Pitfalls in gastrointestinal tract haematopoietic lesions.

Specimens from the gastrointestinal (GI) tract are among the most commonly encountered in routine pathology practice worldwide. It is well known that the luminal GI tract is home to various areas rich in mucosa-associated lymphoid tissue (MALT), whether native or acquired. The latter may be particularly problematic due to its well-known predisposing factors such as Helicobacter pylori infection and autoimmune conditions. Nevertheless, native GI structures are often the subject of query, particularly in conditions that may mimic lymphoproliferative conditions, including infectious and inflammatory diseases. Herein, we describe and share common clinicopathological findings in our daily practice that are challenging to distinguish from subtle low-grade neoplastic lymphoproliferative disorders.

Histologic Study of the Esophagogastric Junction of Organ Donors Reveals Novel Glandular Structures in Normal Esophageal and Gastric Mucosae.

INTRODUCTION: Whether cardiac mucosa at the esophagogastric junction is normal or metaplastic is controversial. Studies attempting to resolve this issue have been limited by the use of superficial pinch biopsies, abnormal esophagi resected typically because of cancer, or autopsy specimens in which tissue autolysis in the stomach obscures histologic findings. METHODS: We performed histologic and immunohistochemical studies of the freshly fixed esophagus and stomach resected from 7 heart-beating, deceased organ donors with no history of esophageal or gastric disease and with minimal or no histologic evidence of esophagitis and gastritis. RESULTS: All subjects had cardiac mucosa, consisting of a mixture of mucous and oxyntic glands with surface foveolar epithelium, at the esophagogastric junction. All also had unique structures we termed compact mucous glands (CMG), which were histologically and immunohistochemically identical to the mucous glands of cardiac mucosa, under esophageal squamous epithelium and, hitherto undescribed, in uninflamed oxyntic mucosa throughout the gastric fundus. DISCUSSION: These findings support cardiac mucosa as a normal anatomic structure and do not support the hypothesis that cardiac mucosa is always metaplastic. However, they do support our novel hypothesis that in the setting of reflux esophagitis, reflux-induced damage to squamous epithelium exposes underlying CMG (which are likely more resistant to acid-peptic damage than squamous epithelium), and proliferation of these CMG as part of a wound-healing process to repair the acid-peptic damage could result in their expansion to the mucosal surface to be recognized as cardiac mucosa of a columnar-lined esophagus.

Gastric foveolar elongation causes invisibility of regular arrangement of collecting venules in chronic active and inactive gastritis.

OBJECTIVES: Helicobacter pylori (H pylori) infection is the most common cause of gastritis. The disappearance of regular arrangement of collecting venules (RAC) is well known as one of the main manifestations of H pylori-affected gastritis while the reason behind it remains obscure. The aim of this study was to investigate the relationship between invisibility of RAC and the length of gastric foveolae. METHODS: 43 RAC-positive and 118 RAC-negative patients were enrolled. Gastric biopsy specimens were obtained from lesser and greater curvature of the corpus with RAC-positive or RAC-negative pattern. Histopathological evaluation was performed based on the updated Sydney System, and foveolar length was derived by a morphometric technique. RESULTS: The median gastric foveolar length in RAC-positive group (median [IQR], 138.54 µm [120.50, 159.09]) was significantly shorter than that in the RAC-negative group (median [IQR], 260.96 µm [217.40, 315.23], P < .05). The length of gastric foveolae in chronic active gastritis (RAC-negative, activity grades 1, 2, and 3) and inactive gastritis (RAC-negative, activity grade 0) was longer than that in normal group (RAC-positive, activity grade 0) (P < .05). The optimal cutoff value for gastric foveolae length of the corpus mucosa showing RAC-negative pattern was more than 181.53 µm. The sensitivity and specificity of more than cutoff value for predicting the invisibility of RAC were 93.03% and 91.78%, respectively. CONCLUSIONS: The elongation of gastric foveolae caused the invisibility of RAC in gastric corpus mucosa in chronic active and inactive gastritis on gastroendoscopy.

A retrospective study on transabdominal ultrasound measurements of the rumen wall thickness to evaluate chronic rumen acidosis in beef cattle.

BACKGROUND: Chronic and subacute rumen acidosis are economically important in the beef industry. The aim of this study was to evaluate the potential suitability of the transabdominal ultrasonographic examination of the ruminal wall to diagnose chronic rumen acidosis in beef cattle compared to direct measurement of ruminal pH, as a fast non-invasive tool to be used in field condition. Ultrasonographic examination of the rumen was conducted in 478 beef cattle before rumenocentesis (chronic rumen acidosis group = pH ≤ 5.8; healthy group = pH ≥ 5.9). Rumen wall ultrasound measurements included rumen wall thickness (RWT) and rumen mucosa and submucosa thickness (RMST). RESULTS: The Analysis of Variance showed the high significant effect of the pH class for RWT and RMST (P < 0.001). Spearman RANK correlation analysis showed interaction between rumen pH and RWT (- 0.71; P < 0.0001) and RMST (- 0.75; P < 0.0001). A significant Spearman's correlations were found between volatile fatty acids (VFA) and RWT and RMST. The differentiation efficiency of RWT between healthy and chronic rumen acidosis groups, as a result of the receiver operator curve (ROC) analysis, was quite good with an area under the receiver operator curve (AUROC) of 0.88: P < 0.0001; 95% CI: 0.83-0.98. Using a cut-off value of > 8.2 mm. The differentiation efficiency of RMST between healthy and chronic rumen acidosis groups, as a result of ROC curve analysis, was good with an AUROC of 0.90: p < 0.0001; 95% CI: 0.85-0.94. Using a cut-off value of > 5.3 mm. CONCLUSIONS: In this study, the thickening of RWT and RMST is correlated with the changes of ruminal pH. Transabdominal rumen ultrasound has the potential to become a powerful diagnostic tool useful to identify fattening bulls affected by chronic rumen acidosis.

Molecular ontogeny of the stomach in the catshark Scyliorhinus canicula.

The origin of extracellular digestion in metazoans was accompanied by structural and physiological alterations of the gut. These adaptations culminated in the differentiation of a novel digestive structure in jawed vertebrates, the stomach. Specific endoderm/mesenchyme signalling is required for stomach differentiation, involving the growth and transcription factors: 1) Shh and Bmp4, required for stomach outgrowth; 2) Barx1, Sfrps and Sox2, required for gastric epithelium development and 3) Cdx1 and Cdx2, involved in intestinal versus gastric identity. Thus, modulation of endoderm/mesenchyme signalling emerges as a plausible mechanism linked to the origin of the stomach. In order to gain insight into the ancient mechanisms capable of generating this structure in jawed vertebrates, we characterised the development of the gut in the catshark Scyliorhinus canicula. As chondrichthyans, these animals retained plesiomorphic features of jawed vertebrates, including a well-differentiated stomach. We identified a clear molecular regionalization of their embryonic gut, characterised by the expression of barx1 and sox2 in the prospective stomach region and expression of cdx1 and cdx2 in the prospective intestine. Furthermore, we show that gastric gland development occurs close to hatching, accompanied by the onset of gastric proton pump activity. Our findings favour a scenario in which the developmental mechanisms involved in the origin of the stomach were present in the common ancestor of chondrichthyans and osteichthyans.

Comparative anatomical studies on the glandular stomach of the rock pigeon (Columba livia targia) and the Egyptian laughing dove (Streptopelia senegalensis aegyptiaca).

The rock pigeon (RP) and the laughing dove (LD) are common and widely distributed species in African countries, including Egypt. The present work was carried out to characterize the comparative features of the glandular stomach (proventriculus) in these two birds, which share diets and habitats. In both species, the proventriculus is an elongated spindle obliquely situated in the cranial two-thirds of the body cavity. The length and weight of the proventriculus in the RP were about one and half times greater than that of the LD. Histologically, the proventricular wall generally consisted of the mucosa (thickest), submucosa, muscular and serosa layers. The proventricular glands occupied most of the wall of the proventriculus within the lamina propria of the mucosa. The glands are tubuloalveolar in type, consist of variable shaped lobules and are more condensed in LD than in RP. At the proventricular-gizzard junction (PGJ), the proventricular glands were observed external to the tubular glands of the gizzard in the RP, whereas in LD, these glands end abruptly and are separated from the tubular glands of the gizzard by a short distance. A scanning electron microscopy (SEM) of the proventricular lumen in RP revealed that the openings of the proventricular glands have an irregular outline surrounded by concentrically arranged mucosal folds that resemble a rosette shape. In the LD, these openings have a regular outline surrounded by thinner, widely spaced mucosal folds. To our knowledge, these results identified the structure of the proventriculus in RP and LD for the first time.

Comparative histological structure of the gastrointestinal mucosa in human and white rat: a bibliographic analysis.

OBJECTIVE: Introduction: According to numerous domestic and foreign researchers, morphofunctional structure of the digestive system of humans and rats have much in common, therefore, rats are used as the laboratory animals during the experiments. The aim of the paper was the comparative study of the histological structure of the gastrointestinal mucosa in human and white rat through the bibliographic analysis of the publications. PATIENTS AND METHODS: Materials and methods: The material for the investigation was current publications on the study of the histological structure of the intestine mucosa in human and white rat by analyzing, synthesizing and generalizing the resulting data. RESULTS: Review and discussion: Histologically, the gastrointestinal mucosa in white rat is similar to the human one. The gastrointestinal mucosa in white rats (with the exception of the generic difference in the structure of the stomach and the caecum), in its histological structure, is quite similar to the human one, to be studied in the experimental simulation of the specific lesions of the digestive system.

Technical note: Changes in rumen mucosa thickness measured by transabdominal ultrasound as a noninvasive method to diagnose subacute rumen acidosis in dairy cows.

Feeding high-grain diets leads to the release and accumulation of short-chain fatty acids in the rumen. The subsequent prolonged decline in ruminal pH can lead to subacute ruminal acidosis (SARA). Accumulation of short-chain fatty acids can cause proliferation of rumen papillae to increase absorption surface, subsequently leading to a thickening of the rumen mucosa. The aim of this study was to evaluate the appropriateness of continuous measurements of the rumen mucosa thickness (RMT) as a diagnostic tool for SARA in dairy cows compared with continuous measurements of ruminal pH. The study used 6 lactating Simmental cows switched from a moderate-grain (MG) diet with 40% concentrate (dry matter basis) for 1 wk to a high-grain (HG) diet with 60% concentrate (dry matter basis) for 4 wk. Reticuloruminal pH was recorded with indwelling sensors throughout the trial. Rumen mucosa thickness was measured by transabdominal ultrasound at 4 d during the MG diet and 23 d during the HG diet. Mean RMT increased from 4.7 ± 0.19 mm in the MG diet to 5.3 ± 0.17 mm in the HG diet, whereas daily mean reticular pH decreased from 6.8 ± 0.01 in the MG diet to 6.5 ± 0.01 in the HG diet. Older cows (>3 lactations) had increased RMT, associated with higher reticular pH throughout the experiment. The higher RMT and pH level in older cows underlines their lesser susceptibility to SARA during high-grain feeding. In conclusion, RMT can successfully be measured using linear ultrasound probes, commonly used by veterinary practitioners as rectal probes. By combining noninvasive RMT measurements with the lactation number of the individual cows in a herd, this study suggests that RMT is a viable option for diagnosing SARA. Further research, using a larger number of cows with different lactations numbers, is needed to establish a cut-off RMT indicating the risk of SARA.

Effect of resistant starch on the intestinal health of old dogs: fermentation products and histological features of the intestinal mucosa.

The effects of resistant starch (RS) intake on nutrient digestibility, microbial fermentation products, faecal IgA, faecal pH, and histological features of the intestinal mucosa of old dogs were evaluated. The same formulation was extruded in two different conditions: one to obtain elevated starch cooking degree with low RS content (0.21%) and the other lower starch cooking with high RS content (1.46%). Eight geriatric Beagles (11.5 ± 0.38 years old) were fed each diet for 61 days in a crossover design. Food intake, nutrient digestibility, fermentation products, faecal pH, and faecal IgA were examined via variance analysis. Histological results of intestinal biopsies were assessed via Wilcoxon test for paired data. The morphometric characteristics of large intestine crypts were evaluated via paired t tests (p < .05). Protein, fat, and energy digestibilities were higher for the low-RS diet (p < .05). Dogs receiving the high-RS diet had lower faecal pH and higher values for propionate, butyrate, total volatile fatty acids, and lactate (p < .05). No differences between diets were found in the histological parameters of the gut mucosa, and only a tendency for deeper crypts in the descending colon was observed for dogs fed the high-RS diet (p = .083). The intake of a corn-based kibble diet manufactured with coarse ground raw material and low starch gelatinization to obtain 1.4% of RS affected microbial fermentation products and faecal pH and tended to increase crypt depth in the descending colon of old dogs.

Recurrencia de infección y diversidad de cepas de Helicobacter pylori en adultos tratados con terapia triple estándar empírica en una población de México / Recurrence of infection and diversity of Helicobacter pylori strains in an adult population in Mexico treated with empirical standard triple therapy

Introducción: posterior al tratamiento erradicador de Helicobacter pylori (H. pylori), podría presentarse recurrencia de infección debido a recrudescencia o reinfección. El objetivo de este estudio fue determinar la recurrencia de infección por H. pylori e identificar cepas virulentas de H. pylori al año posterior de su erradicación con terapia triple estándar. Material y métodos: se realizó un estudio cuasiexperimental. La población estudiada fueron pacientes con enfermedades digestivas asociadas a H. pylori que recibieron terapia triple estándar. Todos los pacientes antes del tratamiento erradicador, y solo aquellos pacientes con prueba de aliento con carbono 14 positivo un año posterior al tratamiento se les realizaron cultivos y reacción en cadena de la polimerasa (PCR) de biopsias gástricas para identificación de cepas. Se realizó análisis estadístico mediante el test t de Student y prueba exacta de Fisher, con un nivel de significancia de 0,05. Resultados: se revisaron 128 pacientes, 51 (39,8%) hombres y 77 (60,2%) mujeres, con una edad promedio de 54,8 (DE 13,8) años. Se halló recurrencia anual de infección por H. pylori en 12 (9,3%) pacientes y reinfección y recrudescencia anual en nueve (7%) y tres (2,3%) pacientes respectivamente. La tasa de recrudescencia en proteína antigénica (cagA) fue de 1/30 (3,3%) pacientes y en citotoxina vacuolizante (vacA) fue de 2/112 (1,8%) pacientes. La tasa de reinfección en cagA fue 3/30 (10%) pacientes y en vacA 6/112 (5,3%) pacientes. Conclusiones: en este estudio la recurrencia de infección fue mayor que en países desarrollados con baja prevalencia de H. pylori y menor que en países en vías de desarrollo con mayor prevalencia de H. pylori. Las cepas cagA o vacA s2/m2 fueron aisladas en reinfección y recrudescencia (AU)

Background. After eradication treatment for Helicobacter pylori, infection could recur due to recrudescence or re-infection. The objective of this study was to determine the recurrence of Helicobacter pylori infection and identify virulent Helicobacter pylori strains one year after eradication with standard triple therapy. Material and methods. A quasi-experimental study was performed that included a patient population with digestive diseases associated with Helicobacter pylori who had received standard triple therapy. Cultures and Polymerase Chain Reaction was performed on gastric biopsies for strain identification in all patients prior to eradication treatment and those with a positive carbon 14 breath test one year after eradication treatment. Statistical analysis was performed using the student T test and Fisher’s exact test, statistical significance was set at 0.05. Results. 128 patients were studied, 51 (39.8%) were male and 77 (60.2%) were female with an average age of 54.8 years (DE 13.8). There was an annual recurrence of Helicobacter pylori infection in 12 (9.3%) patients. An annual re-infection and recrudescence occurred in 9 (7 %) and 3 (2.3%) patients respectively. The recrudescence rate for cagA was 1/30 (3.3%) patients and 2/112 (1.8%) patients for vacA. The re-infection rate for cagA was 3/30 (10%) patients and 6/112 (5.3%) patients for vacA. Conclusions. The recurrence of infection in this study was higher than that recorded in developed countries with a low prevalence of H. pylori and lower than that recorded in developing countries with a higher prevalence of H. pylori. The cagA or vacA s2/m2 strains were isolated after re-infection and recrudescence (AU)

Preclinical efficacy of a gastro-sparing novel thiazolidin-4-one in alleviating secondary lesions of polyarthritis: A multi-parametric approach.

The promising role of thiazolidin-4-ones (TZOs) against inflammatory conditions has been reported. From our lab, one of the TZO derivatives, compound 4C, exerted anti-inflammatory potential via inhibition of locally released cytokines and prostaglandin. In continuance, a detailed study was undertaken for the preclinical profiling of this promising TZO derivative against polyarthritis in rats, along with assessment of risk associated with the treatment. Male Sprague-Dawley rats were used for the adjuvant-induced arthritis (AIA) model. Based on the development of secondary lesion, the animals were randomized into different treatment groups. To establish the efficacy of the test compound, parameters such as inflammation, pain, disease progression, cytokines and prostaglandin (PG)-E2 levels and complete blood cell profile were recorded along with radiological and histological examinations of joints. The study also focused on evaluating the side effect of test compound on gastric, liver, renal, blood and cardiovascular components. Compound 4C exerted promising therapeutic effect against secondary lesions in polyarthritis in rats. It limited the progression of chronic inflammation and associated pain in rats. Modulation of cytokine signalling and arachidonate metabolism by 4C was evident from inhibition of interleukin (IL)-6, tumor necrosis factor (TNF)-α and PGE2 generation in AIA rats. Comparatively, compound 4C was safer than diclofenac to cause gastric, liver, renal, blood and cardiovascular toxicities. These finding supports the efficacy and safety profile of 4C, a TZO derivative in limiting the progression of arthritis when administered orally.

Averaged subtracted polarization imaging for endoscopic diagnostics of surface microstructures on translucent mucosae.

An endoscopic image processing technique for enhancing the appearance of microstructures on translucent mucosae is described. This technique employs two pairs of co- and cross-polarization images under two different linearly polarized lights, from which the averaged subtracted polarization image (AVSPI) is calculated. Experiments were then conducted using an acrylic phantom and excised porcine stomach tissue using a manual experimental setup with ring-type lighting, two rotating polarizers, and a color camera; better results were achieved with the proposed method than with conventional color intensity image processing. An objective evaluation method that uses texture analysis was developed and used to evaluate the enhanced microstructure images. This paper introduces two types of online, rigid-type, polarimetric endoscopic implementations using a polarized ring-shaped LED and a polarimetric camera. The first type uses a beam-splitter-type color polarimetric camera, and the second uses a single-chip monochrome polarimetric camera. Microstructures on the mucosa surface were enhanced robustly with these online endoscopes regardless of the difference in the extinction ratio of each device. These results show that polarimetric endoscopy using AVSPI is both effective and practical for hardware implementation.

Maspin-related Orchestration of Aggressiveness of Gastric Cancer.

BACKGROUND AND STUDY AIM: Although some hypotheses have been postulated on the genesis of gastric cancer (GC), the origin of this disease remains unclear. The aim of this study was to develop a hypothesis about gastric carcinogenesis based on our experience in the field of GC and on published reports on about 28 studies in the field of subcellular maspin expression in GC. In 180 cases of GC, the clinicopathologic features were correlated with the results obtained after paired immunohistochemical stains (tumor/normal mucosa) with 15 antibodies: E-cadherin, HER-2, VEGF, CD31, CD105, COX-2, maspin, bax, bcl-2, p53, Ki67, MLH-1, MSH-2, Mena protein, and vimentin. RESULTS: Cytoplasmic maspin was observed in foveolar cells with intestinal metaplasia, whereas mixed (combined nuclear-cytoplasmic) expressions were more characteristic of the intramucosal foci of signet-ring cells and dysplastic cells. The tumor cells that expressed cytoplasmic maspin were mostly intestinal type bax/COX-2/Mena/E-cadherin-positive differentiated adenocarcinomas with nodular growth and more superficial invasion. The nuclear shift of maspin was more frequent in HER-2/p53-positive intestinal type adenocarcinomas with diffuse architecture at the invasion front, as well as for node-positive poorly cohesive carcinomas. Loss of maspin expression induced a higher risk of distant metastases, without differences in the survival rate. CONCLUSIONS: In GC with associated metaplasia, cytoplasmic maspin is predominant; the nuclear shift induces local aggressiveness and risk of node metastases, whereas total loss can indicate a risk of distant metastases. In GC without associated metaplasia, nuclear expression of maspin is retained, indicating a more aggressive behavior.

Changes in the Gastric Mucosa With Aging.

BACKGROUND & AIMS: We aimed to characterize age-related changes in the gastric mucosa and investigate the contribution of Helicobacter pylori infection to these changes. METHODS: We collected data from a large national pathology database of 895,323 subjects who underwent esophagogastroduodenoscopy with gastric biopsies from January 2008 through December 2013 at endoscopy centers throughout the United States. The prevalence of various types of gastric histopathology was expressed as percent of the total study population, stratified by sex, age, and state. RESULTS: Over a lifetime, the gastric mucosa became abnormal in 50% of subjects. A higher proportion of people in areas with a high prevalence of H pylori infection acquired gastric abnormalities. H pylori-associated chronic active gastritis and mucosal changes caused by infection were observed in 22% of biopsies; these were the most common gastric abnormalities observed. Reactive gastropathy, which was detected in 18% of biopsies, increased with age and was the second most common factor of gastric pathology observed. CONCLUSIONS: On the basis of an analysis of biopsies collected by esophagogastroduodenoscopy in the United States, gastric abnormalities increase with age. Most pathologic conditions detected by histologic analysis are caused by H pylori infection, but the causes of many others are unknown.

Effect of dietary oxidized konjac glucomannan on Schizothorax prenanti growth performance, body composition, intestinal morphology and intestinal microflora.

The aim of the present study was to examine the effect of oxidized konjac glucomannan (OKGM) on Schizothorax prenanti growth performance, body composition, intestinal morphology and intestinal microflora. Fish were fed a basal diet or basal diet plus 4.0, 8.0, 16.0 and 32.0 g kg(-1) OKGM for 60 days. The results indicated that WGR and SGR were significantly higher in fish fed 8.0 and 16.0 g kg(-1) OKGM diets (P < 0.05) than those in fish fed basal diet, and PER was significantly higher and FCR was significantly lower in fish fed 16.0 g kg(-1) OKGM diet (P < 0.05). The content of body protein, lipid and moisture was affected by the OKGM diets. The light and electron microscopy demonstrated that intestinal morphology of fish fed 8.0 and 16.0 g kg(-1) OKGM diet was better (P < 0.05) than the control group, including mucosa fold height, mucosal epithelial height, submucosa height, longitudinal muscularis thickness and circular muscularis thickness. Compared with the control group, fish fed 32.0 g kg(-1) OKGM diet showed significantly lower goblet cell number in anterior intestine (P < 0.05). Furthermore, intestinal microflora was analyzed by PCR-DGGE, and the results showed that OKGM diets also significantly modulated the intestinal microflora of fish (P < 0.05). The study clearly demonstrates that OKGM could enhance the growth performance, improve intestinal morphology and modulate intestinal microflora of S. prenanti, and the optimal dietary OKGM levels was suggested to be 16.0 g kg(-1).

Use of hyperspectral imaging technology to develop a diagnostic support system for gastric cancer.

Hyperspectral imaging (HSI) is a new technology that obtains spectroscopic information and renders it in image form. This study examined the difference in the spectral reflectance (SR) of gastric tumors and normal mucosa recorded with a hyperspectral camera equipped with HSI technology and attempted to determine the specific wavelength that is useful for the diagnosis of gastric cancer. A total of 104 gastric tumors removed by endoscopic submucosal dissection from 96 patients at Yamaguchi University Hospital were recorded using a hyperspectral camera. We determined the optimal wavelength and the cut-off value for differentiating tumors from normal mucosa to establish a diagnostic algorithm. We also attempted to highlight tumors by image processing using the hyperspectral camera's analysis software. A wavelength of 770 nm and a cut-off value of 1/4 the corrected SR were selected as the respective optimal wavelength and cut-off values. The rates of sensitivity, specificity, and accuracy of the algorithm's diagnostic capability were 71%, 98%, and 85%, respectively. It was possible to enhance tumors by image processing at the 770-nm wavelength. HSI can be used to measure the SR in gastric tumors and to differentiate between tumorous and normal mucosa.

Gastritis crónica antral por Helicobacter pylori en pacientes con y sin consumo de antiinflamatorios no esteroideos / Chronic Antral Gastritis by Helicobacter pylori in Patients on under Treatment or Not with Nonsteroidal anti-inflammatory Drugs

Introducción: la infección por Helicobacter pylori y la ingestión de antiinflamatorios no esteroideos (AINEs) constituyen los dos factores de riesgo independientes más importantes involucrados en la etiopatogenia del daño de la mucosa gastroduodenal. Una posible interacción entre ellos que influencie la magnitud de la gastritis crónica antral, es un tema controversial.Objetivo: estimar el comportamiento histopatológico de la gastritis crónica antral por Helicobacter Pylori asociado o no al consumo de antiinflamatorios no esteroideos.Método: estudio caso control, se tomó como universo los 282 pacientes con panendoscopia y biopsia gástrica antral realizadas en el Hospital Vladimir I. Lenin, entre febrero de 2008 e igual mes de 2009. Se seleccionó una muestra de 91 pacientes con diagnóstico histopatológico de gastritis crónica antral por Helicobacter pylori. De ellos, 32 consumidores de AINES (grupo estudio) y 59 no consumidores (grupo control).Resultados: el 81,25 por ciento del grupo estudio presentaron gastritis crónica activa, aunque con predominio en el grupo control (Z=2,085; p<0,05). El 59,37 por ciento del grupo estudio presentó severidad de lesión ligera con una proporción significativamente mayor de severidad de lesión moderada-severa en el control (Z=4,568; p<0,001). La densidad moderada-abundante se observó en 53,13 por ciento del grupo estudio sin diferencia significativa con el control (Z=0,889; P›0,05).Conclusiones: el predominio de la actividad y la severidad de la lesión moderada-severa de la gastritis crónica antral por Helicobacter pylori en los pacientes no consumidores de AINES pudiera deberse a hipotéticas acciones tanto inhibitoria de la actividad inflamatoria como protectora de la mucosa gástrica de los AINES. El consumo de AINES no parece ejercer una influencia significativa sobre la densidad de colonización(AU)

Introduction: Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are two independent risks factors mostly involved in the etio-pathogenesis of gastrointestinal mucosal damage. A possible interaction between them, influencing the magnitude of the chronic antral gastritis, is controversial.Objective: to estimate histopathological aspects of chronic antral gastritis due to Helicobacter pylori, either in association or not with nonsteroidal anti-inflammatory drugs consumption. Method: a case-control study in which the universe was conformed by 282 patients on whom an endoscopic antral biopsy was performed. It took place at Vladimir I. Lenin Hospital, from February 2008 to February 2009. Ninety one patients with histological diagnosis of Helicobacter pylori chronic antral gastritis constituted the sample of the study, 32 of them were non-steroidal anti-inflammatory drugs users (study group), and 59 were not (controls). Results: although 81.25 percent in the study group had chronic active gastritis, this was prevalent in controls (Z=2.085; p<0.05). 59.37 percent of the study group showed mild severity inflammation, with a statistically significant greater proportion of moderate to severe lesions in controls (Z=4.568; p<0.001). Moderate to high Helicobacter density was observed in 53.13 percent of the study group, with no significant differences with respect to controls (Z=0.889; p>0,05). Conclusions: the prevalence of the activity and moderate to severe inflammation in antral chronic gastritis due to Helicobacter pylori in non-consumers of non-steroidal anti-inflammatory drugs might be hypothetically attributed to both the anti-inflammatory action as well as a protective effect of the gastric mucosa exerted by non-steroidal anti-inflammatory drugs in patients taking these drugs. The colonization density does not appear to be significantly influenced by these drugs(AU)

Anatomical study of the gastrointestinal tract in free-living axis deer (Axis axis).

The macroscopic anatomy of the stomach and intestines of adult axis deer (Axis axis), a cervid species considered intermediate/mixed feeder, was observed and recorded. Nine adult wild axis deers of both sexes were used and studied by simple dissection. The ruminal papillae were distributed unevenly in the overall area of the inner surface of rumen and primarily were more large and abundant within the atrium. The ruminal pillars had no papillae. There was an additional ruminal pillar located between the right longitudinal and right coronary ventral pillars connected to the caudal pillar. No dorsal coronary pillars were found, and the ventral coronary pillars are connected. The reticulum was the third compartment in size, and the maximum height of the reticular crests was 1.0 mm. The Cellulae reticuli were not divided and rarely contained secondary crests. There were no Papillae unguiculiformes. The omasum was the smallest gastric compartment. The abomasum had about twelve spiral plicae, and a small pyloric torus was present. The intraruminal papillation was similar to those species that are characterized by a higher proportion of grass in their natural diet. The finding of the small reticular crests is typical for browser ruminants and was coincident with data reported for other deer. The comparative ratio of the small intestine to the large intestine was 1.69, in terms of length measurements in axis deer and appears below of the 'browser range'. We concluded that the gastrointestinal system of axis deer reflected similar morphological characteristics of the both types of ruminants: browser and grazer, and we consider it as an intermediate feeder.

In vivo histologically equivalent evaluation of gastric mucosal topologic morphology in dogs by using confocal endomicroscopy.

BACKGROUND: Confocal endomicroscopy (CEM) is an endoscopic technology permitting in vivo cellular and subcellular imaging. CEM aids real-time clinical assessment and diagnosis of various gastrointestinal diseases in people. CEM allows in vivo characterization of small intestinal mucosal morphology in dogs. OBJECTIVE: To determine the feasibility of CEM to evaluate gastric mucosal morphology in dogs and to characterize the appearance in healthy dogs. ANIMALS: Fourteen clinically healthy research colony dogs. METHODS: Experimental study. Under general anesthesia, dogs underwent standard endoscopic evaluation and CEM of the gastric mucosa. In the initial 6 dogs, fluorescent contrast was provided with the fluorophore acriflavine (0.05% solution), applied topically. Subsequently, 8 dogs were assessed using a combination of fluorescein (10% solution, 15 mg/kg IV), followed by acriflavine administered topically. For each fluorophore, a minimum of 5 sites were assessed. RESULTS: Confocal endomicroscopy provided high quality in vivo histologically equivalent images of the gastric mucosa, but reduced flexibility of the endoscope tip limited imaging of the cranial stomach in some dogs. Intravenous administration of fluorescein allowed assessment of cellular cytoplasmic and microvasculature features. Topical application of acriflavine preferentially stained cellular nucleic acids, allowing additional evaluation of nuclear morphology. Identification of Helicobacter-like organisms was possible in 13 dogs. CONCLUSION AND CLINICAL IMPORTANCE: Confocal endomicroscopy provides in vivo images allowing assessment of gastric mucosal morphology during endoscopy, potentially permitting real-time diagnosis of gastrointestinal disease.

Alterations of the gastric stump and not resected stomach mucosa after truncal vagotomy in rats

To evaluate morphological changes of the gastric stump and not resected stomach mucosa after the completion of truncal vagotomy. METHODS: Eighty male Wistar rats were divided into four groups: CT, TV, RY and RYTV. In CT group, abdominal viscera were manipulated and the abdominal cavity was closed, in TV vagal trunks were isolated and sectioned, in RY a partial Roux-en-Y gastrectomy was performed and in RYTV the vagal trunks were sectioned and a partial Roux-en-Y gastrectomy was performed. At the 54th week after surgery, the rats were euthanized. The findings were submitted to histological analyses. RESULTS: None macroscopic or histological alterations in groups TV and CT was observed. Specimens from RY and RYTV groups did not show alterations in the gastric stump mucosa. At the jejunal side of the gastroenterostomy we found shallow ulcerative lesions always single, well-defined and with variable diameter 3 to 6 mm, six times in the RY group and none in the RYTV group (RY>RYTV, p=0.008). Neoplastic or preneoplastic lesions were not diagnosed in all groups. CONCLUSION: Truncal vagotomy is a safe and non-carcinogenic method in not resected and partially resected stomach.