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Kazuhiro SASAMOTO
1977 Volume 74 Issue 9 Pages
1105-1120
Published: September 05, 1977
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In 74 cases of chronic pancreatitis, pancreozymin secretin test (PS test), amylase isoenzyme analysis and endoscopic retrograde pancreatography (ERP) were performed.
In mild cases of the disease, ERP findings were not always paralleled with secretory function, and serum amylase analysis following stimulation was found to be much more available.
Serum amylase evocative test combined with amylase isoenzyme analysis, however, tended to be positive: an increase in isoamylase activity of pancreatic origin was often noticed after pancreozymin and secretin stimulation.
In moderate to advanced cases of the disease, evocative test was negative in more than half of the cases.
In advanced cases, pancreatic isoamylase was markedly decreased, and abnormal ERP findings were observed.
For the diagnosis of the stage or severity of chronic pancreatitis, the analysis of isoamylases and the evocative test in addition to the analysis of duodenal juice should always be applied.
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Makoto OTSUKI, Hosai YUU, Choitsu SAKAMOTO, Kuniyasu OKANO, Mitsuo MAE ...
1977 Volume 74 Issue 9 Pages
1121-1126
Published: September 05, 1977
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Caerulein, the active decapeptide found in the skin of Australian amphibia Hyla caerulea posesses remarkable similarities in structure and bilogical activities to cholecystokinin-pancreozymin (CCK-PZ).
The present investigation was undertaken to explore the effects of caerulein on the rate of flow and amylase secretion, and insulin and glucagon secretion from the isolated and perfused rat pancreas.
1. Caerulein strongly stimulated both the rate of flow and amylase output.
2. Threshold dose for secretion volume was 0.01 ng/ml. The minimum dose which elicited the maximum secretion of the pancreatic juice and enzyme was 0.05 ng/ml.
3. Supramaximal stimulation with caerulein resulted in significantly decreased pancreatic juice and enzyme secretion. Inhibition of secretion with increasing supramaximal doses of caerulein was revealed.
4. Release of insulin and glucagon into the perfusate from pancreas were not observed by the doses which stimuated the rate of amylase output and flow of pancreatic juice, but they were elicited by only supramaximal dose of caerulein (10 ng/ml and 100 ng/ml).
5. Discrepancy of the effective dose of caerulein between on pancreatic exocrine and endocrine function was observed.
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Developement of our improved method
Ryuichi HONDA, Katsutoshi HIWATASHI, Zen ITCH, Takuji NAKAMURA
1977 Volume 74 Issue 9 Pages
1127-1135
Published: September 05, 1977
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From our study revaluating various types of chronic pancreatic fistula reported in the past, it is concluded that the method for construction of a duodenal pouch draining pancreatic juiced workes for a long period under a stable condition and provides physiological response in spite of partial denervation of the pancreas and contamination of the duodenal fluid in the pancreatic juice. It was found that major points for construction of chronic pancreatic fistula werc a placement of draining apparatus in the pouch and the duodenum and instillation of pancreatic juice into the duodenum. Based upon these observation, we developed our own method. In this procedure, pancreatic juice secreted into the duodenal pouch was induced to the outside of the body with a negative pressure at 25cmH
2O. The juice was detected by means of photo-switch and returned into the body through the duodenal fistula with a peristaltic pump. Since our method enables us to record continuously secretory changes of the pancreatic juice for a long period of time under physiological condition and ti was found that secretory response to secretin or CCK was similar to that reported by others, our improved method will be very useful for studies in exocrine pancreas.
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Shohei KOYAMA, Shoko SHIMIZU, Kiyoshi TOGAWA, Noritsugu UMEDA, Toshiak ...
1977 Volume 74 Issue 9 Pages
1136-1145
Published: September 05, 1977
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Hepatitis B surface antigen in liver tissues of 44 autopsy and 82 biopsy cases with various liver diseases was demonstrated in the cytoplasma of the hepatocytes by Shikata et al's orcein and aldehyde-fuchsin staining method. Furthermore, immunological response study was made by DNCB skin test, subpopulation of peripheral lymphocyte and serum immunoglobulin assay.
1) HBsAg in liver tissues was found in 26 of 44 (59.1 %) in autopsy cases and also observed in 16 of 82 (19.6%) in biopsy cases. Incidence of HBsAg with liver diseases was highly documented in subacute atrophy of the liver, liver cirrhosis and hepatocellular carcinoma. The result strongly suggests that HBsAg is not only the cause of the hepatitis, but is likely to be the cause of the development of liver cirrhosis and hepatocellular carcinoma.
2) Distribution pattern of HBsAg in the liver tissues was tentatively classified a three types, that is;
I. solitary type.
II. scattering type.
III. lobular type.
These patterns correlated well with the histological diagnosis of liver diseases, namely, the type of distribution pattern tended to change from I to II or III, as the liver disease progressed to more severe form.
3) Examination of immunological response study showed the marked depression of the absolute number of T lymphocyte, delayed hypersensitivity to DNCB, and the elevation of serum IgG and IgA in the cases of liver cirrhosis and hepatocellular carcinoma. The cause of development of liver cirrhosis and hepatocellular carcinoma from hepatitis B was discussed with the emphasis on the importance of host immune response.
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Hironori NIKI, Takanori HATTORI, Setsuya FUJITA, Yoshihiro KOHLI, Keii ...
1977 Volume 74 Issue 9 Pages
1146-1153
Published: September 05, 1977
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Cell kinetics of human duodenal mucosa was studied by
3H-thymidine autoradiography and DNA cytofluorometry on Feulgen-stained nuclei.
Autoradiographs of duodenal mucosa (labeled in vitro with
3H-thymidine for 60 min) showed that labeled epithelial cells were located zonally to the lower portion of the crypts of Lieberkuhn, while columnar and goblet cells were not labeled. Labeling index of this zone was about 31%. In the duodenal mucosa, columnar and goblet cells showed morphologically a transitional appearance along each cell line from the lower portion of the crypt of Lieberkuhn to the tip of the villus. These findings indicate that cell proliferation at the lower crypt is for replacement of absorptive and goblet cells.
In Brunner's glands, a few labeled epithelial cells were scattered randomly without any localization, thereby indicating self-replicating activity of this cell type. On the other hand, it was shown by the cytofluorometric measurement that in Brunner's glands almost all the glandular cells contained diploid amount of DNA, but 0.6% of the cells contained the amount of DNA between 2n and 2×2n. These findings indicate that about 0.6% of the cells in the Brunner's glands are in a stage of DNA synthesis to supply cell loss in the glands under normal condition. No evidence that the cells in the Brunner's glands arise through transformation of undifferentiated cells in the crypts was obtained.
From these results it was suggested that in the human duodenum renewal of epithelial cells consists of two different systems. One is supposed to be a well-known pipe line system of cell renewal, in which the absorptive and the goblet cells arising in the crypts, migrate to be sloughed off at the tip of villi according to “first produced, first lost” principle. Another is a random loss system in the Brunner's glands; the cells proliferate in situ to cover cell loss which randomly occurs in the Brunner's glands.
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Akitoshi KOGA, Satoru TODO
1977 Volume 74 Issue 9 Pages
1154-1159
Published: September 05, 1977
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Structure of so-called black gallstones from the two cases was studied by crystal structural analysis, X-ray microanalysis and scanning electron microscopy. So-called black gallstones were found to be amorphous by powder X-ray diffraction and their cut surfaces also amorphous by scanning electron microscopy. However, at the high magnification of 100, 000, densely packed very fine and spherical particles of about 30nm in diameter were observed. At the abrasive surface of the stones, two different reflection colors were noted by reflection microscopy; one embedded like islands in the matrix and the other, the matrix. Vickers hardness test showed the latter to be harder than the former. The elementary analysis by X-ray microanalyser showed that S was more abundant in the island than in the surrounding matrix, probably due to the S-S bond in the protein present.
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Comparative study with synthetized human gastrin and tetragastrin
Takashi KATAYAMA, Fumiko OOHASHI, Mariko SHIMAMURA, Sachiko MIURA, Tsu ...
1977 Volume 74 Issue 9 Pages
1160-1165
Published: September 05, 1977
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The effect of sythetized human gastrin I or tetragastrin on epithelioid cell colony of the rat fundic mucosa in tissure culture was observed. The synthetized human gastrin in a concentration of 10γ/ml in culture medium did not effect on maintenance of epithelioid cell colony. The colony was disappered within about 4 weeks under gastrin treatment as long as that of control group.
3H-thymidine incorporation was increased significantly under the treatment of synthetized human gastrin (0.05γ/ml) or tetragastrin (10γ/ml), respectively.
Both the gastrins showed the proliferative effect on the cultured fundic mucosal cells, and this effect of synthetized human gastrin was about 20 fold powerful than that of tetragastrin.
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Zen ITOH, Shinjin TAKEUCHI, Isamu AIZAWA, [in Japanese], [in Japanese] ...
1977 Volume 74 Issue 9 Pages
1166-1171
Published: September 05, 1977
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Simultaneous measurements of plasma motilin concentration and gastric contractile activity were made in seven healthy conscious dogs. Plasma motilin concentration was measured by radioimmunoassay and gastric contractile activity was recorded by means of chronically implanted force transducers. When gastric contractile activity was in the interdigestive state, it was found that plasma motilin concentration was always elevated in all of the seven dogs. The high plasma concentration of motilin was lowered by ingestion of food and the level of motilin was lasted as long as the gastric motor activity was in the digestive pattern. However, plasma motilin concentration started to increase and returned to the high level again by the time when gastric motor activity was in the interdigestive state. Since the interdigestive contractions were induced by exogenous motilin, it is concluded that the interdigestive motor activity of the stomach is controlled by plasma motilin concentration in the dog.
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correlation between HBs antigen and histopathological course in 142 patients
Masao NAKAJIMA, Kiichi ITO, Akira YOSHIBA, Hiromitsu KUMADA
1977 Volume 74 Issue 9 Pages
1172-1178
Published: September 05, 1977
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We studied the histopathological courses of chronic hepatitis in 142 patients with more than two times of liver biopsy within intervals of two months to several years. For the histopathological diagnosis of chronic hepatitis, Europian classification (De Groote et al 1968) was applied. Histopathological prognosis was based on diagnostic differences between the initial and the last biopsies. We separated the prognosis in three groups: progressive, improving and stationary.
It was observed that out of 142 patients 67 (47.2%) were of progressive ones. And it appeared that the longer the intervals between time of biopsy the higher wasthe rate of progressive ones. Out of the 67 progressive ones 26 patients developed liver cirrhosis. Most of them developed the disease within one to three years of follw up observation.
Forty one of the 142 patients (28.9%) were found to have persistent HBs antigen. Out of these 41 patients 26 (63.4%) were of progressive ones and 14 developed liver cirrhosis. This showed that the rate of developing liver cirrhosis was significantly high compaired with that of HBs antigen negative patients.
From these 41 patients with persistent HBs antigen 25 were searched for HBe antigen, anti HBe and Dane particle associated DNA polymerase activity. Out of the 25 patients examined 3 who were found to possess HBe antigen were in the active state of chronic hepatitis, while four who were found to possess anti HBe were in the static state. All HBe antigen positive patients were found to have DNA polymerase activity as well. Therefore it is suggested that there may be close relationship between them.
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Katsumoto KATO, Takeshi TAKEI, Masao NAKAMURA, Nobuyoshi OKUMURA, Akir ...
1977 Volume 74 Issue 9 Pages
1179-1186
Published: September 05, 1977
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The present study was performed in attempt to clarify the mechanisms of glucose intolerance in chronic liver diseases. The changes of blood glucose and serum insulin (IRI) following oral glucose load were observed in98 patients of chronic hepatitis, 68 of liver cirrhosis, 18 primary diabetics and 17 healthy controls, and the correlation between these changes and the data of liver function tests or the histological changes of liver was studied.
Hyperresponses of IRI were not always demonstrated in the patients with chronic liver diseases, but the cases with fasting hyperglycemia among them showed low responses as well as primary diabetics. It is conceivable, therefore, that most cases of chronic liver disease with overt diabetes have genetic predisposition to primary diabetes.
Cases above 50 years of age and those whose insulinogenic index was less than 0.36 were eliminated in the survery of hepatic factors correlated with glucose intolerance to avoid the infiuence of aging and predisposition to primary diabetes. The lobular reconstiction seemed most influential and the destruction of the limiting plate seemed slightly influential on glucose intolerance in chronic liver disease.
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Kohdoh ISHII, Osamu SUZUKI, Yasuyoshi KIRYU, Masaharu TSUCHIYA
1977 Volume 74 Issue 9 Pages
1187-1194
Published: September 05, 1977
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The present study was designed to elucidate the effect of histidine decarboxylase inhibitor on the treatment of chronic active hepatitis in an attempt to suppress the elevated histamine formation in this disorder. The patients were consisted of biopsy proven 10 men and 3 women receiving ineffective treatment with other drugs, including adrenal cortical steroid, over 3 weeks.
Tritoqualine, a potent histidine decarboxylase inhibitor, was administered orally in dose level of 600 to 1, 600 mg per day. Before treatment the average value of SGOT, SGPT and plasma histamine showed 252±24 U, 318±152 U and 15.2±5.5μg/L, respectively. Results obtained at 6 weeks' treatment, however, gave significantly fallen values, indicating SGOT 57±24 (p<0.001), SGPT 40±28 (p<0.001) and plasma histamine 8.6±0.4 (P<0.001). Serum gammaglobulin also tended to be fall (p<0.1). Marked improvement was noted in reexamined biopsied specimen, representing disappearance of fibrogenesis with small round cell infiltration in and around portal tract, together with pericellular fibrosis. And now, three cases are identified to be healed.
Despite long-term administration, no obvious side effect was noted. Investigation for HBsGg revealed positive in 4, however, no difference was shown from that of negative case in the improvement of liver function tests.
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Toshio FUJIKI, Akihiko MIO, Hideaki HASHIMOTO, Masuyoshi CHO, Kazue TA ...
1977 Volume 74 Issue 9 Pages
1195-1202
Published: September 05, 1977
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Akira KIHARA, Yutaka WAGA, Yoshinori ITO, Akira KIKUCHI, Tetsuya OGASA ...
1977 Volume 74 Issue 9 Pages
1203-1208
Published: September 05, 1977
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1977 Volume 74 Issue 9 Pages
1209-1214
Published: September 05, 1977
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1977 Volume 74 Issue 9 Pages
1215-1229
Published: September 05, 1977
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1977 Volume 74 Issue 9 Pages
1230-1273
Published: September 05, 1977
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