K. Sambe

Clinical course of the gastric ulcer (including Malignancy) review of the course on symptomatic and asymptomatic cases, discovered with the gastric mass survey and the generalized check-up

recurrent ratios were 49 and 37 percent, respectively. Those ratios increased remarkably compared with the previous report (13 percent in male and I0 percent in female). It is suggested that the longer periods of follow-up study show the higher recurrent ratios. 3. In 73 (83 percent) males and 26 (83 percent) females, their ulcers were regarded as showing healing tendencies (once healed, almost healed, and at least reduced in size) during the observation periods, Those ratios were much the same in the previous report (85 percent in male and 92 percent in female). 4. In 33 males and 10 females, the recurrence or exacerbation of ulcer were shown. The ratios of recurrence and exacerbation increased from 15 percent of males and 10 percent of females in the previous report to 38 percent and 35 percent in the present series, respectively. It is said that the gastric ulcer heals very easily in short term, especially on admission, but also recurs very often, and our current study also reveals similar tendency. Namely, the recurrence or exacerbation were observed on about one-thirds of 115 patients who were followed up for more than 2 years. However, it is considered that the patients with intractable ulcer or long-standing complaints have been observed for rather long periods than the patients with curable ulcer or no complaints, since all the patients could not be followed up in this study. Therefore, the real ratio of the recurrence might be somewhat lower than these results.

The experimental study on restraint-induced gastric ulcer—alteration of the microcirculatory system in the gastric wall

Immobil izat ion has been employed as an useful method for the exper imenta l product ion of gas t r ic lesion in the rat . However, the endeavor of the present s tudy was aimed a t some methodological development to produce chronic ulcer, and some considerat ion was given in i ts mechanism. Subjects: Albino ra ts of Wistar-King A s t ra in were used. These an imals were 120~180 days old at the beginning of the experiment . Procedure: Immobil izat ion was applied in following schedule; 24 hrs a day (one t r ia l group), 20 hrs a day for 7 days (long te rm immobil izat ion group), 20 hrs a day for 4 days wi th subcutaneous inject ion of h is tamine (his tamine combined group). Results: Incidence of gas t r ic lesion in the his tamine combined group was h igher than t h a t of control group. In the long t e rm immobil izat ion group, h igher incidence and much more sever i ty of ulceration, up ti l l per fora t ion in some cases, was found in the lumen than those of one t r ia l group. However, a lmost s imi lar findings was shown in the glandular s tomach, in bo th groups. Microscopic findings. (1) Lumen; Circumscr ibed necrosis in both the mucosa and the submucosa are observed. In the bed of ulcer, exist active chronic inf lammatory cell infi l tration and regenera t ion of capillary. These findings suggest the feauture of chronic ulceration. Most cha rac te r i s t i c findings in the lumen of this group are format ion of th rombus or angi t is in the submucosa. These histological changes suggest tha t p r imary vascular changes produce subsequent degenerat ion or necrosis in the submucosa, and thereby it may develop into ulceration. (2) Glandular s tomach ; The muscular i s mucosae is destroyed already, and necrosis extended up to the submucosa. Active chronic inf lammatory cell infi l tration is also seen in the bed of ulcer, however these chronic inf lammatory changes are localized at the affected region of the stomach. In the submucosa, th rombus or angit is can not be observed. These findings of chronic ulcerat ion can be obtained only in the h is tamine combined group. These resu l t s suggest t h a t gas t r ic acid may play a impor tan t role to extend the damage of the injured gas t r ic mucosa. Acknowledgements, We thank Prof. Dr. S. Ueki and Prof. Dr. K. Tanaka and Dr. A. Sumiyoshi for helpful suggest ion and discussion.

Histologic findings of the liver in “autoimmune diseases” with special reference to thymic abnormalities

94 cases of acute hepat i t is were observed in our clinic dur ing past 3 years. They included 48 cases of infect ious hepat i t is and 46 cases of serum hepati t is . F luminan t hepat i t is were 7 cases (7.5%), cholangioli t ic type were 11 ones (11.7%), included 6 who were older than 60 years. 3 cases (3.2%) of them were fatal, 6 (6.4%) progressed to l iver cirrhosis . 6 (12.5%) of infect ious hepat i t is progressed to prolonged or chronic hepati t is , while 14 (21.2%) of serum hepat i t i s did to them. Case report Case 1 was 61 years old female wi th dominant jaundice (total b i l i r u b i n > 2 0 m g / d l , total cho le s t e ro l>380mg/d l and a lka l inephospha tase>5 Bessey unites), under the diagnosis of extrahepat ic obs t ruct ion or in t rahepat ic cholestasis operat ion was done, but ext rahepat ic obstruct ion was not found. Her illness progressed to chronic cholangioli t is . Case 2 was 32 years old female. Dominant elevations of t r ansaminase act ivi ty were observed at six t imes dur ing 3 years, and she was diagnosed to acute hepat i t is by liver biopsy. In interval, her l iver funct ion tes ts showed normal value and biopsy specimens did normal feature. She was dignosed to chronic reccurent hepat i t is .

The role of lymphatic truct on intestinal absorption (II) protein absorption in mackee’s dogs

ConclusionIt was emphasized that lymphatic truct played important role on intestinal absorption and transportation of protein as well as portal vein.

Hypotonic duodenography: Its diagnostic value on pancreatic diseases

Hypotonic duodenography, deviced by D. Liotta, is a method for the diagnosis of the pancrea t ic diseases. The duodenum is placed hypotonic s tate with the in t ravenous inject ion of parasympathetic blocking agents followed by the int roduct ion of surface anes thet ics th rough the duodenal tube into the duodenum. The duodenal port ion is filled ba r ium meal th rough duodenal tube, thereaf te r examined roentgenologically. Th i s is to evaluate the or iginal method. 7 cases of acute pancreat i t is , 6 chronic pancreat i ts , 3 carc inoma of the pancreas and 10 wi th the diseases of the bi l iary t racts , were examined wi th this procedure. All the pat ients wi th the pancreatic diseases were found to have some abnormal i t ies in the duodenum on th is procedure. The following abnormal configurat ions were the common findings: the dislocation of the first and second portion, pro t rus ion of a few folds due to the adhesion to the head of the pancreas and defects due to compress ion wi th the enlarged pancreas, and so forth. Slight disconfipuration of duodenal folds was noted in cases of acute pancreat i t i s , while moderate compression of duodenal wall was found in cases of chronic pancreat i t i s . Localized definite defect was observed in cases of the carc inoma of the pancreas . Var ious degrees of abnormalities were found in 9 out of 10 cases of b i l iary t r ac t diseases, which s t rongly suggests the involvement of the pancreas in these cases.

Methods for study of intestinal absorption

Jr., and H. M. Pollard) have verified the biosynthesis of ~-lipoprotein by the gut with everted sac experiment using fas t ing rats. Incorporat ion of glycerol-l,3-a4C into total cellular lipids and lipoprotein-lipids was markedly enhanced by addit ion of serum (or any other kind of protein) into incubation medium. This enhancemnet was surpressed by puromycin (2• It suggests tha t puromycin inhib i t s the synthesis of prote in par t of /~-lipoprotein. Acanthocytosis (Bassen and Kornzweig, 1950), an inborn e r ror which has s teatorrhea, retinit is pigmentosa and ataxia-like neurological symptoms, bas been defined as a-betalipoproteinemia. It is very in teres t ing and suggestive to take both the exper imental data, t ha t ~-lipoprotein is apparent ly to be the pr incipal lipoprotein in the l ipoprotein format ion in the mucosal cells, and the clinical observat ion, tha t there is s t rong fa t intolerance in the case of a-beta-lipoproteineamia, into considerat ion together.