Reflux Oesophagitis

Expression of the 3-fucosyl N-acetyllactosamine (CD 15) antigen in normal, metaplastic, dysplastic, and neoplastic squamous epithelia

The 3-fucosyl N-acetyllactosamine residue is the antigen recognized by the monoclonal antibody MC2. Using MC2, we demonstrated the distribution of this antigen in a variety of squamous epithelia. The antigen is expressed to a variable degree on supra-basal cells in most normal non-keratinizing squamous mucosae, with a similar distribution in metaplastic squamous epithelia; antibody-labelled latex microspheres and immunogold electron microscopy show the antigen to form part of the glycocalyx. In dysplastic and neoplastic squamous lesions, expression is reduced or absent except in cells around areas of differentiation. Prior neuraminidase treatment of sections had little effect on the amount or distribution of demonstrable antigen. Expression of this antigen by cells in non-keratinizing squamous epithelia gives an indication of cell maturity and may provide a histological marker for the grading of dysplastic and malignant squamous mucosal lesions. A possible role for these carbohydrate residues in squamous mucosal defence is discussed.

Ranitidine, 150 mg three times a day, in the treatment of reflux oesophagitis. A placebo-controlled, double-blind study

The effect of ranitidine, 150 mg three times a day, in the treatment of reflux oesophagitis was studied. A double-blind method was used, and 41 patients with endoscopically verified symptomatic oesophagitis were randomly allocated to ranitidine or placebo. In addition, antacid tablets could be taken as needed. Eighteen patients in both the ranitidine and the placebo groups completed the study. Endoscopically, the healing rate was significantly higher in the ranitidine group after both 6 weeks' (p less than 0.05) and 12 weeks' (p less than 0.01) treatment. The proportion of patients whose oesophagitis healed or improved was also higher in the ranitidine group (p less than 0.05). The patients receiving ranitidine used significantly (p less than 0.002) less antacids than the controls, suggesting a favourable effect of ranitidine on the symptoms of oesophagitis. The histological study did not show significant differences between the ranitidine and the placebo groups. No serious side effects were noted. Ranitidine in a dose of 150 mg three times a day is effective and safe in the treatment of reflux oesophagitis.

Effects of colchicine on the gallbladder of the mouse

The effects of colchicine on the mouse gallbladder followed a course depending on the dosage given (0.4-4 mg/100 g body weight). Following 0.5 mg/100 g, by 16 h there was a marked cholestasis with dilatation of the gallbladder and steatosis. There were progressive alterations in the Golgi apparatus and accumulation of vesicles. The apical mucous droplets decreased in number and became pleomorphic and dispersed throughout the cytoplasm. Lipid droplets appeared in numbers on the epithelial cytoplasm. By 48 h the tissues had reverted to normal appearances. When cholecystokinin, pilocarpine or ceruletide were given to animals which had received colchicine 18 h previously, the excess bile from the dilated gallbladder was discharged into the duodenum, remaining apical mucous droplets secreted and electron dense material accumulated in the lateral intercellular space. This formed a quasi-regular array between the epithelial bases and the basement membrane. Biochemically there was a significant decrease in alkaline phosphatase activity and a significant increase in acid phosphatase activity.

Human oesophageal submucosal glands. Their detection mucin, enzyme and secretory protein content

Human oesophageal submucosal glands may be regularly demonstrated by first exposing the oesophageal lumen to toluidine blue which reveals the duct ostia. Four types of cell were identified in the glands - mucous, subsidiary or serous, myoepithelial and oncocytes. The mucous cell contained neutral, sialated and sulphated mucins. The subsidiary cells held smaller amounts of neutral and sialated mucin, plus fucosyl residues. No lipids were detectable histochemically. ATP-ase and alkaline phosphatase were shown in the capillary endothelium. The duct epithelium showed some nonspecific esterase activity not sensitive to E 600. By immunoperoxidase techniques, the duct epithelium was shown to be rich in cytokeratin. The subsidiary cells contained lysozyme, CEA and pepsinogen. B lymphocytes composed most of the periductular lymphoid aggregates, although some T cells were found there and also intraepithelial and subepithelial in relation to the stratified squamous epithelium lining the oesophagus. Langerhans' cells were also demonstrated as intraepithelial by several techniques.