Gastroenterologia Japonica

This study was performed to investigate whether mucosal diamine oxidase activity could be assessed by measuring expired14CO2 after oral administration of14C-putrescine. Immediately after giving 5 μCi of14C-putrescine, the14CO2 was collected at 1-h intervals for 8 h into a vial containing 1 ml of 10 mM hyamine hydroxide, 2 ml of ethanol, and an appropriate amount of phenolphthalein dye. The expired14CO2 caused the color to disappear. The amount of14CO2, determined by scintillation counting, reached a maximum 1 h after14C-putrescine administration, and gradually decreased thereafter. A positive correlation between the mucosal diamine oxidase activity and the maximal expired14CO2 value was obtained. There is no doubt that this test can be used to easily detect mucosal DAO activity and avoid the necessity of mucosal biopsy.

To clarify the involvement of atrial natriuretic peptide (ANP) in the pathogenesis of liver cirrhosis, we measured plasma ANP in patients with various stages of cirrhosis and in age-matched normal subjects. Urinary cyclic guanosine monophosphate (cGMP) was also measured as a marker of active biological ANP. In addition, effects of exogenous synthetic human ANP (0.5 Μg/kg) on renal functions were examined in normal subjects and in cirrhotics without ascites or with mild ascites. Plasma ANP levels were not significantly different among these 3 groups. Urinary cGMP concentrations were significantly higher in both cirrhotics without ascites and cirrhotics with mild ascites, (340 pmol/ml, P<0.05 and 496 pmol/ml, P<0.01 respectively) than normal subjects (95 pmol/ml). In normal subjects, marked increases in urinary volume (UV), sodium excretion (UNaV), fraction excretion of sodium (FENa) and free water clearance (CH2O) were induced after ANP infusion, and significant recoveries were subsequently observed in these parameters. However, in cirrhotics, the responses to ANP infusion of UV, FENa and CH2O were far less dramatic. The response of UV, UNaV and FENa in cirrhotics with mild ascites was delayed compared to cirrhotics without ascites. These results suggest that the blunted natriuretic responsiveness to ANP is contributory to the pathogenesis of initial sodium retention in cirrhotics.

Our experience showed that we can streamline the management of patients with upper GI bleeding with joint efforts by physicians and surgeons. Secondly, endoscopic epinephrine injection treatment is an effective hemostatic technique to control active ulcer bleeding.

The role of endogenous platelet-activating factor (PAF) in the control of pancreatic blood flow during caerulein stimulation was investigated. Pancreatic blood flow in anesthetized rats was measured continuously by laser Doppler flowmetry for 2h during the intravenous infusion of caerulein (0.25 μg/kg per h). Pancreatic blood flow showed a gradual, consistent, and significant increase, reaching 114.2±2.3% of the basal value after 120 min. Changes in pancreatic blood flow induced by caerulein were completely inhibited by a cholecystokinin (CCK) antagonist (loxiglumide, 5 mg/kg per h, i.v.) and by a specific PAF antagonist (CV-6209, 1 mg/kg, i.v.-bolus). Systemic blood pressure remained stable in all groups. These results suggest an important role of endogenously yielded PAF in regulating pancreatic blood flow during caerulein stimulation to the pancreas.