الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
HISTORICAL BACKGROUND
Spiral bacteria had been seen in the human stomach hundred years ago. The first observation may have been by Krienitz (1906) (1) and subsequently by others but they could not be cultured and their significance was missed.
Friedberg and Barron (1940)(2) using silver staining techniques, studied 35 partial gastrectomy specimens from patients with peptic ulcer or carcinoma. They found spirochetes in 37% of specimens after a long search in the gastric mucosa. They concluded that the bacteria colonizing the tissues near the benign or malignant ulcers are non pathogenic opportunists. (2)
Over similar time period many authors have documented the presence of endogenous urease activity localized to the stomach in animals and humans. Fitzgerald and Murphy (1950) (3) who emphasized the association of the enzyme and ulcer disease. (3)
An extensive review by Kornberg (1955) (4, 5) concluded that gastric urease was localized mainly in the corpus of the stomach and was of bacterial origin. (4, 5)
Following the introduction of flexible fibreoptic gastroscopy during the 1970s, Steer and Colin-Jones (1975) (6) came near to identify Helicobacter pylori (H. pylori ) and its association with gastritis in a large study of biopsy specimens. However, misinterpretation of culture results led to the wrong conclusion that the organisms seen were pseudomonas aeruginosa. (6)
Australian researchers Barry Marshall and Robin Warren (1983) (7) discovered spiral shaped bacteria in the stomach with gastritis and peptic ulcer. After closely studying their effect on the stomach, they proposed that the bacteria were the underlying cause of gastritis and peptic ulcers. After one year the same researchers (8) described spiral or curved bacilli in histological section from biopsy speciemens of human gastric antral mucosa. The culture was positive for gram negative microaerophilic bacterium. The organisms were thought originally to be member of the genus campylobacter and therefore were named campylobacter pyloridis, meaning the curved rod in pyloric region. Because this bacterium differed in the structure and the biochemical behavior from other campylobacter, therefore it was placed in a new genus the helicobacter pylori. (9) The genus name reflects the two morphological appearances of the organism, helical in vivo but often rod-like in vitro. (9, 10)
Within a few years of the publication of Warren and Marshall (1984) (8) work many reports appeared world wide confirming the close association between H. pylori and chronic active gastritis as well as with gastric and duodenal ulcer. Further more, there is now over whelming evidence that H. pylori is linked to gastric adenocarcinoma and gastric non Hodgkin’s lymphoma. (11) Within a few years of the publication of Warren and Marshall many reports appeared world wide confirming the close association between H. pylori and chronic active gastritis as well as with gastric and duodenal ulcer. The development of sensitive and specific diagnostic methods and the application of therapies that can eliminate the infection result in more precise appreciation of the clinical relevance of H. pylori in various gastroduodenal diseases.(12)