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Gut and Liver Jan 2018Differences in the infection rate are not sufficient to clarify the dissimilarity of gastric cancer incidence between Myanmar and its neighboring countries. To better...
BACKGROUND/AIMS
Differences in the infection rate are not sufficient to clarify the dissimilarity of gastric cancer incidence between Myanmar and its neighboring countries. To better understand this trend, the virulence gene was characterized in Myanmar.
METHODS
Glutamate-proline-isoleucine-tyrosine-alanine (EPIYA) patterns and CagA multimerization (CM) motifs of genotypes were examined by performing polymerase chain reactions and DNA sequencing.
RESULTS
Of 69 tested strains, -positive patients had significantly more severe histological scores in their antrum than -negative patients. Sequence analysis revealed that 94.1% of strains had Western-type containing an EPIYA motif (92.6%) or EPIYT motif (6.4%). The intestinal metaplasia scores in the antral of patients infected with the ABC and ABCC types of were significantly higher than those of patients with AB-type . Interestingly, in patients infected with , 46.3% of strains with three EPIYA motifs contained two identical Western-typical CM motifs, and these patients showed significantly higher antrum inflammation scores than patients infected with two identical nontypical-CM motif strains (p=0.02).
CONCLUSIONS
In Myanmarese strains, Western-type was predominant. The presence of CM motifs and the proportion of multiple EPIYA-C segments might partially explain the intermediate gastric cancer risk found in Myanmar.
Topics: 3' Flanking Region; Adult; Antigens, Bacterial; Bacterial Proteins; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Intestines; Male; Metaplasia; Middle Aged; Myanmar; Polymerase Chain Reaction; Pyloric Antrum; Sequence Analysis, DNA; Stomach Neoplasms
PubMed: 29069889
DOI: 10.5009/gnl17053 -
Postgraduate Medicine Apr 2017Although a common cause of intestinal blood loss, the pathophysiology of gastric antral vascular ectasia (GAVE) is not well understood. We aimed to evaluate gastric...
OBJECTIVES
Although a common cause of intestinal blood loss, the pathophysiology of gastric antral vascular ectasia (GAVE) is not well understood. We aimed to evaluate gastric antral and body mucosal flow in GAVE patients compared to a control population using laser Doppler flowmetry.
METHODS
27 patients with GAVE and 11 control patients without GAVE were evaluated using an endoscopic LDF probe. The probe was placed in the gastric antrum and body in order to calculate standardized mucosal flow rates recorded as perfusion units (PU).
RESULTS
Despite its hyperemic appearance and propensity to bleed, antral blood flow was not increased in GAVE: 115.5 PU (IQR: [94.4, 135.9 PU]) in GAVE versus 123.7 PU (IQR: [109.7, 186.5 PU]) in controls. There was a significant gradient between the gastric body and antral blood flow in GAVE (p < 0.001) that was not evident in controls.
CONCLUSION
These results indicate that antral mucosal blood flow is not increased in GAVE despite its grossly hyperemic appearance. A mild but statistically significant gradient was noted between the gastric antrum and body in patients with GAVE compared to controls. The pathophysiological significance of this finding is uncertain.
Topics: Aged; Diabetes Complications; Female; Fibrosis; Gastric Antral Vascular Ectasia; Gastric Mucosa; Gastroscopy; Humans; Laser-Doppler Flowmetry; Male; Middle Aged; Prospective Studies; Proton Pump Inhibitors; Pyloric Antrum; Stomach
PubMed: 28299959
DOI: 10.1080/00325481.2017.1301191 -
Medicine Apr 2023Atrophic gastritis can cause mucosa thinning, while detailed metrological evidence is lacking. We aimed to compare the morphological features of full-thickness gastric...
Atrophic gastritis can cause mucosa thinning, while detailed metrological evidence is lacking. We aimed to compare the morphological features of full-thickness gastric mucosa in antrum and corpus and evaluate the diagnostic performance for atrophy. Gastric cancer patients were prospectively enrolled (N = 401). Full-thickness gastric mucosa was obtained. Foveolar length, glandular length and musculus mucosae thickness were measured. Pathological assessment was conducted using the visual analogue scale of the updated Sydney system. Areas under the receiver operating characteristic curves (AUCs) were calculated for different atrophy degrees. In corpus mucosa, foveolar length and musculus mucosae thickness were positively correlated with the atrophy degree (spearman's correlation coefficient [rs] = 0.231 and 0.224, respectively, P < .05); glandular length and total mucosal thickness were negatively correlated (rs = -0.399 and -0.114, respectively, P < .05). Total mucosal thickness did not correlate with antral atrophy degree (P = .107). The AUCs of total mucosal thickness for corpus and antral atrophy were 0.570 (P < .05) and 0.592 (P < .05), respectively. The AUCs for corpus atrophy, moderate and severe, and severe atrophy were 0.570 (P < .05), 0.571 (P = .003), and 0.584 (P = .006), respectively. The corresponding AUCs for antral atrophy were 0.592 (P = .010), 0.548 (P = .140), and 0.521 (P = .533), respectively. The tendency for mucosal thickness to thin with atrophy occurred in the corpus rather than in the antrum. The diagnostic performance of corpus and antral mucosal thickness was limited for atrophy.
Topics: Humans; Gastritis, Atrophic; Gastritis; Helicobacter Infections; Helicobacter pylori; Gastric Mucosa; Atrophy; Pyloric Antrum
PubMed: 37026936
DOI: 10.1097/MD.0000000000033480 -
Saudi Medical Journal Nov 2023The incidence of malignant transformation in ectopic pancreas (EP), including adenocarcinoma, is extremely rare. Herein, we presented a single case with invasive... (Review)
Review
The incidence of malignant transformation in ectopic pancreas (EP), including adenocarcinoma, is extremely rare. Herein, we presented a single case with invasive adenocarcinoma caused by the EP in the stomach. The patient consulted our hospital due to abdominal discomfort with acid regurgitation. Computed tomography scan showed a pyloric obstruction and thickening of the gastric wall in the gastric antrum; a digestive endoscopic examination showed mucosal congestion, swelling in the anterior pyloric area, and pyloric canal stenosis. Next, the patient underwent gastrointestinal surgery, and the distal gastrectomy specimens revealed a deviation of 10 cm towards the lesser curvature and an extension of 22 cm towards the greater curvature. A 5.5 x 5.4 cm round-like mass was found during surgery. Pathological examination suggested invasive submucosal adenocarcinoma located under the gastric antrum mucosa. Our report provides additional clinical experience for diagnosing EP with canceration in the stomach.
Topics: Humans; Stomach Neoplasms; Pyloric Antrum; Pancreas; Adenocarcinoma
PubMed: 37926464
DOI: 10.15537/smj.2023.44.11.20220914 -
Scandinavian Journal of Gastroenterology Jan 2020Interactions between (Hp) and gastroesophageal reflux disease (GERD), which are common diseases worldwide, are confusing. In this study, the aim was to compare and...
Interactions between (Hp) and gastroesophageal reflux disease (GERD), which are common diseases worldwide, are confusing. In this study, the aim was to compare and evaluate the relationship between reflux esophagitis (RE) and Hp infection in adult patients with both the gastric localization of Hp and its histopathologic features. 248 patients with RE were compared with 249 age and sex matched control groups. Biopsy specimens obtained from the gastric antrum and corpus were histologically evaluated. The incidence of Hp infection was significantly lower in patients with RE than in the control group (Ratio 1.53, 95% CI 1.07-2.20; = .02, < .05). Corpus Hp colonization and corpus gastritis scores were notably lower in the study group ( = .01, < .05), whereas there was no significant difference in Hp colonization and antrum gastritis scores in the antrum. Corpus Hp colonization and gastritis scores were found to be negatively correlated with esophagitis development ( = -0.11; = .01; ( = -0.14; = .00 respectively, < .05). There was no difference between the groups in terms of atrophy development ( > .05). This study showed that the presence of Hp infection in the corpus and corpus gastritis score was significantly lower in patients with erosive reflux esophagitis than in the control group. It also showed that Hp colonization and corpus gastritis scores were negatively correlated with esophagitis development. This inverse relationship was independent of atrophy.
Topics: Adult; Case-Control Studies; Esophagitis, Peptic; Female; Gastric Mucosa; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Pyloric Antrum; Severity of Illness Index
PubMed: 31865819
DOI: 10.1080/00365521.2019.1701071 -
Cellular and Molecular Gastroenterology... 2021Helicobacter pylori infection in humans typically begins with colonization of the gastric antrum. The initial Th1 response occasionally coincides with an increase in...
BACKGROUND & AIMS
Helicobacter pylori infection in humans typically begins with colonization of the gastric antrum. The initial Th1 response occasionally coincides with an increase in gastrin secretion. Subsequently, the gastritis segues to chronic atrophic gastritis, metaplasia, dysplasia and distal gastric cancer. Despite these well characterized clinical events, the link between inflammatory cytokines and non-cardia gastric cancer remains difficult to study in mouse models. Prior studies have demonstrated that overexpression of the Hedgehog (HH) effector GLI2 induces loss of gastrin (atrophy) and antral hyperplasia. To determine the link between specific cytokines, HH signaling and pre-neoplastic changes in the gastric antrum.
METHODS
Mouse lines were created to conditionally direct IL1β or IFN-γ to the antrum using the Gastrin-CreERT2 and Tet activator. Primary cilia, which transduces HH signaling, on G cells were disrupted by deleting the ciliary motor protein KIF3a. Phenotypic changes were assessed by histology and western blots. A subclone of GLUTag enteroendocrine cells selected for gastrin expression and the presence of primary cilia was treated with recombinant SHH, IL1β or IFN-γ with or without kif3a siRNA.
RESULTS
IFN-γ increased gastrin and induced antral hyperplasia. However, antral expression of IL1β suppressed tissue and serum gastrin, while also inducing antral hyperplasia. IFN-γ treatment of GLUTAg cells suppressed GLI2 and induced gastrin, without affecting cilia length. By contrast, IL1β treatment doubled primary cilia length, induced GLI2 and suppressed gastrin gene expression. Knocking down kif3a in GLUTAg cells mitigated SHH or IL1β suppression of gastrin.
CONCLUSIONS
Overexpression of IL1β in the antrum was sufficient to induce antral hyperplasia coincident with suppression of gastrin via primary cilia. ORCID: #0000-0002-6559-8184.
Topics: Animals; Antiviral Agents; Cilia; Gastrins; Helicobacter Infections; Helicobacter pylori; Hyperplasia; Interferon-gamma; Interleukin-1beta; Mice; Mice, Inbred C57BL; Mice, Transgenic; Pyloric Antrum
PubMed: 33347972
DOI: 10.1016/j.jcmgh.2020.12.008 -
Digestive Endoscopy : Official Journal... Nov 2015As atrophic gastritis and intestinal metaplasia as a result of Helicobacter pylori are considered risk factors for gastric cancer, it is important to assess their...
BACKGROUND AND AIM
As atrophic gastritis and intestinal metaplasia as a result of Helicobacter pylori are considered risk factors for gastric cancer, it is important to assess their severity. In the West, the operative link for gastritis assessment (OLGA) and operative link for gastric intestinal metaplasia assessment (OLGIM) staging systems based on biopsy have been widely adopted. In Japan, however, narrow-band imaging (NBI)-magnifying endoscopic diagnosis of gastric mucosal inflammation, atrophy, and intestinal metaplasia has been reported to be fairly accurate. Therefore, we investigated the practicality of NBI-magnifying endoscopy (NBI-ME) for gastritis staging.
METHODS
We enrolled 55 patients, in whom NBI-ME was used to score the lesser curvature of the antrum (antrum) and the lesser curvature of the lower body (corpus). The NBI-ME score classification was established from images obtained beforehand, and then biopsy specimens taken from the observed areas were scored according to histological findings. The NBI-ME and histology scores were then compared. Furthermore, we assessed the NBI-ME and histology stages using a combination of scores for the antrum and corpus, and divided the stages into two risk groups: low and high. The degree to which the stage assessed by NBI-ME approximated that assessed by histology was then ascertained.
RESULTS
Degree of correspondence between the NBI-ME and histology scores was 69.1% for the antrum and 72.7% for the corpus, and that between the high- and low-risk groups was 89.1%.
CONCLUSION
Staging of gastritis using NBI-ME approximates that based on histology, and would be a practical alternative to the latter.
Topics: Atrophy; Biopsy; Cardia; Cross-Sectional Studies; Diagnosis, Computer-Assisted; Diagnosis, Differential; Equipment Design; Gastric Mucosa; Gastritis; Gastroscopes; Gastroscopy; Humans; Metaplasia; Narrow Band Imaging; Pyloric Antrum; Retrospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Stomach Neoplasms
PubMed: 25923666
DOI: 10.1111/den.12483 -
Infection and Immunity Jan 2021is a chronic bacterial pathogen that thrives in several regions of the stomach, causing inflammation that can vary by site and result in distinct disease outcomes....
is a chronic bacterial pathogen that thrives in several regions of the stomach, causing inflammation that can vary by site and result in distinct disease outcomes. Whether the regions differ in terms of host-derived metabolites is not known. We thus characterized the regional variation of the metabolomes of mouse gastric corpus and antrum organoids and tissue. The uninfected secreted organoid metabolites differed between the corpus and antrum in only seven metabolites as follows: lactic acid, malic acid, phosphoethanolamine, alanine, uridine, glycerol, and isoleucine. Several of the secreted chemicals were depleted upon infection in both regions, including urea, cholesterol, glutamine, fumaric acid, lactic acid, citric acid, malic acid, and multiple nonessential amino acids. These results suggest a model in which preferentially uses carboxylic acids and amino acids in complex environments, and these are found in both the corpus and antrum. When organoid metabolites were compared to mouse tissue, there was little overlap. The tissue corpus and antrum metabolomes were distinct, including antrum-elevated 5-methoxytryptamine, lactic acid, and caprylic acid, and corpus-elevated phospholipid products. The corpus and antrum remained distinct over an 8-month infection time course. The antrum displayed no significant changes between the time points in contrast to the corpus, which exhibited metabolite changes that were consistent with stress, tissue damage, and depletion of key nutrients, such as glutamine and fructose-6-phosphate. Overall, our results suggest that the corpus and antrum have largely but not completely overlapping metabolomes that change moderately upon infection.
Topics: Animals; Female; Gastric Mucosa; Gastritis; Helicobacter pylori; Humans; Metabolomics; Mice; Mice, Inbred C57BL; Models, Animal; Pyloric Antrum
PubMed: 33168589
DOI: 10.1128/IAI.00690-20 -
Pyloric gland adenoma with low-grade intraepithelial neoplasia: A case report and literature review.Medicine Jun 2021Pyloric gland adenoma (PGA) is often associated with pyloric gland metaplasia. It has high malignant potential but a low clinical diagnosis rate. Therefore, we reported... (Review)
Review
RATIONALE
Pyloric gland adenoma (PGA) is often associated with pyloric gland metaplasia. It has high malignant potential but a low clinical diagnosis rate. Therefore, we reported a case of PGA and reviewed the literature to summarize the clinicopathological features of pyloric adenoma.
PATIENT CONCERNS
A 62-year-old female underwent gastroscopy due to intermittent acid regurgitation and heartburn, which revealed a 4×6 mm flat, elevated lesion in the greater curvature of the upper gastric body, with depression in the central region and blood scab attachment.
DIAGNOSIS AND INTERVENTION
Biopsy revealed gastric adenoma with low-grade intraepithelial neoplasia. The patient was treated with ESD, and pathology showed gastric pyloric gland adenoma with low-grade dysplasia. The cells were positive for MUC6 and MUC5AC immunohistochemically.
OUTCOMES
The patient received proton pump inhibitors and gastric mucosal protective agents for one month after ESD. She occasionally presented acid regurgitation and heartburn, with no abdominal pain, abdominal distension, melena, or hematochezia. Follow-up gastroscopy will be reexamined 1 year later.
LESSONS
PGA has nonspecific performance under endoscopy, and its diagnosis mainly depends on pathology. Clinicians need to increase their ability to recognize such lesions and treat them in time to improve the prognosis.
Topics: Adenoma; Biomarkers, Tumor; Carcinoma in Situ; Endoscopic Mucosal Resection; Female; Gastric Mucosa; Gastroscopy; Humans; Middle Aged; Pyloric Antrum; Stomach Neoplasms; Treatment Outcome
PubMed: 34160413
DOI: 10.1097/MD.0000000000026378 -
Neurogastroenterology and Motility Jul 2016Depletion and ultrastructural changes of interstitial cells of Cajal (ICC) in the gastric body and antrum have been observed in gastroparesis. This research was...
BACKGROUND
Depletion and ultrastructural changes of interstitial cells of Cajal (ICC) in the gastric body and antrum have been observed in gastroparesis. This research was performed to investigate the ICC population in the muscularis propria and fibrosis of the muscular layer of the pylorus in gastroparesis.
METHODS
Full thickness pyloric and antral biopsies were obtained from 17 gastroparetic and 6 non-gastroparetic controls. Biopsies were stained with C-Kit for ICC and Trichrome for collagen fibrosis. Interstitial cells of Cajal depletion in the antrum was defined as mean ICC count <10 per 20 high power fields (HPF) based on established data.
KEY RESULTS
The average pyloric ICC count was ≥10/HPF in the control patients. Twelve (70.5%) gastroparetic patients had pyloric ICC loss. Only five patients (29.4%) had ICC loss in the antrum. Gastric emptying (GE) was not significantly different in patients with depleted vs normal pyloric ICC. However, GE at 2 h was slower in patients with antral ICC <10/HPF compared to those with normal antral ICC populations. Collagen fibrosis was observed in the pylorus of 14 (82.3%) patients. Inclusion bodies in the muscularis propria of the pylorus were identified in four patients, all with diabetic gastroparesis.
CONCLUSIONS & INFERENCES
In gastroparetic patients, ICC loss in the pylorus is twice as common as in the antrum and fibrosis in the pyloric smooth muscle is nearly three times more common than the antrum. These findings can provide one explanation for pyloric dysfunction which is a contributing factor to the pathophysiology of gastroparesis.
Topics: Adult; Case-Control Studies; Female; Fibrosis; Gastric Emptying; Gastroparesis; Humans; Interstitial Cells of Cajal; Male; Middle Aged; Muscle, Smooth; Pylorus
PubMed: 26940535
DOI: 10.1111/nmo.12806