ABSTRACT
Background: Reflux disease is a common gastrointestinal problem. The association between reflux disease and gastritis pattern is controversial
Aim: To determine the association between reflux disease and gastritis pattern in patients with Helicobacter pylori [H. pylori] infection
Methods: 470 patients with dyspepsia and reflux disease were enrolled in this study. The inclusion criteria were willing to participate in the study, age over 40 years, and having the criteria of ROME III for at least 3 months. Patients with history of H. pylori eradication therapy during the 3 months before the study, a history of gastric surgery, and gastric cancer were excluded. All of the participants underwent upper endoscopy and two biopsy samples were taken from antrum, body, and fundal areas
Results: H. pylori infection rate was 367 [78.1%] with mean age of 59.8 +/- 11.4 years. Of them 131 patients [35.7%] were male. Reflux disease was detected in 273 [74.4%] patients. 216 [58.9%] and 102 [27.8%] patients had non-erosive reflux disease [NERD] and gastroesophageal reflux disease [GERD], respectively. Corpus predominant and antral predominant gastritis were seen in 72 [19.6%] and 129 [35.2%] patients, respectively. Antral gastritis was significantly associated with GERD [p<0.01]. In regression analysis, antral predominant gastritis had a significant association with GERD [OR=1.92; 95%CI: 1.22-3.12]. The same result was observed in mild to moderate antral and greater curvature gastritis [OR= 1.26; 95%CI: 0.25-6.40 and OR= 3.0; 95%CI: 0.63-14.17, respectively]
Conclusion: According to these finding, we could suggest that the pattern of gastritis could be associated with reflux disease and GERD
ABSTRACT
The goal of this study is to evaluate some structural changes in muscular, collagenous and neural components as well as expression of Cajal-like cells and apoptosis of smooth muscle cells in congenital ureteropelvic junction obstruction [UPJO]. Tissue specimens were obtained from 25 patients with UPJO and compared with normal ureteropelvic junction regions of 19 autopsies. In paraffin embedded sections the amount of Cajal-like cells, density of nerve fibers and smooth muscle cell apoptosis [using immunohistochemical staining] were determined. Collagen deposition and muscular components were stained by Trichrome-Masson staining and evaluated by image analysis techniques. Arrangement of muscular bundles was also evaluated qualitatively. The number of Cajal-like cells was significantly lower in patients than in controls. The apoptotic score and mean number of nerve fibers were not statistically different for the two groups. Arrangement of muscular fibers was more irregular in patients than in controls [P<0.001]. Collagen deposition was significantly higher in patients than in controls [P<0.001]. The mean amount of muscular component was lower in patients than in normal ones. [P= 0.09] We found significant pathologic changes in congenital ureteropelvic junction obstruction such as decrease in Cajal-like cells, increase in collagen deposition and irregular arrangement of muscle fibers
ABSTRACT
Regression of precancerous lesions after H. pylori eradication remains controversial. This study evaluates the change and topography in first degree relatives [FOR] of gastric cancer [GC] patients following H. pylori eradication. Participants underwent endoscopy with antrum and corpus histological examinations. Subjects with pangastritis were randomly allocated to placebo or eradication therapy and followed over 41/2 years. Among 989 evaluated FDR, we excluded 468 patients as follows: 108 had macroscopic lesions, 243 had no evidence of any H. pylori infection, and 117 were excluded for other reasons. The remaining subjects [n = 521] were allocated to therapy [group A, n = 261] or placebo [group B, n = 260] groups. Interim analysis of 403 subjects [201 placebo, 202 therapy] showed regression of atrophy [60 out of 97 in the antrum and 37 out of 104 in the corpus] in H. pylori-eradicated versus regression of atrophy [57 out of 184 in the antrum and 23 out of 173 in the corpus] in non-H. pylori-eradicated cases over 21/2 years [P < 0.0001]. No regression of intestinal metaplasia [IM] occurred in the antrum and corpus of treated subjects over 41/2 years. However, progression of IM occurred in the antrum in 17 out of 90 patients in the non-H. pylori-eradicated versus 4 out of 68 H. pylori-eradicated subjects after 41/2 years [P < 0.05]. Eradication of H. pylori is associated with regression of gastric atrophy but not IM, even in its early stages. Gastric atrophy and IM in the antrum have shown more rapid progression in cases not treated for H. pylori infection [over 41/2 years follow-up] compared to H. pylori-eradicated cases
ABSTRACT
Helicobacter pylori [Hp] is a gram negative, spiral shaped bacterium which colonizes the gastric mucosa and induces gastroduodenal complications varying from mild gastritis with no clinical complications to peptic ulcer diseases and even gastric malignancies. The rate of Hp infection is 30-50% in developed countries whereas it has been rated up to 80% of the adult population in developing countries like Iran. Hp infection can be detected by various diagnostic methods. Culturing biopsy specimens and Rapid Urease Test [RUT] are the most common and reliable tests which can manifest Hp infection through proper sampling but these methods are invasive ones due to the need for endoscopy procedure in isolation of biopsy specimen. Application of serological assays are being increasingly used for epidemiological studies and detecting systemic immune responses toward past Hp infection. ELISA assays are the most popular techniques particularly in cases with no previous treatment. In this study we tested three imported IgG ELISA kits which are available for clinical diagnostics in detecting host sero-reactivity to Hp infection and compared them with a home made IgG ELISA kit. Histology and RUT were used as the gold standard tests for determination of Hp positive vs. Hp negative subjects using biopsy specimens from antrum. Sensitivity, specificity, accuracy and other required criteria were evaluated for each ELISA kit. According to the results the original criteria [Sensitivity and specificity] for each kit were as follows: BIOHIT [41.6%, 100%], Trinity [100%, 86.6%], Pishtaz [100%, 86.6%], Home made [100%, 92.6%]. Evaluation of these different IgG ELISA kits originating from different parts of the world and cross comparison of the results indicated that the cut off values should be refined for user country in order to obtain the highest sensitivity and specificity. These differences can be due to the vast geographic heterogeneity among Hp antigens. Furthermore, this study showed that home made ELISA kit can be substituted for imported ELISA kits due to its valid serological criteria