AIM： To evaluate the usefulness of stooI-PCR test for diagnosis of Helicobacter pylori （H pylon） infection in pediatric populations. METHODS： Based on endoscopic features （including nodular gastritis, erosive duo...AIM： To evaluate the usefulness of stooI-PCR test for diagnosis of Helicobacter pylori （H pylon） infection in pediatric populations. METHODS： Based on endoscopic features （including nodular gastritis, erosive duodenitis and ulcer） and/or a positive rapid urease test （RUT） obtained during endoscopy, 28 children from a group of children admitted to the Children＇s Medical Center of Tehran for persistent upper gastrointestinal problems were selected to compare biopsy-based tests with stool- PCR. Their gastric activity and bacterial density were graded by the updated Sydney system, and their first stool after endoscopy was stored at -70℃. Biopsies were cultured on modified campy-blood agar plates and identified by gram-staining, biochemical tests, and PCR. Two methods of phenol-chloroform and boiling were used for DNA extraction from H pylori isolates. Isolation of DNA from stool was performed using a stool DNA extraction kit （Bioneer Inc, Korea）. PCR was performed using primers for detection of vacA, cagA, and 16srRNA genes in both isolates and stool. RESULTS： Sixteen out of 28 child patients （57%） were classified as H pylori positive by biopsy-based tests, of which 11 （39%） were also positive by stool- PCR. Sensitivity and specificity of stool-PCR was 62.5% and 92.3% respectively. H pylori was observed in histological sections for 10 out of 11 stool-positive patients. Association was observed between higher score of H pylori in histology and positivity of stool- PCR. Also association was observed between the more severe form of gastritis and a positive stool-PCR. CONCLUSION： Association between higher score of H pylori in histology and a positive stool-PCR make it a very useful test for detection of H pylori active infection in children. We also suggest that a simple stool-PCR method can be a useful test for detection of Hpylori virulence genes in stool.展开更多
Objective To evaluate the clinical value of alarm symptoms in diagnosis of lower gastrointestinal diseases. Methods Data of consecutive autochthonous patients referred to the endoscopy center of Renji Hospital during ...Objective To evaluate the clinical value of alarm symptoms in diagnosis of lower gastrointestinal diseases. Methods Data of consecutive autochthonous patients referred to the endoscopy center of Renji Hospital during the period of Oct. 2002 to Dec. 2003 were retrospectively analyzed. The prevalence of alarm symptoms in Shanghai patients with colorectal malignancies or other organic or functional lower gastrointestinal diseases was investigated. Results 83 （4. 9% ） cases of colorectal malignancies were found in 1681 patients referred to the center for colonoscopy because of lower gastrointestinal symptoms. All these malignancies were verified to be in the progressive stage. The prevalence of alarm symptoms was 81.9% （68/83）. Hematochezia （ OR 4. 1, 95% CI 3.3 -5.2, P 〈0. 001）, melena （0R6.4, 95%CI3. 7-11. 0, P 〈0. 001） and anemia （OR 9.6, 95%C13. 7 - 25. 0, P 〈 0. 001 ） were the most common and specific alarm symptoms. All the patients without alarm symptoms were above the age of 40 years. 264 （15. 7% ） cases of organic colorectal diseases other than malignancies and 1334 （ 79. 4% ） cases with no causal pathology identified were found in 1681 patients, and the prevalence of alarm symptoms in these two groups was 48. 5% （128/264） and 14. 8% （197/1334）, respectively. Conclusion Alarm symptoms including hemotochezia, melena, and anemia were useful in distinguishing organic from functional colorectal diseases in patients over 40 years old at the onset of symptoms. Furthermore, hematochezia, melena, anemia, severe weight loss, and abdominal mass were helpful in differentiating malignant from non-malignant colorectal diseases. Colonoscopy should be recommended for patients regardless of age with these alarm symptoms, and so do patients above the age of 40 years with no alarm symptoms before the diagnosis of functional diseases are made.展开更多
文摘AIM： To evaluate the usefulness of stooI-PCR test for diagnosis of Helicobacter pylori （H pylon） infection in pediatric populations. METHODS： Based on endoscopic features （including nodular gastritis, erosive duodenitis and ulcer） and/or a positive rapid urease test （RUT） obtained during endoscopy, 28 children from a group of children admitted to the Children＇s Medical Center of Tehran for persistent upper gastrointestinal problems were selected to compare biopsy-based tests with stool- PCR. Their gastric activity and bacterial density were graded by the updated Sydney system, and their first stool after endoscopy was stored at -70℃. Biopsies were cultured on modified campy-blood agar plates and identified by gram-staining, biochemical tests, and PCR. Two methods of phenol-chloroform and boiling were used for DNA extraction from H pylori isolates. Isolation of DNA from stool was performed using a stool DNA extraction kit （Bioneer Inc, Korea）. PCR was performed using primers for detection of vacA, cagA, and 16srRNA genes in both isolates and stool. RESULTS： Sixteen out of 28 child patients （57%） were classified as H pylori positive by biopsy-based tests, of which 11 （39%） were also positive by stool- PCR. Sensitivity and specificity of stool-PCR was 62.5% and 92.3% respectively. H pylori was observed in histological sections for 10 out of 11 stool-positive patients. Association was observed between higher score of H pylori in histology and positivity of stool- PCR. Also association was observed between the more severe form of gastritis and a positive stool-PCR. CONCLUSION： Association between higher score of H pylori in histology and a positive stool-PCR make it a very useful test for detection of H pylori active infection in children. We also suggest that a simple stool-PCR method can be a useful test for detection of Hpylori virulence genes in stool.
基金Supported by Shanghai Leading Academic Discipline Project, China (Y0205)
文摘Objective To evaluate the clinical value of alarm symptoms in diagnosis of lower gastrointestinal diseases. Methods Data of consecutive autochthonous patients referred to the endoscopy center of Renji Hospital during the period of Oct. 2002 to Dec. 2003 were retrospectively analyzed. The prevalence of alarm symptoms in Shanghai patients with colorectal malignancies or other organic or functional lower gastrointestinal diseases was investigated. Results 83 （4. 9% ） cases of colorectal malignancies were found in 1681 patients referred to the center for colonoscopy because of lower gastrointestinal symptoms. All these malignancies were verified to be in the progressive stage. The prevalence of alarm symptoms was 81.9% （68/83）. Hematochezia （ OR 4. 1, 95% CI 3.3 -5.2, P 〈0. 001）, melena （0R6.4, 95%CI3. 7-11. 0, P 〈0. 001） and anemia （OR 9.6, 95%C13. 7 - 25. 0, P 〈 0. 001 ） were the most common and specific alarm symptoms. All the patients without alarm symptoms were above the age of 40 years. 264 （15. 7% ） cases of organic colorectal diseases other than malignancies and 1334 （ 79. 4% ） cases with no causal pathology identified were found in 1681 patients, and the prevalence of alarm symptoms in these two groups was 48. 5% （128/264） and 14. 8% （197/1334）, respectively. Conclusion Alarm symptoms including hemotochezia, melena, and anemia were useful in distinguishing organic from functional colorectal diseases in patients over 40 years old at the onset of symptoms. Furthermore, hematochezia, melena, anemia, severe weight loss, and abdominal mass were helpful in differentiating malignant from non-malignant colorectal diseases. Colonoscopy should be recommended for patients regardless of age with these alarm symptoms, and so do patients above the age of 40 years with no alarm symptoms before the diagnosis of functional diseases are made.
