Yujiro Takao

Alteration of colonic mucin after ureterosigmoidostomy.

PURPOSE: Patients undergoing urinary diversion by ureterosigmoidostomy after complete cystectomy for malignant bladder tumors show a high incidence of neoplasia at and near the site of anastomosis. We examined a risk factor for tumor occurrence in the area of anastomosis, alterations of mucus glycoproteins in the surrounding colonic mucosa. METHODS: Colonoscopy was performed in 37 patients who had undergone ureterosigmoidostomy. Biopsy specimens were obtained near the ureteral anastomosis and were stained with hematoxylin and eosin, high iron-diamine alcian blue (pH 2.5), and a fluorescent lectin conjugate (peanut agglutinin). RESULTS: At the anastomotic site colonoscopy showed protruding lesions in 26 of 37 patients (71 percent), all histologically representing inflammatory granulomas. The mucosa around the anastomosis was normal in endoscopic appearance; however, histologically, slight inflammatory cell infiltration, edema, and increased numbers of Paneth cells were observed. Alcian blue staining revealed an increase in mucosal sialomucin postoperatively compared with preoperatively. The proportion of peanut agglutinin-binding mucin, not observed in normal mucosa but seen in malignant or premalignant tissue, was increased. CONCLUSION: As postoperative interval increases, changes in properties of the “background” mucosa become greater, which suggests an association with colonic carcinogenesis.

The effect of acid secretagogues on mucin synthesis using primary monolayer culture of the guinea pig gastric mucous cells

SummaryMucin plays a principal role in protecting the gastric mucosa against injury. We investigated the effect of acid secretagogues on mucin synthesis using a primary gastric mucous cell monolayer cultue system of guinea pig. Significant increases in mucin synthesis were observed in response to the secretagogues pentagastrin (10-8M, 10-7M) and carbachol (10-4M, 10-3M), but not to histamine. After pretreatment with indomethacin (10-5M), 10-8M pentagastrin significantly increased mucin synthesis to 125.6±3.9%, but carbachol did not. Prostaglandin E2 release into the culture medium was signifiantly increased by 10-4M carbachol to 118.0±5.9%, but there was no change after application of pentagastrin. These findings suggest that pentagastrin and carbachol may act directly on mucous cells, and that part of the mucin synthesis-promoting action of carbachol is mediated by prostaglandins. There were no changes in intracellular cAMP concentration after the addition of these acid secretagogues. However, calcium ionophore (A23187) produced an increase in mucin synthesis, suggesting a Ca++ involvement in mucin synthesis. No differences were found in the sugar side chain structures of newly synthesized mucin glycoprotein as a result of exposure to acid secretagogues by histochemical or biochemical methods using lectins.

Kimura's disease (angiolymphoid hyperplasia with eosinophilia) associated with ulcerative colitis.

SummaryWe treated a 35-year-old Japanese woman who had Kimura’s disease associated with ulcerative colitis. Kimura’s disease is an uncommon chronic inflammatory disease considered to be of allergic origin based on the presence of eosinophilia and IgE hyperimmunoglobulinemia, and may be a manifestation of a systemic immunologic disturbance. Some immunological complications such as nephrotic syndrome have been reported in association with Kimura’s disease, but the present case is the first associated with ulcerative colitis.