An investigation has been designed for the purpose of clarifying the gastric mucosal hemodynamics. The results of studies are summarized as follows: 1) There is a great difference in the mucosal blood flow between the corpus and antrum, and the difference was due to difference of vascular formation between both areas. 2) The gastric mucosal blood flow after noradrenaline injection was lesser than that before noradrenaline injection, and perinuclear vacuoles severely increased after noradrenaline injection. It is showed that the perinuclear vacuoles are one of the morphological substantiation for angiospasm. 3) The mucosal blood flow severely increased in the corpus by gastrin stimulation, but it did not elevate in the antrum even after a gastrin stimulation. The perinuclear vacuoles slightly decreased after gastrin injection. From this findings, it is suggested that gastrin could produce a slight vasodilatation. 4) Groups of 3 and 6 hours after injection of lanthanum carbonate revealed a significant decrease of gastric mucosal blood flow, and perinuclear vacuoles were markedly increased. Animals of 12 hours after injection revealed a slight increase of gastric mucosal blood flow, and perinuclear vacuoles became slowly decreased. 5) From these findings, it is stressed that using of the new method together with findings of perinuclear vacuoles is usuful for analysis of local blood flow of gastric mucosa. The experimental study showed both functional and morphological substantiation for gastric mucosal blood flow.
Phospholipase A activities were determined by means of modified thin layer chromatographic method. The exocrine secretory behavior of phospholipase A and its interrelation to various lipid compositions in duodenal juice with pancreozymin-secretin test were discussed. When the lipid composition of duodenal juice immediately after aspiration from the duodenal cavity using the pancreozymin-secretin test was compared with those of gallbladder bile, no significant change was observed in the level of neutral fat, cholesterol, total phospholipid, cephalin and sphingomyelin, while the free fatty acid and lysolecithin were increased, and lecithin was decreased. When duodenal juice was incubated at 37°C, total phospholipid, lecithin and free cholesterol decreased and increases in lysolecithin, free fatty acid and esterified cholesterol were observed. Phospholipase A which is secreted from the pancreas, changes the lecithin of the gallbladder bile into lysolecithin and free fatty acid, and this enzymatic reaction was activated in the presence of various bile salts, lysolecithin and albumin, but inhibited by adding neutral fat and free fatty acid. Phospholipase A showed a significant positive correlation to amylase in controls, the patients with chronic non-calcified pancreatitis and pancreatic calcification. The secretory patterns also showed similar trends. Compared to phospholipase A, amylase was more strongly disturbed in the patients with chronic pancreatitis.
The measurement of the activity of urine and serum amylase has been used clinically for almost fifty years. However it became to be known that serum and urine amylase levels may be influenced by conditions with or without pancreas. If we could separate the amylase in isozymes and identify the source of individual isozymes, the mesurement of the levels of amylase will be more reliable index of pancreatic involvement. Up to 8 isozymes were observed in urine using a simple thin layer polyacrylamide gel electrophoresis suitable for the analysis of amylase isozymes. On the basis of the results of electrophoretic mobility studies, these isozymes migrate similarly to salivary and pancreatic amylase isozyme. In patients with acute pancreatitis, increased amylase activities were observed on those of pancreatic origin. On the contrary, in patients with pancreatectomy, these isozymes disappeared from urine. In patients with mumps, amylase activities of salivary origin, which were observed in patients with pancreatectomy, increased. From these findings, it was concluded that amylase isozymes in human urine were of pancreatic and salivary origin. Two major bands and 2 to 4 minor bands were observed in urine of normal subjects. One of the major bands was pancreatic origin, the other was salivary origin. The amylase activity of isozyme of pancreatic origin was greater than that of salivary origin in all of the normal subjects. However, in patients with chronic pancreatitis, the amylase activity of pancreatic origin was less than that of salivary origin. Pedigree studies indicate that isozyme of Amy U-ls, which migrates slower than the Amy U-l of pancreatic origin, is under autosomal codominant genetic control.
Total lactate dehydrogenase (LDH) activity in serum from a 64 year-old patient with Oxyphenisatin-induced lupoid hepatitis was 653 W. U. The serum LDH isoenzyme pattern of this patient showed only a single component which was in the LDH-4, i.e. H1M3position. A hemolysate of washed red blood cells from this patient revealed normal LDH isoenzyme pattern. Further investigations showed that the abnormal serum LDH isoenzyme pattern resulted from formation of the macromolecular complex between all of the serum LDH-1, -2, -3, -4 and-5, and M-component (Immunoglobulin G of the kappa class). Papain-digestion of this M-component proved the LDH-binding capacity to reside only in the Fab fragment. Although a small number of antigen-binding homogeneous immunoglobillins produced by benign or malignant monoclonal disorders have been described, this is the first report of the presence of anti-LDH monoclonal autoantibody.
This is a report of a 43-year-old man with polyposis of the colon and the stomach, accompanied by advanced cancer of the rectum and early cancers of the rectum and the appendix. The patient was admitted to our hospital with chief complaints of diarrhea and anal bleeding. Barium enema examination of the large intestine showed multiple round filling defects which suggested polyposis of the colon. Gastrointestinal series showed polyposis of the stomach which was found more thickly in the lower portion of the stomach. The endoscopic examination of the large intestine revealed an advanced cancer with ulcer and bleeding (Borrmann, type II) on the rectum and numerous polyps on the large intestine. The endoscopic study of the stomach demonstrated multiple whitish yellow polyps on the lower portion of the stomah. He was operated on for rectal cancer with polyposis of the colon. Multiple polyps of the terminal ileum as well as numerous polyposis of the large intestine were found in the resected specimen. Histological examination showed one advanced carcinoma in the rectum, with its invasion to the serosa, one early carcinoma in the rectum and one early carcinoma in the appendix. Histological appearance of other polyposis showed typical adenomatous polyps. Benign lymphoid polyposis was seen in the terminal ileum. Gastric polyposis is histologically composed of adenomatous polyps with intestinal metaplasia.
An autopsy case of liver cirrhosis associated with generalized cytomegalic inclusion disease of 44-year-old male was reported. Although the patient had been treated for liver disease with jaundice 20 years before, any abnormality of liver function tests had not been pointed out. In March, 1971, he was admitted to our clinic because of ascites and general malaise. At that time liver cirrhosis was suspected according to his clinical sign and symptoms as well as liver function tests. Hematemesis developed abruptly on 7th hospital day and after that he-became severely ill with disturbed consciousness, anemia, ascites, edema and melena. On 50th hospital day, he died from mixed infection and gastrointestinal bleeding. HB-Ag was negative and examination for cytomegalovirus was not performed. At autopsy there was micronodular cirrhosis of the liver with intranuclear cytomegalic inclusions in hepatocytes. Cytomegalic inclusion bodies were found in lung, kidney, pancreas, stomach, intestine, heart and hypophysis.
Serum α-fetoprotein (AFP) was examined in 14 gastric cancers without hepatic metastasis and 12 gastric cancers with hepatic metastasis. AFP was detected by radioimmunoassay and immunodiffusion methods. Seven cases in 12 patients with gastric cancer with hepatic metastasis were AFP positive, but all of 14 gastric cancers without any metastasis were AFP negative. The AFP levels in 5 of the 7 patients were in the range of 23 to 320 ng per ml, and serum AFP was demonstrated by immunoelectrosyneresis (IES) in the other 2 patients. Histological examination was performed in all of the cases described above and 3 cases of AFP positive gastric cancers with and without hepatic metastasis, which were already reported in another paper. The histological features of AFP positive gastric cancers were more characteristic than those of AFP negative gastric cancers. Their histological features were adenocarcinomas and had some similarity with a trabecular type of hepatocellular carcinoma. AFP was detected by Ouchterlony method in the serum from a case of histologically confirmed gastric cancer without hepatic metastasis. In this case AFP was positive in the extract of gastric cancer tissue and in the metastatic foci of the lymphnodes but negative in the extract of the liver tissue. In another case of gastric cancer, AFP was detected in the serum by Ouchterlony method 2.5 months after gastrectomy and the AFP was increased with the development of the hepatic metastasis. It was suggested by these results that in the cases with AFP positive gastric cancer, AFP might be elevated with increase in the volume of the cancer and metastatic foci, and also the possibility existed that AFP level in the gastric cancer was higher in the cases with liver metastasis than in the cases with metastasis of other organs.