위점막에서 Helicobacter pylori 분포의 내시경적 진단 = Endoscopic Diagnosis of Helicobacter pylori Distribution on Human Gastric Mucosa

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Background: Since the successful isolation of Helicobacter pylori from the human gastric mucosa by Warren and Mashall, biosy studies have shown that this organism is closely related to chronic gastritis and peptic ulcer. However the distribution of this organism has been proved to be uneven and patchy on the gastric mucosa. The aim of this paper is to assess the distribution of this organism on human gastric mucosa in vivo by endoscopy. Method: To control the gastric pH around 4.0 to 6.0, premedication by the intravenous injection of ranitidine 50mg one hour before the endoscopy, was performed. And thereafter, 0.1% phenol red solution containing 0.5M urea was sprayed onto the mucosal surface of the stomach through the endoscope. A red color change was observed in a few seconds after spraying the phenol red solution. The red color change pattern was classified into three types: diffuse, regional and patchy type. Two biopsies were taken from the red color changed area and the unstained area for hitological and bacteriological study. Results: l) In 26 out of 33patients with chronic gastritis, the red color change was observed after spraying the phenol red solution. The diffuse, regional and patchy type in chronic gastritis patients were observed in 17, 5, 4 patients respectively. In peptic ulcer group, the diffuse type was observed in 6 and the regional and patchy type were observed in 3, 1 patients. 2) The bacteriological and histological identification of Helicobacter pylori was observed in 17 of 26patients (65.4%) With Chronic gastritis and 7 Of 10patiCIltS (70%) with peptic ulcer in the biopsy materials taken from the gastric mucosa showing a red color change with phenol red solution. But the organism was not found in the unchanged and unstained mucosa except for one case of chronic gastritis. Conclusion: These results suggest that this endoscopic spraying technique may be useful to determining the distribution of Helicobacter pylori in human gastric mucosa.