[Helicobacter pylori infection, gastritis and non-ulcer dyspepsia--is there a connection?].
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Biomedical subjects
Publications and source records attributed to M Cooreman.
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The 13C-urea breath test was used for diagnosing noninvasively the possible presence of Helicobacter (formerly called Campylobacter) pylori in 20 patients with dyspepsia (ten men and ten women, mean age 40.2 [24-74] years). H. pylori was cultured from 14 patients, while in six the culture was negative. The proportion of 13C in expired air was measured by isotope mass-spectrometer and expressed as Delta (basal value about 20%). A dose of 2.5 mg urea per kg body-weight (BW) was ingested after a standard meal. The test was repeated with 1.75 and 1.0 mg/kg BW in five subjects. Delta had increased significantly after 30 min in all H. pylori-positive patients (P less than 0.001). The maximal value after 90 min ranged from 38 to 114%; in the H. pylori-negative patients it was 24%. After 1.75 and 1.0 mg/kg urea the maximal value after 90 min was 39-52% and 30-52%, respectively. Using a dose of 2.5 or 1.75 mg/kg BW tagged urea one can reliably distinguish between presence and absence of H. pylori. It is sufficient to test a basal and a 90-min expired-air sample.
We have collected sera from 4053 patients of different parts of Belgium. Sera were randomly selected whatever the kind of pathology. Anti-Helicobacter (Campylobacter) pylori IgG were determined with an ELISA technique using whole formalized bacteria. The results suggest that the mean antibody titres differ between various areas, with an overall higher prevalence in the north-western part of the country.
The triad of the Klippel-Trénaunay Syndrome consists of varicose veins, "port-wine" haemangioma of the skin and bone and soft-tissue hypertrophy with a different extension. Often an obstruction of lymphatic vessels and lymphoedema accompany the syndrome. We observed for the first time a patient with an impressive Klippel-Trénaunay-Syndrome in combination with a symptomatic exudative enteropathy. In spite of a regular intravenous protein substitution for many years, this patient had developed a monstrous elephantiasis of the lower extremities. A lymphography demonstrated a blockade of the lymph flow at the height of the middle paraaortic lymph nodes. The cysterna chyli and the Ductus thoracicus were not visualised. The measurement of 51Cr-labelled albumin excretion in the stool for two days after the intravenous injection of 3.07 MBq 51Cr showed an excretion of 17.9% of the total dose, which means an elevated gastrointestinal protein-loss. However, intestinal lymphangiectasia was not seen on histologic examination of bioptic material of duodenal and jejunal mucosa. These results show that the Klippel-Trénaunay Syndrome may be accompanied by a protein-loosing enteropathy due to obstruction of the gastrointestinal lymph flow. As the intestinal lymphangiectasia may occur locally, it is not always demonstrable directly on pathologic examination of biopsies.
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