The Kinetic Analysis of gastric peristalsis in the stomach resection using the distribution of Interstitial cells of Cajal and Electrogastrography

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We have been investigating the resected stomach peristalsis function using Electrogastrography. Imai previously reported that there was no EGG signal after total gastrectomy and EGG signal depended upon the extent of gastric resection in distal gastrectomy cases, and estimated that the pacemaker node in the stomach probably exist upper part of stomach.The aim of this study is to examine the relationship between the function of peristalsis and distribution of Interstitial cells of Cajal (ICC).And we focused the stomach peristalsis not only vagal nerve but also the function of ICC as an electoronic trigger. Finally the end point of this study is how maintain the good QOL (quality of life) after distal and proximal gastrectomy.Methods :We have examined the normal mucosa including resected stomach of gastric cancer by histopathological and immunohistological method, to detect ICC, using c-Kit immuno-histochemical method. Peripheral nerve system was stained by S-100 immuno-histochemical staining as a contrast, which showed submucosal layer and muscular layer such as Auerbach's neuro-ganglion. c-Kit positive cells are located in not only musucular layer but also submucosal layer.Results & Discussions :1) S-100 staining, which means peripheral nerve tissue or cartilage tissue, showed vagal nerve system mainly exited muscular layer.2) c-Kit positive cell existed in the muscular layer. There is slightly difference of location S-100 and c-Kit. c-Kit positive cells are detected also in submucosal layer especially including the just under mucosal layer.3) There are a couple of issues for this research. We cannot obtain residual stomach information such as ICC distribution except EGG analysis. At first we designed the research, we thought total gastrectomy sample was useful. But many cases of total gastrectomy tissue consisted of advanced gastric cancer, it is difficult to find normal gastric wall due to cancer invasion.