The First Department of Internal Medicine, Okayama University Medical School Changes of the lysozyme activities of acute CCl4intoxicated rat or mouse liver and the effects of lysozyme on the injured liver tissues were studied in order to investigate the role of lysozyme in the injured liver tissues. Lysozyme administered group showed less necrosis in the liver, slight elevation of lysozyme in the serum and liver compared to the non administered group. There was no difference of tissue lysozyme activity between the lysozyme treated rat and non treated rat after the CCl4administration.125I-labeled lysozyme was collect in the degenerated cells of CCl4intoxicated mouse liver in the central area. But there was no collection in the control cases. Thus, the lysozyme in the tissue were important for the prevention of necrosis of the cells and clearing the necrotic tissues.
To study on growth behavior and biological characteristics of human stomach carcinomas were heterotransplanted into nude mice. Tumors used by this study were taken by operation and histological types of tumors were classified according to the General Rules For Gastric Cancer Study In Surgery And Pathology. Twenty two out of fifty six tumor pieces of the human stomach carcinomas grown in the subcutaneous space of nude mice were observed. Transplantability of each histological types of tumors as following: 0 out of 2 in well differentiated adenocarcinoma (tub1); 7 out of 8 in moderately differentiated adenocarcinoma (tub2); 8 out of 8 in papillary adenocarcinoma (pap); 3 out of 28 in poorly differentiated adenocarcinoma (por); 4 out of 6 in mucinous adenocarcinoma (muc); 0 out of 2 in signet ring cell carcinoma (sig); 0 out of 2 in adenomatous polyp which were 2 cm in diameter. Tumor growth was divided into rapid, slow, and persistent types. Furthermore, tumor growth became rapidly by serial transfer. Original histology of tumors basically was not changed in nude mice. Results are still primitve, and further study on the accumurated cases are requined.
Using CIS gastrin radioimmunoassay kit, serum gastrin levels in response to feeding were measured in 50 preoperative patients with gastroduodenal diseases, 8 normal subjects, and 48 postoperative cases. 1) Serum gastrin levels in patients with peptic ulcer were significantly higher than the levels of the normal subjects in 7 minutes after feeding. But, as the fasting or postprandial serum gastrin levels in patients with gastric ulcer were compared in accordance with the location of the lesions, the lesions locating in the parietal cell area tended to show higher gastrin levels than those in the antral area. The serum gastrin levels in patients with gastric cancer showed the same tendency as the patients with gastric ulcer. In case of comparison of the serum gastrin levels in various gastric lesions, the location of the lesions has to be the primary consideration. 2) After selective proximal vagotomy in patients with duodenal ulcer, the fasting or postprandial serum gastrin levels were significantly higher than the preoperative levels. Selective proximal vagotomy augmented the gastrin response to feeding. It will be assumed that this result was in consequence of reduced acid secretion after selective proximal vagotomy. 3) After selective vagotomy and antrectomy in patients with gastric ulcer, the fasting or food-stimulated serum gastrin levels were significantly lower than the preoperative levels. Nevertheless, after total gastrectomy and jejunal interposition in patients with gastric cancer, the serum gastrin levels were increased in response to feeding. From these results, both the antral and duodenal gastrin might be considered to respond to feeding.
Radiation proctitis, which is commonly resulted from radiation therapy for malignancies of the pelvic organs, is one of the most remarkable iatrogenic diseases, because of its high frequencies. Seventeen cases who have had radium or roentgen rays therapy were examined endoscopically and their endoscopic findings were classified into three categories; acute phase, chronic-active phase and inactive phase. Chronic-active phase is classified into five subgroup (IV, III, II, Ib and Ia) and inactive phase, into two subgroup (Ob and Oa) according to their severity of the mucosal inflammation. Degree of anal bleeding correlated to endoscopic classification, however, few cases complained severe anal bleeding inspite of their slight endoscopic mucosal appearance. There were recognized no significant correlations between endoscopic findings and clinical features such as irradiation doses, healing time and so on. By using dye spraying method in 13 patients with radiation proctitis, minute mucosal appearances which were classified into four categories (Grade III-0) were more easily and clearly recognized, giving better informations for the extent of the lesions and the degree of the mucosal inflammation.
Thirty patients with alcoholic hepatitis and 18 heavy drinkers with liver disease have been compared with regard to clinical and pathologic obseivations. HBs antigen was negative in all cases with alcoholic hepatitis and 11 of 18 heavy drinkers with liver disease, but was positive in 7. Liver biopsies were performed during 4 weeks of the admission in all present cases. Thirty cases satisfied the criteria for alcoholic hepatitis on the basis of liver cell necroses, neutrophilic leukocyte infiltration, centrolobular fibrosis and the presence of alcoholic hyaline. The characteristic histological abnormalities were improved during 3 months of a withdrawal cure from alcohol. Although the diagnosis of alcoholic hepatitis should be suspected in a history of repeated attacks evoked by drinking, it is not possible to distinguish alcoholic hepatitis from viral hepatitis on the basis of clinical and laboratory data. Attention is focused on the diagnostic specificity of the liver biopsy at early stage from abstinence.
The extrahepatic obstructive jaundice caused by neoplastic diseases with different primary site were studied on autopsy cases of National Cancer Center Hospital from May, 1962, to December, 1968. Among 1806 cases of neoplastic diseases, the extrahepatic biliary tract obstruction was observed in 147 cases (8.2%). These cases were divided following 3 groups, obstruction due to primary tumor (46 cases), metastatic tumor (97 cases), and malignant lymphoma (4 cases). The patients with jaundice as one of initial symptoms were limited to the cancer of extrahepatic biliary tracts, Papilla Vateri, gallbladder and pancreas. And in some patients with gastric cancer, jaundice was a first sign of recurrence after gastrectomy. The gastric cancer was the most frequent cause of malignant jaundice in our series. The interesting cases were observed in cancer of liver, lung, and breast. The causes of jaundice in these cases were tumor thrombus in common bile duct of liver cancer, hematogenic metastases to the pancreas of anaplastic small cell cancer of the lung, and secondary metastases to portal lymph nodes from liver metastases of breast cancer.
The mortality of hepatoma and liver cirrhosis has been known highest in Nagasaki prefecture throughout the country. In an attempt to investigate the pathogenesis of these diseases, we began to examine peoples aged beyond 30 years residing in Tomie town, Goto Island, where the mortality is higher than any other places in Nagasaki prefecture. Among 917 patients who has no complaint on selected for study at random, 180 patients (19.6%) had enlarged liver and 200 patients (21.8%) showed abnormal liver function tests. Patients with these abnormalities tended to be found among the peoples residing in fishing villages compared with those in farm villages in this town. The liver biopsy study was done in 80 of them, and demonstrated 6 patients with cirrhosis, 10 chronic hepatitis, 40 hepatic fibrosis, 6 fatty liver, 6 cholangitis, 5 nonspecific reactive hepatitis, and 7 miscelleneous liver disorders. Fibrosis was unvailed by the biopsy study even in patients whose livers were enlarged with minimum changes of function tests. In terms of histological findings, patients with fibrosis consist of 14 with viral hepatitis, 5 with alcholic and 21 with undetermined cause. Higher than normal values of plasma tyrosine, phenylalanine and methionine were found even in subclinical cases including hepatic fibrosis.
A boy was admitted to the hospital with complaint of epigastric pain. On medication of antacid, he become well. The diagnosis of macroamylasemia was induced by the persistence of high serum amylase level due to remarkable low amylase clearance. The molecular size of this macroamylase was shown as approximate 7S level by means with Sephadex G150 Superfine thin layer chromatography and with concentrative procedure adding dry Sephadex G75 grain to serun. The abnormal amylase was specifically precipitated with anti-human IgA rabbit antiserum. This might be the first reported case of the first decade of macroamylasemia.
Cystic dilatation of the common bile duct is rare in adult. Two cases of this lesion have been studied recently. One was a 19 aged female with acute obstructive suppurative cholangitis and another was a 24 aged female with chronic pancreatitis. The pressure and X-ray study of the biliary tract revealed long narrow distal segment in both cases. Under the control of the operative radiomanometry, transduodenal sphincteroplasty was performed for them. The patients were not eventful after the operations. These clinical features were presented in details.