We investigated the relation between gastric mucosal lesions and substance P (SP) in 64 patients with rheumatoid arthritis (RA) taking nonsteroidal antiinflammatory drugs (NSAIDs). In these patients, the incidence of gastric mucosal lesions was as high as 53.1%. Serum SP levels were significantly higher in patients with gastric mucosal lesions than in those without gastric lesions. Erythrocyte sedimentation rate, serum C-reactive protein and rheumatoid factor (RF) levels were also higher in patients with gastric mucosal lesions. A positive correlation between serum SP and RF levels was found in patients with RA. Experimental gastric mucosal lesions induced by an oral administration of indomethacin in rats were significantly enhanced by an additional intraperitoneal injection of SP. From these observations, it is suggested that, in addition to the effect of NSAIDs, SP elevation in blood has a role in the development of gastric mucosal lesion in patients with RA.
We report on the establishment and characterization of a scirrhous gastric cancer cell line, designated OCUM-2M, derived from a 49-year-old Japanese female. OCUM-2M was derived from a primary tumor of stomach taken by total gastrectomy. The cell line grew singly or in clusters in the cultured medium. The cell line continued to multiply for more than one year. Doubling time was 37.3 hours, chromosomal mode was 70. The DNA ploidy pattern was aneuploid and DNA index was 1.59. It produced several tumor-associated antigens such as CEA, CA19-9, SLX and SPan-1. The cell line was transplantable in athymic BALB/c nude mice, and histological findings of the xenografted tumor showed poorly differentiated adenocarcinoma. The growth of OCUM-2M was stimulated following the addition of EGF, b-FGF and KGF, and decreased following the addition of TGF-β1. This cell line is useful in vitro and in vivo systems for studies of the biology of scirrhous gastric carcinoma.
We examined whether the determination of cell proliferation and cell death rates was useful in the differential diagnosis between benign and malignant myogenic tumors of gastrointestinal tract. As markers for cell proliferation and cell death, Ki-67 (MIB-1) positive rates or argyrophilic nucleolar organizer region (AgNOR) counts and apoptotic cell counts were determined in a total of 53 myogenic tumors comprising 36 leiomyomas and 17 leiomyosarcomas. Apoptotic cells were detected with the in situ nick end labeling method reported by Gavrieli in 1992 with modifications. Significant differences were observed in the Ki-67 positive rates (leiomyoma 1.8±1.4%, leiomyosarcoma 8.6±6.0%, p<0.0001), in the mean AgNOR counts (leiomyoma 1.77±0.53, leiomyosarcoma 3.14±1.02, p<0.0001), and in the apoptotic cell counts (median ; leiomyoma 3.2, leiomyosarcoma 32.5 per 106 tumor cells, p<0.005). All high grade sarcomas were picked up by the Ki-67 index of more than 7%, and almost all leiomyomas were thrown away by the AgNOR counts more than 3.0 within the low Ki-67 cases, which showed 81% of sensitivity and 97% of specificity. These results show that a combination use of Ki-67 and AgNOR is of use in the differential diagnosis between leiomyoma and leiomyosarcoma. Although a significant difference was also noted in apoptotic cell counts between these two categories, this seems not to be a practical index for the discrimination because apoptotic cell death is a rare event in gastrointestinal myogenic tumors.
Transjugular intrahepatic portosystemic shunt (TIPS) was applied in three patients with Child C liver cirrhosis. Portal venous pressure was reduced by an average of 10.7mmHg, and results such as the disappearance of esophageal varices and reduction in ascites were obtained. The portal hemodynamics of these three patients was observed before and after TIPS using the pulse Doppler method. When portal hemodynamics in the main portal vein was examined before TIPS, it was found that the mean blood flow velocity had decreased, the blood flow volume was reduced and the cross-sectional area of the vein had increased. The congestion index was high and there was definite congestion of the portal venous system. After TIPS, the blood flow velocity and volume increased, the cross-sectional area of the vein was reduced and the congestion index was lower. Congestion of the portal venous system was improved in these three patients and the clinical efficacy of TIPS was proven by these results. If the stent can be detected sonographically, stent patency is easily confirmed with the pulse Doppler method which is usefull examination technique for follow-up of patients undergoing TIPS.
Bile acid N-acetylglucosaminide (GlcNAc) was investigated in serum and urine of patients with chronic liver diseases during ursodeoxycholic acid (UDCA) treatment by HPLC. Bile acid N-acetylglucosaminide was not detected other than primary biliary cirrhosis in serum and urine. All of these N-acetylglucosaminide was ursodeoxycholic acid N-acetylglucominide (GlcNAc-UDCA). GlcNAc-UDCA excretion was 17.3 ± 5.7mg/day in PBC stage I, 12.1± 5.4mg/day in stage II, 39.1 ± 20.8mg/day in stage III. Among the GlcNAc fraction GlcNAc-UDCA-gly occupied greatest part followed by GlcNAc-UDCA-tau and non-amidated GlcNAc-UDCA. GlcNAc-UDCA was 50.1% of total urinary bile acids excretion in PBC stage I, 32.5% in stage II, 20.5% in stage III. However, GlcNAc-UDCA was less than 2.5% of total serum bile acids in every stage. These results indicate that N-acetylglucosamine conjugation is one of the major pathway of UDCA in patient with primary biliary cirrhosis.