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Minoru SUKIGARA, Toshiro KOMAZAKI, Ryozo OMOTO
1987 Volume 84 Issue 7 Pages
1365-1372
Published: 1987
Released on J-STAGE: December 26, 2007
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Esophageal varices were observed by endoscopic real-time two-dimensional Doppler echography (EUS 2-D Doppler).
Examination was performed in 11 patients with either esophageal or gastric varices. Equipment used was convex array Aloka XA 340 and XA 350 (5.0MHz).
Color flow mapping of the varices was obtained in 9 out of 11 patients. In 8 patients, deep varices, which penetrated the esophageal wall or located in the paraesophageal region, were displayed in color. Direction of blood flow was discriminated in five patients. They all were hepatofugal flow. Quantitative measurement of flow velocity was performed by fast Fourier transformation in three patients.
EUS 2-D Doppler is useful for the evaluation of deep esophageal varices which can not be observed by conventional endoscopy.
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Masahiro SUENAGA, Akimasa NAKAO, Toshiaki NONAMI, Togru ICHIHARA, Hide ...
1987 Volume 84 Issue 7 Pages
1373-1380
Published: 1987
Released on J-STAGE: December 26, 2007
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The causes and the mechanism of re-bleeding after direct surgical intervention of esophageal varices were reviewed. Two hundreds and five patients with esophageal varices were treated by direct surgical intervention. One hundred and forty-five patients underwent terminal esophagoproximal gastrectomy (TEPG) involving extensive esophagogastric devascularization and splenectomy fifty-eight underwent proximal gastric transection (PGT) and 2 underwent total gastrectomy. We encountered 20 postoperative re-bleeding. The rates of re-bleeding from each operation mentioned above were 7.6, 13.8, and 50%, respectively. The rates of re-bleeding from the causes of portal hypertension were 38.5% in extrahepatic portal obstruction (EPO), 2.7% in intrahepatic portal obstruction (IPO-fibrosis) and 9.0% in liver cirrhosis (IHO). When re-bleeding occurred, we found (1) advancing hepatic damages, (2) development of new hepatofugal collateral veins from the portal trunk and/or splenic vein by portography, and (3) change of portal hemodynamic circulation from IHO to EPO in almost half of the cases.
Re-bleeding after direct surgical intervention can be considered to be predistined, since it does not decompress the portal vein pressure. The results of the present study showed that the re-bleeding rate was the lowest after TEPG, indicating that theis surgical procedure is the most acceptable one for the control of variceal bleeding.
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Takashi KAWAI, Keiichi KAWAI, Hideto INOKUCHI, Takeshi AZUMA, Zenji SA ...
1987 Volume 84 Issue 7 Pages
1381-1388
Published: 1987
Released on J-STAGE: December 26, 2007
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The effect of Omeprazole, a proton pump inhibitor, on DNA synthesis of gastric mucosa was studied by 4 weeks of administration of Omeprazole (S.C.) in new born rats with
3H-thymidine autoradiography. Significant increase in number of labelled cells per pit were noted in rat fundic and pyloric mucosa treated Omeprazole 50mg/kg. Furthermore the labelled cells were observed scatteringiy between the neck area and the bottom of the gland in fundic mucosa treated Omerazole 50 mg/kg. On the other hand, the increase of DNA synthesis by treatment Omeprazole was also confirmed by mesurement of incorporaion of
3H-Thymidine into gastric mucosal DNA. But these change were thought to be reversible after the cessation of administration.
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Pathogenesis of Indomethacin Induced Gastric Ulcer
Keiki OGINO, Shinji OKA, Shinjiro MAZUURA, Isao SAKAIDA, Shunji YOSHIM ...
1987 Volume 84 Issue 7 Pages
1389-1393
Published: 1987
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It has been suggested that superoxide radicals play an important role in the pathogenesis of gastric mucosal lesion. In this report, it was clarified that superoxide dismutase (SOD) and catalase had inhibitory effect on indomethacin-induced gastric ulcer. SOD had the effect of increasing tendency in gastric mucosal blood flow, inhibitory action on gastric acid secretion and promotive tendency of prostaglandin E
2 synthesis in normal adult rats.
Therefore, it was suggested that inhibitory effect of SOD and catalase on indomethacin-induced gastric ulcer may be due to decrease of inhibition of prostaglandin E
2 synthesis or due to the pathogenesis of indomethacin-induced gastric ulcer in association with endotoxin.
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Osamu FUNAKOSHI, Yuhji MURATA, Akihiro MUNAKATA, Kiyoo KUROE, Yutaka Y ...
1987 Volume 84 Issue 7 Pages
1394-1400
Published: 1987
Released on J-STAGE: December 26, 2007
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In order to investigate the influence of smoking upon the onset and relapse of ulcerative colitis (UC) and Crohn's disease (CD), a case-control study was performed on 111 patients with UC and 25 patients with CD.
Patients were divided into non-smokers (NS), ex-smokers (ES) and smokers (S) by smoking habits at the onset of the disease. Relative risk (RR) and dose-response relationship (DRR) were studied in each groups.
It was revealed that RR of UC was 0.89 in ES (not significant), and 0.50 in S (p<0.001). Negative DRR was shown between the quantity of cigarettes smoked daily and RR of UC, and RR of UC decreased significantly (p<0.01) in patients who smoked more than 21 cigarettes daily. RR of CD was 0.53 (not significant), and DRR was not observed.
These results suggest that smoking might be a low risk factor for the onset of UC, and no association between smoking and the onset of CD was shown.
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Dokan SHIN, Yoshihide SAKAGAMI, Yasuhiro MIZUOGUCHI, Hiroshi TAKEDA, S ...
1987 Volume 84 Issue 7 Pages
1401-1405
Published: 1987
Released on J-STAGE: December 26, 2007
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125I-labeled dimeric immunoglobulin A (IgA) was injected into the mesenteric vein of rats or guinea pigs and excretion of its radioactivity into bile was estimated. While
125I-IgA was excreted into bile at a considerably higher speed in the case of rats, its excretion in guinea pigs was extremely low. But radioactivity detectable in liver tissue 2 hours after intravenous injection of
125I-dimeric IgA was not so different between rats and guinea pigs (rats 21.6% and guinea pigs 17.6% for the amount of injected
125I-radioactivity). Furthermore
125I-dimeric IgA was significantly incorporated into the isolated hepatocytes prepared from both rats and guinea pigs, but the release of radioactivity incorporated from hepatocytes were remarkably lower in guinea pigs compared with rats.
These results suggested that IgA transport in liver was different markedly between rats and guinea pigs.
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Hiroyuki SATO
1987 Volume 84 Issue 7 Pages
1406-1414
Published: 1987
Released on J-STAGE: December 26, 2007
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Various hepatic tests which reflect total functioning hepatic cell masses were determined in patients with liver cirrhosis, in order to elucidate the significance of these tests in assessment of the severity of liver cirrhosis. The decreases in survival rates of cirrhosis were associated with abnormalities in various hepatic tests, however, the prognosis of liver cirrhosis was more clearly evaluated when prognosis compared between compensated and decompensated cirrhosis without relation to various tests values. To get a more clear indices for the evaluation of severity in liver cirrhosis, various tests values were assessed with several combinations. Among these combinations, the clearest difference of prognosis was obtained by a combination of hepatic volume, indocyanine green (ICG) maximal removal rate and serum cholinesterase, in which the boundary levels were 500cm
3/m
2 body surface area, 0.2mg/kg/min and 0.2ΔpH, respectively. Survival rate was very low in cases showing lower values than the boundary levels in all three tests, and was very high in cases showing higher values than the boundary levels in all three tests. Furthermore, in the caes keeping low levels of high density lipoprotein (HDL) binding ICG less than 10% were all dead within a few nonths. These results indicated that a combination of three hepatic tests was a most sensitive index to assess the severity in liver cirrhosis and that HDL binding ICG was useful for the detection of the most severe cases of cirrhosis.
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Norio HORIIKE
1987 Volume 84 Issue 7 Pages
1415-1423
Published: 1987
Released on J-STAGE: December 26, 2007
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HLA-class I on hepatocyte membrane was examined in liver biopsy specimens of 46 patients with chronic hepatitis type B by the peroxidase-labeled antibody method using avidin-biotin complex.
HLA-class I was detected in all patients. The pattern of HLA-class I was diffuse honey-comb-like and a dense staining area was often observed. Diffuse type staining (no dense staining area) was observed mainly in patients with CIH. In the HBeAg positive group and in the anti-HBe positive, abnormal GPT group, Focal type staining (dense staining area is focal) and Zonal type staining (dense staining area is zonal) were observed mainly in patients with CAH. A Gloss relation between the Focal type of HLA-class I and a sharp elevation of GPT was demonstrated.
The grade of HLA-class I was enhanced in 3 of 4 cases treated with interferon.
HLA-class I, which is necessary for attack of cytotoxic T cells to infected hepatocytes in chronic hepatitis type B, was detected on the hepatocyte membrane. These data suggest that a close relation between HLA-class I displays and exacerbation of hepatitis exist.
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Kenichi TAKAYASU, Yukio MURAMATSU, Noriyuki MORIYAMA, Tatsuya YAMADA, ...
1987 Volume 84 Issue 7 Pages
1424-1432
Published: 1987
Released on J-STAGE: December 26, 2007
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With reference to recurrence in the residual liver following hepatectomy for small hepatocellular carcinoma (_??_5cm in diameter), 97 patients were followed during the various periods from 9 months to nine years and one month and the following results were obtained; (1) recurrence occurred in 54 patients (55.7%)after a mean of 14.5 months from hepatectomy, (2) as a risk factor for recurrence, a solitary lesion with daughter tumors and multiple lesions, and negative HBs-Ag at the time of hepatectomy were significant. However, pre-operative therapeutic embolization was not effective for preventing the recurrence, (3) survivals for the entire patients who had hepatectomy, and those without and with recurrence were as follows: one year survival, 89%, 93%, 87%; 3 year survival, 54%, 84%, 45%l; and 5 year survival, 26%, 84%, 12%. (4) survivals for the patients with and without postoperative embolization for recurrence were; 1 year survival, 73%, 37%; 3 year survival, 47%, 0%; and 5 year survival, 16%, 0%.
Therapeutic embolization for recurrence proved to contribute to prolonging the survival of patients after hepatectomy and to improving the results of surgery.
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Yoshiya SAKAMOTO, Kazuichi OKAZAKI, Yasuro YAMAMOTO
1987 Volume 84 Issue 7 Pages
1433-1441
Published: 1987
Released on J-STAGE: December 26, 2007
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The functions of the papillary sphincter zone and the pancreatic duct-acinar system were examined myoelectrically and histologically as important factors in the regulatory mechanism of pancreatic ductal pressure in 5 Japanese monkeys. Saline solution was injected through a catheter inserted into the distal end of main pancreatic duct. The pancreatic ductal pressure rose to a plateau level (19.8±3.0mmHg, M±SD, n=5) when the myoelectrical electrodes implanted in the papillary sphincter muscle indicated that the sphincter had relaxed. Under the condition of occlusion of the pancreatic main duct in the pancreas head, increased pressure of the pancreatic caudal duct had no myoelectrical effects on the motility of the papillary sphincter zone. This suggests the existence of a duct-papillary reflex that is controlled by a pressure receptor which may exist in the papillary sphincter zone.
Saline solution mixed with isotonic India ink was injected into the main pancreatic duct in the histological examination of the duct-acinar system. At the pressure of 25mmHg, India ink was microscopically detected in the intercellular space thereby confirming the dilatation of the duct-acinar system. Dilatations of the intercellular clefts were observed under the electron microscope. This suggests that the destruction of the acinar cells by excess pressure in the pancreatic duct is prevented by a mechanism which allows the pancreatic fluid to leak through the intercellular space into the periacinar space where it is absorbed into the lymph or venous system.
We conclude that the motility of the papillary sphincter zone and the duct-acinar system are important factors in the mechanism which regulates the pancreatic ductal pressure.
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Takahiko NAKAMURA, Makoto OTSUKI, Satoshi TANI, Masatoshi FUJII, Toru ...
1987 Volume 84 Issue 7 Pages
1442-1446
Published: 1987
Released on J-STAGE: December 26, 2007
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The effect of ethanol on exocrine pancreatic function was studied in the isolated perfused rat pancreas. Ethanol at a concentration of 340mM caused a significant inhibition on exocrine pancreatic secretion stimulated by cholecystokinin octapeptide (CCK-8) and carbamylcholine of which actions are mediated via a mechanism through Ca
2+ mobilization but didn's inhibit exocrine pancreatic secretion stimulated by secretin and vasoactive intestinal polypeptide (VIP) of which actions are mediated via increase of cellular cyclic AMP. Addition of calcium ionophore (A23187) or increase of Ca
2+ concentration in perfusate from 2.5mM to 5mM abolished the inhibitory effect of ethanol on CCK-8 and carbamylcholine stimulated exocrine pancreatic sectetion. The present observations suggest that ethanol inhibits pancreatic exocrine secretion by acting on postreceptor site and inhibiting intracellular Ca
2+ mobilization.
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Keisuke VEDA, Yukiko NUMATA, Kazunaga TAKAMATSU, Nobukazu YASUOKA, Tad ...
1987 Volume 84 Issue 7 Pages
1447-1452
Published: 1987
Released on J-STAGE: December 26, 2007
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Masato MAEDA, Yoshinori SAKAI, Wataru KOYAMA, Shinichi TOZUKA, Shigemi ...
1987 Volume 84 Issue 7 Pages
1453-1456
Published: 1987
Released on J-STAGE: December 26, 2007
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Ryo ITO, Mitsuro CHIBA, Osamu MASAMUNE, Takashi WAGA, Shinichi SATO
1987 Volume 84 Issue 7 Pages
1457-1461
Published: 1987
Released on J-STAGE: December 26, 2007
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Hiroyuki FUKUDA, Toshiaki YONEKURA, Yoshiyuki FUJITA, Osamu NISHIZAKI, ...
1987 Volume 84 Issue 7 Pages
1462-1465
Published: 1987
Released on J-STAGE: December 26, 2007
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Osamu NISHIDA, Fuminori MORIYASU, Takefumi NAKAMURA, Nobuyuki BAN, Tak ...
1987 Volume 84 Issue 7 Pages
1466-1470
Published: 1987
Released on J-STAGE: December 26, 2007
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Takayuki HIRANUMA, Shouhei KOYAMA, Akira NAKAHARA, Naomi TANAKA, Susum ...
1987 Volume 84 Issue 7 Pages
1471-1475
Published: 1987
Released on J-STAGE: December 26, 2007
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Hitomi TAKAHASHI, Shoji YAMADA, Jiro TAKEZAWA, Tsutomu HORIKOSHI, Masa ...
1987 Volume 84 Issue 7 Pages
1476-1481
Published: 1987
Released on J-STAGE: December 26, 2007
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Shoji MITSUFUJI, Masahiko TAKAMASU, Hideharu TSUJI, Shin-ichi FURUYA, ...
1987 Volume 84 Issue 7 Pages
1482-1487
Published: 1987
Released on J-STAGE: December 26, 2007
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Shigeki MATSUKI, Akira KANAMORI, Akitaka SHIBUYA, Shigehiro KOKUBU, No ...
1987 Volume 84 Issue 7 Pages
1488-1493
Published: 1987
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Tatsuyuki SATOH, [in Japanese], [in Japanese], [in Japanese], [in Japa ...
1987 Volume 84 Issue 7 Pages
1494
Published: 1987
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Kazuhito ROKUTAN, [in Japanese], [in Japanese], [in Japanese]
1987 Volume 84 Issue 7 Pages
1495
Published: 1987
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Yasuhito YAMANISHI, [in Japanese], [in Japanese], [in Japanese]
1987 Volume 84 Issue 7 Pages
1496
Published: 1987
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Shigeyuki MASUZAWA, [in Japanese], [in Japanese], [in Japanese], [in J ...
1987 Volume 84 Issue 7 Pages
1497
Published: 1987
Released on J-STAGE: December 26, 2007
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Yuichiro YAMASAKI, [in Japanese], [in Japanese], [in Japanese], [in Ja ...
1987 Volume 84 Issue 7 Pages
1498
Published: 1987
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Tadao MANABE, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
1987 Volume 84 Issue 7 Pages
1499
Published: 1987
Released on J-STAGE: December 26, 2007
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