Immunohistochemical expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) in invasive breast carcinoma.

Tissue inhibitor of metalloproteinase-1 (TIMP-1) is a natural inhibitor of matrix metalloproteinases (MMPs). Aim of this study was to assess the immunohistochemical expression of TIMP-1 in invasive breast carcinomas, and to examine its association with classical clinico-pathological parameters, oestrogen receptor, progesterone receptor and Her-2/neu protein expression. Immunohistochemistry was used to determine the expression of TIMP-1 on 38 paraffin-embedded breast tissue specimens - 18 with invasive ductal carcinoma, 10 with invasive lobular carcinoma, and 10 specimens from patients with fibrocystic breast disease. TIMP-1 protein was immunodetected in the carcinoma cells, fibroblasts and inflammatory cells of the stroma in 92,9%, 65,8%, and 65,8% of cases, respectively. TIMP-1 protein expression in carcinoma cells showed positive correlation with TIMP-1 protein expression in peritumoural fibroblasts (p=0,010). Positive peritumoural fibroblast TIMP-1 expression was associated with histological tumour type with higher frequency in ductal carcinomas (p=0,023). Negative association was found between TIMP-1 protein expression in carcinoma cells and HER-2/neu nuclear staining (p=0,005). TIMP-1 may be particularly useful as a predictive marker in breast carcinoma when evaluated along with HER-2/neu protein being a promising indicator of favourable prognosis in breast carcinoma.

Dermal squamomelano-cytic tumor: neoplasm of uncertain biological potential.

We report a case of exceedingly rare cutaneous neoplasm with histological features of malignancy and uncertain biological potential. The nodular, darkly pigmented facial tumor with central exulceration, size 12 x 10 x 7 mm, of the skin 61-year-old man preauricular left was completely exised. Histologically tumor consists of atypical squamous cells, which express signs of moderate to significant pleomorphism, mitotically active, with foci forming of parakeratotic horn cysts ("pearls"). Characteristically tumor also consists of large number of atypical melanocytes with multifocal pattern, inserted between atypical squamous cells, and which contain large amount of dark brown pigment melanin. Immunohistochemically, squamous cells stain positively with keratin (CK116), melanocytes were stained with S -100 protein, HMB 45, and vimentin, but failed to stain with CK 116. To our knowledge this is the sixth reported case in world literature. The follow-up time of four years no evidence of recurrence or metastasis, similar all reported cases, but it is too short period in estimation to guarantee a benign course. However, it appears that this group of neoplasm may have different prognosis from pure squamous carcinoma or malignant melanoma.

Testicular metastasis of gastrointestinal stromal tumor of the jejunum.

Gastrointestinal stromal tumors (GIST) are neoplasm of mesenchymal origin that usually begins in cells of the wall of the gastrointestinal tract. It can be benign or malignant. In this report, we have presented a case of malignant GIST with uncommon site of metastasis. This is of interest because of three reasons. Firstly, metastases to the testis are extremely rare. However, metastases to distally localized organs are not commonly associated with GIST, and finally, to our knowledge this is the first case of malignant GIST metastasis to the testis reported in the world.

Zearalenone-induced lymphophagocytosis (T cell apoptosis) on the rat's thymus.

The effects of nonsteroidal mycotoxin zearalenone on the lymphoid tissue of thymus in a sense of investigating the subacute toxicity Wistar-albino rats have been examined in the course of the study. We analyzed 42 rats' specimens of both gender, treated with three dosage levels: 0,5; 2 and 4 mg/kg of body weight, after oral submission of the compound, and observed during three different time intervals: 10, 20 and 30 days. Microscopically was semiquantitatively determined lymphophagocytosis (apoptosis) and cortical thymic cellularity. It was percepted statistically significant growth of lymphophagocytosis compared to a dosage (p<0,01), as well as combination of dosage and interval (p<0,001), while gender had no statistically significant influence on tested parameter (p>0,05). Changes in cortical thyme cellularity were not percepted. Effects of applied doses of zearalenone on the lymphoid tissue of thymus were very mild and in correlation with estrogenicity. They are probably the result of interaction with estrogenic receptors.

[The effect of myocardial bridging on the incidence of coronary arteriosclerosis]. / Uticaj miokardnih mostova na nastanak koronarne arterioskleroze.

In this paper we dissected 50 human hearts obtained from the Department for Anatomy and Department of Forensic Medicine and Pathology, Faculty of Medicne, Sarajevo. Our interest was to show frequency of myocardial bridging on human heart coronary artery branches, their localisation and dimensions. Cross sections of coronary arteries segments in area of bridges, proximal and distal to it, were taken out from hearts on which dissection method showed presence of myocardial bridging of the coronary artery branches. Cuts were made 5microm-tick and coloured by Hematoxylin-eosine, Elastica Van Giesson, and Ladewig after having been fitted into paraffin wax. Preparations were behold mocroscopically and flow direction of myocardial bridge muscle fibres was followed regarding the artery wall, and it was analysed artery wall structure in the myocardial bridge area, proximal and distal to the bridge. Myocardial bridges werw found in 42% examined cases, and with the most frequent localisation on ramus interventricularis anterior (34%). Atherosclerotic change in the artery segments proximal to the myocardial bridge was detected by the histolopathological method and its intensity depended on the myocardial bridge length and years of age. In the area of the myocardial bridge, besided insignificant diffuse intima, there were not any other histopathological changes that would indicate an atherosclerotic process.

Two-criteria dental aging method applied to a Bosnian population: comparison of formulae for each tooth group versus one formula for all teeth.

The purpose of this study was to obtain age estimation formulae using the length of periodontosis, transparency of the root and root height in each tooth group for the current male population in Bosnia and Herzegovina and to compare these formulae with Lamendin's and Prince's formulae. The research was undertaken on 847 single rooted teeth from 200 identified deceased persons, individuals who died between the ages of 23 and 85 years. Periodontosis, transparency and root height were measured according to Lamendin's procedure. All teeth were grouped in two ways: according to the tooth groups and to the age groups. The highest coefficients of correlation are obtained for maxillary canines (R = 0,731) and mandibular canines (R = 0,706) and the maxillary lateral incisors showed the lowest mean error (ME = 6,63 years). In age groups, the lowest mean error was obtained in the 40-49 years age group (ME = 5,15 years). Equations developed in this study give statistically significantly better age estimations in comparison to the original Lamendin and Prince formulae for the whole sample as well as for each tooth group, except for mandibular central incisors. Age estimation with models developed for each tooth group (except for mandibular lateral incisors) was statistically significantly better than models based on the whole sample.

Expression of p53, bcl-2, and Ki-67 proteins in the inflammatory regenerative and dysplastic epithelial lesions of flat colonic mucosa.

The aim of the study was to define the distribution of p53, bcl-2 and Ki-67 proteins in the inflammatory-regenerative and dysplastic lesions of the colon mucosa. The relationship between the presentation of p53, bcl-2 and Ki-67 proteins and the intensity of the inflammatory-regenerative and dysplastic lesions in the colon flat mucosa was investigated as well. Biopsy specimens from 270 patients were examined: 74 were classified as inflammatory-regenerative and 196 as dysplastic lesions (108 mild, 58 moderate, and 30 severe dysplasia). The expression of all three proteins was assessed on the basis of location, quantity, and intensity of immunostaining, by counting antigen positive cells, in comparison with normal mucosa and adenocarcinoma. p53 protein appears only in sporadic cases (6.6%) of severe dysplasia. Bcl-2 expression appears significantly (p<0.005) more often in cases of mild dysplasia (61.1%) compared to inflammatory-regenerative mucosa (14.8%). In cases of mild dysplasia, bcl-2 positive cells were spreading from the lower third to the middle third of the crypts. Bcl-2 expression was maintained through the stadiums of moderate and severe dysplasia (75.8%), where antigen positive cells were found all along the crypts. A significant increase (p<0.005) in the expression of nuclear protein Ki-67 was noticed in the stadiums of moderate (labelling index =26.3) compared to mild dysplasia (labelling index=16.7), and severe (labelling index=36.7) compared to moderate dysplasia, where the zone of cellular proliferation was widen along the whole crypt length. In the process of the development of epithelial dysplasia in the flat mucosa of colon a degree of the gene p53 alteration is low and appears only in sporadic cases of severe dysplasia. Mutation of the bcl-2 gene is involved in the genesis of the lesion but not in its progression to carcinoma. Increased expression of Ki-67 protein speaks in favour of an increased cellular proliferation which, together with the above mentioned mechanisms, is involved in the process of occurrence and progression of epithelial dysplasia in the flat mucosa of colon.

Stature estimation for Bosnian male population.

Since 1996, the Trotter and Gleser formulae to determine the stature of recovered missing persons in Bosnia and Herzegovina have been used. The purpose of this study is to develop appropriate stature estimation formulae from the length of the femur, tibia and fibula for use in the Bosnia and Herzegovina to help in identifications of the victims. Research was undertaken on 50 male cadavers, of individuals who died between the ages of 23 to 54 years. The cadaver length was measured and the length of the long bones was obtained from X-ray photographs. The length of the cadavers of the individuals who died after age of 45 years was corrected according to Giles' table. This study established that using Trotter and Gleser's formulae underestimate stature of tall people in the current population of Bosnia and Herzegovina. Smallest standard error of estimate is observed in the formula that uses the sum of the length of femur and fibula. There are no statistically significant differences between the length of the bones from the left and right sides of the body. Therefore, formulae developed from the average length of bone pairs are recommended for use.

Giant cell fibroblastoma in a 4-year-old boy: a case report and review of the literature.

Giant cell fibroblastoma (GCF) is a rare type of fibroblastic tumor, first described as a juvenile form of dermatofibrosarcoma. Although recurrences are common after local surgical resection, metastasis is not reported.We report a case of a 4-year-old boy with giant cell fibroblastoma, in which the neoplasm was characterized histologically by a proliferation of spindle-shaped cells intermixed with pseudovascular channels called "angiectold spaces". The spaces were lined by large cells with pleomorphic nuclei intermixed with multinucleated cells. Immunohistochemically, the tumor stained diffusely for vimentin and CD34, but negative for S 100 protein. Since the initial description in 1982, less than 100 cases of GCF have been reported. This patient's presentation is particularly interesting because present the first case reported in Bosnia and Herzegovina.

Immunohistochemical evaluation of cyclin D1 in breast cancer.

AIM: To explore the potential prognostic value of cyclin D1 in invasive breast cancer and its correlation with basic histopathological parameters, hormonal status (estrogen [ER] and progesterone receptor [PR]), and bcl-2. METHODS: Medical records of 48 patients, diagnosed in 1998, from the Central Database of the Institute of Oncology, Clinical Center University of Sarajevo, were analyzed. The mean follow-up was 61 months (range: 4-103 months). Routine histopathological evaluation was performed for 48 formalin-fixed and paraffin-embedded tissue samples. For immunohistochemical staining, we used monoclonal antibodies for ER, PR, bcl-2, and cyclin D1. RESULTS: Cyclin D1 expression inversely correlated with tumor grade (P=0.010) and tumor size (P=0.023), whereas significant positive association was found with ER (P=0.001) and bcl-2 (P=0.001) expression. Patients with higher cyclin D1 expression had longer both overall survival (P=0.014) and relapse-free survival (P=0.037). Cox regression analysis for overall survival (OS) showed that lymph node status, ER expression, therapy, and cyclin D1 expression were independent prognostic factors. (P range from 0.003 to 0.04). CONCLUSION: Expression of cyclin D1 is associated with better disease outcome in breast cancer.

CD10 protein expression in tumor and stromal cells of malignant melanoma is associated with tumor progression.

CD10 antigen is a 100-kDa-cell surface zinc metalloendopeptidase expressed in a variety of normal and neoplastic lymphoid and nonlymphoid tissues including melanomas. It was recently shown that metastatic melanomas express more CD10 than primary tumors. We evaluated CD10 expression in tumor and stromal cells in 70 biopsies with primary and 28 with metastatic malignant melanomas. Ki-67, Bcl-2, and Bax were also examined to investigate whether CD10 expression is associated with tumor proliferation index or factors of apoptosis. Formalin-fixed/paraffin-embedded tissues were studied by immunohistochemistry. More advanced primary tumors had higher CD10 expression in the tumor cells (r = 0.27, P = 0.03 for Clark levels and r = 0.29, P = 0.02 for Breslow) and higher Ki-67 proliferation fraction (r = 0.32, P = 0.007 for Clark levels and r = 0.32, P = 0.001 for Breslow). Similarly, CD10 expression in the intratumoral stromal cells was also higher in primary tumors with higher Clark level (P = 0.04, linear-by-linear association) and tumor thickness according to Breslow (r = 0.33, P = 0.01). The presence of CD10+ peritumoral stromal cell cuffs was also positively associated with tumor thickness according to Breslow (r = 0.27, P = 0.05). Also, expression of CD10 and Ki-67 were significantly higher in metastatic than in primary tumors (P = 0.01 and 0.02 respectively), but Bcl-2 expression was higher in primary melanomas (P = 0.02). We conclude that CD10 expression in malignant melanoma is associated with tumor progression.

Expression of bcl-6 and CD10 protein is associated with longer overall survival and time to treatment failure in follicular lymphoma.

Follicular lymphomas (FLs) are a heterogeneous group of tumors, but prognostic factors are evaluated insufficiently in this common hematologic neoplasm. While bcl-6 and CD10 are expressed characteristically in FLs, their significance for biologic behavior of FL has not been studied previously. Samples from 73 patients with FL and clinical follow-up from 7 to 231 months were evaluated by immunohistochemical analysis. Patients with high levels of bcl-6 expression had favorable overall survival (OS) (P = .003), disease-specific survival (DSS) (P = .033), and time to treatment failure (P = .003) compared with patients with low levels of bcl-6 expression. Multivariate analysis showed that the results for OS, DSS, and time to treatment failure were independent of the international prognostic index. Patients with CD10+ FLs also had longer OS (P = .001), DSS (P = .007), and time to treatment failure (P = .004), and grade 1 FL was associated with better OS (P = .01) and a statistical trend for longer DSS (P = .05) and time to treatment failure (P = .05), but these results were not independent of bcl-6 expression or the international prognostic index in multivariate analysis.

The number of malignant neoplasm in Sarajevo region during the period 1998-2002.

UNLABELLED: Due to the specific war and post-war situation in Bosnia and Herzegovina it is possible to notice some differences in the number, type, advancement, biological course, treatment and its outcome. The actual situation which appeared in connection to depleted uranium has additionally raised questions about its influence on human health and about eventual increase in the number of malignant diseases in Bosnia and Herzegovina. In public, we often see that there are claims about enormous increase in the incidence of cancer. In order to achieve a realistic picture of actual condition and to avoid panic and ignorant attitude, correct and constant data of malignant tumors are necessary. THE AIM OF THE STUDY: To collect and analyze data on population with malignant tumors in the region of Sarajevo city, which represents a symbol of difficult times in our country in the recent past. MATERIAL AND METHODS: We have collected and analysed data on, population with malignant tumors which included persons with permanent residence in Sarajevo Canton during 5-year period, from 01.01.1998, until 31.12.2002. Results were compared to regional and world indicators, and were observed in the light of specific local situation. RESULTS: During period of 5 years (1998-2002) 7733 new cases of malignant tumors were registered in Sarajevo Canton; 3940 among men and 3809 among women. Mostly registered tumors were: lung cancer, amelanotic skin tumors, breast cancer, colorectal cancer, cervical and uterine cancer, urinary bladder cancer, prostate cancer and cancer of larynx. CONCLUSIONS: Number of all malignant tumors in the region of Sarajevo Canton correlates to those in South European countries and the one estimated by GLOBCAN 2000. High number was registered in 1998, possibly due to normalization of the health services (diagnostics and treatment of malignant tumors), which didn't exist during the war and early post-war period. After 2000, there is a gradual increase in the number of people with malignant tumors. The most common tumors are lung and breast cancer. Significant differences to estimation and data registrated in other South European counties is high number of laryngeal cancer, urinary bladder cancer, bone and cartilage sarcoma, brain tumors and malignant lymphomas among both genders. Cervical cancer is extremely high up on the list, which correlates with data in developing countries. The incidence of smoking in Bosnia and Herzegovina is extremely high, almost complete, which can influence not only the appearance of lung cancer but also laryngeal and urinary bladder cancer. It is hard to say whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city or some other factor have influenced their appearance among exposed population and differences in the observed incidence.

The Bcl-2 protein: a prognostic indicator strongly related to ER and PR in breast cancer.

Bcl-2, the protein product of the Bcl-2 gene, is a member of the Bcl-2 family of proteins that play a crucial role in a complex mechanism of apoptosis. It was recently proposed that bcl-2 could inhibit cancer progression. In this study, we evaluated the expression patterns of Bcl-2, estrogen receptors (ER), progesterone receptors (PR) in 71 primary invasive breast carcinomas and their association with other clinicopathological parameters. Samples from 71 patients with invasive breast cancer with follow-up ranging from 4-103 months (median 57 months) were included in the study. Forty-six patients (66%) obtained a complete response, while 5 (9%) were considered non-responders during the follow up period of 103 months. Eighteen (25%) patients died, 15 (21%) from primary disease and 3 (4%) from other disease. In unvaried analysis, tumor size (<2 cm), lymph node (<4 lymph nodes), hormonal status and Bcl-2 expression are correlated with longer overall (OS) and relapse-free survival (RFS). Patients with 4 or more positive axillary lymph nodes had significantly shorter OS (p=0.01) and RFS (p=0.009). Higher expression of Bcl-2 was associated with longer OS (p=0.02) and RFS (p=0.03), and this result were independent of axillary lymph nodes and tumor size in Cox multivariate analysis.

Anti-cytokeratin 7: a positive marker for epithelial dysplasia in flat bowel mucosa.

The aim of this paper is to establish by immunohistochemistry the expression of keratin 7 in inflammatory-regenerative flat bowel mucosa and in different grades of epithelial dysplasia regarding the sub-units expressed in normal and carcinomatous colonic mucosa. Biopsy specimens from 270 patients were examined: 74 were classified as inflammatory-regenerative changes and 196 as dysplastic lesions. There were 108 cases of mild dysplasia, 58 cases of moderate and 30 cases of severe dysplasia, respectively). Demonstration of location and intensity of cytokeratin 7 staining was performed by immunohistochemistry using monoclonal antibody (anti-cytokeratin 7). Findings of cytokeratin 7 in dysplastic lesions were compared with those in normal mucosa, inflammatory -regenerative mucosa and adenocarcinoma. Cytokeratin 7 is not found in normal colonic mucosa. In inflammatory-regenerative mucosa it was found in solitary cells in small number of cases. It is found in all cases of epithelial dysplasia and its expression showed no difference regarding moderate and severe dysplasia. In few cases of adenocarcinoma, cytokeratin 7 is found in traces and showed minimal staining intensity. Having in mind that cytokeratine 7 is primarily found in dysplastic lesions of the flat colonic mucosa it can be a valuable diagnostic tool in the histological interpretation of epithelial dysplasia.

[Helicobacter pylori infection and chronic gastritis as extra-esophageal factors in gastroesophageal reflux disease]. / Infekcija Helicobacter pylori i aktivnost hronicnih gastritisa kao ekstraezofagealnih faktora kod gastroezofagealne refluksne bolesti.

INTRODUCTION: Some substances, for example amoniac, that appear during an infection caused by Helicobacter Pylori (HP), can neutralise acid. It is assumed that a HP infection can attribute to the worsening of GERB disease with antral predominant gastritis and a defensive factor eith corpus-predominant gastrytis or esofagitis. AIMS: The aim of this study is to ascertain the role of HP infection in the modification of GORD through a prospective study, that is to see does a HP infection prospectively influence the disease or not, with a special focus on symptomatology with pathohistological findings of the antrum and the corpus of the gaster through a monitoring period of 12 months. MATERIALS AND METHODS: 50 patients of the main group were involved in this prospective study with symptoms of GORD, or that eventually had a black stool. A control group of 47 patients was formed that had Gerb positive symptomatology, identical to the first group. During endoscopic act eventual changes in oesophagus in view of GORD, so they have been graduated according to Sawary-Millerov graduation from 1991: via Standard Olympus byoptic tongs byoptic specimens were taken with changes in view of GORD, and corpus and antrum mucosac of gaster and they were put into 2% formalin, so analyses has been done at Institute for pathology in Sarajevo. A special attention has been made to the graduation of gastritis, so Sydney classification has been followed. A modification lasted for four weeks since dg has been made, so two groups were formed, one with eradicated HP and second with HP presence. In the second part of this study both groups were followed without treatment in the period of 12 months, meaning that the natural course of illness has been followed up. RESULTS: The results of tests of significant differences between treated and control group after 12 months gr. I Sawary-Miller: normal differences n.s. (t = 0.122); chronic differences n.s. (t = 0.724), reflux esophagitis difference n.s.t = 0.733). Tests of differences between treated and control group of pts according to topographic classification of gastritis for GORD gr. I (X2 = 1.076)-n.s.; za GORD gr. II (X2 = 0.999) non significant. Tests between groups of PTS for treated group (X2 = 1.4) n.s., for control group (X2 = 5.073) significant result for p < 0.05; GORD gr. II for treated group (X2 = 1.051) n.s. The results of tests of significant difference between pathohistological findings of corpus antrum treated and control group within gr. I Sawary-Miller: the difference is not statistically significant t = 0.816. The results of test significant differences of antrum after 12 months between treated and control group: within gr. I X2 = 1.623 difference n.s.; within gr. II t = 0.015 difference n.s. CONCLUSION: This study proved that eradication of HP infection acts to GORD course by improvement of endoscopic findings by Sawary-Miller and pathohistological findings on oesophagus, as well as with decrease of activity predominant antral atrophic gastritis in I degree of GORD 12 months after and by decreasing daily acid symptoms. The eradication of HP infection in GORD do not influence on activity of predominant corpus gastritis, as well as on heartburn symptom, weekly acid symptom nor chest pain.

Type IV collagen immunoreactivity of basement membrane in inflammatory-regenerative and dysplastic lesions of the flat colonic mucosa.

UNLABELLED: The aim of this research is to establish by immunohistochemistry if there is a change in the expression of collagen type IV, as a substitute of basement membrane, in development of epithelial dysplasia in chronically inflamed colon mucosa. METHODS: Biopsy specimens from 270 patients were examined: 74 were classified as inflammatory-regenerative and 196 as dysplastic lesions. There were 108 cases of mild dysplasia, 58 cases of moderate and 30 cases severe dysplasia, respectively. Visualisation of collagen IV and its way of expression within basement membrane of glandular crypts was performed by immunohistochemistry and then compared with findings in normal colon mucosa and colon adenocarcinoma tissue. RESULTS: Changes in the expression of collagen IV comprised of its focal irregularities, diffuse thinning and/or thickening, focal interruptions or its complete absence. Significant changes in the expression of collagen IV in relation to normal mucosa already occur in inflammatory-regenerative mucosa. In mild dysplasia, these changes are more intensive in relation to those in inflammatory altered mucosa as well as at severe dysplasia in relation to moderate dysplasia. Changes in the expression of collagen IV in severe dysplasia are significantly more serious than in moderate dysplasia but are identical to those in colon adenocarcinoma tissue. CONCLUSION: These findings suggest that change in the expression of collagen IV is in correlation to a degree of epithelial dysplasia that developed in flat chronically inflamed colon mucosa.

The principles of telemedicine in practice.

Telemedicine (distance medicine) represents a field of medicine that has been in a tremendous expansion over the last couple of years thanks to the fast development of telecommunications and reduction of their costs. It enables a direct communication (visual) between the peripheral hospitals and referral facilities in the interior of the country as well as a connection of centres with referral centres abroad in the fields of diagnostics, consultations or education. The main objective is to encourage interest in telemedicine among physicians and other health care experts, initiate an exchange of opinions, and experience about the application of telecommunication technology in medicine, so to reach a common perception of its role in the context of future development of the health care system in Bosnia and Herzegovina. As a standard, current equipment consists of computers, which are equipped with frame grabbers and communication modem for communication through a public telecommunication system. Input data can all be visual data (X-Ray, CT, MRI, ultrasound, ECG, histological finding, cariogram, and of course photos of the patients, of operational/surgical field. The Institute of Pathology of the Sarajevo Medical Faculty has actively participated in the experimental project "SHARED" (1996-2000) together with the Radiology and Ophthalmology Clinic of the Sarajevo Clinical Centre. The past experience in using telemedicine has shown that the introduction of such a telemedicine system in B&H would be of great significance in the future in the context of providing better and more efficient health services to the patients. In practice, that means a more simple approach to some services and data for patients, a better and faster circulation of information and experience of medical experts and health care workers with cost control at the same time.

[Effect of eradication of Helicobacter pylori infection on endoscopic findings and symptoms of gastroesophageal reflux]. / Utjecaj eradikacije Helicobacter pylori infekcije na endoskopski nalaz i simptomatologiju gastroezofagealne refluksne bolesti.

Gastroesophageal reflux disease (GORD) represents an illness which reflects a syndrome caused by returning of acid gastric, alkaline pancreatic and bowels content into the oesophagus, which is in the stomach, because of the protective mechanisms of oesophageal loss. The aim of this study was that this prospective study should explain the role of Helicobacter pylori infection in modification of GORD, respectively whether the Helicobacter pylori infection acts protectively or by deterioration of the disease. According to the settled rules, the inquiry was performed as well as the selection of 97 candidates to undergo research in this study. Helicobacter pylori infection has been proved by immunoassay in all pts in the beginning of this study. Endoscopy has been performed in all pts, the degree of gastroesophageal reflux disease by Sawary-Miller was done. The main group consisted of 50 candidates in whom the eradication of Helicobacter pylori infection was done with triple therapy, pantoprazol + amoxycilin + klaritromicin, which was proven by an immunoassay test. Two groups of pts were formed: the main one with eradicated Helicobacter infection, and a controlled one with a Helicobacter positive infection, which was subject to modification of life style. During 12 months, this study consisted of endoscopic evaluations and monthly evaluation of pts daily difficulties. The eradication of Helicobacter pylori infection acts on the improvement of gastroesophageal disease course by improvement of endoscopic findings by Sawary-Miller, and by decreasing daily acid symptoms. The eradication of Helicobacter pylori infection in gastroesophageal reflux disease does it act at the symptoms such as heartburn, weekly acid symptoms and chest pain.