[Proximal gastric vagotomy in the treatment of duodenal ulcer; its evaluation in the light of a 10-year prospective study].
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Biomedical subjects
Publications and source records attributed to T Popiela.
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Changes in gastric acid output, as well as the concentration of serum gastrin, blood glucose and serum insulin were measured in hypersecretory and normosecretory duodenal ulcer patients following 2-deoxy-D-glucose (2-DG) administration. The stimulation of gastric acid secretion caused by 2-DG was accompanied by a rise in serum gastrin and blood glucose concentrations. The values of serum gastrin measured during the test were significantly higher in hypersecretors. Despite high glucose level, there was no significant increase in serum insulin concentration both in hypersecretors and in normosecretors.
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The concentration of free amino acids was determined with an amino acid analyzer in the basal and peak secretion fractions of gastric juice obtained from 20 duodenal ulcer patients. 20 amino acids were identified in both fractions, with 5 amino acids, i.e. histidine, glycine, phenylalanine, leucine, and glutamic acid constituting over 50 per cent of the total amino acid concentration. The total concentration of free amino acids in gastric juice, similar in both fractions was lower than in blood serum. The total output of free amino acids was significantly higher in the peak fraction as compared with the basal fraction. The analysis of the results obtained suggests that besides the direct contribution of blood plasma amino acid pool there are two other sources of gastric juice amino acids: secretion from the cells of gastric mucosa and intragastric hydrolysis of proteins and peptides present in gastric juice by concomitantly secreted gastric proteases. No correlation was found between the values of output and concentration of gastric juice amino acids and the correspondent values obtained for hydrogen ion secretion.
The concentrations of myristic, palmitic, palmitoleic, stearic and oleic acids were determined in the products of hydrolysis of lipids of cow milk incubated with human gastric juice using thin-layer chromatography for the separation of lipid fractions, and gas liquid chromatography for the determination of fatty acids. It was found that the percentage ratio of the above fatty acids in hydrolysis products was similar to that in milk triglycerides. It was concluded that triglycerides containing higher fatty acids present in milk are hydrolysed by the lipase appearing in human gastric juice, the rate of hydrolysis of the individual acids being roughly proportional to the concentration of these acids in triglyceride substrate.
The present state and future of endoscopic surgery is analyzed on the basis of our own experience with endoscopic methods applied in clinical practice. Data were obtained from 73,572 diagnostic endoscopies and 1975 surgical procedures performed between 1972 and 1994. A significant role of endoscopic procedures was observed in stomach and duodenum surgery, bile duct and pancreatic surgery and colorectal surgery. We performed 9100 ERCP, 1200 endoscopic sphincterotomies, 61 bile duct prosthesis placement, 1086 cholangioscopies, 61,105 gastroscopies, 422 endoscopic hemostasis of the upper GI tract, and 376 curative polypectomies. We introduced sphincter Oddi manometry, endoscopic ultrasonography and minimal invasive methods to surgical practice in the treatment of oesophageal, gastric and rectal strictures such as balloon dilation and laser recanalization. Modern endoscopic methods used together with ultrasonography, radiology and computer techniques create progress in surgery.
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The occurrence of circulating tumour cells in the blood of 51 patients with gastric cancer (stages I-IV) was studied using flow cytometry, cell sorting, immunohistochemistry and reverse transcription polymerase chain reaction (RT-PCR). The lysed whole blood samples were stained with monoclonal antibodies against common leukocyte antigen (CD45), epithelial membrane antigen (EMA), tumour associated glycoprotein 72kD (TAG72), CD44 variants (v5 and v6) and analysed by flow cytometry within ungated or CD45-gated populations. The frequency of detection of TAG72+, CD44v5+ and v6+ cells within CD45- gate was considerably increased in comparison to the ungated population. Furthermore, the presence of tumour cells was directly demonstrated by immunostaining for cytokeratin 18 of sorted CD45- population. The presence of CD44v5+, v6- cells and CD44v-mRNA in the blood was compared to their expression in the primary tumour. The occurrence of circulating CD44v+ cells was associated with their presence in the primary tumour and CD44v-mRNA in the blood. The method described may provide a sensitive tumour marker-independent tool for detection of circulating tumour cells in cancer patients.