Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 85 , Issue 11
Showing 1-22 articles out of 22 articles from the selected issue
  • Hiroaki UJIIE, Michio HONGO, Kenzo SATAKE, Yo OKUNO, Yoshio GOTO
    1988 Volume 85 Issue 11 Pages 2351-2358
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    Transient LES relaxation, which occurs independently from swallowing effort, is one of the main mechanism of gastro-esophageal reflux. In achalasia patietns, incomplete LES relaxation is one of the characteristic manometric finding, along with loss of peristalsis. We monitored basal LES pressure for 30 minutes in 15 achalasia patients, and transient LES relaxation was observed in 7 patients. CCK has been reported to stimulate inhibitory neuron to LES in normal subjects and in animals. Therefore we monitored LES response to caerulein, which has similar biological effects to CCK, in achalasia patients to see i) whether achalasia patients have abnormality in inhibitory neuron to LES, and ii) whether transient LES relaxation is related to caerulein sensitive mechanism. Within 5 minutes after injection of caerulein 40ng/kg iv in 15 patients, total of 14 LES relaxations were observed in 8 patients. LES pressure decreased in 12 patients, and the increase of LES was observed in 2 patients. Caerulein induced LES relaxation was observed in 86% (6/7) of patients who had transient LES relaxations during basal period. We conclude that mechanism which is sensitive to caerulein may be involved in transient LES relaxation in achalasia patients. The peripheral neural mechanism concerned with LES relaxation might remain intact in some of achalasia patients. We speculated that there may be wide variation in level or degree of neural damage in achalasia patients.
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  • Masahiro ARAKAWA, Masayoshi KAGE, Rintaro INOUE, Kazuyoshi NAGATA, Ats ...
    1988 Volume 85 Issue 11 Pages 2359-2364
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    Pathomorphological studies were undertaken on the esophageal wall to examine the spread of the changes following endoscopic injection sclerotherapy (EIS) in 56 autopsy cases. The spread of the changes were examined under the histological classification of acute and chronic changes. The spread of acute changes were so severe that the involvement of the adventitia was found in 30 of 41 cases. Although there was no significant relationship between the spread of the lesion and other factors such as the time of injection and the dose of injected sclerosant, it was suggested that there was relationship between deep ulcer formation and use of S-B tube. Chronic changes characterized by fibrosis of the tissue less extensively developed than acute changes. This difference may be related to differently applied EIS technique for the emergency case and the elective case. It was also possible that no changes left after complete absorption of acute changes such as edema, hemorrhage and inflammatory cell infiltration.
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  • Hiroyuki NOZIRI, Michio TANAKA, Syuuzi INAZUCHI, Hiroshi SASAKI
    1988 Volume 85 Issue 11 Pages 2365-2371
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    A small-sized thermal diffusion flow probe (Fig. 3), 2.5mm in diameter, was manufactured for the purpose of endoscopical measurement of the gastric mucosal blood flow.
    Calibration characteristics of the probe were evaluated in comparison with the hydrogea gas clearance method in the gastric mucosa of canines and humans.
    1) In experimental study using the stomach of 2 canines with laparotomy, the values obtained by these two methods showed a good correlation (r=0.954, p<0.001) (Table 1, Fig. 4).
    2) In endoscopic study using 4 healthy human subjects, a high significant correlation was recognized between the value obtained by thermal diffusion method and electorochemically generated hydrogen gas clearance method (r=0.932, p<0.001) (Table 2, Fig. 5).
    From these results, the absolute value of the gastric mucosal blood flow could be calculated by using the thermal diffusion method.
    This new type of thermal diffusion flow prove made it possible to measure non-invasively and continuously the human gastric mucosal blood flow in endoscopic examination.
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  • Norimasa YOSHIDA, Toshikazu YOSHIKAWA, Yuji NAITO, Hirokazu OYAMADA, S ...
    1988 Volume 85 Issue 11 Pages 2372-2379
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    This study examined the role of oxygen-derived free radicals in the pathogenesis of gastric mucosal lesions induced by burn injury in rats. Superoxide dismutase (SOD), catalase and combinations of SOD and catalase reduced ulcer index; in addition, SOD and catalase alone inhibited lipid peroxidation in the gastric mucosa. SOD combined with catalase inhibited the volume of gastric juice and acid output, but had no effects on the pH of gastric juice, total acidity, gastric blood flow or hexosamine contents in the gastric mucosa. Ulcer index was reduced in rats treated with allopurinol, but not in polymorphonuclear leukocytes-depleted rats. These results indicate that oxygen-derived free radicals from xanthine oxidase and lipid peroxidation play an important role in the pathogenesis of gastric mucosal lesions induced by burn injury in rats.
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  • Ichiro HIRATA, Katsuyoshi HAYASHI, Shin-ya ORINO, Osamu SAITOH, Touru ...
    1988 Volume 85 Issue 11 Pages 2380-2388
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    We have elucidated the distribution of lymphocyte subsets and the expression of HLA-DR antigen in normal peripheral blood and in normal gastrointestinal mucosa. In comparing the results from peripheral blood with those in gastrointestinal mucosa, we found significant differences. Our investigation of peripheral blood produced the following results: a 1.4 leu 3/2 ratio, 10% B cell (leu 4-DR+) and 5% DR-positive T cell. In contrast, the leu 3/2 ratio in gastric and intestinal lamin propria lymphocytes (LPL) were 1.2 and 2.0, respectively. B cells (leu 14+) were rarely detected in intraepithelial lymphocytes (TEL) and LPL of the gastrointestinal mucosa. No DR-positive TEL was seen in the gastrointestinal mucosa.
    Among the stomach, small intestine and colon, the small intestine had the highest value of leu 4+ TEL, leu 2+ TEL, leu 4+ LPL and leu 3+ LPL. Moreover, the small intestinal epithelium specifically exressed HLA-DR antigen in all cases.
    The present results suggest that the small intestine might have higher"immunoactive potentiality"than the stomach and the colon. Consequently, this higher"immunoactive potentiality"of the small intestine might be related to the lower frequency of malignant tumors in the small intestine.
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  • Tomihiro HAYAKAWA, Kenji KATAGIRI, Shigehiro SHIRAKA, Tomio NAKAI, Aki ...
    1988 Volume 85 Issue 11 Pages 2389-2395
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    Hepatobiliary scintigraphy using 99mTc-N-pyridoxyl-5-methyltryptophan (PMT) was used to elucidate the effect of ursodeoxycholic acid (UDCA) treatment on chronic liver diseases.
    After UDCA administration, the peak of the hepatic uptake-excretion curve of 99mTc-PMT (peak time) was significantly shortened. Serum γ-GTP level also improved during UDCA therapy.
    These results suggest that UDCA enhances uptake especially of anions like 99mTc-PMT, and increases their secretion into bile. Consequently, UDCA may be pharmachologically useful for chronic liver diseases.
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  • Daisaku KOSAKA, Toshihito HIRAOKA, Tadahiro KOHDA, Goro KAJIYAMA, Masa ...
    1988 Volume 85 Issue 11 Pages 2396-2401
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    We determined the concentration of two major serum bile alcohols, 27-nor-5β-cholestane-3α, 7α, 12α, 24, 25-pentol and 5β-cholestane-3α, 7α, 12α, 25, 26-pentol in healthy controls and patients with acute hepatitis, chronic hepatitis and cirrhosis using isotope dilution-mass spectrometry.
    In healthy controls, the mean value of total amounts of the two major bile alcohols was 10.3±3.7 ng/ml(mean±SD). In patients with liver diseases, the mean values were as follows: acute hepatitis, 44.8±18.2ng/ml; chronic hepatitis, 18.2±5.6ng/ml; cirrhosis in Child grade A, 37.9±26.0ng/ml, Child grade B, 42.7±22.0ng/ml, and Child grade C, 71.2±24.2ng/ml. The mean ratio of 5β-cholestane-3α, 7α, 12α, 25, 26-pentol to 27-nor-5β-cholestane-3α, 7α, 12α, 24, 25-pentol in patients with cirrhosis in Child grade C was higher than that in healthy controls (1.42±0.92 versus 0.64±0.16; p<0.079).
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  • Wataru KOYAMA
    1988 Volume 85 Issue 11 Pages 2402-2410
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    To clarify the incidence and clinical significance of Mallory bodies (MBs) in alcoholic liver disease (ALD) in Japan, 88 needle liver biopsy specimens of ALD were examined by the indirect immuno-fluorescence (IF) method using rabbit anti-MB antibody. Although MBs were detected in 11 specimens (12.5%) by hematoxylin & eosin or AZAN staining, they could be seen by the indirect IF method in 24 specimens (27.3%) of ALD including above 11 specimens. Immunoreactive MBs were observed in all 10 specimens of alcoholic hepatitis (ALH) without liver cirrhosis (LC), 6 out of 47 specimens of hepatic fibrosis (HF), and 8 out of 23 specimens of LC (4 with ALH). The specimens of 5 fatty livers and 3 nonspecific changes were negative for MBs by both routine stains and IF method. To examine the clinical significance of MBs in HF, we compared the clinical data of MBs(+)HF group (n=6) with those of ALH without LC group (n=10) and MBs(-)HF group (n=37). No difference was observed between MBs(+) and MBs(-)HF group in clinical data, whereas ALH group was significantly different not only from MBs(-)HF group, but also from MBs(-)HF+MBs(+)HF group. The progression to LC (2 cases) and death (1 case due to hepatic coma) were observed only in MBs(-)HF group during 14.6 months (mean value) after the liver biopsies. Conclusion: The IF method was more sensitive to detect MBs than routine stains. MBs(+)HF group was thought to be close to MBs(-)HF group rather than ALH without LC group in clincial data. The follow-up observation suggests that MBs do not always mean poor prognosis of ALD in Japan.
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  • Kenji IKEDA, Hiromitsu KUMADA, Yasuji ABASE, Kazuaki CHAYAMA, Toshiaki ...
    1988 Volume 85 Issue 11 Pages 2411-2419
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    Side effects of long-term administration of 5-FU derivatives were investigated in 52 patients with hepatocellular carcinoma treated by transcatheter arterial embolization (TAE) therapy. Almost patients (48/52) were associated with liver cirrhosis. Patients were classified into two groups as follows: 27 patients with tegafur 600mg/day administration after TAE (group A), and 25 with UFT (compound of tegafur 400mg/day and uracil) administration after TAE (group B).
    Twenty-four patients could take antitumor drugs more than one month in group A, and 23 in group B. Newly appeared ascites and/or encephalopathy within 6 months were common in both groups: 8/24 (33.3%) in gorup A, and 7/23 (30.4%) in group B. Bilirubin and coagulation tests were significantly aggravated about 6 months after the drug therapy.
    Aggravation of liver function were more frequently observed in patients whose age were more than 55 and whose ICG R15 value were more than 30%. Study of serum concentration of antitumor drugs after 3-5 months administration showed that appearance rate of ascites and/or encephalopathy within 6 months were significantly higher in patients with high 5-FU concentration more than 12pg/ml. Long term use of anticancer drugs may worsen liver reserves, and these drugs should be cautiously administered for hepatocellular carcinoma associated with liver cirrhosis.
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  • Hiroo OHNISHI, Hisataka MORIWAKI, Atsuko TAKAMURA, Takashi TOMODA, Kaz ...
    1988 Volume 85 Issue 11 Pages 2420-2429
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    A comparative study was conducted to evaluate therapeutic effects of ursodeoxycholic acid and of corticosteroid on serum bilirubin levels in patients with intrahepatic cholestasis. Thirty patients were devided into 3 groups as follows: 1) control group (7 cases), 2) corticosteroid group (15 cases), 3) ursodeoxycholic acid group (8 cases). Corticosteroid was found to be effective in 8 cases (53.8%), whereas 6 patients (75.0%) in the ursodeoxycholic acid group responded to the therapy. As to the half life of serum bilirubin levels (T1/2) after the start of each therapy, control group showd the mean T1/2 value of 8.8 days, suggesting that in the cases with T1/2 values longer than 8.8 days some additional therapies other than conservative treatment should be adopted. For these patients with persistent cholestasis, we propose that corticosteroid is to be administered to the cases with elevated serum transaminase activities, and that ursodeoxycholic acid has to be used in the patients of pure cholestatic type. In addition, of 4 cases who did not respond to corticosteroid administration and received subsequent treatment with ursodeoxycholic acid, 3 cases (75.0%) showed rapid decrease of serum bilirubin levels. Since the mean T1/2 value of the corticosterood group was 17.5 days, it was strongly suggested that ursodeoxycholic acid should be tried in the patients resistant to the corticosteroid therapy even after 17.5 days.
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  • Akira SUZUKI
    1988 Volume 85 Issue 11 Pages 2430-2435
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    The incidence and distribution of goblet cells were investigated in 15 cases of carcinoma of the gallbladder and 26 non-malignant lesions of the gallbladder induced in hamsters by either intracholecystic Methylcholanthrene (MC) Beeswax pellets or Beeswax pellects only. The incidence of goblet cells in carcinoma of the gallbladder was 56% (the cancerous region was 20%, and the mucosa surrounding the tumor was 53%). The incidence was higher than 34% in the control group, but was not significantly different. The distribution of goblet cells was mild to moderate in both the carcinomas of the gallbladder and in the control group, but it's frequency was also not significantly different. The incidence of goblet cells according to the histological type of the tumor was 83% in the well-differentiated adenocarcinomas, and this was the highest incidence of any of the other histological types. However, only forty % of the well-differentiated adenocarcinomas were detected by the presence of goblet cells in both the cancerous region and the mucosa surrounding the tumor. All of them showed a mild-to-moderate distribution of goblet cells.
    From the above results, it is suggested that intestinal metaplasia might not play a role in the precancerous lesion of carcinoma of the gallbladder induced in hamsters.
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  • Tomoyuki NAKANO, Ikuo YABUTA, Sachiko IMAI, Hideaki SHIMOMURA, Motomu ...
    1988 Volume 85 Issue 11 Pages 2436-2443
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
    Ultrasonographic examination of gallbladder was carried out in 59 cases of acute hepatitis. The thickening (3.5-20mm) of the gallbladder wall was found in 38 patients (64%). The thickness of gallbladder wall showed good correlation with serum lvels of total bilirubin, direct bilirubin, indirect bilirubin and GPT. The ultrasonographic studies were performed repeatedly in 28 patients. The serial change of thickening of the gallbladder wall was related with the serial change in direct bilirubin (totalbilirubin), but not with the serial change in GPT in clinical course.
    The ultrasonographic examination of the gallbladder in acute hepatitis can provide important information on the prognosis of the jaundice.
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  • Kazutaka KOGANEI, Masahiko FUKANO, Yasunobu YAMAZAKI, Akira SUGITA, Ts ...
    1988 Volume 85 Issue 11 Pages 2444-2449
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Kazufumi SUJITA, Fumio OKUNO, Yoshiaki HIRANO, Sumiya ETO, Masao ARAI
    1988 Volume 85 Issue 11 Pages 2450-2455
    Published: 1988
    Released: December 26, 2007
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  • Nobuyoshi KAWAKITA, Shuichi SEKI, Tetsuo ARAKAWA, Toru KANNO, Hiroko O ...
    1988 Volume 85 Issue 11 Pages 2456-2460
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Hirofumi OOKOSHI, Hitoshi BATA, Sanae OKUYAMA, Tomonobu KAWABE, Hiroki ...
    1988 Volume 85 Issue 11 Pages 2461-2465
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Takashi TAMADA, Fuminori MORIYASU, Kyouko ITO, Akifumi KONDO, Shigeki ...
    1988 Volume 85 Issue 11 Pages 2466-2470
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Hiroshi MURATA, [in Japanese], [in Japanese], [in Japanese], [in Japan ...
    1988 Volume 85 Issue 11 Pages 2471
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Shuji KIMURA, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    1988 Volume 85 Issue 11 Pages 2472
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Tomoaki TOMIYA, [in Japanese], [in Japanese], [in Japanese]
    1988 Volume 85 Issue 11 Pages 2473
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Yoshihide SAKAGAMI, [in Japanese], [in Japanese], [in Japanese], [in J ...
    1988 Volume 85 Issue 11 Pages 2474
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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  • Eiichi SAITO, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...
    1988 Volume 85 Issue 11 Pages 2475
    Published: 1988
    Released: December 26, 2007
    JOURNALS FREE ACCESS
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