SATO, T., SUZUKI, N., TAKAHASHI, W. and UEMATSU, Follow-Up Studiesof Surgical Treatment for Choledocholithiasis. Tohoku J. exp. Med., 1981, 135 (1), 1-9 - The follow-up results of cholecystectomy and common duct exploration with T-tube drainage for 308 patients with common bile duct stones were studied. Nine patients evaluated as “poor” included seven with residual stones and two with recurrent stones. Cholangiography at the time of follow-up manifested the evidence of a statistically significant reduction of the bile-duct diameter compared with the preoperative level in both cholesterol and calcium bilirubinate cases. The reduction was particularly conspicuous in the group with marked dilatation of the bile duct, regardless of the types of stone. Of the 134 patients with cholelithiasis who underwent reoperations in our Department, 75 (87%) belonged to residual, 11(13%) to recurrent group. Of the 11 patients with recurrent stones, nine had obvious causes for stone recurrence such as bile-duct stenosis or stricture at the anastomotic site. These results suggest that without existence of evident stenosis at the papilla of Vater or in the lower bile duct, patients with choledocholithiasis, regardless of types of stone, could be curable effectively only by cholecystectomy and choledocholithotomy with T-tube drainage.
ITO, S., IWASAKI, Y., MOMOTSU, T., TAKAI, K., SHIBATA, A., MATSUBARA, Y. and MUTO, T. Neurotensin and Substance P and Dumping Syndrome. Tohoku J. exp. Med., 1981, 135 (1), 11-21 - To investigste the pathophysiological relation between releases of gut hormones and dumping syndrome, plasma radioimmunoassayable neurotesin, substance P, glucagon-like immunoreactivity (GLI), insulin and blood sugar were measured in both gastrectomized patients and control subjects after 50g oral glucose tolerance tests. Remarkable rises of radioimmunoassayable neurotesin and GLI were found in all gastrectomized patients, but not in control subjects. In contrast, plasma radioimmunoassayable substance P responses were not detected in either gastrectomized patients or control subjects. There were three patients with symptoms of dumping syndrome in the early stage of the test. Plasma radioimmunoassayable neurotensin responses in two out of these three were higher than those in other patients, though the other patient with symptoms had the same degree of neurotensin elevation as patients with no symptoms. In view of the pharmacological effects of neurotensin, it could not be ruled out that a part of the early symptoms of dumping syndrome may result from the remarkably enhanced plasma neurotensin release in some patients, although the enhanced neurotensin responses did not always accompany symptoms of dumping syndrome.
YAMADA, K., SASAKI, T. and SAKAGAMI, T. Phosphatidylcholine andPhosphatidylinostiol Exchange Proteins in Pig Liver. Tohoku J. exp. Med., 1981, 135 (1), 23-36 - The pH 5.1 supernatant fraction of pig liver homogenate stimulated the transfer of [32P]phosphatidylcholine and [32P]phosphatidylinositol from donor liposomes to acceptor liposomes. Purification of the proteins which catalyzed the exchanges yielded five partially purified preparations. A phospholipid exchange protein was purified 63-fold in one of the preparations and the protein was found to be specific for phosphatidylcholine exchange. The molecular weight and isoelectric point of the protein were estimated to be 19, 000 and 5.6, respectively. The other four preparations contained partially purified phospholipid exchange proteins which catalyzed the exchanges of phosphatidylinositol as well as phosphatidylcholine. The molecular weights and the isoelectric points of the phosphatidylcholine-phosphatidylinositol exchange proteins were estimated to be 19, 000 and 4.7, and 19, 000 and 4.8 for the proteins in the second preparation, and 21, 000 and 4.5 for the protein in the third preparation. These parameters in the other two preparations were tentatively estimated to be 24, 000 and 5.6, and 18, 000 and 4.6. Neither sulfhydryl-binding reagents nor trypsin digestion inactivated the activity of the phosphatidylcholine specific exchange protein. Sulfhydryl-binding rgents and trypsin digestion inactivated all the phosphatidylinositol exchange activities of the partially purified exchange proteins and the phosphatidylcholine exchange activities which were presumably associated with the phosphatidylinositol exchange proteins.
YAMADA, K, SASAKI, T. and SAKAGAMI. T, Measurement of Isoelectric Points of Phospholipid Exchange Proteins by Gel Isoelectric Focusing. Tohoku J. exp. Med., 1981, 135 (1), 37-42 - A method of the estimation of isoelectric points of phospholipid exchange proteins is described. The phospholipid presumably bound to a phospholipid exchange protein was replaced with [3H]phosphatidylcholine of a high specific radioactivity by an incubation of the protein with liposomes containing the labeled lipid and dimannosyl diglyceride. After the incubation, a major portion of the liposomes was separated from the protein by an affinity of the liposomes to concanavalin A-Sepharose 2B. The isoelectric point of the protein was measured by gel isoelectric focusing of the protein, which was located by tritium radioactivity of the bound [3H]phosphatidylcholine. The method was used to measure isoelectric points of partially purified phospholipid exchange proteins in pig liver.
NITTA, S., OHNUKI, T., OHKUDA, K., NAKADA, T. and STAUB, N.C. TheCorrected Protein Equation to Estimate Plasma Colloid Osmotic Pressure and ItsDevelopment on a Nomogram. Tohoku J. exp. Med., 1981, 135 (1), 43-49 - Examining the internal discrepancies of three equations (Landis and Pappenheimer 1965) which represent the relationship between colloid osmotic pressures (COP) and normal human plasma proteins, the authors derived a corrected globulin equation: COPglb=1.3c+0.14c2+0.006c3 (COP: mmHg, c: protein content, g/100 ml), instead of their COPglb=1.6c+0.15c2+0.006c3, when A/G (albumin-globulin ratio)=1.1 as they had described. Revising the former globulin equation again, based upon the current estimate of A/G=1.8, we derived a new globulin equation. Our new plasma equation, consisting of their albumin equation and our revised globulin equation, is COPpl=α(2.8c+0.18c2+0.012c3)+β(0.9c+0.12c2+0.004c3), where α and β stand for albumin and globulin fraction, respectively. The last, being generalized for plasma with any protein compositions, and closely corresponded to the values directly measured in normal human plasma with variable protein compositions, we developed it on a nomogram for practical use.
MATSUSHIRO, T, CHO, H., NAGASHIMA, H., OMOKAWA, S, YAMAMOTO, K., HARIU, T. and TATEYAMA, T. Factors Affecting the Cholesterol DissolutionAbility of Human Bile. Tohoku J. exp. Med., 1981, 135 (1), 51-61 - Bile samples were obtained from 13 patients with cholesterol gallstones at laparotomy. Control bile samples were obtained from 15 patients with gastric cancer or gastric ulcer. One mixed stone was cut in half and serial thin sections, 10μm in thickness, were prepared from the cut surface. The solubility of cholesterol in these gallstone sections after immersion in the bile samples was observed microscopically after 1, 3, 5 and 24hr. Of 15 control bile samples, 9 showed a marked cholesterol dissolution after 1hr, and 6 showed it after 3 and 5hr. Three out of 13 bile samples from the patients with cholesterol stones dissolved the gallstone section after 1hr, and 7 after 3 and 5hr. The dissolution was not observed in the remaining 3 bile samples. Cholesterol and total bile acid concentrations of the control bile were significantly higher than those of the bile from the cholesterol gallstone patients (p<0.05 and p<0.02, respectively). Correlative studies of the composition of bile and its ability to dissolve cholesterol revealed that bile samples with a high total bile acid concentration possessed a higher dissolution ability, even when the ratios of total bile acid to cholesterol were almost the same in control and cholesterol gallstone bile. On the basis of these findings, it may be concluded that the solubility of cholesterol in bile cannot simply be explained in terms of relative concentrations of cholesterol, phospholipids and total bile acid, because the absolute concentration of total bile acid also plays a significant role for the dissolution ability.
NONOMURA, A., OHTA, G., KOBAYASHI, K. and KATO, Y. Activities ofLymphocytes Mediating Antibody-Dependent Cell-Mediated Cytotoxicity inPatients with Chronic Active Hepatitis. Tohoku J. exp. Med., 1981, 135 (1), 63-77 - Antibody-dependent cell-mediated cytotoxicity (ADCC) of peripheral blood lymphocytes against sheep erythrocytes, cultured rat hepatocytes (BRL-3A) and Chang cells in the presence of specific anti-serum was evaluated in patients with chronic active hepatitis (CAH) and healthy subjects. ADCC activities against these cells were significantly decreased in patients with CAR when compared with healthy subjects. Significant correlations were observed between degrees of ADCC against BRL-3A, Chang cells and sheep erythrocytes. In patients with CAH, percentage and absolute number of E-rosette forming cells in the peripheral blood lymphocytes were decreased but Fe-receptor bearing (EAγ) lymphocyte concentration was normal. There was no clear-cut relationship between the concentration of EAγ-lymphocytes and the degree of ADCC. Preincubation of lymphocytes from healthy subjects with CAH sera significantly reduced ADCC against sheep erythrocytes. Furthermore, analysis of effector lymphocytes mediating ADCC (K-cell) against BRL-3A indicated that T lymphocytes bearing Fe-receptors with lower affinity for sheep erythrocytes are active in ADCC, though a population of K-cell is heterogeneous. It seems likely that decreased T cells in the peripheral blood and possibly the presence of serum factors in patients with CAR may partly participate in impairment of ADCC.
TAKANO, S. Difference in Effects of Vinblastine and Vincristine on the DogPlatelet Aggregation. Tohoku J. exp. Med., 1981, 135 (1), 79-85 - The present study was attempted to determine difference in effects of vinblastine and vincristine on ADP-induced aggregation of dog platelets. Vinblastine manifested biphasic influence depending upon concentrations, i.e., in low concentrations (0.2-20μg/ml) it promoted the aggregation, and in a high concentration (100μg/ml) it inhibited the aggregation with increasing incubation time. Vincristine in any concentrations, however, neither promoted nor inhibited the aggregation. In scanning electron micrographs, platelets were gradually damaged as revealed by their surface appearances with increasing incubation time in the presence of vinblastine (100μg/ml). There existed a parallel relationship between the inhibition of the aggregation by vinblastine and the increase in number of severely damaged platelets. However, there was no such a parallel relationship between them in the presence of vincristine.
YOSHIDA, T., SUZUKI, H., HATTORI, Y, and NODA, K. Hormonal Changesaround the Parturition in Rats. Tohoku J. exp. Med., 1981, 135 (1), 87-91-Concentrations of serum oxytocin, cortisol, progesterone and estradiol in pregnant rats were assayed by radioimmunoassay methods. The levels of these hormones increased in pregnancy. Around the parturition, oxytocin or estradiol did not show any change, cortisol increased, and progesterone decreased prominently. The trigger of initiation of labor was discussed.
KOYAMA, K., OWADA, Y., IMAOKA, Y. and SATO, T. Oral Ammonia ToleranceTest in Patients with Portal Hypertension. Tohoku J. exp. Med., 1981, 135 (1), 93-101 - Eighty patients with portal hypertension due to various hepatic diseases were subjected to the oral ammonia tolerance test (OATT). Blood samples were collected before and at 30-min intervals after the administration of ammonium chloride (50mg/kg). The ammonia levels, and the OATT curve patterns and ∑NH3-N values were determined and it was investigated whether there are correlations between these values and various other parameters of hepatic function. The results of OATT correlated with the plasma disappearance rate of indocyanine green and the molar ratio of branched chain amino acids to aromatic amino acids. Our findings suggest that the OATT may reflect the degree of hepatic parenchymal disorders rather than the hepatic circulatory abnormalities and that they may represent a valuable aid in the differential diagnosis of hepatic diseases and in determining the operative indication.
HANEW, K., SASAKI, A. and YOSHINAGA, K. Evidence for EndogenousDopaminergic Control of GH Release in Man. Tohoku J. exp. Med., 1981, 135 (1), 103-108 - In order to determine whether or not there is a tonic dopamine (DA) control of GH release, the effect of an anti-dopaminergic agent, sulpiride, on GH secretion was studied in 12 normal subjects. After the administration of sulpiride, serum concentrations of sulpiride reached a peak value (1.93±0.1 μg/ml, mean±S.E.M., n=6) at 15min and then showed a gradual decrease. Concomitantly, mean plasma prolactin (PRL) showed a rapid elevation, with a peak value of 161.9±11.5ng/ml at 30min, followed by a gradual decrease. Even at 180min after sulpiride injection, the plasma PRL was still 9 times higher than the initial level (p<0.005). Within 90min after the injection, 12 subjects showed a minimal but significant decrease in GH (from 0.78±0.17 to 0.32±0.03ng/ml, p<0.02). After another 90min, the plasma GH level increased and the mean peak value (8.1±2.7ng/ml) at 180min was significantly higher than the initial value (p<0.02). From these observations, it was suggested that sulpiride inhibited the endogenous DA activity over 180min, and that the GH decrease within 90min was due to a suppression of endogenous DA activity. Factors other than DA, however, might be considered for the GH increase after 90min.
YAMAMOTO. M., ITO, T., WATANABE, M. and WATANABE, G. EstimatedPrevalence of Chromosome Anomalies in the First Trimester of the JapanesePregnant Population. Tohoku J. exp. Med., 1981, 135 (1), 109-113 - Using the cytogenetic data we have collected in induced abortions, an estimation of the prevalence rate of chromosome anomalies in the first trimester of the general pregnant population was made. Since the maternal age distribution in induced abortions skewed toward the older age group in comparison with that of the general population in Japan in 1975, the maternal age adjustment was conducted. The projected rate was found to be 5.0 per cent. It is inferred that the present frequency may give the lowest limit value, for only the gross chromosome anomalies diagnosed by the conventional Giemsa staining method were counted in the present study.
NEMOTO, R., KATO, T., SHIBATA, K. and KANO, M. Urinary Cytology as aTest in Mass Screening. Tohoku J. exp. Med., 1981, 135 (1), 115-116 - A rapid and simple cytologic screening system for urinary tract cancer stained with toluidine blue was described. Utilizing this system, a hospital population was screened for urinary tract cancer from specimens sent for routine urinalysis. In this study of 16, 062 fresh urine sediments selected at random from non-urologic patients, three cases histologically proven bladder cancer were detected, leading to the detection rate of one bladder cancer in 5, 000 individuals. The results emphasizes the usefulness of this simple screening technique in combination with clinical urinalysis and cytology for early detection of urinary tract malignancy.