Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 76, Issue 11
Displaying 1-20 of 20 articles from this issue
  • Nobuo HIWATASHI, Takao KIKUCHI, Osamu MASAMUNE, Eietsu OUCHI, Hikaru W ...
    1979 Volume 76 Issue 11 Pages 2153-2157
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    HLA antigens were studied in 60 patients with colorectal cancer, 43 with colorectal adenomas, 60 with ulcerative colitis, 10 with Crohn's disease and 120 healthy Japanese controls. HLA typing was performed by the microdroplet lymphocyte cytotoxicity test. From these studies, the following results were obtained.
    1) Seventeen of the 60 (28%) patients with colorectal cancer were found to have Bw35, compared to 10% of controls (P<0.005). In the patients with colorectal adenomas, the frequency of Bw40 was 56% vs 35% in the normal population and the frequency of B5 was decreased (P<0.02 and P<0.005, respectively). When the frequencies of antigens in the patients with adenomas were compared with those with cancer, a decreased frequency of B5 was found in the former group (P<0.05).
    2) B5 was recognized in 62% of the patients with ulcerative colitis, compared to 40% of controls (P<0.01). Furthermore, B7 was decreased in frequency (P<0.05) and there was the highest relative risk value for A3 (R.R.=6.3). When the patients were classified into 3 types according to the extent of the lesions, total colitis, left-sided colitis and proctitis, B5 was recognized in 65% of the patients with left-sided colitis or total colitis and this was statistically significant. However, no significant difference in the frequency of B5 was recognized between the patients with proctitis and the controls, probably due to small number of studied cases to evaluate.
    3) In the patients with Crohn's disease, B27 was recognized in one patient and was increased in frequency (P<0.001), although the number of patients studied was very small.
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  • Tetsuichiro MUTO, Junjiro KAMIYA, Toshio SAWADA, Satoru KUSAMA, Tatsuo ...
    1979 Volume 76 Issue 11 Pages 2158-2166
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Three hundred and seventy polyps in one hundred and ninety four patients were removed via colonoscope between 1972 and 1978, and histologically examined. Eighty percent of the removed polyps were neoplastic and malignant transformation in adenoma was found in 19.6%. The malignancy rate increased with increasing size of the polyp, however it was interesting to note that malignancy rate of adenoma under 1 cm in diameter was as high as 7.3%. In all 49 early carcinomas but two, found in this polypectomy series, showed histological evidence of adenoma origin. Early carcinoma 1-2 cm in diameter or semipedunculated in shape was the commonest type. Management of sessile adenoma and invasive carcinoma was discussed and our experience was also presented.
    Long-term follow-up of patients with adenoma was recommended in terms of detecting second neoplastic lesions as early as possible. The value of colonoscopic polypectomy as excision biopsy and treatment of colonic polyps was stressed. From histological investigation of the removed polyps it was expected to find a new concept of pathogenesis of colorectal carcinoma.
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  • Yasuhiro MIZOGUCHI, Takashi SHIBA, Toshihiro HIGASHIMORI, Hisanori KIT ...
    1979 Volume 76 Issue 11 Pages 2167-2177
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The possible involvement of cell-mediated immunity in the pathogenesis of druginduced allergic hepatitis was investigated in 21 patients;6patients with cholestatic type, 2 cases with hepatocellular type and 13 patients with mixed type. The peripheral blood lymphocytes from all these patients showed the positive lymphocyte transformation and MIF production when stimulated by the caused drug in the presence of liver specific antigen fraction. By injection the culture medium prepared from activated lymphocytes into mesenteric vein of rat, a marked reduction of bile flow and secretion of bile acid wasobserved in 12 cases among 15 patients tested. Active material which caused the reduction of bile flow was fractionated by a gel filtrations and was identified to have similar molecular size to MIF. Morphologically, a dilated bile canaliculus with diminution of microvilli and vesicle around the dilated bile canaliculus were observed an electromicroscopy after injection of the culture supernatant or their fractionated material into mesenteric vein of rat.
    No such changes could be seen in rat by administering the supernatant of lymphocytes from normal individuals samely prepared as above.
    Macrophage activating factor, a kind of lymphokines, was also detected in the culture medium of activated lymphocytes from 8 patients among 11 cases tested. The MAF-activated macrophages were shown to be cytotoxic to the separated liver cells by judging their inhibitory effect the albumin biosynthesis.
    On the one hand, the antibody to liver cell membrane were detectable in serum 3 cases among 9 patients by an antibody-dependent cell-mediated cytotoxicity test. The lymphocytemediated cytotoxicity were also detected in 2 cases among 5 patients by the reduction of 86Rb binding to cell surface.
    These observations suggest that cholestatic factor produced from the sensitized lymphocytes by stimulation with the specific drug in the presence of liver specific antigen, macrophage-mediated cytotoxicity, lymphocyte-mediated cytotoxicity and antibody produced to the liver cell membrane play some important role in the pathogenesis of drug-induced allergic hepatitis although their exact correlations are remained to be elucidated.
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  • Jugoro TAKEUCHI, Masahiko OKUDAIRA, Akira TAKADA, Yasuyuki OHTA, Kiyos ...
    1979 Volume 76 Issue 11 Pages 2178-2185
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Annual per capita consumption of alcoholic beverages in Japan rose from 3.50 liters in 1960 to 7.22 liters in 1975. Therefore, we surveyed a yearly incidence of alcohol-induced liver injuries between 1968 and 1977, among patients who admitted into 94 hospitals because of various liver diseases.
    Between the ten years, a steady and significant increase was observed in the percentage of alcohol-induced liver damage in patients with liver disease; whereas the incidence was 5.1 per cent in 1968, it became to be 10.7 per cent in 1977. In alcohol-induced liver damage, the proportion of alcoholic fatty liver, alcoholic hepatitis, alcoholic cirrhosis, and alcoholic fibrosis of the liver changed from 1:2:5:2 in 1968 to 1:3:5:3 in 1977; it is therefore likely that the observed increase in the incidence of alcoholic liver diseases was greatly incriminated on a consequence of the increased incidences of both alcoholic hepatitis and fibrosis.
    The proportion of alcoholic cirrhosis to total cirrhosis in 94 hospitals in Japan increased from 11.1 per cent in 1968 to 16.9 per cent in 1977; this increase was found to be significant (p<0.01) and linear (y=0.704x+9.31). A high correlation (r=+0.8367) between the incidence of alcoholic cirrhosis and the mortarity rate from total cirrhosis found in Japan between 1968 and 1977 suggests a significance in contribution of alcohol to the recent rise in cirrhosis death in our country.
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  • Makoto OTSUKI, Choitsu SAKAMOTO, Atsushi OHKI, Mitsuo MAEDA, Hosai YUU ...
    1979 Volume 76 Issue 11 Pages 2186-2193
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The concentration of immunoreactive secretin (IRS) in portal plasma and the exocrine pancreatic secretions were simultaneously determined in response to graded amounts of hydrochrolic acid (HCl) (0.04, 0.1, 0.2 and 0.4 mEq per 2 min) instilled directly into the duodenum and compared with those obtained with intravenous bolus injection of synthetic secretin (0.01, 0.1, 1, 10 and 100 μg/kg) in anesthetized rats.
    Pancreatic volume flow, amylase output and the portal plasma IRS concentration in response to intraduodenal acid were closely related to the amount of acid introduced into the duodenum per unit time. Synthetic secretin given intravenously in doses ranging from 0.01 to 100 μg/kg produced almost identical response curves. However, intravenous secretin was extremely poor secretagogue when compared with intraduodena acid on the basis of the maximal portal plasma IRS concentrations. Because the degree of pancreatic exocrine secretions achieved by the duodenal acidification was significantly higher than could be attained with exogenous secretin, even though the portal plsma IRS concentrations were comparable. Therefore, it was necessary to increase the portal plsma IRS concentration up to 12 times to obtain the comparable flow rate of pancreatic juice to that following acid infusion.
    This discrepancy between IRS concentration and pancreatic exocrine secretions may be explained by the release of other stimulators of pancreatic secretions during intraduodenal acidification.
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  • Shosaku HAYASHI, Akiharu WATANABE, Taiji SOGO, Toshihiro HIGASHI, Taka ...
    1979 Volume 76 Issue 11 Pages 2194-2199
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Blood ammonia levels in patients with various liver diseases were determined by a paper method (ultramicrodiffusion procedure) and compared to those measured by microdiffusion, direct colorimetric and enzymatic methods. The levels simultaneously determined by these four methods showed almost similar values. This simple method was found to give approximate, semiquantitative values of blood ammonia and not to be influenced by marked afterations in serum amino acid levels, which were frequently observed in patients with hepatic diseases. Therefore, this simple-rapid paper method was evaluated to be a useful laboratory test for treating and diagnosing patients with liver disease at bed side and also at clinic for outpatient.
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  • With special reference to the effects of diet
    Akira SUZUKI
    1979 Volume 76 Issue 11 Pages 2200-2213
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Rats were maintained on low protein diet, standard diet, and high protein-high fat diet, and the influence oJ each diet was investigated on composition of bile, experimental choledochus dilatation, and gallstone formation.
    As a result on composition of bile, rats fed on low protein diet revealed significantly higher phospholipid concentration than those on two other diets. It suggests that the cholesterol solubility increases in the low protein diet group. As to choledochus dilatation, rats fed on the low protein diet had higher incidence of the dilatation than the other dietary groups. Furthermore, gallstones were produced by both of low protein diet and stricture of the terminal common bile ducts. Histological findings of the common bile ducts containing gallstone showed severe cholangitis. From the above results, it is reasonable to consider that coexistence of bile stasis and cholangisis is important for gallstone formation nrats, and also low protein diet plays some role in gallstone genesis.
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  • Espescially on relationship between pancreatic secretion and blood flow
    Tohru TAKESHIMA, Jiro MIYAMOTO
    1979 Volume 76 Issue 11 Pages 2214-2223
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The double thermistor tissue blood flowmeter has been used to measure pancreatic blood flow after injections of secretin, pancreozymin and glucagon. The relationships between pancreatic blood flow and secretions with the factor of secretory rate, bicarbonate and amylase output were estimated.
    In conclusion, (1) injections of secretin resulted in an increase in both pancreatic blood flow and secretion in above mentioned three factors in accordance with the doses of secretin. (2) Pancreatic blood flow is correlated closely with pancreatic secretion on injections of above mentioned hormones. It is shown that pancreatic blood flow is influenced not only by secretory rate or bicarbonate output, but also by enzyme output. Furtheremore, it is speculated that a change of pancreatic blood flow is prescribed with a sum of the change of secretory rate or bicarbonate output and that of enzyme output.
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  • Takehira YAMAMURA, Mamoru TATSUMI, Yoshinao KOTOURA, Toku TAKAHASHI, J ...
    1979 Volume 76 Issue 11 Pages 2224-2231
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Plasma human pancreatic polypeptide (HPP), a newly recognized pancreatic hormone, was studied in healthy subjects, patients with chronic pancreatitis, and totally pancreatectomis ed subjects. After oral load of 50g of meat extract, the plasma concentration of HPP showed a rapid 4 folds rise at 20 minutes in healthy controls. In contrast, plasma HPP lever rose only 1.5 fold in patient with chronic pancreatitis. This difference was statistically significant (p<0.02). In totally pancreatectomised subjects plasma HPP was not detectable at any time during the test. The increase rate of HPP level during the test in each subject correlated significantly (p<0.01) to total amylase output and maximal amylase concentration measured by pancreozymin-secretin test. Thus, it is suggested that measurement of plasma HPP level may be useful to digagnose the chronic pancreatitis.
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  • Discrimination between Carcinoma of the Pancreas and Chronic Pancreatitis by the Use of Convex Type and Concave Type in ERCP
    Takeshi OGURI, Tatsuzo KASUGAI, Nobuyoshi KUNO, Akira MATSUURA, Katsuh ...
    1979 Volume 76 Issue 11 Pages 2232-2241
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The branches and fine pancreatic ducts when opacified with contrast material can be studied more precisely after direct fourfold magnification during ERCP than by routine ERCP.
    Routine post-mortem pancreatograms (PMP) and direct fourfold magnification during PMP (PMPM) were compared in 16 cases. Greater accuracy was obtained by the latter method resulting in an increase of abnormal areas and a twofold increase in the number of branches of the pancreatic ducts that could be analysed.
    ERCP and direct fourfold magnification during ERCP (ERCPM) were performed in 30 subjects. Twenty-six pairs of ERCP and ERCPM were obtained. These 26 cases included 4 cases of pancreatic carcinoma, 21 of chronic pancreatitis and one normal. Good filling during ERCPM gave more information in 22 cases than during ERCP. In 3 subjects ERCPM was particular value in the diagnosis of pancreatic disease. ERCPM revealed localized pancreatitis in two patients in whom there was a suspicion of pancreatic carcinoma at ERCP. There was no advantage of ERCPM in 3 cases because of a large carcinoma of the pancreas, but particular advantages were found in one case with a small carcinoma.
    Encasement of the pancreatic ducts might be characterized as convex from the side of lumen in carcinoma of the pancreas, i.e., convex type, whereas it might be characterized as concave from the side of lumen in chronic pancreatitis, i.e., concave type. Significant discrimination was obtained between carcinoma of the pancreas and chronic pancreatitis by the use of these types not only in PMPM and ERCPM but also in PMP and ERCP.
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  • An Attempt to Improve Diagnostic Value of PFD
    Seido KUWAHARA
    1979 Volume 76 Issue 11 Pages 2242-2251
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    A Test Meal combined PFD (TMC-PFD) using Sustagen was compared with the conventional PFD to improve the diagnostic value of PFD.
    Urinary excretion of PABA was significantly decreased (p<0.02) in 70% pancreatectomized rats in comparison with that of normal control rats by TMC-PFD, although no difference was noted between them by the conventional PFD.
    PABA excretion showed abnormal range in 90% pancreatectomized rats, while the excretion revealed normal one by PFD in 70% pancreatectomized rats in which PABA excretion was abnormal by TMC-PFD.
    In clinical cases of chronic pancreatitis which had disturbance of two factors in P-S test, PABA excretion by TMC-PFD was abnormal, although the excretion was normal by the conventional PFD.
    Those data, therefore, indicate that the Test Meal combined PFD is more useful than the conventional one as a screening test for exocrine pancreatic insufficiency.
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  • Sumio TENMOKU, Kogoro KASAHARA, Yuichi YAMASHITA, Akiyoshi KASHII, Yas ...
    1979 Volume 76 Issue 11 Pages 2252-2262
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Insulin secretory responses were studied in relation to IRI concentration and electron-microscopic appearance of the tumors in 4 human insulinomas, one of which was of malignant nature. In a case with low basal insulin secretion and exaggerated insulin responses by insulin stimulants, the tumor had high concentration of IRI and typical β granules. In 2 cases with high basal insulin secretion, one case showed high insulin responses and the other case low insulin responses by insulin stimulants. However, in these 2 cases, the tumors contained low concentration of IRI and revealed atypical granules. Meanwhile, an insulinoma, which showed high plasma insulin in the fasting state and failed to respond to various insulin stimulants, demonstrated high concentration of IRI in the tumor and typical β granules.
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  • Hideo NISHIMURA, Mikio HAYAKAWA, Mitsuru ODAWARA, Kiyoshiro KAWAHARA, ...
    1979 Volume 76 Issue 11 Pages 2263-2266
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Shigefumi UEKI, Eizo OKAMOTO, Akihiro TOYOSAKA, Suguru OHMURO, Takashi ...
    1979 Volume 76 Issue 11 Pages 2267-2272
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • M. KAWAMOTO, Y. MISHIMA, S. SHIROMA, T. IMANISHI, Y. TANAKA, T. FUJIOK ...
    1979 Volume 76 Issue 11 Pages 2273-2278
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Hironori SAKAI, Akihiro FUNAKOSHI, Toshinari KIMURA, Hideyuki WAKASUGI ...
    1979 Volume 76 Issue 11 Pages 2279-2285
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Especially about mechanisms and incidence of Ptype hyperamylasemia in SLE
    Kyoko MIYASAKA, Masao OKAMOTO, Masataka HAYASHI, Yasushi KUYAMA, Hiros ...
    1979 Volume 76 Issue 11 Pages 2286-2291
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    A 27-year old woman with SLE was admitted to the hospital because of diarrhea, abdominal pain and vomiting. The laboratory data reveald marked proteinuria, but wirum amylase and cholesterol were normal.
    She was diagnosed SLE in 1973 and she has taken predonisolone, 10-60mg/day. A month before admission, the patient was seen in the clinic and examination revealed complement decreasing, while she was taking predonisolone, 10mg/day.
    On the third hospital day, predonisolone was increased to 50mg/day because of considering exacerbation of SLE, so the next day, abdominal pain was diminished.
    On the 13th hospital day, hyperamylasemia and amylasuria were appeared, and on the amylase isozyme pattern, 85% of total serum amylase was pancreatic type. Asymptomatic hyperamylasemia continued 31 days. Her pancreozymin-secretin test and ERCP were normal.
    We examined 22 cases of SLE, we saw three similar cases (involving this case). (13.6%) We considered the cause of hyperamylasemia was by predonisolone, but the incidence of pancreatic type hyperamylasemia was independent on duration or dose of predonisolone.
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  • Takenobu KAMADA, [in Japanese], [in Japanese], [in Japanese]
    1979 Volume 76 Issue 11 Pages 2292
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Shigeru FUJIMOTO, [in Japanese], [in Japanese], [in Japanese], [in Jap ...
    1979 Volume 76 Issue 11 Pages 2293
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Sukeo YAMAMOTO, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
    1979 Volume 76 Issue 11 Pages 2294
    Published: November 05, 1979
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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