Pentagastrin-stimulated gastric acid secretion in acute and chronic gastritis. Histological and secretory correlations

Basal and pentagastrin-stimulated gastric acid secretion were determined in 122 patients with various types of gastritis and in 20 control subjects. All the gastritis patients and the control subjects were adult Chinese. The histological diagnosis was based on gastric biopsy specimens obtained through a fibergastroscope. Statistical analysis of the results in the various histological groups of gastritis and controls indicated that chronic superficial gastritis and chronic atrophic gastritis are not associated with reduced gastric acid secretion in Chinese subjects. In addition, analysis of combinations of the groups of patients with various types of gastritis showed no significant difference in the mean basal acid output but the mean peak acid output of patients with chronic gastritis was significantly higher than that of patients with chronic atrophic gastritis.

A study of the plasma kinin-generating system in children with the minimal lesion, idiopathic nephrotic syndrome

Although the precise etiologic incitant of the minimal lesion idiopathic nephrotic syndrome of childhood is not known, it is likely that a host mechanism mediates the permeability alterations of the glomerular capillary wall resulting in massive proteinuria. As a first step in examining the possibility that local kinin release may account for the proteinuria in this disorder, two parameters of the plasma kinin-generating system, plasma prekallikrein and kallikrein inhibitor, were assayed during 27 nephrotic episodes in 21 corticosteroid-responsive children. Plasma kallikrein was assayed by means of its esterase activity on a synthetic arginine ester substrate, N-alpha-tosyl-L-arginine methyl ester (TAMe), after activation of Hageman factor by kaolin. This activity, after subtraction of spontaneous arginine esterase activity (i.e., TAMe esterase activity measured in plasma not exposed to kaolin) is derived from prekallikrein. Plasma prekallikrein activity in 11 normal children was 99.6 +/- 2.9 mumol TAMe hydrolyzed/ml plasma/hr (mean +/- SEM). Kallikrein inhibitor was quantified in arbitrary units. Kallifrein inhibitor activity in 11 normal children was 0.94 +/- 0.04 units. During the overt nephrotic syndrome, before initiation of intensive daily corticosteroid treatment, mean values were: prekallikrein, 58.5 +/- 7.24 mumol/ml/hr; and kallikrein inhibitor, 0.35 +/- 0.06 units. After corticosteroid-induced remission occurred, mean values were: plasma prekallikrein, 118.6 +/- 3.2 mumol/ml/hr; and kallikrein inhitor, 0.78 +/- 0.03 mumol/ml/hr. Both parameters were again assayed in 14 of the 21 children after complete cessation of corticosteroid treatment. Plasma prekallikrein was normal, 99.6 +/- 4.8 mumol/ml/hr; but kallikrein inhibitor was still somewhat depressed, 0.84 +/- 0.03 units. A subset of 9 patients had marked depression of plasma prekallikrein to levels less than 20 mumol/ml/hr and essentially undetectable inhibitor activity. Serum alpha-2 macroglobulin was elevated in nephrotic patients: mean value during relapse, 862 +/- 29 mg/100 ml; during corticosteroid-maintaining remission, 615 +/- 29 mg/100 ml. After cessation of corticosteroids, mean serum level was 481 +/- 20 mg/100 ml. The proportional reduction of plasma prekallikrein and kallikrein inhibitor suggested that an enzyme-inhibitor complex formed in vivo, perhaps at a local site of activation in proximity to the glomerular basement membrane. These data suggest that the plasma kinin-generating system may be the host effector mechanism subserving the increased glomerular capillary permeability in the minimal lesion nephrotic syndrome of childhood.

The prevalence of chronic gastritis in patients with gastric ulcer

Multiple gastric biopsies were performed with a duodenofiberscope in 58 Chinese subjects. All 58 cases had a gastric ulcer crater, demonstrated by endoscopy, or barium meal, or both. Histological sections of the gastric biopsies showed chronic atrophic gastritis in 12 (20.6%), chronic gastritis in 31 (53.4%), and acute-on-chronic gastritis in 11 (19%). Only two cases or 3.4% had normal gastric mucosa, while 54 cases or 93% had some form of chronic gastritis, on the gastric biopsy. The gastritis was associated with intestinal metaplasia in 16 cases (27.6%), while two cases had histological evidence of gastric atypia. No significant difference was found in the mean basal and peak acid outputs among the three groups of gastric ulcer cases with chronic atrophic gastritis, chronic gastritis, and acute-on-chronic gastritis. The high frequency of chronic gastritis (93%) occurring in patients with gastric ulcer in the present series suggests that chronic gastritis may be an important aetiological factor in the pathogenesis of gastric ulceration.

Subclasses of T cells with different sensitivities to cytotoxic antibody in the presence of anesthetics

When cytotoxic titrations were made of rabbit anti-mouse brain and anti-Thy-1.2 sera against mouse lymphoid cells in the presence of sodium barbital or xylocaine, it was observed that a proportion of T cells were much more sensitive (50 x) than the remainder. This effect could be detected with ethidium or fluorescein diacetate as indicators of cell death, but not with trypan blue or 51Cr. The highly sensitive cells were found in all lymphoid tissues, being most numerous in spleen and least in lymph nodes.