Studies on enzymological and immunological properties of alkaline phosphatase (ALP) in intestinal metaplasia (I-M) of the stomach were carried out. Biopsy specimens and surgical materials of gastro-intestinal tract were used, and ALP was eluted by Morton's method. The following results were obtained: 1) I-M ALP was identical with that of intestinal and colonic mucosa by polyacrylamidegel disc electrophoresis. 2) Its enzymological properties such as (a) sensitivity to L-phenylalanine and imidazole, (b) heat-stability at 56°C and 65°C, (c) Km value and (d) sensitivity to neuraminidase, (e) histochemical staining, were similar to those of intestinal ALP. 3) By double immunodiffusion technique I-M ALP and intestinal ALP showed a single precipitation line against human anti-intestinal ALP antibody, and their lines fused with one another. 4) By polyacrylamide-gel disc electrophoresis, active band of I-M ALP disappeared after treatment with anti-human intestinal ALP antibody. 5) By radioimmunoassay of I-MALP in intestinal ALP assay system, using double antibody technique I-M ALP showed dose response curve to purified human intestinal ALP. 6) By indirect immunofluorescence technique against human intestinal ALP, brush borders of the epithelial cells of intestinal metaplaisia exibited the intense fluorescence.
Biopsy liver specimens from healthy control subjects (N=5) and patients with various liver diseases (N=43) were investigated by in vitro autoradiography. The Leevy technique of adding 3H-5-uridine (3H-U) to the incubation medium was used. In healthy subjects labeling with 3H-U was observed mostly in hepatocytes and Kupffer cells and the frequency of 3H-U labeled cells was extremely high. In acute hepatitis, high frequencies of labeled fibrocytes and endothelial cells of the blood vessel were found compared to control subjects. In the active form of chronic hepatitis, significantly higher counts of labeled fibrocytes, ductular cells and lymphocytes were found. In patients with acute hepatitis or the inactive form of chronic hepatitis, only a few labeled lymphocytes were observed. Labeled fibrocytes were found in large numbers in patients with chronic hepatitis with sublobular hepatic necrosis, as compared to patients with the active form of chronic hepatitis. In cirrhotic livers, marked increases of labeled ductular cells, fibrocytes and bile duct cells were found. No significant labeling differences were observed in hepatocytes of various liver diseases. In chronic hepatitis with sublobular hepatic necrosis, a significant decrease of labeled Kupffer cells was present compared with the inactive form of chronic hepatitis. Labeled ductular cells and fibrocytes increased as the disease progressed from acute hepatitis to liver cirrhosis. The labeling index of rosettes cells was intermediate between the hepatocytes and ductular cells. The ratio of labeled parenchymal to non-parenchymal cells decreased proportionally from chronic hepatitis to cirrhosis.
Light-microscopic and electron-microscopic observations of the pancreas and parotid gland obtained from the rats were performed in total of 110 rats examined at various periods after bilateral ligation of the parotid gland ducts. The following results have been obtained. 1. With the light-microscopy, the parotid gland became atrophic immediately after ligation. In the pancreas, an atypical arrangement of the acinar cells as well as a slight hypertrophy of the islets of Langerhans was observed at 4 days to two weeks following ligation. 2. Electron-microscopically, in the pancreatic acinar cells the dilatation of the granular endoplasmic reticulum irregularities of the nuclear border and increase of heterochromatin were noticed at 48 hours to 5 weeks following ligation. In the islets of Langerhand, there were observed such changes as a decrease in electron density, swelling of the granules and disintegration and fusion of limiting membranes of granules in the beta cells at 4 days to 5 weeks after ligation. It was speculated that an impairment of the parotid glands influenced on the pancreas to a certain degree.
Gastric motor activity was monitered by means of extraluminal force transducers by strain gauge in conscious dogs. Extraluminal force transducers were sutured onto the serosal surface of the gastric body and the antrum. We observed a diurnal rhythm of gastric motility and this rhythm was divided into the fed state and the fasting state including the basal pattern and the hunger contraction. Our purpose was to determine to the effect of various gastrointestinal hormones on gastric motility during these phases. The intravenous infusion of pentagastrin or CCK-PZ stimulated the gastric antral motility during the fed state and the basal pattern, but inhibited the hunger contraction. The administration secretin, glucagon or synthetic V.I.P. inhibited the antral motor function in the fed state, but had no effect during the condition of typical hunger contraction and the basal pattern. The response of synthetic motilin in the fasting state was similar to the naturally occuring hunger contraction. These results indicates that the effect of gastrointestinal hormones on gastric motility is remarkably different in the fed and the fasting states, and the mechanism of gastric motility are completely different in the fed and fasting state.
The development of sensitive techniques for determination of serum α-fetoprotein (S- AFP) concentration, such as radioimmunoassay (RIA), enable us to detect hepatocellular carcinoma (HCC) in an early stage. This communication describes the clinical significance of S-AFP determination by RIA in the diagnosis of HCC. The sensitivity of the AFP assay with α-Feto-125 kit produced by the Dainabot RI laboratories was over 2.5ng/ml. Reproducivility of the kit was satisfactory; coefficients of variation showed 6-10% in within assays and 13% in between assays. The mean value and standard deviation of S-AFP in the sera of 30 cases of healthy controls was 5.6±2.6ng/ml, respectively. When the serum with a high level of S-AFP (2.9×105ng/ml) was diluted with normal horse serum, the actual concentration of AFP in the diluted serum were consistent with those determined. Thus, normal horse serum was employed to dilute the sera with high levels of AFP. Levels of S-AFP were over 2000ng/ml in 75.5% of 49 cases with HCC, in 0.64% of 157 patients with hepatitis and cirrhosis of the liver, and 3.8% of 52 cases of metastatic gastric cancer to the liver. In 20 patients with HCC, levels of S-AFP ranged widely from 7.5 to 9.5×105ng/ml. In serial determination of S-AFP in the clinical course of patients such as those with S-AFP over 2000ng/ml, the continuous increase of AFP was strongly suggestive of the presence of HCC. In 4 cases of 20 cases of HCC, S-AFP levels remained under 300ng/ml. Histological examination these 4 cases with HCC showed only Classes I and II, and no III in Edmondson's classification. Other cases of HCC with S-AFP levels over 300ng/ml showed Edmondson's Classes II and III.
A synthetic protease inhibitor, ethyl-P-(6-guanidino hexanoyloxy) benzoate methanesulfonate (FOY), and chlorophyll-a have been proposed recently as potential therapeutic agents for acute pancreatitis. To define the mechanisms involved, serum alpha1-antitrypsin, alpha2-macroglobulin and amylase were determined before and after the administration of these agents in humans. Serum alpha1-antitrypsin and alpha2-macroglobulin levels assayed by single radial immunodiffusion were significantly increased by intravenous injections of 100mg FOY in normal control subjects. Daily intravenous infusions of 200mg FOY for 12 days were effective in the treatment of acute pancreatitis, causing 29% increase in serum alpha1-antitrypsin and a marked reduction in urinary isoamylase of pancreatic type as well as in serum γ-glutamyl transpeptidase. In patients with chronic pancreatitis, oral administrations of 1800mg FOY per day for 2 weeks had little effects on serum alpha1-antitrypsin, alpha2-macroglobulin and hourly rate of urinary amylase excretion. No significant correlation was demonstrated between serum alpha1-antitrypsin and alpha2-macroglobulin levels. Intravenous injections of 20mg chlorophyll-a had no effects on serum alpha1-antitrypsin and alpha2-macroglobulin levels in control subjects. These results indicate that the mechanisms of action of the two agents are different.
The advantage and safety of emergency endoscopy have been already reported with so many successful cases. It is said that the influence of upper gastrointestinal endoscopy on the cardiovascular system is only transient and of not serious nature. We, however, think it necessary to publish the present report, since in the present case we have encountered a case where myocardial infarction was caused incidentally at the time of emergency endoscopy. The patient was an old man at the age of 67, and admitted to the Department of Gastroenterology, Akashi Muntipal Hospital, on January 13, 1975, 11:00 am., owing to tarry stool and severe anemia (Ht. 18%). The patient had been suffering from rheumatoid arthritis since 14 years ago, but did not receive the medication of adrenocortical hormone before the hospitalization. Hypertention was diagnosed with him 4 years ago, and since half a year ago, he also suffered from slight breast pains, though did not receive then any particular treatment. Four days prior to the admittance to the hospital, he began to feel dull pain at the epigastrium when he was hungry. The blood pressure was 110/70mmHg and the pulse, 100/min. in the initial inspection after hospitalization, but the pressure was recovered to 150/88mmHg at 3:20 pm. on the same day after saline and blood transfusion. There fore the emergency endoscopy was started 10 minutes later. Immediately after the commencement of endoscopy, the patient began to feel chest pains of non-specific anginous nature, and the examination was obliged to be suspend therefore without succeeding to find out the source of bleeding. The pain lasted for another two days, and ECG taken 24 hours after the endoscopy showed the sign of acute anteroseptal infarction with high values of WBC, ESR, SGOT and LDH. As of 2nd day of treatment, the patient began to have fever, and observing from the frequency of breast pains, changes of various measured values as well as the wave type of ECG, it was presumed that myocardial infarction had been caused incidentally during the course of endoscopy.