Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 78, Issue 11
Displaying 1-23 of 23 articles from this issue
  • Toshio NISHIOKA, Toshikazu SEKIGUCHI, Michio KOGURE, Motoyasu KUSANO, ...
    1981 Volume 78 Issue 11 Pages 2065-2073
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    In 17 healthy subjects, a continuous manometric study in the stomach and the duodenum was performed. In addition, intraduodenal pH was measured simultaneously in 7 subjects out of 17. In the fasting period, four patterns of motility, phase I-IV, were repeated at certain intervals. The intervals of motility cycle, however, differed among each individual. Gastric motility was more irregular than duodenal one. Changes in intraduodenal pH occurred in association with phasic motor activity. Intraduodenal pH was classified into two patterns, the one fluctuating below pH 4, the another remaining in neutral pH period. In interdigestive state, the two patterns occurred alternately but the intervals and the durations of pH cycle coincided with the phasic motor activity. For the period preceding duodenal phase III activity, intraduodenal pH fluctuated frequently and widely with acidification. On the other hand, intraduodenal pH rised quickly up to 7 and maintained neutral pH level soon after phase III activity was mediated to the duodenum.
    From these results, we suggest that the cyclic changes of phasic motor activity and intraduodenal pH are probably related to the release of endogenous secretin as well as motilin.
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  • Clinical Application of a Noninvasive, Consecutive, High-Speed Reflectance Spectrophotometry
    N. SATO, A. NAKAGAWA, S. KAWANO, M. FUKUDA, H. MEREN, M. SHICHIRI, T. ...
    1981 Volume 78 Issue 11 Pages 2074-2078
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Gastric mucosal hemodynamics and oxygen sufficiency were determined in 19 healthy adults ranging 22 to 69 years old by organ-reflectance spectrophotometer (N. Sato et al., Gastroenterology 76, 814, 1979) performed during gastrofiberscopy. The mucosal blood volume in most part of stomach, which was determined by the absorbance (and partly scattering) difference between 569 and 635 nm in spectra obtained via a quartz fiber optics, decreased significantly with age. In contrast, the oxygen sufficiency in the mucosa, which was determined by the oxygen saturation of hemoglobin in the intramucosal vasculature, was not decreased with age. These results suggest that the mucosal blood flow and volume decrease with age after twenties, but that the oxygen sufficiency of gastric mucosa remains to be normal, possibly due to lowered respiratory activities.
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  • Using the Methods of Succinylated Albumin as Substrate
    Kazumasa MIKI, Masao ICHINOSE, Chie FURIHATA, Cing-Ming CHANG, Hirohum ...
    1981 Volume 78 Issue 11 Pages 2079-2086
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Pepsinogen (Pg) activity of gastro-duodenal mucosa were determined using biopsy specimens in 95 cases, both in-and-out patients of our department (Mean age 52 y.o., Gastric cancer 27, Gastric ulcer 26, Duodenal ulcer 12, Normal & others 21). That is, biopsy samples were collected at times of endoscopical examination in these subjects from duodenum, antrum, angle and corpus under direct observation. Two samples from each part, one for Pg assay and the other for histological evaluation such as the existence of intestinal metaplasia and type of gastric gland. From these collected 355 samples in a series of 100 endoscopical examination, Pg was extracted by centrifugation at 105, 000xg for 60 min at 4°C and supernatant was used for assay. Pg activity was measured by the method using succinylated albumin as substrate, and protein concentration, by the method of modification of Lowry's.
    From these aquired Pg activity per mg protein, following results were obtained: 1) Mucosal Pg activity gradually gets higher from pylorus to corpus (P<0.001). 2) Corelation between histology of gastric glands and Pg activity was, func gland>intermediate gland>pylolic gland (P<0.001). 3) The difference of Pg activity between gastric mucosa with and without intestinal metaplasia was statistically significant (P<0.01). 4) In relation to various diseases, mucosal Pg activity of duodenal ulcer was significantly higher than normal and gastric ulcer (P<0.001) in both gastric and duodenal mucosa.
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  • I. Its Evaluation of Quantitative Determination Methods and Significance in Normal Subjects
    Itsuo AMIOKA
    1981 Volume 78 Issue 11 Pages 2087-2095
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The quantitative determination methods of Prostaglandin E (PGE) in gastric juice and the significance of its existence in normal subjects were studied. It was possible to determine the endogenous PGE by extracting with ethyl acetate, separating individual PG groups on silicic acid column chromatography, converting PGE to PGB by alkaline treatment and performing the radioimmunoassay using anti-PGB1 serum. The final recovery of internal standard 3H-PGE1 following all of these procedures ranged from 68.6% to 75.7%.
    There was interconversion of PGE to PGA in an acidic solution of pH1.0 according to the frozen storage periods. Because, 3H-PGE1 was characterized by gradual decrease of elution ratio appeared in the PGE fraction on silicic acid column chromatography to 97.5% after 3 days, 93.6% after 7 days and 82.9% after 14 days. Therefore, it was considered necessary to perform the determination within 1 week.
    The concentration of PGE in the basal state of normal subjects was 262.7±25.7pg/ml(M±SE). After pentagastrin stimulation, the concentration of PGE showed a gradual decrease following an increase of secreted gastric juice volume. The total output of PGE in the basal state and after stimulation recorded 11.0±1.8 ng/h and 12.8±2.1 ng/h (M±SE), respectively. These values were neither statistically significant from basal levels (p>0.05), nor suggestive the possibility that the increased release of endogenous PG would be promoted by pentagastrin stimulation. Furthermore, no significant correlation was seen between the secretion of acid (BAO, MAO) or pepsin (BPO, SPO) and that of gastric PGE (acid and PGE secretion: r=0.21 in the basal state, r=0.37 after stimulation. Pepsin and PGE secretion: r=0.18 in the basal state, r=0.56 after stimulation).
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  • A Study of 21 Autopsied Cases
    Masafumi ICHIKAWA, Yoko NISHIZUKA, Shigeo SUZUKI, Masato TANAKA, Sabur ...
    1981 Volume 78 Issue 11 Pages 2096-2103
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    A study of 21 cases with pseudomembranous enterocolitis diagnosed post-mortem was described. The incidence of pseudomembranous enterocolitis in the all necropsies was 3.2% in a 7-year period from 1973 to 1979 in our hospital. The incidence of the disease did not increase significantly during the recent 7 years.
    As for the abdominal symptoms, diarrhea was noted in 19 cases (90%) and bloody stool was observed in 7 cases (33%). In all 21 cases, various antibiotics has been administered prior to the development of the pseudomembranous enterocolitis. Average interval from the initiation of antibiotic treatment to the onset of abdominal symptoms was 8 days with a range of 1 to 24 days.
    Microscopically, in 19 cases (90%), lesions were located in the large intestine while in the small intestine, lesions were observed only in 2 cases (10%). The lesion of rectum was seen in 18 cases (86%) and the degree of involvement was generally severe in the anal site.
    Histologically, the inflammatory changes were confined to mucosal or submucosal layers except one case in which the perforation leading to peritonitis occured at the transverse colon.
    In 4 cases (19%), serious complications of the pseudomembranous enterocolitis such as sepsis, marked hypoproteinemia and perforative peritonitis were observed.
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  • Especially Long-Term Treatment with Carrageenan and Intestinal Bacteria
    Atsuo KITANO, Kenzo KOBAYASHI, Hidenori OSHIUMI, Kiyotaka OOKAWA, Shir ...
    1981 Volume 78 Issue 11 Pages 2104-2111
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    We have already reported the carrageenan induced colitis which resembled human ulcerative colitis in rabbits. In order to clarify its pathogenesis of lesion, we examined bacterial flora after the administration of antibiotics. For the purpose of elucidating the effect of long-term administration of carrageenan, we further studied the fecal bacteria and the ulcerative lesion histologically.
    In one group treated with antibiotics prior to carrageenan administration, histologically the inflammatory changes were more mild than those of carrageenan only treated.
    In another group of long-term carrageenan treated, Bacteroides fragilis in feces was remarkably increased and histologically mucosal atrophy, mild cellular infiltration with lymphocytes, submucosal edema and deformed glands were observed. These findings suggest that the inflammatory changes may be chronic.
    We concluded that intestinal bacteria may play an important role in formation of ulcerative lesion in the mucosa and chronicity of these lesions.
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  • Soichiro MIURA, Hitoshi ASAKURA, Tetsuo MORISHITA, Kensuke KOBAYASHI, ...
    1981 Volume 78 Issue 11 Pages 2112-2121
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    This study was performed to assess how disorders of intestinal lymphatics affect the fat absorption and plasma fatty acid composition in patients with protein-losing enteropathy (PLE). Olive oil tolerance test, 131I-triolein test and jejunal endoscopy were carried out in patients with PLE. Patients with PLE were divided into two groups. Group A included diseases with disorders of intestinal lymphatics and group B included diseases without such disorders. Plasma lipids in patients with PLE at fasting showed similar abnormalities of fatty acid composition to that of malabsorption syndrome, especially in group A.
    Percentage increases of total concentration of plasma lipids and oleic acid fraction after olive oil administration were depressed in patients with PLE group A and malabsorption syndrome when compared with that of normal subjects and PLE group B. However there are patients with PLE group A who showed normal fecal excretion rate of 131I-triolein, despite the abnormal values of olive oil tolerance test. We observed the findings of white villi or scattered white spots by jejunal endoscopy in all patients with PLE group A. These results suggested that the abnormalities of intestinal lymphatics may play an important role in the impaired lipid absorption and the abnormal plasma fatty acid composition in patients with PLE and that a delayed transport of lipid from intestinal epithelial cells to lymphatics was existed in these patients.
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  • Hiroshi KAWANO, Kiyoshi FUJITA, Masatosi WATANABE, [in Japanese], Yosh ...
    1981 Volume 78 Issue 11 Pages 2122-2128
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The gastrointestinal tract is one of the major system affecte a by P. S. S., but the functional investegations of the colon in P. S. S. are not so much.
    The purpose of this study was to investigate the alternations of the colonic motility that occur in patients with P. S. S..
    The colonic manometric studies using the open tipped method were performed in 3 patients with P. S. S., at 3 portions of the colon, sigmoid, transverse and ascending colon, and were compared to normal subjects. The motility index (M.I.) was used as a parameter. At a basal time, M.I. was low titer as compare to normal subjects.
    The response of the colonic motility to neostigmin 0.5mg administration correlates with the duration and severity of the clinical disease. The abnormality of the colonic motility was to measure in patients with P. S. S. who had no colonic symptoms and normal findings on barium enema.
    The measurement of the colonic manometory may be useful for the diagnosis of the colonic severity in P. S. S.. But both at basal time and at neostigmin loading, the difference of the motility in each portions of the colon were unclear.
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  • Masahiro AKAIKE, Hidemasa OKUMURA, Takumi ARAMAKI, Kyoichi KIKUCHI, Ya ...
    1981 Volume 78 Issue 11 Pages 2129-2135
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    The small outbreak of non-A, non-B hepatitis occurred in the coronary care unit of Nippon Medical School.
    Of 161 patients with acute myocardial infarction hospitalized in the CCU during a period of 2 years, acute viral hepatitis developed in 8 patients. Seven of the 8 cases were thought to be the clustering and the remaining case sporadic. Epidemiologic investigation implicated catheter procedure for measuring cardiac output as the source of exposure.
    On the basis of serologic testing for hepatitis B and hepatitis A, clinical course and detection of antibodies against cytomegalo virus or herpes simplex virus, the diagnosis of non-A, non-B hepatitis was established in all cases.
    In one of the above 7 clustering cases, multiple attacks of non-A, non-B and type B hepatitis were observed. This outbreak illustrates the risk of hepatitis in CCU where many kinds of surgical procedure are performed.
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  • Toshihiro MORIKAWA
    1981 Volume 78 Issue 11 Pages 2136-2143
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Plasma amino acids concentrations were determined in 70 patients of liver diseases. Branched chain amino acids (BCAA) levels were markedly decreased in decompensated liver cirrhosis and subacute hepatitis, and aromatic amino acids (AAA) levels were markedly elevated only in subacute hepatitis. The molar ratios of BCAA/AAA were low in subacute hepatitis, particularly in the cases with hepatic encephalopathy. The ratios in decompensated liver cirrhosis were also low, however correlation between the ratios and hepatic encephalopathy was not observed in liver cirrhosis. The molar ratios of BCAA/AAA were decreased in parallel with the progression of chronic liver diseases. And the ratios well correlated with several hepatic tests which reflect the total functioning hepatic cell mass, especially ICG Rmax, but not correlated with plasma immunoreactive insulin levels. The molar ratios of BCAA/AAA tended to be decreased following repeated infusions of commercial amino acids fluid in liver cirrhosis. Hepatic encephalopathy improved by the treatment with the synthetic high BCAA fluids in 20 times out of 25 treatments (improved rate; 80.0%).
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  • Importance of Sensitivity of the Methods used in the Setting when Mother-Infant Transmission is Possible
    Shousuke IWAMA, Takatsune NAKAYAMA, Seiji TSUCHIYA, Yoshiaki HIYAMA, N ...
    1981 Volume 78 Issue 11 Pages 2144-2150
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Various HBV markers were measured in 106 asymptomatic HBsAg carriers and in 76 infants born from asymptomatic HBsAg carrier mothers. The radioimmunoassay method was more sensitive than the Micro-Ouchterlony method for the detection of HBeAg and anti-HBe in asymptomatic HBsAg carriers. The former was more useful than the latter for predicting the vertical transmission of HB virus from asymptomatic HBsAg carrier mothers to their infants and subsequent development of carrier state. Anti-HBc in cord blood in the infants born from asymptomatic HBsAg carrier mothers was derived from the antibody transmitted trans-placentally from the mother, and disappeared in 1 to 1.5 years when no HBV infection occurred.
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  • Yoshiro MATSUMOTO, Rokuro MASHIMO, Yasuo KAMIYAMA, Kotaro UCHIDA, Kazu ...
    1981 Volume 78 Issue 11 Pages 2151-2160
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    We had 25 patients with the stricture at the upper portion of the biliary ductal system in these 15 years. Of the 25, excluding 3 patients who presented the narrowing of the common hepatic duct due to "Mirizzi's phenomenom", 22 were associated with congenital cystic dilatation of the common bile duct. The strictures located approximately in the region of the hilus, such as at the junction of the intra- and the extrahepatic ductal system, hepatic ducts and the portion at which the right and the left hepatic ducts and/or the common hepatic duct united. Except for a patient with cystic dilatation of the common hepatic and the common bile duct, 21 patients had segmental dilatation of the main intrahepatic and the whole extrahepatic bile ducts. And of the 21, 16 had primary stones in the intrahepatic bile duct proximal to the stricture. The shape of the intrahepatic ductal system of the 16 with intrahepatic calculi were entirely resemble to that of the 5 patients without intrahepatic calculi. Histological aspects of the wall of the stricture presented no remarkable changes as compared with those of the surrounding dilated bile ducts. Accordingly, the strictures were considered to be formed congenitally.
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  • Tissue Derangement of 112 Corticosteroid Treated Autopsy Specimens
    Teruhisa OKUMURA, Masanao OKADA, Kanenobu CHIBA, Hiroyuki NAKAMURA, Ik ...
    1981 Volume 78 Issue 11 Pages 2161-2169
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Autopsy specimens of the pancreas from the 112 subjects with corticosteroid treatment and the 109 subjects with no-treatment were examined histologically in order to elucidate the effect of steroid on the exocrine pancreatic tissue.
    The consequences are that moderate pancreatitis could be observed in 25 cases (53%) out of 47 steroid-treated cases, except for liver cirrhosis and collagen disease, while it was seen in 8 cases (14%) out of 57 non-treated cases.
    In the corticosteroid treated patients with liver cirrhosis, remarkable pathological changes including pancreatic duct epithelial proliferation, intra-pancreatic ductal inflammatory cell infiltration, inflammatory cell infiltration into interstitium of pancreatic lobules and parenchymal focal necrosis were observed more significantly than in non-treated cirrhotic pancreas.
    Consequently, corticosteroid seemed to induce focal necrosis of pancreatic parenchyma associated with inflammatory cell infiltration, fibrosis and hemorrhage.
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  • Rieko NAKAMURA, Hiroshi OKADA, Nobuaki TAMAKI, Hiroko BESSHO, Yasushi ...
    1981 Volume 78 Issue 11 Pages 2170-2176
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Pathological examination of the pancreas was done on 6 autopsied cases with Sjogren's syndrome. All cases showed mild to moderate histological changes of the pancreas.
    Of these changes, acinar atrophy and oncocytic change of acinar and duct cells, were commonly seen and found in 4 of 6 cases. Interstitial lymphocytic infiltration was found in 3 cases, and another findings were interstitial fibrosis, acinar ectasis with eosinophilic plug, and parenchymal fatty infiltration.
    The analysis of relation-ship between the lesion of salivary gland and pancreatic involvement demonstrated that the cases with stage III or IV in sialogram tended to have various lesions in the pancreas.
    This study suggests that the pancreas may be involved in Sjogren's syndrome.
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  • Takaharu KONDO, Tetsuo HAYAKAWA, Aiji NODA, Nobuyoshi OKUMURA, Akira S ...
    1981 Volume 78 Issue 11 Pages 2177-2182
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
    Cornell Medical Index (CMI) and Yatabe-Guilford Personality Inventory (Y-G test) were performed in 37 patients with pancreatolithiasis followed up over 5 years. CMI and Y-G test showed group IV (neurotic) and type E (eccentric type), respectively, in 62.5% of the patients with persistent pain. CMI showed group IV in 50% of patients who lost their employment, and Y-G test showed type E in 62.5% of them.
    Since over half of the patients with group IV in CMI and type E in Y-G test showed poor clinical courses, it was suggested that in these patients psychological or psychiatric therapy should be considered in addition to the ordinary medical or surgical treatment.
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  • Kazuo KUSUGAMI, Yutaka UNO, Yuji OKA, Yutaka KUWAHARA, Kentaro YOSHIOK ...
    1981 Volume 78 Issue 11 Pages 2183-2188
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Eiji KAJIWARA, Kimihiro AKAGI, Koichiro MURAI, Mitsuo OKADA, Kiyoshi T ...
    1981 Volume 78 Issue 11 Pages 2189-2192
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • H. Tsubouchi, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    1981 Volume 78 Issue 11 Pages 2193
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Takao TSUJI
    1981 Volume 78 Issue 11 Pages 2194
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Hiromitsu KUMADA, [in Japanese], [in Japanese], [in Japanese], [in Jap ...
    1981 Volume 78 Issue 11 Pages 2195
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Satoshi MORIOKA, [in Japanese], [in Japanese], [in Japanese], [in Japa ...
    1981 Volume 78 Issue 11 Pages 2196
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Kazunari HINO, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 78 Issue 11 Pages 2197
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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  • Yoshinori NUMA, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
    1981 Volume 78 Issue 11 Pages 2198
    Published: November 05, 1981
    Released on J-STAGE: December 26, 2007
    JOURNAL FREE ACCESS
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