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S Eidt

Publications and source records attributed to S Eidt.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Analysis of inflammatory reaction and epithelial proliferation in corpus mucosa of the stomach. A contribution to carcinogenesis].

To elucidate conflicting evidence concerning the role of Helicobacter pylori (HP) in the evolution of gastric carcinoma, a retrospective analysis was performed on the corpus mucosa of gastric surgical specimens removed from patients with gastric carcinoma (n = 53) and pancreatic carcinoma (n = 45). Prevalence, activity and degree of chronic active gastritis (CAG) were investigated. Furthermore, proliferative activity was determined by the expression of the Ki67 antigen in epithelial cells of the neck region and the foveolae using immunohistochemistry. CAG and intestinal metaplasia were significantly more prevalent in patients with gastric than with pancreatic neoplasms. Degree and activity of CAG were higher in the group of patients with gastric carcinomas. Numbers of Ki67-positive nuclei were significantly higher in pronounced than in mild CAG. Our data are in keeping with the assumption that HP-associated CAG contributes to the development of gastric adenocarcinoma. As possible pathomechanism, it may be assumed that a conspicuously expressed inflammatory reaction triggers epithelial proliferation, with resulting higher vulnerability to mutagenic effects.

Adenocarcinoma↗
PubMed1995

Tissue diagnosis of intestinal microsporidiosis using a fluorescent stain with Uvitex 2B.

AIMS: To detect intestinal microsporidiosis in paraffin wax embedded biopsy specimens using a fluorescence technique incorporating optical brighteners. METHODS: Eight HIV infected patients with confirmed intestinal microsporidiosis (six with Enterocytozoon bieneusi, one with Encephalitozoon intestinalis and one with Encephalitozoon cuniculi infection) and 10 without infection were studied. Tissue sections of paraffin wax embedded duodenal biopsy specimens were stained with 1% Uvitex 2B, coded and analysed independently by two investigators. RESULTS: In all eight cases with confirmed intestinal microsporidian infection, spores could be detected easily in tissue sections using the fluorescence technique. Spores or other elements consistent with microsporidiosis were not found in the 10 patients without infection. CONCLUSION: Staining of tissue sections from paraffin wax embedded intestinal biopsy specimens with stains incorporating Uvitex 2B is a rapid and easy technique for the diagnosis of intestinal microsporidiosis.

AIDS-Related Opportunistic Infections↗
PubMed1995

Analysis of antral biopsy specimens for evidence of acquired mucosa-associated lymphoid tissue in HIV1-seropositive and HIV1-negative patients.

BACKGROUND: There is conflicting evidence concerning the prevalence of Helicobacter pylori gastritis in HIV1-infected patients. Furthermore, a possible influence of immunodeficiency on the acquisition of mucosa-associated lymphoid tissue (MALT) in the antral mucosa remains to be elucidated. METHODS: Seventy-seven consecutive HIV1-infected patients (mean age, 40.2 years) were compared in a prospective study with 77 HIV1-negative age-matched patients, using immunohistochemical stainings. RESULTS: In HIV1-infected patients the prevalence of H. pylori gastritis was lower and the inflammatory reaction less pronounced than in controls. Lymphoid follicles and intraepithelial B cells were significantly more often detected in HIV1-negative patients. CONCLUSIONS: Evidence of acquired MALT is only rarely found in HIV1-infected patients. These findings might contribute to the explanation of why low-grade gastric MALT lymphomas have not been reported in HIV1-infected patients so far.

Adult↗
PubMed1995

The significance of Helicobacter pylori in relation to gastric cancer and lymphoma.

The evidence linking Helicobacter pylori and non-cardia gastric adenocarcinoma is accumulating. Patterns of strain specificities and host factors that increase epithelial proliferation and have implications for mutagenic effects are evolving. The decision by the World Health Organization and the International Agency for Research on Cancer to classify H. pylori as a 'definite' carcinogen, however, represents a milestone in the association of H. pylori with gastric carcinogenesis. The importance of H. pylori in gastric lymphoma has been underscored by the finding that H. pylori eradication can induce complete regression in low-grade mucosa-associated lymphoid tissue lymphomas, at least in the early stages of development.

Adenocarcinoma↗
PubMed1995

Helicobacter pylori eradication in the treatment and differential diagnosis of giant folds in the corpus and fundus of the stomach.

In an earlier study, we were able to show that giant fold gastritis is probably a special form of Helicobacter pylori-associated gastritis. Proof of this contention, however--namely regression of the giant folds following eradication of the organism--in a large number of patients was not then possible. To rectify this, Helicobacter pylori (HP) eradication treatment with omeprazole and amoxicillin was applied to 47 patients with HP gastritis and giant folds (5 patients with giant folds localized in the anterior or posterior wall, 42 patients with generalised giant folds within the corpus and fundus). The results of treatment were investigated by endoscopy and histology at the earliest 4 weeks after termination of treatment. In 40 of the 47 patients (85.1%), HP eradication treatment was successful. In 7 patients in whom treatment was unsuccessful, follow-up examinations revealed no changes in the endoscopic or histological findings. In 2 out of 3 patients in whom the endoscopic findings were unchanged despite successful HP eradication, biopsy material revealed the cause of the giant folds to be a signet ring cell carcinoma; in the remaining patient the cause of giant fold persistence was unclear. In 36 patients, the endoscopic--findings normalised completely, while in one patient there was obvious regression of the giant folds. We conclude from this study that giant fold gastritis is indeed a special form of HP gastritis, and that eradicating the organism in patients with gastric giant folds may help to distinguish between inflammatory, hyperplastic and tumorous giant folds.

Aged↗
PubMed1994

Infradiaphragmatic bronchogenic cyst with high CT numbers in a boy with primitive neuroectodermal tumor.

Abdominal bronchogenic cysts are very rare with less than 20 published cases. We report the case of a retroperitoneal bronchogenic cyst in a 12-year-old boy, who initially presented with a primitive neuroectodermal tumor of the pelvis. Computed tomography (CT) showed a small, hyperdense nonenhancing mass adjacent to the right crus of the diaphragm. Follow-up CT after chemotherapy showed a decrease in CT attenuation of this mass, but a slight increase in size. At surgery the mass was loosely attached to the diaphragm and final pathology confirmed the diagnosis of a bronchogenic cyst.

Bronchogenic Cyst↗
PubMed1994

Factors influencing lymph node infiltration in primary gastric malignant lymphoma of the mucosa-associated lymphoid tissue.

The spread of primary gastric non-Hodgkin's lymphomas of the mucosa-associated lymphoid tissue (MALT) to the perigastric lymph nodes is a very important step concerning the prognosis of these tumours. In order to evaluate the parameters that influence the infiltration of the lymph nodes we retrospectively investigated 145 surgical specimens with gastric MALT lymphoma. The involved factors, i.e. depth of infiltration, degree of malignancy, and largest tumour diameters were strongly intercorrelated and partly showed significant correlations with the lymph node infiltration as well. Further statistical analysis by means of logistic regression revealed that depth of infiltration was the only parameter that remained significantly correlated with lymph node infiltration. Our data further support the notion that the depth of infiltration is a very important prognostic factor in MALT lymphomas. This could contribute to the explanation as to why the so-called early lymphomas with an infiltration limited to mucosa and submucosa have a much better prognosis than more advanced tumours. Our data thus support the thesis that gastric MALT lymphomas show clinicopathologic similarities with gastric carcinomas. We suggest that the depth of infiltration should be included in the pathological reports concerning primary gastric lymphomas of the MALT.

Adult↗
PubMed1994

Evidence of a malignant cycle in early gastric lymphoma.

In order to investigate whether, by analogy with early gastric carcinomas, evidence of a malignant cycle could be found in early gastric non-Hodgkin's lymphomas (EGL), a study of 135 surgical specimens (46 gastrectomies, 80 aboral resections, nine local excisions) was performed. A malignant cycle was considered to have been shown when regenerative changes in the mucosa and fibrosis of the adjacent submucosa were detected. The depth of tumour infiltration was characterized using the UICC classification for gastric carcinomas. An EGL was found in 51.1% of cases (n = 69). The correlation between depth of infiltration and the histological classification of tumours proved statistically significant (p < 0.0001). Evidence of a malignant cycle was demonstrated in 72.5% of EGLs as compared with 27.3% in gastric lymphomas showing deeper infiltration (AL). The same held true for the histological classification of lymphomas. Findings consistent with a malignant cycle were found in 72.7% of low-grade compared with 37.7% of high-grade lymphomas. The difference in distribution proved to be statistically significant in both cases (p < 0.001). Most cases were localized in the antral region (53.6% of EGLs, 40.9% of ALs) and the lower third of the stomach (44.9% of EGLs and 33.3% of ALs). Detecting evidence of a malignant cycle, especially in EGL, has important diagnostic implications, requiring a careful search for minute lymphoma-associated irregularities in the neighbourhood of healed lesions, with the aim of determining the proper locations for a diagnostic biopsy.

Aged↗
PubMed1994

Frequency, location, and age and sex distribution of various types of gastric polyp.

Data on the frequency and location of the various types of gastric polyps are highly inconsistent. In a retrospective analysis of 5515 gastric polyps obtained from 4852 patients in the period between 1969 and 1989, including reexamination of 197 surgical, 1572 polypectomy, and 3746 biopsy specimens, the most frequent types found were Elster's glandular cysts (fundic gland polyps) (47.0%), followed by hyperplasiogenous polyp (28.3%), tubular adenoma (9.0%), adenocarcinoma (7.2%), inflammatory fibroid polyp (3.1%), carcinoid tumor (1.7%), Brunner's gland heterotopia (1.2%), and tubulopapillary adenoma (1.0%). Peutz-Jeghers polyps, juvenile polyps, and pancreatic heterotopia were found in younger patients (mean ages: 33.39 and 45 years, respectively), whereas the age of most patients (66%) with glandular cysts was between 40 and 69 years. Patients with any of the other types of gastric polyps were mostly (55-100%) over 60 years of age at the time of diagnosis. Glandular cysts, hyperplasiogenous polyps, inflammatory fibroid polyps, and carcinoid tumors were significantly more common in women, while all the other polyps were more or less equally distributed between the sexes. Glandular cysts and carcinoid tumors were relatively small (mean diameter 8 mm), and were mostly located in the corpus (100% and 83%, respectively). Medium-sized pancreatic heterotopias, Brunner's gland heterotopias, and inflammatory fibroid polyps (mean sizes 7-10 mm) were usually located in the antrum (100%, 81%, 80%, respectively), while the other polyps had an average size of between 10 and 16 mm and were distributed equally throughout the stomach.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

Helicobacter pylori gastritis and primary gastric non-Hodgkin's lymphomas.

AIMS: To evaluate further the relation between gastric malignant lymphoma of the mucosa associated lymphoid tissue (MALT) and Helicobacter pylori. METHODS: One hundred and sixty two surgical specimens of MALT lymphoma were retrospectively investigated to determine tumour type and inflammatory patterns. In 121 cases biopsy specimens obtained before surgery were available and stained with haematoxylin and eosin, periodic acid Schiff, Giemsa and Warthin-Starry stains. RESULTS: Residual lymphoid follicles were found less often in high grade malignant than in low grade malignant MALT lymphomas. Chronic active gastritis was shown within the mucosa at some distance from the tumours in 143 of 146 specimens. In all the cases for which biopsy specimens could be evaluated, colonisation of the mucosa by H pylori had occurred. Lymphoid follicles and lymphoid aggregates were detected in 82.7% of the antral, and in 85% of the body mucosa specimens. CONCLUSIONS: These data support the hypothesis that H pylori has an important role in the development of MALT lymphomas. Furthermore, the chronic inflammation preceding malignant transformation might enhance the probability of malignant transformation via chronic stimulation of the lymphoid tissue. This might in part indicate why MALT lymphomas occur most often in the stomach.

Adult↗
PubMed1994

Antral intestinal metaplasia in Helicobacter pylori gastritis.

The prevalence of antral intestinal metaplasia (IM) in underlying Helicobacter pylori (HP) gastritis was studied in biopsy specimens of the antral mucosa obtained from 2,692 patients with histologically proven HP gastritis. The prevalence of IM varied in the groups investigated: 47.4% in gastric ulcers, 30.5% in pyloric ulcers, 16.8% in duodenal ulcers, 21.8% in gastritis with no lesions and 9.8% in chronic antral erosions (p < 0.001). A hypothetical model for the role of HP in the development of IM is presented: HP probably promotes mucosal regeneration. The prolonged stimulatory effect on regeneration could then, in the course of time, lead to an increasing likelihood of IM developing.

Adult↗
PubMed1994

Prevalence of intestinal metaplasia in Helicobacter pylori gastritis.

BACKGROUND: The prevalence of intestinal metaplasia (IM) in underlying Helicobacter pylori gastritis was studied in 1446 patients. METHODS: Antral and body mucosa biopsy specimens (stains: hematoxylin and eosin, Warthin-Starry) were taken from five groups of patients: gastritis with no lesions, gastritis with duodenal, pyloric, or gastric ulcers or with chronic antral erosions. RESULTS: The prevalence of IM was higher in the antral than in the body mucosa (22.9% versus 2.8%; p < 0.001). Patients with IM had a higher mean age than those without IM in the overall group (p < 0.01). IM could be detected with the highest frequency in patients with gastric ulcers (p < 0.001). CONCLUSIONS: The higher prevalence of IM in the antral mucosa--the preferred location of gastric carcinomas--further supports the postulated association of H. pylori and gastric carcinoma. The various prevalences of IM might contribute to explaining the different probabilities of gastric carcinoma developing in the groups investigated.

Female↗
PubMed1994

[A rare cause of upper gastrointestinal hemorrhage: large adenoma of Brunner's glands].

We report the rare case of a large adenoma of Brunner's glands as the cause of an upper gastrointestinal hemorrhage. Endoscopic resection is the therapy of choice in the appropriate setting. An unequivocal histological diagnosis by forceps biopsy often is not possible; there are no clear cut endoscopic criteria. The development of complications especially of severe hemorrhage increases with diameter of the adenoma. Therefore, the complete excision either endoscopically or by surgery should be attempted.

Adenomatous Polyps↗
PubMed1993

Humoral and cellular immunity in HIV positive and HIV negative Helicobacter pylori infected patients.

The prevalence of H. pylori associated gastritis seems to be different in HIV positive and HIV negative patients. Therefore a correlation to immunodeficiency can be postulated. The histology of gastritis, status of H. pylori infection and parameters of humoral and cellular immune response were investigated in 41 HIV positive and 47 HIV negative patients, who were subjected to upper endoscopy for the evaluation of gastrointestinal symptoms. In HIV positive patients 37% had active chronic gastritis against 62% of the HIV negative patients. In 73% of HIV positive cases of active chronic gastritis H. pylori was detected by bacteriological culture and/or Warthin-Starry stain. In HIV negative patients active chronic gastritis was always associated to H. pylori infection. Production of antibodies as measured by two commercially available ELISA tests was significant in HIV positive and HIV negative patients; both tests correlated well with H. pylori detection by culture or direct microscopy. Immunoglobulin class specific immunoblots corresponded to the ELISA results in HIV negative patients but to a lesser extent in the HIV positive group which was assumed to be related to unspecific polyclonal activation in these patients. Systemic cellular immunity was investigated by proliferation assays of peripheral blood mononuclear cells (PBMC). Proliferative response to the unspecific mitogen PHA was reduced in HIV positive patients. A sonicated H. pylori antigen failed to induce lymphocyte proliferation. The antimitogenic effect was also seen in case of coincubation with PHA. This observation was independent of H. pylori and HIV infection status. We conclude that in HIV positive as in HIV negative patients active chronic gastritis is predominantly related to H. pylori infection. The prevalence of H. pylori associated gastritis in HIV positive patients is significantly reduced (p < 0.025) compared to HIV negative controls. Decreased susceptibility to H. pylori infection in HIV positive patients may not be explained by the abnormal reactivity of their humoral or cellular immune response.

Adult↗
PubMed1993

Prevalence of lymphoid follicles and aggregates in Helicobacter pylori gastritis in antral and body mucosa.

AIMS: To evaluate the prevalence of lymphoid follicles and aggregates in the antral and body mucosa in Helicobacter pylori gastritis and to assess if there were correlations with ulcers in the duodenum, pylorus, or stomach, and with chronic antral erosions. METHODS: Patients (n = 2692) with histologically confirmed H pylori antral gastritis were investigated. These comprised five groups: those with duodenal ulcers; those with pyloric ulcers; those with gastric ulcers; those with chronic erosions; and those with no associated lesions. In 1446 cases at least two additional biopsy specimens from the oxyntic mucosa were available. RESULTS: Lymphoid follicles and aggregates were found in 53.8% of cases in the antral mucosa compared with 14.8% in the oxyntic mucosa (p < 0.001). The various diseases showed significant differences in terms of the prevalence of follicles and aggregates: The highest numbers in the antral mucosa as well as the lowest in the oxyntic mucosa were found in patients with duodenal ulcers (60.5% and 9.2%, respectively). The highest numbers of follicles and aggregates in the oxyntic mucosa occurred in patients with gastric ulcers. CONCLUSIONS: The detection of lymphoid follicles and aggregates in oxyntic mucosa and the higher prevalence in antral mucosa fits well with the distribution of primary gastric lymphomas. This adds further weight to the notion that the development of follicles and aggregates, triggered by H pylori, might be an early precursor to gastric lymphoma. The differences between the groups investigated might be due to different strains of H pylori or differences in the respective sizes of antral and oxyntic mucosa.

Female↗
PubMed1993

Giant fold gastritis--a special form of Helicobacter pylori associated gastritis.

We investigated the question as to how frequently Helicobacter pylori gastritis is present in cases of endoscopically detected giant folds of the corpus and fundic mucosa, and whether this gastritis differs from Helicobacter pylori associated gastritis with no giant folds. Biopsy material obtained from 138 patients with giant folds (sex ratio: 1.0 men: 105 women; average age 61.0 years) was evaluated histologically and compared with that obtained from 1,196 patients with H. pylori associated gastritis without giant folds (1.1 men: 1.0 women; average age 51.9 years). Among the patients with giant folds, H. pylori colonisation of the gastric mucosa was found in 88.4% of the cases. The degree of H. pylori colonisation determines the degree and activity of the gastritis in the antrum and corpus (p < 0.001). A comparison of the degree of colonisation with H. pylori, the degree of gastritis and the activity of the gastritis in patients with giant folds and in H. pylori gastritis without giant folds revealed no statistically significant differences within the antrum. In contrast, in the case of the corpus, a comparison between the two groups showed that H. pylori colonisation, degree of gastritis, and activity of gastritis were statistically significantly more pronounced in patients with giant folds than in patients with H. pylori gastritis but no giant folds (p < 0.0001). A comparative analysis showed that giant fold formation in the fundus and corpus of the stomach may be a consequence of severe high-grade active H. pylori gastritis, that is, a special and rare form of reaction to the colonisation of the gastric mucosa with Helicobacter pylori.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗