Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 75, Issue 5
Displaying 1-18 of 18 articles from this issue
  • Kaoru TSUJI
    1978 Volume 75 Issue 5 Pages 607-620
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    A study of the pathogenesis of gastric ulcer induced by the serosa and mucosa searing methods is reported. Immediately after experimental gastric ulcer were made in rats, macroscopic, histlogical findings and the changes of microcirculation were observed. Both searing methods were used under identical conditions.
    In the serosa-searing method, ischemic changes of the smooth muscle layer began immediately after the searing, followed by the ischemia of the blood vessel network on the muscularis mucosa. Twenty four hours later, a necrosis of the mucosa and muscularis mucosa progressed remarkably, and in all 30 animals (100%), complete gastric ulcer was formed.
    On the other hand, while there were ischemic changes of the mucosa after mucosa-searing, no ischemic changes of the blood vessel network on the muscularis mucosa and degeneration of the muscularis mucosa were seen. As a result, only 2 animals (16.7%) developed a complete gastric ulcer with the mucosa-searing method.
    This findings indicate that microcirculation disorders and injuries of the muscularis mucosa are important factors in the development of gastric ulcer.
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  • Immunological Aspects of Correlation with M-Components and Cancer
    Nozomi YAMAGUCHI, Keiichi KAWAI, Yoshihide FUJIYAMA
    1978 Volume 75 Issue 5 Pages 621-627
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Myelomas and Waldenstrom's macroglobulinemias have monoclonal immunoglobulins produced by single clone of neoplastic immunoglobulin synthesizing cells in the bone marrow or lymphoid tissues. And monoclonal immunoglobulins have also been found in serum obtained from patients with non-lymphoid neoplasms or inflammatory diseases and from healthy persons, especially those over the age of 60. The association of M-components and plasmocytosis has been occasionally found in patients with carcinomas, described by Waldenström. Isobe and Osserman noted M-components in 128 patients with non-reticular neoplasms, analyzed 806 cases with such proteins. In thier report, these M-components were found most often in patients with carcinoma of the rectosigmoid, prostate and breast. In our report, these M-components were markedly found in patients with gastric cancer (16 cases). On these 16 cases, immunological and histological analysis was reported and the relationship between the presence of the M-components in the serum and histological aspects around the carcinomas was discussed.
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  • Hiroyuki MIYAGAMI
    1978 Volume 75 Issue 5 Pages 628-638
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    In order to assess the function of the retained antrum following the SV+P for duodenal ulcer patients, gastric analysis, plasma gastrin measurements and electron microscopic observations on the antral G cells were performed in eighteen patients underwent SV+P before and the 1st, 3rd, 6th, 12th and 24th month after the operation, almost all the tests were performed.
    M.A.O decreased significantly after operations (p<0.01). Basal plasma gastrin increased significantly one month postoperatively (p<0.01). Integrated gastrin response (IGR) to meat extract stimulation increased significantly six months postoperatively (p<0.01). Despite gastric vagotomy, I.G.R. after insulin hypoglycemia stimulation increased three months postoperatively (p<0.01).
    The G cells after SV+P did not show any fine-structural features suggesting hypofunction and degeneration. On the contrary, they showed hyperfunctioanl and presecretory in state. The G cells were increasing in number six months after operation. After then G cell hyperplasia became to be more remarkable on year post operatively. Emiocytotic figures were observed in denervated G cells after SV+P, which were stimulated meat extract or insulin hypoglycemia stimulation. In pararell with the electron microscopic observations of G cells, the plasma gastrin levels began to be elevated.
    From these findings, G cells could release gastrin in response to meat extract stimulation and insulin hypoglycemia stimulation after the SV+P which were conserved the antrum. Then hypergastrinemia occured due to G cell hyperplasia. So, it is necessary to do complete vagotomy on the parietal cell region in case of SV+P.
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  • Susumu KAWAMURA, Sakae AOYAMA, Yozo IIDA, Yoshiyuki HAMADA, Tadasu FUJ ...
    1978 Volume 75 Issue 5 Pages 639-649
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Our study was excuted with the intention of clarifying the relation between arteriosclerosis and gastric lesions. Clinical, endoscopic and histopathological studies were performed on 71 cases more than 60 years of age, who were operated in our hospital. Our cases consisted of 14 cases of no gastric lesions, 16 cases of gastric ulcer, 12 cases of duodenal ulcer, 16 cases of depressed type early carcinoma, and 13 cases of protruded type early carcinoma.
    Resected stomach was cut into 9 pieces of histological specimens on the small curvature, the anterior wall and the posterior wall, dyeing with H.E. and Weigert elastica stain.
    We graded the severity of gastric wall arteriosclerosis according to Deguchi's classification modified by us and determined the degree of atrophy of the gastric mucosa in accordance with Hirafuku's classification. The results were as follows.
    1) The degree of arteriosclerosis of the gastric wall was most highest grade in gastric ulcer and most lowest grade in early gastric carcinoma.
    2) The relationship could be sugested between gastric wall arteriosclerosis and abdominal aorta arteriosclerosis.
    3) There were no significant relation between general arteriosclerosis and gastic wall arteriosclerosis.
    4) Atrophy of the gastric mucosa was related the gastric lesions rather than gastric wall arteriosclerosis.
    5) In our results, there was a relation between gastric wall arteriosclerosis and atrophy of the gastric mucosa.
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  • M. TADA, K. HAYASHI, [in Japanese], M. OKUDA, K. SHIMAMOTO, S. KINOSHI ...
    1978 Volume 75 Issue 5 Pages 650-655
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Recently according to the change of our manners and customs and the improvement of colon diagnostics, several colon diseases such as ulcerative colitis, cancer, Crohn's disease and so on have been increasing in Japanese as in American and European. Therefore, the early detection of these colon diseases, especially cancer, must be necessary, and several new approaches have been performed in our clinic. One of the most important techmique for the screening of colon cancer is analysis of complaints caused by colon diseases.
    A new questionaire including 25 kinds of question of their symptoms was given to 304 subjects regardless to their complaints and then radiological and/or endoscopical examinations were carried out. Final diagnosis of these 304 subjects were advanced cancer, 53, benign polyp, 45, hemorrhoid, 24 and normal subject, 182.
    The results obtained by this questionaire were as follows:
    1) Patients with colon cancer were easily differentiated from normal subject, but not from hemorrhoid.
    2) Some complaints such as narrow stool, abdominal tumor, anal bleeding, weight loss were much higherly seen in the patients with colon cancer.
    3) Symptoms of slight abdominal pain and abdominal tumor were specific in the patients with distal colon cancer, and symptoms of anal bleeding, with proximal colon cancer.
    4) Patients with benign polyp were not differentiated from normal subjects and they were difficult to be screen out by this questionaire.
    As the questionaire was not enough to screen out polyp or colon cancer in its early stage, it is emphasized that the screening radiological and/or endoscopical examinations should be performed regardless to their complaints.
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  • Mikio NISHIOKA, Toshinori HARADA, Daizo KAN, Youhei FUKUMOTO, Takahiro ...
    1978 Volume 75 Issue 5 Pages 656-663
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Cell-mediated immune responses in patients with chronic liver diseases were studied to elucidate an importance of immunological reaction in the progression of chronic liver diseases.
    These studies demonstrated depression of cutaneous delayed hypersensitivity to tuberculin and phytohemagglutinin (PHA), decrease of the percentage of peripheral rosette forming cells (T-cell), relative increase of the percentage of peripheral null-cells bearing neither of T-nor B-cells markers, demonstration of serum antibodies for T-cells, and decreased responsiveness of lymphocytes to PHA stimulation in patients with chronic liver diseases, paticularly the chronic active hepatitis. It indicates that the immunological abnormalities may lead to the chronicity of the diseases. Degree of the lymphocytic response to stimulation with PHA seems to be associated with a severity of chronic liver diseases.
    T-cells and B-cells in liver sections obtained at biopsy from 16 patients with chronic liver diseases were stained by the immunofluorescent technique using anti-human thymocyte antiserum and anti-human immunoglobulin antiserum. T-cells did not predominate in hepatic lymphoid infiltrates, but marked periportal B-cell infiltrates were sometimes observed. Null-cells were usually found in the hapatic infiltrates. It suggests that killer cells having receptors on their surface for the Fc portion of antibidy molecules are one of the effector cells with autoaggressive activity.
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  • Part III. Changes of Plasma Glucagon and Insulin Levels in Response to Arginine Infusion
    Tetsuya OGASAWARA, Akira KIHARA
    1978 Volume 75 Issue 5 Pages 664-673
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Pancreatic endocrine function following arginine administration was investigated in patients with liver diseases and in normal control.
    The results obtained are as follows:
    1) Significantly higher response of plasma glucagon following arginine infusion was commonly observed in various liver diseases as compared with that of normal control, showing the highest increase in liver cirrhosis and a higher response of glucagon in chronic hepatitis as compared against that in acute hepatitis.
    2) plasma insulin levels also revealed a significantly higher response to arginine infusion. However the highest response of insulin to arginine was shown in acute hepatitis and the response in chronic hepatitis as compared with that in liver cirrhosis.
    3) Accordingly, it was noted that the molar ratios between insulin (I) and glucagon (G) showed an increase in acute hepatitis and a decrease in both chronic hepatitis and liver cirrhosis, with the lowest level in the latter, compared with that in normal control.
    4) Response of plasma glucagon to arginine infusion in chronic active hepatitis was significantly higher than that in chronic inactive hepatitis and also that in decompensated cases with liver cirrhosis was higher than that in compensated liver cirrhosis. The I/G molar ratios of these were lower both in the former than those in the latter.
    From the results it was conjectured that the abnormalities in the pancreatic endocrine function might be closely related with hepatic disorders, especially with dysfunction of the damaged hepatocytes.
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  • With Special Reference to Duodenalization of the Cholecystic Mucosa
    Takao MATSUMINE, Yoshiro KUBOTA, Masaru IWASAKI, Ikuo YAMAOKA, Hiroshi ...
    1978 Volume 75 Issue 5 Pages 674-685
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The heterotopic mucosal tissues on resected specimens of gallbladders affected with chronic cholecystitis were studied histologically and histochemically. As a result, mucous glands (pseudopyloric glands) were found in 234 cases (65.7%), goblet cells in 97 cases (27.2%), enterochromaffin cells in 41 cases (11.5%) and Paneth's cells in 4 cases (1.1%). Furthermore, gastric epithelium above the mucous glands and intestinal absorptive epithelium with the goblet cells were rarely observed.
    These heterotopic cells were apparently formed by the metaplastic differentiation. It is assumed that the chronically inflamed cholecystic mucosa might undergo a gradual change to the duodenal mucosa (duodenalization, duodenal metaplasia) through the regeneration.
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  • (II) Serum Lipase Levels in Patients with Pancreatic Diseases and Other Various Disorders
    Reiji MORISHITA, Haruto UCHINO
    1978 Volume 75 Issue 5 Pages 686-697
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Although various tests have been proposed to differentiate pancreatic disorders, the differential diagnosis of pancreatic diseases remains unsettled today. Serum amylase activity is perhaps the most widely used clinical index for this purposes. Serum lipase activity is considered as a more specific indicator for pancreatic damage than serum amylase, however, the orthodox lipase assay methods using olive oil as a substrate were tedious and non-reproducible and did not gain popularity in clinical laboratories. Recently, a new and simple colorimetric method for human serum lipase assay has been developed by Kurooka et al15). This method using BAL-tributyrate (BALB) as a substrate is more sensitive than the conventional methods. Lipase levels in 159 normal sera and total 173 hyperamylasemic sera from patients with various diseases including the pancreas were measured by this method. The serum lipase levels in normal 113 male and 46 female subjects were 74.61±34.12 (mean±S.D.), without sexual difference and the upper limit of 142.85 BALB units.
    The reproducibility of this method was excellent and human serum lipase was stable after repeated freezing and thawing.
    The determinations of serum lipase were of great diagnostic value in the proved cases of pancreatic diseases. One patient whose cystadenocarcinoma of the pancreas had been removed by total pancreatectomy showed low level of serum lipase. Increase in serum lipase activity was observed in eleven cases of 29 patients with hepato-biliary diseases, however, almost all of these patients were suggested to have some complications of pancreatic disorders. A transient rise of serum lipase activity observed in several patients after abdominal surgery was rapidly normalized, whereas serum amylase remained elevated.
    The acute rise in serum lipase activity after operation might be caused by operative intervention on the pancreas. The serum amylase levels were abnormally high in all 9 patients with acute parotitis, whereas serum lipase levels were normal in these patients. Abnormally high serum lipase levels were observed in 16 cases out of 20 uremic patients and all five patients with chronic nephritis. The mechanisms responsible for the abnormal high levels of serum lipase in these patients are not yet clear and needed to be elucidated to eliminate the falsely positive results for the diagnosis of pancreatic disorders.
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  • Part I. Radioimmunoassay of Porcine Pancreatic Elastase
    Yasuyuki NAKAJIMA, Yoichi SAITO, Noboru NOTO, Seiki MATSUNO, Koji NISH ...
    1978 Volume 75 Issue 5 Pages 698-706
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    This study demonstrates that pancreatic elastase in porcine serum was determined by radioimmunoassay. Anti porcine pancreatic elastase serum was prepared from rabbit. Pancreatic elastase was iodinated by the chloramine-T procedure and its specific radioactivity was 200-300mci/mg. Two antibody method used for BF separation. Satisfactory results, were demonstrated by using DFP in the buffer contrary to the usual method of radioimmunoassay. Trypsin and chymotrypsin did not cross-react in this assay system. The minimal detectable concentration of elastase was 5ng/ml and the range of normal fasting porcine serum level was 70-100ng/ml.
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  • Part II. Immunoreactive Elastase Level during Acute Hemorrhagic Pancreatitis in Pigs
    Yasuyuki NAKAJIMA, Yoichi SAITO, Noboru NOTO, Seiki MATSUNO, Koji NISH ...
    1978 Volume 75 Issue 5 Pages 707-713
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The change and role of elastase were studied during acute hemorrhagic pancreatitis in pigs. Experimental pancreatitis were produced by the injection of autologous bile (0.5ml/kg) into main pancreatic duct with high pressure. Blood samples were drawn from femoral and portal veins and thoracic lymph duct up to five hours after the injection of bile. Average normal levels of immunoreactive elastase was 90ng/ml which increased significantly from fifteen minutes after the injection of bile in femoral and portal vein and thoracic lymph duct. Total and free elastase activities in the pancreas of pancreatitis were decreased to about one fourth compared with normal pancreas. A large amount of immunoreactive elastase was found in the ascites. The change of immunoreactive elastase was very similar to amylase, therefore it is difficult for determination of immunoreactive elastase level to diagnose th severity of pancreatitis.
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  • Shigeaki HASHIHIRA, Shinji SAITO, Masahiko SAEKI, Tadashi NISHII, Yosh ...
    1978 Volume 75 Issue 5 Pages 714-719
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The effect of chronic ethanol intake on the pancreatic exocrine secretion was studied in 13 rats which were given 20% etanol in plase of water ad libitum for 8 months. Nine control rats were given water. The pure pancreatic juice was collected by conulating the pancreatic duct under urethan anesthesia. Basal secretion was collected for 30 minutes. Then, an intramuscular injection of caerulein (4μg/kg) and secretin (40u/kg) was given and the secretion was collected for 30 minutes. For each fraction, volume, protein, amylase, bicarbonate and calcium contents were determined.
    In alcoholic rats, volume, bicarbonate concentration and output of protein, amylase and bicarbonate decreased as compared to control rats. No significant differences could be noted in protein and amylase concentrations between the two groups, while calcium concentration showed a tendency to in crease in alcoholic rats. The histologic features consisted of dilatation of the ducts, sometimes containing protein plugs, and flattening of the epithelium, while the acinar cells were relatively normal.
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  • Early identification of severe acute pancreatitis
    Satoshi NAKANO, Isao TAKEDA, Hajime WATAHIKI, Tetsuo HAYAKAWA, Aiji NO ...
    1978 Volume 75 Issue 5 Pages 720-730
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    A review was made of the record of 63 patients whose diagnosis was confirmed at operation or autopsy.
    To evaluate the severity of this disease in the early stage, clinical signs and symptoms as well as labatory data were reviewed within 48 hours after admission.
    1) Shock, dyspnea, mental disorder and gastrointestinal bleeding were bad prognostic signs of the disease.
    2) Blood amylase over 700 Caraway's Units/dl, Hematocrit over 50%, Blood sugar over 130mg/dl, Urea N over 28mg/dl, Serum K over 5.1mEg/l and Serum Ca under 3.8mEg/l were observed in the severe cases.
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  • Osamu MASAMUNE, Jinju IWABUCHI, Yasutoshi SAITO, Shoichiro ITO, Shiger ...
    1978 Volume 75 Issue 5 Pages 731-737
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Makoto BEPPU, Masato SAKON, Kenichi FUJIMOTO, Kunihiko HIKITA, Kiyoshi ...
    1978 Volume 75 Issue 5 Pages 738-745
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Seitaro OHKUMA, Takeshi OGASAWARA, Haruo KAWAMURA, Kei KASHIMA, Tokind ...
    1978 Volume 75 Issue 5 Pages 746-751
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Yukiko FUKUI, Makoto WATANABE, Kazuhisa TAKETA, Yoshihiro SHIMADA, Kaz ...
    1978 Volume 75 Issue 5 Pages 752-759
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Isao TAKEDA, Satoshi NAKANO, Kimio KITAMURA, Hajime WATAHIKI, Masataka ...
    1978 Volume 75 Issue 5 Pages 760-763
    Published: 1978
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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