Histopathological studies were made in detail on the biopsy specimens of the colonfrom 222 persons who were diagnosed healthy after several examinations. The samestudies were also carried out on the lamina muscularis mucosae, submucus layer andmuscle layer of the colon in 160 autopsies, with emphasis on the senile changes. The result are as follows: The colon from aged persons revealed atrophy of the mucosa, morphological abnormality of intestinal gland, cell infiltration of lamina propriamucosae, hypertrophy of lamina muscularis mucosae, increase of connective tissue, atrophyof muscle layer and arteriolar sclerosis. With aging these changes were increasedboth in degree and frequency. This was particularly true with the changes in connectivetissue. In the electron microscopical examinations of senile epithel cell, increase of smallvacuole, abnormal from of nucleus and increase of electron density of both protoplasmand nucleus were observed.
Purpose; The present were conducted to clarify the clinical singnificance of serumγ-glutamyl tranpeptidase activity. Method; Estimation of serum r-glutamyl transpeptidase activity was made by followingthe original method of Szewczuk and Orlowski. In this work a-(-N-γ-DL-glutamyl)-aminopropionitrile was used as the substrate. Results; A) Clinical experiments. 1) While an elevation of serum γ-gluamyl transpeptideseactivity was seen in a slight or moderate degree in acute and chronic, portalcirrhosis and cardiac cirrhosis. In acute hepatitis while serum γ-glutamyl transpeptideseshowed relation with transaminase activity. 2) A remarkable elevation of serum γ-glutamyltranspeptidase activity appeared in the presence of obstructive jaundice and biliarycirrhosis. In this case while serum γ-glutamyl transpeptidase activity showed aclose to parallel ralation wihe that of alkaline phosphatase activity and leucine amino-peptidase activity, there was no correlation with serum transaminase acivity and liverfunction tests. 3) High serum γ-glutamyl transpeptidase activity was seen in primaryor metastatic liver cancer. On the contrary, since.alkaline phosphatase activity andleucine aminopeptidase activity was merely seen at time showing a slight or moderatedegree of activity, it follows that no correlation was seen between the two. 4) So faras examined, in various afflictions other than those of the liver and biliary duct, noremarkable in the γ-glutamyl transpeptidase activity was seen. B) Animal experiments. A slight elevation of serum γ-glutamyl transpeptidase activitywas seen in dogs with acute or chronic liver injury induced by CCl4, and in dogswith ureteral ligation or with acute pancreas damage by autobile infusion. On the contrary, a remarkable elevation of serum r-glutamyl transpeptidase activity was seen indogs with liver cancer induced by dimethylaminoazobenzene. In addition the degree of γ-glutamyl transpeptidase activity was compared with serum transpepti- dase activitywas compared with serume transaminase activity, alkaline phosphatase activity andleucine aminopeptidase activity. Conclusion; Since a remarkable elevation of serum γ-glutamyl transpeptidase activitywas seen in the presence of obstructive jaundice and liver cancer, it is our belief thatour present findings may contribute to the diagnosis of the above mentioned afflictions.
To investigate the influences of pancreatic disorders on lipid metabolism, the changes, in blood lipid fractions and in blood clearing factors were observed clinically and experimentally after the oral and intravenous administration of fats. (A) In order to study the alterations in digestion and absorption of fat during pancreaticdisorders, the changes in blood total fatty acids, nonesterified fatty acids and fattyacid compositions of blood lipids were determined to 6 hours after the oral administrationof 0.5g per kg of body weight of olive oil and safflower oil, respectively, to thepatients with chronic pancreatitis and to the dogs with acute pancreatitis which wereinduced by the injection of gall powder solution into the pancreatic duct. After the administration of olive oil, the changes in serum total fatty acid levelshowed no significant differences between the dogs with acute pancreatitis and normaldogs, while after the administration of safflower oil, both the time to reach its peak andto return to the preabsorptive level were delayed in dogs with acute pancreatitis. Elevation of serum oleic acid after the administration of olive oil to the dogs withacute pancreatitis was not only lower but also more delayed than to the normal dogs, while elevation of serum linoleic acid after the administration of safflower oil (3 dasyafter the operation) was higher and remained for a longer time than the control. Elevation of serum total fatty acid level after the administration of olive or saffloweroil to the patients with chronic pancreatitis was slightly higher than that to thenormal subjects and showed a delayed recovery time. Elevation in oleic or linoleic acid in serum fatty acid composition of the patientswith chronic pancreatitis was significantly higher than that of the normal subjects, and the recovery of the elevation to preabsorptive level was delayed. (B) In order to study the removal of lipids from circulating blood during pancreaticdisorders, changes of total lipid level and turbidity in blood of the dogs with acutepancreatitis were detected after the intravenous injection of 0.5 g per kg of body weightof Fatgen (commercial fat emulsion, 20%). In addition, the alterations of post-heparinplasma clearing factors of the dogs with acute pancreatitis and of the patients withchronic pancreatitis were determined. After the intravenous administration of Fatgen, lower and more delayed increases ofserum total lipids and of plasma turbidities were found in the dogs with acute pancreatitisthan in the normal dogs. Post-heparin plasma clearing factors of the dogs with acute pancreatitis showed nosignificant alterations compared with those of the normal dogs. Clearing factors of thepatients with chronic pancreatitis also showed few differences from those of the normalsubjects.
The problems involved in a temporary occlusion of the porta hepatis to obtain abloodless field in hepatic surgery are twofold: One is a severe congestion of blood inthe portal bed and the other is a anoxia of the liver. This study was undertaken tosearch for a protective procedure that would lessen the portal congestion and alleviatethe untoward effec is of anoxia when a total inflow to the liver is temporarilly occluded, and to investigate the function of the remaining part of the liver after an extensivehepatectomy. I) Experiment as to the Effect of an Occlusion of the Porta Hepatis on PostoperativeMortality Rate, Biochemical Changes in Blood, Liver Tissue Respiration and Polarography. Fifty-seven mongrel dogs were divided into 4 groups. In the first group, the portahepatis was clamped for a period of 60 minutes with a simultaneous occlusion of thesuperior mesenteric artery under normothermia. In the second group, an equal combinationof procedures was performed under general hypothermia between 31°C and 28°CIn the third group, the porta hepatis was clamped with a splenofemoral shunting undernormothermia and in the fourth group using the same procedure under hypothermia.The superior procedure among the various combinations of procedures described abovewere evaluated on the basis of postoperative mortality rate and by determining changesin SGOT, SGPT, blood sugar, blood ammonia, blood lactic acid, tissue respiration andtissue polarography of the liver after occlusion of the porta hepatis. All of the 10 dogs in the first group died after 60 minutes of porta hepatis occlusion.One out of 9 dogs in the second group, one out of 5 dogs in the the third group andone out of 5 dogs in the fourth group died after occlusion. These results suggestedthat the procedure chosen for the first group was not advisable for clinical use, and theremaining procedures, that showed a rather similar mortality rate, were further studied.Hypothermic group, group 2 and 4, generally showed less marked alterations in thetests described above and group 2 showed the least change in blood ammonia level. To favor a simple technique, lower mortality rate and less marked biochemicalchanges, it was concluded that the occlusion of the port a hepatis with a simultaneousocclusion of the superior mesenteric artery under moderate hypothermia was a practicaland reasonably safe procedure for obtaining a bloodless field in hepatic surgery. II) Experiment as to the Effect of Extensive Liver Resection on the Function of theRemaining Part of the Liver. About 50% of liver tissue (left upper, left lower and a half of the central lobe) wasremoved under normothermia in a group of 26 dogs, and also 50% of liver resectionwas performed by using a temporary occlusion of the porta hepatis with a simultaneousocclusion of the superior mesenteric artery under moderate hypothermia in theother group 30 dogs. Effect of resection on the function of the remaining part of theliver was investigated by determining the changes in SGOT, SGPT, blood sugar, BSPand serum protein. Though the changes in SGOT, SGPT and blood sugar after resection of the liver tissuedid not show any marked difference between two groups, serum protein and BSP test wereless markedly affected by the latter combination of procedures, i.e., liver resection byusing a temporary occlusion of the porta hepatis with a simultaneous occlusion of thesuperior mesenteric artery under hypothermia, than by the former, which is usuallyperformed under normothermia.