Carbohydrate metabolism in liver was studied on Hoffbauer's Stages I to IIIA of fatty liver induced by choline-deficient diet with special reference to the utilization of 14C-u-glucose and 14C-u-xylitol and the variation of some enzymic activities and intermediates related to carbohydrate metabolism. The histological patterns of liver in choline deficient group developed in a similar manner to those shown in Hoffbauer's classification. Week after week triglyceride increased and phospholipid decreased as far as the changes of liver lipids are concerned. The isotopic experiments revealed the fact that development of choline -deficient fatty liver was accompanied by a gradual disturbance of utilization of glucose and xylitol for glycogen formation and energy source. Glucokinase activitywas obviously reduced even at the initial stage of fatty liver, indicating an insufficient phosphorylation of glucose. Glycogenesis decreased week after week. The variation of G-6-PDH activity suggested that pentose phosphate cycle was kept at the normal level at the initial stage, but it was gradually disturbed along with fatty liver development. The activities of GAPDH (S) and pyruvate kinasewere elevated and the amount of liver pyruvate was increased, which reflects that the metabolic pathway from triose to pyruvate might be in a rather promoted state at Stage I. Lactate amount, however, remained unchanged and LDH activity was slightly raised on the 5th week. The variation of the activities of acetyl-CoA carboxylase and NADP-ICD (S) indicated that fatty acid synthesis was significantly promoted at the initial stage of fatty liver and that glucose and xylitolmight be utilized for fatty acid synthesis via acetyl-CoA rather than for lactate formation through reduction of pyruvate. Energy metabolism in mitochondria, as seen from the variation of NADP-ICD (Mt) and GAPDH (Mt) activities, might rather be in a promoted state at the initial stage of fatty liver, but be graduallyinjured along with fatty liver development. Gluconeogenesis, as seen from the variation of G-6-Pase and FDPase activities, was also be in a rather promoted state at the initial stage, and then gradually disturbed along with fatty liver development. These results led to the conclusion that a clear-cut difference in the pattern of carbohydrate metabolism could be observed between Stage I and Stages II & IIIA.
Comparative histologic examination of the pancreas and parotid gland and biochemical examination of parotid saliva were made in four dogs before and after the experimental production of acute pancreatitis. The results are summarized as follows. 1. Histologically, findings of parotid glands show the degenerative changes in acute pancreatitis. 2. Volume and maximum bicarbonate concentration of parotid saliva are markedly reduced with retardation of the beginning time of it's secretion in acute pancreatitis. 3. It is suggested that the marked reduction of maximum bicarbonate concentration in parotid saliva may require some elapsing times after the production of acute pancreatitis. In our present experiment, it was assumed that acute pancreatitis might be diagnosed on the basis of the shift of bicarbonate concentration in parotid saliva.
In this series, 2850 gastrointestinal X-ray studies were carried out, which resulted in the discovery of 7.0 per cent, with diverticula of the duodenum durny the recent 5 years. This is the hightest figure reported among the series based on X-ray examinations. This may be attributed to the exercising of greater care in studying the duodenum during the carrying out of upper gastrointestinal X-ray series in our Division of Radiology. Diverticula of the duodenum have been found in the second decade 4.2 per cent. The average size of duodenal diverticula becomes larger, progressively, by aging. During this time, 2 cases of Intraluminal Duodenal diverticula were found in this G-Iseries. There was no characteristic symptom among the patients with duodenal diverticula, but constipation wasthe most common complaint and was found to be present in as many as 21 per cent of the patients. As the complications, one case of ulceration within the diverticula resulting in hemorrhage.(confirmed by operation) 4 cases of gastric ulcer, 3 cases of duodenal ulcer and 2 cases of carcinoma of the head of the pancreas were found in 200 patients. There has been no mention in the literature of any inborn error accompaning with duodenal diverticula. However, in this series, there were one case of situs inversus, two cases of mesenterium commune and one case of familialy blue sclera in the 200 patients with duodenal diverticula. In 129 cadavers, careful anatomical studies of the duodenum were carried out. Asa result of this study, 41 specimens were found to have diverticula, giving the high figure of 31.8 per cent, the highest on record to the present date.