Takao Morito

The destructive effects of sclerosant ethanolamine oleate on mammalian vessel endothelium

SummaryEthanolamine oleate (EO) used widely in sclerotherapy against esophageal varices was studied for its pharmacological effect on blood coagulation and vascular damage in animals. Blood coagulation was completely inhibited by EO at a concentration of 0.31%. EO destroyed the endothelial cells of the vessel of dog and rat within one minute after injection into the vessels. An accumulation of fibrin and platelets on the surface of the damaged vessel was observed electron microscopically. Mural thrombus was formed in a few hours and the thrombus occluded the blood stream in the vein. From these animal experiment, intravasal injection of EO was considered to cause the disappearance of varices by the following two processes: collapse of varices because of occlusion of the blood stream and shrinking of the obstructed thrombus through organization.

Studies on Hanganutziu-Deicher Antigens-Antibodies

Sera of patients with various liver diseases were examined for the presence of Hanganutziu-Deicher (H-D) antibodies by enzyme immunoassay with high-molecular weight glycoprotein (HMWGP) isolated from

Antibodies to E1 and E2/Protein X components of pyruvate dehydrogenase complex in sera of patients with primary biliary cirrhosis

AIMS/METHODS Using purified E1 component of pyruvate dehydrogenase complex (PDC) from bovine heart, we measured the levels of anti-E1 antibodies in PBC sera using ELISA and determined the degree of inhibition that these antibodies exerted on E1 enzyme activity. We also estimated levels of anti-E2/Protein X (Pro-X) antibodies in PBC sera using purified E2 and Pro-X of PDC which were copurified with E1. RESULTS/CONCLUSIONS Anti-E1 antibodies were detected in 87.5% (35/40) of PBC sera. Some of these sera inhibited E1 enzyme activity but inhibition did not correlate with levels of anti-E1 antibodies. A high positive correlation (r = 0.918) was found between levels of anti-E1 and anti-E2/Pro-X antibodies, suggesting that anti-PDC antibody production was stimulated by PDC itself. Levels of IgG class anti-E2/Pro-X antibodies were significantly higher in sera of symptomatic PBC patients than in those of asymptomatic PBC patients. It was also found that patients who were positive for only IgM class anti-E2/Pro-X antibodies had early-stage PBC.

Nonparticipation of C1q in the Decrease of Complement Activity in the Cold in Sera of Patients with Chronic Liver Diseases

Serum and plasma samples taken simultaneously from 560 patients with various diseases were examined for hemolytic complement activity (CH50) after incubation at 4 degrees C for 20 h. Serum CH50 titers less than 20 U/ml were observed in 39 cases and among them, a difference between serum and plasma CH50 of more than 5 U/ml were observed in 16 cases. Diagnosis of most of them were chronic liver diseases. To analyze the dissociation of CH50 titers between serum and plasma, sequential estimations of CH50 were performed on serum and plasma samples which showed the dissocation incubated at 4 and 37 degrees C. Marked decrease in CH50 titers was obtained in sera but not in plasma incubated at 4 degrees C. In such sera, however, no significant decrease of protein amount and agglutinating activity of C1q was observed. The result could indicate that C1q would not participate in the decrease of serum hemolytic activity in the cold, suggesting an activation of complement other than the classical pathway.

Heterophils Antibodies in Japanese Patients with Various Diseases Including Infectious Mononucleosis

Sera of Japanese patients with various diseases including patients with lympho-proliferative disease similar to infectious mononucleosis (IM) were studied for the presence of heterophile antibodies. Antibodies to sheep erythrocytes were demonstrated in 9 of 19 such patients whereas similar antibodies were found only in 28 of 3570 (0.8%) patients with various other diseases. Adsorption studies revealed that these antibodies in patients with IM-like syndrome are of Hangantziu-Deicher or Forssman nature. On the other hand, Paul-Bunnell antibody characteristic for IM in Caucasians was not demonstrated in Japanese suffering from IM-like syndrome.

Increased percentage of peripheral blood activated cytotoxic T cell in patients with acute phase fulminant hepatitis.

The subsets of peripheral blood lymphocytes in 3 cases with acute type of the fulminant hepatitis (FH) were studied.The percentage of Leu 2a+15- cell and Leu 2a+ HLA-DR+ cell in the peripheral blood at the acute stage increased remarkably in death cases due to FH. In survival cases, increase of Leu 2a+15- cell was not noted, while increase of Leu 2a+ HLA-DR+ was noted. The increase of the percentage of these cells was also noted in the acute viral hepatitis type A (AVH), while ratio of Leu 2a+ HLA-DR+ cell/Leo 2a+15- cell was higher in FH than in AVH.These data suggest that activated cytotoxic T lymphocytes may play a role in the pathogenesis of FH.

Improvement of severe diarrhea by dimethylsulfoxide in a case of AA type secondary amyloidosis

緒言: 慢性関節 リウマチ(RA)に ア ミロイ ドーシスが しばしぼ合併することはよく知 られて いるが,そ の治療は困難 とされている.我 々は, RAの 加療中に治療に抵抗す る水様性下痢を きた し,胃,十 二指腸および大腸生検でア ミロイ ドー シスと診断され,DMSO(dimethylsulfoxide)に よ り軽快 した症例を経験 したので報告す る. 症例: 62才,女 性.主 訴: 水様性下痢.家 族歴: 父高血圧,母 胃癌,妹 慢性関節 リウマチ (RA).既 往歴: 特記事項なし.現 病歴: 昭和 55年 関節痛出現.RAの 診断にて某病院で金療法, D-ペ ニシラミン療法などをうけ症状軽快.昭 和59 年12月 頃 より水様性下痢,腹 痛.〓 吐が出現 し, 翌年9月 同病院入院.止 痢剤などを投与したが, 下痢は1日10数 回に及んだ.同 年11月 胃,十 二指 腸生検でア ミロイ ドの沈着が認め られ(図1A, B),12月 精査加療 目的で当科に入院 となった.入 院時現症: 血圧124/90mmHg,脈 拍90回/分, 整.顔 面蒼白,浮 腫があ り,眼 球結膜貧血様,巨 舌症や甲状腺腫なし.心 濁音界軽度拡大.心 音呼 吸音正常.腹 部異常なし.下 腿浮腫著明で,右 第 5指 左第3指 に変形あ り,関 節痛,関 節炎はなく, 神経学的にも異常なし.入 院時検査成績: 血沈 1時 間4mm,赤 血球数207万/mm3, Hb 6.2g,/dl, 図1A.胃 生 検組 織 像(コ ン ゴー赤 染 色),粘 膜 下 層 に ア ミロイ ドの 沈 着 を認 め る(×100)

An autopsy case of patient with mixed connective tissue disease with pulmonary hypertension and a remarkable thrombus in pulmonary truncus

症例は73才女性. MCTDと診断され10年の経過で肺高血圧症で死亡した.剖検で左右肺動脈幹から肺門部肺動脈をほぼ閉塞する血栓が認められた.肺動脈幹血栓の成因として,肺細小動脈の内膜肥厚と血栓形成により肺血流が緩除になり二次的に形成された可能性が考えられた.

A case report: Polymyositis(PM) associated with primary biliary cirrhosis(PBC) and Sjoegren's syndrome(SjS).

多発性筋炎(PM)経過観察中,原発性胆汁性肝硬変症(PBC), Sjogren症候群(SjS)を合併した一例を報告する.症例は37歳の女性で,25歳時(昭和42年)に前腕の強直感が出現し,当院整形外科にて慢性関節リウマチの診断を受けた.2年後に四肢の脱力感が出現し,東北大学第2内科に入院.筋生検等にてPMと診断されたが,prednisoloneにて自覚症状はかなり改善し,50年当科に紹介となった.しかし51年頃より肝機能検査値に異常を認めるようになり,52年にご肝生検を施行.肝組織は慢性非化膿性破壊性胆管炎の像を呈し,Scheuer分類1期のPBCと考えられた.54年頃から口渇感が出現しSjSと診断された.PMに随伴した肺腺維症に対して,d-penicillamineが51年から59年に副作用のために中止されるまで投与されたが,その後GOT, ALPの上昇が顕著となった.現在までPBCは無症候性のまま推移し,PMの症状も増悪傾向はなく,外来で経過観察中である.

Studies on autoantibodies of autoimmune hepatitis (AIH) and systemic lupus erythematosus (SLE).

自己免疫性肝炎(AIH)を中心に各種肝疾患における抗NAPA抗体と他の自己抗体の出現頻度を検索し,SLEとの比較において,その病態の相違を検討した.抗NAPA抗体は,AIHにおいて,抗RNP抗体,抗Sm抗体,抗SS-B抗体は陰性で,抗SS-A抗体のみ3例(30%)に陽性であった.その中で1例はSjogren syndromeを合併していた.他の肝疾患では,抗RNP抗体,抗Sm抗体共に全例陰性であった.次に,AIHとSLEの相互関係では,両者は,LE test,ANA,抗DNA抗体の出現頻度は似ていたが,抗NAPA抗体はSLEに,抗平滑筋抗体はAIHに高頻度に認められ,AIHはSLEの部分症ではなく,肝を免疫反応の主場とした独立疾患であると推定された.