The Significance of Low Serum Pepsinogen Levels to Detect Stomach Cancer Associated with Extensive Chronic Gastritis in Japanese Subjects

Serum pepsinogen levels were measured in 137 stomach cancer patients and compared with those of 288 normal cancer-free subjects. The serum pepsinogen levels of stomach cancer patients, especially pepsinogen I and the pepsinogen I/pepsinogen II ratio were significantly lower than those of normal controls and correlated well with the extent of chronic gastritis associated with the cancerous stomach. These results were in good accordance with the results of previous studies indicating that the cancer derived from the stomach where chronic gastritis/intestinal metaplasia is extensive. The high sensitivity and specificity of this non-invasive serum test to detect chronic gastritis suggested the possibility of its application to the mass screening of stomach cancer.     

Differential requirements for co-stimulatory signals from B7 family members by resting versus recently activated memory T cells towards soluble recall antigens

The interaction between CD28 on T cells with CD80 (B7-1) andCD86 (B7-2) on APCs is considered to be of critical importancefor primary T cell activation both in vivo and in vitro. Therelative importance of this co-stimulatory signal in memoryT cell activation is, however, less clear, and was thereforestudied by in vitro experiments on T cell responses to solublerecall antigens using peripheral blood mononuclear cells orT cell clones. Our data demonstrate that B7-2 represents themajor co-stimulatory signal for the activation of resting peripheralblood memory T cells with recall antigens, as evidenced by theeffects of anti-B7-1 and anti-B7-2 on T cell proliferation aswell as on IL-2 and INF-y production. Since CTLA-4-lg and anti-CD28Fab fragments had similar inhibitory effects to the combinationof anti-B7-1 plus anti-B7-2, the involvement of a third co-stimulatoryCD28/CTLA-4 ligand is unlikely. Despite the strong effects ofB7-blocking agents, a variable fraction of the memory T cellswas resistant to inhibition. Moreover, T cell clones or in vitropreactivated T cells could efficiently be restimulated by solubleantigens on autologous APCs in the absence of B7-1 or B7-2 co-stimulation.These data show that most memory T cells that are freshly isolatedfrom the blood are still dependent on CD28 triggering for theiractivation. However, recently activated T cells can apparentlybypass the requirement for B7 and use other co-stimulatory signalsfor reactivation, a finding with important implications forthe development of immunosuppressive strategies.     

Familial fatal Parkinsonism with alveolar hypoventilation and mental depression.

The clinical, pathological, and neurochemical characteristics of a newly recognized inherited neurological disorder are reported. Lethargy and mental depression are early symptoms, followed by mild parkinsonism and progressive weight loss. Failure of automatic respiratory control develops and may result in sudden death. Advanced degeneration of the substantia nigra, cell loss and gliosis of the basal ganglia, and focal gliosis in the medulla are seen on pathological study. Degeneration of the nigrostriatal dopaminergic system is evidenced by low levels of tyrosine hydroxylase, dopamine, homovanillic acid, and L-dopa decarboxylase in postmortem brain samples. Taurine concentrations in fasting plasma and CSF are somewhat depressed; brain contents of taurine are within normal limits.     

Water intoxication associated with oxytocin infusion

During a mid-trimester abortion with high dose oxytocin infusion and intravenous fluids, a patient developed an acute dilutational hyponatraemia and coma. The relationship of water intoxication and synthetic oxytocin infusion is discussed and the literature reviewed.