This study is aimed at a role of Helicobacter pylori (HP) infection in reflux esophagitis of the elderly. 46 patients with reflux esophagitis aged at older than 60 years are selected for this study with informed consent. 43 patients without reflux esophagitis, peptic ulcer, and gastric cancer are used as a control group. In reflux esophagitis, gastric mucosal atrophy is judged as closed type of endoscopic findings in all cases. In control, 27 of 43 patients were judged as open type. Serum pepsinogen I, II ratio is 4.73±1.28 which is higher significantly than 3.39±1.69 in control. Serological positive rate of HP antibody is 39.1% in reflux esophagitis. This rate is significantly lower than 62.7% in control. In conclusion, low frequency of chronic HP infection protects gastric mucosa from atrophy, and keeps secretion of gastric acid, resulting in reflux esophagitis of the elderly accompanied with various abnormal esophago-gastric functions.
We investigated esophageal motility in 12 patients with esophageal varices by esophagography, scintigraphy and manometry before and after endoscopic sclerotherapy. In the manometric study, the appearance rates of the primary wave and the deglutitive relaxation decreased gradually after sclerotherapy, and the former improved within 3 months after discharge, while the latter tended to have a prolonged recovery period. The pressure of the lower esophageal sphincter was not significantly different before and after sclerotherapy. The length of the lower esophageal high pressure zone was greater than normal range before sclerotherapy, but it gradually shortened after sclerotherapy and improved by 3 months after sclerotherapy. The inducting rates of gastroesophageal reflux by abdominal compression was significantly higher at 3 months after sclerotherapy than before. In radiologic study, the esophageal transit time tended to prolong early after sclerotherapy, and it improved only slowly. We concluded that we need contrive to prevent from motility disorder of esophagus at the time of endoscopic sclerotherapy for patients with esophageal varices.
We evaluated the number of clones and the degree of nucleotide diversity in the HVR of the HCV genome in patients with chronic active hepatitis C who were treated with IFN (interferon). We could not obtain the nucleotide sequence per se of the HCV genome but were able to evaluate the degree of diversity in the nucleotide sequence of the HCV genome using FSSA. Nonresponders to IFN therapy showed significant diversity in the nucleotide sequence, even if their number of HCV clones was small. Responders showed little diversity in the nucleotide sequence, which suggests that their viral clones were composed of populations with less variability in the HVR. IFN therapy had more impact on diversity in the nucleotide sequence than on the number of HCV clones.