Nuri Ozden - Academia.edu (original) (raw)
Papers by Nuri Ozden
Journal of the Pancreas, 2017
Skin manifestation associated with pancreatitis can have various presentations. Skin manifestatio... more Skin manifestation associated with pancreatitis can have various presentations. Skin manifestations such as Grey Turner sign or Cullen's sign are known and well documented findings of pancreatitis and carry significant prognostic value. However, livedo reticularis is a rare phenomenon in setting of pancreatitis. Here we report a case of 40 year old female who experiences recurrent episodes of livedo reticularis which is coupled with each bout of acute on chronic pancreatitis. In our patient, livedo reticularis disappears each time with resolution of acute episode of pancreatitis. The recurrent episodes of livedo reticularis from pancreatitis has been very rarely reported in literature. Recognizing skin manifestations in pancreatitis can help clinicians understand the severity and pathology of pancreatitis. Unlike Grey Turner sign or Cullen's sign, livedo reticularis has limited prognostic value, however, their presence deserve our attention. Further case reports and studies ...
Baylor University Medical Center Proceedings, 2020
Most low-grade gastric lymphomas arising from the mucosa-associated lymphoid tissue (MALT) are di... more Most low-grade gastric lymphomas arising from the mucosa-associated lymphoid tissue (MALT) are directly related to Helicobacter pylori infection. Most cases of MALT lymphoma limited to the stomach can be cured with H. pylori eradication and remain in remission for years. In contrast, high-grade lymphomas of the stomach, although potentially related to H. pylori, do not usually respond to H. pylori eradication. Here, we present the case of a woman with high-grade diffuse large B-cell lymphoma who achieved complete remission following H. pylori eradication.
American Journal of Gastroenterology, 2015
a 16x10x13 cm heterogeneous mass in ascending colon and multiple liver masses consistent with met... more a 16x10x13 cm heterogeneous mass in ascending colon and multiple liver masses consistent with metastases (Figure 1). Colonoscopy showed a necrotic friable mass in ascending colon nearly obstructing the lumen (Figure 2). Pathology revealed diff use large B cell lymphoma and immunohistochemical stains confi rmed a pattern favorable of a primary colonic B-cell lymphoma with positive CD20, PAX5, CD10 and BCL6 (Figure 3). Ki 67 was expressed as well in 85 to 95 % of the specimen. Biochemical profi le showed an elevated LDH, while CEA level was within normal limits. Flow cytometry blood test was negative and bone marrow biopsy ruled out any involvement. Th e patient refused surgery and was started on chemotherapy tailored to his lymphoma with favorable response on a PET scan done 6 months later. Primary malignant lymphoma of the colon remains a rare clinical entity specifi cally in immunocompetent individuals, accounting for a small proportion of both colorectal malignancies and GI lymphomas. Commonly it is a disease reported in association with disorders of altered immune status, infl ammatory bowel diseases and celiac disease. Historically, aggressive B-cell lymphomas have been the most common GI lymphomas reported in the literature. Most patients present with nonspecifi c symptoms which oft en lead to delays in diagnosis and advanced stage at presentation, as demonstrated in our patient who presented with metastatic disease to the liver. Treatment usually involves chemotherapy, radiation, surgery or a combination of these, in contrast to colonic adecarcinoma where surgery is the mainstay of therapy. In aggressive lymphomas, resection serves to control local disease to prevent obstruction and perforation, however the defi nitive management remains to be CHOP or other polychemotherapies. Increased awareness of this disease is of utmost importance to avoid delays in diagnosis and tailor further management accordingly, in order to prevent complications.
American Journal of Gastroenterology, 2016
Case reports in gastroenterology
Colonic postanastomotic strictures occur in 1.5-8% of patients following colorectal surgery. Trad... more Colonic postanastomotic strictures occur in 1.5-8% of patients following colorectal surgery. Traditionally, colonic strictures were treated by multiple modalities including endoscopic dilatation. Self-expanding metal stents (SEMS) have been indicated in the management of benign colonic strictures; however, there are limited available data with regard to their efficacy. We present the case of a 68-year-old male who had perforated sigmoid diverticulitis followed by Hartmann's procedure with eventual reanastomosis 6 months later. He subsequently developed benign colonic stricture, which was treated with a metal stent. SEMS are associated with a low mortality rate and are appropriate in treating acute colonic obstruction as a result of benign stricture in the setting of postanastomosis.
Clinics in geriatric medicine, 2007
Intestinal ischemia is a relatively common disorder in the elderly and, if not treated promptly, ... more Intestinal ischemia is a relatively common disorder in the elderly and, if not treated promptly, still carries a high morbidity and mortality rate. High degree of clinical suspicion is of paramount importance in diagnosis, because there is no specific laboratory test available and physical examination findings may be subtle. Once the diagnosis is made, management relies on early resuscitation, identification, and treatment of the predisposing conditions, along with careful planning of the therapeutic invasive interventions, which altogether may help reduce the mortality and morbidity associated with this condition.
Medical science monitor : international medical journal of experimental and clinical research, 2002
1. Med Sci Monit. 2002 Dec;8(12):LE51-2. How hemolysis causes acute pancreatitis. Saruc M, Ozden ... more 1. Med Sci Monit. 2002 Dec;8(12):LE51-2. How hemolysis causes acute pancreatitis. Saruc M, Ozden N, Yuceyar H. PMID: 12546022 [PubMed - indexed for MEDLINE]. Publication Types: Letter. Mesh Terms: Acute Disease; Animals; ...
Medical science monitor : international medical journal of experimental and clinical research, 2002
We aimed to clarify the outcome of perendoscopic prophylactic injection of sclerosing agent in Fo... more We aimed to clarify the outcome of perendoscopic prophylactic injection of sclerosing agent in Forrest's II ulcers. Patients with upper gastrointestinal bleeding in last 6 hours were performed emergency endoscopy and were enrolled. The patients in group-1 were performed prophylactic injection therapy with 1% aethoxysclerol and then given medical treatment with intravenous 40 mg omeprazole twice a day and somatostatin infusion at the dose of 6 mg/day during 3 days. Group-2 patients were only given medical treatment with same agents and at same doses without having any perendoscopic therapy. There were 32 patients in group-1 and 20 in group-2. In emergency endoscopy, 20 (62.5%) patients had IIa ulcers and 12 (37.5%) patients had IIb ulcers in group-1. These patients underwent prophylactic perendoscopic hemostasis by 1% aethoxysclerol in addition to medical treatment. Early rebleeding occurred in 9 (28.1%) patients of group-1 and 3 (15%) in group-2 (p<0.001). At the endoscopic c...
International Journal of Gastrointestinal Cancer, 2004
Journal of Hepatology, 2003
seroconversion was observed in LMV alone group, 6 (14.6%) and in LMV plus IFN group, 3 (10.0%) pa... more seroconversion was observed in LMV alone group, 6 (14.6%) and in LMV plus IFN group, 3 (10.0%) patients (p>O.O5). Conclusions: Prolonged LMV treatment in children with CHB may increase the seroconversion rate. Although seroconversion rate of treatment regimens were not significantly different in second year, LMV plus IFN combination group seemed to be more effective than the LMV group. I 582 LAMIVUDINE THERAPY FOR CHEMOTHERAPY INDUCED REACTIVATION OF HEPATITIS B VIRUS INFECTION
Gastrointestinal Endoscopy, 2012
The gastric mucosa is relatively sensitive to the effects of radiation, which can be intensified ... more The gastric mucosa is relatively sensitive to the effects of radiation, which can be intensified by the use of certain chemotherapeutic agents such as fluorouracil. The case reported here demonstrates that where HBOT is unsuccessful, alternative multimodality endoscopic therapy including RFA and APC can be considered to avoid the need for ongoing transfusion and the possible need for secondary resection. In this case, RFA was particularly advantageous because of the large mucosal surface area requiring Figure 3. The gastric conduit after the completion of endoscopic therapy. Note the absence of residual telangectasias.
Gastrointestinal Endoscopy, 2009
Results: Out of total 84 procedures, CP failed in 7 (8.3%) cases. The reasons for failure were: e... more Results: Out of total 84 procedures, CP failed in 7 (8.3%) cases. The reasons for failure were: equipment related 5 (71.4%), narrowed biliary duct 1, and sphincterotomy bleed 1. There was only one minor complication (1.19%; sphincterotomy-site bleed). The mean age was 64.78 years (range 18-97). Gender: F 46, and M 38 cases. Sedation type: monitored anesthesia care 78 (92.8%), 5 conscious sedation, and 1 general anesthesia. CP was used for diagnostic purpose in 62 (73.8%) and therapeutic in 22 (26.2%) cases. Therapeutic uses were: EHL (electrohydraulic lithotripsy) for stones in 20, and CP forceps for foreign body removal in 2 cases. Biliary findings/applications were (total 79 cases): 31 benign biliary stricture, 27 extrahepatic duct stone removal (size ranging from sludge to 2 cm), 10 malignant stricture, 3 removal of foreign body, 2 intrahepatic stone removal, 1 choledochol cyst, and unremarkable in 5 cases. Pancreatic findings were (total 5 cases): 3 IPMN (intraductal papillary mucinous neoplasia), 1 stone removal, and 1 stent removal. The diagnostic yield of CP forceps was obtained in 34 out of 39 cases (87.2%). Conclusion: We found peroral cholangiopancreatoscopy as a safe and effective technique with very low failure rate of 8.3% and various applications in clinical practice. Background: Current guidelines for screening and surveillance colonoscopy intervals are based on the assumption that patients have a satisfactory bowel preparation. It is unknown whether the yield on follow up examinations in patients with suboptimal bowel preparation differs from those with adequate preparation. Methods: We reviewed all adult colonoscopies that were complete to the cecum performed in 2001 at an urban university hospital. We included those patients in Abstracts
Gastrointestinal Endoscopy, 2010
Gastroenterology Nursing, 2003
Anterograde memory was found in 310 (88.0%) of 352 patients. Three hundred and forty-two of the p... more Anterograde memory was found in 310 (88.0%) of 352 patients. Three hundred and forty-two of the patients (98.0%) cooperated well during the procedure. If we exclude hypnotic effect, side effects were rarely seen (3.6%), and included nausea, vertigo, and vomiting. The acceptability of further endoscopy by patients was present in 338 (96.0%) of 352 patients. No patients experienced significant cardiopulmonary problems during or after the upper gastrointestinal endoscopic procedures. The frequent anterograde memory did not decrease the rate of cooperation. Study results suggest midazolam, as a premedication agent in upper gastrointestinal endoscopy, seems safe and effective with a low rate of side effects and a high rate of acceptability of further endoscopy. Upper gastrointestinal endoscopy can be performed without intravenous sedation, but most patients and endoscopists prefer some form of premedication be given (Bell, 1990). Intravenous diazepam or midazolam have been used by the majority of endoscopists (Wille et al., 2000). Midazolam quickly gained popularity after it was introduced in the mid-1980s (Zakko, Seifert, & Gross, 1999). Many
Gastroenterology, 2003
Gastroenterology, Volume 124, Issue 4, Pages A738, April 2003, Authors:Halim O. Muslu; Nuri Ozden... more Gastroenterology, Volume 124, Issue 4, Pages A738, April 2003, Authors:Halim O. Muslu; Nuri Ozden; Murat Saruc; Kamran Safdar; Douglas Meyer; Marzia Montalbano; Guy W. Neff; Andreas Tzakis; Christopher B. O'Brien; Eugene R. Schiff. ...
Clinical Gastroenterology and Hepatology, 2011
Brazilian Journal of Medical and Biological Research, 2003
The etiology of functional dyspepsia is not known. The objective of the present study was to dete... more The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL), 321 (35.6%), motility disorder-like (ML), 281 (31.2%), and the combination (C) of these symptoms, 298 (33.1%). All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp) density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-α (TNF-α) and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-α and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups.
Journal of the Pancreas, 2017
Skin manifestation associated with pancreatitis can have various presentations. Skin manifestatio... more Skin manifestation associated with pancreatitis can have various presentations. Skin manifestations such as Grey Turner sign or Cullen's sign are known and well documented findings of pancreatitis and carry significant prognostic value. However, livedo reticularis is a rare phenomenon in setting of pancreatitis. Here we report a case of 40 year old female who experiences recurrent episodes of livedo reticularis which is coupled with each bout of acute on chronic pancreatitis. In our patient, livedo reticularis disappears each time with resolution of acute episode of pancreatitis. The recurrent episodes of livedo reticularis from pancreatitis has been very rarely reported in literature. Recognizing skin manifestations in pancreatitis can help clinicians understand the severity and pathology of pancreatitis. Unlike Grey Turner sign or Cullen's sign, livedo reticularis has limited prognostic value, however, their presence deserve our attention. Further case reports and studies ...
Baylor University Medical Center Proceedings, 2020
Most low-grade gastric lymphomas arising from the mucosa-associated lymphoid tissue (MALT) are di... more Most low-grade gastric lymphomas arising from the mucosa-associated lymphoid tissue (MALT) are directly related to Helicobacter pylori infection. Most cases of MALT lymphoma limited to the stomach can be cured with H. pylori eradication and remain in remission for years. In contrast, high-grade lymphomas of the stomach, although potentially related to H. pylori, do not usually respond to H. pylori eradication. Here, we present the case of a woman with high-grade diffuse large B-cell lymphoma who achieved complete remission following H. pylori eradication.
American Journal of Gastroenterology, 2015
a 16x10x13 cm heterogeneous mass in ascending colon and multiple liver masses consistent with met... more a 16x10x13 cm heterogeneous mass in ascending colon and multiple liver masses consistent with metastases (Figure 1). Colonoscopy showed a necrotic friable mass in ascending colon nearly obstructing the lumen (Figure 2). Pathology revealed diff use large B cell lymphoma and immunohistochemical stains confi rmed a pattern favorable of a primary colonic B-cell lymphoma with positive CD20, PAX5, CD10 and BCL6 (Figure 3). Ki 67 was expressed as well in 85 to 95 % of the specimen. Biochemical profi le showed an elevated LDH, while CEA level was within normal limits. Flow cytometry blood test was negative and bone marrow biopsy ruled out any involvement. Th e patient refused surgery and was started on chemotherapy tailored to his lymphoma with favorable response on a PET scan done 6 months later. Primary malignant lymphoma of the colon remains a rare clinical entity specifi cally in immunocompetent individuals, accounting for a small proportion of both colorectal malignancies and GI lymphomas. Commonly it is a disease reported in association with disorders of altered immune status, infl ammatory bowel diseases and celiac disease. Historically, aggressive B-cell lymphomas have been the most common GI lymphomas reported in the literature. Most patients present with nonspecifi c symptoms which oft en lead to delays in diagnosis and advanced stage at presentation, as demonstrated in our patient who presented with metastatic disease to the liver. Treatment usually involves chemotherapy, radiation, surgery or a combination of these, in contrast to colonic adecarcinoma where surgery is the mainstay of therapy. In aggressive lymphomas, resection serves to control local disease to prevent obstruction and perforation, however the defi nitive management remains to be CHOP or other polychemotherapies. Increased awareness of this disease is of utmost importance to avoid delays in diagnosis and tailor further management accordingly, in order to prevent complications.
American Journal of Gastroenterology, 2016
Case reports in gastroenterology
Colonic postanastomotic strictures occur in 1.5-8% of patients following colorectal surgery. Trad... more Colonic postanastomotic strictures occur in 1.5-8% of patients following colorectal surgery. Traditionally, colonic strictures were treated by multiple modalities including endoscopic dilatation. Self-expanding metal stents (SEMS) have been indicated in the management of benign colonic strictures; however, there are limited available data with regard to their efficacy. We present the case of a 68-year-old male who had perforated sigmoid diverticulitis followed by Hartmann's procedure with eventual reanastomosis 6 months later. He subsequently developed benign colonic stricture, which was treated with a metal stent. SEMS are associated with a low mortality rate and are appropriate in treating acute colonic obstruction as a result of benign stricture in the setting of postanastomosis.
Clinics in geriatric medicine, 2007
Intestinal ischemia is a relatively common disorder in the elderly and, if not treated promptly, ... more Intestinal ischemia is a relatively common disorder in the elderly and, if not treated promptly, still carries a high morbidity and mortality rate. High degree of clinical suspicion is of paramount importance in diagnosis, because there is no specific laboratory test available and physical examination findings may be subtle. Once the diagnosis is made, management relies on early resuscitation, identification, and treatment of the predisposing conditions, along with careful planning of the therapeutic invasive interventions, which altogether may help reduce the mortality and morbidity associated with this condition.
Medical science monitor : international medical journal of experimental and clinical research, 2002
1. Med Sci Monit. 2002 Dec;8(12):LE51-2. How hemolysis causes acute pancreatitis. Saruc M, Ozden ... more 1. Med Sci Monit. 2002 Dec;8(12):LE51-2. How hemolysis causes acute pancreatitis. Saruc M, Ozden N, Yuceyar H. PMID: 12546022 [PubMed - indexed for MEDLINE]. Publication Types: Letter. Mesh Terms: Acute Disease; Animals; ...
Medical science monitor : international medical journal of experimental and clinical research, 2002
We aimed to clarify the outcome of perendoscopic prophylactic injection of sclerosing agent in Fo... more We aimed to clarify the outcome of perendoscopic prophylactic injection of sclerosing agent in Forrest's II ulcers. Patients with upper gastrointestinal bleeding in last 6 hours were performed emergency endoscopy and were enrolled. The patients in group-1 were performed prophylactic injection therapy with 1% aethoxysclerol and then given medical treatment with intravenous 40 mg omeprazole twice a day and somatostatin infusion at the dose of 6 mg/day during 3 days. Group-2 patients were only given medical treatment with same agents and at same doses without having any perendoscopic therapy. There were 32 patients in group-1 and 20 in group-2. In emergency endoscopy, 20 (62.5%) patients had IIa ulcers and 12 (37.5%) patients had IIb ulcers in group-1. These patients underwent prophylactic perendoscopic hemostasis by 1% aethoxysclerol in addition to medical treatment. Early rebleeding occurred in 9 (28.1%) patients of group-1 and 3 (15%) in group-2 (p<0.001). At the endoscopic c...
International Journal of Gastrointestinal Cancer, 2004
Journal of Hepatology, 2003
seroconversion was observed in LMV alone group, 6 (14.6%) and in LMV plus IFN group, 3 (10.0%) pa... more seroconversion was observed in LMV alone group, 6 (14.6%) and in LMV plus IFN group, 3 (10.0%) patients (p>O.O5). Conclusions: Prolonged LMV treatment in children with CHB may increase the seroconversion rate. Although seroconversion rate of treatment regimens were not significantly different in second year, LMV plus IFN combination group seemed to be more effective than the LMV group. I 582 LAMIVUDINE THERAPY FOR CHEMOTHERAPY INDUCED REACTIVATION OF HEPATITIS B VIRUS INFECTION
Gastrointestinal Endoscopy, 2012
The gastric mucosa is relatively sensitive to the effects of radiation, which can be intensified ... more The gastric mucosa is relatively sensitive to the effects of radiation, which can be intensified by the use of certain chemotherapeutic agents such as fluorouracil. The case reported here demonstrates that where HBOT is unsuccessful, alternative multimodality endoscopic therapy including RFA and APC can be considered to avoid the need for ongoing transfusion and the possible need for secondary resection. In this case, RFA was particularly advantageous because of the large mucosal surface area requiring Figure 3. The gastric conduit after the completion of endoscopic therapy. Note the absence of residual telangectasias.
Gastrointestinal Endoscopy, 2009
Results: Out of total 84 procedures, CP failed in 7 (8.3%) cases. The reasons for failure were: e... more Results: Out of total 84 procedures, CP failed in 7 (8.3%) cases. The reasons for failure were: equipment related 5 (71.4%), narrowed biliary duct 1, and sphincterotomy bleed 1. There was only one minor complication (1.19%; sphincterotomy-site bleed). The mean age was 64.78 years (range 18-97). Gender: F 46, and M 38 cases. Sedation type: monitored anesthesia care 78 (92.8%), 5 conscious sedation, and 1 general anesthesia. CP was used for diagnostic purpose in 62 (73.8%) and therapeutic in 22 (26.2%) cases. Therapeutic uses were: EHL (electrohydraulic lithotripsy) for stones in 20, and CP forceps for foreign body removal in 2 cases. Biliary findings/applications were (total 79 cases): 31 benign biliary stricture, 27 extrahepatic duct stone removal (size ranging from sludge to 2 cm), 10 malignant stricture, 3 removal of foreign body, 2 intrahepatic stone removal, 1 choledochol cyst, and unremarkable in 5 cases. Pancreatic findings were (total 5 cases): 3 IPMN (intraductal papillary mucinous neoplasia), 1 stone removal, and 1 stent removal. The diagnostic yield of CP forceps was obtained in 34 out of 39 cases (87.2%). Conclusion: We found peroral cholangiopancreatoscopy as a safe and effective technique with very low failure rate of 8.3% and various applications in clinical practice. Background: Current guidelines for screening and surveillance colonoscopy intervals are based on the assumption that patients have a satisfactory bowel preparation. It is unknown whether the yield on follow up examinations in patients with suboptimal bowel preparation differs from those with adequate preparation. Methods: We reviewed all adult colonoscopies that were complete to the cecum performed in 2001 at an urban university hospital. We included those patients in Abstracts
Gastrointestinal Endoscopy, 2010
Gastroenterology Nursing, 2003
Anterograde memory was found in 310 (88.0%) of 352 patients. Three hundred and forty-two of the p... more Anterograde memory was found in 310 (88.0%) of 352 patients. Three hundred and forty-two of the patients (98.0%) cooperated well during the procedure. If we exclude hypnotic effect, side effects were rarely seen (3.6%), and included nausea, vertigo, and vomiting. The acceptability of further endoscopy by patients was present in 338 (96.0%) of 352 patients. No patients experienced significant cardiopulmonary problems during or after the upper gastrointestinal endoscopic procedures. The frequent anterograde memory did not decrease the rate of cooperation. Study results suggest midazolam, as a premedication agent in upper gastrointestinal endoscopy, seems safe and effective with a low rate of side effects and a high rate of acceptability of further endoscopy. Upper gastrointestinal endoscopy can be performed without intravenous sedation, but most patients and endoscopists prefer some form of premedication be given (Bell, 1990). Intravenous diazepam or midazolam have been used by the majority of endoscopists (Wille et al., 2000). Midazolam quickly gained popularity after it was introduced in the mid-1980s (Zakko, Seifert, & Gross, 1999). Many
Gastroenterology, 2003
Gastroenterology, Volume 124, Issue 4, Pages A738, April 2003, Authors:Halim O. Muslu; Nuri Ozden... more Gastroenterology, Volume 124, Issue 4, Pages A738, April 2003, Authors:Halim O. Muslu; Nuri Ozden; Murat Saruc; Kamran Safdar; Douglas Meyer; Marzia Montalbano; Guy W. Neff; Andreas Tzakis; Christopher B. O'Brien; Eugene R. Schiff. ...
Clinical Gastroenterology and Hepatology, 2011
Brazilian Journal of Medical and Biological Research, 2003
The etiology of functional dyspepsia is not known. The objective of the present study was to dete... more The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL), 321 (35.6%), motility disorder-like (ML), 281 (31.2%), and the combination (C) of these symptoms, 298 (33.1%). All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp) density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-α (TNF-α) and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-α and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups.