Helicobacter pylori infection, glandular atrophy, intestinal metaplasia and topography of chronic active gastritis in the Nepalese and Japanese population: the age, gender and endoscopic diagnosis matched study.

BACKGROUND: The incidence and mortality from gastric cancer is high in Japanese but extremely low in Thailand. It is different among Asian countries. The aim of this study is to investigate the difference of peptic ulcer disease, glandular atrophy, intestinal metaplasia and topography of chronic active gastritis between the Nepalese and Japanese population. MATERIALS AND METHODS: Nepalese patients were paired with Japanese patients by age, gender and endoscopic diagnosis in order to compare the prevalence of H. pylori infection (N=309) and the difference of H. pylori related peptic ulcer disease (N=48). Glandular atrophy and intestinal metaplasia scores were also compared between the Nepalese and Japanese population in H. pylori positive cases (N=152) and negative cases (N=145) using paired cases by age, gender and endoscopic diagnosis. Paired H. pylori-positive Nepalese and Japanese population were also used to compare the ratio of corpus gastritis to antrum gastritis (C/A ratio) (N=152). RESULTS: Among peptic ulcer diseases, gastric ulcer was frequent in Japanese and duodenal ulcer was frequent in Nepalese. The prevalence of H. pylori infection in the Nepalese and Japanese population were similar. Glandular atrophy and intestinal metaplasia scores in the H. pylori positive Japanese were significantly higher than those of Nepalese in all positions according to triple site biopsy. Furthermore, there were significant differences in glandular atrophy and intestinal metaplasia scores between in the H. pylori-negative Nepalese and Japanese population except intestinal metaplasia score in the greater curvature of the upper corpus. Japanese C/A ratio was significantly higher than that of Nepalese. Corpus predominant gastritis (C/A ratio>1.00) was characteristic in the elderly Japanese. Nepalese was antrum predominant (C/A ratio<1.00) in every age group. CONCLUSIONS: Gastric ulcer was a common disease in Japanese, in contrast duodenal ulcer was common in Nepalese. H. pylori infected Japanese patients showed severe atrophic and metaplastic gastritis in comparison with Nepalese. These results may be associated with the high incidence of gastric cancer in Japanese. Corpus predominant gastritis was found in the elderly Japanese and antrum predominant gastritis was found in every age Nepalese.

Comparative studies on iodine levels in gallstones and bile of Japanese and Thais (Chiang Mai and Bangkok).

We measured the iodine content of gallstones and bile from patients in three areas (Kawasaki in Japan, and Chiang Mai and Bangkok in Thailand) by means of neutron activation analysis. The mean values for iodine content in three types of gallstones (cholesterol, pigment and rare stones) and bile from patients living in Chiang Mai were clearly smaller than those from patients living in Kawasaki and Bangkok. The low iodine intake by Chiang Mai patients continued from the start of gallstone formation until the time when the stones were excised, and the iodine intake was low when bile was collected. The PBI levels in the sera of Chiang Mai residents with low iodine intake over a long period were clearly lower than those of Bangkok patients with normal intake, and the levels in goiter patients were similar to those in healthy people and patients with gallstones among Chiang Mai residents.

Mercury content in the gallstones and bile of Thai people (Chiang Mai and Bangkok) and Japanese.

Mercury contents in the gallstones and bile of patients living in Thailand (Chiang Mai and Bangkok) and Japan were studied by neutron activation analysis. The correlation between contents in the gallstones and bile, and the amount of mercury in the diet and environment was investigated by comparing the contents in patients living in three different areas. The content in the bile of the Japanese patients was significantly greater than that of the Thai patients. The distribution of mercury contents in the pigment and rare stones of patients living in Bangkok indicated a bipolarity. However, the distribution of the contents in cholesterol, pigment, and rare stones of Japanese patients did not indicate a bipolarity. Bipolarity would indicate the amount of mercury in dietary foods, and the pollution level of mercury. The mercury contents in the gallstones and bile would reflect the amount of mercury in the diet and environment.

Incidence of cholelithiasis in the northern part of Thailand.

It may be concluded from comparisons of recent u/s examinations in Northern Thailand to studies in Japan and to the gallstone study conducted over two decades ago that gallstone disease in Thailand is starting to exhibit the same situation as in the West. In comparing overall rates over time the gallstone incidence in Thailand appears to have climbed from 2.61 to 3.10 per cent (Fig. F). The rate increase is even more significant when broken down by sex (male: 1.89%--> 2.50%, female: 3.23%--> 3.70%). In addition, the present rates of female and male gallstone incidence in Northern Thailand closely match the rates found in studies of the Japanese population. Because gallstone disease has become a major public health problem in the West, a number of studies have emphasized the epidemiological characteristics of the disease in order to implement controls. As Thailand's gallstone problem seems to be heading towards the same level of importance further studies involving epidemiological factor linkage may be necessary and the technological advances in Ultrasonography make such studies quite feasible.