Adhesive Effect of Ecabet Sodium in a Porcine Gastric Leer Model

Abstract: Protection of the gastric mucosa, based on its high affinity for mucosal lesions, has been reported as one of the antiulcer effects of ecabet sodium. We investigated the adhesive effect of this drug on mucosal lesions in a porcine gastric ulcer model (freshly isolated stomach) and on human mucosal lesions resulting from endoscopic gastric mucosal resection (EMR) and polypectomy. After ulcer lesions had been induced by EMR in the isolated porcine stomach, ecabet sodium and sucralfate suspensions were applied. After washing with citrate buffer, at a pH of 1, 3 or 5, the adhesion of each drug to the gastric mucosa was measured. At pH 1, both drugs showed satisfactory adhesion to the ulcer lesions. When the acidity of the ulcer surfaces was decreased to pH 3 and then to pH 5, the adhesion of sucralfate showed a marked decrease (100%→31→% 13%). while that of ecabet sodium showed only a slight decrease (100%→75%→64%). Futhermore, the activity of thrombin in the ecabet sodium suspension remained high at pH 1, 3 and 5. Since the ecabet sodium suspension produced a satisfactory covering effect on gastric mucosal lesions and this effect was maintained even at low acidity, this drug is considered suitable for endoscopic directsprinkling therapy for gastric mucosal lesions.     

GASTRIC ADENOCARCINOMA OF FUNDIC GLAND TYPE (CHIEF CELL PREDOMINANT TYPE) TREATED WITH ENDOSCOPIC ASPIRATION MUCOSECTOMY

Upper endoscopy screening in an asymptomatic 56‐year‐old man showed a small, yellowish elevated lesion with a central depression on the posterior wall in the gastric cardia. Biopsy specimens from this lesion were suspicious of carcinoid tumor. We suspected this lesion to be a sporadic gastric carcinoid tumor with a diameter of 5 mm, limited to the mucosal layer. We then performed an endoscopic aspiration mucosectomy with a cap‐fitted endoscope. Microscopically, the lesion obtained from the resected specimen was minimally invasive to the submucosa and showed highly differentiated columnar cells in irregularly anastomosing glands. Immunohistology was positive for pepsinogen‐I, and MUC6, partially positive for H⁺/K⁺‐ATPase, and negative for MUC5AC. In addition, it was positive for synaptophysin and CD56, and negative for chromogranin A. We finally diagnosed the patient as having gastric adenocarcinoma of fundic gland type (chief cell predominant type) with minimal invasion (100 µm) to the submucosa. Surveillance endoscopy with biopsy specimens and abdominal computed tomography at 1 year revealed no evidence of tumor recurrence. We herein report this rare case of gastric adenocarcinoma of fundic gland type (chief cell predominant type).     

Treatment with a novel lipid A analogue, FS-112, and partial hepatectomy causes submassive liver necrosis and impaired liver regeneration in mice

A novel experimental model of submassive liver necrosis with impaired regeneration has been established. A novel lipid A analogue, FS-112, was injected intravenously into male BALB/c mice, followed 2 days later by a 70% partial hepatectomy. Over the next 9 days, mice became severely jaundiced, with a peak total bilirubin (TBil) concentration of (mean±s.d.) 12.9±2.1 mg/dL 7 days postoperatively. In contrast, the TBil concentration in vehicle-treated mice remained less than 2 mg/dL. Significant elevations of L-alanine:2-oxoglutarate aminotransferase (ALT) were also observed 3–7 days after the operation in mice pretreated with FS-112, compared with mice pretreated with the vehicle. Submassive liver necrosis was observed with extensive mononuclear cell infiltration in mice treated with FS-112 and subjected to partial hepatectomy. Furthermore, both the BrdU and the proliferating cell nuclear antigen (PCNA) labelling index (LI) 1 day following partial hepatectomy in mice pretreated with FS-112 (8.6±4.3 and 7.9±4.2%, respectively) were significantly lower than levels in vehicletreated mice (25.8±3.8 and 26.5±10.5%, respectively). The time course of changes in the BrdU LI in liver specimens from mice treated with both FS-112 and partial hepatectomy did not increase, even 3, 5, and 7 days postoperatively. Excellent liver regeneration with a PCNA LI 10-fold higher than the resting level was observed in mice treated with D-galactosamine hydrochloride. These results strongly suggest that this animal model of submassive liver necrosis may be suitable for clarifying the mechanisms of impaired liver cell regeneration often seen in fulminant hepatitis.