The purpose of the present study is to know the histochemical and ultrastructural changes in the gastric mucosa of mice with gastritis induced by neonatal thymectomy 3 days after birth. The gastric mucosa in mice with gastritis was examined within given periods of time after the operation. Destruction and degeneration of parietal and chief cells were firstly observed with cellular infiltration in deep glandular mucosa 2 months after thymectomy. The mucosa was occupied with immatured, usually mitotic, cells and mucus-containing cells 3 months after the operation. At this period, parietal and chief cells were extremely few in number, which were almost all immatured. The mucus-containing cells observed in deep glandular mucosa showed variable reactivities to PAS-alcian blue, which are completely different from normal mucus neck cells.
Sixty-three feces samples from forty-five patients were screened for C. difficile and its toxin. C. difficile was found in 16 samples (25.4%) in 13 patients (28.9%). Toxin-producing clostridia were considered responsible for pseudomembranous colitis that ensued antibiotic therapy. In some cases endoscopic examinations showed erosion, edema, and bleeding, but no pseudomembrane. In some cases of ulcerative colitis, C. difficile and its toxin could be detected, suggesting their relation with relapse or exacerbation of the disease. Clinically metronidazole was effective for elimination of C. difficile and symptomatic improvement.
The activity of sialyltransferase elevates in serum usually at the time of blood coagulation, which is mainly attributed to platelects. Therefore, it has to be taken into consideration that the values obtained by determination would be largely influenced by the time from a blood collection to a centrifugation and the number of peripheral platelets. The results of determination of sialyltransferase activity in serum performed in various hepatic diseases are that the case of hepatic cirrhosis shows apparently a low value and case of hepatic cancers shows a markedly high value. Although the activity in circulating plasma of the case of hepatic cirrhosis is not different from that of healthy subjects, the activity in serum of the case of hepatic cirrhosis clearly lower than that of healthy subjects. This fact is caused by a decrease in the number of platelets in the case of hepatic cirrhosis. While, in the patients with hepatocellular carcinoma and the patients with cancer metastatic to the liver, the activity of sialyltransferase shows a high value in circulating plasma, and it markedly elevates more due to some elevation occurred at the time of blood coagulation.
Serum ACE activity was measured for a variety of liver diseases, and was found to be elevated in patients with acute hepatitis, chronic hepatitis and liver cirrhosis. The elevation of ACE activity was recognized in both compensated and decompensated liver cirrhosis, and there is no relationship between the ACE activity and arterial oxygen pressure in these cases. On the other hand, patients with fatty liver had normal ACE activity, and patients with obstructive jaundice revealed activity slightly lower than that of the controls. This may suggest that the elevation of ACE activity indicates the degree of liver cell damage, and thus serum ACE determination is useful in diagnosing liver diseases under certain conditions.
The authers have carried out a clinical trial of hepatitis B vaccine prepared by the Hepatitis B Vaccine Research Committee of the Japanese Ministry of Health and Welfare. The study population comprised HBs antigen-negative 51 employees of the Nihon University Hospital, who were divided into two categories: 6 persons in a phase I study and 45 persons in a phase II study. All recipients received subcutaneously three injections of HB vaccine at time 0, 4 and 24 weeks, at two different dose levels of 16μg and 40μg in phase I and II studies, respectively. Of the 6 recipients in a phase I study, 4 who had a previous exposure to HBV showed a quick and abrupt rise of HBs antibody as an anamnestic response and the other 2 without a previous expouse to HBV developed a primary HBs antibody response. Eight of the 45 recipients in a phase II study developed an anamnestic HBs antibody response in 6 with both HBs antibody and HBc antibody and a primary HBs antibody response in 2 with only HBc antibody. Of the remaining 37 recipients without a previous exposure to HBV, 33 developed a primary HBs antibody response (15/18 in males and 18/19 in females) and the other 4 failed to respond to the vaccine. The higher immune response rate in this trial was confirmed in females and also in recipients aged less than 50. These results might suggest that HB vaccine appeared to be safe and efficacious when tested in a high risk group of infection.
In order to investigate the effect of gallstones on induction of gallbladder carcinoma, gallbladder carcinoma was induced by injection of diisopropanolnitrosamine under experimental production of gallstones in hamsters. Eighty male hamsters were divided into following four groups: (I) normal controls; (II) receiving lithogenic diet; (III) receiving DIPN; (IV) receiving both lithogenic diet and DIPN. All animals were sacrificed in the period between 20th and 28th week. Neoplastic growth was found in 11% of group III animals and 40% of group IV anpmals. Incidence of neoplastic growth was relatively higher in group IV animals compared with group III animals. Scanning electron micrograph of the gallbladder mucosa showed a series of degenerative and regenerative changes in group II and, in addition, showed proliferative changes in group IV. So, it was clarified that gallstones played one of the important roles in the etiology of the gallbladder carcinoma in association with other carcinogenic factors.
In patient with pancreatic disease, activity of ribounclease (RNase), amylase level and immunoreactive trypsin (IRT) in duodenal juice obtained during pancreozymin secretin test were measured and their secretory patterns were studied. Secretory pattern of RNase in the group with pancreatic carcinoma was generally lower titre than those with non pancreatic disease or suspected chronic pancreatitis, but not specific for pancreatic carcinoma. So far as correlation among three enzymes after administration of secertin was concerned, 80% of the group with pancreatic carcinoma were in the ranges of 50 to 180units/ml of RNase activity and 40, 000 to 70, 000 Somogyi units/dl of amylase activity. Therefore determination of these enzymes in duodenal juice is useful for the diagnosis of pancreatic carcinoma. In the group without pancreatic disease, the secretory pattern of RNase and amylase was parallel. In the disease groups, however the three enzymes showed different secretory pattern. As a result, it is suggested that secretory pattern of pancreatic enzymes is non parallel in patient with pancreatic desease.
The clinical significance of serum elastase-1 determinations were studied in 63 patients with pancreatic disorders, confirmed clinically and surgically, including 4 cases of acute pancreatitis (A.P.), 4 cases of relapsing acute pancreatitis (R.A.P.), 12 cases of chronic relapsing pancreatitis (C.R.P.), 29 cases of chronic pancreatitis (C.P.) and 14 cases of pancreatic carcinoma (P.Ca.). The serum elastase-1 level was determined by the radioimmunoassay kit (Dainabot Co., Japan). These level obtained was compared with the level of serum amylase in the same samples. The incidence of hyperenzymemia for serum elastase-1 and amylase, determined at the first hospital days, was 66.7% (100% in A.P., R.A.P. and C.R.P., 41.4% in C.P. and 71.4% in P. Ca.) and 41.3% (100% in A.P., 75% in R.A.P., 83.3% in C.R.P., 6.9% in C.P., and 50% in P.Ca.), respectively. The incidence of abnormal elastase-1 elevation was much higher than that of amylase. In the course of 9 patients with acute attack of pancreatitis, serum elastase-1 and amylase were measured. The mean duration of hyperenzymemia was 25±14 days (Mean±SD) in elastase-1, while 7±5 days in amylase, indicating that the normalization of elastase-1 levels delayed in comparison to serum amylase levels. The serial changes of serum elastase-1 levels in the course after acute attack of pancreatitis tended to reflect the clinical manifestation much more than that of serum amylase. From our observations, it was confirmed that the serum elastase-1 is much more sensitive for a diagnostic test of pancreatic diorders, and that the clinical courses of pancreatitis were reflected in the levels of elastase-1 than serum amylase.