S...

The incidence of gastric cancer is decreasing and lies between 10 15 new cases per 100,000 population year in most Western countries. Peak age 60 80 years. While distal cancers account for the overall decrease cancer, tumors proximal stomach (cardia esophagogastric junction) are on rise. Recognized risk factors infection with <i>Helicobacter pylori</i>, dietary (e.g. high intake salt-preserved foods), smoking, pernicious anemia a history partial gastrectomy.

OBJECTIVE To determine the efficacy and safety of a structured diabetes teaching treatment program (DTTP) in patients with insulin-dependent mel-litus (IDDM) an outpatient setting. RESEARCH DESIGN AND METHODS All IDDM who completed 5-day DTTP were reevaluated after mean follow-up 3 years. A standardized interview was used to assess frequency severe hypoglycemia, type insulin treatment, self-monitoring, other diabetes-related parameters. HbA1c measured by high-performance liquid...

The optimal management of patients with reflux-associated laryngitis is unclear. We performed a placebo-controlled crossover trial in proven reflux disease and associated to determine the effect pantoprazole gain information on natural course disease.Sixty-two consecutive non-smoking hoarseness were examined. Scores respect larynx for subjective complaints determined 24-h pH-metry assess acid lower oesophagus pharynx was performed. Patients pathologic given chance enter double-blinded...

We tested the hypothesis that therapeutic endoscopy using Nd:YAG (neodymium:yttrium–aluminum–garnet) laser would benefit patients with acute peptic-ulcer bleeding. Over 43 months, 174 active bleeding (n = 32) or stigmata of recent 142) due to peptic ulcers were randomly assigned during either standard treatment photocoagulation therapy without photocoagulation. There no significant differences in a number outcomes between group treated and control group. Continued rebleeding was observed 22...

We attempted to reproduce the diarrhea of pancreatic cholera syndrome with prolonged (10-hour) administration vasoactive intestinal polypeptide (VIP) in five healthy nonfasting subjects. The was given as a continuous intravenous infusion at rate 400 pmol per kilogram body weight hour. By two hours plasma VIP concentration had risen from normal basal value 15.3±0.2 (mean ±S.E.M.) 129±40 liter — within range found patients syndrome. In each subject profuse watery developed 4.3±0.8 (range, 2.0...

We randomly assigned 95 patients with large esophageal varices (Grade 3 or 4) who had not previously upper gastrointestinal tract bleeding to two groups: 49 received intravariceal sclerotherapy, and 46 were followed as controls. Over a mean follow-up of 13 months there was no difference between the sclerotherapy group control in mortality (24.4 percent) any significant average hospital stay per month (3.0 vs. 2.6 days). Sclerotherapy associated significantly more episodes (26 10 episodes,...

Ductal adenocarcinoma of the pancreas has an incidence approximately 10 per 100,000 population year. This number pertains to Europe, North America and parts South (Argentina). Men are more often afflicted than women (female:male ratio about 1:1.5, though reports vary). There been a very small but steady increase in over last 50 years. Unfortunately, numbers for mortality still practically identical this cancer. The peak is between 60 80 years age. In absolute numbers, there 8,000 cases...

The effect of vasoactive intestinal polypeptide (VIP) on water and electrolyte transport transmucosal potential difference was investigated in the dog jejunum vivo compared to secretion induced by cholera toxin. Isolated jejunal loops were perfused with a plasma-like solution. VIP (0.08 μg/kg per min) administered directly into superior mesenteric artery continuous infusion over 1 h. From dye dilution method, it estimated that mean plasma concentration 12,460 pg/ml reached loops. caused...

The lower esophageal sphincter (LES), surrounded by diaphragmatic muscle, prevents gastroesophageal reflux. When these structures become incompetent, gastric contents may cause reflux disease (GERD). For treatment, lifestyle interventions are always recommended. We hypothesized that actively training the crura of diaphragm as part LES using breathing exercises, GERD can be positively influenced.A prospective randomized controlled study was performed. Patients with non-erosive or healed...

Diarrhea is best defined as passage of loose stools often with more frequent bowel movements. For clinical purposes, the Bristol Stool Form Scale works well to distinguish stool form and identify stools. Laboratory testing consistency has lagged behind. Acute diarrhea likely be due infection self-limited. As becomes chronic, it less infection; duration 1 month seems work a cut-off for chronic diarrhea, but detailed scientific knowledge missing about utility this definition. In addition...

OBJECTIVE: To evaluate commercially available determination methods for HbA1c in patients with hemoglobin variants. RESEARCH DESIGN AND METHODS: values were determined various methods, including ion-exchange high-performance liquid chromatography (HPLC), boronate affinity assay, and immunoagglutination the mutations Hb Graz, Sherwood Forest, O Padova, D, S. RESULTS: The effect of hemoglobinopathies on glycohemoglobin measurements was highly method dependent. HPLC lacked resolution necessary...

To evaluate the clinical and analytical accuracy of home blood glucose meters.Six meters--Reflolux S (Boehringer Mannheim, Germany), One Touch II (LifeScan, Milpitas, CA), Glucocard Memory (Menarini, Florence, Italy), Precision QID (Medisense, Cambridge, U.K.), HaemoCue (HaemoCue, Angelholm, Sweden), Accutrend alpha Germany)--were compared with a reference method (Beckman Glucose Analyzer II) under controlled conditions (glucose clamp technique). Validation meters was accomplished by...

NN304 is a long-acting insulin analogue that acylated with 14-C-fatty acid chain. Protraction of action this novel due not to slow absorption after subcutaneous administration but reversible binding albumin. We investigated the pharmacokinetic and pharmacodynamic properties (0.3 0.6 U/kg) in comparison NPH IU/kg) 10 healthy volunteers performing randomised, double-blind, cross-over, placebo-controlled glucose clamp study. During observation period 24 hours areas under curve for NPH[0.3...

The effect of a synthetic somatostatin analog was studied in patient with severe secretory diarrhea due to pancreatic cholera syndrome. Basal intestinal perfusion studies indicated an absence water and sodium absorption, active chloride secretion the small bowel. Intravenous administration (1 µg/kg · h) changed zero net movement absorption (122 mL/30 cm jejunum per hour). Chloride (5.0 7.9 meq/30 h), plasma vasoactive polypeptide concentration reduced from 330 45 pmol/L (normal, less than...