by Lau Wan Yee, Joseph. / Thesis (M.D.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 145-189). / Title Page --- p.1 / Dedication --- p.2 / Table of Contents --- p.3 / Hypotheses --- p.7 / Precis to the thesis --- p.8 / List of Publications of my research work used in this thesis --- p.19 / List of Figures --- p.25 / List of Tables --- p.26 / Acknowledgments --- p.27 / Statement of Originality --- p.28 / Chapter PART I --- HISTORICAL REVIEW --- p.30 / Chapter Chapter 1 --- History of Endoscopic and Laparoscopic Surgery --- p.31 / Chapter 1.1 --- History of Endoscopic Surgery --- p.31 / Chapter 1.2 --- History of Documentation of Endoscopic and Laparoscopic Surgery --- p.38 / Chapter 1.3 --- History of Laparoscopic Surgery --- p.39 / Chapter 1.4 --- The future of Endoscopic and Laparoscopic Surgery --- p.52 / Chapter Chapter 2 --- History of Perforated Peptic Ulcer --- p.53 / Chapter PART II --- SIZE OF THE PROBLEM --- p.57 / Chapter Chapter 1 --- Incidence of Feptic Ulcer in Different Parts of The World --- p.58 / Chapter Chapter 2 --- Incidence of Peptic Ulcer in Hong Kong 1970 -1993 --- p.60 / Chapter Chapter 3 --- Incidence of Perforated Peptic Ulcer --- p.70 / Chapter 3.1 --- Incidence of Perforated Peptic Ulcer in Different Parts of The World --- p.70 / Chapter 3.2 --- Incidence of Perforated Peptic Ulcer in Hong Kong --- p.71 / Chapter 3.3 --- "Incidence of Perforated Peptic Ulcer in Prince of Wales Hospital, Hong Kong" --- p.71 / Chapter PART III --- CURRENT TREATMENT OF PERFORATED PEPTIC ULCER --- p.74 / Chapter Chapter 1 --- Recent Developments in Treatment of Uncomplicated Peptic Ulcer --- p.75 / Chapter Chapter 2 --- My Contributions to the Medical Treatment of Uncomplicated Peptic Ulcer --- p.78 / Chapter Chapter 3 --- Review on Current Treatment of Perforated Peptic Ulcer --- p.79 / Chapter 3.1 --- Introduction --- p.79 / Chapter 3.2 --- Currently Available Treatment Options --- p.80 / Chapter 3.2.1 --- Perforated Duodenal Ulcer --- p.81 / Chapter [A] --- Nonoperative Treatment --- p.81 / Chapter [B] --- Laparotomy and patch repair --- p.83 / Chapter [C] --- Definitive Ulcer Surgery --- p.84 / Chapter [D] --- Laparoscopic Treatment --- p.87 / Chapter 3.2.2 --- Perforated Gastric Ulcer --- p.89 / Chapter PART IV --- DEVELOPMENT OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER IN OUR CENTRE --- p.91 / Chapter Chapter 1 --- Development of the Technique of Laparoscopic Suture Repair of Perforated Peptic Ulcer --- p.92 / Chapter 1.1 --- Surgical Technique --- p.93 / Chapter 1.2 --- Initial Results of Laparoscopic Suture Repair --- p.95 / Chapter Chapter 2 --- Development of the Technique of Laparoscopic Sutureless Repair of Perforated Peptic Ulcer --- p.98 / Chapter 2.1 --- Animal Studies --- p.98 / Chapter [A] --- Pilot Animal Study --- p.99 / Chapter [B] --- Mortality Rate on Different Methods of Repair of the Perforations --- p.100 / Chapter [C] --- Strength of the Repair Site by Studying the Bursting Pressure --- p.103 / Chapter [D] --- Detailed Histological Study --- p.108 / Chapter 2.2 --- Clinical Studies --- p.111 / Chapter [A] --- Surgical technique of Laparoscopic Sutureless Repair --- p.113 / Chapter [B] --- Initial Results of Laparoscopic Sutureless Repair --- p.114 / Chapter PART V --- TESTING THE HYPOTHESES OF THIS THESIS --- p.117 / Chapter Chapter 1 --- A Non-randomised Clinical Study --- p.119 / Chapter Chapter 2 --- A Randomised Clinical Study --- p.126 / Chapter PART VI --- CONCLUSIONS --- p.140 / Chapter PART VII --- THE FUTURE OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER --- p.142 / Chapter PART VIII --- REFERENCES --- p.145 / References to the Precis --- p.146 / References to Part I Chapter 1 --- p.147 / References to Part I Chapter2 --- p.157 / References to Part II --- p.162 / References to Part III --- p.168 / References to Part IV --- p.183 / References to Part V --- p.186 / References to Part VII --- p.189 / APPENDIX I BRIEF SUMMARY OF MY CONTRIBUTIONS TO THE MEDICAL TREATMENT OF UNCOMPLICATED PEPTIC ULCER --- p.190

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-06-14T17:40:51Z No. of bitstreams: 1 AnaKelySousa.pdf: 782298 bytes, checksum: 5ac1a801ac9a89d84c9762c0e4709cbe (MD5) / Made available in DSpace on 2017-06-14T17:40:51Z (GMT). No. of bitstreams: 1 AnaKelySousa.pdf: 782298 bytes, checksum: 5ac1a801ac9a89d84c9762c0e4709cbe (MD5) Previous issue date: 2016-05-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) / Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (FAPEMA) / Psidium guineense Swartz (Myrtaceae) is a popular shrub commonly as araçá, araçá do campo, araçá vedaleiro, araçá mirim, araçá pedra ou araçazinho, and is widely distributed in Brazil, taking place in the Amazon, Caatinga, Cerrado and Atlantic Forest. Its barks and roots are used commonly in the treatment of gastrointestinal disorders such as colic, diarrhea, gastroenteritis and gastritis. The phytochemical research reveals that the species is rich in flavonoids and tannins, classes of compounds that have shown potential antiulcerogenic activity. Based on their phytochemical characteristics and in popular usage, the aim of this study was to investigate the antiulcerogenic activity of aqueous extract of Psidium guineense (EAPg) and possible mechanisms involved in this activity. The extract was prepared from the powder by aqueous extraction of the leaves at 60 °C. In acute toxicity, EAPg was administered orally in a single dose (5g/kg). The antiulcer activity of EAPg (125, 250 and 250 mg/kg) was evaluated using models of gastric ulcer induced by etanol 75% (10 mL/kg) or indomethacin (30 mg/kg). Were determined baseline antisecretory activity by the method of pyloric ligation, the involvement of nitric oxide and sulfhydryl compounds, and quantified the levels of gastric mucus and sulfhydryl compounds. The anti-Helicobacter pylori activity was determined by in vitro assay. No signs of toxicity or death was recorded after oral administration of EAPg at a dose of 5.0 g/kg. Oral administration of EAPg (125, 250 and 500 mg/kg) was effective in protecting the gastric mucous membrane, reducing by 45.0, 88.0 and 93.0% gastric lesions induced by ethanol, respectively. Furthermore, EAPg reduced by 53.0, 79.0 and 94.0% gastric ulcer induced by indomethacin, respectively. EAPg (250 mg/kg) increased the pH and reduced the total acidity, but did not change the volume of gastric secretion, suggesting an absence of antisecretory effect. The antiulcerogenic activity EAPg is not related to nitric oxide, but is dependent on the presence of sulfhydryl compounds. The prior administration of EAPg increased basal levels of mucus 89,4% and 78,9% sulfhydryl compounds in the gastric mucosa, thus confirming their cytoprotective activity. The EAPg showed no bactericidal activity against Helicobacter pylori, having a minimum inhibitory concentration (MIC) 2000 mg/mL. The results showed that the aqueous extract of Psidium guineense has antiulcer activity. In addition, they contribute to a better understanding of the species and to validate the use of this species in the treatment of gastrointestinal disorders / Psidium guineense Swartz (Myrtaceae) é um arbusto conhecido vulgarmente como araçá, araçá do campo, araçá vedaleiro, araçá mirim, araçá pedra ou araçazinho, e está amplamente distribuído pelo Brasil, ocorrendo na Amazônia, Caatinga, Cerrado e Mata Atlântica. Suas cascas e raízes são usadas popularmente no tratamento de distúrbios gastrointestinais tais como cólica, diarreia, gastroenterite e gastrite. A investigação fitoquímica revela que a espécie é rica em flavonoides e taninos, classes de compostos que têm demonstrado potencial atividade antiulcerogênica. Com base nas suas características fitoquímicas e no uso popular, o objetivo deste estudo foi investigar a ação antiulcerogênica do extrato aquoso das folhas de Psidium guineense (EAPg) e os possíveis mecanismos de ação envolvidos nesta atividade. O extrato foi preparado a partir do pó das folhas por extração aquosa. Na toxicidade aguda administrou-se o EAPg por via oral numa dose única (5 g/kg). A atividade antiulcerogênica do EAPg (125, 250 e 250 mg/kg) foi avaliada utilizando modelos de úlcera gástrica induzida por etanol 75% (10 mL/kg) ou indometacina (30 mg/kg). Foram determinados a atividade antissecretória basal pelo método da ligadura pilórica, o envolvimento do óxido nítrico e dos compostos sulfidrílicos, e quantificados os níveis de muco gástrico e compostos sulfidrílicos. A atividade anti-Helicobacter pylori foi determinada por ensaio in vitro, utilizando microplaca. Nenhum sinal de toxicidade ou mortes foi registrado após a administração oral do EAPg na dose de 5,0 g/kg. A administração oral do EAPg (125, 250 e 500 mg/kg) foi efetiva na proteção da mucosa gástrica, reduzindo em 45,0; 88,0 e 93,0% a lesão gástrica induzida por etanol, respectivamente. Além disso, EAPg reduziu em 53,0, 79,0 e 94,0% a úlcera gástrica induzida pela indometacina, respectivamente. EAPg (250 mg/kg) aumentou o pH e reduziu a acidez total, mas não alterou o volume da secreção gástrica, sugerindo uma ausência de efeito antissecretório. A atividade antiulcerogênica do EAPg não está relacionada ao óxido nítrico, mas é dependente da presença de compostos sulfidrílicos. A administração prévia do EAPg aumentou os níveis basais de muco em 89,4%e de compostos sulfidrílicos em 78,9% na mucosa gástrica, confirmando assim sua atividade citoprotetora. O EAPg não apresentou atividade anti-H. pylori, apresentando uma concentração inibitória mínima (CIM) de 2 mg/mL. Os resultados obtidos demonstram que o extrato aquoso das folhas de Psidium guineense apresenta atividade antiulcerogênica. Além disso, contribuem para um maior conhecimento da espécie e para validar o uso desta espécie no tratamento de distúrbios gastrointestinais.

Thesis (Ph. D.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.

共著者あり。共著者名:Asaka Masahiro, Kudo Mineo, Sukegawa Makoto, Katagiri Masaki, Koshiyama Tatsumi, Kagaya Hidetoshi, Nishikawa Keiko, Hokari Kaku, Takeda Hiroshi, Sugiyama Toshiro. / Hokkaido University (北海道大学) / 博士 / 医学

No description available.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most frequently prescribed classes of drugs worldwide. Due to their excellent effects for analgesic, anti-inflammatory and antipyretic, most elder population used frequently for osteoarthritis. Gastrointestinal symptoms and ulceration associated with NSAIDs are common. Such ulcers may cause pain, bleeding, or perforation. It leads to other medical problems. The aim of this study was to examine the utilizations of medical resources associated with inpatients with NSAID related peptic ulcer disease and compared to non-NSAID related peptic ulcer disease. The study used the database from a teaching hospital in southern Taiwan. Inpatients who were identified ICD-9 CM codes as peptic ulcer diseases from January 1st of 2008 to December 31 of 2008 were included in this study. We also examined the indications for usage of NSAIDs, the date of prescription before the index date. The results showed 17.6% of inpatients with peptic ulcer disease related to NSAIDs. Inpatients with NSAIDs related peptic ulcer disease compared with inpatients with non-NSAIDs related peptic ulcer disease had significant difference in age and comorbidity. Although rapid urease test positive rate for Helicobacter pylori was higher in group of non-NSAID related peptic ulcer disease, it seemed underestimate because of the test number of patients was low. The average total direct medical cost of inpatients with NSAID related peptic ulcer was NT$ 36,491 and non-NSAID related peptic ulcer was NT$ 37,266.1. There were no significant difference in medical costs of standard care , intensive care , blood products,endoscopy, endoscopic hemostasis, surgery, CT scan , ultrasound, laboratory tests,medications, doctor¡¦s service between the two groups. Diagnostic and therapeutic procedures were no statistically significant difference, including blood transfusion,CT scan, endoscopic hemostasis, surgery, symptoms presentations, and intensive care. In this study, the duration for using NSAID was within 30 days for inpatients associated with NSAID related peptic ulcer, which had a substantial excess numbers of ulcer hospitalization. Since the common disease for using NSAID is osteoarthritis,which is very popular in elderly, therefore, we suggested that the policy makers of the National Health Insurance should be aware that preventive usage of proton pump inhibitors for the elder population who need frequent use of NSAIDs might decrease NSAID related ulcer complications.

published_or_final_version / Pharmacology / Master / Master of Philosophy

published_or_final_version / Pharmacology / Master / Master of Philosophy

published_or_final_version / Pharmacology / Doctoral / Doctor of Philosophy

published_or_final_version / Pharmacology / Doctoral / Doctor of Philosophy