The Sydney System for classification of gastritis 20 years ago.

The roots of research into gastritis go back into the early decades of the 20th century. Modern aspects of its classification and knowledge of its biological course and consequences were relatively well known even at the time that Helicobcter pylori was discovered by Robin Warren and Barry Marshall in 1982. This discovery, however, significantly changed the field, establishing that the commonest form of gastritis is simply an infectious disease, a finding that raised enormous interest in the subject amongst gastroenterologists, microbiologists, pathologists and basic researchers.

Differential effect of Helicobacter pylori eradication on time-trends in brady/hypokinesia and rigidity in idiopathic parkinsonism.

Background: We examine the effect of eradicating Helicobacter in idiopathic parkinsonism (IP). Marked deterioration, where eradication-therapy failed, prompted an interim report in the first 20 probands to reach de-blinding. The null-hypothesis, "eradication has no effect on principal outcome, mean stride length at free-walking speed," was rejected.

Helicobacter hypothesis for idiopathic parkinsonism: before and beyond.

We challenge the concept of idiopathic parkinsonism (IP) as inevitably progressive neurodegeneration, proposing a natural history of sequential microbial insults with predisposing host response. Proof-of-principle that infection can contribute to IP was provided by case studies and a placebo-controlled efficacy study of Helicobacter eradication. "Malignant" IP appears converted to "benign", but marked deterioration accompanies failure.

Flat colorectal neoplasms and the impact of the revised Vienna Classification on their reporting: a case-control study in UK and Japanese patients.

Objective: The prevalence and interpretation of flat colorectal neoplasms in the East or West remain highly variable. Several factors may contribute to this variability including differences in reporting techniques between Japanese and Western histopathologists when lesions are classified. The aims of this study were (i) to determine the frequency and characteristics of flat colorectal neoplasms in British and Japanese patients, (ii) to examine whether histopathological discrepancies exist between Western and Japanese-trained pathologists applying conventional classification methods and (iii) to determine the impact of the revised Vienna Classification on any differences observed.

Thirty-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis.

Background & Aims: The value of colonoscopic surveillance for neoplasia in long-standing extensive ulcerative colitis remains controversial. This study reports on prospectively collected data from a surveillance program over a 30-year period.

Methods: Data were obtained from the prospective surveillance database, medical records, colonoscopy, and histology reports.

Role of chronic infection and inflammation in the gastrointestinal tract in the etiology and pathogenesis of idiopathic parkinsonism. Part 2: response of facets of clinical idiopathic parkinsonism to Helicobacter pylori eradication. A randomized, double-blind, placebo-controlled efficacy study.

Background: Links between etiology/pathogenesis of neuropsychiatric disease and infection are increasingly recognized.

Aim: Proof-of-principle that infection contributes to idiopathic parkinsonism.

Methods: Randomized, double-blind, placebo-controlled efficacy study of proven Helicobacter pylori eradication on the time course of facets of parkinsonism.

Role of chronic infection and inflammation in the gastrointestinal tract in the etiology and pathogenesis of idiopathic parkinsonism. Part 1: eradication of Helicobacter in the cachexia of idiopathic parkinsonism.

Background: Neuronal damage in idiopathic parkinsonism may be in response to ubiquitous occult infection. Since peptic ulceration is prodromal, Helicobacter is a prime candidate.

Aim: To consider the candidature of Helicobacter in parkinsonism with cachexia.

A new prognostic staging system for rectal cancer.

Objective: To clarify the appropriateness of tumor "budding," a quantifiable histologic variable, as 1 parameter in the construction of a new prognostic grading system for rectal cancer.

Summary Background Data: Patient division according to an accurate prognostic prediction could enhance the effectiveness of postoperative adjuvant therapy and follow-up.

Patients And Methods: Tumor budding was defined as an isolated cancer cell or a cluster composed of fewer than 5 cells in the invasive frontal region, and was divided into 2 grades based on its number within a microscopic field of x250.

Pathology of drug-associated gastrointestinal disease.

A large number of drugs have gastrointestinal side-effects of which diarrhoea or constipation, nausea and vomiting are amongst the commonest. In relatively few are there diagnostic pathological changes and this review draws attention to the most common. Incriminating a drug as a cause of specific pathological changes requires the drug to be associated with the changes, for the latter to resolve when the drug is withdrawn and for them to re-appear when a patient is rechallenged with the drug.

Microscopic colitis: the tip of the iceberg?

Objectives: The aims were to determine whether a wide variation exists between hospitals in the diagnosis of microscopic colitis and to assimilate clinical data.

Design: Retrospective study of 90 patients with microscopic colitis aged between 16 and 92 years from 11 hospitals in south-east England.

Methods: A questionnaire was designed to collect relevant data from all patients in whom a new diagnosis of microscopic colitis had been made at the source hospital between January 1990 and December 1996.

Female anal sphincter: age-related differences in asymptomatic volunteers with high-frequency endoanal US.

Purpose: To evaluate endoanal ultrasonographic (US) anatomy in a large group of nulliparous women by using a high-frequency 10-MHz transducer to define normal age-related differences in sphincter morphology.

Materials And Methods: One hundred fifty asymptomatic nulliparous women (mean age, 31 years; range, 19-80 years) underwent endoanal US with a high-frequency 10-MHz transducer. Anal canal structures were measured at high, middle, and low levels and were correlated with age by using the Pearson simple linear correlation coefficient.