The diagnosis of peptic ulcer must be precise and based on both endoscopic examination (in the case of gastric ulcer to differentiate between benign or malign ulcers), and on bioptic examination. Peptic ulcer is pathogenetically associated with H. pylori. A small group of patients with duodenal ulcers and without H. pylori or without an other known cause (NSAID, etc.) is a poorly defined sub-group of patients. H. pylori has an important role in the pathogenesis of gastritis and bulbitis. Both states are involved in the pathogenesis of peptic ulcer. If H. pylori is eradicated, inflammatory changes of the gastric and duodenal mucosa recede and the recurrence of peptic ulcer decreases to a minimal size. For estimation of H. pylori, several invasive and non-invasive techniques are used. Among invasive methods most used in peptic ulcers, a combination of the rapid urease test and histology seems to be the most important. Among non-invasive methods, the breath tests are the most reliable. The treatment is focused on the eradication of H. pylori (no H. pylori is found one month or more after completed therapy). Of the eradication regimens, the triple therapy with proton pump inhibitors, claritromycin and metronidazole or amoxicillin are most effective. If this therapy fails, quadrutherapy (triple therapy combined with colloid bismuth subcitrate) may be successful. The precise diagnosis of peptic ulcer and H. pylori infection is a basic prerequisite for rational therapy of peptic ulcer disease and its relapses.
The authors present a review of contemporary findings concerning treatment of gastroduodenal ulcers with a positive finding of Helicobacter pylori. Only combined anti-Helicobacter treatment leads to the eradication of Helicobacter pylori in 80-96% of the patients. Moreover it leads to gradual recovery from gastritis and bulbitis and thus prevents ulcer recurrence.
- MeSH
- gastritida komplikace MeSH
- Helicobacter pylori * MeSH
- infekce vyvolané Helicobacter pylori komplikace farmakoterapie MeSH
- lidé MeSH
- peptický vřed komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Neopterin, a pteridine compound produced by macrophages activated by interferon-gamma, is widely used to assess the activation of cellular immunity. An elevation in serum or urinary neopterin reflects immune activation in many different disorders, including viral infections, cancer, autoimmune diseases or acute myocardial infarction, but less attention has been paid to neopterin concentration in other biological fluids. The aim of the present study was to examine neopterin concentration in gastric juice. An association with the presence of Helicobacter pylori, a bacterium linked to the most common disorders of upper digestive tract, was also investigated. Gastric juice was obtained at endoscopy from 61 patients. Neopterin was determined by a radioimmunoassay and the presence of H. pylori was examined by urease test. The macroscopic finding of bile in gastric juice was associated with significantly higher neopterin levels compared to patients where no bile was noted (15.5 +/- 15.6 vs. 2.1 +/- 3.0 nmol/l, P < 0.001). However, similar concentrations were observed in the H. pylori positive and H. pylori negative patients (7.6 +/- 12.0 vs. 11.1 +/- 14.9 nmol/l). Even in the absence of macroscopic bile contamination, no significant difference could be found between the infected and uninfected patients (2.3 +/- 3.2 vs. 1.3 +/- 1.9 nmol/l), and the patients with duodenal ulcer and normal findings (3.8 +/- 4.6 vs 1.6 +/- 1.9 nmol/l). The contamination of gastric juice with bile represents the limitation for the use of neopterin as a marker of immune activation in the gastric mucosa. Rather than an index of immune activation, gastric juice neopterin concentration represents a marker of duodenogastric reflux.
- MeSH
- antrum pyloricum mikrobiologie MeSH
- biopteriny analogy a deriváty biosyntéza MeSH
- buněčná imunita MeSH
- dospělí MeSH
- Helicobacter pylori imunologie MeSH
- infekce vyvolané Helicobacter pylori imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- neopterin MeSH
- radioimunoanalýza MeSH
- senioři MeSH
- ureasa metabolismus MeSH
- žaludeční šťáva chemie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- biopteriny MeSH
- neopterin MeSH
- ureasa MeSH
UNLABELLED: Inflammatory bowel disease can be associated with increased platelet count. Aim of our study was focused on assessing thrombocyte count in evaluation of the activity in Crohn's disease (CD). The study included a total of 19 patients [6 men, 13 women (aged 18-57 years, mean 33, median 28]. All patients were malnourished in active stage of the disease on total parenteral and/or enteral nutrition (TP/EN). Thrombocytes were estimated at the beginning and after 3 weeks of TP/EN in venous blood sample using automatic analyser Coulter Counter JT3 (normal range: 130-380.10(9)/l). Serum prealbumin, transferrin, haptoglobin, alpha 1-orosomucoid and C-reactive protein were measured simultaneously. Thrombocytes count below 400.10(9)/l was found only in 1/19 at the beginning and in 7/19 patients in the end of the study. After 3 weeks of TP/EN a significant platelet count fall was found (mean +/- sd: 472 +/- 98 vs. 354 +/- 110, p < 0.01). A correlation was found between thrombocytes and serum prealbumin (r = -0.3871, p < 0.05), haptoglobin (r = 0.5247, p < 0.001), alpha 1-orosomucoid (r = 0.4857, p < 0.01) a C-reactive protein (r = 0.4354, p < 0.01). CONCLUSION: Thrombocyte count helped in the assessing of disease activity in CD on 3-week-TP/EN. Improvement of clinical status, increase of nutritional parameters and decrease of positive acute phase reactants were associated with a fall of platelet count in 15/19 patients.
- MeSH
- Crohnova nemoc krev diagnóza terapie MeSH
- dospělí MeSH
- enterální výživa * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- parenterální výživa úplná * MeSH
- počet trombocytů * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
Increased immunoglobulin G2 [IgG2] in Crohn's disease in contrast with increased IgG1 in ulcerative colitis was reported in literature data. The aim of our study has been focused on serum IgG subclasses in Crohn's disease with resected bowel (11 patients) and without previous surgery for Crohn's disease (12 patients). All patients were in active stage of the disease on total parenteral nutrition. Serum IgG subclasses were estimated by means of radial immunodiffusion. There was no significant differences between in IgG subclasses in Crohn's disease with and without bowel resection. IgG2 over 4.5 g/l was found only in 2/12 with resected bowel and 1/11 without previous surgery for Crohn's disease. Surprisingly, IgG1/IgG2 ratio below 1.5 was found only in 5/23 persons. In 3/23 patients IgG1 was over 10.5 g/l although there was no doubt about the diagnosis of Crohn's disease. IgG subclasses failed to help in confirmation of the diagnosis of Crohn's disease. Serum IgG subclasses alterations probably are not influenced by bowel resection and/or nutritional status.
- MeSH
- Crohnova nemoc imunologie chirurgie MeSH
- dospělí MeSH
- imunoglobulin G krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- střeva chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- imunoglobulin G MeSH
Helicobacter pylori (Hp) is unequivocally the most frequent cause of antral gastritis and most probably participates in the majority of cases in the aetiology of gastritis affecting the body of the stomach. The close relationship between antral gastritis and duodenal ulceration is documented by the high incidence of Hp in these patients (90-100%). The problem of Hp negative cases of duodenal ulceration was not finally resolved yet. The absence of Hp in duodenal ulcer usually implies a different aetiology (NSAID, gastrinoma etc.). Hp is eliminated by a number of drugs (bismuth preparations, some antibiotics, metronidazole), however, eradication (Hp negativity after a month or longer following termination of treatment) is ensured so far only by a combination of several drugs. Less clear are the relations with gastric ulcers. The presence of Hp in the antral mucosa is substantially smaller, however, when the mucosa near the ulcer is examined it is also almost 100%. The relationship of antral gastritis and non-ulcer dyspepsia is not quite clear. Hp is found in about half the patients and its elimination (e.g. by bismuth preparations), has a favourable impact on inflammatory changes as well as on the patient's complaints. The regression of complaints is more permanent than after antacids which have only a favourable effect on complaints but not on Hp and the inflammation.
- MeSH
- dospělí MeSH
- gastritida mikrobiologie MeSH
- Helicobacter pylori * MeSH
- infekce vyvolané Helicobacter pylori komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- peptický vřed mikrobiologie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
Colicins are proteinaceous substances produced by Escherichia coli strains and related bacteria of Enterobacteriaceae family. They are considered to be an important factor in preserving the balance of the intestinal microflora. Their antibiotic action on susceptible bacteria is supplemented with cytotoxicity for several pro- and eukaryotic cells. The large bowel is a natural site of their action. Besides of enhancing oxidoreductive activity of leukocytes in vitro, colicins are also believed to influence inflammatory reaction in vivo. For these reasons, the first part of the present work was concerned with studying colicinogeny in nonspecific inflammatory bowel diseases (IBD). No significant difference has been found out in colicinogeny between a total of 93 IBD-related and 160 healthy controls. In testing leukocyte migration inhibition, colicins of autologous E. coli were used as antigens. The migration index out of normal range showed 36% patients with ulcerative colitis (5/14), 80% patients with Crohn's disease (12/15), and only one clinically healthy control subject (1/16; 6%). The obtained results are considered to be proof of cellular hypersensitivity of IBD patients to colicins of their own E. coli strains. In several colicins the antitumorous effect has been reported in both the in vitro and in vivo experimentation. The second part of this work was concerned with colicinogeny in colorectal cancer. Colicinogenic E. coli were evidenced in 42 subjects (40%) from 105 patients with colorectal carcinoma. Controls showed colicinogenic E. coli in 102/160 clinically healthy subjects (64%), and the difference was as significant as p less than 0.05. In colorectal cancer group, the subjects with proved colicinogeny showed lesser amounts of colicinogenic E. coli strains in contrast with non-colicinogenic ones. In colorectal cancer patients with colicinogenic E. coli strains, B and M colicins were of most frequent occurrence in them no antitumorous effect has been experimentally stated. If changes of colicinogeny were only either the manifestation or consequence of tumor disease, so both the presence or absence of colicinogenic E. coli would have been dependent of clinical patients's condition, stage of disease (in accord with Dukes) or correlated with the tumor markers. For these accounts, a total of 28 colorectal cancer patients underwent a colicinogenic study. However, no colicinogeny dependence was evidenced of either clinical condition or Dukes stage, showing no correlation with any of cancer markers investigated (carcinoembryonic antigen, CA 19-9, alfa-1-fetoprotein, alfa-1-orosomucoid, Cancer serum index, sialic acid, lysozyme).(ABSTRACT TRUNCATED AT 400 WORDS)
- MeSH
- dospělí MeSH
- Escherichia coli genetika metabolismus MeSH
- idiopatické střevní záněty mikrobiologie MeSH
- koliciny metabolismus MeSH
- kolorektální nádory diagnóza mikrobiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádorové biomarkery analýza MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- koliciny MeSH
- nádorové biomarkery MeSH
The authors describe a case of myeloid leukemia of the myelomonocytic type (M4, FAB 1976) where blastic cells bear the lymphoblastic cALL sign. These cases of the so-called hybrid phenotype of acute leukemia are rare. The importance of the hybrid phenotype for the course and prognosis of the disease is not known.
- MeSH
- akutní myelomonocytární leukemie imunologie MeSH
- antigeny nádorové analýza MeSH
- diferenciační antigeny analýza MeSH
- dospělí MeSH
- hematopoetické kmenové buňky imunologie MeSH
- lidé MeSH
- nádorové biomarkery analýza MeSH
- neprilysin MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- antigeny nádorové MeSH
- diferenciační antigeny MeSH
- nádorové biomarkery MeSH
- neprilysin MeSH
Crohn's disease is a disease with unknown etiology of which immunological mechanisms participate. As standard treatment is sometimes ineffective, in 15 patients therapeutic plasmapheresis was used. Before plasmapheresis and immediately after it some immunological parameters were assessed. In the serum a significant drop of all immunoglobulins of the basic classes was recorded: (P less than 0.05) and of circulating immunocomplexes (P less than 0.02). Marked clinical improvement was observed in three patients, which as compared with data in the literature, is somewhat less. The cause is in the author's opinion in the selection of patients (plasmapheresis is usually most successful in patients with marked activity of the disease and non-intestinal symptoms) even in case of less active plasma exchange. Despite this plasmapheresis can be recommended in patients with a poor response to common conservative treatment and in some of them we may expect a marked therapeutic effect with a favourable influence on the prognosis of the disease.
- MeSH
- Crohnova nemoc terapie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- plazmaferéza * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
The leukocyte migration inhibition test was performed in 39 patients with Helicobacter pylori infection and in 38 patients without such infection. The culture of Helicobacter pylori was used as antigen. A highly significant inhibitory effect on leukocyte migration was found in patients with Helicobacter pylori infection. The results can be taken as proof of a systemic immune response to helicobacters at the cellular level in patients with Helicobacter pylori infection.
- MeSH
- buněčná imunita MeSH
- dospělí MeSH
- Helicobacter pylori imunologie MeSH
- infekce vyvolané Helicobacter pylori imunologie MeSH
- inhibice migrace buněk * MeSH
- lidé středního věku MeSH
- lidé MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
