The biologic effects of radiation on the gastrointestinal tract have not been emphasized, although it is known among basic radiation investigators. The present study was designed to elucidate radiation injuries to the gastrointestinal tract in mice and rats and among patients with uterine cancer undergoing radiation therapy. It was found that administration of x-ray in a dose range near LD50 nhibited mitosis in the cryptic cells with subsequent retardation of cell migration toward the villus tip and reduction in cell number per villus. The changes were maximal between 2nd and 3rd days with flattening and denudation of villi after which animals either died or recovered. The mucosal serotonin was reduced and urinary 5-HIAA was increased. The motility and absorption of the intestine was studied with 57Co-vit. B12 and it was found that shortly after the radiation, the stomach failed to expel the content, probably due to pylorospasm, and propulsive movement of the bowel was reduced. Absorption was not much altered before 48 post-irradiation hours after which there was a drastic reduction in absorptive capacity. In human studies, it was found the the serum sodum and potassium were decreased after radiation therapy, and there was a slight increase in fecal excretion of 131I-PVP and in the absorption of 131I-triolein, D-xylose and 57Co-B12. It was concluded that the alimentary tract is very sensitive to radiation, and that the primary injury to the bowel mucosa is the inhibition of cryptic cell division.
The content of glucaric acid was evaluated in 72 gallbladder bile specimens from patients with gastric diseases, gallstones and other biliary tract diseases. Also total bilirubin, activity of β-glucuronidase and bacterial infection were studied in all specimens. (1) The content of glucaric acid estimated was 200.7, 78.1 and 40.0μg/ml on an average, in control group, cholesterol stone cases and calcium bilirubinate stone cases, respectively. Apparently these gallstone patients had a lower concentration of glucaric acid than control group. In comparison with this, the specimens taken from pure pigment stone cases and calculous hemolytic jaundice cases contained much the same or rather more amount of glucaric acid. (2) Specimens from control group, cholesterol stone cases and calcium bilirubinate stone cases contained total bilirubin in the concentration range of 100-700, 0-250 and 14-80mg/dl respectively. (3) The activity of β-glucuronidase was low in control group, pure pigment stone cases and calculous hemolytic jaundice cases, as it was high in cholesterol stone cases (at around pH 4.6) and calcium bilirubinate stone cases (at around pH 6.8). (4) It was revealed that the control specimens contained high concentration of glucaric acid and showed lower activity of β-glucuronidase. In cholesterol stone cases, there was inclined to be estimated less glucaric acid when activity of β-glucuronidase was intense, and vice versa. On the contrary, this mutual relation was not recognized in the specimens of calcium bilirubinate stone cases. These facts may suggest that glucaric acid-1, 4-lactone estimated as glucaric cid in the present study inhibits activity of β-glucuronidase in bile. Also it is interesting there was relative to the content of glucaric acid and of total bilirubin in control group, but not in calculous cases.
In 500 cases with various diseases and 50 normal control cases, standard secretin test was done and amylase activity was measured in the pancreatic juice obtained as well as in serum and in urine before and after the secretin stimulation. Amylase activity in pancreatic juice of the control group showed enough variance to that no clear cut normal range can be established statistically. However, if the lowest activity found in the control group is taken as the lowest normal threshold, then, amylase activities of the pancreatic juice of the cases with pancreatic diseases were found to be significantly lower than normal control group, and no significant difference was found between normal control group and cases with non-pancreatic diseases. In cases with established diagnosis of chronic pancreatitis, incidence of abnormal maximal bicarbonate concentration is higher than the abnormality of other two factors (volume and amylase output). In cases with pancreatic carcinoma, incidence of abnormal results were about the same in each of the 3 factors (volume, maximal bicarbonate concentration and amylase output) and there were cases which showed only the abnormal amylase activity in pancreatic juice. Furthermore, in the cases where chronic pancreatitis was suspected or in cases with moderate to slight chronic pancreatitis associated with the diseases of intraabdominal organs ajacent to the pancreas, the determination of the amylase activity of the pancreatic juice was found to be promising. It was therefore concluded that the measurement of the amylase activity in the pancreatic juice should be included in the standard secretin test. The simultaneous measurement of the serum and urinary amylase activity does not significantly increase the diagnostic ability of the secretin test in the cases with advanced chronic pancretitis or carcinoma of the pancreas, however it is useful in the diagnosis of mild pancreatic diseases where no abnormality can be found in the factors of pancreatic juice analysis or in the early detection of the chronic cases following acute pancreatitis. In the latter situation, the determination of urinary amylase need not be performed. Determinations of serum and urinary amylase activities before and after pancreozymin-secretin stimulation alone can not be used as a screening test of the chronic pancreatic diseases for there were enough false negative cases.
Pancreas and the parotid gland are digestive secretory organs with similar histologic structure and function. It can be estimated that affection of one organ cause compensatory, adaptive or destructive changes in its analogous organ. Comparative histologic examination and measurement of amylase in the pancreas and the parotid gland were made in thirteen rats of control group and in a group of eight rats with experimental production of acute pancreatitis. The results are summarized as follows. 1. Histologically, grade of findings of acute pancreatitis in the pancreas well correlated to the atrophic changes of the parotid gland. 2. Comparing amylase value between the control group and the acute pancreatitis group, the latter apparently showed lower value of both the pancreas and the parotid gland. Lowering rate of amylase value was remarkable in the pancreas, while it was moderare in the parotid gland. 3. In conclusion, the present experiment has demonstrated that the experimental roduction of acute pancreatitis also causes atrophic changes and hypofunction of the parotid gland.
One hundred cases of gastric varicies that were seen in our department and affiliated hospitals have been analyzed as to incidence of gastric varix among liver cirrhosis, cirrhosis plus hepatoma and idiopathic portal hypertension, the best technique for demonstrating the varix in barium swallow study, the relationship to esophageal varix and splenic portographic findings and the endoscopic findings. The incidence of gastric varix among portal hypertension was about 60%, higher han that of esophageal varix, and 90% of patients with idiopathic portal hypertension had gastric varicies. One quarter of gastric varicies were not accompanied with esophageal varicies, whereas only 10% of the esophageal varicies were without gastric varicies. There was no correlation in the degree of varicies between the two locations. The splenoportographic studies revealed that the coronary and the short gastric veins are responsible for gastric varicies, and the route through the left renal to the inferior vena cava is the major collateral after the varicies in patients without esophageal varicies. The endoscopically, the gastric varicies reveal themselves as smooth surfaced tense elevations, winding, nodular or branching. There was no clear difference in the liver functions or physical examination findings between patients with portal hypertension having gastric varicies and not having them. It is concluded that gastric varicies are not infrequently seen in portal hypertension and careful barium examination with certain technique and splenoportography are desirable in detecting gastric varicies, a prerequisite for operative management.