[Zymogenic cell mass and serum pepsinogen I: the cell secretory correlations in patients with gastric intestinal-type cancer of the corpus-fundus]

The chief cell mass and serum pepsinogen I (PGI) have been evaluated in 18 patients with gastric cancer of intestinal type of the body-fundus. Moreover, a correlation with the parietal cell mass and the maximal acid output it has been effected. The patients have been subdivided in relation to histologic condition of the fundic mucosa. In case of gastric cancer with preatrophic fundic gastritis it has been revealed hypozymogenism with normoPGI and hypoparietalism with hypochlorhydria, in case of gastric cancer with atrophic fundic gastritis it has been revealed hypozymogenism with hypoPGI and hypoparietalism with hypochlorhydria. From this experience it emerges a similar anatomic-functional profile between gastric cancer of the body-fundus and chronic fundic gastritis without cancer. In particular, it emerges that serum PGI is a good marker of atrophic fundic gastritis, but it is not discriminant between atrophic fundic gastritis and atrophic fundic gastritis associated to gastric cancer.

[The formation of a hypokinetic syndrome of the digestive system under conditions of weightlessness]

In space flights of various duration, the gastropancreatic complex turned out to be the most liable part of the digestive system. The main changes occurring in the gastrointestinal tract involve an increase in the peptic gastric potential, pancreatic hyperenzymemia, change of the glycemic curve forms, a decrease in the liver and pancreas density.

Comparison of anthelmintic control programs for sheep in Virginia

Haemonchus contortus is the most serious parasitic problem encountered by sheep producers in southwestern Virginia. Four anthelmintic control programs for grazing lambs were tested. Group TR received monthly SC injections of ivermectin (200 micrograms/kg of body weight). Group SI received the same dose of ivermectin at 0, 3, 6, 9, and 12 weeks after the start of the grazing season. Group SL was given levamisole (8 mg/kg, PO) 0, 3, 6, 9, and 12 weeks after the start of the grazing season, and group TA received ivermectin (200 micrograms/kg) 0, 8, 16, 20, and 24 weeks after the beginning of grazing. None of the 4 programs provided satisfactory control of parasites as indicated by fecal egg counts and serum pepsinogen concentrations, although group-TR lambs gained significantly more weight than lambs in groups SI and TA. Group-TA lambs developed clinical haemonchosis in early August and required additional treatment at that time. These findings suggest that reliance on anthelmintics alone may not provide the most effective and economic control of parasitic infection.

Pernicious anaemia as a risk factor for osteoporosis

1. If gastric acid is necessary for the absorption of dietary calcium, the total absence of gastric acid secretion that occurs in pernicious anaemia could result in bone loss. To investigate this, we measured calcium absorption and bone density in 21 postmenopausal women (ages 51-76 years) with pernicious anaemia and in 24 normal postmenopausal women (ages 51-79 years). 2. Relative to the normal women, in the women with pernicious anaemia the bone mineral density of the lumbar spine was decreased by 16% (P less than 0.001). 3. After adjustment for age and body weight, lumbar spine bone mineral density correlated with the serum concentration of group 1 pepsinogens (a group of proteins produced by the gastric fundus) (r = 0.61, P less than 0.01). 4. Despite achlorhydria, the women with pernicious anaemia had normal true fractional calcium absorption and normal serum levels of parathyroid hormone and 1,25-dihydroxyvitamin D. 5. We conclude that gastric acid is not required for the absorption of dietary calcium. Thus, the loss of cancellous bone must be caused by some mechanism yet to be identified.

Short report: twenty-four-hour hyperpepsinogenaemia in Helicobacter pylori-positive subjects is abolished by eradication of the infection

Twenty-four-hour plasma pepsinogen I and II concentrations were determined in 8 healthy subjects with antibody to Helicobacter pylori, before and after treatment with tripotassium dicitrato bismuthate, amoxycillin and metronidazole, Therapy was successful in the 5 subjects with active H. pylori infection. In these subjects, median integrated 24-h plasma pepsinogen I and II concentrations significantly decreased from 2288 and 357 micrograms.h/L before treatment, respectively, to 1811 and 171 micrograms.h/L at 4-6 weeks after treatment, and 1643 and 150 micrograms.h/L at 20-24 weeks. By contrast, in the 3 subjects without evidence of active H. pylori infection, pre-treatment plasma pepsinogen I and II concentrations were similar to values found in the H. pylori-infected subjects after successful therapy, and they did not change significantly in response to therapy. H. pylori infection is associated with reversible hyperpepsinogenaemia.

Influence of age and Helicobacter pylori infection on serum pepsinogens in healthy blood transfusion donors

In a healthy population pepsinogen A and pepsinogen C increase with advancing age. As pepsinogen A and C are raised in chronic superficial gastritis which is caused by H pylori infection, we investigated whether H pylori is responsible for the age related increase of pepsinogen A and C. In H pylori positive blood transfusion donors serum pepsinogen A (mean (SD) 73 (35) micrograms/ml v 52 (19) micrograms/ml, p much less than 0.01) and C (mean (SD) 24 (13) micrograms/ml v 10 (7) micrograms/ml, p much less than 0.01) concentrations were significantly higher than in H pylori negative blood transfusion donors, while the serum pepsinogen A:C ratio mean (SD) 3.5 (1.4) v 6.2 (3.4), p much less than 0.01) was significantly decreased because of a relative greater increase in serum pepsinogen C in H pylori positive blood transfusion donors. Analysis of variance showed that pepsinogen A and C concentrations differed significantly in the different age groups (p much less than 0.01) when we considered all blood transfusion donors and H pylori positive blood transfusion donors, the mean pepsinogen levels being highest in the older age categories. In H pylori negative blood transfusion donors no such age related difference in pepsinogen A and C could be shown. In H pylori positive blood transfusion donors a weak positive but significant correlation between pepsinogen A and C and age could be shown (r = 0.30; p = 0.01 and r = 0.31; p = 0.01 respectively). In H pylori negative blood transfusion donors no correlation between serum pepsinogens and age was found. We conclude that the age related increase in serum pepsinogen A and C described in healthy control populations is caused by an increasing prevalence of H pylori infection. Serum pepsinogen A and C concentrations in patients should therefore be related to the presence or absence of H pylori infection.

[Chief cell mass in gastric ulcer: cyto-secretory correlations]

The aim of this experience has been to evaluate the chief cell mass and serum pepsinogen I in gastric ulcer patients. Comparisons were also made with parietal cell mass and acid secretion. Chief cell mass and serum pepsinogen I are not only influenced by the localization of ulcer but, also, by the histological condition of fundic mucosa. In fact, the behaviour of serum pepsinogen I and chief cell mass in type I gastric ulcer is the same observed in case of fundic chronic gastritis without gastric ulcer. In case of gastric ulcer type I with superficial fundic gastritis it emerges normozymogenism with hyperpepsinogenemia++ I, with preatrophic fundic gastritis hypozymogenism with normopepsinogenemia, with atrophic fundic gastritis hypozymogenism with hypopepsinogenemia I. In type II and III gastric ulcer the chief cell mass and serum pepsinogen I behaviour as they do in duodenal ulcer with hyperpepsinogenemia although hypozymogenism is present.

Haematological and clinicochemical blood profiles in slaughter pigs

In a cohort study, 40 pig finishing herds were selected: twenty pig herds with a low and twenty pig herds with a high prevalence of several pathological lesions recorded at slaughter in a six-month period before the start of the study. Blood samples were taken from 20 pigs per herd at the end of the finishing period to investigate haematological and clinicochemical profiles. There was only a significant difference in serum albumin concentration between the low and high lesion prevalence groups. There were distinct differences in blood profiles between pig herds, but also between batches of pigs within a herd, housed in different compartments. Differences between castrated males and gilts were also demonstrated with respect to mean values of the blood variables haemoglobin, iron, copper, beta-globulin, eosinophils and segmented neutrophils. However, the differences were not of a biologically important magnitude. The mean values of the blood variables pepsinogen and lymphocytes differed significantly between pig herds from the two participating integration groups. Pigs with a higher albumin concentration, a lower gamma-globulin concentration, a higher copper concentration and a higher creatine kinase activity in serum showed a higher daily weight gain.

The efficacy of an albendazole intraruminal controlled-release device against gastrointestinal parasitism in lambs

The effectiveness of albendazole in a controlled-release bolus in controlling gastrointestinal nematodes in lambs was assessed during the summer of 1986. Faecal egg counts were almost entirely negative throughout in the treated group and larval challenge remained low at below 2000 larvae kg-1. Untreated control lambs showed a characteristic pattern of auto-infection, culminating in a peak pasture larval count of over 70,000 larvae kg-1 and an outbreak of parasitic gastroenteritis in September associated with a serum pepsinogen concentration of 1.183 IU tyrosine and a mean worm burden of 91,165 nematodes at necropsy, including Ostertagia, Trichostrongylus and Nematodirus species. Subject to the restrictions imposed by the size of the bolus, this was considered to be a highly effective method of seasonal parasite control.

Dementia patients with low serum cobalamin concentration: relationship to atrophic gastritis

Serum concentrations of group I pepsinogens (pepsinogen-I) and gastrin were determined in patients with dementia disorders in order to assess the relationship, if any, between these indices of gastric mucosal function and serum cobalamin (vitamin B12) levels. A significant positive correlation between pepsinogen-I and B12 and, as expected, an inverse relationship between gastrin and pepsinogen-I concentrations was found, indicating that vitamin B12 deficiency was mainly determined by gastric mucosal atrophy (atrophic gastritis) in this West-Swedish sample of patients with dementia disorders. Patients with low B12 but normal gastrin and pepsinogen-I concentrations should, therefore, be further evaluated for possible nutritional deficiency, as well as nongastric causes of poor B12 assimilation from the diet.

Relationship of Helicobacter pylori to serum pepsinogens in an asymptomatic Japanese population

A seroepidemiologic study of the prevalence of Helicobacter pylori infection in Japan was performed, and the relationship between serum pepsinogen I and II levels (markers of gastritis and gastric atrophy) and H. pylori infection was investigated. Four hundred and eighteen asymptomatic children and adults were studied. The prevalence of anti-H. pylori immunoglobulin G antibody increased with age. For persons born after 1950, the frequency of H. pylori infection increased at approximately 1% per year; for those born before 1950 the prevalence was high (70%-80%) and relatively constant. Serum pepsinogen I and II levels were significantly higher in H. pylori-infected volunteers than in H. pylori-uninfected volunteers [51.6 +/- 3 vs. 42.9 +/- 2 ng/mL (P less than 0.05) for pepsinogen I; 16.0 +/- 1 vs. 7.5 +/- 0.8 ng/mL (P less than 0.001) for pepsinogen II]. The ratio of pepsinogen I to pepsinogen II was significantly lower in H. pylori-infected volunteers (3.5 +/- 0.2) than in uninfected volunteers (6.3 +/- 0.3; P less than 0.001). The apparent decrease in prevalence of H. pylori accompanying the Westernization of Japan may eventually be accompanied by a reduction in the frequency of atrophic gastritis, the precursor lesion of the epidemic form of gastric carcinoma, and ultimately result in a decrease in the incidence of gastric carcinoma in Japan.

Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients

Vitamin and mineral assays were performed on blood in 20 gastric bypass patients preoperatively and 6 and 12 months postoperatively. Values were compared with serial food records in nine patients. Postoperatively, all patients were prescribed a supplement containing the recommended dietary allowances (RDA) for vitamins and minerals. Weight, calorie and protein intake, and total serum protein decreased over the study interval (p less than 0.01). Dietary intakes of vitamins B1, B2, B6, folate, iron and zinc fell (p less than 0.01), but total intake (i.e., diet + supplement) did not decrease with the exception of iron. Blood indicators of these nutrients were normal preoperatively and did not decline. However, plasma vitamin B12 levels decreased from 385 pg/ml preoperatively to 234 pg/ml at 1 year (p = 0.0064), despite an increase in total vitamin B12 intake from 2.6 to 11.7 micrograms/day (p = 0.1173). Five patients (27.8%) had abnormally low plasma vitamin B12 levels at 1 year postoperatively; four were taking at least the RDA for vitamin B12 as supplements. Although oral supplementation containing the RDA for micronutrients can prevent abnormal blood indicators of most vitamins and minerals, it is insufficient to maintain normal plasma B12 levels in about 30% of gastric bypass patients.

Serum pepsinogen I levels of gastric ulcer patients are determined by the location of the ulcer crater

To examine the relation between gastric ulcer (GU) location and serum pepsinogen I (PGI) level, we measured this marker in 284 endoscopically proved GU patients. Their ulcer locations were further divided according to Johnson's criteria modified to the corpus (type 1a), gastric angle (type 1b), combined with duodenal ulcer (type 2) and prepyloric area (type 3). The number of each subset were 96, 81, 58 and 49, respectively. Mean serum PGI level (99.6 +/- 44.8 ng/ml) of all GU patients showed no difference from that of their sex and age matched controls. Mean serum PGI levels in both type 1a and 1b patients, did not differ from each other but were significantly lower than in controls, in contrast to those in type 2 and 3 patients which were significantly higher than in controls and comparable to the PGI levels of patients with duodenal ulcer. Smoking did not affect mean serum PGI levels in all subsets except the smoking type 2 patients who manifested a significantly higher mean PGI level. Helicobacter pylori infection did not show different serum PGI levels in any subset. In conclusion, different location of ulcer in the stomach results in a characteristic serum PGI level.

Effect of Helicobacter pylori on serum pepsinogen I and plasma gastrin in duodenal ulcer patients

Duodenal ulcer patients have increased serum pepsinogen I (PGI) concentrations and an increased prevalence of Helicobacter pylori infection. We have examined the effect of eradicating the infection on PGI. In 12 duodenal ulcer patients in whom H. pylori was successfully eradicated, the median basal PGI was 90 ng/ml (range, 37-252) before treatment and fell to 74 ng/ml (28-197) 1 month after treatment (p less than 0.01). In 12 patients in whom therapy failed to eradicate the infection, the PGI was 87 ng/ml (35-128) before treatment and remained unchanged at 83 ng/ml (36-119) 1 month after treatment. In the group with successful eradication the median basal plasma gastrin was 43 ng/l (15-95) before treatment and fell to 30 ng/l (17-75) 1 month after treatment (p less than 0.003), but there was no change in the corresponding values in the group without eradication (55 ng/l; range, 25-120, and 45 ng/l; range, 5-175; p = 0.9). In conclusion, eradication of H. pylori results in a fall in PGI and plasma gastrin, and these changes are not due merely to the anti-H. pylori drugs themselves or to discontinuation of previous ulcer therapy.

Experimental infections with Cooperia oncophora in calves. A study with two different larval dose levels and dosing regimens

The effect of different larval dose level and dosing regimens on the course of Cooperia oncophora infection in calves was studied. Four groups each of 4 calves were experimentally infected either with 50,000 or 200,000 C. oncophora larvae (L3) given either as single infections or as daily trickle infections. An additional group of calves remained as uninfected controls. The animals were necropsied on week 4 after infection. Mild to moderate clinical signs of parasitic gastroenteritis developed among calves given high doses of larvae, but liveweight gains were not significantly different from those of the uninfected controls. Serum pepsinogen levels of dosed animals were within normal ranges but rose slightly, and on day 14 p.i. they differed significantly from those of the controls. On that occasion, the levels of serum pepsinogen in the trickle infected groups significantly exhibited the levels of the single infected groups. Hypoalbuminaemia was not a feature on any occasion. The various groups did not differ significantly with regard to total worm counts and adult worm counts, but the groups receiving high larval dose harboured significantly more fourth stage larvae than the group receiving low doses of larvae, both in terms of absolute counts and in terms of percentages of total worm burdens. Within the same dose level, there was a tendency of a more even distribution of worms along the small intestine when the infections was given as a single infection compared with a trickle infection. The results indicate that C. oncophora larval dose and dosing regimens may influence the pathogenic effects and to some extent the distribution of the parasite in the small intestine.

Helicobacter pylori and hypergastrinaemia during proton pump inhibitor therapy

The rise in serum gastrin and pepsinogen I after 5 days' treatment with the proton pump inhibitor pantoprazole (40 mg/day) was examined in eight duodenal ulcer patients with Helicobacter pylori infection and compared with eight in whom it had been eradicated. Before treatment, the post-prandial serum gastrin concentrations were higher in the H. pylori-positive than -eradicated patients (p less than 0.05). The median rise in pre-prandial serum gastrin concentrations on treatment was similar in the H. pylori-positive (41%) and -eradicated patients (45%). The rise in post-prandial serum gastrin was also similar in the H. pylori-positive (81%) and -eradicated patients (69%), resulting in significantly higher gastrin concentrations during treatment in the former. The median rise in serum pepsinogen I on treatment was greater in the H. pylori-positive (114%) than in the -eradicated patients (8%), resulting in significantly higher concentrations during treatment in the former. These observations indicate that eradication of H. pylori may be a means of moderating the hypergastrinaemia caused by acid-inhibitory therapy. They also indicate that H. pylori-related hypergastrinaemia is not due to an increase of the antral surface pH by the bacterium's urease activity.

Gastric chief cell mass in chronic gastritis. Count and relationships to parietal cell mass and functional indices

The chief cell mass, expressed as the Zymogenous Index (number of cells per mm2 multiplied by the thickness of the glandular layer) was calculated in 42 subjects with chronic gastritis, and in 40 subjects with normal gastric mucosa, and was compared with the serum concentration of Pepsinogen I (PG I), with the parietal cell mass (expressed as Parietal Index: number of cells per mm2 multiplied by the thickness of the glandular layer), and with the acid output. The results showed that there are no significant variations in the chief cells in comparison with healthy controls in the case of superficial gastritis and follicular gastritis. Conversely, in the case of pre-atrophic and atrophic gastritis there is a significant reduction in the chief cell mass. The serum PG I increases significantly in the case of superficial gastritis as compared with healthy controls, while it is equivalent in the case of follicular gastritis, decreases non-significantly in pre-atrophic gastritis and is significantly reduced in the case of atrophic gastritis. The parietal cell mass shows a behavior equivalent to that of the chief cell mass, and the acid output decreases significantly in the case of pre-atrophic and atrophic gastritis, with no significant variations in the case of superficial and follicular gastritis. On comparing the behavior of the chief cell mass with that of the parietal cell mass, it was noticed that in the most severe stages of chronic gastritis there is a more pronounced reduction of the former than of the latter.

Changes in total pepsin activity and pepsinogen I in human sera under stimulation and inhibition of gastric acid secretion

The levels of total pepsin activity and pepsinogen I in sera were first studied in 10 healthy volunteers undergoing stimulation of gastric acid secretion at random on 4 different days with a) a maximum dose (6 micrograms/kg) of pentagastrin, b) ranitidine injection 5 minutes before maximal pentagastrin stimulation, c) ranitidine injection 1 hr before maximal pentagastrin stimulation, or d) sham feeding. In a further 10 healthy volunteers the levels of total pepsin activity and pepsinogen I were studied over 5 days by short-term oral intake of ranitidine. The total pepsin activity and pepsinogen I increased significantly in the sera after maximum-dose pentagastrin, but not after sham feeding. The increase could be completely prevented by ranitidine given only 1 hour before pentagastrin stimulation. The total pepsin activity and pepsinogen I decreased significantly after brief oral intake of ranitidine. It can be concluded that the measurement of total pepsin activity and pepsinogen I in the sera could serve as a rough parameter for testing the effectiveness of potential agents inhibiting gastric secretion.

The effect of parasite control on fertility in beef heifers

The effect of anthelmintic treatment on the growth and conception rate in beef heifers was studied in southwestern Virginia, USA. Forty mixed-breed heifers were divided into two groups at weaning and placed on experimental pastures. Control heifers did not receive anthelmintic treatment, while animals in the treatment group were given ivermectin (200 micrograms kg-1) at the time of allocation to groups in October and again in April the following year. Supplemental feed was provided throughout the winter to ensure adequate weight gains. In May, the heifers were exposed to bulls for natural breeding for a period of 6 weeks. Weight gains, fecal egg counts, serum pepsinogen levels and pasture larvae counts were monitored throughout the experiment. No difference in conception rate was observed between the two groups, although the cumulative weight gain was significantly greater in treated than non-treated animals. Serum pepsinogen levels and fecal egg counts were also generally lower in treated than non-treated heifers.

Plasma pepsinogens, nutrients, and diet in areas of Italy at varying gastric cancer risk

In a survey of 930 adults aged 35-74 years randomly sampled from the general population of four areas of Italy at different risks for gastric cancer (GC), plasma levels of pepsinogens (PGI and PGII) and fat-soluble vitamins were assayed. Pepsinogen levels were used to identify individuals with chronic atrophic gastritis (CAG). Severe CAG (PGI < or = 20 pg/liter) affected 5.8% of the population, but the prevalence rose with increasing age and declining social class. Severe CAG was 5 times more common in areas with high compared to low rates of GC. Risk also rose with increasing consumption of salted/dried fish but was inversely related to dietary intake of beta-carotene and to plasma retinol and cholesterol levels. The prevalence of moderate CAG (PGI > 20 pg/liter, but PGI/PGII < or = 2.9) was 6.3%. Moderate CAG was also related to age and social class and increased 1.8-fold in areas where GC rates were high, but was not strongly associated with diet or plasma nutrients. The authors discuss these findings in relation to those from a previous case-control study of GC in the same areas.

Effects of antirheumatic treatment on gastric secretory function and salivary flow in patients with rheumatoid arthritis

Many patients with rheumatoid arthritis have impaired gastric acid secretion and dysfunction of the lacrimal and salivary glands, conditions which have been proposed to be due to glandular atrophy. The hypothesis that the rheumatoid inflammation by itself has a depressive effect on these secretory functions was tested on 20 patients with active rheumatoid arthritis who underwent 16 weeks of sulphasalazine therapy. The patients responded well to the treatment, with reduction of joint indices and acute phase reactants. The resting and stimulated whole salivary secretion rate increased in 9/10 and 8/10 patients, respectively. The maximal gastric acid output increased in those patients who had a moderate reduction in acid output prior to treatment. When estimated by s-pepsinogen I, the gastric secretory capacity increased in all patients but one. In a group of auranofin treated patients, s-pepsinogen I rose only in those who responded to treatment with reduced disease activity. These results support the idea that the impaired secretory functions are at least partially reversible and probably also partly inflammatory mediated.