Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 72, Issue 4
Displaying 1-8 of 8 articles from this issue
  • Nobuo YOSHIBA, Hiroshi SUTO
    1975 Volume 72 Issue 4 Pages 339-354
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The present study was undertaken to investigate the mechanism of the regeneration of the gastric ulcer.
    I. Autoradiographs of the experimental gastric erosion.
    Rats and rabbits were used. The erosive lesions which consisted of only the differentiated glandular cells were obtained by stripping surgically the half zone of the upper side of the gastric mucosa (fundic area). The erosive lesions were examined by using 3H-thymidine-autoradiographic techniques. Two days after the experimental erosion, the glandular cells were labeled with 3H-thymidine, suggesting a change of the differentiated cells into the proliferative cells. Seven days later, the foveolar epitheliums became visible in the erosive lesions. The foveolar epitheliums seemed to be regenerated from the differentiated cells.
    II. Autoradiographs of the experimental gastric ulcer.
    Rats were used. A circular piece of the mucosa 5mm in diameter was removed from fundic raea of the stomach. The parts of these ulcerative lesions were examined by the autoradiograph with 3H-thymidine. Two days later, the glandular cells in the bottom of glands around the margin of the defect were labeled with 3H-thymidine. Three days later, newly generated glandular canals, in which these glandular cells were distinctly labeled, appeared in the bottom of the glands around the margin of the defect. Five days after the ulcer, these new canals were gradually spreaded into the bottom of the gastric ulcer.
    III. Serial histologic sections of the experimental gastric ulcer.
    Rats were used. A circular piece of the mucosa 5mm in diameter was removed from fundic area of the stomach. Then serial sections of the lesions were histologically examined (H-E staining). Five days later, the new glandular canals appeared in the region of the bottom of the glands around the margin of the ulcer. These canals were related to neither the superficial regenerative epitheliums nor the neck region of the glands around the margin of the ulcer, suggesting that the new canals were generated from the bottom of the glands around the margin of the mucosa.
    These findings suggest that the regeneration of the gastric ulcer does not only occur in the epitheliums and the undifferentiated cells on the neck region of the glands but also does in the differentiated glandular cells at the bottom of the glands.
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  • II. Protein-Losing Gastroenteropathy
    Motoharu KONDO, Kazuo NAKANISHI, Hironobu TANAKA, Tadao BAMBA, Keimei ...
    1975 Volume 72 Issue 4 Pages 355-364
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Previously, the authors have reported from the experiences of three cases of protein-losing gastroenteropathy, that the fibrinolytic activity in the digestive tract, mainly tissue activator of plasminogen, plays an important role in the pathogenesis of excessive enteric loss of protein. This is a report of experimental protein-losing gastroenteropathy in which the participation of tissue fibrinolysis on the increase of permeability of mucous membrane to plasma protein is examined.
    1) Activators of plasminogen, either streptokinase or rokinase, was found to produceexperimental protein-losing gastroenteropathy in rats, indicating the activation of fibrinolyticsystem have participated in the increase of mucosal permeability.
    2) Whole body irradiation has already been known to produce protein-losing gastro-enteropathy in experimental animals. Tissue fibrinolysis in the small intestine of irradiatedmice was found to increase after 24 to 48 hours of irradiation, and decrease after 72 hours. Similarity of the pattern of the increase in tissue fibrinolysis with that of fecal excretion of 131I-PVP in the irradiated rats, as well as the reduction of fecal excretion of 131I-PVP by the useof t-AMCHA, a specific inhibitor of fibrinolysis, strongly indicated the correlation of tissuefibrinolysis with enteric loss of plasma protein.
    3) In experimental protein-losing gastroenteropathy produced by the use of 5-fluorouracil (5FU), the increase of tisseue fibrinolysis in the digestive tract of rats was demonstratedto parallel with the increase of 131I-PVP fecal excretion, and further t-AMCHA waseffective to prevent the clearance of 131I-PVP, also supported our new concept.
    4) Ligature of thoracic duct has been reported to produce protein-losing gastro-enteropathy. The evidence that the ligature of rat thoracic duct did not affect the tissuefibrinolysis suggested the mechanism of enteric loss of protein produced by the increase oflymphatic pressure is different from that shown before.
    Tissue fibrinolysis in the digestive tract, whether it is increased primarily or secondary tothe underlying disorders, is thus proved to increase the permeability of mucous membraneof digestive tract and enhance the enteric loss of plasma protein when the increase is occuredin wide range. It seems reasonable to classify the protein-losing gastroenteropathy accompaniedby the increase of lymphatic pressure in the different category.
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  • Part I Clinicopathological Classification of Congenital Cystic Dilatation of the Common Bile Duct
    Yoshiro MATSUMOTO, Kotaro UCHIDA, Akira NAKASE, Ichio HONJO
    1975 Volume 72 Issue 4 Pages 365-375
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Forty-six patients with congenital dilatation of the common bile duct were studied. As the typical form of this disease, a succular dilatation of the common bile duct and narrowing of the terminal bile duct below the dilatation were seen and the microscopic findings of thedilated wall showed the absence of the subserous muscle layer.
    Cystic dilatations (Alonso-Lej's Type I) were most common. We classified congenital cystic dilatation (Alonso-Lej's Type I) into two subtypes, infant type and adult type, on the basis of morphological and clinical findings.
    The patients, whose common bile duct and/or common hepatic duct were affected by the enlargement, had the typical cyst combined with the remarkable narrow segment of terminal bile duct. These were encountered in children. On the other hand, the patients whose whole extrahepatic bile duct and/or the main branches of intrahepatic bile duct were affected, had the fusiform cyst or cylindrical cyst, and most of them had floating stones in the cyst. These were most common in adults. It is reasonable that the formers are called"infant type"and the latters are"adult type".
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  • Part II Choledocholithiasis Related to Congenital Cystic Dilatation of the Common Bile Duct
    Yoshiro MATSUMOTO, Kotaro UCHIDA, Akira NAKASE, Ichio HONJO, Sadao KAS ...
    1975 Volume 72 Issue 4 Pages 376-384
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Sixty-seven patients with the adult type of congenital cystic dilatation of the common bile duct (Alonso-Lej's Type I) were studied. Fifty-seven of them had gallstones, which were found in about half of patients below 30 years old and in most of those over 30. Gallstones were found almost in common bile duct and/or intrahepatic bile duct. We knew that congenital cystic dilatation of the common bile duct was closely related to the formation of primary choledochus stone.
    On the surgical treatment of choledocholithiasis due to this disease, cholecystectomy, choledocholithotomy and choledochocysto jejunostomy with Roux-en-Y anastomosis or choledochocystoduodenostomy were most effective for this malady in our studies.
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  • Hideo SEKI, Yutaro TAKAMURA, Tomoyuki KONO, Akio KAMIYO, Tetsuo MURAI
    1975 Volume 72 Issue 4 Pages 385-391
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Hidemi YAMAUCHI, Kenji KOYAMA, Yasushi MATSUO, Seiichi KASHIMURA, Yasu ...
    1975 Volume 72 Issue 4 Pages 392-406
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Ligation and section of the common bile duct in the Wistar rat was made. Liver biopsies were done weekly for 7 weeks. Light and electron microscopical specimens were prepared for the morphometric studies.
    The volume ratio of the hepatic parenchyma declined proportionally to the duration after bile duct ligation, however, such findings as presence of dividing cells, increase in the mean sectional area of the nucleus and unchanged estimated weight of the hepatic parenchyma throughout the biliary obstruction suggest that decreased hepatocytes were covered by their regeneration.
    Mitochondrial swelling and curling of the cristae was noted in biliary obstruction in general. Moreover, both the number and volume ratio of the mitochondria were increased corresponding to the duration. These changes may be adaptive phenomena for their dysfunction.
    Dilation and hyperplasia of the smooth endoplasmic reticulum was observed in most of the rat livers in biliary obstruction.
    Number of the lysosomes was increased as the duration prolonged, however, declined after 6 weeks.
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  • Masatoshi UEDA, Makoto FUJII, Yukimasa NAKASHIMA, Hiroaki HIRATA, Jish ...
    1975 Volume 72 Issue 4 Pages 407-413
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Two patients with persistent hyperamylasemia are described. Case 1 is a 18-year-old female who had repeated hospitalization with a chief complaint of abdominal pain and whose serum amylase level remained abnormally high over four years' period. Macroamylasemia screening test by Sephadex G-100 microcolumn disclosed the existence of amylase of large molecular size (macroamylasemia) in her serum. Case 2 is a 79-year-old female with pronounced hyperamylasemia and hyperamylasemia, associated with metastatic carcinoma of the lung. The metastatic liver nodule contained a pronounced degree of amylase activity which exceeded that in the serum. Ion exchange chromatography further revealed that the mobility pattern of the amylase in the serum and tumor tissue of the patient resembled salivary amylase. Those observations indicate that amylase may be produced ectopically in tumor cells.
    It is of great value to use Sephadex G-100 microcolumn as well as DEAE-Sephadex A-50 ion exchanger in evaluating persistent hyperamylasemia of unknown origin.
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  • Masataka MARUYAMA, Chiaki OTSUBO, Michio TANAKA, Itaru OI, Mutsuo UECH ...
    1975 Volume 72 Issue 4 Pages 414-427
    Published: 1975
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    475 patients were examined through forward-viewing fiberscope by single examiner from November 1971 to February 1974. In 130 cases of these patients, we could find some changes other than duodenal ulcer or its scar in their duodenal bulb endoscopically, such as diffuse hyperemia, dotted redness, so-called salami appearance, erosions, irregularity of villi, appearance of blood vessels or liver area and small elevations or depressions with various sizes and figures. We are not sure whether all of these endoscopic findings would indicate the inflammatory changes of the duodenal mucosa or reversely, whether the duodenal mucosa might be normal in the cases without these endoscopic findings.
    Among these endoscopically detectable changes, diffuse hyperemia, dotted redness, salami appearance and some type of villous irregularities corresponded histopathologically to cell infiltration, extravasation of red cells, hyperemia or congestion of small vessels, and/or erosions of the mucosa. These findings indicated the superficial duodenitis from the reason that these changes were mainly observed in the villous layer although it was difficult to estimate from small biopsy particles whether these changes were limited only in the villous layer or invaded into deeper interstitial layer. There were some evidences to suggest some relationship between the superficial duodenitis and the superficial gastritis.
    On the other hand, visible blood vessels, appearance of liver area or villous atrophy might relate to the atrophic duodenitis. Unfortunately, frequency of typical atrophic duodenitis is extremely rare in Japan. Moreover, to clarify the relationship between these endoscopic findings and atrophic changes, histopathological study should be necessary, but in our experiences, endoscopic biopsy study was not contributive so far, because of the difficulty of estimation of atrophic changes by small biopsy particles.
    The other endoscopic findings might have the possibility to indicate traces of the superficial changes or relation to the atrophic duodenitis, but further investigations are necessary.
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