Behind a wall of mordern sanitation, it's believed that the parasitic diseases became very rare in Japan. But in spite of decreasing the parasitismus of Nematodes, the patients harbouring cestodes became to increase. This paper described the clinical picture of the human taeniasis (Taenia saginata), the roentgenographic signs produced by taenia saginata and an investigation of the host- parasitic relationships. In Okayama District, recent yearly rate of cattle, containing viable cystocercus bovis was 0.1 to 0.2%. Since 1955 to. 1971 in Chugoku District of Japan, 50 patients with Taenia saginata aged 3 to 70 years were studied. Most infections were asymptomatic (48%) and 52% of the patients were symptomatic. The symptomatic patients complain the abdominal pain (16%), anal discomfort and itching (10%), decreased appetit (8%) and malaise (8%) (Table 5). In the patients within the 4 months after infection of the beef tapeworm, over 10% eosinophilia were found in the peripheral blood. But in the patients, over 5 months after infection of the beef tapeworm, the authors could not be recognized the eosinophilia of the peripheral blood. (Fig. 1) Since X-ray demonstration of the scolex of Taenia saginata was rare, the authors demonstrated the scolex and the neck portion of tapeworm on roentgenograms in the 3 to 5cm anal side of the duodenojejunal angle, correctly (Fig. 3). In all cases, the adult proglottide of the tapeworm could be visualized clearly on contrast roentgenograms of the small bowel and appears as a long, taperring radiolucency (Fig. 2, 5.).
This paper described the epidemiology and the clinical picture of the broad tapeworm in Chugoku District of Japan. Geographically, the broad tapeworm was common in Hokkaido and the Northan part of Honshiuu. Before 1959, there was no report of the broad tapeworm infection in Chugoku District. In 1960, 2 cases of the broad tapeworm infections have been reported by the authors. Since 1960, 14 cases have been reported by the authors. 9 cases out of 14 cases were infected in Chugoku District and foci of infection are presented along the River Yoshii, Takahashi, Chiyo, and Saijoyo District. The infections were acquired by eating raw or slightly salted trouts from these Rivers, a custom which have been widespread among the Japanese. Most of the infections are asymptomatic. The complaints associated with the tapeworm are diarrhoea, soft stool (29%), general malaise (14%) and loss of weight (14%). In one of them, hyperchromic anemia is found with 14 cases of the tapeworm infestations. The eosinophilia of peripheral blood can not be found in any patients. The adult proglottide of the broad tapeworm could not be visualized on contrast roentgenograms of the small bowel. As a result of correct analysis of the personal history, the larvae of the broad tapeworm develop to maturity in the intestine about 20 days after the trout was ingested by man.
In spite of a number of reports on the side effect of aspidium, it's misbelieved generally that most reliable and effective drug for the expulsion of tapeworms is aspidium. But the treatment of tapeworm by aspidium is empirical, often inefficient, not uncommonly dangerous and toxic to the host. Since 16 years, the authors tried the various anthelminthics and the physical expulsive method on 50 patients harbouring Taenia saginata and 13 patients harbouring Diphyllobothrium latum (Table 4, 5). As a result of the treatments, niclosamide is most effective and safety in elminating large tapeworms from the the human intestinal tract. But niclosamide should not be used in Taenia solium infections because of the increased risk of cystocercosis. Damaso De Rivas reported in 1932 the physical expulsive method of intestinal parasitism and in this report, he applied a transduodenal irrigation with hot physiological salt solution at a temperature in the duodenum of between 45°to 47°C. But according to the authors' animal experiments, the authors may infer that this hot physiological salt solution is injurious to the rat duodenal mucosa (Fig. 2, 3, 4, 5, ). The authors modified this method and applied the hot pysiological salt solution at a temperature in the duodenum of 42°C. The authors tried this modified method of Damaso De Rivas on 5 patients with beef tapeworm and 2 patients with broad tapeworm and all cases discharged a long stroblia with scolex after the transduodenal irrigation. This modified physical expulsive method, when properly applied, has been proven to be effective and free from toxic side effects and secondary complications. (Table 6).
Several ulcerogenic factors were tried to rats and the vascular changes of the microcirculation of the stomach were observed superficially and from the lateral side untill the ulcerformation started. 1) In the serotonin administered rats, it was observed that the collecting venules constricted in the middle to deeper layer of the mucosa and superficial capillaries dilated secondarily and then ulcerformation occurred. 2) In the reserpine treated rats, two types of change appeared; i) the quite same process to that of the serotonin received rats and ii) influence of gastric juice, that is, the histological defect from superficial side, was added to that process 4 hours after injection. 3) In the HCl intragastrically perfused rats, extensive superficial capillary dilatation was observed and then hemorrhage and ulcerformation followed. 4) In the gastrin treated rats, it was observed that the mucosal vascular changes occurred secondarily as a result of the hypersecretion of the gastric juice and then the ulcer was formed. 5) In the restraint rats, the severe constriction of the terminal arterioles and the capillary enlargement of the peripheral portion were observed in the anterior and posterior wall of the fundic area and then hemorrhage and ulcerformation occurred.
Four kinds of Drip Infusion Cholangiography (DIC) were performed to the patients of hepatobiliary diseases. By DIC-A method the detection rate of gallstone was 57% of cases. In non-visualized cases DIC-B or -D were performed and the detection rate increased to 77%. There were two groups in non-visualized cases of gallbladder and bile duct by DIC-A. One group included cases with ICG excretory defect, mainly with gallstone, and this group was visualized by DIC-B or -D. Another group included cases with ICG uptake defect, mainly hepatocellular disorders and these cases were visualized by DIC-C. These results were analyzed by observations of 131I-labelled iodipamide administration. The elevation of serum transaminase after DIC was observed in several cases and it was temporary. From these results it was concluded that DIC was useful in clinical medicine to diagnose diseases of biliary tract and each method should be preferred by analysis of ICG disappearance curve.