Helicobacter pylori and intestinal metaplasia

Gastric carcinoma of the intestinal type is assumed to develop from precancerous gastric lesions. It is now widely accepted that Helicobacter pylori (HP) infection causes chronic gastritis and, after a period of time, intestinal metaplasia (IM). It was suggested that these gastric lesions may evolve into gastric carcinoma after a lengthy latency period. HP seropositivity is high in Turkey at early ages. This may explain the high incidence of gastric carcinoma in this geographic region. In this study, we examine the relationship between HP and IM in endoscopic gastric biopsy specimens. We examined 840 biopsies taken from 210 patients. HP positivity and the presence of IM were examined in these specimens by histopathologic methods. HP positivity was also determined by CLO testing. HP was positive in 156 of the 210 patients examined (74.3%). The distribution of HP seropositivity did not differ between age groups (p > 0.05). IM was present in 101 patients in the entire study group (48%). Among the 156 HP-positive patients, the rate of IM was 44.8% (n = 70). The rate of IM among the 54 HP-negative patients was 57.4% (n = 31), which was not statistically significant (p > 0.05). IM positivity has been shown to increase in older age, which was statistically significant (p < 0.001). We were not able to show a relationship between HP seropositivity and IM. Increased HP seropositivity at an early age is a common risk factor in our population. We must consider other factors that may contribute to the increased rate of IM in older age groups.     

Gallbladder volvulus with gangrene. Case report and review of the literature

A total of 126 cases of primary adenocarcinoma of distal (antrum and/or adjacent body) stomach were reviewed. These cases were collected from the histopathology laboratory of Asir Central Hospital, Southwestern Saudi Arabia over an 8 year period (1987-94). Only gastrectomy specimens with non-neoplastic antral mucosa available for histological examination were included. Of 126 cases, 85 (67.5%) were of the intestinal type and 41 (32.5%) were of the diffuse type. Histological examination of the non-neoplastic antral mucosa showed: gastritis in 100% of these cases; Helicobacter pylori in 103/126 cases (81.8%); multifocal atrophic gastritis (MAG) in 53/126 cases (42.1%); intestinal metaplasia (IM) in 62/126 (49.2%); and type III intestinal metaplasia in 30/62 cases (47.7%). None of these non-neoplastic changes of antral mucosa was significantly different when the prevalence of these changes in intestinal and diffuse type gastric adenocarcinoma were compared using the chi 2 test. The prevalence of these non-neoplastic lesions were calculated in a 126 dyspeptic age- and sex-matched control patients and were as follows: H. pylori 91%; gastritis 78%; MAG 7.4%; IM 19% and type III IM 1.6%. The prevalence of H. pylori bacilli and gastritis was not significantly different between the cancer patients and the controls. The prevalence of MAG, IM and type III IM was significantly higher among cancer patients compared with the control group.     

Upper digestive tract dyspepsia and early gastric cancer

AIM: The study of the frequency and evolution of upper digestive tract dyspepsia in a group of patients operated for early gastric cancer (EGC) and to perform a strategy of diagnosis for the patients with long term upper digestive tract dyspepsia. METHODS: Clinical data of 35 patients operated for EGC were retrospectively evaluated. The frequency, characteristics and evolution time of upper digestive tract dyspepsia, main when it began more than 6 months before surgery, were analyzed. Radiologic and endoscopic exams carried out for diagnosis were also evaluated. Histological diagnosis of surgical specimens were considered, looking for the presence of chronic atrophic gastritis, intestinal metaplasia, and peptic gastric ulcer. RESULTS: Long-term upper digestive tract dyspepsia was present in 27 patients (mean evolution time of 43.4 months). Clinical changes of previous symptoms that suggested gastric carcinoma were not found in 15 patients. Concurrent peptic gastric carcinoma were not found in 15 patients. Concurrent peptic gastric ulcer along with EGC was diagnosed by histology in 11 patients, and chronic atrophic gastritis and intestinal metaplasia were both present in the non-tumoral gastric mucosa in all cases. CONCLUSIONS: 1) Unspecific upper digestive tract dyspepsia is frequently found in patients with EGC. 2) Endoscopy should be the first exam performed in patients with upper digestive tract dyspepsia. 3) The patients with gastric ulcer, chronic atrophic gastritis or intestinal metaplasia must be submitted to sequential endoscopic follow-up.     

Synthetic implants in the reconstruction of the ossicular chain

OBJECTIVE: To determine whether there is a relationship between overexpression of c-met oncoprotein and stage of human gastric mucosal lesions, and its significance. METHOD: Immunohistochemical staining was used in 157 cases of endoscopic biopsies with c-met monoclonal antibody, S-19, which was raised against the human c-met gene product. RESULTS: overexpresion of c-met oncoprotein was detected in 3/30 cases (10%) of superficial gastritis, 4/33 cases (12.1%) of chronic atrophic gastritis, 10/31 cases (32.3%) of intestinal mataplasia, 10/30 cases (33.3%) of dysplasia, and 10/30 cases (33.3%) of gastric carcinoma. The positive staining rate was higher in intestinal mataplasia (54.8%), dysplasia (56.7%), carcinoma (53.3%) than in two kinds of simple chronic gastritis (P < 0.05). The positive staining was obviously located in luminal membrane of mucosal cells. The positive cells were mainly situated in proliferative cell zone of gastric glands. Moreover, the weak staining only in this zone was shown in two of the three normal mucosa. CONCLUSIONS: The overexpression of c-met may be involved in proliferation of gastric mucosa. It is possible that persistent overexpression of c-met oncoprotein is associated with the malignant transformation of gastric mucosal cells.     

钴冰镍常压浸出工艺研究

以镍转炉渣还原硫化熔炼得到的钴冰镍为原料,在常压下于硫酸体系中进行浸出,考察了硫酸浓度、液固比、浸出时间及浸出温度对钴冰镍中有价成分浸出率的影响。结果表明,液固比和硫酸浓度对钴、镍、铁的浸出率影响较大。当硫酸浓度为1.6mol/L、液固比5、浸出时间2.5h、浸出温度85℃时,铁浸出率达到69%,镍、钴浸出率分别控制在1%和5%以内,取得了很好的选择性浸出效果。     

酸析法结晶钴铜矿浸出反萃液中的硫酸铜

采用酸析法结晶钴铜矿浸出反萃液中硫酸铜。结果表明,沉淀3h,结晶率可达第一个最大值80%左右,沉淀5h,结晶率下降至70%左右,此后随着反应时间的增加,结晶率增加;结晶过程随着溶液温度的降低,结晶率上升;结晶过程随着硫酸用量的增加,结晶率先升高后降低;结晶过程随着铜反萃液中Cu~(2+)浓度的增加,结晶率增加。最佳工艺条件为:室温、每100mL铜反萃液中加入30mL硫酸、沉淀3h,结晶率超过80%。结晶母液可循环利用,不会带来环境污染。     

Gastric emptying time with 99mTc-resin solid experiment meal

Half gastric emptying time (GET1/2) was measured by using radionuclide gamma-photography with 99mTc-resin solid experiment meal. The results were as follows: 1. GET1/2 in the normal controls (10 cases) was 51.62 +/- 3.69 minutes. 2. GET1/2 in mild chronic atrophic gastritis (CAG) patients was 51.68 +/- 9.20 Min, not significantly different with the normal controls (P > 0.05). GET1/2 in 15 cases with moderate and severe CAG was 70.39 +/- 14.86 Min, which was apparently longer than that in normal controls (P < 0.01). 3. There was no significant difference in GET1/2 between carcinoma of the gastric corpus, fundus and cardia (50.77 +/- 2.73 Min) as well as the normal controls (P > 0.05). GET1/2 of the cancer of gastric antrum was 89.06 +/- 19.55 Min, being longer than that in normal controls (P < 0.01). 4. No obvious difference was observed between the GET1/2 of patients with corpus and fundus peptic ulcer (55.36 +/- 6.80 Min.) and the normal controls (P > 0.05). It was apparently longer in patients with antral peptic ulcer (76.62 +/- 16.96 Min.) than in patients with ulcers of corpus, fundus and normal controls (P < 0.01). 5. GET1/2 in patients with duodenal ulcer (42.49 +/- 6.26 Min.) was apparently shorter than those with gastric ulcer and normal controls. 6. GET1/2 in diabetic patients was 70.01 +/- 29, 46 Min, it was obviously longer in those patients with autonomic nervous dysfunction (84.03 +/- 22.31 Min.) than that those without (34.14 +/- 7.90 Min.).(ABSTRACT TRUNCATED AT 250 WORDS)     

Gastric acid secretion in chronic atrophic gastritis and chronic (superficial) gastritis

Basal and pentagastrin-stimulated peak acid outputs were determined in 21 subjects with chronic atrophic gastritis and 10 subjects with chronic superficial gastritis. All subjects were Caucasian. The histological diagnosis was based on multiple gastric biopsy specimens obtained through a fibregastroscope. Comparison of the results with those of a previously reported Caucasian control group show that the mean basal acid outputs of subjects with chronic (superficial) gastritis were significantly higher than that of controls and subjects with chronic atrophic gastritis. No significant difference was found in the mean peak acid outputs of controls and subjects with chronic atrophic gastritis or chronic (superficial) gastritis.     

Surgical treatment of metastatic lung tumors

To evaluate an association between Helicobacter pylori (H. pylori) infection and chronic atrophic gastritis (CAG), an established precursor of gastric cancer, we performed a cross-sectional study using IgG antibody against H. pylori and pepsinogens of blood donors in four prefectures in Japan. Although a geographic correlation between the age-adjusted prevalence rates for H. pylori infection and those for CAG was not seen, the age-adjusted odds ratios (OR) of H. pylori infection for CAG were high in each area (around five for men and from four to 12.6 for women). The association between them weakened with advancing age; the ORs in the youngest age group (16-29 yrs) and in the oldest age group (50-64 yrs) were 12.5 and 2.8 for men, and 11.5 and 5.2 for women, respectively. These findings suggest that H. pylori infection is strongly associated with CAG, while there are some other factors interacting in the development of CAG. A prospective cohort study in which CAG and H. pylori infection are taken into account will be necessary to assess the risks of gastric cancer.     

石煤中钒酸浸出工艺研究

通过对陕西某地石煤钒矿的物相和化学成分分析, 依据矿物的特点确定用H_2SO_4溶液作为浸出剂从石煤钒矿中浸出钒. 实验主要研究了H_2SO_4浓度、浸出温度、液固比、浸出时间对石煤钒矿中钒的浸出率的影响. 结果表明, 在一定范围内钒的浸出率随H_2SO_4浓度及浸出温度的升高、浸出时间的延长而提高; 得出的较优条件为H_2SO_4浓度6.0 mol·L~(-1)、浸出温度95 ℃、液固比为3∶ 1、浸出时间5 h, 可以使钒的浸出率达到93.83%.     

A novel gastric-cancer-associated mucin antigen defined by a monoclonal antibody A3D4

De-glycosylation of mucins may expose new tumor-associated core protein epitopes. In this study, to attempt to develop useful markers for gastric cancers, we have purified and de-glycosylated gastric mucin and tried to establish monoclonal antibodies (MAbs). A MAb designated A3D4 among established MAbs was shown to react with gastric cancer with high frequency, but not with normal gastric epithelium. Among normal digestive organs, only the colon and gall bladder were positive for MAb A3D4. The incidence of positivity in gastric cancer was 75% for intestinal-type adenocarcinoma (n = 28), 40% for solid-type adenocarcinoma (n = 5) and 33% for signet/scirrhous-type adenocarcinoma (n = 15). Interestingly, adenoma and intestinal metaplasia (IM) with chronic gastritis or peptic ulcer were negative for MAb A3D4, whereas 8 out of 13 cases (62%) of IM with gastric cancer was positive. Western-blot analysis using the lysate from normal colon tissues revealed a high-molecular-weight (> 300-kDa) smear-like band. Immunohistochemical analysis indicated that the reactivity of MAb A3D4 was clearly increased when tissue sections were pre-treated with periodic acid or O-glycanase, while it was decreased by pre-treatment with trypsin or protease V8. There was no reactivity with the synthetic peptide encompassing the tandem-repeat sequence of MUC2 or MUC3. These data suggest that MAb A3D4 detects a novel gastric-cancer-associated mucin antigen whose epitope may be peptide in nature.     

Appendicular skeletal muscle mass: prediction from multiple frequency segmental bioimpedance analysis

The presence of Helicobacter pylori (H. pylori) in the stomach is closely associated with histological signs of chronic active gastritis and peptic ulcer. Another spiral organism named Gastrospirillum hominis (G. hominis) has led to further interest in the bacterial pathogenesis of gastritis. Due to the low prevalence of G. hominis, it is difficult to evaluate its biological behavior. Recently 16 cases of G. hominis-associated gastritis were found in 257 Thai individuals, which made it possible to study the biological characteristics of G. hominis and its relationship with gastric mucosal inflammation. The results showed that H. pylori and G. hominis could be easily observed in the lower third of the mucous layer and in the mucosa of the gastric pits by means of toluidine blue staining. Both bacteria immunostained positive. Helicobacter pylori were usually in the shape of curved bacillary while G. hominis often appeared in spiral configuration. In 257 cases of Thai subjects, 169 cases were found to be H. pylori positive, the detection rate was 65.7%, and 16 cases were G. hominis positive, with a 6.2% detection rate. In G. hominis infection, 43.6% of cases had normal gastric mucosa. Superficial, erosive and atrophic gastritis cases were 13.2, 10.9 and 12.5%, respectively. Mucosal inflammation was usually severe in H. pylori, but neutrophil polymorph infiltration was often mild and focal in G. hominis infection. Although no G. hominis infection with carcinoma was shown in our cases, the occurrence of mucosal atrophy, metaplasia and dysplasia was higher in both bacterial infections compared with H. pylori- and G. hominis-negative cases. It is suggested that G. hominis may be partly responsible for the mucosal inflammation and some malignant-associated lesions.     

Influence of Helicobacter pylori on gastric secretion. Study on variously associated gastric body, fundus and antrum chronic gastritis

Among the various themes related to Helicobacter pylori (HP) which is still a subject of discussion, there is the possible influence of this bacterium on gastric secretory physiology. In the present study, an evaluation has been carried out of stimulated gastrinemia, stimulated acid secretion and total peptic activity in gastric juice in the course of a paradigmatic condition, as autonomous chronic gastritis, in order to reveal possible modifications induced by the HP infection. In cases of HP positive chronic superficial antral gastritis associated either with normal body-fundic mucosa or with superficial gastritis, there is a significant increase of stimulated gastrinemia in comparison to HP negative groups and controls. In the course of body-fundic atrophic and preatrophic chronic gastritis associated either with antral superficial chronic gastritis or with antral atrophic gastritis, there are no statistically significant differences between HP positive and HP negative subjects. As regards acid and pepsin secretion no significant differences emerge in any group between HP positive and HP negative subjects. In the HP positive subjects with antral superficial gastritis and higher gastrin values the study of acid and pepsin secretion has yielded no significant variations. From the results of this study it emerges how gastric secretory parameters vary exclusively according to the histologic state of gastric mucosa. Therefore, the lesion action of HP may mainly be attributed to a direct action, rather than to substantial gastric secretory changes.     

核桃壳还原浸出软锰矿的动力学

探究以核桃壳为还原剂硫酸浸出氧化锰矿过程的动力学。考察了搅拌速度、反应温度、硫酸浓度、反应时间以及核桃壳用量对锰浸出率的影响。结果表明,锰的浸出率随着搅拌速度、硫酸浓度、核桃壳用量的增大和温度的升高而增大。浸出前60 min浸出率的增长速度较快。在反应温度为369 K、硫酸浓度3.5 mol/L、核桃壳加入量40 g/L、反应时间2.5 h、转速200 r/min时,锰浸出率达93.18%。浸出过程属于化学反应控制,对应的活化能为45.5 kJ/mol,硫酸浓度和核桃壳用量的反应级数分别为0.897、0.2。     

Minimal chronic inactive gastritis: indicator of pre-existing helicobacter pylori gastritis?

Minimal chronic inactive gastritis is regularly observed in routine histopathology. Presently, it is not clear whether this type of gastritis should be regarded as a histopathological entity or a normal variant. The similarity to lesions observed after H.pylori eradication prompted us to look for an association between minimal chronic inactive gastritis and status post H.pylori eradication. In a prospective study of 110 consecutive patients undergoing upper gastrointestinal endoscopy, at least two mucosal biopsies were taken from the gastric antrum and body. Gastritis was classified according to the Sydney System. Antibodies to H.pylori were determined serologically by immunofluorescence test, ELISA, and complement binding reaction. A status post eradication of H.pylori was revealed by medical history and/or positive serology; H.pylori gastritis was found in 39.1%, reactive gastritis in 12.7%, and minimal chronic inactive gastritis in 29.1%. In 19.1% a combination of reactive/ minimal chronic gastritis was diagnosed according to morphology. Status post eradication was observed significantly more often in cases with minimal chronic inactive gastritis (43.8%) than in cases with reactive gastritis (7.1%, p < 0.004). Furthermore, positive ELISA and/or status after eradication was found in 50% of the cases with minimal chronic inactive gastritis (p < 0.005 vs reactive gastritis), in 42.9% of the cases with mixed reactive/chronic inactive gastritis (p < 0.03 vs reactive gastritis), and in 7.1% of the cases with reactive gastritis. Lymphoid aggregates, considered another sign of former H.pylori presence, were found significantly more often in minimal chronic inactive gastritis than in reactive gastritis (50% versus 7.1%, p < 0.005). Minimal chronic inactive gastritis is significantly associated with both positive H.pylori serology and status post eradication and is, therefore, an indicator of pre-existing H.pylori gastritis.     

Cytotoxin genes of Helicobacter pylori in chronic gastritis, gastroduodenal ulcer and gastric cancer: an age and gender matched case-control study

Helicobacter pylori (H. pylori) infection is involved in many gastrointestinal diseases, such as chronic gastritis (CAG), peptic ulcer and gastric cancer (GCA). Both host factors and H. pylori strain differences may contribute to differences in the diseases. Thus, we conducted an age and gender matched case-control study of 35 patients each with CAG, gastric ulcer (GUL), duodenal ulcer (DUL) and gastric cancer (GCA) to examine the role of strain differences of the H. pylori cytotoxin genes cagA and vacA in these diseases. We employed polymerase chain reaction to examine the gastric juice for H. pylori DNA. The test was positive for 26 (74.3%) CAG, 29 (82.9%) GUL, 28 (80.0%) DUL and 27 (77.1%) GCA patients, showing no statistically significant difference among the diseases (P = 0.84). cagA and vacA genes (picked up by using a vacA1 + vacA2 primer pair which detected non-variable regions of the vacA gene) were detected by PCR in the H. pylori DNA-positive cases as follows: CAG, 92.3% and 76.9%; GUL, 100% and 86.2%; DUL, 89.3% and 89.3%; GCA, 92.6% and 85.2%, respectively. No statistically significant differences were found in the frequencies of these cytotoxin genes in H. pylori-positive cases among the various gastric diseases (P = 0.39 for cagA and P = 0.64 for vacA).     

CAG方案治疗低增生性急性髓系白血病29例

目的 观察CAG方案治疗低增生性急性髓系白血病(AML)的临床疗效.方法 对29例低增生性AML患者采用CAG方案,阿柔比星(Acla)14 mg/m2,第1天至第4天,静脉注射;阿糖胞苷(Ara-C)10 mg/m2,第1天至第14天,每12 h皮下注射;粒细胞集落刺激因子(G-CSF)200μg/m2,第1天至第14天,皮下注射,并于第1次注射Ara-C之前12 h开始使用,最后一次注射Ara-C前12 h停用;当中性粒细胞＞10×109/L时,暂时减少或停用G-CSF.结果 29例患者中完全缓解(CR)14例(48.3%),部分缓解(PR)7例(24.1%),总有效率72.4%,治疗失败(NR)7例,早期死亡1例.结论 CAG方案治疗低增生性AML安全有效,可有效缩短外周血粒细胞减少的时间,降低化疗相关死亡率.     

Pathogenesis and clinics of gastric stump carcinoma (author's transl)

Statistics of postmortem examinations and retrospective long-term observations indicate a disposition of the resected stomach for the development of a primary carcinoma. The risk to develop a carcinoma after resection for peptic ulcer shows a two- to three-fold increase compared to gastric cancer mortality of the normal population. Because of the lack of typical symptoms for gastric stump cancer surgical treatment will occur late and the 5-years survival rate is only 1.38%. The cause of the increased cancer risk after gastric resection seems to be the atrophic gastritis in the gastric remnant which is found after a few years.     

酸度及酸化介质对铀矿石微生物浸出酸化的影响

通过室内柱浸试验,研究了溶浸液加入硫酸的浓度和酸化介质类型对铀矿石生物浸出酸化阶段的影响。结果表明,当初始硫酸浓度相同时,尾液比清水酸化时间短、耗酸率低,两者浸铀率相差不大,尾液比清水的累计净铁浸出量小,但后期差值逐渐缩小。尾液介质酸化时,随着初始酸度的增大,酸化时间缩短,累计净铁浸出量增加,但耗酸率增高,累计铀浸出率增大。合适的方案为酸化阶段采用尾液介质、40g/L初始硫酸浓度酸化。     

低品位氧化锌矿石铁还原度对硫酸浸出锌的影响

研究了低品位氧化锌矿石的微波还原焙烧—硫酸浸出锌,考察了微波功率、活性炭粉加入量和微波加热时间对矿石中铁还原度及铁还原度对锌、铁浸出率的影响。结果表明:低品位氧化锌矿中铁的还原度随微波功率、活性炭粉加入量和加热时间的增大而增大,锌浸出率随铁还原度的增大而升高;铁还原度控制在60%以下,用质量浓度为80g/L的硫酸溶液浸出,锌浸出率为85.36%,铁浸出率为33.75%。