Non-endoscopic diagnosis of multifocal atrophic gastritis; efficacy of serum gastrin-17, pepsinogens and Helicobacter pylori antibodies.

BACKGROUND/AIMS: Infection with H. pylori is an important risk factor for the development of gastric cancer and glandular atrophy is an intermediate stage in gastric carcinogenesis. While screening the patients with atrophic gastritis by endoscopy is unrealistic, a concept of "serological gastric biopsy" based on measurement of gastric secretory proteins and peptides should be further validated. We sought to determine if the laboratory panel composed of serum PGI and protein stimulated gastrin-17 might select patients with MAG, and what is diagnostic significance of H. pylori serology in population of high prevalence of H. pylori infection. MATERIAL AND METHODS: 55 consecutive patients of both sexes (M/F 25/30; range of age 55 -81 years) were referred for gastroscopy with antrum and corpus mucosal biopsies. Patients with histological signs of glandular atrophy at any site of the stomach were considered to have multifocal atrophic gastritis. A first blood sample was collected for measurement of basal gastrin-17, pepsinogens and H. pylori IgG-antibodies, and second was taken 20 minutes after use of protein-rich drink to measure stimulated gastrin-17. RESULTS: Signs of mucosal atrophy were found in 19 patients, while 29 patients showed non-atrophic gastritis and seven H. pylori-negative patients had no histological pathology. Low serum level of stimulated gastrin-17 (< 5 pmol/l) and/or pepsinogen I (< 50 microg/l), were found in 16 of 19 patients (84.2%) with and in 7 of 36 patients (19.4%) without atrophy in the histological study. Combining of H. pylori serology with serum levels of secretory peptides had no significant effect on diagnostic sensitivity of the test panel. CONCLUSION: The test panel composed of pepsinogen I and protein stimulated gastrin-17 may be used as the "serological gastric biopsy" detecting multifocal atrophic gastritis. The diagnostic sensitivity of this test panel is not increased by knowledge of H. pylori status.

[Clinical assessment of treatment results for atherosclerotic ischemia of the lower extremities with intraarterial ozone injections]. / Ocena kliniczna skutecznosci leczenia miazdzycy zarostowej konczyn dotetniczym wstrzykiwaniem ozonu.

Ten injections of O3 into femoral arteries were administered to 50 patients with atherosclerotic ischemia of the lower extremities and to 49 diabetic patients. All patients were assessed clinically with the ankle-arm index, measurement of intermittent claudication distance prior to and after the treatment. The treatment showed a significant improvement in both groups manifested by an increase in ankle-arm index, and prolongation of the intermittent claudication distance by more than twice. The treatment of atherosclerotic ischemia of the lower extremities with O3 is both valuable and safe.

[Endoscopic picture of hemorrhage from the upper digestive tract in elderly patients]. / Obraz endoskopowy krwawienia z górnego odcinka przewodu pokarmowego u osób w wieku podeszlym.

The causes of upper gastrointestinal tract bleeding were analysed in 412 patients dividing them into age groups below and over 60 years. Both groups were compared using endoscopic classification of bleedings by Forrest. In the group aged over 60 years a significantly higher per cent of type II lesion was found, especially non-bleeding vascular stump protruding from the bottom of the ulcer. This lesion was associated in nearly half the cases with recurrence of bleeding. The finding of this endoscopic picture should suggest the necessity of a more radical operation, although the operative risk is higher in patients aged over 60 years.

[Ozone therapy and viscosity of blood and plasma, distance of intermittent claudication and certain biochemical components in patients with diabetes type II and ischemia of the lower extremities]. / Ozonoterapia a lepkosc krwi i osocza, dystans chromania przestankowego oraz niektóre skladniki biochemiczne krwi u chorych na cukrzyce typu II z choroba niedokrwienna konczyn dolnych.

Blood and plasma viscosity, total blood lipids, triglycerides, total cholesterol, free fatty acids, fibrinogen, hematocrit, and lipidogram were determined in patients with diabetes mellitus type II and coexisting symptoms of the obliterative arteriosclerosis of the lower limbs. Intermittent claudication distance has been measured parallel. The same tests have been carried out after ozone therapy. A significant improvement in the intermittent claudication and reduction in blood and plasma viscosity have been noted. There was statistically significant correlation between intermittent claudication decrease and blood viscosity reduction following ozone therapy.

[Ozone therapy and viscosity of blood and plasma, distance of intermittent claudication and certain biochemical plasma components in patients with occlusive arteriosclerosis of the lower limbs]. / Ozonoterapia a lepkosc krwi i osocza, dystans chromania przestankowego oraz niektóre skladniki biochemiczne osocza u chorych na miazdzyce zarostowa tetnic konczyn dolnych.

Blood and plasma viscosity, total lipids, triglycerides, total cholesterol, free fatty acids, fibrinogen, lipid-gram, and hematocrit were determined in 53 patients with occlusive arteriosclerosis in the lower limbs prior to and after ozone therapy. At the same time the distance of the intermittent claudication was measured. A significant prolongation of the distance walked painlessly, reduction in blood and plasma viscosity as well as the decrease in total cholesterol after therapy with ozone correlated with a decrease of the blood viscosity.

[Blood and plasma viscosity versus claudication distance in patients with obliterative atherosclerosis of the lower limbs]. / Lepkosc krwi i osocza a dystans chromania przestankowego u chorych na zarostowa miazdzyce tetnic konczyn dolnych.

The aim of the investigations was to show the influence of increased blood and plasma viscosity on the claudication distance in patients with obliterative atherosclerosis of lower limbs. The investigations were carried out in 53 patients: 41 men and 12 women (group I, age 45-67 years). The control group consisted of 100 healthy persons (group II) with similar range of age. The rheological studies of blood were carried out by low-shear 100 Contraves viscometer, the plasma viscosity--by means of capillary viscometer. Moreover, the total lipids, alpha, pre-beta, beta-lipoproteins, triglycerides, total cholesterol, free fatty acids, fibrinogen and hematocrit of the blood were determined. The blood for above mentioned estimations was collected before testing of the claudication distance. A significant increase of blood and plasma has been shown as well as an increase of total lipids, fibrinogen, triglycerides, total cholesterol, free fatty acids. The alpha lipoproteins were significant decreased in patients with intermittent claudication compared to the controls. The claudication distance ranged 10-500 m (the mean: 143 +/- 119 m). The correlation between claudication distance and blood and plasma viscosity was significantly negative (r = -0.42, p less than 0.001 and r = -0.32, p less than 0.05 respectively). The obtained results indicated that an increase of blood and plasma viscosity in patients with obliterative atherosclerosis of lower limbs was correlated to the decrease of claudication distance.

[Various parameters of lipid metabolism after intra-arterial injections of ozone in patients with ischemia of the lower extremities and diabetes mellitus]. / Niektóre parametry gospodarki lipidowej po dotetniczych wstrzyknieciach ozonu u chorych na chorobe niedo-krwienna konczyn dolnych oraz cukrzyce.

In 50 subjects with arteriosclerotic ischaemia of the lower extremities and 41 subjects with diabetes mellitus ozone was applied intra-arterially. Before and after the treatment serum lipids concentration was examined. In the group with arteriosclerotic ischemia significant decrease in cholesterol level and both his fractions was seen. Whereas in the group with diabetes the cholesterol LDL was significantly reduced. In both groups total lipids level serum was decreased. It suggests that ++ozone therapy set back the arteriosclerosis progress, normalized some parameters of lipid metabolism and improved HDL to LDL cholesterol fractions relationship.

[Blood and plasma viscosity and the distance of intermittent claudication in patients with type II diabetes and thrombophlebitis]. / Lepkosc krwi i osocza a dystans chromania przestankowego u chorych na cukrzyce typu II z choroba niedokrwienna konczyn dolnych.

In 49 patients with insulin-resistant diabetes, with ischaemia of the lower extremities blood viscosity was measured at low coagulation rates and plasma viscosity was determined also. Moreover plasma measurements were done of total lipids, alpha-, pre-beta-, and beta lipoproteins, triglycerides, total cholesterol, free fatty acids, and, besides that, the hematocrit was measured. Immediately after blood sampling for rheological and biochemical investigations the distance of intermittent claudication was measured. A rather considerable increase of blood and plasma viscosity was noted in the patients in comparison with controls, other findings included disturbances of lipid metabolism, increased fibrinogen level, and a negative correlation between the distance of intermittent claudication and blood and plasma viscosity.

[Some parameters of hemostasis in diabetic patients]. / Niektóre parametry ukladu hemostazy u chorych na cukrzyce.

Parameters of blood coagulation and fibrinolysis in diabetic patients chronically treated with oral hypoglycaemic agents and insulin have been analysed. All examined patients were divided into four subgroups: I-treated with biguanides, II-treated with sulfonylurea derivatives, III-sulfonylurea and biguanide derivatives simultaneously, IV-treated with insulin. Observed decrease in haemostasis parameters and activation of fibrinolysis in patients treated with only biguanides seemed associated with favourable effect of these agents on the decrease in the risk of the thrombotic complications in diabetes mellitus.

[Acute hemorrhagic gastritis as a cause of bleeding from the upper gastrointestinal tract]. / Ostry krwotoczny niezyt zoladka jako przyczyna krwawienia z górnego odcinka przewodu pokarmowego.

In a material of 4560 panendoscopic investigations carried out in an endoscopy laboratory haemorrhages from the upper gastrointestinal tract were found in 201 cases. In 49 cases the cause of blood loss was acute haemorrhagic gastritis. Among them males accounted for 41% (mean age 35.6 years) and females for 59% (mean age 41.8 years). Acute haemorrhagic gastritis was associated with active peptic ulcer (20% of cases), portal hypertension (18%), which were, however, not the cause of haemorrhage. In only 19 cases (39%) acute haemorrhagic gastritis was not associated with any detectable pathological lesions in the upper gastrointestinal tract, adn massive haemorrhage appeared without any preceding symptoms. Considering the total number of bleedings haemorrhagic gastritis was the cause of massive bleeding in 10% of cases.