Biomedical subjects

S Falkmer

Publications and source records attributed to S Falkmer.

At least 37 records · Page 2Linked to original sources

PubMed1995

The value of cytometric DNA analysis as a prognostic tool in neuroendocrine neoplastic diseases.

In several traditionally non-endocrine, common, human, neoplastic diseases, it has become well established during the last few years, that cytometric analyses of the DNA distribution pattern of the nuclei of tumour cells can be an excellent supplement to the conventional prognostic tools, (such as clinical staging and histopathologic malignancy assessments). When analogous studies of the value of DNA analysis by means of flow cytometry and/or image cytometry are made in neuroendocrine (NE) neoplastic diseases, the ensuing results often become rather disappointing. Thus, clear-cut aneuploid DNA histograms can be found in the neoplastic cell nuclei of clinically and histopathologically completely benign NE adenomas (and even hyperplastic nodules). In contrast, highly aggressive NE carcinomas not seldom reveal themselves to be composed of tumour cells with nuclei, displaying an euploid, i.e. normal, DNA pattern. Statements of this kind have been based on the results of comprehensive investigations in several laboratories, analysing such NE tumours as insulomas/insular carcinomas, bronchial/gastrointestinal carcinoids, phaeochromocytomas, paragangliomas, neuroblastomas, adenomas of the anterior pituitary gland, parathyroid adenomas, medullary carcinoma of the thyroid and Merkel-cell tumours of the skin. Thus, the prognostic value of the cytometric DNA ploidy pattern of the nuclei of neoplastic parenchymal cells is definitely lower in NE tumours than in most of the traditionally non-endocrine carcinomas and sarcomas. Data from published and unpublished series of these kinds of NE tumours, and those of prostatic and breast carcinomas with NE differentiation, are given. By means of a new, consecutive double staining technique, it was shown that in idiopathic nesidioblastosis, the hyperinsulinism is caused by beta cells with a nuclear DNA ploidy pattern of euploid type. By the same technique, it can be shown that in the pathogenesis of the hypergastrinaemia-induced ECL-cell carcinoids of the stomach, a switch from an euploid to an aneuploid nuclear DNA distribution pattern occurs in the ECL-cells when they pass from a state of hyperplasia to that of a genuine neoplasia. In neuroblastomas, a triploid (i.e. aneuploid) DNA pattern is part of an algorithm capable of predicting a 96% survival rate, whereas a diploid/tetraploid (i.e. euploid) DNA pattern predicts a 0% survival.

DNA, Neoplasm↗

PubMed1995

Preserved beta-cell density in the endocrine pancreas of young, spontaneously diabetic Goto-Kakizaki (GK) rats.

The Goto-Kakizaki (GK) rat represents a spontaneous animal model of non-insulin-dependent diabetes mellitus (NIDDM) characterized by impaired glucose-stimulated insulin release from the pancreatic beta cells. To study whether an alteration in their islet beta-cell numbers occurs in parallel with the impairment of insulin secretion in this model, the relative volume density of beta cells was determined by means of conventional point sampling in immunostained 4-microns-thick sections of the pancreata from 8-week-old GK rats. The pancreata of nondiabetic Wistar rats were used as control parenchyma. In the GK pancreata the majority of islets was found to have a normal structure; only a few of the islets demonstrated an irregular shape (starfish-shaped islets) with fibrosis. The relative volume of the total endocrine parenchyma was found to be 2.0 +/- 0.6% (mean +/- SEM) of the whole pancreatic parenchyma in GK rats. In the control rats the corresponding value was 2.3 +/- 0.5%. The islet beta-cell density was also similar in GK and control rat islets, amounting to 75.2 +/- 8.5 and 66.9 +/- 6.6%, respectively. Thus, the total relative volume of beta cells was 1.5 +/- 0.5% in GK rats and 1.6 +/- 0.4% in controls. In conclusion, the density of beta cells is preserved in the pancreata of the young, diabetic GK rats, suggesting the absence of a causal relationship between the relative pancreatic beta-cell volume and the impaired glucose-induced insulin secretion in this NIDDM animal model.

Analysis of Variance↗

PubMed1994

IGF-2-like peptides are present in insulin cells of the elasmobranchian endocrine pancreas: an immunohistochemical and chromatographic study.

Evidence for the presence of peptides, related to insulin-like growth factor 2 (IGF-2), has been obtained in the endocrine pancreas of the elasmobranchian species Raja clavata, the sting ray. By radioimmunoassay, IGF-2-like immunoreactivity was detected in Raja pancreas extract. Further characterization of this activity by acid gel chromatography revealed two distinct peaks of IGF-2-like immunoreactivity with apparent molecular weights of approximately 8.2 kDa and 4.5 kDa. Using the same IGF-2 antibody as well as antisera specific for mammalian IGF-1, insulin, glucagon, somatostatin and pancreatic polypeptide in double immunofluorescence studies, IGF-2-like immunoreactivity was located exclusively in insulin-immunoreactive cells. In contrast, IGF-1-like immunoreactivity was mainly observed in somatostatin- and glucagon-immunoreactive cells. A varying proportion (0-70%) of insulin-immunoreactive cells, however, displayed both IGF-1- and IGF-2-like immunoreactivity. Absorption studies indicated that the IGF-2-like peptides in Raja are different from mammalian and submammalian insulin and mammalian IGF-1, but similar to mammalian IGF-2. Thus, IGF-2-like peptides seem to occur during evolution as early as the phylogenetic development of the elasmobranchians. Furthermore, the results indicate a particularly conservative evolution of the islet IGF-2 system.

Animals↗

PubMed1993

The branching of insulin-like growth factor 1 and insulin: an immunohistochemical analysis during phylogeny.

The co-existence of insulin-like growth factor 1 (IGF-1) with the classical islet hormones insulin (INS), glucagon (GLUC), somatostatin (SOM) and pancreatic polypeptide (PP) in the endocrine pancreas of representative species of cyclostomes (Myxine glutinosa), cartilaginous fish (Raja clavata, Squalus acanthias) and bony fish (Cottus scorpius, Carassius auratus, Cyprinus carpio, Anguilla anguilla) was studied by the use of monoclonal and polyclonal antisera and the double immunofluorescence technique. In all species investigated, IGF-1-like-immunoreactive cells were found in the endocrine pancreas, however, in varying localization. In Myxine glutinosa, all INS-immunoreactive cells and some of the SOM-immunoreactive cells contained IGF-1-like-immunoreactivity. In Raja and Squalus, only a minority of the INS-immunoreactive cells also displayed IGF-1-like-immunoreactivity. The majority of the IGF-1-like-immunoreactivity was observed in SOM- and in GLUC-immunoreactive cells. Different results were obtained in bony fish. In Cottus, in the Brockmann bodies and the small islets IGF-1-like- and INS-immunoreactivities co-existed to 100%. In contrast, in the other bony fish studied IGF-1-like-immunoreactivity was not observed in INS-immunoreactive cells: in Cyprinus, IGF-1-like-immunoreactivity was found in GLUC-, PP- and SOM-immunoreactive cells and in Carassius and Anguilla, in SOM-immunoreactive cells only. Thus, in all bony fish species with the exception of Cottus, IGF-1 and insulin display a distinct cellular distribution, similar to that of mammals. The present results, thus, may indicate that the branching of IGF-1 and insulin has occurred at the phylogenetic level of bony fish.

Anguilla↗

PubMed1993

A high-molecular IGF-2 immunoreactive peptide (pro-IGF-2?) in the insulin cells of the islets of Langerhans in pancreas of man and rat.

Histopathologically normal pancreatic parenchyma from 12 adult men and women, as well as that from 14 adult rats (Sprague-Dawley and Wistar strains), were investigated immunohistochemically with a mouse monoclonal antibody, raised against recombinant human pro-IGF-2. The antiserum showed no crossreactivity with insulin; IGF-1 had 0.1% of the reactivity of IGF-2. The immunohistochemical observations were checked by means of a radioimmunoassay (RIA), based on the same antibody, of an extract of a sample of one of the human pancreatic glands. Analogous investigations for insulin were made in parallel, using polyclonal insulin antisera. A high-molecular (12 kDa) IGF-2-like peptide was found in the islets of Langerhans, being localized to the insulin cells. These cells were identified as beta-cells by immunohistochemistry with insulin antisera on adjacent paraffin sections. From observations made by means of acid-gel-chromatography, the peptide was tentatively supposed to represent either pro-IGF-2, or a partially processed form of it.

Animals↗

PubMed1993

Identification of IGF-1 receptors in primitive vertebrates.

This is the first report of the existence of insulin-like growth factor (IGF-1) receptors in three representatives of lower vertebrates: the osteichtyes, chondrichtyes and cyclostomi. Competitive binding studies and affinity labelling of brain membranes from Cottus scorpius (sea scorpion), Raja clavata (ray) and Myxine glutinosa (atlantic hagfish) identified a mammalian type 1 or IGF-1 receptor by its binding specificity and the molecular size of its alpha-subunit. IGF-1 and IGF-2 are almost equally potent in displacing receptor-bound 125I-IGF-1 or 125I-IGF-2, and the proteins labeled with both tracers have a molecular size of 100,000-120,000 under reducing conditions. There was no evidence for the presence of a mammalian type 2 or IGF-2/mannose 6-phosphate receptor in brains of Cottus, Raja or Myxine. In all three species the binding of 125I-IGF-1 and 125I-IGF-2 was significantly higher in brain compared with liver and gastrointestinal tract, and the IGF-1 receptor could only be identified with certainty in Raja liver. It is concluded that the brain of three lower vertebrates express mammalian IGF-1 receptors, whereas IGF-2-mannose 6-phosphate receptors could not be detected.

Affinity Labels↗

PubMed1993

Occurrence of members of the insulin superfamily in central nervous system and digestive tract of protochordates.

Antisera specific for mammalian insulin-like growth factor 1 (IGF-1) and mammalian insulin and the double immunofluorescence technique were used for this study. IGF-1-like-immunoreactivity was localized in entero-endocrine cells in the gastro-intestinal tract of the protochordates Ciona intestinalis and Branchiostoma lanceolatum. Some of the specimens also showed IGF-1-like-immunoreactive (-IR) perikarya and fibers in the central nervous system. Whilst in rat endocrine pancreas, IGF-1-IR and insulin-IR occurred in different cell populations, in Ciona and Branchiostoma the vast majority of entero-endocrine cells and central neurons were IGF-1-like- +insulin-IR. A minor portion exhibited IGF-1-like-IR alone. For further characterization of the IGF-1-like-IR material, in Ciona intestinalis, peptides related to IGF-1 were identified by radioimmunoassay and gel chromatography. In accordance with the immunohistochemical results, IGF-I-like-IR was detected both in cerebral ganglion and in gastro-intestinal tract. Using acid gel chromatography, in Ciona gastro-intestinal tract the IGF-1-like-IR was found to occur in two peaks, with apparent molecular weights of approximately 16 kDa and 3 kDa. Absorption studies with insulin- and IGF-related peptides, with crude extracts and the peak material obtained after gel chromatography, indicated that the IGF-1-like peptides in Ciona are different from mammalian insulin and IGF-1. The findings are in accordance with the presence of a common insulin/IGF precursor molecule in protochordates.

Animals↗

PubMed1993

Phylogeny and ontogeny of the neuroendocrine cells of the gastrointestinal tract.

The results of both phylogenetic and ontogenetic investigations of the evolution of the disseminated NE cells of the GIT have shown that they are members of the large NE system, consisting not only of the GI-NE cells but also of the neurons of the central and peripheral nervous system with their nerve fibers (the peptidergic nervous system) and of the classic, solid endocrine glands. The evolutionary studies also have shown that these three major parts of the NE system are closely interrelated to each other. The most original part is obviously the neuronal one, occurring already in the most primitive animals (the coelenterates). The next step in the evolution of the NE system is the appearance of NE cells of open type in the mucosa of the alimentary tract. Such gut NE cells are present in the most highly developed invertebrates, both Protostomian and Deuterostomian, and they persist and become even more diversified in the vertebrates, including humans. The presence of GEP-NE glands of classic, solid type seems to be a feature restricted to the true vertebrate animals. The earliest vertebrates (the jawless fish and the cartilaginous fish) often offer the best pieces of evidence for the manner in which the parenchyma of such a GEP-NE gland, notably the islets of Langerhans, is formed from disseminated NE cells of open type in a mucosa, in this case that of the gut.

Animals↗

PubMed1992

Peptides related to insulin-like growth factor 1 in the gastro-entero-pancreatic system of bony and cartilaginous fish.

Evidence for the presence of peptides, related to insulin-like growth factor 1 (IGF-1) has been obtained in serum and various organs of representatives of osteichthyes and chondrichthyes, i.e., the bony fish Myoxocephalus (Cottus) scorpius and the cartilaginous fish Raja clavata. The peptides were identified by means of gel chromatography and an IGF-1 radioimmunoassay. IGF-1-like immunoreactivity was detected in three different apparent molecular mass forms, i.e., 17 kDa, 6 kDa and 4 kDa, the occurrence of which seemed to depend on the species. When the same antiserum was used immunohistochemically, IGF-1-like immunoreactivity was observed in endocrine cells of the open type in the intestinal mucosal epithelium. These cells exhibited distinct and species-specific distribution patterns. Endocrine cells of the pancreas as well as epithelial cells of the pancreatic duct also showed IGF-1-like immunoreactivity. Occasionally, IGF-1-like immunoreactivity was observed also in interstitial cells. The distribution patterns and densities of the IGF-like immunoreactive cells correlated with the results obtained by radioimmunoassay of the crude extracts. Absorption studies indicated that the IGF-1-like peptides observed differ from mammalian and submammalian insulins as well as from mammalian IGF-1.

Animals↗

PubMed1992

Flow and image cytometric study of pancreatic neuroendocrine tumours: frequent DNA aneuploidy and an association with the clinical outcome.

Eighteen pancreatic neuroendocrine (NE) tumours were analysed for nuclear DNA content by image cytometry (ICM) and flow cytometry (FCM). The DNA indices (DIs) obtained by ICM were somewhat higher than those obtained by FCM, but a major disagreement was present only in 1 case. Thirteen patients had been followed up at least for 6 years after the diagnosis or until death. At 6 years of follow-up all 4 patients with a tumour with a DI greater than or equal to 1.8 by ICM had died from their NE tumour or had metastatic disease, whereas all 9 patients with a smaller DI had no evidence of the disease (P = 0.001). The DIs calculated from the FCM data also correlated well with the final outcome (P = 0.01). A high incidence of DNA aneuploidy was found by both methods in histologically and clinically benign NE tumours; 12 (67%) were DNA aneuploid by FCM and 16 (89%) by ICM. It is concluded that pancreatic NE tumours are frequently DNA aneuploid, and both cytometric DNA methods give prognostic information in these tumours. The presence of DNA aneuploidy should not be considered as a sign of malignant behaviour in pancreatic NE tumours, whereas a large DI is associated with poor prognosis.

Adult↗

PubMed1992

Chromogranin A immunoreactivity compared with argyrophilia, calcitonin immunoreactivity, and amyloid as tumour markers in the histopathological diagnosis of medullary (C-cell) thyroid carcinoma.

Applying the WHO criteria for the histopathological diagnosis of medullary thyroid carcinoma (MTC)--as well as the criterion that a significant amount of argyrophil cells, amyloid deposits, or calcitonin (CT) immunoreactive cells shall be present--122 cases were identified from the files of the Swedish Cancer Registry. Both non-occult (n = 110) and "occult" (less than 1 cm in diameter) (n = 12) MTCs were included. Both primary tumours (n = 91) and metastatic lesions (n = 31) were investigated. The specimens available were all only conventionally formalin-fixed and paraffin-embedded. The presence of neoplastic cells immunoreactive with antisera against chromogranin A (Chr A) was compared with that of the other three MTC markers. Chr A immunoreactive cells were present in practically all the cases. Similar results were obtained when the argyrophil reaction alone and CT immunoreactivity alone were used as markers. When two of the three MTC markers were combined, it was found that virtually everyone of the 122 tumours could be identified as a MTC. In contrast, the presence of amyloid deposits was found to be a less constant MTC marker; whereas 94% of the primary tumours had amyloid deposits, they were present in only approximately 70% and 60% of the metastatic and "occult" tumours respectively. No differences in the staining reaction patterns were found between familial (n = 18) and the sporadic (n = 104) types of MTC.(ABSTRACT TRUNCATED AT 250 WORDS)

Amyloid↗

PubMed1991

Evolution of the insulin gene superfamily. Sequence of a preproinsulin-like growth factor cDNA from the Atlantic hagfish.

Complementary DNAs encoding a preproinsulin-like growth factor (prepro-IGF) have been cloned from a primitive vertebrate species, the Atlantic hagfish, by using a DNA amplification strategy based on the polymerase chain reaction. A composite sequence containing a 414-nucleotide open reading frame encoding 138 amino acids and 164 nucleotides in the 3'-untranslated region was obtained. The deduced partial sequence of hagfish prepro-IGF reveals that it is organized like the mammalian prepro-IGFs with an unusually large (greater than 39-amino acid) signal peptide (initiator methionine residue is missing), 29-amino acid B, 15-amino acid C, 21-amino acid A, 10-amino acid D, and 26-amino acid E domains. All the invariant residues necessary to form the correct tertiary fold of an insulin-like molecule have been conserved in hagfish IGF. Sequence comparisons revealed that the A and B domains of hagfish IGF are equally similar to those of human IGF-I (35 out of 50 amino acids) or IGF-II (37 out of 53 amino acids). In contrast, the similarity between hagfish and mammalian pro-IGFs in the C, D, and E domains is relatively low. Northern blot analysis of RNA isolated from hagfish brain, heart, liver, skeletal muscle, and islet organ, however, indicated that hagfish IGF, like mammalian IGF-I, is expressed predominantly in the liver as a 4.2-kilobase transcript. DNA blot analysis revealed that hagfish IGF is a single copy gene. The predicted sequence of hagfish prepro-IGF thus demonstrates that the divergence of the IGF and insulin genes occurred prior to the separation of the Agnatha and that the organization and tertiary structure of IGF have been well maintained throughout 550 million years of vertebrate evolution.

Amino Acid Sequence↗

PubMed1991

Presence of IGF-1-like peptides in the neuroendocrine system of the Atlantic hagfish, Myxine glutinosa (Cyclostomata): evidence derived by chromatography, radioimmunoassay and immunohistochemistry.

By the use of radioimmunoassay and chromatography peptides related to insulin-like growth factor 1 (IGF-1) have been identified in the cylostomian species Myxine glutinosa. IGF-1-like-immunoreactivity was detected in serum as well as in brain, intestine, pancreas and liver. After acid gel chromatography, the IGF-1-like immunoreactivity eluted as one major peak, with an apparent molecular weight of between 2-4 kDa. When the same antiserum was applied immunohistochemically, IGF-1-like-immunoreactivity was observed in endocrine cells of the mucosal epithelium throughout the primitive intestinal tube. These cells were of the open type and occurred in small clusters. In addition, the majority of the endocrine cells of the pancreas of Myxine displayed IGF-1-like-immunoreactivity. In some of the specimens investigated IGF-1-like-immunoreactive perikarya and fibers were observed on all levels of the brain. Distribution patterns and densities of the IGF-1-like-immunoreactive structures in Myxine correlated with the measurements obtained by radioimmunoassay. Absorption studies with insulin- and IGF-related peptides as well as with crude extracts and the peak material obtained after gel chromatography indicated that the IGF-1-like peptides in Myxine are different from mammalian and non-mammalian insulins as well as from mammalian IGF-1. Generally, the results suggest a long phylogenetic history of IGF-1-like peptides and indicate their fundamental functional impact in all vertebrates.

Animals↗

PubMed1991

Paragangliomas: neuroendocrine features and cytometric DNA distribution patterns. A clinico-pathological study of 22 cases.

Paragangliomas from 22 patients with extraadrenal tumours of this type were studied. Neuroendocrine features were examined using immunohistochemical techniques. Twenty-two antisera raised against neuroendocrine "markers", regulatory peptides, serotonin and intermediate filament proteins were studied in this group and cytometric DNA assessments were made by means of image cytometry. One normal and 5 hyperplastic carotid bodies were used as controls in the DNA cytometric investigations. Clinical and/or histopathological evidence of "malignancy" was present in 5 cases. The tumour cells showed heterogeneity with regard to their expression of different peptides, and the immunohistochemical analyses did not permit differentiation between benign and malignant paragangliomas. An euploid nuclear DNA distribution pattern was found in all controls and in 17 of the tumours; all except 1 were clinico-pathologically benign. An aneuploid DNA pattern was observed in 5 of the cases and some malignant features were present in 4 of these cases. DNA data may give further information apart from that obtained from the histopathological findings which may be of value in predicting the biological behaviour of this tumour type.

Adult↗

PubMed1991

Phylogenetic aspects of pancreastatin- and chromogranin-like immunoreactive cells in the gastro-entero-pancreatic neuroendocrine system of vertebrates.

Using a battery of region-specific antisera raised against different amino acid sequences of pancreastatin (Pst) (Pst-1-6, Pst-1-17, Pst-14-49, Pst-33-49) as well as two antisera raised against chromogranin (Cg) A and CgA/B and the biotin-avidin technique, the phylogenetic distribution of Pst-immunoreactive (-IR) and Cg-IR cells was studied in the gastroentero-pancreatic (GEP) neuroendocrine system. The investigation was carried out with representatives of all vertebrate classes as well as with the protochordates Branchiostoma lanceolatum and Ciona intestinalis. The study revealed the presence of Pst-IR and Cg-IR cells in the gastro-intestinal mucosal epithelium as well as in the islet parenchyma of all vertebrates studied with the only exception found in rat. In the rat GEP system unequivocal immunoreactions were obtained only by the use of antiserum CgA/B. In the gastro-intestinal tract of the deuterostomian invertebrates no Pst-IR or Cg-IR cells could be observed with any of our antisera. Whether this might indicate that Pst-like or Cg-like peptides are characteristic for vertebrates or, more likely, whether similar proteins/peptides might be present in the alimentary tract of protochordates which do not react with the antisera at hand, remains to be clarified. Thouh pronounced interspecies and some intraspecies differences were found, several general conclusions can be drawn. In all vertebrate species, the Pst-IR and Cg-IR cells observed in the mucosal epithelium of the gastro-intestinal tract showed an endocrine structure and were of the so-called open type. The Pst and the Cg antisera which gave immunoreactions with parenchymal cells in the islets of Langerhans also reacted with cells in the epithelium of the pancreatic ducts. Comparative analysis of the reaction properties of the region-specific antisera used indicated that the Pst-like material in the islet cells of the cartilaginous fish species studied seems to be "mammalian-like," whereas it appears to be different in the other (phylogenetically younger) submammalian vertebrates. In addition, the Pst-like peptides in the gastro-intestinal mucosal epithelium and in those in the islets seem to differ in most submammalians. Finally, in the pyloric-duodenal junction of the quail (Coturnix c. japonica) the presence of a so far unknown peptide of the Cg family is presumed. In general, our results seem to indicate that the phylogeny of Pst-like and Cg-like peptides is not as "straight" as those which have been demonstrated for several other neurohormonal peptides.(ABSTRACT TRUNCATED AT 400 WORDS)

Amino Acid Sequence↗

PubMed1991

Prognostic implications of image cytometric assessments of nuclear DNA distribution pattern of neoplastic cells in thyroid medullary carcinoma. A retrospective study using disaggregated, formalin-fixed, paraffin-embedded specimens.

A modified technique for cytometric analysis of the nuclear DNA distribution pattern of neoplastic cells has been applied on archival histopathological specimens originating from 42 patients who had undergone thyroidectomy for medullary carcinoma of the thyroid gland. Five of the cases were of familial type. The DNA cytometric assessments were made by means of computerized image analysis techniques on Feulgen-stained, intact, cytodiagnostically identified neoplastic nuclei obtained from histopathologically selected areas of paraffin blocks. The nuclei were enriched by means of a cytospin technique after deparaffinization of pronase-induced disaggregation of 50 microns thick sections. Only seven of the tumours were found to consist of neoplastic cells where the nuclei showed a DNA distribution pattern of "aneuploid" type; six of these patients had a rapidly progressive neoplastic disease, but the seventh patient did not. Among all the patients whose tumour cell nuclei showed a cytometric DNA ploidy pattern of "euploid" type, not less than about half had a rapidly progressive neoplastic disease. Thus, even when a refined cytometric technique is used, the value of the nuclear DNA ploidy pattern of the neoplastic cells as a prognostic variable in MTC is limited.

Adolescent↗

PubMed1991

Prevention of relapse of reflux esophagitis after endoscopic healing: the efficacy and safety of omeprazole compared with ranitidine.

Ninety-eight patients with erosive and/or ulcerative esophagitis unhealed after at least 3 months' treatment with standard doses of cimetidine (greater than or equal to 1200 mg daily) or ranitidine (greater than or equal to 300 mg daily) were primarily included in an acute healing phase study, and 51 were allocated to 40 mg omeprazole once daily and 47 to 300 mg ranitidine twice daily. After 12 weeks of treatment, 46 (90%) patients given omeprazole were healed, compared with 22 (47%) allocated to ranitidine. Healed patients were then given maintenance treatment with either 20 mg omeprazole once daily or 150 mg ranitidine twice daily for 12 months. Plasma gastrin was determined and gastric mucosal biopsy specimens were obtained during the entire study to assess the structure of the exocrine and endocrine cell populations of the oxyntic mucosa. Sixty-seven per cent of the total number of patients randomized to omeprazole were maintained in clinical and endoscopic remission throughout the 12-month study period as compared with only 10% among those given ranitidine (p less than 0.0001). After 4 weeks of omeprazole treatment basal gastrin levels were slightly increased, with a 95% confidence interval for the change of from 8.6 to 16.9 pmol/l. No further increase in basal gastrin levels was observed during the ensuing study months. No significant histopathologic lesion was found in the oxyntic gland mucosa. In conclusion, omeprazole was far superior to ranitidine in preventing recurrence, a goal achieved without adverse events and significant abnormalities in the oxyntic mucosal exocrine or endocrine cells but with a moderate increase in basal gastrin levels.

Adult↗

PubMed1991

DNA ploidy pattern of parathyroid parenchymal cells in renal secondary hyperparathyroidism with relapse.

The nuclei of parathyroid parenchymal cells, analyzed using image cytometry (ICM), in relapsing and non-relapsing secondary hyperparathyroidism due to uremia, showed a DNA-distribution pattern of diploid type. Nevertheless, some differences were observed within the groups, as regards the concept of 'scattered cells' in ICM DNA histograms. The relative incidence of 'scattered cells' was particularly high in the histograms from parathyroid glands with nodular hyperplasia and in those from parathyroid parenchyma grafted into the skeletal musculature. In these two kinds of parathyroid specimens, the 'scattered cells' were both of chief-cell and oxyphil-cell types. In contrast, 'scattered cells' were not so conspicuous when parenchymal cells of glands with diffuse hyperplasia were analyzed. As there is some clinical and histopathological evidence that the cells in both nodular-hyperplastic and autografted parathyroid parenchyma have increased growth potential, it is hypothesized that the relative incidence of the 'scattered cells' in the ICM DNA histograms indicates an increased proliferative activity.

Adult↗