Takafumi Yamashita

Idiopathic portal hypertension associated with high serum titer of autoantibodies and liver dysfunction.

Idiopathic portal hypertension (IPH) is a condition marked by unexplained portal hypertension. Although a number of immunological abnormalities occur in patients with IPH, liver function is usually normal. We experienced an unusual case of IPH in a 49-year-old woman, who had pronounced splenomegaly. Laboratory data revealed pancytopenia, hypergammaglobulinemia, and liver dysfunction. Antinuclear antibodies were positive, with high titer at 1280 dilutions of sera. LE cell phenomena were also positive. Histological examination of biopsied liver showed only mild changes, but portal venous pressure was markedly elevated, at 38 cm H2O. This case was thus characterized by both a high serum titer of autoantibodies and liver dysfunction.

Nonfunctioning islet cell carcinoma presenting bleeding gastric varices and splenomegaly

This is a report of a 63-year-old Japanese woman with a nonfunctioning islet cell carcinoma of the pancreas presenting bleeding gastric varices and splenomegaly. These manifestations are extremely rare in patients with nonfunctioning islet cell tumor. The tumor originated in the tail of the pancreas and grew mainly within the spleen. The gastric varices due to increased blood flow to the tumor and arteriovenous fistuals within the tumor were confirmed by angiography and operation. The tumor was resected and she is in a good health for 14-months after the operation.

A CASE OF NON-SPECIFIC MULTIPLE ULCER OF THE SMALL INTESTINE

症例は, 23歳,女性.平成11年,十二指腸潰瘍穿通にて広範囲胃切除術施行された.同年,癒着性イレウスの診断にて,癒着剥離術を施行した.この際,回腸末端部より約80cm付近に8カ所の輪状の壁肥厚を認めたため一部を切除した.肥厚部にはびらんを認め,病理学的には非特異的炎症所見のみであった.平成14年8月,突然の下腹部痛が出現し,外来を受診した.受診時,下腹部に強い圧痛を認めたが腹膜刺激症状は認めなかった.腹部CTで小腸の拡張とTargetsign様の所見を認めたため,腸重積を疑い緊急手術を施行した.回腸末端部に8カ所の壁肥厚を認め,それより口側の腸管の拡張を認めたため同部を切除した.切除標本では輪状の潰瘍瘢痕様の病変を8カ所に認め,病理学的には浅い潰瘍形成と粘膜下層の非特異的炎症像が認められ非特異的多発性小腸潰瘍症と診断した.

The changes of cell kinetics of uni- and binucleated hepatocytes after partial hepatectomy in DEN induced chronic liver injured rats.

障害肝における肝切除後の肝再生について細胞動態の面から検討する目的で,diethylnitrosamine投与による障害肝ラットを作成し,肝線維症と肝硬変症に分け,70%肝切除後のmitotic index (MI)ならびにbromodeoxyuridine (BrdU)を用いた1核,2核細胞のlabeling index (LI)を測定し,正常ラットの肝再生と比較検討した.MIは障害肝でも正常肝と同様の推移を示し,肝切48時間後に最も高値を示したが,肝障害が強くなるほどMI値は低値を示す傾向がみられた.1核,2核細胞それぞれの動態をMIで検討することは困難であったので,BrdUのとり込みによるLIについて1核,2核細胞にわけ検討した.その結果,1核細胞は肝障害の程度が強くなるに従ってLIは低値を示す傾向がみられた.一方,2核細胞のLIは肝障害の程度による著明な差はなく,正常肝に比べて低値を示し,肝再生への関与が少ないように思われた.

Cell kinetics of uni-and binucleated hepatocytes after partial hepatectomy.

ラットにおける肝再生時の1核,2核肝細胞の細胞動態をthymidineのanalogueであるBrdUに対する抗BrdUモノクローナル抗体を用いたDNA合成期(S期)細胞の測定ならびにDNA量ヒストグラムの測定により検討した.正常ラット肝(7週齢)での1核,2核細胞の各々は87%, 13%にみられ,70%肝切72時間後まで2核細胞は減少する傾向にあった.S期細胞(LI)は,1核,2核細胞とも肝切24時間後で最も多かったが,1核細胞より2核細胞で高値を示す傾向がみられた.DNA量ヒストグラムパターンは,肝切後1核細胞は2cから4cへ,2核細胞は4cから8cへのpolyploidizationがみられ,24～48時間後が最も著明であった.以上のことから70%肝切後の肝再生では,1核,2核細胞とも肝切24～48時間後に最も活発な細胞動態を示すが,1核細胞より2核細胞のLIが高いことから,肝再生時には2核細胞の細胞動態がより活発であるように思われた.

Monoclonal Antibody AM34 Detects New Proteins Associated with Secondary Amyloidosis

Amyloidosis is a metabolic disease which is characteristic for the deposition of amyloid substances in various organs. Currently chemical types have been clarified for some types of amyloid-related proteins such as AL for primary or myeloma-associated amyloidosis, AA for secondary amyloidosis and transthyretin (TTR) variant for familial amyloid polyneuropathy (FAP).