The antral somatostatin concentration was determined in non-ulcer subjects and patients with duodenal ulcer. It decreased in parallel with age in non-ulcer subjects but it was low in most patients with duodenal ulcer regardless of age. It also showed a parallel decrease with the advance of antral atrophic change in non-ulcer subjects. On the other hand, it showed a significantly low level in ulcer patients even with mild or moderate atrophic change in the gastric antrum. These findings suggested the possibility that although the antral somatostatin concentration was influenced by antral gastritis, its low level irrespective of the presence or absence of antral gastritis is involved in the pathogenesis of duodenal ulcer.
Localization of CEA has been examined in 21 cases (22 lesions) of atypical epithelium and 24 cases (25 lesions) of well-differentiated early cancer, Type IIa, of the stomach using immunoperoxidase technique. 19 of 22 lesions (86.4%) of atypical epithelium were negative to CEA, and a small portion of 3 lesions showed a weak positive reaction. Among the 25 lesions of well-differentiated early cancer, a strong positive reaction to CEA was observed throughout 20 lesions (80.0). A weak to moderate positive reaction to CEA was observed in epithelium with intestinal metaplasia surrounding both lesions. Such a remarkable difference of CEA localization between lesions of atypical epithelium and well-differentiated early cancer suggests that the two lesions may be different from each other biologically. Furthermore, it is presumable that atypical epithelium may be not premalignant lesion. It is considered that examination of CEA localization may be helpful for differentiation of atypical epithelium from well-differentiated early cancer, in most cases.
Carcinoembryonic antigen (CEA) producing human gastric carcinoma (NSC-4, NSC-5) were transplanted into BALB/c Ajcl-nu nude mice. The original tumor of NSC-4 was obtained from a 61-year-old patient, and the tumor has been transplanted serially 18 passages in nude mice. The tumor of NSC-5 was obtained from a 45-year-old patient, and the tumor has been transplanted serially 11 passages. The transplantability was 100%. The doubling time of NSC-4 in the first passage was 4.6 weeks, and that of NSC-5 was 3.5 weeks. The doubling time of NSC-4 was ranged from 1.0 to 1.9 weeks, and that of NSC-5 was from 0.9 to 2.2 weeks in the serial transplantation. CEA was appeared in the serum of nude mice after transplantation and plasma CEA level of mice was elevated as a function of time. Positive correlation was observed between plasma CEA level and tumor size. The histology of original tumor, poorly differentiated adenocarcinoma, was retained in each passage. CEA was stained positively with immunochemical technique in the original and transplanted tumors, and it was located in the cytoplasms of the tumor cell. These results indicate that CEA producing human gastric carcinomas transplanted into nude mice provide a usefull experimental model for CEA producing gastric carcinomas.
Effect of anti-ulcer drugs on the hemodynamics and oxygen sufficiency in the gastric mucosa of rats was studied by a reflectance spectrophotometry. Histamine H2 receptor antagonists (cimetidine, ranitidine), muscarin receptor antagonist (pirenzepine) and prostagladin E1 derivative (17S-20-dimethyl-6-oxo-prostaglandin E1 methyl ester) were administered, and the mucosal blood volume and oxygen saturation of hemoglobin in the gastric mucosa were examined for 30min. Thereafter, 2% blood of body weight was removed from a carotid artery in 15min, and, again, the gastric mucosal blood volume and oxygen saturation of hemoglobin were estimated from the spectra which were taken at every 5min for 30min after hemorrhgae. At basal state before hemorrhage, all anti-ulcer drugs did not effect the gastric hemodynamics and oxygen sufficiency. In face of hemorrhagic shock, all drugs inhibited the decreases of mucosal blood volume and oxygen saturation of hemoglobin in the gastric mucosa and also protected the formation of stress ulceration. In conclusion, these results suggest that histamine H2 receptor antagonists, muscarin receptor antagonist and prostaglandin E1 derivative had the protective effect against the decresaes of mucosal blood volume and hypoxia in face of hemorrhagic shock, thus preventing the gastric mucosa from ulceration.
In control subjects (n=15) and two groups of duodenal ulcer (DU) patients, normosecretor (n=15) and hypersecretor (n=15), total gastrin and G34-like immunoreactivity (G34LI) in serum were studied. Tw oantisera were used: R-2702 with specificity for hG34 and its N-terminal fragments (G34LI) and 2604 with specificity for the four main components of gastrin (total gastrin). Basal concentrations of both total gastrin and G34LI were higher in hypersecretors than in control subjects and normosecretors. Total gastrin response to a test meal was greater during the initial postprandial 15 minutes in DU patients; this might not be due to G34, but also possibly due to G17.
Everted intestinal sacs have widely been utilized for in vitro studies of absorption of various nutrients. The ordinary everted sac method, however, can give only one point's value. We have developed a new method which enabled us to observe the continuous time course of glucose absorption by an everted intestine. In this method the upper end of a sac was tied over a small polyethylene sampling tip and an aliquot (10μl) was collected from the serosal side every 12 minutes. The same amount of fluid was also collected from the mucosal side at the same time interval. The collected fluids were analyzed for glucose concentration by using a Beckman Autoanalyzer. Using this method, we tested glucose absorption of 8 week-old female Sprague-Dawley rats. We found that glucose absorption of both upper and middle portions of the small intestine was remarkable as evidenced by an increase in glucose concentration in the serosal fluid. The serosal glucose concentration reached a maximum at about 84min. after the start of incubation, and the high concentration was sustained until 180 minutes. On the other hand the glucose absorption by the lower portion of the ileum was very little, e.i. the glucose concentration in the serosal side increased only slightly or insignificantly.
Fecal flora of five patients with untreated Crohn's disease were analysed qualitatively and quantitatively. In comparison with normal healthy subjects, the counts of bacteroidaceae, bifidobacteria, clostridia except Clostridium perfringens were remarkably decreased (p<0.01), while the counts of aerobes including enterobacteriaceae, micrococcaceae (p<0.01), and streptococci (p<0.05) were significantly increased. These results were considered to be secondary changes due to diarrhea rather than specific patterns of Crohn's disease. Changes in fecal flora during treatment with elemental diet (ED), averaging fifty-five days in four patients with Chron's disease, were also studied. During treatment with ED the bacterial counts per gram of wet feces were greater compared with those after begining of oral digestion. However, average fecal volume per day during treatment was much smaller than after treatment. It was concluded that total intestinal bacterial counts were decreased duting treatment. Following treatment with ED, possible harmful changes of intestinal flora were noted. Especially, clostridia except Clostridium perfringens were significantly increased.
The present investigation was undertaken to clarify the effects of ethanol administration on plasma glucagon with special regard to gut glucagon-like immunoreactivity (GLI) secretion in rats. The results obtained were as follows: 1) After a single oral ethanol administration, blood ethanol concentrations reached a maximum at 30 minutes, but blood sugar levels in 10% ethanol ingested rats decreased significantly as compared with those before administration. Plasma immunoreactive insulin levels were significantly depressed in both 10 and 20% ethanol ingested groups. On the other hand, levels of plasma glucagon immunoreactivity (GI) were elevated significantly from the basal levels in both 10 and 20% ethanol ingested groups, although only the 10% ethanol ingested group revealed a significant elevation as compared with control rats. Plasma gut GLI tended to increase gradually after ethanol loading. No differences were, however, observed between ethanol loading groups and the control group. 2) In rats with chronic ethanol administration, plasma GI responses to intravenous bolus arginine injection tended to be lower than those in control rats, whereas the levels of plasma gut GLI before arginine injection were found to be high. In addition, significantly higher responses of gut GLI in these rats were noted at 3 and 5 minutes after the arginine stimulation as compared with those in control rats. From these results, it could be seen that different changes in plasma GI and gut GLI levels occurred between the rats with single and chronic ethanol administration. These changes may have a possible relation to alcohol induced gastrointestinal disorders.
Activated macrophages exhibited cytotoxic effects on isolated liver cells and produced plasminogen activator in vitro. A high molecular weight fraction of normal human serum (Fr-1) was shown to reduce the macrophage-mediated hepatocytotoxicity and enhance the plasminogen activator activity of activated macrophages. Conversely, a lower molecular weight fraction of serum (Fr-3) was found to enhance the hepatotoxic potential and reduce the plasminogen activator activity of activated macrophages. Although similar effects were seen with serum fractions prepared from patients with acute hepatitis, somewhat different influences were observed with serum components from patients with chronic active hepatitis or liver cirrhosis: Fr-1 from patients with chronic active hepatitis was less active in reducing macrophage-mediated hepatocytotoxicity, and Fr-3 was more active in enhancing it, in comparison with corresponding fractions from individuals or patients with acute hepatitis. Fr-3 from patients with liver cirrhosis was shown to be remarkably less active in enhancing macrophage-mediated hepatocytotoxicity. Furthermore, Fr-1 from patients with liver cirrhosis reduced plasminogen activator activity, while Fr-3 was less active in reduing such activity. These findings suggest that these serum components may regulate macrophage-mediated hepatocytotoxicity as well as plasminogen activator secretion of activated macrophages. Our studies also suggest the possibility that relative doses of these serum components may differ in various pathological conditions of the liver.
Sixty patients with portal hypertension in whom percutaneous transhepatic portography was carried out and one hundred normal subjects were studied by real-time ultrasound with respect to the diameters of various sites of the portal vein system, the size of the spleen, and the collateral veins. The diameters of the portal vein system and the size of the spleen measured on sonograms were closely correlated with that on portograms and splenic angiograms respectively. Dilatation of veins in the portal syatem, particuraly of the splenic vein, and splenomegaly were observed as the sonographic findings of portal hypertension. However, no correlation was observed between the degree of dilatation of veins and portal vein pressure, and nor between the size of the spleen and portal vein pressure. Various hepatofugal collateral veins such as a patent paraumbilical vein, dilated and tortuous left gastric and short gastric veins that are the difinite signs of portal hypertension, were also detected by sonography. Real-time sonography is useful in the diagnosis of portal hypertension as a non-invasive modality.
A new high performance liquid chromatographic (HPLC) method was developed for analysis of bile pigments using a reversed phase partition method. This method allows a better separation of a variety of conjugated and unconjugated bilirubin than similar HPLC methods previously reported, and the xyloside conjugate which was not detected by other HPLC methods was identified. There is no degradation of bilirubin tetrapyrroles during the total 90 minute period for this HPLC procedure. The bile of healthy adult subjects was found to contain bilirubin diglucuronide (75.4%), bilirubin monoglucuronide (10.4%), bilirubin monoglucuronide monoglucoside diester (7.4%), bilirubin monoglucuronide monoxyloside diester (3.0%), unidentified bilirubin tetrapyrrole (2.7%) and bilirubin IXα (1.1%).
The fibrosis of the pancreas tissue was successfully made by the contact freezing method, and we used it as an experimental chronic pancreatitis model. By using this model, we studied the correlation between the histologic findings and the pancreatogram, especially about the adjacent fibrosis and stricture of the main pancreatic duct. The results were as follows. 1) The histologic section and the pancreatogeam showed the stricture of the main pancreatic duct when the periductal fibrosis was advanced. 2) On the histologic section, the shape of the main pancreatic duct was sometimes transformed by the parenchymal atrophy, edema and fibrosis. The wall of the pancreatic duct was sometimes stretched by the adjacent fibrosis. I supposed that the pancreatogram reflected these histologic changes as the irregularity and the hardening of the pancreatic duct. 3) In some cases, the dilatation of the distal pancreatic duct and secondary histologic changes around it due to the stricture of the proxymal pancreatic duct, were shown. These results revealed that the stricture of the main pancreatic duct due to adjacent fibrosis, was the manifestation of the early stage of chronic pancreatitis. I had the opinion that these results manifestated the pattern of the progress of chronic pancreatitis.
With an aim to find a clue for CT diagnosis in detecting smaller carcinoma of the pancreas, a comparative study on four cases of the resected pancreatic carcinoma was performed based on CT findings and histology. The following conclusions have been drawn: (A) a few number of well-defined, thick low density areas in small round shape existing in the central part of the pancreatic parenchyma, and (B) a finding of slightly dilated main pancreatic duct are two major important clues for detection of smaller pancreatic carcinoma. A low density area was histologically interpreted as cross-section of the dilated main or branching pancreatic ducts, which was not caused by necrosis. These two major clues (A & B) are frequently observed in either case of chronic pancreatitis or pancreatic cyst; however, our results suggest that we must be sensitive for a possibility of small carcinoma of the pancreas when we encounter these clues. CT scan with 5mm spacing is recommended.