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Volume 66 - 2003 - Fasc.2 - Original articles

Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis

Background : The etiopathogenesis of chronic inflammation at the gastric cardia is still debated. It is suggested that carditis may be a finding of gastro-oesophageal reflux disease (GORD) or it may occur as a result of the gastritis caused by Helicobacter pylo- ri (H. pylori) infection. Aim : To examine morphological features of carditis, as well as the associations of carditis with Helicobacter pylori gastritis and oesophagitis as a marker of gastro-oesophageal reflux disease. Patients and methods : Endoscopic biopsy specimens obtained systematically from oesophagus, cardia, corpus and antrum of 135 dyspeptic patients were retrospectively evaluated. In biopsies, we have searched for any correlations between clinical, endosco- pic, and histological features. Results : Carditis was detected in 123 (91.1%) of the cases. The mean age of the carditis group was 47.9 years and the male-to- female ratio was 1.08:1. The relation of carditis with age and sex was not significant (p = 0.19 and p = 0.24, respectively). All cases of the carditis group had concomitant chronic gastritis. In these cases, chronic inflammation, degree of neutrophil-mediated activi- ty and H. pylori colonisation were significantly correlated in car- dia, corpus and antrum (p < 0.001). Intestinal metaplasia was observed in 14 cases (11.3%) and, was associated with H. pylori colonisation (p < 0.001). Microscopic oesophagitis detected in 37.7% cases also showed correlation with reflux symptoms and endoscopic oesophagitis but not carditis. When all cases with car- ditis were evaluated for H. pylori infection and oesophagitis, which are presumed risk factors for carditis, H. pylori infection appeared to be an independent risk factor for carditis (p = 0.012), while oesophagitis did not. Conclusions : This study suggests that carditis is commonly found in patients presenting with dyspepsia and the histological features of carditis were similar to those seen in H. pylori gastritis in antrum and corpus. In addition, our data have also shown that carditis was significantly associated with H. pylori infection but not with symptoms or signs of GORD. (Acta gastroenterol. belg., 2003, 66, 144-149).


An ultrastructural investigation in stomach epithelial cells of mice during pregnancy and early lactation

In this study, stomach epithelial cells from adult nonpregnant, pregnant lactating mice were examined by histochemical, immu- nohistochemical and ultrastructural methods. Tissue samples taken from different groups were stained with haematoxylin-eosin and PAS-alcian blue and semithin sections were stained with toluidin blue for light microscopic examination. For ultrastructur- al examination ultrathin sections were stained with uranyl acetate and lead citrate. Additionally, by applying immunoperoxidase method, the distribution of EGF receptors of all groups was stu- died. We concluded that in the pregnant mice, stomach surface had lower mucus than the nonpregnant group. The acid content was balanced in active and inactive parietal cells. Examination results of lactating mice were similar to the results obtained from non- pregnant and pregnant mice. (Acta gastroenterol. belg., 2003, 66, 137-143).