Endoscopic classification of chronic gastritis based on a pilot study by the research society for gastritis.

BACKGROUND: Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence. METHODS: One hundred and fifty-five patients were enrolled and underwent gastroscopy. Eight basic endoscopic and histological types of gastritis (superficial, hemorrhagic, erosive, verrucous, atrophic, metaplastic, hyperplastic and special types) were defined. Gastritis was endoscopically diagnosed according to the definition of the endoscopic types of gastritis. Four or more biopsy specimens were obtained from the lesser and the greater curvatures of the antrum and the corpus of each patient, and the histological findings of gastritis and Helicobacter pylori infection were assessed. The histological diagnosis of gastritis was made according to the definition of histology types of gastritis. The endoscopic and the histological diagnoses were then compared in a blinded fashion. RESULTS: Endoscopic diagnosis was 62% as sensitive as histological diagnosis for erosive gastritis, 67% for verrucous gastritis and 84% for atrophic gastritis in the antrum. In superficial gastritis, sensitivity was approximately 25% in the corpus, but only 8% in the antrum. Metaplastic and hyperplastic gastritis were correctly diagnosed only in severe cases. CONCLUSION: Five basic types of gastritis (superficial, erosive, verrucous, atrophic and special types) should be employed for the new endoscopic gastritis classification. Metaplastic and hyperplastic gastritis are considered to be subtypes of atrophic gastritis and they should be excluded from the basic endoscopic classification. A new definition of gastritis in the antrum accompanied by redness still remains to be investigated.

[Evaluation of the diagnostic efficacy of SPIO enhanced MRI in patients with focal hepatic lesions--comparison with CECT and CTAP].

The aim of this study was to compare the diagnostic efficacy of superparamagnetic iron oxide (SPIO)-enhanced MRI for the detection and diagnostic accuracy of focal liver lesions with helical contrast enhanced CT (CECT) and CT during arterial portography (CTAP). Thirty-nine patients (25 men and 14 women, mean age 63.5 years) were examined by SPIO-MRI and triple-phase CECT. Eleven of them were also examined by CTAP. There were a total of 96 confirmed focal hepatic lesions, 61 metastatic cancers in 18 patients and 35 hepatocellular carcinomas (HCCs) in 21 patients. Final diagnosis was established by operation in 25 cases, by biopsy in 7 cases, and by progression of disease on follow-up examination in the other 7 cases. The sensitivity of SPIO-MRI for HCC detection was almost equal to CECT, but that of SPIO-MRI for metastatic cancer detection, especially cancers smaller than 1 cm in size, was significantly superior to CECT. The sensitivity of SPIO-MRI for both HCC and metastatic cancer detection was almost equal to that of CTAP, but the specificity of SPIO-MRI for detection of both lesions was significantly superior to that of CTAP because CTAP produced a higher incidence of false-positive findings. In conclusion, SPIO-MRI could take the place of CTAP as a non-invasive excellent modality to determine the distribution of hepatic lesions preoperatively. SPIO-MRI could also be a useful modality to follow liver metastasis postoperatively in patients with advanced digestive cancers.

Application of the Chinese steamed bun starter dough (CSB-SD) in breadmaking.

The application of Chinese steamed bun starter dough (CSB-SD) in breadmaking was investigated. The activation of CSB-SD to activate the growth of lactic acid bacteria (LAB) and to increase the number of yeast, prior to making bread, was conducted by mixing CSB-SD with wheat flour and water and then incubating for 24 h. Wheat flour was then substituted by this activated CSB-SD (aCSB-SD) at 10%, 30%, and 50% (w/w) to make bread. Dough and bread properties were studied comparing to the control (without aCSB-SD). From the farinograph results, a high aCSB-SD substitution level resulted in a less stability in dough with a higher degree of softening. Extensigraph results suggested that after aging, all the substituted dough yielded a greater resistance to extension with lower extensibility values than the control. Substitutions with 30% and 50% (w/w) aCSB-SD significantly increased the total CO(2) gas generation. Scanning electron microscopy SEM images of the 30% and 50% (w/w) substituted dough showed a well-developed gluten matrix. The 50% (w/w) substituted breads obtained a greater risen volume, finer crumb grain, and retained more softness after 5-d storage than the control. In addition, both the 30% and 50% (w/w) substituted breads showed a slightly increased mold stability, as compared to the 0% and 10% (w/w) substituted breads.