comparative ultrastructural study of the helicobacter pylori in duodenal ulcer patients before and after treatment

To study the ultrastructural findings of gastric antral mucosa and Helicobacter pylori in 10 normal subjects and 30 duodenal ulcer patients before and after treatment. Three antral biopsies were taken from each control and duodenal ulcer patients for a rapid urease test, histopathology and electron microscopic study. All patients underwent a thorough upper gastrointestinal endoscopy before and four weeks after medical treatment of their ulcers. Electron microscopic examination showed a normal gastric mucosa and few numbers Helicobacter pylori in 6 normal controls. However, in duodenal ulcer patients before treatment, electron microscopy showed different patterns of contact between the gastric mucosa and Helicobacter pylori. The more severe damage of epithelial tissue was accompanied by less mucus secretion and a large number of bacteria. Successful eradication of Helicobacter pylori after medical treatment was associated with normalization of gastric mucosa and disappearance of symptoms in 93.3% of our patients. In duodenal ulcer patients, Helicobacter pylori infection was accompanied by destruction of gastric glands, vacuolation of the lining epithelium and atrophic changes of the microvilli. Ulcer healing and eradication of Helicobacter pylori resulted in normalization of the gastric epithelium at the electron microscopic level which we think is more accurate and reliable compared with different diagnostic methods

Ocorrência do Campylobacter pylori em pacientes com gastrite e úlcera péptica / Occurrence of Campylobacter pylori in patients with gastritis and peptic ulcer

Biopsias endoscópicas do antro e da borda da lesäo péptica (úlcera gástrica e úlcera duodenal)foram obtidas de 56 pacientes para estudo histológico e microbiológico, no sentido de se determinar a ocorrência do C. pylori. Trinta e nove pacientes apresentaram evidências de gastrite antral e em 37 (94,8%) deles o bacilo foi detectado, enquanto que nos 17 com histologia normal a cultura foi positiva em somente dois (p<0,01). Nos pacientes com úlcera duodenal e úlcera gástrica a positividade para o C. pylori, no fragmento da borda da lesäo, foi de 100% e 88,8%, respectivamente. Os achados sobre a microbiologia do C. pylori näo diferiram daqueles previamente descritos em estudos similares. A microscopia eletrónica o bacilo foi encontrado próximo ou aderido às superfícies celulares sem haver sinais e localizaçäo intraepitelial. Este estudo confirma a associaçäo do C. pylori com a gastrite e a úlcera gastroduodenal, descrita na literatura

Ulceras pépticas posoperatorias recurrentes: correlación clínicas, biológica e histológica en los antros retenidos / Peptic ulcers postoperative recurrent: correlation clinic, biology and histologic in the cavern reteing

Se presentan los resultados quirúrgicos obtenidos en 20 pacientes con úlceras pépticas posoperatorias recidivantes originadas por insuficientes conductas operatorias previas. Se establecen los fundamentos fisiológicos de las operaciones correctoras analizando especialmente la correlación clínica, biológica e histopátológica en los antros retenidos. Con técnicas inmunohistológicas se estudia la relación celular G/D alterada por el pH luminal y reponsable de la recurrencia ulcerosa en un paciente con antro retenido señalando las discretas gastrinemias que se registran en todos estos enfermos