Stress ulcer formation is reportedly much less frequent in SHR than in normotensive control rats (Wistar Kyoto Rat : WKY). The purpose of this study was to investigate the mechanism of maintenance of gastric mucosal blood flow (GMBF) during imposed stress in SHR. In stressed-only SHR, GMBF did not significantly change during water immersion and restraint conditions and ulcer index (UI) was significantly lower than that of WKY. Stress conditions led to a fall in blood pressure and a gradual fall in heart rate in WKY and SHR. It was assumed that the changes in blood pressure and heart rate during stress were due to vagal hyperfunction. The catecholamine level in the fundic gland of the gastric tissue was higher in the non-stressed SHR than in the non-stressed WKY. The administration of 6-hydroxydopamine to SHR produced a significant reduction in GMBF during stress conditions and UI was significantly higher in this group than in the stressed-only SHR. In SHR treated with nifedipine, UI was lower than that of the control group and GMBF showed no significant change compared with the stressed-only SHR. However, the administration of verapamil produced a significant reduction in GMBF during stress conditions and increased UL The norepinephrine and dopamine levels of the groups treated with verapamil were significantly lower than those in the groups treated with nifedipine. These results suggest that local regulation of gastric mucosa mediated by sympathetic hyperfunction in SHR is more important for the maintenance of GMBF during stress conditions than changes in peripheral artery resistance.
We performed the endoscopic and clinicopathologic analysis for the development of superficial colorectal carcinoma, using 149 submucosal (sm) invasive colorectal carcinomas. It was observed that superficial colorectal carcinomas had a tendency to rise by their sm massive invasion. In this study, we judged that the sm colorectal carcinomas originated from superficial colorectal carcinoma were 37 (25%) of 149 lesions, and their distribution in the colon and rectum was similar to that of advanced colorectal carcinomas, although the lesions originated from non-superficial (polypoid) colorectal carcinoma did not show so tendency. On the other hand, sm colorectal carcinomas originated from superficial colorectal carcinoma contained the evident adenomatous components in 7 (19%) of 37 lesions and had significantly higher incidence of lymph node metastasis than those originated from non-superficial (polypoid) carcinoma. These results suspected the facts as follows ; 1) Superficial early colorectal carcinoma may be compatible as the origin to advanced colorectal carcinoma and has higher malignant potential than non-superficial early carcinoma. 2) Superficial colorectal carcinoma might also have the route of the development of “adenoma-carcinoma sequence”, as well as “de novo” histogenesis.
Plasma levels and localization of vitronectin in patients with ulcerative colitis (UC) were investigated. Plasma vitronectin levels in patients with UC were significantly lower than those of healthy persons, in proportion to clinical activity and severity. In addition, plasma vitronectin levels at the remission phase were high when compared with those at the active phase. Vitronectins, in addition, were found in mucosa of the active phase where a lot of inflammatory cells were found by immunohistological staining. Based on the above results, vitronectins were considered to leak from blood vessel and to be consumed for mucosa recovery in the active phase of UC, and plasma vitronectin levels were lowering. Therefore, determination of plasma vitronectin levels were considered to be useful for an index of clinical activity and severity of patients with UC.
AE patients can be cured only by complete excision of the lesions. In Europe and the United States, however, benzimidazole-type drugs have been reported to be effective. We treated 37 patients (20 males and 17 females, mean age of 45.9 years) with mebendazole (MBZ) (n=17) or albendazole (ABZ) (n=20) according to the WHO chemotherapy protocol, and compared adversed reactions, drug concentrations, serological parameters, and measurable lesions by CT scan and/or X-ray examination. In the MBZ group, serological parameters were unaffected. One patient each had hepatic disorder and alopecia (12%), and 5 lesions in the liver and 3 in the lung gradually increased in size (105% in 1 year, 112% in 2 years), and showed NC (no response) in 6, PD (progressive disease) in 2. One case of released biliary obstruction were judged as PR (partial response) (Response rate : 11.1%). In the ABZ group, no adverse reactions were found and ELISA level decreased significantly in 10 out of 12 patients. One lesion in the liver, 3 in the lung, 1 in the chest wall and 1 in the retropancreatic region reduced in size significantly (Mean :56%) (PR 3, NC 3 ; Response rate : 50.0%). ABZ was safer and more effective than MBZ.
We administered 3 g of taurine orally for four weeks to 35 patients suffering from liver cirrhosis with repeated muscle cramp (MC). Improvement of MC was noted in 22 cases (62.9%). We also determined the plasma taurine concentration in eight cases of liver cirrhosis with MC. The plasma taurine concentration before ingestion was 54.1±20.7nmol/ml, whereas that of four weeks after ingestion was 125.1±59.lnmol/ml, which was significantly elevated by 2.3 fold. As the concentration increased, the frequency of MC decreased, suggesting the good correlation between ingestion and the decrease in frequency of MC. In liver cirrhosis without MC the plasma taurine concentration was 81.0±16.7nmol/ml, which was significantly higher than in liver cirrhosis with MC. In a few cases with taurine ingestion, serial plasma taurine concentrations were detected.; Plasma taurine reached the peak value during the first week of ingestion and plasma taurine levels were maintained 2-5 fold higher during ingestion.
Eleven liver cirrhosis patients with variceal bleeding and/or ascites were treated by transjugular intrahepatic portosystemic shunt. Four of the patients were combined with hepatoma, and 2 had portal thrombosis. Ten of the patients were successfully achieved TIPS, but one patient who had portal thrombosis was failed because of portal vein occlusion ; success rate of 90%. An average decrease of 14mmHg in portal vein pressure was measured in the 10 patients. All of the successful patients including 4 with hepatoma were observed the disappeared or diminished varices and ascites without technical complication. Mild encephalopathy was encountered in 2 patients but who responded well to medical therapy. Three dimension MRA before TIPS was helpful for understanding the anatomical relationship between portal vein and hepatic vein. It is concluded that TIPS is an effective and safe treatment, indicating for the patients who have uncontrollable variceal bleeding and/or ascites even with hepatoma.
We investigated the influence of alcohol and the low protein diet upon rat pancreas. Rats were separated in four groups, 1) Control diet group (Cont), 2) Alcohol diet group (Al), 3) Low protein diet group (Lp), 4) Low protein and alcohol diet group (Lp+Al). They were fed on isocaloric liquid diet compulsorily through the gastric tube. They were sacrificed 3, 6, 12 weeks after. By the light microscopic observation on the rat pancreas which were fed for 12 weeks, lipid droplets in the acinar cells were observed in all groups other than Cont. Apoptosis was founded in Lp and Lp+Al groups. Protein plugs were observed in all groups, and no relation was found between the plugs and the location of the injured acinar cells. By the electromicroscopic observation, in Lp+Al group, acinar cells were typically injured (ER dilation, atrophic nuclei, mitochondria degeneration, etc.) and mesenchymal cells appeared among acinar cells. These results suggest that alcohol causes pancreatic acinar cell injury directly, and relative low protein diet helps to turn it worse.