The hemostatic action of pitressin and scopolamine butyl bromide to the gastrointestinal hemorrhage, especially bleeding esophageal varices was investigated both experimentally and clinically. These agents were administered intravenously in dogs, and their effects on the arterial and venous bleeding were observed. Arterial pressure (AP), portal vein pressure (PP), hepatic vein pressure (HVP), splenic vein pressure (SVP), splenic volume (SV) and hepatic blood flow (HBF) were measured before and after the administration of these agents. In rats, blood capillaries on the surface of the liver and of the intestine were examined by a biomicroscope to evaluate the effects of these drugs. Effects of these agents for the bleeding esophageal varices of the cirrhotic patients were also studied. The results would be summarized as following: 1) Pitressin In dogs, after the intravenous administration of 20 units of pitressin, AP was elevated, PP, HVP and SVP decreased and HBF was reduced. Decreased arterial bleeding was observed in 5 dogs out of 7, and that of venoud bleeding in four out of five dogs. In rats, contraction of the arterioles on the surface of the liver and intestine was confirmed. Pitressin induces a marked contraction of the arterioles which increases the peripheral vascular resistance, and as the result circulating blood flow in the portal system reduces. Thus the gastrointestinal bleeding becomes suspended. In our experience, temporary hemostatic effect on the esophageal bleeding was revealed in seven cases out of twelve. 2) Scopolamine butyl bromide Intravenous administration of 20mg. of scopolamine butyl bromide in dogs induced a drop of AP, PP, HVP and SVP; there was also decrease of hepatic blood flow. Arterial and venous bleeding was reduced remarkably. Capillaries on the surface of the liver and intestine of rats were slightly dilated. The main effect of this agent is presumably the hemostatic action resulting from the decrease in the blood flow velocity in the portal vein and a drop of the pressure in the blood vessels of the entrails. The author used this agent for gastrointestinal hemorrhage and satisfactory effects were revealed in eight cases out of eleven. 3) Noradrenaline Elevation of AP, PP and SVP and decrease of HVF was conspicuous in dogs after intravenous injection of 0.2mg of noradrenaline. This reinforced the bleeding from arteries and veins. Distinct contraction of capillaries by this agent was observed on the surface of the liver and intestinal tract in rats.
The fatty acid composition of serum lipid in various liver diseases was analyzed by gasliquid chromatography and compared with that of normal and hypercholesterolemia. In liver diseases, the change of fatty acid composition was most remarkable in cholesterolester fraction, less marked in triglyceride and phospholipid fraction, and least in free fatty acid fraction. In all lipid fractions examined, percentages of palmitate, palmitoleate and oleate were increased, and arachidonate was decreased in liver diseases. Linleate was markedly decreased in cholesterol-ester fraction and slightly in triglyceride and free fatty acid fraction. Amoung various liver diseases, the change of fatty acid composotion was most conspicuous in liver cirrhosis, hepatoma and fatty liver. Analysis of serum fatty acid composition can be utilized as an indicator of liver dysfunction. The mechanism of the change of fatty acid composition in liver diseases was discussed in comparison to the results of plasma fatty acid composition of ethionine treated rats.
Many authors report that the onset of carcinoma of the gallbladder is insidious and often reaches a advanced stage before it becomes clinically manifest as a malignant condition. But, the fact is well known that cholelithiasis often precedes and may be an etiological factor. So, it is considered worth while for early diagnosis and treatment to clarify the clinical and pathological features of relatively early primaly carcinoma of the gallbladder. Seventeen cases of carcinoma of the gallbladder were analyzed in detail for clinical and laboratory data and pathological results. They were divided into the early carcinoma which had a better prognosis surviving for over three years after cholecystectomy, and the progressed carcinoma which had a worse prognosis dying within one year after the admission to hospital. The early carcinoma was almost combined with gallstone and showed clinical signs and symptoms as chronic cholecystitis or cholelithiasis with a long clinical course for over two years, while the progressed carcinoma was combined with symptomless gallstone or without gallstone and showed clinical signes and symptoms as a malignant condition with a short clinical course for several months. Among many clinical investigations, cholecystographic diagnosis was the most valuable for the early carcinoma. From gross appearance of the mucous membrane surface, the early carcinoma was divided into the flatt, protuberant and hollowed type. It could be considered that early primary carcinoma of the gallbladder to expect a relief by surgery show microscopically a localized infiltrtion to the mucosa and musculature without penetration through the muscular layer and no metastasis to lymph nodes and other organs.
It has been reported by Sarles et al. ('65) and Bonfils et al. ('66) that 1-phenyl-1-hydroxy-n-pentane (PHP) known as a cholagogue caused increase in volume of the pancreatic juice output as well as the bile. In this study, the mode of action of PHP on the pancreatic tissue was morphologically examined. Administrations with a single dosage of PHP in which 10mg/kg, 100mg/kg or 1000mg/kg of PHP were catheterized into the stomach caused washing out of secretory product from the lumen and release of zymogen granules from the acinar cell. That is, 30 minutes after PHP administration the great majority of the acinar cells were markedly depleted of zymogen and the lumen appeared empty. One to two hours after PHP administration, the acinar cells recovered zymogen granules to be same as those before stimulation. It can be said that such an effect of PHP on the pancreatic tissue is quite similar to that of pancreozymin described by Ichikawa ('65). Long term administrations of PHP in which animals were given 10mg/kg or 100mg/kg once a day for a month were also carried out, but the pancreatic tissue always showed normal histological features under physiological conditions.