Kanji Komatsu

Clinical significance of glucagon provocation test in the diagnosis of hypergastrinemia

SummaryGlucagon provocation test was performed in the patients with hypergastrinemia and hyperchlorhydria to investigate its diagnostic value. A paradoxical response of plasma gastrin level in the patients with the Zollinger-Ellison syndrome and a marked decrease of plasma gastrin level in the patients with gastric ulcer, duodenal ulcer, excluded gastric antrum, multiple endocrine adenomatosis, pernicious anemia and chronic renal failure were demonstrated by glucagon infusion. Glucagon provocation test, therefore, was considered to be of great value in the diagnosis of the Zollinger-Ellison syndrome, particularly, in the case of an excluded gastric antrum in which secretin provocation test caused the false positive result because of a marked increase of pancreatic secretion. Glucagon provocation test in combination with secretin provocation test, therefore, is at present the most preferable diagnostic procedure for detecting the Zollinger-Ellison syndrome.

A Multicentre Randomized Controlled Trial of Recombinant Interferon-Alpha-2a in the Treatment of Patients with Chronic Hepatitis C

Sixty-one chronic hepatitis C patients were randomly assigned to receive either 6 x 10(6) or 9 x 10(6) U of recombinant interferon-alpha-2a (IFN alpha-2a) six days a week for the first two weeks of treatment, followed in both cases by 6 x 10(6) U three days a week for the next 22 weeks. In the low dose group, 11 patients showed a complete response maintained for at least six months, 12 responded but then relapsed and nine did not respond; the corresponding figures in the high dose group were 10, 15 and five patients, respectively. The differences between groups are not statistically significant. Thus, this study provides no evidence of therapeutic benefit from increasing the initial dose of IFN alpha-2a. In both treatment groups, complete responders had significantly lower pretreatment viral titres than nonresponders and were significantly more likely to be infected by type 2a versus type 1b virus.

Epidemiological and clinical studies of liver cirrhosis in a rural area.

過去5年間, 当院に入院した肝硬変症164症例について, HBs抗原・HBs抗体検査から, 成因別分類を行なった。その結果, 当地域では, 男性ではアルコール性が, 女性では原因不明, NANB肝硬変が多かった。HBs抗原陽性肝硬変は8.3%と少なかった。HBs抗原持続陽性例の肝癌合併率は53.8%と高かったが, 全体では14.1%と低く, アルコール性からの発癌はまれであり, NANB肝硬変の発癌性も低いものと思われる。HBs抗原陽性肝硬変は, 肝癌の早期発見を, アルコール性は, 食道静脈瘤の治療が, 予後次善につながるものと思われる。