Serum gastrin in patients with various types of chronic gastritis

Fasting serum gastrin was determined in 35 Chinese patients with various types of chronic gastritis and in 23 Chinese control subjects. The mean (+/- S.D.) fasting serum gastrin levels for 13 patients with chronic atrophic gastritis, 16 patients with chronic gastritis and six patients with acute-on-chronic gastritis were 32.1 (+/- 38.9) pg./ml., 36.1 (+/- 23.2) pg./ml. and 33.7 (+/- 19.4) pg./ml., respectively. The mean (+/- S.D.) fasting serum gastrin levels for the whole gastritis group (35 patients) and the control group were 34.2 (+/- 28.8) pg./ml. and 24.6 (+/- 13.7) pg./ml., respectively. Statistical analysis showed that the mean basal serum gastrin levels of the three gastritis groups did not differ significantly from control subjects and with each other.

Relationship of cytochrome content to the sensitivity of bacteria to NaCl on freezing and thawing

Eight species of bacteria representing rod, coccus, gram-positive, and gram-negative forms were tested for their sensitivity to sodium chloride during freezing and thawing. Six of the eight species tested were salt-sensitive, though to different degrees, while Lactobacillus casei and Streptococcus faecalis were resistant. Escherichia coli grown anaerobically exhibited only 38% of the salt sensitivity of aerobically grown cells. Analysis of cytochrome pigments in the organisms revealed that the six sensitive organisms all contained these pigments but in varying amounts, while the two resistant ones were devoid of them. Anaerobically grown E. coli contained 50% of the cytochromes of aerobically grown cells. A relationship between cytochrome content of the organisms and salt sensitivity during freezing and thawing was demonstrated with a correlation coefficient of 0.76 (P less than 0.05); the higher the cytochrome content, the more salt-sensitive the organism. This indicated that 58% of the salt sensitivity was due to the cytochrome content. Using a model organism E. coli, the effect of salt during freezing and thawing on the respiratory activity was examined. Freezing and thawing in water or saline decreased the respiration by whole cells of substrates expected to be NAD-linked while NADH-stimulated respiration was increased. In cell-free extracts derived from unfrozen cells or those frozen and thawed in water or saline, the respiration of ascorbate plus N,N,N',N'-tetramethyl-p-phenylenediamine (TMPD) was constant. The respiration of NADH, succinate, and lactate in cell-free extracts derived from cells frozen and thawed in saline was reduced compared with those extracts derived from unfrozen cells or cells frozen and thawed in water. Studies with E. coli showed that the decreased respiratory activity caused by disruptions in the electron-transport chain could not account for the salt sensitivity on freezing and thawing. More likely, salt sensitivity is related to the presence of bonds between cytochromes and other membrane components which are disrupted by sodium chloride on freezing and thawing. This would then result in loss of membrane integrity and function.

Idiopathic membranous glomerulopathy preceding the emergence of systemic lupus erythematosus in two children

An idiopathic nephrotic syndrome associated with membranous glomerulopathy antedated the subsequent emergence of systemic lupus erythematosus in two patients (7-year-old and 14-year-old girls). At the onset of INS, there was neither clinical evidence of multisystem disease nor unequivocal serologic evidence of SLE. The only early possible indication of SLE was the presence of microtubular inclusions in glomerular endothelial cells on electron microscopy. In each instance (one year and three years after onset of INS), a second renal biopsy showed transformation of the membranous glomerular lesion to a more florid type with glomerular subendothelial dense deposits. One patient died of overwhelming pulmonary infection while she was receiving prednisone and cyclophosphamide; the other developed progressive renal failure despite steroid treatment. SLE should be considered in patients presenting with apparent idiopathic MG, in whom nephrotic syndrome persists. Intraendothelial cell microtubular inclusions may be an early clue to later emergence of SLE.

Diagnosis of gastric prepyloric and antral lesions: comparison of fiberendoscopy and gastric biopsy with radiology

Fibergastroscopy and direct-vision gastric biopsy were performed in 47 patients who had a prepyloric or antral gastric lesion on barium meal (single-contrast) examination. Of 27 cases with a radiological diagnosis of prepyloric or antral ulceration, five cases (18.5%) had evidence of ulceration, 12 cases (44.4%) had acute or chronic gastritis and eight cases (29.6%) had normal gastric mucosa, on fibergastroscopy. Multiple gastric biopsy confirmed the presence of acute-on-chronic gastritis (ACG), chronic gastritis (CG) and chronic atrophic gastritis (CAG), with or without intestinal metaplasia (IM) or epithelial atypia (Aty), in 24 cases (89%). Normal gastric mucosa was found in three cases (11%) and malignancy in none. Of 15 cases with a radiological diagnosis of prepyloric or antral malignancy, only three cases (20%) had evidence of adenocarcinoma on endoscopy and biopsy. One case had rounded nodules seen on endoscopy and gastric biopsies showed malignant lymphoma. In two cases with endoscopic suspicion of malignancy, gastric biopsies showed ACG in one and CAG in the other. Gastric biopsies showed histological changes of CG (+/- IM) or CAG (+/- IM) in 11 cases (73%). In five cases with a radiological diagnosis of various prepyloric or antral lesions, endoscopy and biopsy revealed CG (+/- IM) in all and malignancy in none. It is concluded that fiberendoscopy and gastric biopsy are superior to the single-contrast barium meal in the diagnosis of prepyloric or antral gastric lesions. Direct-vision gastric biopsy should be done in all cases since it increased the diagnostic accuracy of fiberendoscopy.

Autoantibodies in chronic gastritis

Gastric parietal cell, antinuclear, smooth-muscle, mitochondrial and microsomal antibodies were determined in 12 Chinese patients with chronic atropic gastritis, 15 Chinese patients with chronic (superficial) gastritis, four Chinese patients with acute-on-chronic gastritis and 16 Chinese control subjects. With the exception of a weakly positive gastric parietal cell antibody test in one of the 12 patients with chronic atrophic gastritis, autoantibodies were not found in all the gastritis and contol groups. It is concluded that autoantibodies are rarely present in Chinese patients with chronic gastritis.

Diagnosis of gastric malignancy by fibreoptic endoscopy and gastric biopsy: Comparison with radiology

Of 473 patients examined with the fibregastroscope, 27 were found to have evidence of gastric malignant disease on the endoscopic and biopsy results. Of these 27 patients, 20 were initially examined by barium-meal (single-contrast) radiography then by endoscopy and biopsy. The barium-meal study was reported as showing definite malignant disease in two cases (10%), appearances suggestive of malignant disease in 11 cases (55%), and other lesions in eight cases (35%). Endoscopic examination enabled a diagnosis of advanced gastric cancer to be made in 13 cases (65%), of appearances suggestive of malignant disease in two cases (10%), and of other lesions in five cases (25%). Gastric biopsies gave a histological diagnosis of gastric malignant disease in 19 cases (95%), and of appearances suggestive of malignant disease in one case (5%). Furthermore, the histological types of gastric malignant disease were shown by the gastric biopsies. In seven cases without initial screening by barium-meal radiography, endoscopy and biopsy confirmed the diagnosis of gastric cancer in all. It is concluded that endoscopy is superior to radiology in the diagnosis of gastric malignant disease. The study also shows that gastric biopsy further increases the diagnostic ability of endoscopy and should be done in all cases in which gastroscopy is performed.

Developmental changes in mitochondria during the transition into lactation in the mouse mammary gland. II. Membrane marker enzymes and membrane ultrastructure

The activity of cytochrome oxidase (an inner mitochondrial membrane marker) in mouse mammary gland homogenates was found to increase five- to sixfold from late pregnancy to day 8 of lactation, while that of monoamine oxidase (an outer membrane marker) increased only about 25%. The specific activity of cytochrome oxidase in the isolated mitochondria decreased slightly over the same period while the specific activity of monoamine oxidase decreased fivefold. This reflects the fact that both cytochrome oxidase and mitochondrial protein are increasing at a much greater rate than is monoamine oxidase activity. Mixing experiments preclude the possibility that the release or removal of an inhibitor or stimulator produces the changes in enzymatic activity. The cytochrome oxidase to monoamine oxidase ratio was followed throughout the pregnancy-lactation cycle in total mammary homogenates, isolated mammary parenchymal cells, and isolated mammary mitochondria. In each preparation the pattern was the same with little change in the ratio until late pregnancy; and then a three- to fourfold increase occurred and the values reached a maximum by day 8 of lactation. These experiments were interpreted as demonstrating that the observed enzymatic changes are reflective of alterations in the mitochondria of the mammary parenchymal cell population. Electron micrographs of mid-pregnant and mid-lactating mammary parenchymal cells in situ were prepared, and distinct changes in the mitochondrial morphology noted. The most significant and obvious change is the large increase in the number of inner membrane cristae and an increase in matrix density in the lactating gland cell. Therefore, both enzymatic and morphological studies support the concept of an expansion of the mitochondrial inner membrane during presecretory differentiation in the mouse mammary parenchymal cell.

Levamisole augmentation of lymphocyte hyporesponsiveness to phytohaemagglutinin in patients with pulmonary tuberculosis

Levamisole has been shown to augment the in vitro responsiveness of lymphocytes to PHA stimulation. The response of lymphocytes of 14 (42%) of 33 patients with pulmonary tuberculosis was augmented by levamisole. Augmentation was observed in 9 (64%) of 14 PHA hyporesponsives lymphocytes and in 5 (26%) of 19 normo-responsive lymphocytes.

Nasopharyngeal cancer in Bermuda

Six cases of nasopharyngeal carcinoma (NPC) were diagnosed in residents of Bermuda in the 7-year period 1966-1972. While epidemiologic study revealed no history of common environmental exposures, two of the six cases occurred in adult sibs from a family in which a third adult sib developed NPC in 1963. These three cases were from a large, possibly in-bred Portuguese family with origins in the Azores Islands. The remaining four cases were all in black children ages 10-15; two of these were first cousins. These observations suggest the possibility that genetic influence may contribute to the etiology of NPC.

Histological appraisal of ulcerative colitis fibreoptic colonoscope biopsy specimens

The availability of the fibreoptic colonoscope with biopsy facilities has created new opportunities for the investigation of ulcerative colitis. Morphological assessment of the disease, which has hitherto been limited to observing changes in the mucosa of the sigmoid colon and rectum, can now be made on biopsy material obtained under direct vision from the large bowel above the level of the sigmoid. On the basis of 157 colonoscopic biopsies taken from 38 patients with endoscopic appearances of the disease is proposed. The classification is as follows: (i) active chronic phase without ulceration; (ii) active chronic phase with ulceration; (iii) quiescent chronic phase; (iv) healed chronic phase; (v) precancerous phase. Three degrees of severity (mild, moderate and severe) for each phase are recognized.

The effect of cooling and warming rates on the survival of a variety of bacteria

Cooling and warming rates affect bacterial survival profoundly with all bacteria tested (Azotobacter chroococcum, Klebsiella aerogenes, Salmonella typhimurium, Pseudomonas aeruginosa, Streptococcus faecalis) behaving similarly. Most bacteria were sensitive to salt on freezing and thawing. Viabilities of population frozen and thawed in saline were always less (by at least 20%) than comparable ones frozen in water alone. Under these conditions, S. faecalis was resistant to the presence of sodium chloride; viabilities of populations frozen in the presence or absence of sodium chloride were always less than 5% different. The implications of these results in light of the organisms' shape, Gram stain, and respiration are discussed.

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.