Agar induces obstruction of the small pancreatic duct. Here, obstructive pancreatic injury was induced in guinea pigs by injection of agar into the pancreatic duct. Morphological alteration was studied by light microscopy, electron microscopy and immunohistochemical method for 6 months. Morphological examination revealed atrophy of exocrine pancreatic cells and fibrosis or fatty change. Immunohistochemical staining of PCNA suggested that moderately proliferative activity of exocrine pancreatic cells occured in the early stage. Calcification was observed in the pancreatic duct with gradual increasing frequency. In conclusion, this animal model is considered to be useful for studying the pathogenesis of chronic pancreatitis and these results can be taken to indicate that diagnosis of early stage chronic pancreatitis or detection of reversible pancreatic injury is important for successful treatment

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Despite numerous reports on the effect of nitric oxide on neurogenic hormones on the aganglionic colon of Hirschsprung's disease, there are few reports in terms of the sensory function of extraneous nerves of the aganglionic colon of Hirschsprung's disease. In the present study, c-fos expression in the spinal cord was investigated in congenital aganglionosis rats (n = 10) and in normal siblings as controls (n =10), obtained from National Institute for Physiological Sciences. A balloon was inserted into the rectum of the animal under urethane anesthesia and inflated using distilled water for two hours to stimulate the sensory nerve of the rectum. Then serial sections (40μm) of the obtained spinal cords were taken. Following immunohistochemical stain (avidin-biotin-peroxidase complex) c-fos positive neurons were counted. C-fos positive neurons were present in L₅-S₁ segments, but were not demonstrated in the segments above L₄ in both groups. In the control group, c-fos positive neurons were distributed in laminae I -II, V-VIII and X of the axial sections of L₅-S₁, whereas c-fos positive neurons were detected only in laminae I -II in the aganglionic rats. C-fos positive neurons in aganglionosis rats (22.5±15.9 cells/L₆ half section, n =124) were less frequently distributed than in control rats (57.6±34.0 cells/L₆ half section, n =168) (p<0.001) . These results suggest that aganglionosis rats have poor sensory function in the constricted bowel.

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Intraduodenal bile affects cholecystokinin (CCK) release and pancreatic exocrine secretion in rats, but the effects of intraduodenal bile on CCK release have not yet been well documented in humans. Patients with obstructive jaundice treated with external biliary drainage are a suitable model to determine whether or not CCK release is mediated by bile in humans. Nonspecific interference is observed in radioimmunoassay (RIA) for CCK in plasma. A highly sensitive RIA for the detection of CCK in blood using anti-CCK-8 N-terminus antibody (OAL-656) was developed by extraction of CCK from plasma using a Sep-Pak C₁₈ cartridge. Using this RIA, the modulating role of intraduodenal bile in the regulation of blood CCK release was investigated in ten patients with obstructive jaundice due to cholangioma under management by external biliary drainage (PTCD, ENBD) . Fasting blood CCK levels in the patients after external drainage persisted at a significantly higher level than those in control subjects. Before drainage, administration of a test meal caused a high CCK response, and a high blood CCK concentration was persistently observed. After external drainage, the CCK response to the test meal was significantly lower than before drainage, but the blood CCK concentration was significantly higher compared with control subjects after 20 minutes. These results suggests that intraduodenal bile plays an important modulating role in CCK release in humans.

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Serial serum zinc concentrations were measured in 24 very-low-birth-weight infants (VLBWI) for 25 weeks after birth. A high concentration level of 86.9-92.0μg/dl was maintained for the first 5 weeks, followed by a rapid decrease of 49.5-54.6μg/dl in 11-15 weeks and a slow increase thereafter. No significant difference was shown in the zinc concentration between the infants of birth weight less than 1000g and those of 1000-1500g. Serum zinc concentration in the group with parenteral nutrition (PN) during 6-10 weeks after birth (65.8 ± 14.3μg/dl) was significanty higher (p<0.01) than those without PN (57.3±10.8μg/dl) . Intravenous zinc supplement increased the serum zinc concentration, but it was still insufficient for the zinc requirement for each age group. And although VLBWI were given in dietary formula with supplemental zinc (340-390μg/dl) or breast milk in the present study, the serum zinc level at the 40 post-conceptional week was lower compared to the reported data in the full-term infant. Hair zinc concentration of the 96 samples including 47 samples from VLBWI was measured. No significant correlation in the same infants was noted between the zinc concentrations of serum and that of hair. The evaluation of the hair zinc concentration in the VLBWI should be considered with the state of the infant, especially in cases of poor nutrition such as in VLBWI.

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We studied the effect of neonatal hypoxia on high-affinity, Ca²⁺-stimulated, Mg²⁺-dependent ATPase activity (Ca²⁺, Mg²⁺-ATPase) and ATP-dependent Ca²⁺ uptake (Ca uptake) in newborn rat brain synaptosomal membranes. One group of rat pups (hypoxic group) were placed in low oxygen (5 % O₂ and 95 % N₂) for 30 minutes on the first postnatal day. A second group of rat pups were treated with the NOS inhibitor : N-Nitro-Arginine Methyl ester (L-NAME) (10 mg/kg ; administrated intraperitoneally) 90 minutes before exposure to low oxygen. In the hypoxic group, Ca²⁺, Mg²⁺-ATPase activity and Ca uptake were slightly reduced immediately post hypoxia, but decreased significantly after 15 minutes and 30 minutes post hypoxia. We compared Ca²⁺, Mg⁺²-ATPase activity and Ca uptake in the L-NAME-treated group and the hypoxic group to those of the control group. Those of the L-NAME-treated group was not significantly different from the control group. These results suggest that the unfavorable effects of neonatal hypoxia on regulation of intraneuronal free calcium ion concentration can be prevented by administration of L-NAME.

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The BMD of the craniofacial skeleton was measured in 36 patients with cleft palate [mean age 14; 11 bilateral cleft lip and palate, 19 unilateral cleft lip and palate, 6 isolated cleft palate] and 17 normal healthy controls (mean age 15) using DEXA. BMD of the craniofacial skeleton was divided into cranial vault portion (CV), midface portion (MF) and maxillo-mandibular portion (MM) .
The results are as follows : 1) There are no significant differences between the BMD of the patients and the BMD of the controls in all portions ; 2) There also were no significant differences between the BMD of the patients and the BMD of the controls in all portions in the comparison of the divided subgroups (under 10 years, 11-15 years old, above 16 years old) ; 3) There were no significant differences among the BMD of the patients with bilateral cleft lip and palate, unilateral cleft lip and palate, and isolated cleft palate ; 4) There were no significant differences between the BMD of the males and the BMD of the females in both the patients and the controls ; and 5) There were significant correlations between age and BMD of the CV in the patients (r=0.564, p<0.001), between age and BMD of the MM in the patients (r=0.373, p<0.03), between body weight and BMD of the CV in the patients (r=0.494, p<0.003), between body weight and BMD of the MM in the controls (r= 0.585, p<0.03), and between height and BMD of the MM in the controls (r= 0.553, p<0.04) .
The results indicate that there are no significant differences between BMD of the craniofacial skeleton in the patients and those in the controls, and both cleft palate and palate plasty have no influence on the bone mineral deposition pattern of the craniofacial skeleton. But the significant correlations in the patients between age and BMD of the CV and between age and BMD of the MM suggest that the patients with cleft palate have a special growth pattern of the craniofacial skeleton unlike the controls.

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To investigate the clinical characteristics and the outcome of panic disorder, 76 panic disorder patients, who visited the outpatient clinic of the Department of Psychiatry of Showa University Hospital, between June 1993 and May 1994 were included. The inclusion criteria were : 1) diagnosis of panic disorder according to DSMIII-R, 2) no other comorbid psychiatric disorders, 3) no benzodiazepine and antidepressant treatment in the previous month. First, the patients were treated with alprazolam. If the symptoms did not improve, imipramine was added. Assessments were made at the pretretment baseline period and at 4, 8, 12, 24 weeks. The mean onset age of the 43 male patients was lower than that of the 33 female patients. In the older group (the onset age was older than or equal to 40), the ratio of males to females was lower and the panic attacks at the baseline period were less frequent and less severe, but these differences were not statistically significant. Fifty-five patients were assessable at 24 weeks. The frequency of panic attacks and situational panic attacks, and the severity of anticipatory anxiety and phobic avoidance improved significantly. I compared the clinical characteristics at the baseline period in the remitted group of patients (no panic attacks, and no or slight anticipatory anxiety and phobic avoidance at the 24 week assessment) with those in the non-remitted group. In the remitted group, mean onset age was higher, the panic attacks were less frequent, and the anticipatory anxiety was less severe. These differences were statistically significant. Among the symptoms during panic attacks at the baseline period, sweating and nausea were less severe in the remitted group.

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We investigated the configration and motility of the distal segment of the papilla Vater, by measuring the pressure of the common bile duct (CBD) and papilla Vater in 54 patients under endoscopic manometry using a microtransducer pre or post operatively. We classified views of the orifice of the papilla Vater into four types : granular type ; slite-like type ; elongated type ; and persistent relaxation type. The CBD pressure was extremely low in the persistent relaxation type. The amplitude of the phasic wave was significantly elevated in the slit-like type. Basal pressure was the highest in the elongated type and the lowest in the persistent relaxation type. This study suggests that there is a very close relation between the function of the palilla Vater and its orifice configration. Orifice typing will provide valuable information in determining the indication of transduodenal sphincteroplasty or additional operative procedures for common bile duct.

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Omphalocele, hernia of the abdominal wall, is ventral wall malformation that results from the lack of formation of all or part of the embryonic folds. However, it remains unclear how the embryonic abdominal wall is formed. In this study we examined rat embryos (12-15 days p.c.) to clarify the development of the abdominal wall in view of epithelial cell proliferation, using monoclonal antiserum aginst proliferating cell nuclear antigen (PCNA) . Rat embryonic ventral wall was temporally diviede into 5 regions : thoracic, epigastric, hypogastric and lateral walls. Throughout this period of rat embryos, the proliferation rate of the epithelial cells remained at higher levels in both the epi-and hypogastric walls (>70%), especially in the median regions, compared to those of the thoracic (-60%) and lateral walls (-50%) . These findings indicate that the median regions play important roles serving as a center of cell source of epithelium during formation of the rat abdominal wall. Moreover, though the mechanism is unknown, the active cells in the epigastric wall may not be derived from the thoracic wall but rather from a part of the somatic layers of the lateral folds.

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To clarify the relationship between the sensitivity to noise and the personality scale, a survey of the health status and troublesome events in the daily life and that of CAS using Cattell's questionnaire was given to 393 females who live on the side of a road The factor analysis showed that the sensitivity to noise can be classified roughly into“noise type”, “vibration type”, “air pollution type”and“anxiety type”. Further, the factor analysis showed that the personality scale can be definitely divided into the following two groups. (1) The group of persons who answered “Yes” to question (A) “Do you prevent yourself from speaking until you are sure that your opinion is right, when you are discussing something with someone?”, and, at the same time, “No” to the question (B) “Do you make an unexpected comment and then become irritated while you are speaking to someone?” (2) The group of persons who answered otherwise. Then, applying the method of principal component analysis, the personality scale was roughly classified into the following three groups : Group I : The group of persons who belong to the above-mentioned group (1) . Group II : The group of persons who answered “No” to question (A), and, at the same time, “Yes”to question (B) . Group III : The group of persons who answereed either, , “Yes”to question (A) or “No” to question (B) . The Chi-square test and the significant difference test by means of Mantel-Haenszel chi-square were made on the relationship between the sensitivity to noise and the personality scale. The results of these tests showed a significant relationship between the “noise type” and the personality scale in many items. However, the relationship between the other types of sensitivity to noise and the personality scale was hardly detected except in a few items. As there appeared to also be a relationship between the personality scale and the degree of health, it is considered necessary to further investigate, the epidemiological relationship between the personality scale and the health factor. A strong relationship was detected between the sensitivity to noise and the personality scale, the personality scale of the person to be investigated should be included among the test items when the relationship between environmental noise and complaints and/or the degree of health is investigated.

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To evaluate the serial change of the cerebral blood volume (CBV) in orthostatic dysregulation (OD) patients during the orthostatic test, we applied near infrared spectroscopy (LAIRS) on 19 OD patients and 5 normal children. The patterns of the serial changes of CBV in NIRS were divided into the following four groups ; Type 1 : no changes seen in oxyHb, deoxyHb and CBV (all 5 cases of control group) . Type 2 : oxyHb was decreased and deoxyHb remained unchanged, CBV was reduced (8 cases) . Type 3 : oxyHb was decreased and deoxyHb was increased, CBV remained unchanged (5 cases) . Type 4 : oxyHb remained unchanged and deoxyHb was increased, CBV was increased (3 cases) . Sixteen out of 19 OD patients showed a significant change in CBV in NIRS, while all 5 in the control group showed no change in NIRS. The occurrence of the change in NIRS was significantly higher in the OD group than control group. The same orthostatic test with NIRS was done on 5 OD patients after more than 2 weeks of treatment of midodrine hydrochloride. After the midodrine hydrochloride administration, gravity of change in CBV was apparently improved, and 2 cases showed a normal Type 1 pattern. In this study, the change of the cerebral circulatory condition during orthostatic test was suspected to occur in OD patients by utilizing NIRS, and the pathophysiology of OD could be classified in terms of the pattern in CBV change.

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In patients undergoing radical mastectomy, we utilized isoflurane-induced hypotensive anesthesia in 8 patients, and isoflurane-induced normotensive anesthesia in 8 patients. We measured the blood glucose level, plasma insulin concentration, lactic acid, pyruvic acid and nonesterified fatty acid in each group. All patients were premedicated with 0.5mg atropine sulfate, and 50mg hydroxyzine. Anesthesia was induced with thiamylal and the trachea was intubated after vecuronium or succinylcholine administration. Isoflurane was administered until systolic blood pressure decreased to 80-90mmHg in the hypotensive group. In the normotensive group (control group), a concentration of 1-2% isoflurane was administered. Hemodynamic data (blood pressure, heart rate) and blood samples for the measurement of the blood glucose level (BG), plasma insulin concentration, pyruvic acid, lactic acid, and non-esterified fatty acid were collected : 1) before induction (S-1), 2) 30min after (S-2), 3) 60min after (S-3), and 4) 90min after the start of operation (S-4) . Decreases in mean blood pressure below the baseline were significantly greater in the hypotensive group than in the control group. Heart rate did not change in the control group, but in the hypotensive group, it increased significantly. Blood glucose level (S-2, S-3, S-4) in the hypotensive group was significantly greater than in the control group. Insulin concentration did not changed significantly in the hypotensive group, but it (S-3) was significantly below the baseline (S-1) in the control group. Lactic acid (S-2, S-3, S-4) was significanty above the baseline (S-1) in both groups. Lactic acid (S-2, S-3, S-4) in the hypotensive group was significantly greater than in the control group. Pyruvic acid was not changed significantlly in either group. L/P (S-2, S-3, S-4) was significantly greater in the hypotensive group than in the control group. NEFA (S-2, S-3, S-4) was significantly greater in the hyptensive group than in the control group. The result suggests that isoflurane induced hypotension did not markedly affect the carbohydrate metabolism. We speculate that isoflurane causes almost the same effects as other hypotensive agents on carbohydorate metabolism. We conclude that isoflurane can be employed safely and effectively as a hypotensive agent.

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