title: Helicobacter pylori and the surface mucous gel layer of the human stomach.
abstract: BACKGROUND
  The colonization of Helicobacter pylori in the surface mucous gel layer (SMGL) was investigated.
  
  
  METHODS
  Surgically removed stomachs were obtained from patients and included gastric ulcer (4 cases), duodenal ulcer (2), and gastric cancer (24). Five of these cases were examined at 8, 19, 28, 143, and 171 days after the end of eradication therapy. For the preservation of the SMGL, these specimens were fixed in cold Carnoy's solution, cleared in xylene, and embedded in paraffin. Serial sections were obtained and were stained by dual staining with the galactose oxidase-cold thionin Schiff reaction followed by paradoxical Concanavalin A staining and immunostaining for H. pylori.
  
  
  RESULTS
  H. pylori characteristically attached to surface mucous cells and colonized in the SMGL H. pylori in the SMGL was more abundant than that attached to the surface mucous cells. The degree of H. pylori infection both on the surface of surface mucous cells and in the SMGL correlated well with the severity of gastritis. In the SMGL, this organism obviously preferred to colonize in the layer of surface mucous cell-type mucins, and the multilaminated structure of the SMGL deteriorated markedly. Eradication of H. pylori restored the structure of the SMGL, and the inflammatory reaction decreased gradually.
  
  
  CONCLUSIONS
  The SMGL is an indispensable site of H. pylori colonization, and this organism damaged the gastric mucosa partially by causing deterioration of the SMGL. Removal of the organism from the SMGL should be considered for eradication of this organism.
authors.affiliation: Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: T
authors.initials: T
authors.lastname: Akamatsu
authors.forename: A
authors.initials: A
authors.lastname: Sugiyama
authors.forename: H
authors.initials: H
authors.lastname: Ota
authors.forename: T
authors.initials: T
authors.lastname: Katsuyama
mesh_terms: D019342:Acetic Acid; D000900:Anti-Bacterial Agents; D002725:Chloroform; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004801:Eosine Yellowish-(YS); D000431:Ethanol; D005260:Female; D005404:Fixatives; D005753:Gastric Mucosa / Q000382:microbiology* / Q000473:pathology; D005756:Gastritis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D005782:Gels; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006416:Hematoxylin; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009077:Mucins / Q000032:analysis; D009093:Mucus / Q000382:microbiology*; D010437:Peptic Ulcer / Q000209:etiology / Q000382:microbiology / Q000473:pathology; D013194:Staining and Labeling; D013274:Stomach Neoplasms / Q000209:etiology / Q000382:microbiology / Q000473:pathology; D016707:Tissue Fixation
chemical_list: D000900:Anti-Bacterial Agents; C033474:Carnoy's solution; D005404:Fixatives; D005782:Gels; D009077:Mucins; D000431:Ethanol; D002725:Chloroform; D019342:Acetic Acid; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin