N. Koide

The influence of small intestine on gastrin ulcer

A total of 32 cases with liver cirrhosis was diagnosed with a simultaneous examination by laparoscopies and liver biopsies. These patients were typed as Diabetic (22 cases) and Normal (10 cases) according to the data of GTT. In this abstracts, we report the relationship between liver functions or GTT and findings by laparoscopies and by biopsied liver specimens, and also between liver functions and GTT findings. Liver functions are more impaired in the post-necrotic type and coarse-nodular type than in the portal type, macro-nodular type and narrow-band type, respectively. Likewise, redness and capillary proliferation of the liver surface, increased hepatic consistency and splenomegaly reflect relatively well the abnormalities of various liver functions, in contrast to hepatomegaly. Hepato-celluar necrosis tended to correlate with ZnTT and TTT, cellular infiltrations with GOT and r-GL, ZnTT, TTT and BSP, and fibroses with II, ?-GL, A/G, ZnTT, TTT, BSP and cholesterol, where as fatty liver, nuclear vacuolation and cholangiolar proliferation did not show any particular correlation with liver functions. Thirteen patients with the portal cirrhosis of the 22 Diabetic type outnumbered 9 patients with the post-necrotic cirrhosis. In contrast, the portal and post-necrotic cirrhoses were 4 and 6 cases respectively, in the Normal type. There was no statistical difference in nodule sizes in both Diabetic and Normal types. Nodules in the liver surface tended to the denser in the Diabetic type than in the Normal type. Splenomegaly were more often observed among the patients with liver cirrhosis of the Normal type than in the Diabetic type. Vacuolated nuclei are often seen in the Diabetic type, while hepato-cellular necrosis, fibroses and cholangiolar proliferations are in the Normal type. Abnormal levels of AI-P and Ctt-E were found in the Diabetic type, where as those of II, 7-GL, ZnTT and TTT were in the Normal type.

Experimental gastroduodenal ulcer induced by synthesized tetragastrin in rats. (VI)

ConclusionsMost case of gastrin induced ulcers were observed predominantly in duodeuum and, therefore, especially in duodenal ulcer the role of gastroduodenal motility may be not evident as a causative factor.

Endoscopic figure of duodenal papillary portion

We have recently observed the duodenal ulcer of 82 cases by the duodenofiberscope. Of these 15 cases with deformities of the pyloric ring, and 18 cases with erosion in Antrum pyloricum were seen. In 101 cases which were considered to be demonstrated apparently on the X-ray film in the view of the grade of deformed bulb and ulcer crater, 19 cases could be observed unsuccessfully. Those which could directly observed through the pylorie ring were only three cases located on tile anterior wall, therefore, for seeing the duodenal ulcer more closely and clearly, the endoscope must be inserted into the dnodenal bulb. But, even if inserted, it is sometimes difficult to detect the duodenaI ulcer of Basis. 61 cases or 62.9% out of 92 cases were seen on the anterior wall, 20.6% on the posterior wall, 11.3% on the lesser curvature, 5.2o/0 on the greater curvature respectively. In our series, the various findings of simple, multiple, linear, kissing ulcer were reported. in a majority of cases, these were similar to those of the gastric ulcer, while the ulcer of the Shimofuri type with scattered white coating in the depression were peculiar. In fewer cases, clearer findings were obtained by sprinkling a dye solution over the duodenal mucosa.

The finding of FDS, especially of descending duodenum

The endoscopy for the digestive tract has achieved marked advance in these days, permitting to carry out the direct visual observation and the biopsy at almost every site of the whole canal. In the duodenum, it is possible even to take the backward Vr However, most of these techniques have been applied to the morphological examination, giving little consideration to the functional or physiological aspects. The authors have developed a new technique for the functional examination of the Vaters papilla and its surroundigns, by recording, under the direct visual control, the smooth muscle electromyogram with a pair of electrodes atached to its tip and grounding wire and lead wires sealed within, inserted through the forceps channel of the duodenoscope. As the electrode, a silver wire coated with silverchloride of 0.3 mm diameter and 5 mm lentgh was soldered to an enamel-coated wire of diameter approximately 0.3 mm. A pair of such electrodes were fixed in parallel at a space of 0.5 mm and sealed in a vinyl tube of 2 mm diameter. The bioelectrical signals picked up by this electrode were fed into a recorder. For the pretreatment, the mucosa was anesthetized with xylocaine and buscopan. After the insertion of F. D. S. and the application of electrodes, the state of reduced noises and stabilization was considered as the reference, and the drug reaction was checked with buscopan, morphine chloride, and atropine, which had been previously evaluated. Among 30 cases examined, the duration of discharge, the number of discharge bursts and the number of discharges in a burst were measured in two cases each derived from the papilla and a point approximately 1 cm away from it and a case of choledocholithiasis. The result of drug reaction was in accord with the general property of smooth muscle electromyogram, since morphine augmented the discharge activity of Oddis sphincter. The present method of E. M. G. lead will supposedly provide a stride beyond the existing technique for electromyogram study of the human smooth muscles in which the lead electrode was positioned surgically or radiographically.

A report on cholecyst-angiography

T h e d iamete r a n d the densi ty of each pa r t of bi l iary sys tem were m e a s u r e d us ing the film of D. I. C (Drip Infus ion Cho lang iography) . T h e rate of visualizat ion, the f requency of the maxim u m demons t r a t ion a n d the changc wi th thc lapse of t ime were also s tudied inc luding the course of bil iary tract . T h e o b j e c t o f s t u d y ; T h e resul t of liver funct ion, u r ine amylase , PS test etc. and clinical s y m p t o m s were taken into considerat ion. 80 cases free f rom the pathological f indings in liver, bi l iary t ract a n d pancreas a n d 23 cases wi th chronic pancreat i t i s were thus selected for this study. T h e m e t h o d of cho lang iog raphy ; 2 A m P of 30% bi l igraphin in 100cc of 5% glucose was slowly injected in t ravcnous ly in 30 min . and at 30 r, 45 r, 60 r, 90 ~ and 120 r following injection and at 30 after egg yellow in take the, pictures were taken. T h e r e s u l t ; T h e rate o f visual izat ion a n d the m e a n m a x i m u m d iamete r in the r ight and left hepa t ic duc t were 83 .8%, 81 .3%, 3.64-1.2 m m , 3 . 3 4 1 . 2 m m respectively. 30 r a n d 45 were sui table t ime for good visual izat ion a n d the p ic ture got worse after the t ime. T h e m e a n m a x i m u m d iamete r of the c o m m o n hepa t ic duc t was 5 . 7 • a n d its p ic ture was good a t 45 a n d 60 , g radua l ly becoming worse after 90. T h e m e a n m a x i m u m d iamete r of the c o m m o n bile duc t was 5 . 3 • 1.6 m m and its d i ame te r was the widest a t 45 . Its densi ty reached peak at 120 ~. However bo t h d iamete r a n d densi ty were well visualized at any t ime of projection. T h e size a n d densi ty of gall b l adder increased wi th the lapse of t ime after injection of the contrast m e d i u m and reached m a x i m u m at 90 . T h e m a x i m u m dimensions of the b ladder was 24.7~5.7 cm 2 a n d cont rac t ive rate (30 ~ to 120 ~ after egg yellow intake) was 5 7 . 5 • The rate of visual izat ion of the b ladder was 75% and no connec ton was found with the passage of t ime after injection. In the case of chronic pancreat i t i s the en l a rgemen t of d i ame te r of b ladder and the decrease of its contract ive power were the case and the convex projection of arc in the course of c o m m o n bile t rac t was encountered .

On the gastrotrophic action of gastrin tetrapeptide

ConclusionThe hyperplasia of parietal cell occurs by continuous administration of gastrin suspended by 16% gelatin. The gastrone and secretin inhibit the gastrotrophic action of gastrin tetrapeptide.

Clinical study on gastric acid and pepsin relation between caffeine and gastrin method

Male albumino rats, weighing between 200 and 400 g, were fasted for 48 hours and divided into two groups. A group of rats were anesthet ized with ure thane and another group were given stress by confinement. Stomach was drained with a canula and perfused with saline at a cons tant flow rate. The fluid was collected every 30 minites. Gastrin was given by a continuous intravenous infusion at a rate between 5 and 160 microgram/kg/hr for 24 hours. Secretion of gastric acid at a cons tant rate was obtained at least for 24 hours in these conditions. In anesthetized rats, the acid secretion in response to gastr in increased with increasing doses of gastr in from 5 to 40 microgram/kg/hr . Maximal response was produced by 40 microgram/kg/hr and followed by a decline of the secretion with fur ther increase in the dose of gastr in f rom 40 to 100 microgram, After minimal response to gastr in was obtained, the acid secretion increased again with increasing doses from 100 to 160 microgram/kg/hr . Thus , two phases of st imulation, the initial and the late phase, were obtained in the dose-response curve, and the response to gastr in 160 microgram/kg/hr was almost the same as the response to gastr in 40 microgram/kg/hr . Ulcerative lesions in the gastric mucosal membrane were reported previously by us in the rats following infusion of large amount of gastr in. These lesions seem to have relation to the increase in the output of gastric acid in the late phase of the dose response curve in the present experiment. In the s tress group, the basal secretion of gastric acid was higher than in the anesthetized group. Maximal response was obtained by gastr in at a dose between 20 and 40 microgram/kg/hr . The acid output at the maximal response was almost the same in the anesthetized group. The high level of acid output in the stress group with 0 and submaximal doses of gastr in mus t be due to the endogenous gastr in secretion caused by nervous st imulation.

On the inhibition of gastrin induced ulcer by gastrointestinal hormones

Trying to clealify the gastric acid, pepsin and protein secretion systems, we made use of the perfusion method on rat stomach (Schilds rat). Effects of tetragastrin, dextran sulfate and hydrocotisone were examined on pH, conductivity, pepsin activity and protein concentration successively. Following the i.v. administration of each dose of tetragastrin (0.032--2.0/~g), pH curve declined instantenously, while the conductivity, pepsin activity and protein concentration rose almost simultaneously. These pat terns gradually returned to normal level within 40 minutes to 1 hour which were well reproducible for 6 hours. Good dose responces were observed with the maximal dose of tetragastrin (1.0 pg). Dextran sulfate (1--12mg/100g i .v . )which has been said to inhibit pepsin activity in vitro, seemed to have no effects on pH, pepsin activity and protein concentration and did not move the maximal gastrin pattern. However, it is very interesting that remarkable increase of pepsin activity and protein concentration were observed 4 hours after i.v. administration of hydrocortisone (2--10 mg/100 g), while the pH remained almost flat. This finding is very suggestive to the pharmacological actions of hydrocortisone on the gastric mucosa.