Mucoprotein (MP), protein bound polysaccharide (PBP), mucoprotein bound polysaccharide (PMP), diphenylamine reacting substance (DPA), β-lipoprotein (β-Lip) and C-reactive protein (CRP) were determined in sera of patients who were suffered from gastric cancer (68 cases) and other diseases. (44 cases; gastric polyps 5 cases, gastroduodenal ulcer 29 cases, cholelithiasis 10 cases.) The sera were aspirated from these patients before breakfast in the early morning. Before operation, more than 70% of the patients with gastric cancer showed higher values than normal in MP, PBP, PMP, and DPA. While about 60% of the patients with other diseases showed normal values. There was no significant difference in values of β-Lip between patients with gastric cancer and with no cancer. Those who indicated positive reaction of high BSR values (larger than 20cm within one hour) were patients with gastric cancer. After operation, values of MP, PBP, PMP increased markedly after gastrectomy the patients of gastric cancer as well as gastric ulcer, while these values were not changed after simple laparatomy and paliative gastrojejunostomy in the patients with severe gastric cancer. Patients with gastric cancer showed little change in the value of DPA after simple laparatomy. On the contrary, after gastrectomy the values of MP, PBP, PMP, and DPA in patients with gastric cancer and other diseases increased markedly. A pattern of β-Lip value after operation showed no difference between gastric cancer group and no cancer group. In addition, the following positive correlationship was found between the diameter of tumors and preoperative values of MP and PMP, between total amount of bleeding and the highest values of MP after operation, and finally between values of CRP and PMP on the first day after operation.
Retrograde portography was performed to study the angiographic patterns of various liver diseases such as cirrhosis, tumor, Banti's syndrome and hepatitis using hepatic vein catheterization in 42 patients. Cournand catheter was advanced into the hepatic vein until wedged. After taking wedged hepatic vein pressure, the tip of the catheter was withdrawn to about 10cm under diaphragma. Hepatic blood flow was measured by ICG clearance method. Contrast substance 80% sodium salt of 5-acetoamide-2, 4, 6, -triiode-N-methyl-isophthalamic acid was injected as rapid as possible when the tip was wedged again to take X-ray images of portal branches. Circulatory systems described by retrograde portography of hepatic diseases were discussed considering these findings alongwith liver biopsy, functiontests and serum immunoglobulins. Conclusion: 1) Venographic changes of sinusoids and portal branches were observed not only in liver cirrhosis but in some cases of chronic hepatitis. 2) In some cases of persisting hepatitis, the changes of visualized sinusoids were observed. 3) In diffuse liver diseases, the venographic findings of sinusoids and portal branches. 4) In the tumor, by an appropriate hepatic vein it was possible to diagnose the localization, size and shape. 5) In Banti's syndrome, venographic changes were more remarkable in intrahepatic portal branches rather than in hepatic vein branches. 6) There was no correlation betweenangiographic changes and S-GOT activity, T.T.T. and serum immunoglobulins. 7) The greater angiographic changes occured, the higher wedged hepatic vein pressure and also the less hepatic blood flow were observed.
Esophagoscopical observations were performed and gastric juice was examined in 83 patients; 25 with hiatal hernia, 11 with gastric ulcer, 22 with chronic gastritis, 22 with duodenal ulcer and 11 with liver cirrhosis. The volume and acidity of gastric juice were determined in fasting and after the stimulation by the intramuscular injection of 3-beta-amino-ethyl pyrazol. 1) Esophagitis was found in 11 cases (44.0%) of hiatal hernia, 11 cases (18.2%) of gastric ulcer, 6 cases (27.2%) of chronic gastritis, 7 cases (50.0%) of duodenal ulcer and 2 cases (18.2%) of liver cirrhosis, respectively. 2) The incidence of esophagitis was high (53.3%) in cases with hyperacidity of fastig juice but no correlation was observed between the incidence of esophagitis and gastric acidity after the stimulation. 3) Reflux of gastric juice occurred frequently in hiatal hernia (12 out of 25 cases (48.0%)), and the incidence of esophagitis was higher in the group with reflux than that without reflux. 4) There was no significant correlation between the incidence of esophagitis and gastric juice acidity in the group with reflux, but the incidence of esophagitis was higher in hyperacidic than hypo- or normoacidic group without reflux. These findings indicate that reflux and hyperacidity of gastric juice play more important role than the primary disorders in the pathogenesis of esophagitis.
Pylorus was ligated according to Shay's method in 45 rats. Thereafter the volume and acidity of gastric juice were measured and serial changes of esophageal mucosa were examined macro- as well as microscopically. 1) The significant increase in the volume of gastric juice was found postoperatively, and it amounted to 14.4±3.7ml 18 hours after the operation. 2) The pH of gastric juice was 2.4±0.28 before the operation, however, it rose temporarily to 4.6 after 2 hours followed by a decline to below 2.0 after 18 hours. 3) A significant invers correlation was observed between pH and logalithmic value of the volume of gastric juice. 4) Inflammatory changes were found macroscopically from 8 hours and microscopically from 4 hours after the operation, respectively. The incidence of esophagitis was increased as the intervals after the operation became longer. Esophagitis was found in all animals microscopically after 18 hours. The changes in esophageal mucosa closely resembled to those found in the idiopathic esophagitis of men. 5) The esophagitis was found frequently when the volume of gastric juice was increased or the pH was lowered to a great extent. The foregoing findings indicated that esophagitis was clearly produced by the ligation of pylorus in rats and its morphological features closely resembled to human idiopathic esophagitis. It was suggested from the auther's observations that the secretory increase of gastric acidity might play an important role in the pathogenesis of esophagitis.
The possible existence of segregated streams of blood in the portal vein (stream line "phenomena in the portal vein) and their subsequent distribution to definite parts of the liver is of interest and was studied by many investigators. Although the portal stream-lining was proven in the dog, it could not be confirmed in man. In the present paper, some detailed investigations were made on "stream line" phenomena in the portal vein by the scanning method using 131I labelled macro-aggregated albumin (MAA) injection. Two hundred 300μ Ci of 131I MAA, ranging 20-100μ in size, dissolved in 0.4-1.5ml saline solution, was employed as the indicator. 131I MAA injection was carried out in two different ways; into several radicles of the portal vein and the spleen. In the former, 11 cases of human subjects, having normal hepato-portal circulation, and 8 dogs were studied after laparotomy. Two minutes were taken for infusion in order not to disturb the stream line. Splenic injection was carried out in 30 cases of human subjects, including 19 cirrhotic cases (percutaneously) and 4 dogs (after laparotomy). The ultimate localization of 131I MAA in the regional capillaries of the liver was observed using scanning method for man externally and for the dog after removal of the liver. The results obtained were as follows: (1) When the injection of 131I MAA was made into tributaries of portal vein, the segmental istribution of radioactivity in the liver was observed in the most cases studied. Therefore the existence of "stream line" phenomena in the portal vein can be confirmed not only in the dog but also in man. (2) When injection was made into the spleen, the diffuse distribution of radioactivity in the liver was found for the dog and non-cirrhotic human subjects. This fact will indicate the presence of complete mixing of blood flowing out from the spleen, in spite of the existence of "stream line" phenomena in the portal vein. (3) By similar intrasplenic injection cirrhotic cases show predominant distribution of radioactivity in the left lobe, indicating the increased inflow of portal blood into this side of the liver.
The influence of various diets upon alcoholic fatty liver was studied. Alcoholic fatty liver was induced by feeding ethanol for 450 days. By feeding the normal diet with addition of ethanol, small fat deposition was recognized on the rat liver. With high fat feeding, fatty liver was accelerated with addition of ethanol. On the contrary, by high protein diet with or without ethanol, we could not recognize any abnormality on the liver. According to the fact mentioned above, it was clarified that fatty liver induced by ethanol was influenced by the proportion of fat to protein in diets. The mechanism of the influence of diets upon fatty liver with ethanol was discussed.
A rapid and simple turbidimetric method for the determination of the lipase in pancreatic juice is described. This method is the modified Vogel & Zieve turbidimetric method for the determination of serum lipase. Fatgen is emploied as the triglyceride sauce of substrate. The substrate is 0.01% triglyceride in Tris buffer, with sodium deoxycholate. The lipase unit with a nearly pure sesame oil as substrate is slightly increased than that with Fatgen. There is no difference between values with two different concentration (0.01%, 0.02%) of triglyceride in substrate. The pancreatic juice contains a lipase with optimal action at pH 8.6 and sodium deoxycholate concentration of 0.35%.