Influence of the site of a duodenal ulcer on its mode of presentation

The aims of this study were to define the localization of duodenal ulcer and to determine whether the site influenced the initial presentation. Eight hundred eighty-four duodenal ulcer patients diagnosed by endoscopy in Singapore and Sydney were studied. The ulcer was situated on the anterior wall of the bulb in 49% and the posterior wall of the bulb in 23%. The distribution was not influenced by sex, age, or the center of diagnosis. Those situated posteriorly in the bulb were more likely to present with hemorrhage than those situated elsewhere.

The influence of sex, race and dialect on peptic ulcer and non-ulcer dyspepsia in Singapore

A consecutive series of 2,277 patients presenting for upper gastrointestinal endoscopy was analysed. The following groups of patients were studied with reference to sex, race and dialect groups: those presenting with dyspepsia but no haemorrhage, those presenting with upper gastrointestinal haemorrhage, those with non-ulcer dyspepsia, gastric ulcer and duodenal ulcer. Males out-numbered females in all diagnostic groups. Male and female Malays were under-represented in all diagnostic groups when compared to the Singapore population. Amongst female Chinese, there was an excess of Cantonese patients and an under-representation of Teochew patients in most diagnostic groups. These dialect differences were not remarkable amongst male Chinese. The possible reasons for these differences and their significance are discussed.

Psychological characteristics of duodenal ulcer patients (a pilot report on 30 patients)

A psychological investigation of 30 duodenal ulcer patients showed that their profile differed from that of the Western patients in that drinking, smoking, anxiety, depression and psychopathy were not more common than in the general population. Psychological stress as measured by recent life events was low, but 40% had complaints relating to their work. Their scores for Friedman's Type A Behavior as measured by the Bortner's Scale was low. They had a high Lie Score for the Eysenck Personality Inventory indicating a desire to project a socially desirable image.

A problem of management in Whipple's disease

A patient with Whipple's disease did not respond to appropriate antibiotic treatment. A therapeutic response was obtained by a combination of tetracycline and prednisolone.