Takayoshi Tobe

Experimental Study on the Influence of Pancreatic Duct Obstruction on Pancreatic Lysosome in Rabbits and its Protection by a Protease Inhibitor.

膵管結紮家兎にて膵腺房細胞の変化と新しい蛋白分解酵素阻害剤E3123の保護効果を検討した.3時間の短期間膵管閉塞とsecretin (0.2CU/kg・hr) 投与にて, 門脈血中amylase (46±4U/ml) (p<0.01), cathepsin B値 (9.6±0.7U/ml) (p<0.01), 膵水分量 (87±2%) (p<0.05), 膵amylase量 (614±42U/mg DNA) (p<0, 02) およびin-vitroでの膵ライソゾームの脆弱性はコントロール群 (amylase;15±2U/ml, cathepsin B;1.8±0.2U/ml, 膵水分量;74±2, 膵amylase量;387±23U/mg DNA) に比べ有意に上昇・亢進を示し, 膵腺房細胞内にてもcathepsin B活性がライソゾーム分画 (30±3%) より, チモーゲン分画 (49±4%) に移動するのが観察された (コントロール群: ライソゾーム分画;55±3%, チモーゲン分画;23±2%).これらの変化はE3123を5mg/kg・hrにて, 膵管閉塞時に投与することにより, ほぼ完全に阻止され, 2mg/kg・hrにても高アミラーゼ血症やcathepsin B活性の移動に対して抑制効果が示された.以上の結果は膵管閉塞障害における膵腺房内ライソゾームの脆弱化にE3123が抑制効果を発揮することを示唆させるものであった.

Estimation of Operation for Hilar and Gallbladder Carrcinoma in View of Quality of Life.

教室の過去10年間の手術施行上部胆道癌133例を対象として, 在宅生存率を, stage, 治癒度, 術式別に検討した.在宅生存率は, stageの進行と一致して低下し, stage IVの1年在宅生存率は, 胆嚢癌7%, 胆管癌4%と低かった.治癒度からは, 絶対非治癒群では, 胆管癌0%, 胆嚢癌4%と低いが, 切除により, 前者で30%前後と上昇, 後者では相対非治癒8%, 治癒切除群で65%前後に上昇し.StageIII, IVの進行胆道癌に対する術式別では, 胆管癌, 胆嚢癌の姑息, 縮小, 拡大手術群の1年在宅生存率は, それぞれ, 0%, 25%, 22%;4%, 42%, 22%であった.以上, 切除により, quaiity of life (QOL) の改善は認められるものの, 拡大手術は必ずしも, 現段階では, QOLの改善には結びつかず, 今後, 拡大手術の適応について検討すべきであると考えられた.

Distribution of immunoglobulin-producing cells in the human gastrointestinal tract —Cellular localization of adenovirus antibody—

anaerobic bacilli were found fa r more f requent ly than in those less than pH 4. Among l iver diseases aerobic Gram negative bacilli were found most f requent ly in cases with l iver cirrhosis . Aerobic Gram negat ive bacilli and anaerobic bacilli were found more f requent ly in cases with abnormal A/G ratio, Z. T. T., T. T. T., and al-phosphatase tes t than in those with normal value. Minimal inhib i tory concentra t ion of cholic acid, desoxycholic acid and taurocholic acid against isolated organisms was h igher in the following order : Candida, aerobic Gram negat ive bacilli, Staphylococci, Enterococci, Lactobacilli, anaerobic cocci, and anaerobic bacilli. Sensi t ivi ty of isolated bac ter ia against daily used antibiot ics was not different f rom those of the other clinical origins. In t ramuscu la r injections of 1,000,000 uni ts of penicillin-G and 1 gm of cephaloridine produced negligible concentra t ion in small intest inal juice.

Dumping syndrome after gastrectomy

was cooled as low as 15~ as tempera ture of an te r ior wall of body (measured with a needle thermis ter) . The other par t s of s tomach were es t imated to range within 15_+3~ as indicated by a pre l iminary study. Wi th this gastr ic tempera ture , cooling was carr ied out for 60 minu tes and following observations were performed. (1) Gastric specimens (27 in total) were obtained before and 24 hrs , 4, 7 and 10 days af ter cooling. Histologically these specimens had edema, thrombosis, hyperemia and round cell infiltration, the most f requent change being edema af ter 24 hrs (24%) and round cell infi l trat ion af te r 4 to 10 days (80 to 33%). The parietal cell count was noted decreased (20 to 25%) in specimens af ter 24 hrs , 3 and 7 days and re turned to the control level af ter 10 days. The chief cell count was noted decreased in all kind specimens. (2) Free Hydrochloric acidity (1 case) was noted to be profoundly decreased (83%)a f t e r 24 hrs and to be same as control af ter 7 days and above the control (40%) af ter 14 days. (3) Gastric e lec t romyography revealed an excited moti l i ty on inser t ion of the balloon. With cooling started, frequency of motion decreased markedly and this decrease re turned to the control level along the recovery of normal gas t r ic tempera ture (4) E. C. G. (9 cases) general ly showed only bradycardia, and one case T wave became reversed. (5) Portal pressure rose as much as 40 mmHzO only with inflation of the balloon and approximated to the control when balloon was deflated. Cooling itself did not cause noticeable change. In conclusion, there was no grave irreversible ha rms caused by gast r ic cooling with p resen t magnitude, but it is also worth an at tent ion tha t gastr ic cooling has disadvantages as well as advantages f rom the view point of controll ing hemorrhage or its recurrence .