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 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The rate of gastric epithelial cell proliferation was studied in healthy volunteers and in patients with different degrees of gastritis. Endoscopic biopsies from the antral and fundic part of the stomach were incubated in vitro with 3H-thymidine for 30, 120, and 210 minutes respectively. Autoradiographs were prepared, and the percentage of DNA-synthesizing cells (labeling index) in the progenitor cell region was estimated. From the successive labeling indices the rate of entry of cells into DNA-synthetic phase (S-phase) and the duration of the S-phase could be estimated. All the biopsies were classified according to the degree of gastritis. The mean (+/-SEM) length of the S-phase was found to be 7.4 +/- 0.3 hours in antral mucosa and 7.2 +/- 0.4 hours in fundic mucosa. There was no significant difference between the S-phase duration in normal mucosa, superficial gastritis, mild atrophic gastritis and severe atrophic gastritis. This observation suggests that the labeling index can be used as an expression for the rate of cell proliferation in human gastric mucosa. A significant correlation between the labelling indices and the degree of gastritis was found in both antral and fundic mucosa. In six cases, labelling indices estimated by cell counts performed on longitudinal or cross sections of foveolae were compared. Ther was no significant difference between the results obtained by the two different counting techniques.
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PMID:Cell proliferation in normal and diseased gastric mucosa. Autoradiography after in vitro continuous labelling with tritiated thymidine. 46 68

The IgG subclass response is determined by the type of bacteria producing the infection and by genetic factors of the host. Patients with a Helicobacter pylori infection develop a specific immune response that is mainly of the IgA and IgG class. We measured the IgG subclass response in 20 patients with chronic active gastritis without a history of duodenal ulcer and 20 patients with chronic active gastritis and duodenal ulcer diagnosed by endoscopy and histology. A control group included 20 H. pylori-negative patients and 60 H. pylori-positive blood transfusion donors. Systemic IgG subclass response was measured with a modified enzyme-linked immunosorbent assay technique, using as antigen a sonicate of six different H. pylori strains. Mouse monoclonal antibodies against each of the four human IgG subclasses (IgG1, IgG2, IgG3, and IgG4) were used. The total IgG anti-H. pylori antibody titres were equal in all three H. pylori-positive groups and significantly different from that of the negative control group (p less than 0.01). The IgG subclass response in persons infected with H. pylori involved all four subclasses but was predominantly of the IgG1 and IgG2 subclasses. All of the groups with H. pylori infection had significantly higher levels of IgG1 than the negative control group, but no differences were detected among the three groups. However, the duodenal ulcer group had a significantly higher IgG2 response than the gastritis group (mean optical density +/- SEM, 0.382 +/- 0.047 versus 0.200 +/- 0.025, respectively; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:IgG subclass response to Helicobacter pylori in patients with chronic active gastritis and duodenal ulcer. 156 26

Luminal and mucosal pH were measured endoscopically in patients with reflux esophagitis and antral gastritis and in control subjects. In all subjects, significant lumen-to-mucosa gradients were observed in the esophagus, stomach and acidified proximal duodenum. In the reflux patients luminal pH was lower in the fundus (mean +/- SEM, control vs. reflux esophagitis: 2.01 +/- 0.17 vs. 1.32 +/- 0.18; p less than 0.02) and antrum (3.51 +/- 0.35 vs. 2.13 +/- 0.24; p less than 0.01) and, in the gastritis patients, in the fundus (2.01 +/- 0.17 vs. 1.3 +/- 0.17; p less than 0.02). In both patient groups, mucosal pH was lower in the fundus (control vs. reflux vs. gastritis: 4.84 +/- 0.37 vs. 3.37 +/- 0.61 vs. 3.12 +/- 0.6; p less than 0.05) and acidified duodenal cap (6.74 +/- 0.13 vs. 6.09 +/- 0.24 vs. 5.73 +/- 0.46; p less than 0.03). Mucosal pH profiles at the various sites showed less resistance of the gradient to a highly acidic environment in both the lower esophagus and antrum than in fundus and duodenum, and this was the case in the patient and control groups. Though associated with a more acid environment, neither esophagitis nor antral gastritis exhibits a specific deficit in the 'mucus-bicarbonate barrier', suggesting that the pathogenesis of these disorders may depend more on abnormal 'attack' rather than impaired defense.
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PMID:Studies of luminal and mucosal pH in reflux esophagitis and antral gastritis. 161 9

A prospective multifactorial study of symptoms and disturbance of gastrointestinal function has been undertaken in 50 patients with non-ulcer dyspepsia. Objective tests including solid meal gastric emptying studies, gastric acid secretion, E-HIDA scintiscan for enterogastric bile reflux, and hydrogen breath studies were carried out in all patients and validated against control data. Gastroscopy and biopsy were carried out in non-ulcer dyspepsia patients only. Non-ulcer dyspepsia patients were categorised on the basis of predominant symptoms as: dysmotility-like dyspepsia (n = 22); essential dyspepsia (n = 14), gastro-oesophageal reflux-like dyspepsia (n = 11); and ulcer-like dyspepsia (n = 3). In the total non-ulcer dyspepsia population, solid meal gastric emptying was delayed (T50 mean (SEM) = 102 (6) minutes (patients) v 64 (6) minutes (controls), (p less than 0.01) and high incidences of gastritis (n = 26) and Helicobacter pyloridis infection (n = 18) were found. An inverse correlation was observed between solid meal gastric emptying and fasting peak acid output (r = -0.4; p less than 0.01). Indeed gastric emptying was particularly prolonged in eight patients (T50 mean (SEM) = 139 (15) minutes) with hypochlorhydria. In the non-ulcer dyspepsia population oral to caecal transit time of a solid meal was delayed (mean SEM = 302 (14) minutes (patients) v 244 (12) minutes (controls) (p less than 0.01]. Seven patients had a dual peak of breath hydrogen suggestive of small bowel bacterial overgrowth. No association was observed between symptoms and any of the objective abnormalities. This multifactorial study has shown that hypomotility, including gastroparesis and delayed small bowel transit, is common in non-ulcer dyspepsia and may be related to other disorders of gastrointestinal function. No relation between symptoms and disorders of function, however, has been shown.
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PMID:Evidence for hypomotility in non-ulcer dyspepsia: a prospective multifactorial study. 201 18

Symptoms of severe nausea, vomiting, abdominal pain, and frequent bezoars, as well as objective gastric retention, can occur following Roux-Y biliary diversion for alkaline reflux gastritis. Medical therapy and prokinetic drugs have proven ineffective. This review evaluates 37 patients who underwent further gastric resection from 1979 to 1987 to improve gastric emptying and resolve symptoms. Fifteen patients underwent perioperative radionuclide solid-food gastric emptying studies. Seventy-three per cent (27 of 37 patients) of the patients who underwent further gastric resection (70% to 95%) had a satisfactory postoperative response. Twenty patients were graded Visick 1 or 2 and 7 Visick-3 patients, although much improved, still had some symptoms of gastroparesis. Twenty-seven per cent (10 of 37 patients) failed to improve and underwent completion total gastrectomy. Overall, 70% of this group had almost complete resolution of their symptoms. Three of 10 patients were considered "failures" due to postprandial pain in 1 and early vasomotor dumping in 2. Of the 10 patients who failed initial revisional surgery, 7 underwent a 70% to 80% subtotal gastric resection (STG) and 3 patients underwent 85% to 95% extensive resection (EXT.G.). Of the 15 patients who underwent perioperative radionuclide evaluation, a mean two-hour gastric retention of 61.4% +/- 4% (SEM) decreased to 25% +/- 4% following further gastric resection. Eight patients were in the STG group and seven patients were in the EXT.G group. Following STG, mean two-hour gastric retention of 58.2% +/- 3.5% decreased to 38% +/- 3% (p less than 0.05). In seven patients who underwent EXT.G, mean two-hour retention of 65% +/- 4% decreased to 10% +/- 2.5% (p less than 0.005). EXT.G resulted in normal gastric emptying and few late failures. In post-Roux-Y patients with symptoms of gastroparesis and documented gastric retention, EXT.G normalizes gastric emptying and restores a better quality of life. Total gastrectomy should be reserved for those patients who are failed by more extensive resection.
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PMID:The surgical treatment of chronic gastric atony following Roux-Y diversion for alkaline reflux gastritis. 273 Jan 85

Single biopsies of human gastric mucosa from controls and different groups of patients were used for enzymatic cell isolation by pronase and collagenase and subsequent count of parietal and nonparietal cells. This procedure was tested in regard to its validity and delivered the following cell numbers. Total gastric cells/mg wet weight gastric mucosa: normal gastric mucosa [controls (C), n = 95] 31,500 +/- (SEM) 1,490, chronic superficial gastritis (GI; n = 49) 36,300 +/- 2,770, chronic gastritis with beginning atrophy (GII; n = 36) 44,100 +/- 3,050 (p less than 0.025), chronic atrophic gastritis (GIII; n = 12) 40,100 +/- 5,760, duodenal ulcer (DU; n = 26) 29,340 +/- 2,280, gastric ulcer (GU; n = 23) 37,090 +/- 3,000, gastric resection according to Billroth I (BI; n = 7) 57,480 +/- 12,360 (p less than 0.005) and Billroth II (BII; n = 12) 52,560 +/- 6,730 (p less than 0.005). Parietal cells/mg wet weight gastric mucosa: 1,910 +/- 490 (C), 1,980 +/- 140 (GI), 1,700 +/- 200 (GII), 1,170 +/- 220 (GIII, p less than 0.025), 2,580 +/- 240 (DU, p less than 0.05), 1,690 +/- 150 (GU), 1,500 +/- 250 (BI), 1,360 +/- 320 (BII). Parietal cell concentration (density) did not differ in males and females and did not change with age. The method delivers relevant cell numbers, is suitable to detect qualitative differences and can be used for the interpretation of biochemical studies.
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PMID:Morphologically different biopsy specimens of the human gastric mucosa. I. The use of enzymatic cell isolation for quantitative determination of parietal cells. 301 1

The serum gastrin response to a standard protein meal has been determined in achlorhydric patients with atrophic gastritis and contrasted with the response in normal subjects whose gastric contents were kept continuously neutral by intragastric bicarbonate instillation. Five normal subjects showed a significant increase in serum gastrin from a mean (+/- SEM) of 17 +/- 3 pg/ml to 119 +/- 10 pg/ml but their response did not approach that of four patients with atrophic gastritis and antral sparing (605 +/- 133 pg/ml to 1418 +/- 186 pg/ml). By contrast, in four patients with antral gastritis, there was no significant change in gastrin levels (24 +/- 13 pg/ml to 55 +/- 19 pg/ml). These studies indicate that the gastrin-secreting cell mass is increased in atrophic gastritis with antral sparing and decreased in atrophic gastritis with antral involvement, as compared to the normal state. They provide further evidence for the existence in man of two distinct forms of atrophic gastritis.
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PMID:The functional 'G' cell mass in atrophic gastritis. 503 89

Duodenogastric reflux was assessed scintigraphically in normal subjects (n = 20) and in patients with duodenal (n = 15) or gastric ulcers (n = 14). Reflux was graded 0-4 according to degree and was minimal in the control group (0.25 +/- 0.12) (mean +/- SEM), but significantly increased in 11 out of 15 patients with duodenal ulceration (1.33 +/- 0.25) and in 12 out of 14 patients with gastric ulceration (1.86 +/- 0.29) (P less than or equal to 0.0025). Gastric mucosal biopsies taken at endoscopy showed changes of gastritis which correlated well with the degree of reflux. It is suggested therefore that duodenogastric reflux may play a significant role in the pathogenesis of some peptic ulcers, and may be responsible for many of the pathophysiological changes seen in these patients.
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PMID:The possible role of duodenogastric reflux in the pathogenesis of both gastric and duodenal ulcers. 658 5

Fifty-seven patients undergoing routine or review gastroscopy had multiple gastric biopsies taken and assessed histologically for gastritis, metaplasia and dysplasia. Duodenogastric reflux was graded scintigraphically by BIDA Scanning. Patients with dysplastic changes in the gastric mucosa (n = 33) had a higher mean grade of reflux 2.1 +/- 0.21 (mean +/- SEM) than patients with no dysplasia (1.1 +/- 0.24: P less than 0.0025). Patients with metaplasia (n = 33) had an increased mean grade of reflux of 2.0 +/- 0.19 compared with patients without metaplasia (1.3 +/- 0.29: P less than 0.05), but there was no significant difference in degree of reflux between patients with and without gastritis. When the grade of reflux was plotted against increasing degrees of mucosal abnormalities, there appeared to be a positive correlation between duodenogastric reflux and severity of mucosal change.
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PMID:The clinical assessment of duodenogastric reflux by scintigraphy and its relation to histological changes in gastric mucosa. 658 12

Recent reviews have documented significant delayed gastric emptying following Roux-Y biliary diversion for alkaline gastritis. This study establishes the use of radionuclide imaging in the experimental model and evaluates the following: (1) gastric emptying following antrectomy with and without vagal denervation; (2) the effect of Roux-Y diversion on gastric and upper gastrointestinal emptying using animals as their own controls; and (3) the role of truncal vagotomy in the "Roux-Y delayed emptying syndrome." Upper gastrointestinal emptying was evaluated in 8 dogs using the radionuclide technetium 99 labeled egg white method with continuous visualization by gamma camera. Eight dogs underwent B-II antrectomy without vagotomy and were divided into two groups. Four underwent vagotomy, re-evaluation, and Roux-Y diversion. Four underwent Roux-Y diversion first, re-evaluation, then truncal vagotomy. Control dogs retained 65% +/- 4% (SEM) and 45% +/- 6% of ingested food at 2 and 4 hours, respectively. Following antrectomy only, rapid gastric emptying of radionuclide solid is observed with 35% +/- 7%, 16% +/- 4% and 7% +/- 4% retention and 2, 3, and 4 hours, respectively. Roux-Y antrectomy without vagotomy results in similar rapid gastric emptying. Truncal vagotomy following B-II antrectomy delays gastric emptying compared to antrectomy only. Truncal vagotomy and Roux diversion results in varied patterns of gastrointestinal emptying. Significant gastric retention and gastric and Roux limb retention are observed in 25% of trials. Significant Roux limb retention is observed in 45% of the group. Prior to vagotomy there is no retention or altered transit in the Roux limb. In general, no delay in gastrointestinal emptying is observed in the absence of vagal denervation. These data corroborate our clinical experience in observing both Roux and gastric retention following radionuclide evaluation in Roux-Y patients.
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PMID:Alterations in gastrointestinal emptying of 99m-technetium-labeled solids following sequential antrectomy, truncal vagotomy and Roux-Y gastroenterostomy. 662 21


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