Anti-human pepsinogen (PG) I and II monoclonal antibodies were used in an immunohistochemical study of 56 cases of gastric carcinoma (37 early stage and 19 advanced stage). We examined the relationship between positivity of the carcinoma for producing PG I and II and serum PG I and II levels. We found that in 2 cases (3.6%), the carcinoma produced PG I and in 11 cases (19.6%), it produced PG II. Early gastric carcinomas and differentiated-type carcinomas produced PG II more frequently than advanced and undifferentiated-type carcinomas. Also, type II c carcinomas and carcinomas located in the C area of the stomach produced PG II more frequently. But there was no significant difference between PG I and II-positive and negative cases in relation to both serum PG I and II levels. Moreover, the rate of positivity did not correlate with cases of abnormally high levels of serum PG I and II, (except in 1 case with abnormally high serum PG I in which PG II was produced.) These results suggest that there is no significant relationship between PG I or II-producing gastric carcinomas and serum PG levels. Furthermore, we examined PG II-producing and non-producing carcinomas in relation to the grade of inflammation, atrophy and intestinal metaplasia in gastric mucosa. However, there was no statistically significant difference among these factors. Only serum PG I and II levels were related to these parameters.
The prevalence of Helicobacter pylori (HP) were studied in 117 subjects with no gross findings whose stomach age was equal to its chronological age. HP was detected by culture. The prevalence of HP significantly was higher in thirties and forties than other ages, and in C3 and O1 groups than other groups. Most of forties and fifties belonged to C3 or O1 groups. Histologically, HP infection was significantly frequent in the gastric mucosa with advancing inflammation. These findings suggest that HP infects in early middle age, causes the destruction and atrophy of gastric mucosa and disappears with ageing and chronological expansion of mucosal atrophy. We consider that HP infection may play a causative role of the aging process of the stomach.
The most common primary site of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is the gastrointestinal tract, particularly the stomach. The relationship of MALT lymphomas, however, with the more commonly occurring large B-cell gastric lymphoma has not been directly discussed except in the report of Chan et al. (1990), which lacked clinical information regarding the behavior of these tumors. To elucidate the relationship between high-grade large-cell lymphoma and MALT lymphoma, we studied in detail the histopathological and clinicopathologic features with the survival data of 77 Japanese cases of primary gastric lymphoma (PGL) of B-cell type. Based on the degree of morphologically recognizable low- or high-grade components of the tumor, PGL was divided into four types: 18 cases of pure MALT lymphoma (type I); 13 cases of MALT lymphoma with small areas of high-grade lymphoma (type II); 22 cases of high-grade lymphoma with small areas of MALT lymphoma (type III); and 24 cases of pure high-grade lymphoma (type IV). Corresponding to the differences in the histologic pictures of each type, there were differences in the gross appearance, pathologic stage (including depth of invasion) and prognosis. These data suggests that both MALT and high-grade lymphomas of the stomach belong to the same cell lineage and constitute a pathological spectrum and that the histological grouping of PGL is clinico-pathologically useful.
We studied the effects of synthetic protease inhibitors on the motility of the human duodenal papilla. Before and after the intravenous administration of gabexate mesilate (GM) or nafamostat mesilate (NM), the duodenal papillary pressure was measured with a catheter tip pressure transducer under duodenoscopy. GM was administered to fourteen subjects at 1 and 3mg/kg/h. The peak pressure and the basal pressure were dose-dependently reduced by GM, but the frequency did not change. The blood CCK concentration was not changed after GM administration. NM was administered to twelve subjects at 0.3mg/kg/h. Both the papillary pressure and the frequency were not changed by NM. GM inhibited the papillary motility, but NM had no consistent effect on the papillary motility.
Effect of hepatic ischemia and reperfusion on hepatic regeneration after 70% partial hepatectomy was evaluated in rats. Total hepatic ischemia by portal triad cross clamping (15 minutes) and reperfusion (15 minutes) was repeated two times during partial hepatectomy in the PS, non-PS, and G groups. In the C group, partial hepatectomy was made as a control without ischemia and reperfusion. In order to evaluate the effect of portal pooling, portal systemic shunt (PS shunt) was made by splenic transposition to subcutaneous space in the PS group, and compared with the non-PS group. Gadolinium chloride (GdCl3), the selective blocker of Kupffer (K) cell, was intravenously administered to the rat in the G group. Hepatic regeneration rates, labelling index of liver cells, rates of bacterial infection of mesenteric lymphnodes (MLN), blood levels of endotoxin (Ex) and tumor necrosis factor-α (TNF) were compared. Hepatic regeneration at 28 days was suppressed by total hepatic ischemia in the non-PS group. Increased positive rates of MLN culture and blood levels of Ex showed bacterial translocation induced by the portal pooling during portal triad clamping. PS shunt reduced both bacterial translocation and the suppression of hepatic regeneration occurred in the PS group. Hepatic regeneration was not suppressed and blood TNF level did not increased in the G group by the inhibition of K cell function. In conclusion, repeated total hepatic ischemia and reperfusion induced portal pooling, bacterial translocation, and activated K cell, then inhibited hepatic regeneration after partial hepatectomy.
The gallbladder muscular layers of the patients with cholecystolithiasis were examined to evaluate the relationship between the gallbladder contractility and fibrosis in the muscular layers. Gallbladder contractility decreased as the fibrosis of muscular layers became severe. The density of the antimacrophage (Mφ) antibody positive cells in the muscular layers was apparently greater in the remarkable fibrosis group than in the unremarkable fibrosis group, and the density of the anti-TGF-β antibody positive cells in the remarkable fibrosis group was significantly greater than in the unremarkable fibrosis group. Smooth muscle cells in the muscular layers had changed morphologically from a contractile type to a synthetic type, and fibroblasts were frequently observed in the muscular layers of the remarkable fibrosis group. Immunohistochemically, type III collagen was detected in the rough endoplasmic reticulum not only of fibroblasts but also of synthetic type-smooth muscle cells. These results suggest that the fibrosis in the muscular layers is one of the factors responsible for reduced gallbladder contractility in patients with cholecystolithiasis, and the increase of Mφ, fibroblasts and synthetic type-smooth muscle cells is involved in such a fibrotic change of the gallbladder muscular layers.
To evaluate the tumor blood flow in hepatocellular carcinoma, we have introduced color Doppler imaging during operation. 37 hepatocellular carcinoma patient with 54 nodules were included in this study. Following categories were analyzed, those were detectability of pulsatile blood flow and continuous blood flow signal in the tumor, pulsatile blood flow velosity depend on tumor size and pathological feature. Even the size of the tumor is less than 1cm in diameter in 70% of those nodules we could detect and analyze the flow signal. This new modality could have a possibility to be a useful diagnostic device for small mass lesions in the liver.
KSG-504, a new synthetic cholecystokinin (CCK) receptor antagonist derived from proglumide, has superior selectivity and affinity to CCK-A receptors. We have investigated the effect of KSG-504 on ethionine-induced acute pancreatitis in rats and the influence of endogenous CCK on evolution of pancreatitis and regeneration of pancreatic acinar cells. Reduction of pancreatic proteins and digestive enzyme contents was dose-dependently prevented by subcutaneous administration of KSG-504. The inhibition of evolution of pancreatitis was demonstrated histologically in KSG-504 treated rats. The effect of KSG-504 on pancreatic regeneration was evaluated by bromodeoxyuridine labeling index (B.L.I.) of acinar cells. There was no significant difference of B.L.I. between KSG-504 treated and non-treated rats. These results suggest that KSG-504 has a beneficial effect on ethionine-induced acute pancreatitis by blockade of endogenous CCK.