The retrospective study was aimed at assessing the usefulness of the application of the criteria of SIRS for identifying a subset of patients with higher mortality in 22 cases (21 patients) of liver cirrhosis with upper gastrointestinal hemorrhage (GIH) and 16 cases (14 patients) of liver cirrhosis with hepatocellular carcinoma with upper GIH. The following results were obtained ; (1) The incidence of SIRS on upper GIH was 66%. (2) The mortality rate in patients with SIRS on GIH was significantly higher than in patients with non-SIRS on GIN in 60 days after GIH (50% vs. 8% ;p<0.01). (3) The rate of patients who met four criteria of SIRS on GIN or during admission and of patients whose durations of SIRS was over 5 days was significantly higher in the died patients with SIRS on GIH than in the survived patients with SIRS on GIH (67% vs. 0% ; p<0.01, 67% vs. 0% ;p<0.01, respectively). These results suggested that the application of the criteria of SIRS was useful for identifying a subset of patients with higher mortality in chronic liver disease with GIH.
Multinucleated giant cells in the pancreas (five giant cell carcinomas, a mucinous cystadenocarcinoma attended with many osteoclast-like giant cells, 42 invasive ductal carcinomas and 29 chronic pancreatitises) were examined. Three types of multinucleated giant cell were identified : epithelial type, coexpressive type, mesenchymal type. Epithelial type expressed epithelial markers, such as keratin and EMA in 23 ductal carcinomas. Coexpressive type expressed both epithelial markers and mesenchymal marker vimentin was in four ductal carcinomas. Mesenchymal type expressed mesenchymal markers, vimentin and CD68 in four osteoclastoid type giant cell carcinomas, the mucinous cystadenocarcinoma, six ductal carcinomas and ten chronic pancreatitises. Epithelial and coexpressive type were considered to be epithelial neoplastic origin, those had bizarre appearance and transitional area from definite adenocarcinoma area. Vimentin expression is associated with sarcomatous proliferation. Mesenchymal type was considered to be nonneoplastic and a certain type of macrophage polykaryons.