Seroprevalence of anti-HCV among HIV-infected persons and general population.

From November 1993 to December 1994, the seroprevalence of anti-HCV, HBsAg was studied among 346 HIV-infected persons (asymptomatic HIV-infected persons and AIDS patients) and 1,023 subjects from the general population (including 119 cord blood samples). The prevalence of anti-HCV, HBsAg among HIV-infected patients aged 15-45+ years was 11.0 and 11.6 per cent respectively which is significantly higher than the comparable levels for the general population (1.9% and 4.7%) in the age group 15-44 years. There was no statistically significant association of anti-HCV and HBsAg prevalence among 200 asymptomatic HIV-infected carriers and 146 AIDS patients. Assays for anti-HCV among blood donors are highly recommended to reduce the development of liver disease or cirrhosis in the immediate future.

Liver abscess in polycystic liver disease.

A case of an elderly female whose clinical manifestations were atypical in view of physiologic aging changes and multiple pathology commonly found in the geriatric group. The liver abscess had presented clinically and radiologically like a hepatic malignancy and pus was obtained during the process of liver biopsy. Even though anchovy-like pus suggested amebic in origin, the microscopic exam showed numerous polymorphonuclear leucocyte and the culture both from the blood and pus grew Klebsiella spp. as well as the study for E. histolytica antibody was also negative. Pyogenic liver abscess was the working diagnosis and indicated for surgical drainage. Adult polycystic liver disease was found intraoperatively and the liver pathology did reveal the presence of many amebae in the cavity of the right lobe of the liver. After the administration of ceftriaxone and metronidazole as well as the surgical drainage, the patient recovered uneventfully within sixteen days of admission.

The advantages of upper gastrointestinal tract brush cytology.

A two-year study of endoscopic brush cytology and biopsy histology was carried out in 63 patients suspected of having malignant lesions in the stomach and the eosophagus. The study was designed to evaluate the accuracy and usefulness of combined cytological examination with biopsy histological examination in the diagnosis of malignancy of the upper gastrointestinal tract. The rate of diagnostic accuracy of the combined technique was found to be high and comparable with those of other published studies. Correlations between the cytological and histological findings were observed in 52 cases (82.53%). The combined method detected malignancy in 27 cases, whereas, the brush cytology alone detected malignancy in 19 cases. The findings of our study indicate that combined brush cytology and biopsy histology under direct vision using fibrescope are of value for the diagnosis of gastroeosophageal malignancy.

Helicobacter pylori: a comparison of CLO test and Giemsa's stain with culture in dyspeptic patients.

The prevalence of H.pylori in Thailand is high compared with Western countries and is the same as in China. We suggest either rapid urease test (CLO test) or Giemsa stain to be a rapid, reliable and convenient detection method for H.pylori and is also suitable for use in follow-up studies by gastroenterologists.

Helicobacter pylori and peptic ulcer diseases: prevalence and association with antral gastritis in 210 patients.

Evidence is accumulating that Helicobacter pylori infection plays a major contributory role in peptic ulcer disease [Duodenal Ulcer (DU) and Gastric ulcer (GU)] and non-ulcer dyspepsia (NUD). We, therefore, studied prospectively 210 consecutive patients with upper gastrointestinal symptoms (62 DU, 38 GU and 110 NUD) to determine the prevalence of H. pylori infection and to investigate their association with histological gastritis. Using endoscopic biopsy of the gastric antrum for diagnosing H. pylori infection by Campylobacter-like Organism (CLO) test, histology or bacteriology, the overall prevalence of H. pylori was 63.3 per cent. When H. pylori infection was related to diagnosis, DU had the highest prevalence rate of H. pylori infection (66%), GU and NUD were less frequently associated with H. pylori infection (55% and 44% respectively). We found a close association between H. pylori infection and histologically antral gastritis, in that 72.7, 61.7, and 62.6 per cent of the DU, GU and NUD patients with antral gastritis (respectively) had H. pylori infection. In contrast, none of these patients seen with normal antrum had H. pylori infection. We also found that the prevalence of H. pylori in our patient series was not age related. Of the three procedures used to demonstrate H. pylori, the CLO test and histological staining method gave the highest yields of 84.9 and 79.6 per cent respectively, and bacteriology in only 44.3 per cent, we conclude that the prevalence of H. pylori infection in Thai patients with upper gastrointestinal symptoms is high. H. pylori infection commonly occurs in the patients with antral gastritis, suggesting a possible etiologic role for the bacterium in the histologic lesion.