Multicenter evaluation of dual-therapy (omeprazol and amoxycillin) for Helicobacter pylori-associated duodenal and gastric ulcer (two years of the observation).

Treatment with the proton pump inhibitor (omeprazole) and single antibiotic (amoxycillin), two synergistic compounds, can cure Helicobacter pylori (H. pylori) infection, but this therapy is not as effective as had been expected. However, some studies show promising results. The aim of our study was to evaluate the effect of two weeks dual-therapy with omeprazole (O) and amoxycillin (A) on gastric (GU) and duodenal ulcer (DU) patients: ulcer healing, eradication of the H. pylori and recurrence rate of the ulcer. We studied 216 patients (aged 18-70) endoscopically proven GU (58 patients) and DU (158 patients). Rapid urease test from the two antrum biopses and two antral and two corporeal biopses using Giemsa stain method for confirmation of the H. pylori infection were used. The patients were treated with omeprazole 20 mg BID and amoxycillin 1.0 g BID for 2 weeks and investigated every 4 months during 2 years. Clearance effect of Hp infection was achieved in 65.1% GU and 66.4% DU patients. Eradication ("check point" after 4 months) in 43% DU and 56.6% GU patients was confirmed. Reinfection rate was found in 16% during 2 years. We conclude--dual-therapy (O and A) is not sufficiently effective to be recommended as an anti-H. pylori treatment. H. pylori eradication prevents recurrence of peptic ulcer and is an important issue in attempts to achieve permanent ulcer healing.

Helicobacter pylori infection in Eastern Europe: seroprevalence in the Polish population of Lower Silesia.

The Helicobacter pylori status of the population of Eastern European countries has not been explored despite the high incidence of peptic ulcer disease and gastric cancer observed in these countries. A seroprevalence study has been performed in Wroclaw, a city of Lower Silesia, Poland, to provide insight into this question. Sera were collected to obtain 50 subjects per 5 yr increment of age. A second generation ELISA kit with a high sensitivity and specificity was used. The results plotted by year of birth show a very high prevalence of H. pylori infection in all adults groups born before 1970 (80-100% positive). In the younger age groups, a dramatic decrease was observed. Because it is now known that most H. pylori infections are acquired in childhood (cohort effect), it can be predicted that the infection rate in the adult population will be much lower in the future compared with that presently observed, and it can be expected that evolution in H. pylori prevalence will have an impact on the rate of gastroduodenal diseases in Poland. Because of the high prevalence, it was not possible to identify risk factors for infection in this population.

Polymorphic epithelial mucin (PEM) epitopes in the estimation of the sequence of neoplastic changes in colon adenocarcinoma.

AIMS: The relation between the expression of PEM epitopes and the sequence of neoplastic changes in individual patients with colon adenocarcinoma was investigated. METHODS: Immunohistochemical staining was performed using four monoclonal antibodies to PEM epitopes (139H2, 140C1, 115D8, 115F5) on tissue sections from frankly malignant lesions, adjacent mucosa, colonic mucosa taken 1 cm and 5 cm from the lesion and normal control mucosa. RESULTS: A clear correlation between PEM expression and the site of mucosa sampling was demonstrated. The expression of PEM molecules defined by all studied monoclonal antibodies was highest in colon adenocarcinoma, similar but slightly weaker in adjacent mucosa and colon mucosa taken 1 cm from the frankly malignant lesion, lowest in mucosa 5 cm from the lesion, and virtually absent in control normal colonic mucosa. CONCLUSIONS: The immunological changes could be one of the first signs of a premalignant process and the estimation of PEM epitopes could show some cellular abnormalities not detectable by standard pathomorphological criteria.

Serological examinations in patients with Helicobacter pylori infections.

A passive microhemagglutination test was applied for the detection of H. pylori antibodies. The presence of elevated antibody titers was most frequently encountered in the sera of patients from whom H. pylori was isolated. No relationship between the level of antibodies and the clinical picture of peptic ulcer disease was noted. In addition, negative results from bacteriologic and serologic studies in patients with confirmed histopathologic changes and typical clinical symptoms may suggest that peptic ulcer disease and chronic inflammation of gastric mucosa is not always accompanied by the presence of H. pylori. It is concluded that the passive microhemagglutination test is a convenient and easily performed screening method.

Non-ulcer dyspepsia.

During the last decade a new disease entity numbered among functional disorders of the digestive tract and defined as "non-ulcer dyspepsia", has been isolated. This disease is diagnosed most frequently at the age of 20 to 40 years. In West-European countries it is diagnosed in about 30% of out patients. Symptomatology of the disease is very ample and is, after exclusion of organic diseases of the digestive tract, the basis of diagnosis and classification. Present knowledge on the pathophysiology of "non-ulcer dyspepsia" is incomplete and based mainly on study results of the motility of the stomach and small intestine under manometric examination. In spite of that one attains satisfactory therapeutical effects during a prolonged administration of prokinetic drugs (dopamine receptor antagonists and peripheral parasympathomimetics).

Effect of a single dosis of 96% ethanol on rat gastric mucosa. Part II. Histoenzymological studies.

The histoenzymological studies of ATPase and SDH enzymes in rats' gastric mucosa after a single 90 s administration of 96% ethanol proved considerable changes in the enzymes activity in course of injury and subsequent regeneration of mucosa.