[Prognosis of stomach cancer patients in the age of complex diagnostic methods]. / Gyomorrákos betegeink prognózisa a komplex diagnosztika idöszakában.

A retrospective study was done in 1986-87 on the survival of patients with stomach cancer. Their disease was established with complete diagnostic methods between 1975-87. In 244 patients diagnosis had been set up more than five years before. The survival of these patients was 19.4%, i.e. 47 of them were alive five years after the diagnosis. Both operability and resectability improved when compared to the earlier results (between 1965-74.). The most favourable 5-year survival and resectability were found in patients with intestinal type cancer. Early cancer was 8.3% of total, however, when only those patients were taken into consideration who had been treated either surgically or underwent surgical or endoscopic polypectomy, the percentage markedly increased 22.7%. The survival of patients with early stomach cancer was excellent: 34/37 (91.9%). A significant decrease of the incidence of stomach cancer in the region so far could not be observed.

Amoxycillin levels in human serum, bile, gallbladder, lung, and liver tissue.

Amoxycillin levels were measured in the serum, bile, lung, gallbladder, and liver tissue in 19 cases of lung and 22 cases of cholecyst operations following intramuscular administration of 1 g amoxycillin. After 60-160 min, 4.4-5.6 mcg/g intact lung tissue and 1.5-3.9 mcg/g tumorous lung tissue concentrations were found, representing 41-48% and 15-32%, respectively, of the corresponding serum levels. Between 70 and 160 min when the ducts cysticus was open, the cystic bile contained 5.2-8.8 mcg/ml, the bile taken from the biliary ducts showed 10.9-13.2 mcg/ml, whereas the wall of the gallbladder and the liver tissue displayed 4.4-5.1 and 1.7-2.8 mcg/g amoxycillin levels. These levels represented 50-92, 118-136, 50-52 and 17-28% of the actual serum levels. As in the serum levels, the bile and tissue levels were about twice as high as those following ampicillin administration. The amoxycillin levels measured in the serum, bile, and other tissue tissues in most cases exceeded the minimal inhibitory concentrations for most of the bacteria usually considered. Therefore, amoxycillin can be applied successfully to treat respiratory and biliary infections.

Immunological investigations in acute and chronic human pancreatitis.

Follow-up immunological studies in 27 patients with acute pancreatitis of known etiology showed a significant elevation in the level of circulating immune complexes (IC), a significant inhibition in migration of leukocytes (with direct LMT) of patients and a significant decrease in the percentage of T-active, T-total peripheral lymphocytes and in the absolute count of peripheral T cells. Elevated circulating IC levels could been detected 3-4 weeks after the onset of acute pancreatitis. These immunological changes have still been demonstrated in a number of patients 7-14 months after recovery. We have found similar immunological alterations in patients with chronic pancreatitis as well. The possible causes and role of these long-term existing immunologic abnormalities are discussed.

Pharmacokinetic study of rifampicin in biliary surgery.

Following the oral administration of 600 mg rifampicin, the concentration of antibiotic in serum, bile of the gallbladder and choledochus, cholecystic wall, and hepatic tissue was determined with the agar diffusion method in 23 patients undergoing surgery for cholelithiasis. After 80-340 minutes the average rifampicin concentration was 6.4 microgram/ml in serum, 78.4 microgram/ml in the bile of the gallbladder, 91.6 microgram/ml in the bile of the choledochus, 4.0 microgram/g in the cholecystic wall, and 23.3 microgram/g in the hepatic tissue. After 24 hours the level was significantly reduced in the serum and hepatic tissue. The rifampicin level in the bile of the gallbladder was twelvefold, in the bile of the choledochus fourteenfold, in the cholecystic wall 61.1% and in the hepatic tissue 364% of the serum level. In general, the rifampicin concentration obtainable in the bile and hepatic tissue is sufficient against bacterial strains causing infections of the biliary duct, and for this reason rifampicin will play in the future an important role in the treatment of infections of the biliary duct.

Abnormalities in humoral and cellular immune activity in pancreatitis. I. Study of the humoral immune system.

The abnormalities of the humoral immune phenomena in pancreatitis may be summarized on the grounds of published evidence and of the present results as follows: 1. Circulating anti-pancreas antibodies are present in acute pancreatitis as also after its cure, and in chronic pancreatitis. 2. The appearance of soluble immune complexes in pathological amounts was demonstrated in the sera of the patients by radiobioassay in acute pancreatitis of identified aetiology 3 to 4 weeks after onset. On the evidence of follow-up studies over 1 to 8 months the immune complexes were found to persist at increased levels after complete cure of acute pancreatitis. Soluble immune complexes were demonstrable in pathological amounts in the cases of chronic pancreatitis as well. 3. In acute pancreatitis the total serum complement titres decline fast and after a few weeks persistent hypocomplementaemia develops in a number of cases. 4. The possible role of circulating soluble immune complexes and of the complement system in pancreatitis is discussed, and it is suggested on the grounds of the present data that acute pancreatitis is associated with a specific and nonspecific immune sensitization, still demonstrable in a number of cases after a few months.