BACKGROUND. Until now, the influence of sex, age, smoking, drinking on serum pepsinogen levels has been assessed by single regression analysis. However, the influence of those factors on pepsinogen levels should be assessed exactly by multiple regression analyses. SUBJECTS AND METHODS 891 subjects were collected from by questionnaire and serum tests. Analyses were done with serum pepsinogen I(PG I), pepsinogen II(PG II) and pepsinogen I/II ratio (PG I/II)as a criterion variable and as categorized explanatory variables, sex, age, current or past smoking habit, and current drinking habit. And analyses are done by Mann-Whitney U test, correlation coefficient, single regression method, multiple regression method. RESULTS. PG I level is significantly higher in men than in women by Mann-Whitney U test. But the effect of sex factor is not remarkable by multiple regression analyses. PG II level increased and PG I/II level decreased with progression of age by all analyses methods. Current or past smoking elevates PG I level by MannWhitney U test, but current smoking dose and past smoking amount showed no dose-dependent associations with PG I level. Current drinking elevates PG I level by Mann-Whitney U test, but current drinking dose showed no dose-dependent associations with PG I. However, the effects of current smoking and current drinking to serum PG levels is not so large by multiple regression analyses. CONCLUSION. The effects of sex, current smoking and current drinking to serum PG levels are not remarkable by multiple regression analyses. Significantly, PG II level increased and PG I/II level decreased with progression of age. Therefore it may not be necessary to consider the effects of sex, smoking habit and drinking habit when serum pepsinogen levels are used as markers for gastric cancer.
Esophagogastric material resected for malignancy, obtained from 52 adult patients, was examined histologically. In a longitudinal examination of 32 total gastrectomies, intramucosally located pancreatic acinar cell-like cells (PALC) were observed frequently (10 of 12 patients, p<0.05) only in the uppermost one-sixth part, especially in a 10 mm-long zone around the squamocolumnar junction (SCJ). Entire sampling of the junctional mucosa revealed no significant difference in frequency of occurrence of PALC between esophageal and gastric cancer groups (13 of 20 patients, 20 of 31 patients, respectively). In 59 sections examined precisely, 43 sections showed zonal atrophy of the gastric glands. More than half of these zones (25 of 44 zones) did not overlap with 4 mm-long SCJ zones. In the latter zones, stratified columnar epithelia, epithelial islands, and PALC were observed more frequently, although intestinal metaplasia was not. These data suggested that the occurrence of PALC is correlated with the anatomical site, i.e. SCJ, but not with such ill conditions, i.e. atrophic gastritis or gastric cancer. PALC in the SCJ may be orthotopic.
This study examined the validity of the Japanese version of the hospital anxiety and depression scale (HAD) in a gastro-intestinal outpatient clinic. One hundred and twenty-three men and 142 women consulting a gastro-intestinal outpatient clinic at a primary care hospital in Kyoto during 1995 were surveyed. Item-remainder correlation and internal consistency were examined for reliability. Concurrent validities were examined using the stait-trait anxiety inventory (STAI) and Zung's self-rating depression scale (SDS). The prevalence of psychiatric disorder in this population ranged from 27% to 39%. Cronbach's coefficients were greater than 0.8 for the anxiety subscale and more than 0.7 for the depression subscale. Spearman's correlation of the anxiety subscale scores and the STAI were r=0.678 for men, and r=0.717 for women. The correlation of depression subscale scores and SDS were r=0.457 for men, and r=0.565 for women. It is suggested that the use of the HAD to general hospital outpatients clinic would facilitate detecting emotional disorders in outpatients.
The course of gastric type epithelium during the healing process and beyond the scarring stage of duodenal ulcer was studied in patients with and without Helicobacter pylori(H. pylori) eradication. Materials were consist of 110 patients with active H. pylori ulcers, 27 patients with H. pylori positive ulcer scars and 6 patients with active H. pylori positive duodenitis. The results obtained were as follows.
We evaluated the efficacy of high dose interferon therapy in 122 patients with chronic hepatitis C between 1992 and 1995. They received 612 to 836 mega-units (MU) of recombinant interferon α-2b as a total dose during a 6-month treatment in our hospital. Fifty one patients (41.8%) achieved complete response (CR) which was defined as persistent normalization of serum aminotransferase levels and disappearance of serum HCV-RNA for more than 6 months after the end of interferon administration. However, there were no CR in patients with genotype II and in those with serum HCV-RNA levels above 1.5 Meq/ml, quantified by branched DNA probe assay. The rate of CR was not increased even if a total dose of IFN administration was increased from 612 MU to 836 MU. These results indicate that some new regimen of interferon therapy is necessary for these cases with high titer of serum HCV-RNA and genotype II to increase the rate of CR.