In order to investigate the mechanism of elevation of serum γ-glutamyl transpeptidase (γ-GTP) in liver disease, several types of liver damage induced experimentally were analysed biochemically. An activity of γ-GTP was mainly localized in the microsomal fraction of the hepatic parenchyma) cells and is induced gradually in the course of the chronic hepatocellular injury, while no induction was observed in acute hepatic damage. On the ligation of common bile duct, no induction of γ-GTP was found in the liver, but a marked elevation of serum activity was observed, indicating that the enzyme may be excreted mainly via biliary system. Neither regeneration nor fatty methamorphosis of the liver caused the elevation of the enzyme activity in serum as well as in the liver. Under the single administration of ethanol, the activity in the liver increased slightly, but not in serum, while prolonged administration of ethanol resulted in the depression of the activity in the liver, suggesting ethanol may induce γ-GTP as well as ADH until redistribution of enzyme protein may occur. On the Morris hepatoma bearing animal, a remarkable induction of particle-bound γ-GTP in the microsomal fraction of tumor cells was found, while no induction was found in host liver.
The clinical meanings of an elevation of the serum γ-glutamyl transpeptidase as one of the liver function tests were examined in detail on the patients of various hepatobiliary disorders and the following evaluations were made. 1) Serum γ-glutamyl transpeptidase levels of healthy adults are 29.7±38.5mU/ml for males, and 14.4±15.5mU/ml for females. The activity is readily influenced by aging as well as by habitual intake of alcoholic beverages. 2) As an index for the evaluation of the prognosis of acute hepatitis, when a diagnostic level of serum γ-glutamyl transpeptidase set on 100mU/ml and the serum level over 100mU/ml at the onset of the disease means the possibility of the prolongation of the clinical course. 3) This diagnostic value is also reliable for the prediction of histological difference between inactive and active type of chronic hepatitis. Over 100mU/ml means active changes while less than 100mU/ml inactive. 4) The changes of serum enzyme level are far more sensitive than alkaline phosphatase in the case of cholecystobiliary obstruction. 5) The highest range of the serum enzyme level is observed in both primary and secondary hepatoma, while on the isozymograms of the serum, an appearance of the isozyme on α-band usually means primary hepatoma.
By the histochemical and biochemical methods, the structural changes of mucopolysaccharides of the gastric and duodenal mucosa were investigated. 1) The normal gastric and duodenal mucosa of rat are covered by two kinds of thin layer. One of these is a superficial layer consisted of glycoprotein, which is stained well by P.A.S. and Mowry's alcian blue, but poorly by Scott's alcian blue, and the other is a profound layer consisted of mucoprotein, which is stained well by Scott's alcian blue. The gastric mucosa is covered well with glycoprotein layer, but poorly with mucoprotein layer, and the duodenal mucosa poorly with glycoprotein layer, but well with mucoprotein layer. 2) Bile makes marked depletion of the glycoprotein layer, but gastric juice does not, and gastric juice makes destruction of the mucoprotein layer, but bile does not. These differences of resistance of the gastric and duodenal mucosa against to bile and gastic juice, and the differences of structures of mucopolysaccharides in the gastric and duodenal mucosa are the important factors contributed to the difference of pathogenesis between gastric and duodenal ulcer. 3) When the gastric mucosa is treated with urea, together with mucopolysaccharase and gastric juice, the mucosa is destructed remarkably with depletion of the thin layers. 4) Effect of histamine or gastrin as an aggressive factor, and effect of prednisone or mucopolysaccharase as a destructive factor in the protective mechanism, on pathogenesis of peptic ulcer were observed. When gastrin together with mucopolysaccharase are injected into the peritoneal cavity of rat, peptic ulcer occurs most frequently. 5) When rat is treated with serotonine and under goes stress of confinement, multiple peptic ulcers occur with disappearance of the mucous layers and with activation of lysosomal enzymes corresponding to the lesion, where there are marked changes in microcirculation around the muscularis mucosae. Therefore, these findings suggest that destruction of the mucous layers is one of the important factors on pathogenesis of peptic ulcer.
Relative large amount of blood must be drawn to observe kinetics of sulfobromophthalein in liver according to the conventional colorimetric procedures. It might be inadequate to get correct informations about the dye metabolism in a small experimental animal because of excessive blood loss in these procedures. Therefore, new micro-sampling method for dynamic study of 131I-BSP in a rat is divised and this does not show any serious affects on its physiological conditions. After injecting 0.025mg/0.5ml of 131I-BSP into rat tail vein, more than 10 blood samples of 0.07ml each are able to be sequentially collected with microhematocrit tubes. Mean T1/2, blood disappearance rate and blood retention rate in 10 normal control rats are 1.16min., 0.606, 0.69% in 40min., on the contrary, these values in 7 CC4-administered rats are 1.90min., 0.383, 1.46% respectively. This new method seemed to be quite valuable for study of excretion mechanismus of 131I-BSP in a small experimental animal.
The purpose of this study is to compare cytological findings of nucleus of atypical epitheliae of elevated lesions of stomach with that of elevated, well differentiated early gastric cancer. The two groups of 62 cases with atypical epitheliae and 20 cases with well differentiated early gastric cancer of the elevated type were studied. Cytological materials were obtained by direct biopsy method, and cytological slides were prepared by both crushing and rolling-on methods with Papanicolaou staining, and observed microscopically under 1000X magnification. The cytological characteristics of the nucleus are classified into six groups, i, e, size of the nucleus, chromo-center, distribution of chromocenter in the nucleus, nuclear rimbs, nuclear clear area, and color density, of which features were comparatuiely analyzed in the two groups. It may be concluded that differential diagnosis by the intranuclear findings between atypical epitheliae of the elevated lesions in the stomach and cancer cells of the elevated type of the early gastric cancer could be made in the majority of the cases studied.
Macacus rhesus hemagglutination, Australia antigen and Australia antibody were tested in 36 cases with acute hepatitis and 15 cases with chronic hepatitis, and the correlation between Macacus rhesus hemagglutination and Australia antigen and Australia antibody in hepatitis was evaluated. The following results were obtained. 1) The positive per-centage for the Macacus rhesus hemagglutination test was higher in patients of acute hepatitis without Australia antigen or without Australia antibody than in those with Australia antigen or with Australia antibody. 2) The percentage of the chronicity of acute hepatitis was less in patients who have positive Macacus rhesus hemagglutination and negative Australia antigen or negative Australia antibody than in patients who have negative Macacus rehsus hemagglutination and positive Australia antigen or positive Australia antibody. 3) Australia antigen and Australia antibody were positive in most cases with chronic hepatitis without acute episode, but the Macacus rhesus hemagglutination test was negative. 4) It is thought that the Macacus rhesus hemagglutination is closely correlated with patients of hepatitis who have no relation to Australia antigen or Australia antibody.
A case of Crohn's disease of the colon complicating adenocarcinoma of the coecum was presented. As far as we know, there was no such report except a case presentation of Crohn's disease of the colon complicating carcinoma in Japan. Some discussions of the relationship between Crohn's disease of the colon and carcinoma from previous world literatures were added.