Yuji Mizukami

Abnormal Gastric Motility in Liver Cirrhosis Roles of Secretin

Cutaneous electrogastrography (EGG) revealedthat the power ratio, an indicator of rhythmicity of EGGwaveforms was significantly less in liver cirrhosis(power ratio: 28.2 ± 14.5%) than in normalsubjects (power ratio: 45.6 ± 16.2%) (P <0.01), thus demonstrating dysrhythmic EGG waveforms forliver cirrhosis. Gastric emptying time(T1/2), calculated from the half-life ofretained radioisotope (RI) in the region of interest (ROI) in the stomachfollowing the ingestion of RI containing test meal wassignificantly prolonged in patients with liver cirrhosiscompared to the control (liver cirrhosis vs controls 43.2 ± 20.3 min vs 24.8± 9.6 min, P < 0.01). Of the fivegastrointestinal hormones — gastrin, secretin,motilin, cholecystokinin (CCK), and glucagon —serum secretin was significantly higher in liver cirrhosis than the control (P <0.05) and negatively correlated with the power ratio (r= 0.51, P < 0.01). Normal, regular EGG waveforms(power ratio: 47.1 ± 10.2%) became dysrhythmic in normal volunteers (power ratio: 34.1 ±12.4%), when their serum secretin was experimentallyincreased to essentially that in liver cirrhosis andpossible roles of hypersecretinemia in abnormal gastric motility in liver cirrhosis areproposed.

Recurrence of Gastric Ulcer Dependent Upon Strain Differences of Helicobacter pylori in Urease B Gene

To evaluate the role of different strains of Helicobacter pylori on the recurrence of gastric ulcer, we divided H. pylori into four types (I, II, III, and IV) according to the urease B gene using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). The relationship between the recurrence of gastric ulcer and the prevalence of H. pylori types was studied in 32 patients with benign open gastric ulcers using upper gastrointestinal endoscopy. The rate of recurrence was significantly lower in patients with type II than in patients with types I, III, and IV (P < 0.05). Using Mongolian gerbils, an animal model of H. pylori infection, we also showed that the occurrence of gastric ulceration following restraint water-immersion stress was significantly lower in type II compared with types I and III. These data indicate that in the context of ulcer recurrence, it is not necessary to eradicate H. pylori during infection with type II.

Apoptosis of rat gastric mucosa and of primary cultures of gastric epithelial cells by indomethacin: role of inducible nitric oxide synthase and interleukin-8: Apoptosis of gastric mucosa by indomethacin

In order to gain insights into indomethacin‐induced gastric injury, rats were fed with indomethacin (20 mg/kg), or alternatively, the primary cultures of rat gastric epithelial cells were cultured with different doses of indomethacin (1–1000 µm). Light microscopy, electron mircroscopy, fluorescence microscopy, TdT‐mediated dUTP‐biotin nick end labelling staining, ssDNA staining and DNA fragmentation assay were employed to evaluate the levels of gastric injury and apoptosis. Cells expressing inducible nitric oxide synthase (iNOS) and interleukin (IL)‐8 were localized at the rat gastric mucosa by immunohistochemistry. Administration of indomethacin to rats caused apoptosis and injury of the gastric mucosal epithelial cells. Indomethacin also induced apoptosis of primary cultures of gastric epithelial cells in a dose‐dependent manner. Cells expressing iNOS and IL‐8 were detected at and around the sites of gastric injury in the indomethacin‐fed rats, but not in the control rats. The induction of apoptosis by indomethacin in the primary cultures of gastric epithelial cells suggests that the direct apoptotic capacity of indomethacin. iNOS and IL‐8 may be involved in this process.

A Case of Ileal Malignant Lymphoma Presenting with Intussusception

Abstract: A‐66‐year‐old male presented with a chief complaint of intermittent abdominal pain. Colonoscopy and barium enema indicated intussusception of a submucosal tumor of the ileum into the ascending colon. Surgery was thus carried out. The tumor was located 25 cm from the ileocecal junction, measured 4.1 × 3.2×2.3 cm, and showed intraluminal growth. Histopathologic examination of the resected specimen revealed a diffuse mixed cell type malignant lymphoma, and the tumor had invaded the subserosal layer. Intussusception due to malignant lymphoma is relatively rare in adults. We reviewed 43 cases of ileal lymphoma involving intussusception, reported in Japan over the preceding 12 years, and these cases are discussed along with the present case.