Amburatory 24-hour pH monitoring was conducted in 11 patients with H2-blocker resistant reflux esophagitis to compare the effects of standard doses of H2-blocker (famotidine 20mg twice daily) and proton pump inhibitor (omeprazole 20mg once daily) on the inhibition of intraesophageal acidity. Mean intraesophageal pH during PPI treatment was significantly higher than that during H2-blocker treatment. Proportion of abnormal intra-esophageal acidity in 24hr (%time pH<4) during PPI treatment was significantly less than that during H2-blocker treatment (11.7±3.1% vs 31.6±4.8%). The difference of the effect was more apparant in day time (upright time) than in night time (supine time). Thus PPI is superior to H2-blocker in treatment for refractory reflux esophagitis, but proportion of abnormal intra-esophageal acidity in 24hr (%time pH<4) could be normarized only in 4 out of 11 patients even by standard dose PPI treatment. Effects of not only long-term maintenance therapy but also high dose therapy with PPI should be examined in future studies.
The purpose of this study was to determine the etiology of peptic ulceration in patients with pulmonary emphysema. We performed endoscopy in 50 patients with chronic pulmonary emphysema, these were patients with and without peptic ulcer. There was no significant differences between the patients with and without ulcer, with respect to past history of pneumonia, degree of dyspnea, current drugs, nutritional status, the extent of gastric mucosal atrophy, gastric mucosal blood flow, gastric mucosal hexosamine content and serum pepsinogen levels. But patients with peptic ulcer were significantly younger than patients without peptic ulcer. Cigarettes per day in patients with peptic ulcer 29.3 ± 11.6 cigarettes/ day were significantly higher than those without peptic ulcer 22.5 ± 10.0 cigarettes/day. We concluded that increased incidence of peptic ulceration in patients with chronic pulmonary emphysema is related to the quantity of cigarette smoking.
Using an immunohistochemical technique, we investigated expression of collagen receptor VLA-2 integrin and laminin receptor VLA-6 integrin in human gastric carcinoma. The expression of VLA integrins was compared in carcinoma of each histologic type and invasion/growth pattern. VLA-2 and VLA-6 were expressed more weakly in undifferentiated carcinoma than in non-cancerous epithelium. Non-localized invasion was observed in 89% of undifferentiated carcinoma. In differentiated carcinoma, expression of VLA-2 was weak in the mucosal layer. In the submucosal layer, however, VLA-2 expression was significantly different according to the invasion/growth pattern (p<0.01) ; weak expression of VLA-2 in the localized invasion type and strong expression of VLA-2 in the non-localized type. VLA-6 was strongly expressed in the mucosal and submucosal layers of the differentiated carcinoma, regardless of the invasion/growth pattern. The present study suggested that VLA-6 contributed to the histologic type and VLA-2 affected the invasion/growth pattern of the gastric carcinoma in varied manners according to the histologic type.
The aim of this study was to determine if upper gut function and pancreatic exocrine secretion are affected by the presence of unabsorbed carbohydrate in the distal ileum. In this investigation, starch or glucose was perfused into the canine ileum. This study showed that ileal perfusion of both starch and glucose delayed gastric emptying and prolonged small bowel transit time. Furthermore, glucose had greater effects on gastrointestinal transit time than starch. In contrast, amylase output was increased by ileal perfusion of starch, but was not affected by that of glucose. Our results suggest that the ileal regulation of gastrointestinal transit and amylase output could be mediated by different mechanisms.
HP-specific antibodies were measured in each collected fraction obtained from gel-filtrated separation method with selected patients sera by enzyme-linked immunosorbent assay (ELISA). Most of the fractions reacted with the patients sera also responded to HP urease-specific monoclonal antibodies. In addition, the fractions which showed urease activity strongly correlated with the HP antibody positive ones. Also, we could not detect any crossreactivity to ureases of other species. Moreover, most patient sera strongly responded to the purified HP urease B subunit separated with SDS/PAGE by western blotting analysis. These findings suggest that the major target for HP-specific antibodies appears to be HP-urease, in particular around 68kd large molecule, urease B subunit and such urease-specific antibodies are isolate-species specific.