[Helicobacter pylori and gastro-duodenal pathology]. / Helicobacter pylori e patologia gastro-duodenale.

Helicobacter Pylori (HP) were found in 878 (73%) of 1205 patients undergoing upper G-I endoscopy with multiple biopsies for gastroduodenal diseases. HP were present in similar percentages among patients with active (89%) or healed (81%) peptic ulcer as well as in non ulcerous dyspeptics affected with gastritis (85%). 96% of active chronic gastritis were infected by HP as compared with 55% of quiescent gastritis. Antral gastritis was more frequently active in patients with ulcer diseases (76%) than in dyspeptic and asyntomatic patients (50%). Healed gastric and duodenal ulcers showed decreased incidence of active antral gastritis (69) as compared with active ulcers. Conversely body gastritis was more frequently active in healed (37%) than in overt (18%) duodenal ulcers. 95 histologically normal stomachs as well as 9 cases exhibiting type A gastritis were devoid of HP. High rates of infection were found in 610 cases of chronic gastritis without atrophy as well as in 151 atrophic antral (type B) gastritis. Cytoplasmic vacuolization and swelling of foveolar-superficial cells with adhering bacteria, micropapillae and microerosions were commonly found in HP-infected mucosa. In 16 of 19 children with type B chronic gastritis antibacterial therapy eradicated HP. This was followed by resolution or striking improvement of gastritis and disappearance of epithelial lesions.

[Clinical results of a combined peri- and intra-venous technic in endoscopic sclerosis of esophageal varices]. / Risultati clinici di una tecnica mista peri- ed endovenosa nella sclerosi endoscopica di varici esofagee.

A series of 20 patients with bleeding oesophageal varices treated by endoscopic sclerotherapy is presented. The technique employed involved injecting the sclerosing fluid into peri- and endovenous variceal sites once a week for 4 weeks running followed by a month's rest. Up to three of those cycles were performed. However in 12 patients the risk of bleeding had fallen from 100% to 0% after 6 sessions. In the other 6 patients the risk was eliminated after the remaining cycles. In 2 patients only the sclerotherapy was suspected after the first session due to the deterioration of the syndrome. Four different complications were observed. Various degrees of bleeding recurred in 9 patients, retrosternal or epigastric pain after injection in 6, medium level coma in 2 and oesophageal ulcers at the injection site in another 2. Overall the mixed peri- and endovenous sclerosing technique was easy to handle and effective with a low incidence of failures and complications.

High incidence of Campylobacter-like organisms in endoscopic biopsies from patients with gastritis, with or without peptic ulcer.

Campylobacter-like organisms (CLOs) were histologically detected in 230 (74.5%) of 310 patients undergoing endoscopy with multiple gastric biopsies for symptoms suggestive of upper digestive disease. CLOs were found in 78.6% of nonulcerous dyspeptic patients, 82.2% of healed ulcers, 88.2% of duodenal or pyloric ulcers and 90.0% of gastric ulcers but only in 46.9% of gastric stumps and 47.6% of nonulcerous patients without dyspepsia. Among 274 subjects with gastritis, CLOs were found in 83.9%, while none of the 36 gastritis-free stomachs harbored CLOs. Severe atrophic gastritis was less frequently infected with CLO (55.5%) as compared with superficial, interstitial or preatrophic gastritis (84.4%). CLOs were only slightly more frequent in the presence of intraepithelial granulocytes and were never found in areas of complete intestinal metaplasia. Foveolar and superficial epithelia heavily infected with CLOs showed peculiar ultrastructural changes (micropapillary hyperplasia with luminal bulging of mucous cells, cytoplasmic vacuolization and edema, etc.) suggesting a direct link between CLO infection and epithelial damage, which in turn may have a role in the genesis of mucosal inflammation.

[Use of the pancreolauryl test in the diagnosis of exocrine pancreatic insufficiency. Preliminary results]. / Utilizzazione del pancreolauryl test nella diagnosi di insufficienza pancreatica esocrina. Risultati preliminari.

The Pancreolauryl Test (PLT), a tubeless test used to study exocrine pancreatic function, was performed in 18 patients (8 healthy controls and 10 patients with suspected chronic pancreatitis) to evaluate its sensitivity and clinical applicability. The sensitivity rate of PLT was 75%, the specificity 85.7%, the predictive value of a positive test 60% and of a negative test 92.3%. The PLT proved to be a non invasive, easy to perform test; besides it was acceptable to the patients, without collateral effects.