Evidence Of Chronic Gastritis Research Articles

The disappearing chief cell phenomenon (DCP): a preliminary report.

The appearance of chief cells was studied in normal dogs and in dogs after anterior and bilateral highly selective vagotomy. The normal chief cell is columnar in shape, with a well-defined cell membrane, basal nucleus and basophilic cytoplasm. Many cells show what has been called the 'disappearing chief cell phenomenon'--DCP. The features of the DCP are striking. There is fragmentation of the cell membrane, loss of cytoplasm, changes in the appearance of the nucleus and actual disappearance of some cells. The parietal cells remain normal. The DCP is seen in normal mucosa and should not be regarded as evidence of chronic gastritis. From this preliminary study it is suggested that the procedure of highly selective vagotomy may have a specific effect on pepsin secreting cells, increasing the amount of the DCP.

A topographic study of Helicobacter pylori density, distribution and associated gastritis.

The topographic distribution and density of Helicobacter pylori and associated gastritis in the stomach were studied in order to determine which biopsy sites are likely to provide the maximum yield so as to reduce the fallacious results due to sampling error. Fifty patients with upper gastrointestinal symptoms were studied. Eleven gastric biopsies from predetermined sites were obtained and subjected to ultra-rapid urease test, imprint cytology and histology. Haematoxylin and eosin stain was used for defining gastritis and other associated histopathological details. Loeffler's methylene blue stain was used to confirm the presence of H. pylori in imprint smears and histological sections. All 50 patients had H. pylori infection and evidence of chronic gastritis at one or more of the 11 biopsy sites. Maximum and minimum percentage positivity were observed at A3 (antral lesser curvature) and B4 (corpus greater curvature), respectively. Various sites in decreasing order of percentage positivity were A3 > A2 > A1 > A4 > B3 > B1 > A5 > B6 > B5 > B2 > B4. Among the biopsies obtained from the corpus, B3 (corpus lesser curvature) was the site with maximum positivity. A3 and B4 had a statistically significant difference in percentage positivity (P < 0.0001) for H. pylori and gastritis. The maximum and minimum density scores of H. pylori and gastritis were found in A3 and the B4, respectively. A3 had a significantly higher (P < 0.0001) mean density score than any other site in the stomach. The difference in the grading of H. pylori between A3 and B3 (sites of maximum positivity in antrum and corpus) was statistically significant (P < 0.0001). A statistically significant (P < 0.001) positive correlation between increasing grades of H. pylori and gastritis was observed at the site of maximum density. Eighty per cent of the patients had antral predominant gastritis and in 82%, H. pylori was predominantly observed in antral biopsies. It is concluded that two biopsies taken from A3 are sufficient for confirmation of presence of H. pylori and associated gastritis for initiation of treatment. However, additional biopsies from B3 will help in deciding the topographic pattern of gastritis.

Multiple transverse folds in the gastric antrum.

Fine transverse folds of the esophagus are well described as a transient motor phenomenon seen in patients with or without gastroesophageal reflux. They appear to be due to contraction of the muscularis mucosa and are thought to have little, if any, significance. We have observed similar transverse folds in the gastric antrum during double-contrast upper gastrointestinal series in five patients. In contrast to the transient nature of the folds in the esophagus, these gastric folds were more persistent. They were seen in multiple spot images with the gastric antrum distended or partially collapsed and even during peristalsis. In follow-up studies, the folds were repeatedly demonstrated in two patients. Two patients had associated gastric polyps with histologic evidence of chronic gastritis; however, the antral mucosa appeared normal on endoscopy. The remaining three patients had no associated gastric disease. The pathophysiologic significance of these folds is yet to be determined; however, they appear to be clinically insignificant.

Intestinal mucinous substances in gastric intestinal metaplasia and carcinoma studied by immunofluorescence.

Immunofluorescent studies using specific antisera against intestinal mucins revealed small intestinal mucin antigen (SIMA) and large intestinal mucin antigen (LIMA) in areas of intestinal metaplasia of the stomach. In 25 gastric carcinomas studied, both these antigens were detected in seven carcinomas, SIMA only was present in four and LIMA in only four cases; the antigens could not be detected in ten of the carcinomas. In 21 of the 25 gastric operation specimens, including the 15 carcinomas positive for intestinal mucin antigens, there was evidence of chronic gastritis and intestinal metaplasia. These immunohistologic observations confirm the results of recent histochemical studies that both small and large intestinal type mucins are present in intestinal metaplasia and gastric carcinomas. Our findings provide further evidence that at least a proportion of gastric carcinomas may supervene on intestinal metaplasia. The absence of one or both antigens in gastric carcinomas may indicate stages of dedifferentiation or alternatively differences in histogenesis.