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Volume 84, Issue 5
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Rintaro INOUE1987 Volume 84 Issue 5 Pages 1015-1024
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSElective and prophylactic EIS was performed in 38 cirrhotic patients with esophageal varices. Clinical study was made on esophageal ulceration by EIS and its effects on esophageal function were evaluated by esophagoscintigram. Esophageal ulceration should be avoided on the early course of EIS because it may also cause the bleeding. In order to avoid esophageal ulceration, it is of great importance to confirm the blood to be aspirated from the varix into the injection needle and not to form large mucosal upheaval and hematoma like appearance at the site of needle puncture just after the injection.
The formation of three or more esophageal ulcereations during the course of EIS, definitely causes the disturbance of lower esophageal sphincter function and esophageal motility. On the follow-up after EIS, it is important to pay an attention on long term complications of reflux esophagitis, esophagel ulcer and stricture.View full abstractDownload PDF (3098K) -
Concomitant or Time Lag Oral Administration of Cimetidine and SucralfateYukio YOSHIDA, Tetuo KASANO, Ken KIHIRA, Masao HIROSE, Ken KIMURA1987 Volume 84 Issue 5 Pages 1025-1028
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSSucralfate (1.0g) was orally given each to five healthy males 2 hours after meal its effects on the blood concentration of oral cimetidine (200mg) was investigated. When sucralfate was given together with cimetidine, the blood concentration of cimetidine was decreased compared to that after postprandial administration of cimetidine alone, and the area under the plasma concentration curve (AUC0→∞) was significantly decreased (ca. 22%) as well, suggesting the inhibitory action of sucralfate against cimetidine absorption. However, when sucralfate was given 2 hours after postprandial cimetidine administration such effect of sucralfate was not observed at all. Therefore, in the combined oral therapy of cimetidine with sucralfate, it is theoretically desirable to separate administration of these drugs with an adequate doing interval.View full abstractDownload PDF (463K) -
Kumiko KURIMOTO, Tomoyuki KANO, Yasuaki ARAI, Seibi KOBAYASHI, Choichi ...1987 Volume 84 Issue 5 Pages 1029-1036
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSOne hundred patients with malignant liver tumor (ninety with liver metastasis and ten with hepatoma) underwent hepatic artery infusion chemotherapy.
Twelve of 33 patients who developed upper gastrointestinal symptoms during the course of treatment were examined endoscopically. Seventeen patients were found to have AGML (fourteen with acute gastric ul and three with acute gastritis). The incidence of AGML was higher in the heavy chemotherapy group, ie, 9.4% in the one shot group, 13.3% in the intermittent infusion group, 25% in the continuous infusion group.
The site of AGML was conincident with the area of corresponding blood supply where anti-cancer drugs were administered. To avoid these complications, selective hepatic artery infusion should be performed not to flow anti-cancer agents into the right hepatic artery. Such patients complaining gastrointestinal symptoms should be examined endoscopically and if AGML are found, discontinuation of HAIC and adequate therapy for AGML is nesessary as soon as possible.View full abstractDownload PDF (1321K) -
Analysis from the Standpoints of Gastric Mucosal Microcirculation and Liver FunctionHiroshi NISHIDA, Tadashi KODAMA, Hitoshi OKANO, Tatsuyuki SATOH, Hideh ...1987 Volume 84 Issue 5 Pages 1037-1044
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSGastric mucosal lesions, such as redness or hemorrhagic erosion, are common in portal hypertension. But very little information is available on the gastric mucosa, especially after sclerotherapy.
In this paper, we investigated the change on the gastric mucosa after E.I.S.
Redness, which was found on the corpus, was dilatation of capillaries around pits by the magnifying view. This was demonstrated in the resected stomach with portal hypertension.
Redness on the corpus and hemorrhagic erosions on the antrum developed after sclerotherapy in 20.9-46.0%, but were transient.
Using hydrogen gas clearance method, gastric mucosal blood flow was decreased after E.I.S.
From these results, the important factors causing gastric lesions after E.I.S. were decreased blood flow and congestion of the gastric mucosal microcirculation.View full abstractDownload PDF (1405K) -
Yoshikazu YONEI1987 Volume 84 Issue 5 Pages 1045-1056
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSThe morphological distribution of the autonomic nervous system and mucosal mast cells in the human colonic wall were studied by light and electron microscopy using histochemical techniques. Colon specimens for histological examinations were obtained from patients with ulcerative colitis (UC) and from healthy subjects by punch biopsy under a colonoscope. Acetylcholinesterase (AChE) was stained histochemically by the method of Karnovsky & Roots and was used as a marker for the cholinergic nerve activity. The AChE activities in the colonic biopsy specimens were divided into three grades; grade ±, + and ++. They were compared among the control, UC-active and UC-inactive group. The AChE-positive nerve fibers were noted abundantly in the interglandular spaces of the colonic mucosa. The grade ++ activity of AChE indicatig the overactivity of the cholinergic nerves was noted in 64% of the UC-active group, while it was not found in the control and UC-inactive group. Ultrastructurally the AChE reaction products were localized mainly to the axonal membranes of the unmyelinated nerve endings in the mucosa. The mucosal mast cells were clearly seen in the colonic mucosa when using an isotonic solution of formaldehyde and acetic acid as fixative. The mast cells were mostly oval-shaped in the control group, while in the UC-active group they were often found to be degranulated in parallel with the degree of the inflammation.
The degranulated mast cells were often found in the vicinity of the nerve endings as observed by electron microscopy. Coincident with the previous report that cholinergic agents act directly on the mast cells via the muscarinic acetylcholine receptors on the cell surface, the present fingings suggest that the excessive stimulation of cholinergic nerves and the degranulation of mast cells may be involved in the mechanism of the exacerbation of UC and that the former may enhance the latter.View full abstractDownload PDF (3876K) -
Norihiko MORI1987 Volume 84 Issue 5 Pages 1057-1067
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSThe vascular structure of rat colon tumors induced with ENNG, MNNG or DMH was studied. The vascular structure changed with tumor growth. The factors that affected the change were assumed to be the size of the lesion, main vector of tumor development-i.e. the dominant direction of tumor growth (intraluminal, horizontal or into deeper layers of the colon wall), the volume of tumor mass including accompanying fibrous proliferation and/or coexisting lymphoid follicles (not only the pathological depth of invasion), and the manner of invasion mainly determined by the grade of differentiation. Early vascular changes were limited to mucosal vessels, but with tumor growth, abnormal vascular structures protruded into the lumen, extended horizontally and/or involved deeper vessels. With deeper tumor invasion, reconstruction of submucosal vessels and then in deeper layers was noted.View full abstractDownload PDF (1786K) -
Study of 100 PatientsYuichi TANABE, Kunihiko OHNISHI, Munemasa RYU, Hiroshi YAMAMOTO, Sadah ...1987 Volume 84 Issue 5 Pages 1068-1076
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSSurvivals for 100 patients with small hepatocellular carcinoma, less than 5cm in diameter, were analyzed based on different therapeutic modalities and Child's gradings.
When analysis was made with respect to major therapeutic modalities wihtout considering stage, the median survival was 35.0 months for 34 patients treated by surgery, 28.8 months for 20 patients treated by transcatheter arterial embolization (TAE), 10.6 months for 25 patients treated by intraarterial chemotherapy (IAC), and 9.7 months for 17 patients who received no specific treatment.
When patients were divided into 3 stages without considering treatment, the median survival was 37.1 months for 37 Child's A patients, 16.2 months for 37 Child's B patients and 1.6 months for 26 Child's C patients. When the effect of major therapeutic modalities on survival was analyzed with considering Child's grading, the survival rate for surgery was better than those for TAE and IAC in Child's A patients. Among Child's B patients, the survival rate for TAE was better than others. Among Child's C patients, there were no significant differences in the survival rate of each treatment or no treatment.
These results suggest that the prognosis depends on treatment given and Child's gradings, and also suggest that surgery will be indicated as a first choice in Child's A, TAE will be preferred in Child's B and a new treatment should be developed for Child's C patients with small hepatocellular carcinoma.
Regardless of treatment, the major cause of death was hepatic failure and cancer death was rare.View full abstractDownload PDF (1099K) -
Hitoshi TAKAGI, Takehiko ABE, Shuuichi SAITOH, Hisashi TAKAYAMA, [in J ...1987 Volume 84 Issue 5 Pages 1077-1083
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESS25 cases of hepatocellular carcinoma were compared with 20 cases of liver cirrhosis about α-fetoprotein (AFP), ferritin, β2 microglobulin (β2M), immunosuppressive acid protein (IAP) and sialic acid. We also investigated the serial changes of those tumor markers after transcatheter arterial embolization (TAE). AFP was the best in sensitivity, specificity and accuracy. There was no correlation between AFP and the other four tumor markers. Every five tumor marker became higher with the growing of the tumor. AFP level decreased after TAE, on the contrary Ferritin and IAP increased in all cases treated with TAE. Ferritin was the highest on two days and IAP was the highest on 14 days after TAE respectively. 1 months after TAE, ferritin and IAP became higher than pretreated levels of them significantly (p<0.01). β2M and sialic acid changed little after TAE. There was no correlation between AFP and the other four markers in the serial changes after TAE.View full abstractDownload PDF (882K) -
With Simultaneous Use of Doppler Flowmetry and Portal CatheterizationTakefumi NAKAMURA, Fuminori MORIYASU, Nobuyuki BAN, Osamu NISHIDA, Tak ...1987 Volume 84 Issue 5 Pages 1084-1089
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSIn order to investigate the splenic circulation in patients with portal hypertension, we calculated the splenic vascular resistance as (mean arterial pressure- portal venous pressure)/splenic arterial blood flow volume in 15 patients with liver cirrhosis (LC), four with idiopathic portal hypertension (IPH) and in six controls. The splenic arterial blood flow volume was obtained percutaneously using an ultrasonic Doppler duplex system.
The splenic vascular resistance of the LC (0.099±0.069mmHg•ml-1•min, mean±S.D.) and IPH (0.042±0.008) patients was significantly lower than that of the controls (0.175±0.081). When corrected according to splenic volume, as obtained using an X-ray CT, the resistance in the LC patients (42.1±22.7mmHg•ml-1•min•cm3) was significantly higher than in the controls (18.2±7.2), but in the IPH patients (26.2±7.3) was not statistically different from in the controls.
These findings suggest that, the splenic vascular resistance in LC is low as a whole, but high from the viewpoint of unit of splenic volume. The resistance in IPH is markedly low as a whole, but normal from the viewpoint of unit of splenic volume.View full abstractDownload PDF (982K) -
Low Productivity of Interleukin 1 and 2Hiroko TSUTSUI, Yasuhiro MIZOGUCHI, Keiji MIYAJIMA, Yoshihide SAKAGAMI ...1987 Volume 84 Issue 5 Pages 1090-1096
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSWe have proved that the serial injection of Propionibacterium ances (P. acnes) and lipopolysaccharide with a week's interval leads to massive necrosis in liver in mice. Such a treatment, simultaneously, decreases the function of T cells: splenic lymphocytes from the liver injury-induced mice hardly respond to mitogenic stimulations. The weakened response might be ascribed partially to the suppressor macrophages activated by the induction of the, liver injury.
To make clear the another cause of the dysfunction of spleen cells, we examined the productivity of interleukin 1 and Interleukin 2, cytokines controlling immunoresponsiveness, of their splenic macrophages and lymphocytes. The production of interleukins in the mice treated by P. acnes alone was not so declined as that in normal mice, while that in the mice suffering from the experimental liver injury was almost vanishing. These data suggested that the mal-productivity of interleukins partialy cause the dysfunction of T cells in the liver injury-induced mice.View full abstractDownload PDF (793K) -
The Effect of Tamoxifen and the Change of Estrogen ReceptorsKatsuji KOHIGASHI, Yoshihiro FUKUDA, Hiroo IMURA1987 Volume 84 Issue 5 Pages 1097-1102
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSMale Sprague-Dawley rats were given a single intraperitoneal injection of diethylnitrosamine (DEN, 200mg/kg body weight). Two weeks later the rats were divided into 4 groups, which were fed olive oil, diethylstilbestrol (DES, 0.5mg/day), tamoxifen (TMX, 1.0mg/day) or both DES and TMX for 8 months. The rats fed DES developed grossly visible hepatic tumors. On the other hand, tumor development was significantly inhibited in the rats fed both DES and TMX. Quantitative analysis of γ-glutamyl transpeptidase positive foci indicated that the promoter action of DES was significantly inhibited by TMX. Estrogen receptors (ER) contents of liver cytosol were significantly larger in the rats fed DES than the rats fed olive oil and smaller in the rats fed TMX or both DES and TMX than the rats fed olive oil. On the other hand, ER contents of liver nuclei were significantly larger in the rats fed TMX or both DES and TMX than the rats fed olive oil or DES. These results suggest that the promoter action of DES and inhibitory action of TMX to it are, at least in part, mediated by ER in the hepatocarcinogenesis in the rat.View full abstractDownload PDF (878K) -
Hideaki AOKI, Akimasa NAKAO1987 Volume 84 Issue 5 Pages 1103-1109
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSExperimental liver cirrhosis was induced in Donryu test rats by intraperitoneal administration of thioacetamide.
Endotoxin (ET) quantitative analysis were then conducted of blood from the inferior vena cava and portal vein and lymph from the thoracic duct.
There was no significant difference in ET levels of inferior vena cava blood, portal vein blood and thoracic duct lymph, either in the group with cirrhosis of the liver or in the control group.
ET levels were higher in the group with cirrhosis of the liver than in the control group, and the physiological effects of the operations led to greater elevation in the ET levels in the group with cirrhosis of the liver than in the control group.
Plasma endotoxin inactivating activity in the group with cirrhosis of the liver was lower than that in the control group.
It is proposed that the decreased plasma endotoxin inactivating activity in the group with cirrhosis of the liver is one important cause of intrinsic endotoxemia.View full abstractDownload PDF (997K) -
Kojiro TAKASE1987 Volume 84 Issue 5 Pages 1110-1120
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSThe effects of the serum of the patients with intrahepatic cholestasis (IHC), free bile acids and conjugated bile acids on the lymphoproliferative response to mitogens such as PHA, PWM and con A were investigated in vitro. Both of the serum of IHC and total bile acid extracted from IHC inhibited the lymphocyte transformation. Most of conjugated bile acids caused lesser degrees of inhibition than the respective free bile acids, and the inhibition was marked in DCA, CDCA and LCA. At the concentration of 10mol/L, all of bile acids showed inhibitory action, and at higher concentration the response was much suppressed. Glycoconjugated bile acids showed similar effects on the transformation as tauroconjugated bile acids. The ultrastructure of the lymphocytes which showed lesser response revealed that the destruction of cristae of mitochondria was marked, on the other hand the cell menbrane was not impaired. These results led to conclude that bile acids induced suppressin of lymphoproliferative transformation by damaging intracellular organella.View full abstractDownload PDF (1794K) -
Toru OKA, Makoto OTSUKI, Itsuo SUEHIRO, Masatoshi FUJII, Takahiko NAKA ...1987 Volume 84 Issue 5 Pages 1121-1125
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSThe renal tubular reabsorption of pancreatic secretory trypsin inhibitor (PSTI) was studied in 13 healthy volunteers by measuring urinary excretion of PSTI before, during and after a 20-minute infusion of arginine at a rate of 0.6 (n=7) or 1.0g/min (n=6), and compared with that of β2-microglobulin (BMG).
During arginine infusion at a rate of 0.6 and 1.0g/min the excretion of BMG showed a 137- and 450-fold increase over the mean basal excretion, respectively. On the other hand, serum BMG concentration was decreased during arginine infusion. The excretion of PSTI rose to 3.5 and 5.7 times above the mean baseline excretion by arginie infusion at a rate of 0.6 and 1.0g/min, respectively. Serum PSTI concentration was also decreased by arginine infusion.
These results indicate that PSTI is reabsorped in the tubular cells, but only a very modest degree compared to BMG. Thus, it is important to consider the renal function especially the renal tubular function before assessing the increased urinary PSTI excretion.View full abstractDownload PDF (505K) -
Special Reference to Endotoxin ClearanceAtsushi OZAWA, Kazuro YOSHIDA1987 Volume 84 Issue 5 Pages 1126-1134
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSEndotoxin concentration in city water increased following the storage at room temperature and decreased by applying purifications-systems determined using the fluorescent probe method.
High concentrations of endotoxin were detected in pleural and peritoneal fluids, bile and urine with positive cultures of gram-negative rods. Plasma endotoxin concentrations in rabbits were decreasing exponentially after administration of endotoxin, and then the plasma disappearance rate (K) was able to be calculated. The maximum removal rate (Rmax) was also able to be calculated, because K values decreased proportionally to increased administered endotoxin doses. K and Rmax apparently decreased when rabbits were pretreated with dextran sulfate, and K elevated and Rmax were similar to the controls when the animals were pretreated with zymosan. These results suggested that at least two disposing mechanisms are involved in the clearance of endotoxin by the reticuloendothelial system.View full abstractDownload PDF (925K) -
Hiroyuki SUGIMOTO, Masahiko TOKUSHIMA, Shozo KUBOTA, Jiro TAKEZAWA, Yo ...1987 Volume 84 Issue 5 Pages 1135-1139
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSDownload PDF (903K) -
Yasushi MATSUURA, [in Japanese], [in Japanese], [in Japanese], [in Jap ...1987 Volume 84 Issue 5 Pages 1140
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSDownload PDF (133K) -
Hiroshi NAKAMURA, [in Japanese], [in Japanese], [in Japanese], [in Jap ...1987 Volume 84 Issue 5 Pages 1141
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSDownload PDF (219K) -
Hiroya YAMAGUCHI, [in Japanese], [in Japanese], [in Japanese]1987 Volume 84 Issue 5 Pages 1142
Published: 1987
Released on J-STAGE: December 26, 2007
JOURNAL FREE ACCESSDownload PDF (137K)
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