Stomach biopsy specimens from greater than 40 individuals with Campylobacter pyloridis-associated gastritis were examined by light and electron microscopy. The bacteria were consistently seen in two locations: within the gastric mucus and associated with intercellular junctions of gastric epithelial cells. C. pyloridis is suggested to be one of a broad group of spiral bacteria that are adapted to the peculiar niche provided by intestinal mucus. The spiral morphology and the form of motility of these organisms give them a selective advantage in a viscous environment. This point has been demonstrated in vitro by measurement of the velocity of clinical isolates in solutions of methyl cellulose of varying viscosity. The localization of C. pyloridis close to intercellular junctions is proposed to be due to the presence of preferred metabolites or growth factors, e.g., urea and hemin. All isolates show an extremely high urease activity and require hemin for growth.
Patients presenting with acute upper gastrointestinal bleeding from a variety of lesions were admitted to a prospective double-blind controlled trial to determine if cimetidine reduces the severity of bleeding and/or the incidence of rebleeding. During the first 48 hours, the patients received intravenous cimetidine (200 mg four-hourly) or placebo, and for the following ten days, oral cimetidine (1 g/24 hr) or placebo. Eight-eight patients entered the trial of whom 45 (51%) were in the cimetidine-treated group. Six of the seven patients requiring surgery for life-threatening bleeding and four of the six patients who rebled were in the cimetidine-treated group. This study failed to demonstrate any advantage of using cimetidine routinely in the treatment of acute upper gastrointestinal bleeding.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.