Document Detail

Endoscopic injection of bleeding esophageal varices with a poly-N-acetyl glucosamine gel formulation in the canine portal hypertension model.
MedLine Citation:
PMID:  10343225     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has been shown that poly-N-acetyl glucosamine produces rapid hemostasis by stimulating erythrocyte aggregation. Endoscopic injection of this substance may be effective in the treatment of bleeding varices. METHODS: In eight heparinized dogs with a bleeding esophageal varix greater than 2 mm in diameter, 2.5% to 3.5% poly-N-acetyl glucosamine gel was injected intravariceally and paravariceally. Endoscopy, endosonography, and histopathology were performed at 1, 7, 21, and 90 days after injection. RESULTS: In all cases, the variceal hemorrhage was stopped with three to four injections of a mean total gel volume of 1.9 mL. No recurrence of bleeding, ulceration, or stricture formation occurred. Through replacement of the gel by connective tissue, the varix was permanently obliterated in its whole course in five cases and in more than 70% of its length in three cases. No embolization and no poly-N-acetyl glucosamine antibodies were detected. CONCLUSIONS: Endoscopic injection of bleeding esophageal varices in this animal model with the use of poly-N-acetyl glucosamine gel was an effective and safe method for stopping the hemorrhage and inducing permanent varix obliteration.
D Kulling; J N Vournakis; S Woo; M V Demcheva; D U Tagge; G Rios; S Finkielsztein; R H Hawes
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  49     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-07-21     Completed Date:  1999-07-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  764-71     Citation Subset:  IM    
Digestive Disease Center, Department of Medicine, Medical University of South Carolina, Charleston, USA.
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MeSH Terms
Acetylglucosamine / administration & dosage*
Disease Models, Animal
Enzyme-Linked Immunosorbent Assay
Esophageal and Gastric Varices / drug therapy*,  etiology,  ultrasonography
Esophagoscopy / methods
Gastrointestinal Hemorrhage / drug therapy*,  etiology,  ultrasonography
Homeostasis / drug effects,  physiology
Hypertension, Portal / complications,  drug therapy
Injections, Intralesional / methods
Treatment Outcome
Reg. No./Substance:
0/Gels; 0/poly-N-acetyl glucosamine; 7512-17-6/Acetylglucosamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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