Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 76 , Issue 9
Showing 1-19 articles out of 19 articles from the selected issue
  • with special reference to hemorrhage
    Kazuo FUKUDA, Takahiko SATOMI, Masataka IWASAKI, Atsushi TOYONAGA, Mas ...
    1979 Volume 76 Issue 9 Pages 1743-1750
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    1) 75% of cases with persisting endotoxemia had episodes of hemorrhage and 50% of them was shown to have the Stage 3 of esophageal varices.
    2) Only 4.7% of cases without endotoxemia had episodes of hemorrhage and most of them were shown to have the Stage 1 and 2 of esophageal varices.
    3) The postoperative prognosis of cases with persistent endotoxemia was poor. On the other hand, in the cases without endotoxemia or, in which endotoxemia disappeared by Lactulose or Kanamycine, their postoperative prognosis seemed to be good. It is, thus, suggested that endotoxemia is one of the important factors to infuluence the postoperative course, and the preoperative treatment with Lactulose or Kanamycine against endotoxemia is essential before the surgery.
    4) It was found that 53.8% of cases with endotoxemia had upper gastro-intestinal lesions such as erosion or peptic ulcer, which was significantly frequent compared with 23.8% of cases with no endotoxemia having these lesions.
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  • IgA and Secretory Component
    Hideaki SAKAI, Kenichi IDO, Ken KIMURA, Atushi GOTOH
    1979 Volume 76 Issue 9 Pages 1751-1756
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    A study of local immunology of the gastric mucosa was carried out, with special reference to mucosal localization of secretory component (SC) and immunoglobulin A (IgA). The subjects were 9 cases of normal gastric mucosa, 15 cases of atrophic gastritis and 4 cases of regenerative epithelium around the gastric ulcer.
    The following results were obtained;
    1) A tendency was confirmed that SC was reactive in the foveolar epithelium more strongly in atrophic mucosa than the normal mucosa.
    2) IgA was hardly found in the foveolar epithelium of the normal gastric mucosa but found fairly strong in the foveolar epithelium of the atrophic mucosa.
    3) As to SC and IgA in relation with gland areas of pyloric gland, intermediate and fundic gland, both SC and IgA were reactive with the gland of atrophic mucosa in each gland area. The gland in normal gastric mucosa, however, SC and IgA were found not reactive.
    4) In the regenerative epithelium around gastric ulcer, both SC and IgA were observed strongly reactive.
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  • An experimental study with special reference to α-L-Fucosidase activity and Gastric Ulecr
    Yoshikazu ITO
    1979 Volume 76 Issue 9 Pages 1757-1767
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    The relation between α-L-fucosidase activity and glycoprotein in gastric mucosa were examined in gastric ulcer formation. An experimental ulcer of the rat was produced by the injections of histamine and vitamine A.
    The activity of α-L-fucosidase rose soon after histamine injection, while protein-bound fucose in gastric wall decreased and free fucose in gastric juice increased after vitamine A was administered.
    Following a large dose of vitamine A, glycoprotein in the gastric mucosa were analysed by means of DEAE-column chromatography.
    Glycoprotein was separated into three fractions. A remarkable decrease of fucose was seen in the first fraction.
    These findings suggested that α-L-fucosidase take part in metabolism of glycoprotein in the gastric mucosa and is considered to be one of the most important aggressive factors in gastric ulcer formation.
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  • Yoshiaki HORIE, Yoshio MISHIMA, Tetsuichiro MUTO, [in Japanese], Moriy ...
    1979 Volume 76 Issue 9 Pages 1768-1781
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    The Department of Surgery, Tokyo Metropolitan Geriatric Hospital During last ten years, we have encountered 45 cases with the bowel lesions thought to be caused by ischemic process. These cases were classified into three categories, namely, transient type (14 cases), ulcerative-stenotic type (18 cases), and gangrenous-perforative type (13 cases). 8 cases with so-called obstructive enterocolitis resulting from increased intraluminal pressure were included in the ulcerative series.
    In about half of the cases, minute vessels occlusion in the bowel wall was seen microscopically, occluded by microthrombi and arteritis of the intramural vessels. In spite of the ischemic bowel lesions, it is usually very difficult to determine whether these lesions are primary or secondary to pathological process of the bowel. It seems very likely, however, that these microthrombi could play a significant role in the clinical course of the lesions, even if they were secondary in origin. In 26 per cent of the cases, no evidence of organic occlusion to the mesenteric arteries or intramural vessels was found.
    Further, it was nearly always possible to find many predisposing factors in the patients suffered from bowel ischemia. It has been clarified that organic heart disease, congestive heart failure, atherosclerosis, diminished cardiac output and mesentric flow, post-operative state etc. played a significant role in the aetiology.
    From our clinical analyses, it may be comfirmed that the careful observations on the preceeding historys and background diseases were greatly valuable for anticipitation of ischemic attack and early diagnosis for ischemic intestinal diseases.
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  • Yukio KUSUMOTO
    1979 Volume 76 Issue 9 Pages 1782-1792
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    The First Department of Internal Medicine, Nagasaki University School of Medicine
    1) Possible roles of HBs antigen and antibody in causing liver diseases were studied on 3, 251 inhabitants of Tomie-Town, Goto Island, Nagasaki prefecture, consisting of 1, 592 men aged from 5 to 85 years and 1, 929 women aged from 5 to 87 years. Positive were found in 5.5% of this population by the determination of HBs antigen and in 22% by the HBs antibody study. The incidence of positive HBs antigen increased with age until the third decade; after highest frequency at this decade, the incidence then tended to become less common with age. The incidence of positive HBs antibody increased gradually with age.
    2) These results led us to assume that about one third of those infected with HB virus at the age under 20 years became carriers and the remaining two third held a positive antibody.
    3) In the retrospective or prospective studies of 73 cases with positive HBs antigen over the age of 20 years, 64 cases were kept positive through one to four years, 3 aquired antibody, 3 turned to be negative, 2 were indefenite, and one became a new carrier.
    4) In most of the families consisting of many members with positive HBs antigen, infection seemed due to vertical transmission, and was otherwise assumed to be from individuals outside the family.
    5) HBs antigen was emphasized to play an important role in the pathogenesis of liver disease/abnormal liver function in Tomie-Town of 68 cases examined by histology, HBs antigen was positive in one with hepatoma, 4 of 6 with liver cirrhosis, 4 of 10 with chronic hepatitis, and one of 32 with liver fibrosis. Liver disorders, that were clinically latent, in Tomie-Town were suggested to be closely related with HB virus infection.
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  • Its Binding Power and Competition Among Cholephilic Dyes
    Motonobu SUGIMOTO
    1979 Volume 76 Issue 9 Pages 1793-1801
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    In order to clarify the role of ligandin, an intrahepatic carrier protein, in the hepatic clearance of cholephilic dyes, rat liver ligandin was conjugated to agarose beads. The binding power of the conjugated ligandin to bromsulfophthalein (BSP), indocyanine green (ICG) and bilirubin was compared and competitions of the dyes in binding were investigated.
    The following results were obtained: (1) the binding power of ligandin was about three times lesser than that of bovine albumin for BSP, (2) up to the concentrations tested, 10M per 1M ligandin for BSP and ICG and 2M per 1M ligandin for bilirubin, no competitions were seen among the dyes in binding to ligandin, and (3) the binding power of ligandin to the dyes were larger in the order of bilirubin, BSP and ICG, in the presence of equimolar amount of albumin in the media. It was concluded that ligandin was not the site of competition which are seen among the cholephilic dyes in the hepatic disposal.
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  • Tetsuaki KUNIMASA, Akio SUMITANI, Seiki YAMASHITA, Eiichi TAKEZAKI, Ma ...
    1979 Volume 76 Issue 9 Pages 1802-1808
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    A comparative study was made of sex differences in serum gamma glutamyl transpeptidase levels (γ-GTP) by age in healthy adults and patients with various liver diseases. In healthy adults less than age 40, the γ-GTP level was found to be significantly lower in females than in males, whereas almost no difference was noted between males and females at ages above 50. Females less than age 40 had significantly lower values than those over age 50. The determinations in patients with acute hepatitis, chronic hepatitis, and cirrhosis of the liver were found to be lower in younger females than in males or older females similarly as in healthy adults. The administration of exogenous estrogen : ethinyl estradiol to older females with cirrhosis of the liver, who had high serum γ-GTP levels, resulted in a reduction of the serum γ-GTP level but an increased occurred when the administration was discontinued.
    The findings obtained suggest a relationship between estrogen and serum α-GTP suppression.
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  • Yasuhiro MIZOGUCHI, Takashi SHIBA, Toshihiro HIGASHIMORI, Fumiaki OHNI ...
    1979 Volume 76 Issue 9 Pages 1809-1814
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    When the peripheral blood lymphocytes from patients with drug-induced allergic hepatitis were stimulated with a specific drug in vitro in the presence of soluble liver specific antigen fraction, lymphocytes transformation was seen in 6 cases.
    The macrophage activating factor (MAF), a kind of lymphokines, was also detected in the culture medium of activated lymphocytes from 4 patients who showed positive blastogenesis. This was estimated by the uptake of 3H-glucosamine into macrophage. The activated macrophages by MAF were shown to be cytotoxic to the separated liver cells causing the marked inhibition of albumine synthesis. These macrophage-mediated cytotoxicities were observed in 6 cases who showed the positive lymphocyte transformation. These observations suggest that the macrophage-mediated cytotoxicity may play an role in pathogenesis of drug-induced allergic hepatitis.
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  • Noriyuki KITAMI
    1979 Volume 76 Issue 9 Pages 1815-1825
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    Clinical observations of drug-induced hepatic injury due to delayed hypersensitivity reaction were performed in 170 cases whose causative drugs had been detected by the lymphocyte stimulation test. One third of causative drugs was antibiotics. There was a peak in the third decade of year in the distribution of age, and there was no difference in sex. Eighty two per cent of cases showed any kind of sign and/or symptome of hepatic injury within 8 weeks after drug administration. Over half of cases complained jaundice, fever and/or gastrointestinal symptome as the initial signs. About labolatory findings half of cases showed leucocytosis and eosinophilia. Most of cases showed moderate elevation of serum transaminase and alkaline phosphatase. Eighty per cent of cases recovered within 12 weeks after onset. The recovery period was shorter in cases whose maximal elevation of transaminase and alkaline phosphatase were observed simultaneously. Eight cases died with massive or submassive hepatic necrosis.
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  • Akiharu WATANABE, Norio HOBARA, Hideo NAGASHIMA
    1979 Volume 76 Issue 9 Pages 1826-1835
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    Sprague-Dawley rats given azathioprine (AZP) and phenobarbital in the diet and drinking water, respectively, for 3 to 4 weeks developed severe liver damage. Elevations of serum alkaline phosphatase and γ-glutamyl transpeptidase activities were associated with increased hepatic glucose 6-phosphate dehydrogenase levels and decreased liver glucose 6-phosphatase activities. Light and electron microscopic observations revealed centrolobular necrosis with large scars and the proliferation of the mitochondria and rough endoplasmic reticulum. Similar biochemical and morphological observations were also obtained by feeding the diets containing AZP or its metabolites such as 6-mercaptopurine (6-MP) and 6-thioinosine ribose (TIR) alone. Injections of reduced glutathione (GSH) during the feeding of AZP-containing diet did not prevent but rather deteriorated AZP-induced liver injury. An increase of hepatotoxicity by simultaneous injections of GSH could be similarly obtained in acute liver injury following a single administration of AZP. Furthermore, an inhibitor of xanthine oxidase which catalizes the breakdown of 6-MP, 4-hydroxypyrazole (3, 4-)pyrimidine, resulted in the severity of AZP- and especially 6-MP-induced acute liver injury.
    These results suggest that AZP-induced hepatotoxicity may be due to the inhibition of nucleic acid and protein biosyntheses by active metabolites such as 6-thioinosine monophosphate, which are formed from AZP via 6-MP and TIR.
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  • Hiroshi KIMURA, Makoto KAKO, Masao TORII, Katsuyoshi TAKATSUKI, Kenji ...
    1979 Volume 76 Issue 9 Pages 1836-1841
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    A clinicopathological study was performed in 59 patients with primary hepatocellular carcinoma in relation to liver cirrhosis and HBsAg.
    The incidence of HBsAg in patients with liver cirrhosis was 30% in serum and 46% in tissue. In contrast, it was negative in both serum and tissue in those without liver cirrhosis. The patients with positive HBsAg were much younger on an average age at the time of diagnosis than those with negative HBsAg. Besides, there was a significant difference in family history, clinical manifestations, liver function tests, survival time, causes of death and autopsied findings between in patients with liver cirrhosis and in those without that. This difference seemed attributable to the presence of liver cirrhosis.
    These results suggest that HB virus is not an associated factor with hepatocellular carcinoma in liver without liver cirrhosis, but that it might play a role on the development of hepatocellular carcinoma in combination with liver cirrhosis.
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  • In Comparison with Pancreozymin Secretin Test
    Itoko IKUBO, Hideo HARADA, Tetsumasa SHUNDO, Masahiko TAKEDA, Hideyuki ...
    1979 Volume 76 Issue 9 Pages 1842-1850
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    PFT is a new exocrine pancreatic function test by means of measurement of PABA recovery in 6 hour urine after oral administration of BT-PABA which is specifically cleaved by the pancreatic chymotrypsin to release PABA.
    To evaluate its diagnostic value, we performed PFT in 220 patients with pancreatic and hepatobiliary diseases and 29 controls. The results were compared with pancreozymin secretin test (PS test) in 111 patients.
    Following results were obtained. 1) PFT value was significantly decreased in chronic pancreatitis, pancreatolithiasis, cancer of the pancreas, and hepatobiliary diseases. 2) A good correlation was obtained between the PFT value and each of three parameters of PS test (p<0.001 respectively). 3) PFT value was decreased in 62.5%, 92% and 100% of patients with one, two, and three abnormal parameters on PS test respectively. 4) PFT value was decreased in almost all patients with more than one abnormal parameter of more than moderate degree on PS test. However, only half of patients with minimal to mild abnormality on PS test showed decreased PFT. 5) A decrease of pancreatic chymotrypsin output was observed in 2 of the patients who showed abnormal PFT despite normal PS test. This finding is interesting in the light of non-parallel secretion of pancreatic enzymes. These results indicate that PFT is a simple and useful test to detect exocrine pancreatic insufficiency of more than moderate degree.
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  • Tetsuichiro MUTO, Junjiro KAMIYA, Toshio SAWADA, [in Japanese], Satoru ...
    1979 Volume 76 Issue 9 Pages 1851-1856
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Yuichi HASEDA, Kiyoo MORI, Takasi SATO, Tamehisa ONOE, Umeo MIWA, Yoic ...
    1979 Volume 76 Issue 9 Pages 1857-1863
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Kiyokazu HOMMA, Yukifumi SAITO, Masayuki NIWA, Kohji SATO, Kazuei OGOS ...
    1979 Volume 76 Issue 9 Pages 1864-1870
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Tomoko KAWASAKI, Kazuhisa TAKETA, Masatoshi UEDA, Akiharu WATANABE, Ma ...
    1979 Volume 76 Issue 9 Pages 1871-1877
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Keishi TAKECHI, Naoki TOKIMITSU, Tsuneo TAZIMA, Masaaki KAMETANI, Taka ...
    1979 Volume 76 Issue 9 Pages 1878-1882
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    A case of hepatic artery aneurysm in a 78 year-old female is reported. She was admitted to our hospital with chief complaint of epigastric discomfort and jaundice. Laboratory findings showed obstructive jaundice and inflammation. Abdominal plain film revealed a calcification in diameter of 1.7×1.2cm.
    According to Upper GI series and PTC, the calcification had no relation to upper GI tract, common bile duct and gallbladder. Angiographic examination disclosed hepatic artery aneurysm with calcification on hepatic artery division of coeliac artery.
    Hepatic artery aneurysm is rare. This is the 14th case reported in Japanese literature according to our survey.
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  • Toshiharu MITSUHASHI, Masaaki MURAYAMA, Yoshiteru AZUUMI, Takeshi GOTO ...
    1979 Volume 76 Issue 9 Pages 1883-1887
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Shigeru FUJIMOTO, Hiroaki ISHIGAMI, Masaru MIYAZAKI, Kenjiro ITOH
    1979 Volume 76 Issue 9 Pages 1888
    Published: September 05, 1979
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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