Tatsuo Wada

Identification of carcinoembryonic antigen in the C‐Cell of the normal thyroid

Carcinoembryonic antigen (CEA) activity was confirmed in the C‐cell of the normal thyroid by immunohistochemical techniques. This suggests that CEA production in medullary carcinoma of the thyroid is not initiated by carcinogenesis, but reflects a function of the normal C‐cell. It is not yet clear whether CEA production in the C‐cell may be influenced by carcinogenesis. The C‐cell is the first APUD cell that was confirmed to have CEA activity.

Hepatic transport of indocyanine green in dogs chronically intoxicated with dimethylnitrosamine

Hepatic transport of indocyanine green (ICG) was examined in dogs chronically intoxicated with dimethylnitrosamine (DMN) (2 mg/kg) intraportally once a week for 6 weeks. In pathophysiological consequences, significant increases (p less than 0.05) were shown in both glutamic-pyruvic transaminase (GPT) and total plasma bile acids, but no significant difference was shown in body weight, liver wet weight, glutamic-oxaloacetic transaminase (GOT), plasma alkaline phosphatase activity, total plasma protein, and total plasma bilirubin. By histologic examination of livers from intoxicated dogs, increased fibrosis in periportal, perisinusoidal, and especially pericentral areas, with loss of normal architecture, was observed. Partial fibrous bridging between periportal and pericentral areas was also demonstrated, but extensive pseudolobulation with regenerative nodules was not observed. The portal venous pressure of the intoxicated dogs was increased by approximately 50% of that of control dogs. In intoxicated dogs, delays were shown in both plasma disappearance and biliary excretion of ICG and significant decreases were observed in the pharmacokinetic parameters k12 (plasma to liver transfer rate constant), V2 (distribution volume of liver compartment), and CLtot (total body-plasma clearance), while a significant increase was observed in k23 (intrahepatic diffusion and transport rate constant); the V1 (distribution volume of plasma compartment) was not altered. From these findings, it is suggested that the decrease in the intrinsic clearance of ICG for the hepatic uptake process might explain the decrease in ICG uptake rate into the liver which was observed in the DMN-intoxicated dogs. Dogs chronically intoxicated with DMN might be a good model for studying hepatic dysfunction.

Quantitative determination of non-sulfated bile acids in the serum of patients with hepatobiliary diseases by mass fragmentography.

SummaryIndividual non-sulfated bile acids in the serum of 65 patients with hepatobiliary diseases were quantitated by mass fragmentography. Serum with deuterium labeled deoxycholic acid as an internal standard was hydrolyzed with strong alkali, extracted with ether after acidification under cooling, and quantitated by mass fragmentography as the hexafluoroisopropyl-trifluoroacetyl derivatives. In obstructive jaundice, the ratio of cholic to chenodeoxycholic acid was significantly higher than others. Cholic or chenodeoxycholic acid levels were correlated with total bilirubin levels in obstructive jaundice and acute hepatitis. Lithocholic acid value was independent of the degree of liver injury. Total bile acid value was helpful in estimating the extent of liver cell injury and cholestasis, and these two pathological conditions can be distinguished to some extent by cholic to chenodeoxychoic acid ratio.

Duplication of common bile duct—A case report

A case of double common bile duct is presented. Precise preoperative recognition of this anomaly is extremely rare. Preoperative adequate appreciation of these anomalies of the biliary tree prevents surgeons from impairing the anomalous bile ducts, or from going astray, being faced with these anomalies at operation accidentally.

Echo guided percutaneous transhepatic cholangiography with puncture transducer.

Conventional percutaneous transhepatic cholangiography (PTC) has some disadvantages because it is customarily performed blindly. If the bile duct is made visible, these disadvantages are eliminated. The biliary tree, if dilated, can be clearly delineated by ultrasound technique. By combining the B-mode examination of the biliary tract with the ultrasonic puncture transducer, percutaneous transhepatic cholangiography was performed successfully in 16 examinations on 12 patients. PTC needle could be inserted directly into the lumen of the bile duct without appreciable difficulty. The echo guided PTC was found to be an easier, safer, and more reliable method than the conventional blind technique.

Hepatic extraction of chenodeoxycholic acid in dogs chronically intoxicated with dimethylnitrosamine.

The pharmacokinetics of chenodeoxycholic acid (CDCA) in hepatic dysfunction were evaluated by analyzing the plasma disappearance curves after simultaneous administration of [3H]- and [14C]-CDCA through the femoral and portal veins, respectively, in dogs chronically intoxicated with dimethylnitrosamine (DMN). The plasma concentration-time curve of intravenously administered [3H]-CDCA was best fitted to a three-exponential equation, while that of intraportally administered [14C]-CDCA was fitted to either a two- or a three-exponential equation. In the DMN-intoxicated dogs, significant decreases were observed in total body plasma clearance (CLp), hepatic extraction ratio (EH) and apparent intrinsic clearance (CLint) compared to those of the untreated (control) dogs. The hepatic blood flow (QH), calculated from CLp, CLint and blood-to-plasma concentration ratio (RB) according to the equation reported by Wilkinson and Shand [Clin. Pharmac. Ther. 18, 377 (1975)], was reduced to approximately 70% in the DMN-intoxicated dogs compared to the control dogs. The bindings of CDCA to plasma and liver cytosol fraction were determined by equilibrium dialysis; no significant difference was observed in the unbound fraction between the DMN-treated and control dogs. By comparing both pharmacokinetic parameters obtained from intravenous and intraportal administration, the usefulness of the oral bile acid tolerance test was examined. From these findings, it was suggested that the decrease in the CLp of the DMN-intoxicated dogs was due to both the decrease in QH and that in CLint, and that the decrease in CLint may be due not to an alteration of plasma or cytosol binding but to that of a carrier-mediated transport system. It is also suggested that the measurement of fasting plasma bile acid concentration or the oral bile acid tolerance test is more sensitive for the detection of hepatic dysfunction than the intravenous bile acid tolerance test.

Hepatic artery aneurysm

SummaryOne hundred and nineteen cases, including the one reported here, of hepatic artery aneurysm were reviewed. The clinical features and surgical management in four etiologic groups, consisting of arteriosclerosis, cholecystolithiasis, trauma and, specific diseases, were investigated. Interruption of the hepatic artery, entailing ligation of the hepatic artery, excision of the aneurysm without vascular reconstruction, and obliterative aneurysmorrhaphy, was done in 50 patients. Its high mortality rate (26%) was principally ascribed to delayed diagnosis or inappropriate site of interruption. If conditions such as shock, anoxia and portal thrombosis are avoided, interruption of the hepatic artery seems to be a safe and useful operative method for hepatic artery aneurysms, especially accompanied by severe local infection.

Excimer fluorescence of α,ω-biscarbazolylalkanes doped in polycarbonate

Abstract Fluorescence properties of biscarbazolyl compounds in polycarbonate have been examined. The intensity of excimer fluorescence progressively decreases for compounds in which two carbazole groups are bound by C 6 , C 10 , C 4 , C 5 and C 3 methylene chains. It is determined that the intramolecular interaction dominates the excimer formation.

Hypotonic resistance and shape of erythrocytes in portal hypertension Special reference to influence of spleen

門脈圧充進症90例を対象にCoil Planet Centrifuge systemによる赤血球浸透圧抵抗の測定と赤血球形態の観察を試み,肝機能と脾機能の影響を検討した.脾摘出後の溶血終了点は著しく低張側に偏位する(浸透圧抵抗増強)とともに,標的赤血球の出現をみた.溶血終了点は標的赤血球が多数出現するほど低張側に偏位する一定の関係が判明した.脾摘出前の溶血終了点は,本症における肝障害の存在にもかかわらず健常群と変らず,基礎疾患群による差異も認めなかった.脾腫の存在により,赤血球の球状化,脆弱性獲得機転が働き,浸透圧抵抗が減弱するためと考えられた.脾摘出前後の肝機能は血清総コレステロールの上昇を除いて一定の傾向を認めず,脾機能亢進を伴う門脈圧充進症での赤血球の浸透圧抵抗性は,肝機能よりも脾機能の影響を強く受けることが判明した.脾摘出前に認められた貧血は脾摘出により改善し,血清ビリルビンは低下した.脾での溶血機転が除去された結果と考えられた.

Experimental Portal Hypertension and Changes of Gastric Acid Secretion

雑種成犬4頭において,門脈本幹に狭窄を作製し,さらにGore-Tex人工血管を使用して,大動脈-門脈短絡を形成することによって,手術後2週目で274～620mm Saline(平均389.8±161.7mm Saline)の実験的門脈圧亢進症を作製し得た.この門脈圧亢進症犬において,手術前後で肝機能の変化はほとんど見られなかった.内視鏡による胃粘膜の観察では,門脈圧が上昇すると胃炎の頻度が増す傾向が見られた.胃液検査では,門脈圧が上昇するとMAOが有意の低下を示し,門脈圧が下降すると回復する傾向を見た.