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Background/aims: Combining the magnifying endoscopy and the narrow-band imaging (NBI) system is an endoscopic imaging technique for the enhanced visualization of mucosal microscopic structure and capillaries of the superficial mucosal layer. Light blue crest (LBC) and, ridge/villous pattern have been thought to be suggestive signs for gastric intestinal metaplasia (IM) of magnifying NBI endoscopy. Since the IM is related to gastric cancer risk (GC), the prevalence of LBC and ridge/villous pattern in the nonneoplastic gastric antrum was examined in relation to gastric cancer (GC) risk and serological severity of gastritis., Methodology: In 100 subjects including 13 GC patients, gastric mucosal pattern were examined using magnifying NBI. The mucosal patterns in the antrum were classified according to the presence of LBC or ridge/villous pattern. Serum pepsinogen (PG) levels were also examined., Results: The sensitivity and specificity for predicting IM was the best when LBC and ridge/villous patterns were combined (sensitivity 95.2%, specificity 98.7%). Both LBC and ridge/villous pattern showed lower serum PGI and PGI/II ratio than those without (P = 0.046, 0.0005, respectively.) In particular, PGI/II ratio was lowest in ridge/villous pattern. The LBC and ridge/villous pattern showed higher incidence of all GC and diffuse GC compared to those without (P = 0.002, 0.002, respectively)., Conclusions: LBC and ridge/villous pattern in uninvolved gastric antrum by magnifying NBI endoscopy are useful signs for predicting gastric atrophy in the entire stomach and GC risk.

Background/aims: We investigated the effect of IL-1β and TNF-α polymorphisms, and its synergistic effect with age, gender and H. pylori status on the gastric pre-malignant condition., Methodology: IL-1β-31(T>C) and -511(C>T) and TNF-α-857 (C>T) polymorphisms were genotyped in 123 cancer free subjects. Degree of histological gastritis in both antrum and corpus, and extension of endoscopic gastric atrophy were also evaluated., Results: Significant associations were found between degrees of mononuclear cell infiltration (p=0.007) and atrophy (p=0.01) in the antrum with IL-1β-31(T>C) polymorphism, and degree of endoscopic gastric atrophy with both IL-1β-31(T>C), -511(C>T) polymorphisms (p=0.03, 0.04, respectively). When subjects were divided into the 3 groups according to the histological severity of gastric mucosal atrophy: the non-atrophic gastritis (NA) group (atrophy score=0 and metaplasia score=0), the severe atrophic gastritis (SA) group (atrophy score>=2 or metaplasia score>=2), and the mild atrophic gastritis (MA) group (all others), synergistic effect was found between numbers of IL-1β-31C, IL-1β-511T variant alleles with co-factors on the development of gastric atrophy in the antrum (gender + H. pylori + number of IL-1β-31C allele: p=0.001, age + gender + H. pylori + number of IL-1β-31C allele: p=0.0008, gender + H. pylori + number of IL-1β-511T allele: p=0.016, age + gender + H. pylori + number of IL-1β-511T allele: p=0.013), while such association was found for TNF-α-857 T allele in the antrum and all genotypes in the corpus., Conclusions: IL-1β-31C, IL-1β-511T variant alleles may accelerate gastric mucosal inflammation and atrophy, not only by themselves, but also through the interaction with co-factors.

Background/aims: Although serum pepsinogen (PG) is considered as a marker of gastric atrophy, it also reflects gastric acid secretion, which closely influences dyspeptic symptoms. We investigated serum PG levels and PGI/PGII ratios in dyspeptic patients, in relation to various different subtypes of symptoms including Rome III classifications., Methodology: Serum PGs were measured in 75 subjects with dyspeptic symptoms and 42 asymptomatic healthy subjects., Results: PG II level was significantly higher (p=0.0001) and PG I/II ratio was significantly lower (p<0.0001) in subjects with H. pylori infection than those without, while no associations were found between PG levels and usage of H2 receptor antagonists or proton-pump inhibitors. In all subjects with pain in stomach, abdominal bloating and PDS-like symptoms according to Rome III criteria, presented significantly higher levels of PGI, compared to subjects without symptoms (p=0.043, 0.015 and 0.037, respectively). In addition, burning sensation and abdominal pain presented significantly higher PGI/II ratios (p=0.0005 and 0.003, respectively), and higher PGI/II ratio was also positively correlated with a number of symptoms (p=0.04). When subjects were divided according to H. pylori infection status, higher PGI/II ratio was significantly associated with abdominal pain in H. pylori negative subjects (p=0.03), while higher PGI level was significantly associated with functional esophageal disorders (FEG) according to Rome III criteria, and higher number of dyspeptic symptoms in H. pylori positive subjects (p=0.016)., Conclusions: Our data suggest that subjects with higher PGI level, and PG I/II ratio are more likely to develop several dyspeptic symptoms.

Background/aims: There have been reports showing the protective role of inducible heat-shock protein (HSP) 70 in gastric epithelial cells. An A to G transition at the 1267 position HSP70-2 gene has been shown to be associated with a different level of HSP70 mRNA expression. We aimed to clarify the effect of HSP70-2 polymorphism on the risk of peptic ulcer diseases in a Japanese population., Methodology: A total of 519 subjects participated in this study. All subjects underwent upper gastroscopy. Restriction fragment length polymorphism analysis was performed for polymorphisms at 1267 of HSP70-2 gene in all the subjects., Results: After gastroscopy, 109, 53 and 357 subjects were diagnosed as gastric ulcer, duodenal ulcer and non-ulcer subjects, respectively. Although, there were no significant differences of HSP70-2 genotype distributions among nonulcer subjects, overall ulcer, gastric and duodenal ulcers when the subjects were divided into two groups according to age distribution, logistic regression analysis showed that the BB genotype increased the risk of duodenal ulcer in subjects 60 years and older. (Gender, status of H. pylori infection and NSAID use adjusted OR=3.12, 95%CI=1.33-7.35, p=0.009)., Conclusions: It appears that polymorphism of HSP70-2 gene is not directly associated with the susceptibility to peptic ulcer diseases but BB genotype is associated with an increased risk of duodenal ulcer in older subjects in the Japanese population.

Background/aims: The role of genetics in the susceptibility to functional dyspepsia (FD) is not well established. Cholecystokinin (CCK) is released from enteroendocrine cells in the duodenal mucosa after food ingestion and signals satiation through peripheral or central actions. A common polymorphisms of CCK and it's receptor gene has been shown to be associated with panic disorder and schizophrenia. It was investigated the prevalence of CCK polymorphism in dyspeptic patients in a Japanese population., Methodology: A total of 124 dyspeptic patients, 119 non-symptomatic healthy controls participated in this study. Dyspeptic patients were also classified by Rome III criteria. T779C of Cholecystokinin (CCK)-1 intron 1, by polymerase chain reaction-restriction fragment length polymorphism. H. pylori infection status was examined by histology or antibody against H. pylori., Results: Although frequency of CCK-1 polymorphisms in overall dyspeptic patients, subgroups by Roma III criteria and non-symptomatic healthy controls did not show any significant differences, 779 T carriers significantly increased the risk of postprandial syndrome (PDS) in male subjects (53.5% vs, 84.2; OR = 4.63, 95% CI = 1.24-17.31, p = 0.018). This significant association was also remained after logistic regression analysis with adjustment for age and H. pylori infection status (OR = 4.99, 95% CI = 1.31-18.95, p = 0.018). In female and different H. pylori infection status, no significant association was observed between CCK-1 polymorphisms and dyspepsia., Conclusion: Our data suggest that the 779 T carriers of CCK-1 intron 1 is associated with an increased risk of PDS in Japanese male subjects.

Background/aims: A complex interaction of genetic and environmental factors is relevant in gastric carcinogenesis. Cyclin D1 (CCND1) is known to regulate function in G1 arrest and therefore, may play an important role in carcinogenesis. The present study aimed to clarify the effect of G870A polymorphism of the CCND1 gene on the risk of gastric cancer (GC) in a Japanese population., Methodology: Restriction fragment length polymorphism analysis was performed for polymorphisms at 870GA in the CCND1 gene in 392 GC and 359 cancer-free subjects including 203 H. pylori positive gastritis and 156 H. pylori negative healthy stomach, Results: Non significant association was found between CCND1 G870A genotypes and risk of GC when compared to that of all non-cancer subjects (AA vs. GG+GA: OR = 1.13, 95% CI = 0.81-1.58, A carrier vs. GG: OR = 1.13, 95% CI = 0.81-1.56), healthy stomach(AA vs. GG+GA: OR = 1.27, 95% CI = 0.81-2.00, A carrier vs. GG: OR = 1.13, 95% CI = 0.8-1.84) and gastritis. (AA vs. GG+GA: OR = 1.03, 95% CI = 0.7-1.53, p = 0.92, A carrier vs. GG: 1.06, 95% CI = 0.72-1.56, p = 0.77) No association was found between CCND1 genotypes and any of clinico-pathological features of GC., Conclusion: It appears that the G870 polymorphism of CCND1 is not associated with the risk of GC in the Japanese population.

Background/aims: A complex interaction of host genetic and environmental factors may be relevant in the development of Helocobacter pylori (H. pylori) related gastroduodenal diseases. Catechol-O-methyltransferase (COMT) is expressed catalyzes the methylation of various endobiotic and xenobiotic substances and thus might protect DNA from oxidative damage. We aimed to clarify the effect of COMT functional polymorphism on the severity of histological gastritis in a Japanese population., Methodology: 203 subjects were included in this study. Restriction fragment length polymorphism analysis was performed for polymorphisms at codon 158 in the COMT gene. Gastritis scores of antral gastric mucosa were assessed according to the updated Sydney system., Results: COMT genotype distribution in the study subjects was 158Val/Val (51.2%), 84Val/Met (41.4%), and 15Met/Met (7.4%). It was within the Hardy-Weinberg equilibrium (p = 0.73). In over all subjects, the degree of intestinal metaplasia tended to be lower among 158Met/Met when compared to Val/Val (Val/Val vs. Met/Met; 0.59 +/- 0.93 vs. 0.13 +/- 0.52, p = 0.052). Among H. pylori infected subjects, the degree of intestinal metaplasia was significantly lower among 158Met carriers in 50 years or older age (Val/Val vs. Met carriers; 1.20 +/- 1.06 vs. 0.75 +/- 1.08, p = 0.0436). No significant association was found between COMT genotypes and the degree of gastritis in different gender, Conclusion: Our data suggest that COMT gene 158Met polymorphism is associate with a reduced risk of developing more severe intestinal metaplasia in H. pylori infected older subjects.

Background/aims: Reactive oxygen species has been implicated in the development of gastric cancer. NADPH oxidase, a major source of superoxide generation play a critical role in H. pylori related gastric inflammation. We aimed to clarify the effect of C242T polymorphism of p22PHOX, an essential component of NADPH oxidase on the risk of gastric cancer, gastric ulcer and duodenal ulcer in a Japanese population., Materials and Method: 376 gastric cancer patients and 436 cancer-free subjects participated in this study. The p22PHOX C242T polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism., Results: In the non-cancer subjects, the p22PHOX genotype distribution was 365CC (83.7%), 63CT (15.4%), and 4TT (0.9%). Meanwhile, the p22PHOX genotype distribution in gastric cancer was 311CC (82.7%), 63CT (16.8%), and 2TT (0.5%). There was no significant difference between two groups in the distribution of T carrier frequency (OR=1.04, 95% CI=0.71-1.53). No association was also observed between p22PHOX genotypes and Lauren's classification, tumor stage and anatomical locations., Conclusion: It appears that the C242T polymorphism of p22PHOX is not associated with the incidence of gastric cancer in the Japanese population.

Background/aims: The role of genetics in the susceptibility to functional dyspepsia (FD) is unclear. Serotonin (5-HT) is expressed in gastro-intestinal tract and modulates the sensory-motor functions in the digestive tract. Genetic association has been reported between C102T polymorphism in the gene encoding 5-HT 2A receptor (5HTR2A) and various diseases. We aimed to clarify the association between 5HTR2A C102T polymorphism and dyspeptic symptom in a Japanese population., Methodology: 91 dyspeptics and 93 non-dyspeptic subjects enrolled in this study. Dyspeptic symptoms were divided into 9 categories. 5HTR2A gene T102C polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism., Results: In the non-dyspeptics, the 5HTR2A geno type distribution was 21TT (22.6%), 50TC (53.8%), and 22CC (23.6%). Meanwhile, the 5HTR2A genotype distribution in dyspeptics was 30 TT (33.0%), 40 TC (43.9%), and 21 CC (23.1%). There was no significant difference between the two groups in the genotype distribution. We did not find any association between 5HTR2A genotypes and dyspeptic patients in different gender and H. pylori infection status. Also, no correlation was found between 5HTR2A polymorphism and any of the 9 different dyspeptic symptoms., Conclusions: Our results suggest that 5HTR2A polymorphism is unlikely to be associated with susceptibility of dyspeptic symptoms. The role of genetics to the development of dyspepsia needs further evaluation.

Background/aims: Reactive oxygen species has been implicated in the development of ulcerative colitis (UC). NADPH oxidase, a major source of superoxide generation play a critical role in H. pylori related gastric inflammation. We aimed to clarify the effect of C242T polymorphism of p22PHOX, an essential component of NADPH oxidase on the risk of UC in a Japanese population., Methodology: 123 UC patients and 459 healthy control (HC) subjects participated in this study. The p22PHOX C242T polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism., Results: In the HC group, the p22 PHOX genotype distribution was 379C/C (82.6%), 79C/T (17.2%), and 5T/T (1.2%). Meanwhile, the p22 PHOX geno type distribution in UC group was 96C/C (78.0%), 26C/T (21.1%), and 1T/T (0.9%). No significant difference of the p22 PHOX genotype distribution was observed between HC and UC groups. (C/C vs. T/T; OR=0.80, 95% CI=0.09-6.84, C/C vs. C/T; OR=1.37, 95% CI=0.83-2.25, C/C vs. T carriers; OR=1.33, 95% CI=0.82-2.18, T/T vs. others; OR=0.74, 95% CI =0.09-6.43). No association was also found between p22PHOX gene polymorphism and different clinicopathological features of UC such as gender, age, age of onset, clinical type, extension of colitis and response to treatment., Conclusions: It appears that the C242T polymorphism of p22 PHOX is not associated with the incidence of gastric cancer in the Japanese population.

Background/aims: Non-steroidal anti-inflammatory drugs (NSAIDs) aggravate or ameliorate clinical disease activity in patients with ulcerative colitis (UC). UC is associated with increased local production of prostanoids. This study attempted to clarify the relationship between cyclooxygenase-1 (COX1) gene polymorphisms (T-1676C and A-842G/C50T) and ulcerative colitis in a Japanese population., Methodology: The study was performed on 108 patients with UC (mean age: 39.1 years, M:F=56:52) and 293 healthy controls (mean age: 49.0 years, M:F=161:132). The PCR-SSCP method was employed to detect COX1 polymorphisms using DNA extracted from peripheral blood cells., Results: No A-842G/C50T polymorphism was detected in all 401 Japanese subjects. The frequency of -1676C allele of COX1 gene in HC group and UC group was 48.8% and 48.1%, respectively. T-1676C genotypes of COX1 did not show significant association with UC risk. In addition, these genotypes were not also associated with the clinicopathological parameters of UC., Conclusions: This research suggests that COX1 promoter polymorphisms (T-1676C and A-842G/ C50T) may not be associated with the risk of developing ulcerative colitis in a Japanese population.

Background/aims: The role of genetics in the susceptibility to functional dyspepsia (FD) is unclear. Catechol-O-methyltransferase (COMT) has been an important enzyme in brain gut axis and pain sensitivity. Polymorphism in codon 158 of the COMT gene influences its activity. This study aimed to clarify the association between COMT polymorphism and dyspepsia in a Japanese population., Methodology: 91 dyspeptics and 94 non-dyspeptic subjects enrolled in this study. Dyspeptic symptoms were divided into 9 categories. COMT gene val158met polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism., Results: The frequency of Met carriers was lower in over all dyspeptics than healthy control but the difference was not significant (OR=0.79, 95%CI=0.44-1.41) However, when the interaction between age, gender, H. pylori infection status and the number of COMT 158Met alleles was assessed using ANOVA, a slight interaction with gender + age + COMT polymorphism was found in relation to overall dyspeptics (p=0.0476) No correlation was found between COMT polymorphism and any of 9 symptoms., Conclusions: The data suggest that the COMT genotype seems to influence the susceptibility of dyspepsia when it interacts with gender and age. The role of genetics in the development of dyspepsia needs to further evaluation.

Background/aims: Three gene polymorphisms of Nrf2, which regulate the expression of detoxifying and antioxidant genes, have been identified. We attempted to clarify the relationship of these polymorphisms with the carcinogenesis in the stomach., Methodology: The study was performed in 209 patients with gastric cancer and 198 patients with no evidence of gastric malignancies on upper gastroduodenal endoscopy. We employed PCR-SSCP method to detect gene polymorphisms., Results: Overall, both polymorphisms at position of -686/-684 and -650 were not significant risk factors of carcinogenesis in the stomach. However, the -686/-684 A/G allele carrier had a significantly reduced risk for gastric carcinogenesis (p = 0.022), especially of diffuse type (p = 0.020), in H. pylori-negative cases. The activity and inflammation scores in Nrf2 -686/-684 A/G carriers were significantly lower than those in the non-A/G carriers (p = 0.038 and p = 0.019, respectively)., Conclusions: The -686/-684 haplotype of Nrf2 gene may be associated with the development of gastric inflammation and with gastric carcinogenesis without the influence of H. pylori infection, although overall association with gastric carcinogenesis seems to be none.

Background/aims: Transcription factor Nrf2 regulates the expression of detoxifying and antioxidant genes. Three promoter polymorphisms of this gene have been identified. This study attempted to clarify the relationship between Nrf2 gene polymorphism and ulcerative colitis in a Japanese population., Methodology: The study was performed in 89 patients with ulcerative colitis (mean age: 40.2 years, M:F = 47:42) and 141 healthy volunteers (mean age: 38.7 years, M:F = 75:66). The PCR-SSCP method was employed to detect Nrf2 polymorphisms using DNA extracted from peripheral blood cells., Results: Comparison of genotype frequency, -686*-684 A* G/A*G genotype was significantly lower in the UC group than those in the HC group (OR = 0.45, 95% CI:0.22-0.93, p = 0.029) and G*G carrier was higher in the UC group, especially in female subjects. Furthermore, -686*-684 G*G carrier was more closely associated with chronic continuous phenotype (OR = 2.57, 95% CI:1.01-6.60, p = 0.043). On the other hand, no association between -650 genotype and ulcerative colitis was found., Conclusions: The -686*-684 genotype of Nrf2 gene may be associated with the development of ulcerative colitis.

Background/aims: The aim of this research is to investigate the international and intra-observer differences in the macroscopic classification of early colorectal cancer between Japan and China., Methodology: Color pictures of 9 cases of early colorectal cancer were distributed to 6 Japanese and 5 Chinese endoscopists. After reviewing the pictures, the doctors made their classificatory diagnoses independently and indicated their findings on which the diagnoses were based., Results: There was some consistency in the classification of distinctly elevated lesions among all the Japanese and Chinese endoscopists. However, some elevated lesions classified as type II in Japan might be diagnosed as type I by Chinese endoscopists. For superficial lesions consisting of elevation plus central depression, IIa+IIc or IIc+IIa, were classified according to the ratio of elevation and depression. Although international difference is not significant, inter-observer differences still exist in classifying these lesions. In addition, the differences in laterally spreading tumor were mainly due to terminology., Conclusions: Japanese and Chinese doctors share a lot of similarities in the classification of flat elevated lesions; however, both international and inter-observer differences still exist in the macroscopic classification for early CRC.

Background/aims: DNA methylation has been reported to correlate with the development of colitis associated cancer. We detected the promoter methylation of estrogen receptor gene (ER), TP53, p14, p16, p21 and hMLH1 in ulcerative colitis without neoplasia., Methodology: A total of 49 specimens from 36 patients, including 36 at rectal inflammatory mucosa and 13 at terminal ileum were obtained by colonoscopic biopsies. Methylation specific polymerase chain reaction were performed to detect the methylation in promoters of the above six genes., Results: Methylation rate of ER promoter was significantly higher in the rectal mucosa than that in the ileum (76.3% vs. 46.2%, P=0.044). Moreover, ER methylation in rectal mucosa was significantly higher in relapse-remitting type compared to one attack only type cases (P=0.008), and also increased in cases longer than 7 years (P=0.036). Methylation rates of p14 or p16 were higher in rectal mucosa than those in the ileum, but the differences were not of statistic significance. Meanwhile, methylation in TP53 promoter was found in only one case, while p21 and hMLH1 methylation were negative in all cases., Conclusions: Methylation in promoters of ER, p14 and p16 occurs in rectal inflammatory mucosa without neoplasia. Examination of ER methylation in rectal mucosa may be useful for predicting cases at high risk of neoplasia.

Background/aims: Expression of peroxisome proliferator-activated receptor gamma (PPARgamma) has been reported to be impaired in patients with ulcerative colitis (UC), and activation of PPARgamma is proved to inhibit the intestinal inflammation. As Plo12Ala polymorphism in codon 12 of the PPARgamma gene may decrease the promoter activity, we investigated the influences of PPARgamma polymorphism on the risk of UC in Japanese population., Methodology: The study recruited 118 patients with UC and 142 health controls. Plo12Ala polymorphisms of PPARgamma were detected by polymerase chain reaction based restricted fragment length polymorphism., Results: The frequency of Pro/Alo heterozygotes of PPARgamma gene in UC and control group was 4.2% and 4.9%, respectively. No significant difference was found between UC and control group (P=1.00, Fisher's exact test). Plo12Ala genotype of PPARgamma did not show significant association with UC risk (OR=0.85, 95%CI=0.26-2.76)., Conclusions: Our research suggests that Plo12Ala polymorphism of PPARgamma may not be associated with the risk of developing ulcerative colitis in Japanese population.

Background/aims: Helicobacter pylori (HP) infection is reported to be involved in gastric carcinogenesis. However, only a small percentage of HP-infected patients actually develop gastric cancer. In the present study, we assessed HLA antigen polymorphism and investigated its relationship with the development of gastric epithelial tumors in patients who had HP infection., Methodology: Among patients with serologically proven HP infection, 80 cases who underwent endoscopic mucosectomy for gastric epithelial tumors (24 adenomas and 56 carcinomas) were recruited in the study (the tumor group), and 20 cases without tumors were also included as controls (the nontumor group). HLA status (HLA-A, HLA-B, HLA-DRB1 and HLA-DQB1) was determined by HLA-DNA typing., Results: HLA-B*05401, HLA-DQB1*0601 and HLA-DRB1*1502 genes showed a significantly higher frequency in the control group than in the tumor group (0.225 vs. 0.088, P=0.015; 0.3 vs. 0.163, P = 0.047; 0.175 vs. 0.069, P = 0.036, respectively)., Conclusions: It suggests that HLA-B*5401, HLA-DQB1*0601 and HLA-DRB1*1502 may contribute to the inhibition of gastric carcinogenesis. Thus, HP-infected patients without these genotypes should undergo HP eradication therapy and close follow-up.

Background/aims: Various studies have indicated a relationship between Helicobacter pylori infection and upper gastrointestinal lesions, but this relationship needs to be assessed in individuals not seeking medical treatment for complaints., Methodology: We screened community residents for H. pylori infection and upper gastrointestinal lesions during an annual mass health examination aiming to determine relationships between infection and lesions. In 932 examinees we performed a 13C-urea breath test for H. pylori infection, and assessed degree of gastric atrophy by measuring pepsinogen I and II in serum. In 738 subjects we also performed upper gastrointestinal radiography with or without endoscopy., Results: Prevalence of H. pylori infection increased with age, and the ratio of serum pepsinogen I to II decreased with age. Prevalence of H. pylori infection did not differ significantly between subjects with and without radiographically or endoscopically evident lesions. Of H. pylori-positive subjects with peptic ulcer, 73.2% had no recurrence of ulcer despite absence of medical treatment., Conclusions: Prolonged H. pylori infection was associated with atrophy of the gastric mucosa, but little relationship was evident between H. pylori infection and development or recurrence of peptic ulcer.

Background/aims: We studied highly specific chicken egg yolk-derived anti-Helicobacter pylori antibody, and examined efficacy in inducing passive immunity and a bacteriostatic effect on H. pylori., Methodology: Heat-killed H. pylori were administered orally to hens, and specific anti-H. pylori antibody was purified from the yolk of eggs laid by these hens. The antibody's ability to inhibit H. pylori growth, urease activity, ammonia production, the cytopathic effects, and its effects on serum anti-H. pylori immunoglobulin G (IgG) production were investigated in vitro and in vivo. In addition, H. pylori-infected volunteers received the antibody orally and underwent repeated 13C-urea breath test after antibody ingestion., Results: Anti-H. pylori antibody derived from egg yolk strongly inhibited growth of H. pylori and increased agglutination of H. pylori in vitro. It also strongly inhibited H. pylori-associated urease activity and ammonia production as well as the cytopathic effect of H. pylori on cultured cells. The antibody also inhibited serum anti-H. pylori IgG production and the incidence of acute gastritis in H. pylori-infected Mongolian gerbils. In volunteers, urea breath testing showed decreased urease activity after antibody ingestion., Conclusions: Anti-H. pylori antibody derived from egg yolk was specific for H. pylori. The antibody had a bacteriostatic effect on H. pylori, inhibited H. pylori urease activity, and inhibited H. pylori infection in Mongolian gerbils and humans.

Background/aims: Hyperammonemia causes dysfunction of multiple organs in patients with cirrhosis, including hepatic encephalopathy. Blood ammonia concentrations are monitored with respect to disease progression and efficacy of treatment. Fetor hepaticus, the characteristic breath odor in hepatic encephalopathy has called little quantitative attention to breath ammonia. We studied the dynamics of ammonia metabolism in cirrhosis in terms of the relationship between breath and blood ammonia., Methodology: Breath and blood ammonia levels were measured simultaneously in 20 cirrhotic patients and in 10 healthy volunteers. Breath ammonia was measured using ammonia electrodes in collected expired air. Helicobacter pylori serum antibody titers were also measured, since the organism produces ammonia., Results: Blood ammonia correlated positively with breath ammonia in patients with cirrhosis. Breath ammonia levels were significantly higher in cirrhotic patients (0.745 ppm) than in controls (0.278 ppm), and higher in cirrhotic patients with hyperammonemia (0.997 ppm) than in those without (0.558 ppm). Breath and blood ammonia decreased together with treatment of hyperammonemia. H. pylori seropositivity was 20% in controls, 27.3% in cirrhotic patients with normal blood ammonia, and 66.7% in those with hyperammonemia., Conclusions: Breath ammonia measurement may be useful in diagnosis, treatment assessment, and follow-up in hepatic encephalopathy.

Routine films of 596 upper GI endoscopies with the diagnosis of duodenitis were reviewed and a classification was made into granular (G), multi-polypoid (MP), reddened (R) and erosive (E) types. Two hundred and thirty-four histological specimens from 117 of the patients, as well as 100 specimens from 50 controls, were analyzed for villous obliteration, Brunner's gland dilatation and mucus depletion, erosion, mucosal hemorrhage and edema, atypia of the surface epithelium and gastric surface epithelial metaplasia. Inflammatory cell counts for polymorphonuclear and mononuclear cells in the epithelium, in the lamina propria together with a histological score was also made. On the basis of this study and a review of classifications of duodenitis in the literature, it is concluded that some endoscopical features like erosions and redness may represent more acute phases of duodenitis, mucosal elevations representing more hyperplastic changes and that the endoscopic classification into G, MP, R and E types seem relevant to use in clinical practice.