Relationship between the gastric myoelectric and mechanical activity in the genesis of ulcers in indomethacin-insulin-treated rats

We have proposed that gastric contractile activity mechanically induces ulcers in the nonsteroid antiinflammatory drug (NSAID)-treated rat. This study examines first the relationship between number (dose) of peristaltic contractions applied to the mucosa and the ulcer score. Second, it examines the relative roles of: altered gastric myoelectrical activity (MEA) resulting from indomethacin (Indo) pretreatment, insulin-induced gastric peristalsis, and a combination of the two in the generation of mucosal lesions. Third, it examines the effect of exogenous prostaglandin on the Indo-altered MEA and relates it to ulcerogenesis. Indo pretreatment increased gastric tone and MEA. In such animals, the dose of peristaltic contractions applied to the gastric wall was related to the ulcer score in a dose-dependent manner. Exogenous prostaglandin (PG) reversed the MEA effect of Indo and reduced ulceration. It is postulated that an altered smooth muscle state secondary to inhibition of prostaglandin synthesis (PG-S) renders the mucosa vulnerable to injury by peristaltic action.This study was supported by the Fast Foundation.     

Prognosis for patients with carcinoma in the middle third of the stomach

In 268 of the 1,115 patients (24.0%) with gastric cancer who underwent a curative resection in our clinics, the tumor was located in the middle third of the stomach. The clinicopathological features and prognosis of these patients were divided into two groups, according to site of the tumor: anterior wall (n = 58) vs. other sites (n = 210). Clinicopathological factors did not differ between the two groups. The survival time for patients with a tumor in the anterior group was shorter than that for patients with a tumor in other areas (P < 0.05). The five-year survival rate was 79.3% for patients with an anterior tumor and 91.9% for those with a tumor at a different site. A multivariate analysis indicated lymph node metastasis, serosal invasion, and anterior wall location to be independent prognostic factors indicative of a poor prognosis when the tumor was located in the middle third of the stomach. For such patients, close follow-up is needed to detect possible recurrences. © 1993 Wiley-Liss, Inc.     

胃腺癌微卫星不稳定性与VEGF蛋白表达关系的研究

目的：探讨胃癌微卫星不稳定性(MSI)与胃腺癌中皿管内皮生长因子(VEGF）之间的关系。方法：应用PCR—SSCP技术检测30例胃腺癌5个位点的微卫星不稳定性，同时应用免疫组织化学的方法检测肿瘤皿管内皮生长因子(VEGF)蛋白的表达。结果：MSI阳性率为43．4％(13／30)。VEGF阳性率为60％(18／30）。MSI—H胃癌VEGF的表达显著减少。结论：MSI—H的胃癌与MSS胃癌可能存在两种不同的胃癌及肿瘤血管新生形成的途径。MSI—H肿瘤较低的VEGF表达可能可以解释为何MSI-H胃癌有较低的侵袭性。     

Iatrogenic diaphragmatic hernia due to laparoscopic gastric banding

A patient developed a huge diaphragmatic hernia following laparoscopic gastric banding. Almost the entire stomach was incarcerated within the left chest. Segmental necrosis of the greater curvature of the stomach necessitated partial gastrectomy. The postoperative course was uneventful. The etiology, diagnosis and treatment of this previously undescribed complication of laparoscopic gastric banding are addressed in relation to the present case.     

TH胶胃冠状静脉栓塞术治疗门脉高压症

11例TH胶胃冠状静脉栓塞术临床治疗结果表明:(1)11例中的4例急性上消化道大出血患者均在12h左右出血基本停止,随访近一年未再发生出血现象。(2)10例半年后复查肝功能均有不同程度改善。(3)一年后复查食道钡餐透视X线平片发现8例患者食道静脉曲张有不同程度减轻。(4)11例中1例因术中急性肝功能衰竭死亡。因此我们认为此术式操作简便,手术创伤小、较易推广,是治疗门脉高压症合并食管胃底静脉曲张出血的一种有效方法。     

Helicobacter pylori infection and gastric emptying of solids in humans

Helicobacter pylori has been implicated in a number of upper gastrointestinal illnesses. In a controlled study, we have investigated the relationship between H. pylori infection and gastric emptying of solids in two groups of patients with chronic symptoms of dyspepsia. In the first group, 19 patients with non-ulcer dyspepsia and H. pylori infection underwent a standard test of gastric emptying after ingestion of 500 μCi of Tc-labelled chicken liver. The results were compared to a control group of 16 uninfected volunteers. We also studied a second group of 20 patients with previously diagnosed idiopathic gastroparesis for the prevalence of H. pylori infection and its relationship to symptom severity and rates of gastric emptying. In the first group of patients, the half-time of gastric emptying was significantly less among the infected patients compared to the uninfected volunteers (108 ± 9 vs. 142 ± 14 min, P < 0.05). In the second group of patients with gastroparesis, the prevalence of H. pylori was not significantly different among these patients than among 21 age and sex matched controls (20% vs. 38%, P = 0.32). Gastric emptying was markedly slow in all 20 patients in the second group but less so among the four with H. pylori infection. Symptom scores were no different between infected and uninfected patients. We conclude that H. pylori infection is not associated with abnormally slow gastric emptying. On the contrary, gastric H. pylori infection appears to be associated with mildly accelerated emptying of solids compared to normal controls. Idiopathic gastroparesis and dyspepsia related H. pylori infection are separate but sometimes overlapping disorders.     

胃癌单克隆抗体-丝裂霉素C结合物的制备及其细胞毒特征

作者报道胃癌单克隆抗体MG11-丝裂霉素C(MMC)结合物的制备及其对肿瘤细胞的杀伤作用。首先用戊二酐处理MMC,于MMC上引入羧基,MMC衍生物与N羟基琥珀酰亚胺及2,2′-二环已基碳二亚胺反应,得到MMC活性酯,后者与抗体反应将MMC引入抗体中。经测定,每克分子抗体中引入约6～7克分子药物,结合物对人胃癌细胞KATⅢ具有较强的选择性杀伤作用,在0.56μg/ml水平(药物浓度)对肿瘤细胞杀伤牢达60％,优于游离药物(51％)及无关抗体结合物(9.3％),提示选用的胃癌单抗对MMC具有较好的导向作用。     

Acute volaemic changes modify the gastroduodenal resistance to the flow of saline in anaesthetized dogs

The effect of acute and sequential volaemic changes on the gastroduodenal flow of saline was assessed in 23 anaesthetized dogs following two different experimental protocols. Hypervolaemia, by i. v. infusion of saline, induced a gradual decrease on gastroduodenal flow which amounted to 76% below control values (P < 0.001) when volaemic expansion attained 5% of body weight. This effect was volume dependent (17% increase on gastroduodenal flow per volume of infused saline equivalent to 0.5% of body weight, P < 0.001), lasted for at least 90 minutes after infusion was completed and was also obtained by expanding previously bled animals. Hypovolaemia due to bleeding was followed by an increase on gastroduodenal flow of about 88% above control values (P < 0.05) when haemorrhage was equal to 3% of body weight. This effect was also volume dependent (23 % increase on gastroduodenal flow per volume of blood shed equivalent to a 0.5% of body weight, P < 0.01) and was reversed after blood volume was restored. These modifications in the resistance of the gastroduodenal segment to the flow of liquid due to acute volaemic changes suggest that the extracellular fluid volume modulates the contractile activity of the gastroduodenal portion of the gut possibly to set a gastroduodenal handling of liquid adequate to cope with volaemic imbalances.     

T3期胃癌CD34与新生血管形成及淋巴结转移的关系

目的研究T3期胃癌CD34与胃癌新生血管形成及淋巴结转移的关系.方法随机选取胃癌手术标本41例,其中T3N0M020例,T3N1M021例,分别进行特异性抗体免疫组化染色,并采用Image Pro Plus 5.0图像软件分析数据,计算胃癌组织CD34微血管密度(MVD)和其他相关抗体(CD44、Ⅳ型胶原、层黏蛋白)的表达,并进行统计学分析.结果CD34 MVD计数(CD34表达强度),在T3N0M0和T3N1 M0肿瘤组分别为43.10±18.22和56.24±28.36,两组比较有显著差异(P＜0.05);CD44、Ⅳ型胶原、层黏连蛋白的表达强度,T3N0M0和T3N1M0肿瘤组比较无显著差异(P＞0.05).结论CD34与T3期胃癌组织新生血管形成及淋巴结转移的关系密切,可作为诊断T3期胃癌淋巴结转移的参考指标.