Recently, we demonstrated that O-2 generated in in situ tissues could be detected with cypridina luciferin analog (CLA) as a chemiluminescence probe and a sensitive photon counting system as the detector of chemiluminescence. With these, we examined whether or not O-2 generates in in situ gastric mucosa of rats under the conditions to induce experimental acute gastric mucosal lesions (AGMLs) and ischemia-reperfusion of gastric mucosa. The results obtained were as follows: (1) O-2 generated by activated granulocytes was detected at a time at which the gastric mucosal blood flow had already decreased in experimental AGMLs and the ischemia-reperfusion system. (2) The edema and erosion formation occurred in the fundic gastric mucosa due to granulocyte mediation. (3) The edema formation was inhibited by a continuous infusion of superoxide dismutase at a time at which the O-2 was being generated, but the erosion formation was not inhibited in the same experiment. These results indicate that granulocyte activation, which induces the tissue injury, occurs in the gastric mucosa in an early developmental phase in AGMLs due to the injury to the circulation, and that O-2 is related to the edema formation.
We investigated the relationship between preoperative serum IAP levels and lymphocyte subsets in 81 gastric cancer patients to clarify the clinical significance of serum IAP level of cancer host. In the two groups divided by cut-off point of serum 580μg/ml, the percentage of CD4+ cells and CD4+/CD8+ ratio of the high IAP group was significantly lower than that of the low group and the percentage of CD11b+ cells and CD25+ cells of the high IAP group was significantly higher than that of the low group. There was positive correlation between the IAP levels and CD11b+ cells, CD25+ cells. These results suggest that BRM therapy will be more effective in the low IAP group. Assaying of serum IAP is thought to be useful as immunological parameter in BRM therapy for cancer patients.
The effect of exogenous and endogenous dopamine on the gastric microcirculation and their action sites on stomach were investigated by laser Doppler flowmetry, histochemistry, electron microscopy and radioautography. The effects of graded doses of dopamine on the gastric mucosal blood flow were different from those on the systemic blood flow, implying that there may exist a dopaminergic control of gastric mucosal blood flow independent from the systemic circulation. By histochemical observatins of the horseradish peroxidase (HRP) infused preparations, HRP was found to be distributed mainly to the arterioles and venules at the base of the gastric mucosa with a high dose of dopamine which may contributed to open the arterio-venular shunt either at the base of mucosa or in the submucosa. Pretreatment with monoamine oxidase inhibitor and/or 6-hydroxydopamine caused changes in the levels of endogenous catecholamine (dopamine, noradrenaline and adrenaline) in the stomach wall. An imbalanced catecholamine in the stomach wall, particularly an increse in DA, decreased gastric mucosal blood flow. Radioautographic studies revealed that D1-receptors are located mainly on the arterioles in the lower part of the mucosa and submucosa, while D2-receptors are located mainly on the muscularis mucosae and on the collecting venules. Tyrosine hydroxylase (TH) positive nerve fibers possibly corresponding to the dopaminergic fiber were evident in the vicinity to the arterioles, venules, and muscularis mucosae. Some TH-positive fibers were extended to the true capillaries in the mucosa. Dopamine β-hydroxylase positive fibers were noted near the arterioles and venules both in the submucosa and the lower portion of mucosal layer. Based on the above results, the dopaminergic mechanisms are considered to be involved in the regulation of the gastric mucosal microcirculaton through the dopaminergic nerves.
To elucidate the pathogenesis of acute gastric mucosal lesion (AGML), burn stress was loaded in rats with and without obstructive jaundice. The activation of gastric mucosal glycosidases (β-N-acetyl-D-glucosaminidase (NAG), β-glucuronidase (BG)), which were released into the cytoplasm as a results of instability of the lysosomal membrane, was studied biochemically, enzymatically and histochemically after burn stress with and without obstructive jaundice. The latent enzyme activity calculated by NAG or BG, which represented the stability of lysosomal membrane, was lowest at 2-3 hour after burn stress in both groups. In other words, the degree of activation of the glycosidases was highest at 2-3 hour after burn stress. The latent enzyme activity calculated by NAG decreased significantly (p<0.05) at 1 hour after burn stress in obstructive jaundice group compared with the non-obstructive jaundice group. The staining of NAG before burn stress was observed in mucus neck cell and surface epithelial cell in granular shape and it was observed diffusely after burn stress, especially in obstructive jaundice group. The changes in staining of BG was similar to NAG. Before activation of glycosidases, the thiobarbituric acid reactants, which are considered products of lipid peroxidation, increased promptly at 30min after burn stress in both groups. Ulcer index increased gradually after burn stress and the significance was found between in the obstructive jaundice group and in non-obstructive jaundice group at 3 hour after burn stress. It's concluded that obstructive jaundice accelerated the fragility of lysosomal membrane after burn stress and these change were considered to be the reasons of frequent ocurrence of AGML.
The authers evaluated a new device the ultrasonic micro-probe (2.4mm in the outer diameter, radial scanning system, 15MHz, Toshiba Co.) from both its basic and clinical aspects using resected gastric specimens and clinical subjects. The ultrasonic resolution of this new ultrasound imaging catheter was demonstrated to be best the probe-object distance was 1.0-3.0mm and angle of inclination was 0-20. On clinical use of the probe, the above-mentioned basic evaluation is important to achieve high resolution ultrasonic image. For attenuation of ultrasound due to the high-frequency (15MHz), the main subjects of this probe for evaluation of gastrointestinal tract are small lesions of mucosal-submucosal layers. Because of its small caliber (2.4mm), the micro-probe can be passed through the biopsy channel of common used endoscope, and permits the intra-luminal ultrasound examination at routine endoscopy, if necessary. This new device the ultrasonic micro-probe will develop the ability of endoscopic ultrasound in diagnosing gastrointestinal disorders.
Paracolic marginal artery and/or vein of rabbit descending colon were ligated at two points with a distance of 3cm each other. The animals were sacrificed 1, 4 and 7 days after the operative procedure. The colonic segment including the vessel-ligated region was removed and studied macroscopically and microscopically. The impairment of arterial blood supply was more responsible for the development of colonic lesions. Especially, ulcerative lesions occurred only in artery-ligated and both of artery and vein-ligated groups. All the lesions occurred in the vein-ligated group were those showing only edema. Three types of mucosal folds with different etiology appeared in the vessel-ligated region of the colon, i. e., longitudinal and transverse folds and those converging to the ulcerative lesion. The morphological features of colonic lesions changed gradually. In the artery-ligated group, a variety of lesions including multiple ulcers and petechiae appeared with a longer lapse of time.
When treating patients with Crohn's disease (CD), external or internal fistulas connected to the intestine were encountered, and these were often difficult to diagnose correctly. In order to diagnose such fine fistulas, we modified a method of using indocyanine green (ICG) administration to the gut lumen. The subjects of this study comprised nine patients with CD who had an obscure fistula which could not be demonstrated by barium study, fistulography, or by urological or gynecological examinations. If the administrated ICG was detected by various ways from an external fistula or from the neighboring organs, a fistulous connection was thought to be evident. Following oral administration in nine patients, colonic fistulas became evident in seven and by ICG enema in three patients, colonic fistulas became evident in all three. In addition, since the fistulous connection was ameliorated following nutritional therapy, it would appear that ICG administration is a useful marker of such therapy for this condition. ICG administration was therefore thought to be a useful method of detecting obscure fistulas connected to the intestine.
We studied osteopenia in patients with liver cirrhosis by dual energy X-ray absorptiometry (DXA). Total body bone mineral density showed a positive corelation with the lumbar spine bone mineral density, and % age matched total body bone mineral density under 90% was defined as osteopenia. The incidence of osteopenia in 54 patients with liver cirrhosis was 20.4%. Since this osteopenia had no relationship to the general risk factors for osteoporosis, it was suggested that it is a complication specific to liver cirrhosis. Because the level of serum total bilirubin and the activity of serum total alkaline phosphatase in the group with osteopenia were usually higher than those in the group without osteopenia, it was suggested that osteopenia in liver cirrhosis might be related to hepatic dysfunction.