To evaluate the psycho-social factors of peptic ulcer, we carried out a comparative study. Seventy-six men and 19 women with peptic ulcers diagnosed at seven hospitals in Kyoto, Osaka and Hyogo Prefectures in Japan were surveyed during November 1990 about their daily hassles, depressive state, social support and life style using a self-administered questionnaire. The results were compared to those for two control groups. One control group was diagnosed with normal, atrophic gastritis, or superficial gastritis by the gastro-duodenal endoscopic examinations in the same hospitals. The other control group consisted of participants in a health-screening examination at one of the above hospitals. There were no significant differences between patients and controls in daily hassles, depressive state, and social support. However, being unmarried, smoking and eating irregular meals significantly increased the relative risk of peptic ulcer in men and family history of peptic ulcer significantly increased the risk in women.
Thirty-seven cases of pseudosarcomatous lesion (PSL) are studied clinicopathologically on the upper gastrointestinal tract. Majority of the cases showed polypoid tumor lesions, and only minority of them showed non-polypoid lesions. All showed surface erosion or ulcer. Atypical proliferating cells, easily mistaken for sarcoma, were observed in the stroma. The cellular atypia of the stromal cells was related on site and shape ; polypoid or non-polypoid. The lesions with severe atypia were observed mainly in the esophago-cardiac junction, lower portion of esophagus and cardia. Non-polypoid lesions showed mild atypia. Immunohistochemically, atypical stromal cells were positive only for vimentin, so considered to be fibroblastic cells. In order to avoid over-diagnosis on biopsy of the upper gastrointestinal tract, recognition of the clinicopathological features of PSL is very important.
To elucidate the immunological effects of transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC), serum and urinary neopterins were measured using the radioimmunoassay in patients with HCC before and after TAE (n=11), and compared with one shot arterial injection (AI)(n=8). At the third day after TAE, serum and urinary neopterin levels were maximally elevated up to 164% and 158% from their respective baselines (p<0.01). By contrast, these levels were unaffected after Al. In considering the changes of natural killer cell activity, C-reactive protein, transaminase and α-fetoprotein, these results suggest that the determination of neopterin levels after TAE may be not only valuable to assess the necrotic effect of TAE, but also be useful for evaluating cellular immunity after TAE.
We investigated the effect of temporary occlusion of the superior mesenteric artery (SMAO) on the hepatic tissue concentration of anticancer drugs in hepatic artery infusion. Adriamycin (ADR : 1 mg/kg weight) was continuously administered into the hepatic artery for five minutes in dogs. Depending on the use and method of vascular occlusion, animals were allocated into five groups and hepatic tissue ADR levels were determined : Group I, SMAO ; Group II, no vascular occlusion ; Group III, occlusion of the common hepatic artery (CHAO) ; Group IV, combined SMAO and CHAO ; Group V, occlusion of the portal vein. The hepatic tissue ADR level at 10 minutes was significantly higher in Group I than those in Group II and III. The tissue ADR level in Group IV and V tended to be slightly higher than in Group I, although there is no statistically significant difference. These results indicate that SMAO may provide a useful means of increasing local drug level during regional chemotherapy of the liver.
Enzyme-linked immunosorbent assay for measuring biliary apolipoprotein A-I was established. Utilizing this assay, a diurnal change of apolipoprotein A-I concentration in hepatic bile obtained from percutaneous transhepatic drainage was investigated. A biliary apolipoprotein A-I concentration changed from time to time, and correlations between apolipoprotein A-I and total protein concentration, cholesterol concentration and lithogenic index, r=0.873, 0.863 and 0.567 respectively, were observed. Moreover, biliary total protein concentration was closely related with lithogenic index (r=0.671). These data suggest that hepatic lithogenic bile may induce apolipoprotein A-I secretion into hepatic bile.