The effects of surgical operation or schizophyllan (SPG) on serum proteins in patients with cancer and mice with experimentally transplanted cancer were examined using polyacrylamide gel electrophoresis and two dimensional electrophoresis. Protein components in the mice, designated as LA, LB and LC were detected and were found to have increased in mice with cancer, reccurrence of cancer or treated with SPG. In patients with cancer, acute-phase crude proteins increased but a newly isolated protein component having a molecular weight of approximately 150, 000 decreased. Although it is said that this component can be seen in healthy persons, this study showed that it remained unchanged in patients without cancer and who had had tumors surgically removed, but increased after the administration of SPG. It is suggested that this component could be a factor potentiating the host defence system and might be a useful indicator to differentiate between benign and malignant tumors. In addition, the fact that increased serum protein components in mice after the administration of SPG similar to those in men after the administration of SPG throws an interesting light on the mechanism of anti-cancer activity.
Duodenal mucosa obtained by duodenoscopic biopsy was examined in 250 normal human control. Classification of villous shape was made and size of the villi was measured under dissecting microscope. Results obtained were summarized as follows; The villous shape was classified finger shaped, leaf shaped, ridge shaped, and convoluted villi. The leaf shaped and ridge shaped villi were most frequently observed in all portion of the duodenum, and covoluted villi were more frequently observed in the bulb than in other duodenal portion. Villous height was significantly lower in the bulb than in other portion. Villous width was similar among different portion of the duodenum. The finger shaped villi of both the bulb and the second portion were more frequently observed in the group of over 70 years old men than younger age group, and the villous height of the bulb was significantly heigher in the former group, too. In conclusion, the differences of the mucosal structure (Villous shape and size) of normal human duodenum were found among different portion and age of the duodenum though the functional significance related to these differences remains to be elucidated.
To investigate the relation between occurence of PCC and TE, it is important to know the working condition of the patient with PCC. After incidence of PCC, however, the solvent used in the workshop was changed from TE to tetrachloroethylene (PE). Even though, useful information about the working condition would be obtained by the analysis of trichloroacetic acid (TCA) concentration in the urine of the workers, as one of the metabolites of PE since environmental condition except solvent in the workshop has not been changed. 42 urine samples were collected from the workers who were engaged in degreasing fabricated metal parts, including case 1 patient. To decrease in colour development by unknown materials in urine, urines were pretreated with Sep Pack C18 prior to analysis of TCA by Fujiwara reaction. Average amount of urinary excretion of TCA in the workers was 2.4 mg/l, whereas that of TCA in healthy control urines was 0.2 mg/l (n=16). The difference was statistically significant (p<0.001). Urinary excretion of TCA in PCC patient (No. 1 case) was 6.7mg/l, which was the second highest level of the workers tested. TCA concentrations of twelve workers were above the maximum allowable concentration of 3 mg/l.
Local distribution of T lymphocyte subsets in ulcerative colitis and Crohn's disease was examined in tissue section using monoclonal antibodies. In ulcerative colitis, OKT3+ cells (p<0.01) and OKT4+ cells (p<0.01) were increased in the involved colonic wall. In Crohn's disease, OKT8+ cells were increased (p<0.01) and OKT4 to OKT8 ratio was decreased (p<0.01) in the involved area. The significant difference of local predominant T lymphocyte subsets suggests the etiological distinction between both diseases.
RAdiation therapy was given not to the whole liver but mainly to the tumor in 24 patients with hepatocellular carcinoma, 20 of whom had a tumor smaller than 10cm in size. The results were as follows; one year survival rate after treatment was 58% in the whole series, and 68% in those who had no tumor thrombus in the main trunk or the first order branch of the portal vein. Tumor regressed in 90% of all the patients, remarkably in those with tumors smaller than 10cm. Serum AFP levels decreased in 90% and tumor stain by angiography or dynamic CT decreased in 75%. Tumor thrombus in the portal veiv trunk or its first order branch regressed or stopped growing in 3 among 5 patients (60%). Pathological examination in 6 patients showed necrosis and fibrosis in the tumor tissue. Atrophy of the irradiated area of the liver and decrease in both albumin and cholinesterase levels occurred after the radiation therapy. It was concluded that the patients with inoperable hepatocellular carcinoma smaller than 10cm in size without severe liver cirrhosis are good indication of radiation therapy.
In a retrospective study, we selected 40 patients with hepatocellular carcinoma treated by transcatheter arterial embolization (TAE) in whom no obstruction of the first or second branches of the portal vein was recognized and divided them into two groups. One group consisted of 26 patients who died within two years (_??_2yr) after TAE, and the other group consisted of 14 patients who survived longer (_??_2yr). Fifteen parameters (age, sex, eleven liver function tests, ascites, and esophageal varices) were compared. Six were statistically significant and one, though not significant, seemed important. These seven parameters were analyzed using the theory of quantification. Results showed that esophageal verices, the hepaplastin test, the indocyanine green test, and serum albumin would be most useful in discriminating between the two groups. By employing these four parameters, the outcome could be correctly predicted in 35 of the 40 patients (87.5%).
To investigate the effects of propranolol or nitroglycerin on portal hypertension, hepatic vein pressure gradient, cardiac index and azygos blood flow were measured on patients with portal hypertension (PH group, N=26) and patients with chronic inactive hepatitis (control group, N=7). Hepatic vein pressure gradient, cardiac index and azygos blood flow on PH group were significantly higher than those on control group. Azygos blood flow was correlated with hepatic vein pressure gradient (r=0.65), but wasn't correlated with the stage of esophageal varix. Hepatic vein pressure gradient and cardiac index were decreased by propranolol and nitroglycerin. Azygos blood flow was decreased by propranolol and increased by nitroglycerin. It was suggested that nitroglycerin might be useful for decreasing the portal vein pressure.
The left hepatic duct shows a comparatively regular distribution and is the largest of all the intrahepatic ducts. It tends to en large at the earliest stage of extrahepatic duct obstruction. From our radiological and ultrasonographical anatomic studies, the left hepatic duct is midway between a position immediately superior to the apex of the duodenal bulb and the cardio-phrenic angle on the line of right paravertebra, and this relationship is maintained regardless of the icteric grade. In addition, the falciform ligament is at the line of the right paravertebra. So aiming at the prevention of spontaneous slippage of the PTCD catheter, s-PTLD was attempted by placement in the left hepatic duct for paracentesis on the line of the right paravertebra, at which the catheter passes through the falciform ligament, under ultrasonography or X-ray control. The rate of success registered by the present method in 179 patients with obstructive jaundice was 99%, and spontaneous slippage of the catheter was seen in only 3 (1.6%). As PTCD using the present method is relatively simple and reliable with a very low rate of slippage of the catheter, it was regarded as a most useful method for PTCD in cases of obstructive jaundice.
The effect of CDP-choline, a potent inhibitor of phospholipase A2 (PLA2), on cholecsytokinin (CCK) and carbachol-induced amylase secretion from dispersed rat pancreatic acini was examined. Amylase secretion stimulated by CCK-8 or carbachol increased with increasing concentrations, became maximal at the concentration of 0.1nM CCK-8 or 3μM carbachol respectively, and decreased with further increasing concentrations of secretagogues. CDP-choline inhibited selectively the amylase secretion stimulated by submaximal concentrations of CCK-8 (up to 3nM) or carbachol (up to 10μM) but not by supramaximal concentrations of CCK-8 or carbachol. CDP-choline neither affected the binding of 125I-CCK to its receptors on pancreatic acini nor influenced calcium outflux stimulated by CCK-8. These results indicate that CDP-choline inhibit CCK and carbachol-induced amylase secretions by eliminating subsequent activation of intracellular mechanisms to receptor bindings of secretagogues. Since CDP-choline has been known to a potent inhibitor of PLA2, it seems likely that activation of membrane PL2 will be involved in the action of CCK and carbachol.
Quantitative examination of serum pancreatic secretory trypsin inhibitor (PSTI) was performed in order to clarify the mechanism of abnormal elevation of serum PSTI levels in patients with chronic renal failure (CRF). There found no substances that interfere PSTI-radioimmunoassay (RIA) system. Dilution curves of serum and urine of the patients with CRF were parallel with standard curve for PSTI, and recovery of exogeneous PSTI added to serum and urine of CRF was 102.6±1.6% and 108.8±1.6%, respectively. Moreover, elution profile of serum PSTI from patients with CRF through Sephadex G-200 column was the same as that of PSTI in normal subject. Taken together with the previous our observations that denied excess production of PSTI from pancreas in patients with CRF, these results indicate that reduced renal clearance of PSTI is the main reason for abnormal elevation of serum PSTI levels in patients with CRF. However, urinary PSTI excretion was markedly increased in patients with CRF and inversely correlated with creatinine clearance. These findings could not be explained simply by the reduced glomerular filtration of PSTI in CRF but suggested production of PSTI in kidney. The present observations suggest that elevation of serum PSTI levels in CRF is mainly due to reduced renal clearance of PSTI and additionally to renal production of PSTI.
The pancreatic duct cell adenocarcinoma induced in Syrian golden hamster by di-isopropanol nitrosamine could be easily and repeatedly implanted into the subcutaneous tissues of the homologous animals. The antitumor effect of mitomycin-C (MMC) was tested against established palpable tumors. Four weeks after implantation, the animals were divided into five groups. Saline was injected into the tumor (control group). Saline containing MMC and suspension of charcoal particles adsorbing MMC were injected into the tumor, respectively (MMC-L and MMC-CH-L groups). The needles containing and slowly releasing MMC were stung into the tumor (MMC-N-L group). The saline solution of MMC was injected into peritoneal cavities (MMC-S group). The tumor size in MMC-L and MMC-CH-L groups increased significantly slowly, as compared with that in control group. No inhibitory effect on tumor growth was seen in MMC-N-L and MMC-S groups. The assay of MMC concentration suggested that differences of antitumor effects observed in the MMC treatment groups were derived from the differences of MMC concentration in tumor tissues.