Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 27, Issue 1
Displaying 1-12 of 12 articles from this issue
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Contents
  • Changes of Bile Contents and Reduction of Jaundice by Percutaneous Transhepatic Cholangial Drainage in Obstructive Jaundice.
    KUNIO OZAWA
    1981 Volume 27 Issue 1 Pages 24-39
    Published: March 10, 1981
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.27.24
    JOURNAL FREE ACCESS
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    The percutaneous transhepatic cholangial drainage (PTCD) is much beneficial method for reduction of jaundice than the conventioval surgical bile drainage method in obstructive jaundice cases to patients, with easier procedure and less complications. In this paper, the factors of effectiveness of this method is discussed. Thirty nine cases of complete obstructive jaundice cases were examined and analysed the reduction effect, according to the time change of bile contents, liver function, strategical portion of obstruction, and liver biopsy. Liver function before and after PTCD showed no significant difference in cases of responded and non-responded. The portion of obstruction was lower, the response to PTCD was better. Discharges of over 300m1/day of bile, over 150mg/day of cholesterol, over 150mg/day of birilubin, and or 150mg/day of bile acid were indication for reduction effect of jaundice. Especially the amonut of birilubin in drainaged bile reflected the effectiveness. Electrolytes in bile, and alkaline phsphatase did not show significant changes. In cases performed surgical drainage, the amount of bile and bile acid drained for first and second week was relatively small, which was thought to be the effect of anesthesia and surgery. The histopathology of biopsy material showed no significant difference.
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  • Histopathological Studies on Lesions of the Liver and Blood Vessels due to Congestive Heart Failure
    YUKICHI SAKUMA
    1981 Volume 27 Issue 1 Pages 40-59
    Published: March 10, 1981
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.27.40
    JOURNAL FREE ACCESS
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    One hundred twenty autopied cases (28 children and 92 adults) with congestive liver were classified histopathologically into four grades by following criteria for hepatic lesions. Grade I : Congestion and atrophy in hepatic lobules. Grade II : Degeneration, necrosis and focal or centroportal fibrosis in hepatic lobules. Grade III : Congestive liver fibrosis; formation of reversed lobules due to centrocentral fibrosis among hepatic lobules. Grade IV : Congestive liver cirrhosis : formation of pseudolobules due to centroportal and centrocentral fibrosis between hepatic lobules. The morphogenesis and morphological characteristics of hepatic lesions due to acute or chronic congestive heart failure were studied in detail. In addition, intimal thickening of the blood vessels (inferior vena cava, hepatic vein, portal vein and hepatic artery), weight of the organs (liver and spleen) and volume of ascites corresponding to each grade of congestive liver were also investigated. Marked development of hepatic lesions and intimal thickening of posthepatic veins were observed in adult cases with severe congestive heart failure. The results were as follows.1) In child cases, the incidences of congestive liver in grades I and II were 17.9% and 82.1%, respectively. In adult cases, the incidences of congestive liver in grades I, II, III and IV were 13.0%, 72.8%, 10.9% and 3.3%, respectively. In all of child cases and the majority of adult cases, grades I and II were prominent. 2) Valvular disease, coronary heart disease and hypertensive heart disease in adult cases were original diseases of congestive liver fibrosis and cirrhosis. 3) Grade of congestive liver was relative to degrees and periods of heart failure in adult cases. Repeated heart failure was more important than continuous heart failure for genesis of congestive liver cirrhosis. 4) The liver weight was within normal limits in any grade of congestive liver in child and adult cases. 5) Intimal thickening of the blood vessels due to congestive heart failure was observed in posthepatic veins (IVC and HV) of adult cases. Phlebosclerosis of posthepatic veins was relative to degrees and periods of heart failure and had good relation to grades of congestive liver. 6) The spleen weight and ascites increased slightly with grades of congestive liver in adult cases. The portal hypertension due to congestive heart failure was suggested in congestive liver fibrosis and cirrhosis.
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  • Histopathological Study on the Non-neoplastic Thymus and the Thymoma in Myasthenia Gravis
    SHIRONOBU OIKAWA
    1981 Volume 27 Issue 1 Pages 60-76
    Published: March 10, 1981
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.27.60
    JOURNAL FREE ACCESS
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    Histhlogical characteristics of the thymic tissues in the patients with myasthenia gravis (MG) have been believed to be in the follicular hyperplasia of the thymic tissues or in the thymoma tissues. In this study, both histological and histometrical analyses on non-neoplastic thymi and thymomas of 65 MG patients and of 12 non-MG patients were performed. All of the investigated thymi of MG patients showed lymph follicular formations in the thymic tissue. The volume ratio of the residual thymic tissue, which was measured by a point-count method, was decreased along with aging. On the other hand, the lymph follicles did not show any remarkable aging involution. The entire thymic tissue related to the pathogenesis of MG, may not have the age involution. On the contrary, the fact that hyperplasia of the lymph follicle has no relationship with aging, may suggests the role of lymph follicle in pathogenesis of MG. In cases having germinal centers, follicular vasculature showed similar type to those in the lymph follicles of lymph nodes. That was, the arteriolar system merged in the lymph follicle immediately after its divergence, then passed over to multiple postcapillary venules around the follicles and returned to small veins of vascular stroma of the thymus. It become clear in the histological findings that these follicles were located and grown up in these vascular stroma of the thymus. There were distinct limiting membrane were locally interrupted or dispersed in all MG cases. In the cases studied the thymoma tissues in MG and in non-MG showed no histological differences. However, the peripheral residual thymic tissues in the thymoma in cases of MG revealed similar histopathological changes as in the non-neoplastic thymus of MG. From all the data described, it may be suggested that lymph follicular formation in the thymic tissue of neoplastic and non-neoplastic MG gives rise to a kind of reconstruction of the kind of reconstruction of the vascular structures in the thymus, and some focal interruption or dispersion of the limiting membrane. It is concluded that a kind of reconstruction of thymic vascular structures may be one of the most characteristic findings in the nonneoplastic and thymomatous thymic tissues in the myasthenia gravis patients.
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