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Article
Detection of DNA H.pylori and distribution of CagA genotype in cancerous and precancerous tissue
الكشف عن الحامض النووي لبكتريا H. pylori وتوزيع جين CagA في النسيج السرطاني وماقبل السرطاني

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Abstract

Helicobacter pylori (H. pylori) has been recognized as the causative agent of chronic gastric inflammation, which can progress further to a variety of diseases such as peptic ulcer and adenocarcinoma. The major bacterial virulence markers of H. pylori, the cytotoxin-associated gene (CagA), may play a role in determining the clinical outcome of Helicobacter infections. Aim of this study to investigate the presence of H.pylori DNA within gastric epithelial cells in patients with H.pylori infection and to determine the prevalence of CagA among patients with cancerous and precancerous lesion. Methods: A total of 92 gastric biopsy samples, 25 H.pylori negative and 67 H.pylori positive patients. H.pylori DNA in gastric epithelial cells and CagA gene of H. pylori was assessed by using the in situ hybridization test. Results: In H. pylori positive group, the positive rates of H.pylori DNA in the gastric epithelial cells were progressively increased in chronic superficial gastritis, precancerous changes and gastric cancer groups(P>0.01); The detection of CagA positive H. pylori was significantly higher in patients with gastric cancer compared to those with chronic superficial gastritis and atrophic gastritis(P<0.01). Conclusion: The pathological progression from chronic superficial gastritis, precancerous changes to gastric cancer is associated with higher positive rates of H.pylori DNA presence in the gastric epithelial cells, and there was a significant increase in CagA-positive H.pylori among patients with gastric cancer.

بكتيريا Helicobacter pylori هي احد العوامل المسببة لالتهابات المعدة المزمنة وسرطان المعدة. عامل الضراوة الموجود في هذه البكتريا هو CagA الذي يلعب دور في امراضية هذه البكتريا الهدف من الدراسة: هو التحقق من وجود الحامض النووي لبكتريا H. Pylori ضمن الخلايا الطلائية المعدية في المرضى المصابين بهذه البكتريا وتقرير انتشار بكتريا H. pylori الحاملة لجين CagA في مرضى سرطان المعدة وماقبل سرطان المعدة. طريقة العمل: من مجموع 92 نموذج مأخوذ من المعدة من مرضى يعانون من امراض المعدة 25 منهم سالبين لبكتريا H. pylori و موجبين لبكتريا H.pylori حيث تم تحديد الحامض النووي لبكتريا H. pylori و وجود جين CagA بطريقة التهجين الموضعي.النتائج: في المجموعة الموجبة لبكتريا H. pylori نسبة ظهور الحامض النووي في الخلايا الطلائية للمعدة تزداد تقدميا في التهاب المعدة السطحي والتغيرات ماقبل سرطان المعدة وصولا الى سرطان المعدة (P<0.01). اما وجود بكتريا H. pylori الحاملة لجين CagA تكون اعلى معنويا في سرطان المعدة مقارنة بالتهاب المعدة المزمن وضمور المعدة.الاستنتاج: التقدم المرضي من التهاب المعدة السطحي والتغيرات ماقبل سرطان المعدة الى سرطان المعدة يتشارك مع النسبة العالية لوجود الحامض النووي لبكتريا H. pylori في الخلايا الطلائية للمعدة. وهناك زيادة معتدة لبكتريا H. pylori الموجبة لجين CagA ضمن مرضى سرطان المعدة.

Keywords

H. pylori --- DNA --- CagA --- ISH --- H. pylori --- DNA --- CagA --- ISH


Article
THE EFFECT OF HELICOBACTER PYLORI ERADICATION THERAPY ON PLATELET COUNT IN IDIOPATHIC THEROMOBOCYTOPENIA : APILOT STUDY
تأثير استئصال جرثومة الهليكوباكتر على عدد الأق ا رص ألدموية لدى المرضى المصابين بنقص الأق ا رص ألدمويه الفرفريه العفوي

Authors: ASWAD AL-OBEIDY اسود العبيدي --- AHMED Y. ELMESHHEDANY احمد المشهداني
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2012 Volume: 6 Issue: 1 Pages: 28-33
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background and objectives Conflicting reports on the relationship between Helicobacter pylori infection and idiopathic thrombocytopenia had previously appeared in the literatures.This study examines the effect of Helicobacter pylori eradication on platelet counts in Iraqi patients with Idiopathic Thrombocytopenic Purpura (ITP).Methods The study population comprised 31 Iraqi patients with chronic ITP and a platelet count of less than 100.0 x109/L and positive serum H pylori antibodies (indirect immunofluorescence). They were divided into two groups, the first (17 patients) received anti H Pylori plus conventional treatment for ITP, the second group (14 patients) received conventional treatment for ITP only. The effect of H pylori eradication on platelet count was evaluated 6 months after therapy.Results There was significant improvement in platelet count in response to conventional treatment in both groups but there were no significant improvement after H Pylori eradication therapy.Conclusions Based on this pilot study eradication of H pylori does not appear to be effective in increasing platelet count in H pylori–positive patients with chronic ITP.

خلفية واهداف البحث: العلاقة بين الهليكوباكتر ونقص الأق ا رص ألدمويه الفرفريه العفوي مثبته سابقا. هذه الدر اسه تحدد تأثير استئصال جرثومة الهليكوباكتر على عدد الأق ا رص ألدمويه.طرق البحث: هذه الدر اسه تتضمن واحد وثلاثون مريض ع ا رقي مصابون بمرض نقص الأق ا رص ألدمويه الفرفريه العفوي مع عدد الأق ا رص اقل من 100000 مصابون بجرثومة الهليكوباكتر.المرضى قسموا إلى مجموعتين ألمجموعه الأولى 17 ) استلمت علاج استئصال جرثومة الهليكوباكتر مع العلاج التقليدي لمرض نقص الأق ا رص ألدمويه الفرفريه. )ألمجموعه ألثانيه استلمت العلاج التقليدي لمرض نقص الأق ا رص ألدمويه الفرفريه فقط . تأثير استئصال جرثومة الهليكوباكتر على عدد الأق ا رص ألدمويه تم تقييمه لمدة 6 أشهر.النتائج: كان هناك تحسن معتبر بعدد الأق ا رص ألدمويه في المجموعتين ردا على العلاج التقليدي ولكن لم يكن هناك تحسن معتبر بعد استئصال جرثومة الهليكوباكتر.الاستنتاجات: استئصال جرثومة الهليكوباكترغير فعال في زيادة عدد الأق ا رص ألدمويه عند مرضى نقص الأق ا رص ألدمويه الفرفريه المصابون بجرثومة الهليكوباكتر.


Article
Bcl-2 Expression in CagA Strain H. Pylori Gastritis (Immunohistochemical and Insitu Hybridization Study)

Author: Hussam Hasson Ali
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 1 Pages: 71-75
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Carriage of Helicobacter Pylori in the human stomach is associated with increased risk of peptic ulcerdisease, distal gastric adenocarcinoma and gastric B-cell mucosa associated lymphoid tissue lymphoma.OBJECTIVE:To study the immunohistochemical expression of bcl-2, as apoptosis makers in the gastric mucosa ofpatients infected with cagA Helicobacter Pylori demonstrated by insitu hybridization method.PATIENTS MATERIALS AND METHODS:Gastric antrum biopsies from 99 patients presented with dyspeptic symptoms (50 men, 49 women,median age 40) were analysed for the presence of H. pylori, and were classified according to updatedSydney system. Insitu hybridization technique was done to detect cagA H. pylori.Immunohistochemical expression of bcl-2 using (Avidin- Biotin method) was performed on paraffinembedded biopsy specimens.RESULTS:Forty four patients (44.44%) had H. pylori cagA positive starin. Atrophy of gastric mucosa was presentin 14 (14.14 %) patients. Intestinal metaplasia was present in 8 (8.08%) patients. The frequency ofatrophy and intestinal metaplasia were significantly higher in cagA H. pylori gastritis than non-cagA H.pylori gastritis (p=0.023 and 0.041respectively). Bcl2 expression was not significantly higher in H.pylori gastritis than non-H. pylori gastritis (p= 0.101). Bcl2 expression was significantly higher in thepresence of atrophy (p<0.001). Bcl2 expression was significantly higher in the presence of intestinalmetaplasia (p<0.001).CONCLUSION:The rate of apoptosis decreases when lesions (gastric atrophy and intestinal metaplasia) are present.


Article
Detection of Helicobacter pylori antibodies in Patients with Chronic

Author: Najah Ali Mohammed نجاح علي محمد
Journal: JOURNAL OF THI-QAR SCIENCE مجلة علوم ذي قار ISSN: 19918690 Year: 2012 Volume: 3 Issue: 2 Pages: 9-15
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSTRACT:The study was carried out to determine the prevalence of H. pylori antibodies in patients with chronicliver disease (CLD), by detecting the presence of stool antigen (HpSA), serum, and salivary anti-H.pylori antibody using ELIZA and compared with Rapid Urease test (gold standard). A one hundred andseventy six endoscopy were carried out for patients with or without chronic liver disease. The resultindicated that among 130 patients with (CLD), and 46 patients without CLD, the commonest endoscopydiagnosis by gastric biopsy was gastritis (22.72%), duodenal ulcer (17.61%), and Gastric ulcer (11.93%).The serum antibody positivity was higher (83.0%), followed, HpSA (74.4%), salivary antibodypositivity (71.0%) and rapid urease test (RU) positivity (70.6%). In controls salivary antibody and rapidurease test positivity was higher than in CLD patients, while HpSA and serum antibody was higher inCLD patients. On the other hand, it was associated with sex and age. The sensitivity and specificity ofHpSA were 94.6% and 91.6%, respectively.

الخلاصة:تم التحري عن اضداد الملویة البوابیة لدى المصابین بام ا رض الكبد المزمن والذین اجري لهم تنظیر هظمي, وذلك بالكشف عن تلكالاضداد في مصل الدم واللعاب ومستضد الملویة البوابیة في الخروج بطریقة الالی ا ز واستخدام اختبا ا رلیوریز(للخزعة) كمعیار ذهبي 0 اجریتالاختبا ا رت ل 176 مریض, تطلبت حالتهم اج ا رء تنظیر هظمي واخذ خزعة من المعدة. ومن بین 130 مریض مصاب بمرض كبدي مزمن46 مریضا غیر مصاب بمرض كبدي مزمن , كان التشخیص الاكثر شیوعا بالتنظیر الهظمي هو التهاب المعدة ( 22,72 %), التهاب الاثني,(% عشري ( 17,61 %) وقرحة المعدة ( 11,93 %) .وكانت ایجابیة الاضداد عالیة في مصل الدم ( 83 %), واختبار الخروج ( 74,4واختبا ا رللعاب ( 71,0 %) ثم في اختبار الیوریز ( 70,6 %). كانت الایجابیة للملویة البوابیة في اختبار الیوریز واختبار اللعاب عالیة بینمجموعة السیطرة,بینما كانت ایجابیة اختبا ا رلخروج واختبار المصل اكثر بین مجموعة مرضى الكبد المزمن, مع وجود علاقة بین ایجابیةالملویة البوابیة في اللعاب وبین تقدم العمروالجنس.وكانت حساسیة ونوعیة اختبار اللعاب 94,6 % و 91,6 % على التوالي.


Article
PCNA EXPRESSION IN CAGA STRAIN H. PYLORI GASTRITIS: IMMUNOHISTOCHEMICAL AND INSITU HYBRIDIZATION STUDY

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Abstract

Background: Carriage of Helicobacter Pylori (H. Pylori) in the human stomach is associated with increased risk of peptic ulcer disease, distal gastric adenocarcinoma and gastric B-cell mucosa associated lymphoid tissue lymphoma. Several studies have shown increased evidence of increased cell proliferation in the gastric mucosa both in human carrying H. Pylori, and animal model of H. Pylori infection.Objective: To study the immunohistochemical expression of Proliferating cell nuclear antigen (PCNA), as a proliferative marker in the gastric mucosa of patients infected with CagA Helicobacter Pylori demonstrated by insitu hybridization method.Methods: Gastric antrum and corpus biopsies from 99 patients with dyspeptic symptoms (50 men, 49 women, and median age 40) were analyzed for H. pylori, presence of chronic inflammation, intestinal metaplasia, and atrophy according to updated Sydney system. Insitu hybridization technique was done to detect cagA H. pylori. Immunostaining for PCNA (Avidin- Biotin method) was performed on paraffin embedded tissue specimens.Results: Forty four patients (44.44%) had H. Pylori cagA positive strain. Atrophy of gastric mucosa was present in 14 (14.14 %) patients. Intestinal metaplasia was present in 8 (8.08%) patients. The frequency of atrophy was significantly higher in cagA H. Pylori gastritis than non-cagA H. Pylori gastritis (p=0.041). The frequency of intestinal metaplasia was significantly higher in cagA H. Pylori gastritis than non-cagA H. Pylori gastritis (p=0.023). PCNA labeling index (LI) of the gastric glands was significantly higher in presence of atrophic alterations (p <0.001), intestinal metaplasia (p <0.001) and in cagA strain H. Pylori positive gastritis (p<0.001).Conclusion: The rates of gastric glandular atrophy, intestinal metaplasia, and epithelial proliferation increase in the presence of H. Pylori infection, and are further increased when H. Pylori is of cag A strain.Key words: cag A H. pylori gastritis, PCNA immunohistochemical expression.


Article
Study of H.Pylori in a Group of Iraqi Patients with Inflammatory Bowel Disease (Histological and Molecular Study)

Authors: Sinan S. Farhan --- Khalid A. Al-Khazraji --- ,Fadhil A. Al-Khafaji --- Huda M. Al-Khateeb --- et al.
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 734-741
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Helicobacter pylori is one of the commonest bacterial pathogens in human. The organism is associated with development of peptic ulcer diseases, lymphoproliferative disorders and gastric cancer.Helicobacter pylori could be isolated from patients with inflammatory bowel disease (IBD) but still the possibility of etiological link need further study thereforeOBJECTIVE:Is to assess the possible causal factor of H.pylori in development of inflammatory bowel disease, in addition to assess Cytotoxic associated gene A(CagA) gene status in H.pylori positive samples.PATIENTS AND METHODS:Study involved 120 patients of colonoscopically determined normal colon (n=90) & patients with IBD (n=30) including both Ulcerative colitis(n=16) and Crohn’s disease(n=14). Those patients is further divided into three age groups including <20 years group, 20-40 years group and >40 years group of Iraqi patients. Endoscopic specimens after histopathological confirmation of diagnosis will be tested for Biopsy Urease Test (BUT) and Hematoxylin & Eosin (H&E) methods (for detection of H. pylori) also detection of CagA mRNA using In Situ Hybridization technique with a biotin labeled probe (to specify pathogenic H. pylori)RESULTS:H.pylori detected in 36.7% (using BUT) and 30% (using H&E) in the colon of IBD patients and 33.3% (using BUT) and 26.7% (using H&E) in patients with normal colon (NC patients) as a control. Among our H.pylori positive patients, there was significant difference (P=0.036) regarding CagA status in which 25% were CagA positive of NC patients and 66.7% CagA positive H.pylori in IBD patients using In Situ Hybridization technique.CONCLUSION:H.pylori was isolated from nearby or the site of lesion of patients with inflammatory bowel disease although there was no statistical relationship between H.pylori and IBD. In addition CagA genes were more prominent in H.pylori that isolated from IBD patients than H.pylori of normal colon. Also there was no possible relationship between age and infection rate of H.pylori in both IBD & NC patient

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