[The expression of chemokines and the dynamics of inflammatory cell infiltration before and after H. pylori eradication].

We attempted to evaluate the relationship between the expression of IL-8 and RANTES and the dynamics of their target cells in human gastric mucosa of H. pylori associated gastritis, including their changes after H. pylori eradication. We performed the measurement of the mucosal level of IL-8 and RANTES protein by ELISA and immunohistochemistry. The neutrophil infiltration into the gastric mucosa was identified by the histological examination based on the Updated Sydney system and the measurement of MPO activity. The memory T lymphocyte and eosinophil were indicated by immunohistochemistry of CD45RO that is one of surface markers indicating memory T lymphocytes and MBP that is contained in the granules of eosinophils. H. pylori positive gastric mucosa demonstrated a remarkable increase in neutrophils. CD45RO positive cells and eosinophils, compared to H. pylori negative gastric mucosa. Gastric mucosal level of IL-8 and RANTES protein and MPO activity was significantly higher in H. pylori positive cases than that in H. pylori negative controls after H. pylori eradication, both of the level of IL-8 protein and MPO activity reduced at the same levels as negative controls. However, RANTES expression, CD45RO positive T lymphocytes and eosinophils remained in H. pylori eradicated gastric mucosa at the significantly high level, compared with H. pylori negative cases. Therefore, it seems possible that IL-8 might enhance the inflammation by facilitating the neutrophil infiltration into H. pylori infected gastric mucosa and that RANTES might play an important role in the specific immune response against H. pylori and the maintenance of the immune memory after H. pylori eradication.

[Biliary excretion and clinical evaluation of cefoperazone in the biliary tract infections].

Biliary excretion Cefoperazone (CPZ) in a dose of 1 g was intravenously injected to each of 13 cases with obstructive jaundice. Entire bile was collected through percutaneous transhepatic cholangiodrainage (PTCD) catheter in every 1 hour for 6 hours. The mean concentration of CPZ in serum was 112.1 +/- 17.8 micrograms/ml (mean +/- S.E.) at 1 hour and 55.1 +/- 19.2 micrograms/ml at 6 hours after injection. The mean recovery of CPZ in bile within 6 hours was 1.13 +/- 0.60%. Average CPZ concentrations in bile were 64.0 +/- 45.8 micrograms/ml in the 1 hour fraction, 142.7 +/- 78.4 micrograms/ml in the 2 hours fraction and 72.2 +/- 34.0 micrograms/ml in the 6 hours fraction. Biliary excretion of CPZ was low in cases where the serum concentration of total bilirubin was high, but maximum CPZ level in bile in patients with higher serum bilirubin concentrations than 30 mg/dl was still more than 3 micrograms/ml. Clinical evaluation. CPZ was administered to 43 patients with biliary tract infections. The efficacy ratio was 88.4% (excellent and good cases) in all cases, and especially high in cases with cholecystolithiasis. But no difference in efficacy ratio was observed among cases with cholecystolithiasis, choledocholithiasis without gallstone and cases subjected to PTCD. In 10 patients examined by ultrasonography, 8 cases showed reduced diameters of gallbladder. No adverse effect of CPZ was noted in any cases. These results suggest that a fairly large portion of CPZ was excreted through bile and that CPZ is a very useful drug for the treatment of biliary tract infections.