Prognostic Significance of Fibrotic Focus and Tumor Infiltrating Lymphocytes in Breast Cancer According to Molecular Subtypes

Purpose@#This study aimed to analyze the association between fibrotic focus (FF) and tumor-infiltrating lymphocytes (TILs) and to determine the prognostic significance of FF and TILs in the breast according to its molecular subtypes. @*Methods@#The study included patients who underwent surgical treatment for breast cancer, for whom tissue samples were available. FF within the tumor and TILs in breast cancer tissues were evaluated. Clinicopathological characteristics were reviewed from medical records. @*Results@#FF and TILs were present in 31.3% and 81.7% of the patients, respectively. FF and TILs showed a positive correlation. FF were significantly associated with tumor size, lymphovascular invasion, regional lymph node metastasis, and tumor stage. TILs were significantly associated with menopausal status, histologic grade, tubule formation, nuclear grade, mitosis, human epidermal growth factor receptor 2 (HER2) overexpression, molecular subtype of breast cancer, and the number of cluster of differentiation 8+ T cells. In TIL-positive cases, FF were significantly associated with tumor size, regional lymph node metastasis, extranodal extension, lymphovascular invasion, tumor stage, recurrence-free survival, and overall survival (OS). Based on HER2 overexpression status, TILs were significantly associated with tumor size, tumor necrosis, histologic grade, estrogen receptor status, and epidermal growth factor receptor expression in HER2-negative breast cancer. Further, in HER2-negative breast cancer, OS and recurrence-free survival were significantly associated with FF. The OS of FF-positive patients was significantly shorter than that of FF-negative patients. @*Conclusion@#Our study showed an association between FF and TIL levels in breast cancer, indicating that FF are associated with poor prognostic factors for breast cancer and poor OS, and that TILs are associated with HER2 overexpression. However, further studies are needed to elucidate the interactions between FF and TILs in breast cancer.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries:Clinical Outcomes of Transcatheter Systemic Artery Embolization

Purpose@#We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. @*Materials and Methods@#Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. @*Results@#Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. @*Conclusion@#TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency sur-gery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries:Clinical Outcomes of Transcatheter Systemic Artery Embolization

Purpose@#We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. @*Materials and Methods@#Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. @*Results@#Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. @*Conclusion@#TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency sur-gery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

The Effects of Posttraumatic Growth and Meaning in Life on Health Promotion Behavior in Cancer Patients

PURPOSE: The purpose of this study was to identify the influence of posttraumatic growth and meaning in life on health promotion behavior in cancer patients. METHODS: The participants were 124 cancer patients who were treated at a general hospital in Pusan. Data were collected for posttraumatic growth, meaning in life, and health promotion behavior. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficients and stepwise multiple regression with SPSS 21.0. RESULTS: The mean scores were health promotion behavior 2.72+/-0.47, posttraumatic growth 3.38+/-0.89, and meaning in life 3.29+/-0.59. The scores of health promotion behavior were significantly different by gender, perceived economic status, and economic difficulties due to diagnosis. Health promotion behavior had a significant correlation with posttraumatic growth and meaning in life. In multiple regression analysis, meaning in life and posttraumatic growth accounted for 26.0% of health promotion behavior. CONCLUSION: Posttraumatic growth and meaning in life were important factors that could be used to improve the health promotion behavior of cancer patients.

Structure and Expression Analyses of SVA Elements in Relation to Functional Genes

SINE-VNTR-Alu (SVA) elements are present in hominoid primates and are divided into 6 subfamilies (SVA-A to SVA-F) and active in the human population. Using a bioinformatic tool, 22 SVA element-associated genes are identified in the human genome. In an analysis of genomic structure, SVA elements are detected in the 5' untranslated region (UTR) of HGSNAT (SVA-B), MRGPRX3 (SVA-D), HYAL1 (SVA-F), TCHH (SVA-F), and ATXN2L (SVA-F) genes, while some elements are observed in the 3'UTR of SPICE1 (SVA-B), TDRKH (SVA-C), GOSR1 (SVA-D), BBS5 (SVA-D), NEK5 (SVA-D), ABHD2 (SVA-F), C1QTNF7 (SVA-F), ORC6L (SVA-F), TMEM69 (SVA-F), and CCDC137 (SVA-F) genes. They could contribute to exon extension or supplying poly A signals. LEPR (SVA-C), ALOX5 (SVA-D), PDS5B (SVA-D), and ABCA10 (SVA-F) genes also showed alternative transcripts by SVA exonization events. Dominant expression of HYAL1_SVA appeared in lung tissues, while HYAL1_noSVA showed ubiquitous expression in various human tissues. Expression of both transcripts (TDRKH_SVA and TDRKH_noSVA) of the TDRKH gene appeared to be ubiquitous. Taken together, these data suggest that SVA elements cause transcript isoforms that contribute to modulation of gene regulation in various human tissues.

Characterization of the expression of cytokeratins 5, 8, and 14 in mouse thymic epithelial cells during thymus regeneration following acute thymic involution / 대한해부학회지

The thymus is a central lymphoid organ for T cell development. Thymic epithelial cells (TECs) constitute a major component of the thymic stroma, which provides a specialized microenvironment for survival, proliferation, and differentiation of immature T cells. In this study, subsets of TECs were examined immunohistochemically to investigate their cytokeratin (CK) expression patterns during thymus regeneration following thymic involution induced by cyclophosphamide treatment. The results demonstrated that both normal and regenerating mouse thymuses showed a similar CK expression pattern. The major medullary TECs (mTEC) subset, which is stellate in appearance, exhibited CK5 and CK14 staining, and the minor mTEC subset, which is globular in appearance, exhibited CK8 staining, whereas the vast majority of cortical TECs (cTECs) expressed CK8 during thymus regeneration. Remarkably, the levels of CK5 and CK14 expression were enhanced in mTECs, and CK8 expression was upregulated in cTECs during mouse thymus regeneration after cyclophosphamide-induced acute thymic involution. Of special interest, a relatively high number of CK5+CK8+ TEC progenitors occurred in the thymic cortex during thymus regeneration. Taken together, these findings shed more light on the role of CK5, CK8, and CK14 in the physiology of TECs during mouse thymus regeneration, and on the characterization of TEC progenitors for restoration of the epithelial network and for concomitant regeneration of the adult thymus.

A Case of Perilla Allergy in a 2-Year-old Boy / 소아알레르기및호흡기학회지

Even though perilla is one of the most commonly consumed grain in Asia including Korea, perilla allergy is rare. A 2 year-old boy had erythematous popular urticaria on his whole body, as well as vomiting and diarrhea after ingestion of boiled perilla. On the second day of admission, old blood clots in the vomitus and blood tinged stool were shown. He underwent an esophago gastro duodenoscopy which showed a large duonenal ulcer. After treatment, his general condition improved. We report a case of perilla allergy with brief review of related literature.

Clinical manifestations and neuroimaging findings of schizencephaly in children / 소아과

PURPOSE: Schizencephaly is a uncommon congenital brain anomaly characterized by congenital clefts spanning the cerebral hemispheres from pial surface to lateral ventricles and lined by gray matter. In this study, we investigated the clinical manifestation and radiologic findings of pediatric schizencephaly. METHODS: The data of 13 patients who were diagnosed with schizencephaly in Severance Childrens Hospital and Yongdong Severance Hospital from January 2005 to December 2007 were analyzed retrospectively. RESULTS: The mean age at diagnosis was 9.08+/-2.67 months old and ranged from 1 to 30 months. The ratio of male to female patients was 3.33:1. Five (38.5%) patients had bilateral clefts, while 8 (61.5%) had unilateral clefts. Five (38.5%) patients had closed lip clefts, and 4 (30.8%) had opened lip clefts. Four (30.8%) patients had multiple clefts. Associated anomalies showed in all cases. The clinical features consisted of mild unilateral weakness in 7 (53.8%) cases and a hemiparesis was present in 3 (23.1%) patients. A tetraparesis was in 3 (23.1%) patients. There was no difference in motor deficit between unilateral and bilateral clefts. Delayed development was observed in all cases. Epilepsy was present in 7 (53.8%) patients, 5 patients with unilateral clefts and 2 patients with bilateral clefts. Three (42.8%) patients showed intractable seizures. CONCLUSION: Schizencephaly showed variable clinical manifestations and radiologic findings in association with the types and locations of the clefts. It is necessary to diagnose schizencephaly early and to detect the development of epilepsy. Intensive and large studies of the correlation of clinical outcomes and radiologic findings should be continued for more effective treatment.

Brain Magnetic Resonance Angiography in Children with Chronic Headache / 대한소아신경학회지

PURPOSE: Headaches occur frequently in the pediatric population and have a significant impact on their quality of life. Several mechanisms are currently thought to contribute to headache pathogenesis. Our aim was to investigate the association of chronic headache in children and cerebral vascular anomaly by performing brain magnetic resonance angiography (MRA). METHODS: We retrospectively reviewed medical records and MRA of 44 patients with chronic headache who visited the pediatric clinic of Young Dong Severance hospital from January 2006 to April 2008. RESULTS: The number of enrolled patients was 44. Eight(18.2%) of them showed abnormal brain MRA findings. Abnormal findings included 5 cases of unilateral A1 hypoplasia, 1 case of unilateral vertebral artery hypoplasia, 1 case of unilateral A1 and P1 hypoplasia, 1 case of Moyamoya disease. Among the 44 patients, 21 had complained only headache and 23 had complained other neurological symptoms with headache. The ratio of abnormal MRA between the two groups showed no statistical difference. CONCLUSION: Vascular anomaly could be a possible pathogenesis and risk factor in chronic headache in children. Further investigation and long term follow up is needed.

Validity study for subjects of national examination for dietitian's license in Korea

National examination for dietitian's license should be reliable and valid to appreciate the ability to carry out the duty as dietitians in diverse area. Thus, it is necessary to investigate whether the present examination accomplishes the task of the evaluation of ability to perform the minimum duty for dietitians. To analyzes the situation, professor in the university, who educate future dietitians, and currently employed dietitians are surveyed for their opinions about the validity of national examination and future directions. Also dietitian's duty analysis, foreign national system for dietitians license, current educational system, and duty analysis in different areas are analyzed. With results of data analysis and the public hearing, subjects for dietitians examination are proposed. The result are following. About current national examination, the average score of survey was 3.14 for overall examination, 3.54 for the reflection of current education, 2.98 for the minimum ability for the dietitian, 2.47 for the problem solving ability, 2.58 for the ability to adapt the environment, 3.27 for knowledge of the study which is necessary for dietitian, 3.27 for the comprehension, 3.18 for the application, 2.74 for the analysis, 2.84 for synthesis and 2.79 for evaluation. Professors and dietitians show the difference which was statistically significant(p<0.05). Among current 9 subjects for examination, food sanitation and clinical dietary therapy had high scores for validity. In the duty analysis (year 2000), distribution for each subjects were 55.58% for nutrition, 33.15% for food service and hygiene, 6.57% for foundation and 3.83% for food and cookery. By the survey result of dietitian in the food service and clinical setting with the duty analysis, distributions for subject which has above 2.0 score for the validity , difficulty, importance, and frequency , were 59.14% for nutrition, 22.43% for food service and hygiene, 10.26% for foundation, 4.03% for food and cookery, and the other appeared with 3.15%. With the fact that items for duty are composed of attitude items 18%, knowledge items 53%, and technical items 29%, current national examination which mostly evaluate knowledge has only 53% degree of the evaluation for the ability to perform at the job. The proportion of opinion which approves the integration of subjects was 80.3% for professors and 78.7% for dietitians. It was visible as approval, the approval rate of the whole 79.6%. For integrations of subjects for the examination and in what kind of form it was done, the investigation of opinion results in 4 subjects areas of foundation, nutrition, food and cookery, and food service and hygienic field. It was the opinion for 31.4% of the respondent.. With these results, it referred to the national examination and set to the making items in 4 subjects areas of foundation, nutrition, food and cookery, and food service and hygienic field. In the future, it is recommended that, even if subjects for the national examination of dietitians are not changed, the number of questions in the examination, the proportion in the item pool, management of pools, should be adjusted by the 4 subject areas.

Pineal Germinoma with Extracranial Metastases: Case Report

Pineal germinoma is the commonest pineal region tumor of childhood and adolescence. Metastatic germinoma most commonly occurs via the cerebrospinal fluid (CSF), and it is usually limited to the cerebrospinal axis. Extacranial hematogenous metastasis is known to be very rare. We report here on a case of pineal germinoma with gradual extracranial metastases that occurred both through the CSF pathway and by hematogenous spread. The patient had multifocal CSF seeding after his surgery for pineal germinoma, and the left iliac metastasis and lung metastasis then occurred.

Feasibility of Saline Infusion on the Liver Surface during Radiofrequency Ablation of Subcapsular Hepatic Tumor: An Experimental Study

PURPOSE: The purpose of the study was to evaluate the feasibility of infusion of normal saline onto the surface of the liver capsule for minimizing thermal injury of the adjacent organs during radiofrequency ablation of subcapsular hepatic tumor in an ex-vivo porcine model. MATERIALS AND METHODS: We used porcine small bowel with it's serosal surface spread onto the porcine liver as an experiment model. The puncturing electrode was inserted into a 6 Fr introducer sheath, and the introducer sheath was connected to the infusion pump for creating a saline flow over the liver surface . A total of 15 ablations were divided into the control group (n=5), intermittent saline infusion group (n=5) and continuous saline infusion (n=5) group. The ablations were done during 3 minutes, and the infusion was set at 2 ml/min and stopped every 30 seconds in the intermittent saline infusion group. After the ablation, we measured the size of the ablated lesion on the surface of bowel and liver, and we also measured the depth of hepatic lesion. RESULTS: Ablated areas of bowel and liver surface in the control group, intermittent saline infusion group and continuous infusion group were 210.7+/-89.1 mm2, 74.6+/-27.2 mm2 and 35.8+/-43.4 mm2, respectively, and 312.6+/-73.6 mm2, 228.4+/-110.5 mm2, and 80.9+/-55.1 mm2, respectively. In contrast to the broad base of the ablated area on the surface of the liver in the control group, the shapes of the lesions became narrower approaching to the liver surface in all cases of the continuous saline infusion group, and the shapes of the lesions were broad based in 3 cases and narrow based in 2 cases of the intermittent saline infusion group. CONCLUSION: Continuous infusion of normal saline onto the surface of the liver during radiofrequency ablation of subcapsular hepatic tumor is a feasible method for minimizing thermal injury of the adjacent organs. Further exploration of the optimal parameters or techniques to maximize the hepatic ablation and simultaneously to minimize the thermal injury of adjacent organs is required.

The Relationship between Tobacco Price Rises and Willingness to Quit Smoking among University Students / 한국역학회지

BACKGROUND: The smoking rate of adult male is 68.2% in Korea and that of adolescent and women has risen recently. Ministry of Health and Welfare plans to raise the price of cigarettes by 1,000 Won per pack this year in hopes of securing funds to aid the underprivileged and discourage excessive smoking. In this study, we tried to find the relationship between tobacco price increase and willingness to quit smoking among university students, and the factors associated with willingness to quit smoking. METHOD: The data were collected by questionnaire survey from 225 university students living in Seoul. The questionnaire contained items on age, sex, smoking history, economical status and the intention to quit smoking when the tobacco price be raised. RESULT: The proportion of smokers who has the intention to quit smoking if the price of tobacco be raised by 3,000 Won was 46.2%. The factors associated with willingness to quit smoking were age of initiating smoking, opinion for price of cigarette, self efficacy scores, current plans to quit smoking, and viewpoint of changes in the rate of smokers. CONCLUSION: The results showed that tobacco price rises will increase willingness to quit smoking among university students.

Survey on Running Smoking, No-Smoking Area in Restaurants in Seoul

Running smoking, no-smoking area in restaurants(n=546) in 25 districts in Seoul area was surveyed and evaluated. No-smoking restaurants were evaluated as A(2.0 points). Restaurants running no-smoking area with guidance to the customers were evaluated as B(1.7 points), and those without guidance as C(1.4 points). In case of the distinction of smoking or no-smoking area are not clear, it was evaluated as D(1.1 points). Restaurants which are not running no-smoking area were scored E(0.8 points). Western style restaurants scored average of 1.55points, which was significantly higher than that of Korean, Chinese or Japanese style ones(average of 1.24~1.27 points). The highest mean score for restaurant 1.625 points in Songpa-gu(district).

Analysis and Framing of Dietitian's of Description

This study was conducted as a part of the project developing the standards of national board test for the dietitian's licence. The purpose of this study was to define the job description of dietitians, and to describe the task elements based on the detailed analysis of the dietitians' work. This study team established the research team which was composed of food and nutrition experts, 7 of registered dietitians and 3 of university professors. Draft job description form was made to fully explain the dietitians' task elements, process and sequence by the research team. Final job description form was confirmed after the validity of 576 task elements was reevaluated upon 4 point scale test based on the frequency, importance, and difficulty by 21 field registered dietitian by the study team. It was also confirmed by the university. This form was formated by following DACUM method which analyzed the job description containing duty, task and task elements. It was organized to include every dietitians' work and to describe the every detailed process of work. Duty was defined as the specific and independent work as a dietitian, and was composed of 17 parts, i.e 10 parts in food supply management area and 6 parts in nutritional care service area and self promotion area. Duties were also divided into 99 tasks containing the 576 detailed task elements to describe definite action, steps and decisions. Seventeen parts are following; menu planning, storage and inventory control, food production, meal service, waste management, sanitation, equipment and facility management, human resource management, financial management, nutrition assessment of life cycle, nutritional assessment of several disease, nutritional assessment in specific condition, medical nutrition therapy, nutritional education, public health nutrition and self promotion. If these protocols are properly performed and presented, they can provide the likelihood that dietetics professionals work as a primary contributors in promoting health care and preventing disease nationally.

Analysis of the Frequency, Criticality and Difficulty of Each Job Task Elements for the Validity of the Dietitian`s Job Description

This study was conducted a part of the project developing the standards of national board test for the dietitian's licence. The purpose of this study was to verify the dietitian's job description. To do this the survey was carried out for the frequency, criticality and difficulty of each job description with 4 point scales. The subjects was 521 dietitians, who have been working over 3 years at their position. The results are following ; 1. The each duty, task and task elements are verified with survey results. 2. Duties with high frequency and criticality were menu management, purchasing, storage and stock management, operational management for cooking, system management for distribution and sanitation management. 3. Duties with middle frequency and high criticality were managing equipment and facility, food service management, human resources management and self-development. 4. Duties with low frequency and high criticality were nutritional assessment for life cycles, nutrition therapy, nutrition education and disease management. 5. For difficulty, food service area show lower than of nutrition service area.

Analysis of and Draw up Dietitian`s Job Description

This study was conducted as a part of project developing the standards of the national board test for dietitian's licences. The purpose of this study was to define the job specification for dietitian's job description based on the knowledge, skill, attitude and related to the curriculum. The study team established the research team which composed of 11 person(7 professor in the university and 4 dietitians in hospitals, schools and private firms). The job description composed of 17 duties, 99 tasks and 576 task elements. For each element, the job specifications are written, which composed of introduction, process, required equipments, and required ability. Required ability included knowledge, skill and attitudes. The relations of the knowledge, skill and attitudes with the possible curriculum currently operated in the college or university were analyzed, also. Job specifications for 576 task elements are analyzed and framed.

The Difference of Biochemical Status, Dietary Habits and Dietary Behaviors according to the Obesity Degree among Obese Children

This study was conducted to find biochemical status, dietary habits and dietary behaviors according to the degree of obesity among obese children, and to provide baseline data for nutrition education. The number of subjects was 64 obese children(Mildly obesed : MI 19, Moderately obese : Mo 30, Severely obese : SI 15) participated in '98 Summer Nutrition Camp'. The results of this study were as follows. 1. Weight and body fat rate was increased according to obesity degree(p<0.05). Total cholesterol and TG also was increased according to obesity degree but it was statistically significant. 2. In dietary habits, it wasn't statistically significant but MI tended to eat fast and to eat the snacks before sleeping. MO tended to skip the breakfast. SI tended to eat more snacks and dinner and they tended to overeat. 3. In cognition of self-weight, most obese children(93.7%) worried about their weight but 73.4% of obese children thought that it was possible for losing weight. There were no difference by the obesity degree. 4. In dietary behaviors, there were no statistically significant difference but MI and SI than MO tended to had worse dietary behaviors. 5. In life styles, SI than the others have tendency to have more regular exercise but they had more indoor activities than outdoor activities. 6. In foods intake frequency, SI than MI and MO ate instant foods more frequently and MI than the others ate hot and salty foods more frequently(p<0.05). With these result, MI and SI than MO tended to have undesirable dietary habits and behaviors. Many obese children worried about the weight but they had positive thought about losing weight. SI tended to do regularly exercise but they had more indoor activities than outdoor activities. Therefore, only with this study, it is difficult to say that there is the clear difference by the obesity degree. Because, in this study, we can have some difference among these groups, we should study more about these difference for effective, systemic and practical nutrition education in the future.

A Study on Dietary Habits, Dietary Behaviors and Body Image Recognition of Nutrition Knowledge after Nutrition Education for Obese Children in Seoul

"The purpose of this study was to obtain basic data of nutrition education for obese children in Seoul and to examine dietary habits, dietary behaviors, and body image recognition before and after nutrition education. A convenience sample of 69(male : 54, female : 15) obese children was selected from "98 Children Nutrition Camp" in Seoul. The survey design employed a structured questionnaires. The results of this study were summarized as follows ; 1. Anthropometric parameters such as height, weight were measured in 69 obese subjects of age 10~12. 2. Effects of nutrition knowledge were gained by dietary habits, dietary behaviors and body image recognition. 3. Comparison of nutrition knowledge scores for obese children was to obtain basic data of effects for nutrition education. "

Effect of Helicobacter pylori infection on antral gastrin and somatostatin cells and on serum gastrin concentrations

OBJECTIVES: Helicobacter pylori infection induces selective reduction of the number of antral D-cells and results in abnormal regulation of serum gastrin secretion. The purpose of this study was to investigate the relationship between H. pylori infection and the numbers of G-cells and D-cells. METHODS: The numbers of antral G-cells and D-cells, the ratio of G-cells to D-cells and fasting serum gastrin concentrations were compared between 37 patients with (29 with duodenal ulcers and 8 with gastric ulcers) and 33 without H. pylori infection (22 with duodenal ulcers and 11 with gastric ulcers). Serum gastrin concentrations were measured using the radioimmunoassay technique. Antral mucosal biopsy specimens were examined using immunohistochemical staining with antibodies specific for gastrin and somatostatin and the numbers of G-cells and D-cells per gastric gland were counted. RESULTS: Fasting serum gastrin concentrations were significantly higher in patients with H. pylori infection compared to patients without infection (80.3 +/- 23.5 vs 47.6 +/- 14.1 pg/ml, p 0.5). The number of D-cells was significantly lower in patients with H. pylori infection than in uninfected patients in both duodenal and gastric ulcer patients (1.3 +/- 0.4 vs 2.5 +/- 1.6, respectively, p < 0.001). The ratio of G-cells to D-cells was also significantly higher in infected patients compared with uninfected patients for both gastric and duodenal ulcers (5.7 +/- 2.7 vs 3.5 +/- 1.9, respectively, p < 0.001). CONCLUSIONS: These results strongly suggest that Helicobacter pylori infection induces reduction of the number of antral D-cells. The resulting relative hypofunction of the inhibitory action of D-cells against G-cells may be responsible for increased serum gastrin secretion.