Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of h... more Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of histologic type, location, stage and outcome of surgical treatment of gastric carcinoma. Br J Surg 2000; 87: 618-26
Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of h... more Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of histologic type, location, stage and outcome of surgical treatment of gastric carcinoma. Br J Surg 2000; 87: 618-26
Borch K, Axelsson CK, Halgreen H, Damkjaer Nielsen M, Ledin T, Szesci PB. The ratio of pepsinogen... more Borch K, Axelsson CK, Halgreen H, Damkjaer Nielsen M, Ledin T, Szesci PB. The ratio of pepsinogen A to pepsinogen C: a sensitive test for atrophic gastritis. Scand J Gastroenterol 1989, 24, 870-876
Helicobacter pylori infection is the main cause of chronic gastritis. The infection has been link... more Helicobacter pylori infection is the main cause of chronic gastritis. The infection has been linked to altered proliferative activity and changes in various cell cycle regulating proteins. To determine, in a general population sample, the proliferative activity and expression of p53 and p21 in males and females of different age groups with and without H. pylori-associated chronic gastritis, gastric biopsies from 273 subjects (188 with and 85 without H. pylori infection) randomly selected from a general population were examined immunohistochemically for Ki-67, p53, and p21. One thousand epithelial cells, including the surface, neck, and glandular areas, were counted in both the corpus and the antrum. Results are expressed as the percentage of positive cells. Subjects with H. pylori infection showed significantly increased proliferative activity and expression of p53 compared to uninfected individuals. Regarding the expression of p21, no difference was detected. Multiple linear regres...
Some benign and malignant diseases develop on the background of chronic gastritis or duodenitis. ... more Some benign and malignant diseases develop on the background of chronic gastritis or duodenitis. The present study was performed in order to determine the magnitude of these background changes with relations to symptomatology and life style in the general population. Examinations were performed in 501 volunteers (age 35-85 years). Fifty percent had gastritis; this was associated with H. pylori in 87%. H. pylori-negative gastritis was associated with regular use of NSAIDs [odds ratio 3.8 (1.6-9.9)]. Duodenitis, observed in 32%, was associated with H. pylori infection [odds ratio 2.3 (1.3-4.6)], previous cholecystectomy [odds ratio 3.6 (1.1-16.1)], and regular use of NSAIDs [odds ratio 3.0 (1.4-7.1)]. Neither gastritis nor duodenitis was associated with smoking or alcohol consumption. The rate of digestive symptoms did not differ between subjects with and without uncomplicated gastritis or duodenitis. In conclusion, half of this adult population had gastritis strongly associated with ...
Pancreaticojejunostomy is the method of choice for surgical treatment of pain in chronic pancreat... more Pancreaticojejunostomy is the method of choice for surgical treatment of pain in chronic pancreatitis in the case of ductal dilation. The operative risk is small and all remaining glandular tissue preserved. At 5 years postoperatively, about two-thirds of the patients still experience pain relief. In the absence of dilated ducts, the surgical options are somewhat more controversial. Parenchyma-saving alternatives such as nerve-cutting procedures have not met expectations. Instead, percutaneous blockage of the celiac plexus using alcohol and phenol have been more commonly used for short-term pain relief. The relatively great number of different resective procedures probably reflects the dissatisfaction with the effect of each one of them. Neither left resection nor total pancreatectomy is, today, an attractive alternative due to the relatively high mortality and morbidity (short- and long-term) risks, especially when evaluated against the backdrop of the limited pain reduction in many patients. The Whipple procedure is still the best alternative, although it should be used with critical selection by both the patient and the surgeon. As for the new operations presented during the 1980's, it is too early to foresee their possible future role. We feel, however, that we still have to await the operation which fulfills the criteria of an ideal operation for pain in chronic pancreatitis.
The prevalence and development of antibodies to H+,K+-ATPase were investigated with a sensitive e... more The prevalence and development of antibodies to H+,K+-ATPase were investigated with a sensitive enzyme-linked immunosorbent assay in 86 patients with autoimmune atrophic gastritis (type A). Sixty-nine of the patients had pernicious anemia, and 17 had simple atrophic gastritis. Elevated titers were found in 93% of pernicious anemia probands. Women had higher levels than men: 3.24 versus 1.58 U/l (p = 0.002) (upper reference limit, 0.55 U/l). The antibody levels did not change over 1-4 years, but a gradual decrease in titers over decades was observed. All patients with pernicious anemia had low levels of pepsinogen A, a product of the gastric chief and mucous neck cells (median, 8.5 micrograms/l; reference range, 10-90 percentile, 64.4-195.5 micrograms/l), and elevated serum gastrin values (greater than 55 pmol/l) were found in 87%. Serum pepsinogen A, but not serum gastrin, correlated with H+,K(+)-ATPase antibody titers (r = 0.35, p = 0.01). In the 17 cases with simple atrophic gastritis, H+,K(+)-ATPase antibodies correlated inversely with fundic mucosal gland destruction. The data indicate that H+,K(+)-ATPase antibody titers reflect the immune responsiveness of a given patient as well as the antigenic amount, dependent on the degree of mucosal destruction and the duration of the disease.
Gastrin exerts trophic effects on the gastric mucosa by mechanisms not yet completely elucidated.... more Gastrin exerts trophic effects on the gastric mucosa by mechanisms not yet completely elucidated. Our aim was to localize the cholecystokinin-2 (CCK2) receptor in epithelial cells of foetal and adult rat stomachs in order to determine the cell types that are directly affected by gastrin. Gastric tissue was subjected to indirect double immunofluorescence staining with antiserum against the C-terminal decapeptide of the CCK2 receptor and antibodies against 5' bromo-2-deoxyuridine, which had been injected into the rats I h before they were killed, the acid pump H,K-ATPase, the membrane-cytoskeletal linker ezrin, pepsin/pepsinogen or histidine decarboxylase. Undifferentiated foetal gastric epithelial cells expressed CCK2 receptors, whereas stem cells of adult gastric glands did not exhibit immunoreactivity. However, other epithelial cells in the progenitor zone of adult gastric glands did express CCK2 receptors. Some of these cells were faintly stained for H,K-ATPase; pepsin/pepsinogen was also detected in this region. Parietal cells in the isthmus/pit region of the glands contained ezrin, and some showed weak immunoreactivity for the CCK2 receptor. As expected, enterochromaffin-like cells also expressed CCK2 receptors. Our findings are consistent with the hypothesis that a CCK2 receptor mediates direct effects of gastrin on gastric epithelial cells during both stomach organogenesis and adult life.
Using Syrian golden hamsters, we studied the effect of pancreaticobiliary diversion (PBD) on plas... more Using Syrian golden hamsters, we studied the effect of pancreaticobiliary diversion (PBD) on plasma cholecystokinin (CCK) and exocrine pancreatic tissue over 5, 10, and 24 days. As compared with sham-operated controls, PBD-operated animals had increased plasma CCK concentrations by 228, 318, and 207% at 5, 10, and 24 days, respectively. Correspondingly, pancreatic wet weight increased by 24, 61, and 87%; total pancreatic protein by 6, 57, and 73%; and total pancreatic DNA by 35, 52, and 98%, respectively. At 5 days, but not at 10 and 24 days, there was a significant increase in the pancreatic tissue DNA concentration (p less than 0.01) and [3]H-thymidine incorporation into DNA (p less than 0.02). Autoradiography showed increased [3]H-thymidine labeling index in acinar cells at 5 and 10 days after PBD (p less than 0.01 and p less than 0.005). Although not significant, ductal cell labeling index was also increased at 5 and 10 days. These findings provide evidence that, as in the rat, PBD in the hamster induces hypercholecystokininemia with ensuing pancreatic hyperplasia and hypertrophy. The hamster model may be useful for studies on the effect of endogenous CCK on pancreatic ductal cell carcinogenesis and diseases of the gallbladder, neither of which can be studied in the rat.
Background and Aims. Helicobacter pylori infection causes chronic gastritis and leads to peptic u... more Background and Aims. Helicobacter pylori infection causes chronic gastritis and leads to peptic ulcer and gastric adenocarcinoma. An impaired gastric mucosal barrier could be involved in these processes. Our aim was to investigate gastric barrier function in H. pyloriinduced gastritis. Methods. Stripped gastric mucosal tissues of H. pyloriinfected Mongolian gerbils (4 weeks and 70 weeks after inoculation, respectively) and controls were mounted in Ussing chambers. 51 Cr-EDTA (paracellular probe) and horseradish peroxidase (HRP, protein antigen) were used to assess mucosal barrier function. The electrophysiological parameters of the mucosa (transepithelial potential, short circuit current, and transepithelial resistance) were monitored as measurements of barrier integrity and viability. Tissue histology was performed to assess inflammation. Results. In the antrum, both short-term gastritis [4.68 (3.88-5.74) × 10 −6 vs. control 2.86 (2.34-3.77) × 10 −6 cm/s, p < .001] and gastritis of long-standing [5.72 (3.88-10.94) × 10 −6 cm /s, p < .001 vs. control]
Since hypochlorhydria can induce hypergastrinemia, and gastrin has atrophic effect on some gastro... more Since hypochlorhydria can induce hypergastrinemia, and gastrin has atrophic effect on some gastrointestinal cells, states that cause elevated plasma gastrin levels are of interest in terms of effects on cell growth and function. This article reviews the relationship between gastric mucosal cells during periods of acid stimulation and inhibition and analyses the effects of hypochlorhydria and hypergastrinemia on gastric and colonic cells and tumors. Hypochlorhydria releases the inhibitory effect of antral gastrin cells, inducing them to release gastrin in the presence of peptides or amino acids in the gastric lumen or in response to antral distension. Gastrin stimulates the oxyntic mucosa, which may lead to hyperplasia of enterochromaffin-like cells, resulting in enterochromaffin-like carcinoid tumors in aged rats and, rarely, in patients with chronic atrophic gastritis or gastrinomas. In addition to hypergastrinemia, other factors appear to be required for the progression of enterochromaffin-like hyperplasia to carcinoids; genetic factors may be involved. Gastrin elevations due to antisecretory drug therapy are indirectly proportional to the degree of acid inhibition and are reversible upon cessation of therapy. The gastrin levels during omeprazole therapy are similar to those caused by gastric vagotomy. Available evidence does not support a relationship between hypergastrinemia and the occurrence or growth of gastric carcinoma or colonic tumors. KEY WORDS: omeprazole; hypochlorhydria; hypergastrinemia; enterochromaffin-like cell carcinoids; peptic ulcer.
The effects of gastric fundectomy and antrectomy on the colonic mucosa were studied in hamsters o... more The effects of gastric fundectomy and antrectomy on the colonic mucosa were studied in hamsters over 5 and 25 days. Sham-operated animals served as controls. Basal plasma gastrin concentrations were significantly increased after fundectomy and significantly decreased after antrectomy. Five days after fundectomy, there was a significant increase in scintigraphically determined colonic tissue [3H]-thymidine uptake and [3H]-thymidine labeling index of goblet cells, both of which were reduced 5 days after antrectomy. After fundectomy, the labeling index was maximal in differentiating-proliferative cells in the midportion of the colonic crypts, whereas the labeling index of the immature proliferative cells at the base of the crypts did not differ from that in the controls. On day 25, the crypt size and the number and percentage of goblet cells in the crypts were significantly increased in fundectomized animals. The number and percentage of goblet cells in antrectomized animals were significantly reduced on day 25. It is concluded that fundectomy in the hamster induces colonic mucosal hyperplasia with goblet cell proliferation, whereas antrectomy leads to retardation of colonic goblet cell proliferation.
... J Clin Invest 1988;81:475479. External Resources 29. Saltzman JR, Russell RM: The aging gut:... more ... J Clin Invest 1988;81:475479. External Resources 29. Saltzman JR, Russell RM: The aging gut: Nutritional issues. ... goto top of outline Author Contacts. Katarina Nägga, MD Department of Geriatric Medicine University Hospital SE581 85 Linköping (Sweden) Tel. ...
In the hamster, as well as in the rat (5-8), pancreaticobiliary diversion (PBD) with transpositio... more In the hamster, as well as in the rat (5-8), pancreaticobiliary diversion (PBD) with transposition of the orifice of the endogenous hypercholecystokininemia with ensuing pancreatic of Copenhagen, Copenhagen, Denmark hyperplasia and hypertrophy (33,34). This trophic effect is 2 To whom correspondence should be addressed prevented by simultaneous administration of a specific CCK-In order to examine the effect of cholecystokinin on spon-A receptor antagonist, such as L-364,718 (34). PBD thus taneous and induced pancreatic carcinogenesis in the hamseems to be a useful model for investigating the effect of ster, two sets of experiments were carried out, one involving long-term endogenous hypercholecystokininemia on pancreatic long-term hypercholecystokininemia and one involving cancarcinogenesis without laborious and non-physiological cer induction during hypercholecystokininemia. The effect exogenous CCK administration or special feeding.
Several epidemiological studies have been published, but there are few reports on relations betwe... more Several epidemiological studies have been published, but there are few reports on relations between gallstone incidence, symptomatology and risk factors. Of 621 randomly selected individuals aged 35-85 years in a general population who had been screened previously with ultrasonography and found to have no gallbladder stones, 503 (81.0 per cent) were re-examined after a minimum interval of 5 years. At baseline and re-examination, heredity for gallstone disease was explored and body mass index, digestive symptoms including abdominal pain, quality of life, alcohol and smoking habits, use of non-steroidal anti-inflammatory drugs and oestrogen, parity and blood lipid levels were recorded. Forty-two (8.3 per cent) of the 503 subjects developed stones. Subjects were followed for a total of 3025.8 person-years, yielding an incidence for newly developed gallstones of 1.39 per 100 person-years. A positive association for gallstone development was found only for length of follow-up and plasma low-density lipoprotein-cholesterol levels at baseline. Weekly alcohol consumption was inversely related to gallstone development. The incidence of gallstones in this population was 1.39 per 100 person-years. Gallstone development was related to length of follow-up and LDL-cholesterol levels, and inversely related to alcohol consumption.
The introduction of laparoscopic cholecystectomy has resulted in increased options for the manage... more The introduction of laparoscopic cholecystectomy has resulted in increased options for the management of bile duct stones and has stimulated a fundamental reappraisal of the situation before the laparoscopic era. This article reviews the natural history of bile duct stones and details the different ways in which they may now be treated. New areas of controversy are highlighted and the need for further studies is emphasized.
Background: Two main types of receptors for gastrin and cholecystokinin (CCK) have been cloned an... more Background: Two main types of receptors for gastrin and cholecystokinin (CCK) have been cloned and identified. CCK1 (CCK-A) receptors are expressed in the pancreas, the gallbladder, and parts of the brain, while CCK2 (CCK-B/ gastrin) receptors (CCK2R) are expressed in gastric glands and in most of the brain. A splice variant of the CCK2R designated CCKRi4sv (CCK-C), which is constitutively expressed in human pancreatic cancer cells, has also been described. The purpose of the present investigation was to study CCK2R, CCK2i4svR, and gastrin mRNA expression in human pancreatic adenocarcinoma on the assumption that co-expression of CCK2R and gastrin or constitutive CCK2i4svR mRNA expression plays a pivotal role in the progression of pancreatic cancer.
Background: Bacterial and cellular genotyping is becoming increasingly important in the diagnosis... more Background: Bacterial and cellular genotyping is becoming increasingly important in the diagnosis of infectious diseases. However, difficulties in obtaining sufficient amount of bacterial and cellular DNA extracted from the same human biopsy specimens is often a limiting factor. In this study, total DNA (host and bacterial DNA) was isolated from minute amounts of gastric biopsy specimens and amplified by means of whole genome amplification using the multiple displacement amplification (MDA) technique. Subsequently, MDA-DNA was used for concurrent Helicobacter pylori and human host cellular DNA genotyping analysis using PCR-based methods.
Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of h... more Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of histologic type, location, stage and outcome of surgical treatment of gastric carcinoma. Br J Surg 2000; 87: 618-26
Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of h... more Borch K, Jönsson B, Tarpila E, Franzén T, Berglund J, Kullman E, Franzén L. Changing pattern of histologic type, location, stage and outcome of surgical treatment of gastric carcinoma. Br J Surg 2000; 87: 618-26
Borch K, Axelsson CK, Halgreen H, Damkjaer Nielsen M, Ledin T, Szesci PB. The ratio of pepsinogen... more Borch K, Axelsson CK, Halgreen H, Damkjaer Nielsen M, Ledin T, Szesci PB. The ratio of pepsinogen A to pepsinogen C: a sensitive test for atrophic gastritis. Scand J Gastroenterol 1989, 24, 870-876
Helicobacter pylori infection is the main cause of chronic gastritis. The infection has been link... more Helicobacter pylori infection is the main cause of chronic gastritis. The infection has been linked to altered proliferative activity and changes in various cell cycle regulating proteins. To determine, in a general population sample, the proliferative activity and expression of p53 and p21 in males and females of different age groups with and without H. pylori-associated chronic gastritis, gastric biopsies from 273 subjects (188 with and 85 without H. pylori infection) randomly selected from a general population were examined immunohistochemically for Ki-67, p53, and p21. One thousand epithelial cells, including the surface, neck, and glandular areas, were counted in both the corpus and the antrum. Results are expressed as the percentage of positive cells. Subjects with H. pylori infection showed significantly increased proliferative activity and expression of p53 compared to uninfected individuals. Regarding the expression of p21, no difference was detected. Multiple linear regres...
Some benign and malignant diseases develop on the background of chronic gastritis or duodenitis. ... more Some benign and malignant diseases develop on the background of chronic gastritis or duodenitis. The present study was performed in order to determine the magnitude of these background changes with relations to symptomatology and life style in the general population. Examinations were performed in 501 volunteers (age 35-85 years). Fifty percent had gastritis; this was associated with H. pylori in 87%. H. pylori-negative gastritis was associated with regular use of NSAIDs [odds ratio 3.8 (1.6-9.9)]. Duodenitis, observed in 32%, was associated with H. pylori infection [odds ratio 2.3 (1.3-4.6)], previous cholecystectomy [odds ratio 3.6 (1.1-16.1)], and regular use of NSAIDs [odds ratio 3.0 (1.4-7.1)]. Neither gastritis nor duodenitis was associated with smoking or alcohol consumption. The rate of digestive symptoms did not differ between subjects with and without uncomplicated gastritis or duodenitis. In conclusion, half of this adult population had gastritis strongly associated with ...
Pancreaticojejunostomy is the method of choice for surgical treatment of pain in chronic pancreat... more Pancreaticojejunostomy is the method of choice for surgical treatment of pain in chronic pancreatitis in the case of ductal dilation. The operative risk is small and all remaining glandular tissue preserved. At 5 years postoperatively, about two-thirds of the patients still experience pain relief. In the absence of dilated ducts, the surgical options are somewhat more controversial. Parenchyma-saving alternatives such as nerve-cutting procedures have not met expectations. Instead, percutaneous blockage of the celiac plexus using alcohol and phenol have been more commonly used for short-term pain relief. The relatively great number of different resective procedures probably reflects the dissatisfaction with the effect of each one of them. Neither left resection nor total pancreatectomy is, today, an attractive alternative due to the relatively high mortality and morbidity (short- and long-term) risks, especially when evaluated against the backdrop of the limited pain reduction in many patients. The Whipple procedure is still the best alternative, although it should be used with critical selection by both the patient and the surgeon. As for the new operations presented during the 1980&#39;s, it is too early to foresee their possible future role. We feel, however, that we still have to await the operation which fulfills the criteria of an ideal operation for pain in chronic pancreatitis.
The prevalence and development of antibodies to H+,K+-ATPase were investigated with a sensitive e... more The prevalence and development of antibodies to H+,K+-ATPase were investigated with a sensitive enzyme-linked immunosorbent assay in 86 patients with autoimmune atrophic gastritis (type A). Sixty-nine of the patients had pernicious anemia, and 17 had simple atrophic gastritis. Elevated titers were found in 93% of pernicious anemia probands. Women had higher levels than men: 3.24 versus 1.58 U/l (p = 0.002) (upper reference limit, 0.55 U/l). The antibody levels did not change over 1-4 years, but a gradual decrease in titers over decades was observed. All patients with pernicious anemia had low levels of pepsinogen A, a product of the gastric chief and mucous neck cells (median, 8.5 micrograms/l; reference range, 10-90 percentile, 64.4-195.5 micrograms/l), and elevated serum gastrin values (greater than 55 pmol/l) were found in 87%. Serum pepsinogen A, but not serum gastrin, correlated with H+,K(+)-ATPase antibody titers (r = 0.35, p = 0.01). In the 17 cases with simple atrophic gastritis, H+,K(+)-ATPase antibodies correlated inversely with fundic mucosal gland destruction. The data indicate that H+,K(+)-ATPase antibody titers reflect the immune responsiveness of a given patient as well as the antigenic amount, dependent on the degree of mucosal destruction and the duration of the disease.
Gastrin exerts trophic effects on the gastric mucosa by mechanisms not yet completely elucidated.... more Gastrin exerts trophic effects on the gastric mucosa by mechanisms not yet completely elucidated. Our aim was to localize the cholecystokinin-2 (CCK2) receptor in epithelial cells of foetal and adult rat stomachs in order to determine the cell types that are directly affected by gastrin. Gastric tissue was subjected to indirect double immunofluorescence staining with antiserum against the C-terminal decapeptide of the CCK2 receptor and antibodies against 5&#39; bromo-2-deoxyuridine, which had been injected into the rats I h before they were killed, the acid pump H,K-ATPase, the membrane-cytoskeletal linker ezrin, pepsin/pepsinogen or histidine decarboxylase. Undifferentiated foetal gastric epithelial cells expressed CCK2 receptors, whereas stem cells of adult gastric glands did not exhibit immunoreactivity. However, other epithelial cells in the progenitor zone of adult gastric glands did express CCK2 receptors. Some of these cells were faintly stained for H,K-ATPase; pepsin/pepsinogen was also detected in this region. Parietal cells in the isthmus/pit region of the glands contained ezrin, and some showed weak immunoreactivity for the CCK2 receptor. As expected, enterochromaffin-like cells also expressed CCK2 receptors. Our findings are consistent with the hypothesis that a CCK2 receptor mediates direct effects of gastrin on gastric epithelial cells during both stomach organogenesis and adult life.
Using Syrian golden hamsters, we studied the effect of pancreaticobiliary diversion (PBD) on plas... more Using Syrian golden hamsters, we studied the effect of pancreaticobiliary diversion (PBD) on plasma cholecystokinin (CCK) and exocrine pancreatic tissue over 5, 10, and 24 days. As compared with sham-operated controls, PBD-operated animals had increased plasma CCK concentrations by 228, 318, and 207% at 5, 10, and 24 days, respectively. Correspondingly, pancreatic wet weight increased by 24, 61, and 87%; total pancreatic protein by 6, 57, and 73%; and total pancreatic DNA by 35, 52, and 98%, respectively. At 5 days, but not at 10 and 24 days, there was a significant increase in the pancreatic tissue DNA concentration (p less than 0.01) and [3]H-thymidine incorporation into DNA (p less than 0.02). Autoradiography showed increased [3]H-thymidine labeling index in acinar cells at 5 and 10 days after PBD (p less than 0.01 and p less than 0.005). Although not significant, ductal cell labeling index was also increased at 5 and 10 days. These findings provide evidence that, as in the rat, PBD in the hamster induces hypercholecystokininemia with ensuing pancreatic hyperplasia and hypertrophy. The hamster model may be useful for studies on the effect of endogenous CCK on pancreatic ductal cell carcinogenesis and diseases of the gallbladder, neither of which can be studied in the rat.
Background and Aims. Helicobacter pylori infection causes chronic gastritis and leads to peptic u... more Background and Aims. Helicobacter pylori infection causes chronic gastritis and leads to peptic ulcer and gastric adenocarcinoma. An impaired gastric mucosal barrier could be involved in these processes. Our aim was to investigate gastric barrier function in H. pyloriinduced gastritis. Methods. Stripped gastric mucosal tissues of H. pyloriinfected Mongolian gerbils (4 weeks and 70 weeks after inoculation, respectively) and controls were mounted in Ussing chambers. 51 Cr-EDTA (paracellular probe) and horseradish peroxidase (HRP, protein antigen) were used to assess mucosal barrier function. The electrophysiological parameters of the mucosa (transepithelial potential, short circuit current, and transepithelial resistance) were monitored as measurements of barrier integrity and viability. Tissue histology was performed to assess inflammation. Results. In the antrum, both short-term gastritis [4.68 (3.88-5.74) × 10 −6 vs. control 2.86 (2.34-3.77) × 10 −6 cm/s, p < .001] and gastritis of long-standing [5.72 (3.88-10.94) × 10 −6 cm /s, p < .001 vs. control]
Since hypochlorhydria can induce hypergastrinemia, and gastrin has atrophic effect on some gastro... more Since hypochlorhydria can induce hypergastrinemia, and gastrin has atrophic effect on some gastrointestinal cells, states that cause elevated plasma gastrin levels are of interest in terms of effects on cell growth and function. This article reviews the relationship between gastric mucosal cells during periods of acid stimulation and inhibition and analyses the effects of hypochlorhydria and hypergastrinemia on gastric and colonic cells and tumors. Hypochlorhydria releases the inhibitory effect of antral gastrin cells, inducing them to release gastrin in the presence of peptides or amino acids in the gastric lumen or in response to antral distension. Gastrin stimulates the oxyntic mucosa, which may lead to hyperplasia of enterochromaffin-like cells, resulting in enterochromaffin-like carcinoid tumors in aged rats and, rarely, in patients with chronic atrophic gastritis or gastrinomas. In addition to hypergastrinemia, other factors appear to be required for the progression of enterochromaffin-like hyperplasia to carcinoids; genetic factors may be involved. Gastrin elevations due to antisecretory drug therapy are indirectly proportional to the degree of acid inhibition and are reversible upon cessation of therapy. The gastrin levels during omeprazole therapy are similar to those caused by gastric vagotomy. Available evidence does not support a relationship between hypergastrinemia and the occurrence or growth of gastric carcinoma or colonic tumors. KEY WORDS: omeprazole; hypochlorhydria; hypergastrinemia; enterochromaffin-like cell carcinoids; peptic ulcer.
The effects of gastric fundectomy and antrectomy on the colonic mucosa were studied in hamsters o... more The effects of gastric fundectomy and antrectomy on the colonic mucosa were studied in hamsters over 5 and 25 days. Sham-operated animals served as controls. Basal plasma gastrin concentrations were significantly increased after fundectomy and significantly decreased after antrectomy. Five days after fundectomy, there was a significant increase in scintigraphically determined colonic tissue [3H]-thymidine uptake and [3H]-thymidine labeling index of goblet cells, both of which were reduced 5 days after antrectomy. After fundectomy, the labeling index was maximal in differentiating-proliferative cells in the midportion of the colonic crypts, whereas the labeling index of the immature proliferative cells at the base of the crypts did not differ from that in the controls. On day 25, the crypt size and the number and percentage of goblet cells in the crypts were significantly increased in fundectomized animals. The number and percentage of goblet cells in antrectomized animals were significantly reduced on day 25. It is concluded that fundectomy in the hamster induces colonic mucosal hyperplasia with goblet cell proliferation, whereas antrectomy leads to retardation of colonic goblet cell proliferation.
... J Clin Invest 1988;81:475479. External Resources 29. Saltzman JR, Russell RM: The aging gut:... more ... J Clin Invest 1988;81:475479. External Resources 29. Saltzman JR, Russell RM: The aging gut: Nutritional issues. ... goto top of outline Author Contacts. Katarina Nägga, MD Department of Geriatric Medicine University Hospital SE581 85 Linköping (Sweden) Tel. ...
In the hamster, as well as in the rat (5-8), pancreaticobiliary diversion (PBD) with transpositio... more In the hamster, as well as in the rat (5-8), pancreaticobiliary diversion (PBD) with transposition of the orifice of the endogenous hypercholecystokininemia with ensuing pancreatic of Copenhagen, Copenhagen, Denmark hyperplasia and hypertrophy (33,34). This trophic effect is 2 To whom correspondence should be addressed prevented by simultaneous administration of a specific CCK-In order to examine the effect of cholecystokinin on spon-A receptor antagonist, such as L-364,718 (34). PBD thus taneous and induced pancreatic carcinogenesis in the hamseems to be a useful model for investigating the effect of ster, two sets of experiments were carried out, one involving long-term endogenous hypercholecystokininemia on pancreatic long-term hypercholecystokininemia and one involving cancarcinogenesis without laborious and non-physiological cer induction during hypercholecystokininemia. The effect exogenous CCK administration or special feeding.
Several epidemiological studies have been published, but there are few reports on relations betwe... more Several epidemiological studies have been published, but there are few reports on relations between gallstone incidence, symptomatology and risk factors. Of 621 randomly selected individuals aged 35-85 years in a general population who had been screened previously with ultrasonography and found to have no gallbladder stones, 503 (81.0 per cent) were re-examined after a minimum interval of 5 years. At baseline and re-examination, heredity for gallstone disease was explored and body mass index, digestive symptoms including abdominal pain, quality of life, alcohol and smoking habits, use of non-steroidal anti-inflammatory drugs and oestrogen, parity and blood lipid levels were recorded. Forty-two (8.3 per cent) of the 503 subjects developed stones. Subjects were followed for a total of 3025.8 person-years, yielding an incidence for newly developed gallstones of 1.39 per 100 person-years. A positive association for gallstone development was found only for length of follow-up and plasma low-density lipoprotein-cholesterol levels at baseline. Weekly alcohol consumption was inversely related to gallstone development. The incidence of gallstones in this population was 1.39 per 100 person-years. Gallstone development was related to length of follow-up and LDL-cholesterol levels, and inversely related to alcohol consumption.
The introduction of laparoscopic cholecystectomy has resulted in increased options for the manage... more The introduction of laparoscopic cholecystectomy has resulted in increased options for the management of bile duct stones and has stimulated a fundamental reappraisal of the situation before the laparoscopic era. This article reviews the natural history of bile duct stones and details the different ways in which they may now be treated. New areas of controversy are highlighted and the need for further studies is emphasized.
Background: Two main types of receptors for gastrin and cholecystokinin (CCK) have been cloned an... more Background: Two main types of receptors for gastrin and cholecystokinin (CCK) have been cloned and identified. CCK1 (CCK-A) receptors are expressed in the pancreas, the gallbladder, and parts of the brain, while CCK2 (CCK-B/ gastrin) receptors (CCK2R) are expressed in gastric glands and in most of the brain. A splice variant of the CCK2R designated CCKRi4sv (CCK-C), which is constitutively expressed in human pancreatic cancer cells, has also been described. The purpose of the present investigation was to study CCK2R, CCK2i4svR, and gastrin mRNA expression in human pancreatic adenocarcinoma on the assumption that co-expression of CCK2R and gastrin or constitutive CCK2i4svR mRNA expression plays a pivotal role in the progression of pancreatic cancer.
Background: Bacterial and cellular genotyping is becoming increasingly important in the diagnosis... more Background: Bacterial and cellular genotyping is becoming increasingly important in the diagnosis of infectious diseases. However, difficulties in obtaining sufficient amount of bacterial and cellular DNA extracted from the same human biopsy specimens is often a limiting factor. In this study, total DNA (host and bacterial DNA) was isolated from minute amounts of gastric biopsy specimens and amplified by means of whole genome amplification using the multiple displacement amplification (MDA) technique. Subsequently, MDA-DNA was used for concurrent Helicobacter pylori and human host cellular DNA genotyping analysis using PCR-based methods.
Uploads
Papers by Kurt Borch