Risk of gallstones following gastrectomy in Japanese men

The risk of gallstones developing after gastrectomy in middle-aged Japanese men was investigated in a study of 2,738 men aged between 48 and 56 years who underwent both gallbladder ultrasonography (US) and a barium study of the upper digestive tract. It was revealed that 61 men had gallstones, 37 had had their gallbladder removed previously, and 55 had a history of gastrectomy. The prevalence of gallstones was 3.5 times higher in the men who had previously undergone gastrectomy (7.7%) than in those who had not (2.2%) (P=0.03). Moreover, gallstones tended to be more prevalent in those who had undergone Billroth II gastrectomy (12.5%) compared with those who had undergone Billroth I gastrectomy (5.6%); however, the difference was not significant. These results indicate that gastrectomy using either Billroth I or Billroth II reconstruction predisposes to gallstone formation. Nevertheless, it was estimated that prior gastrectomy was responsible for no more than 5% of gallstones in the study population.     

Computational simulation method of intraluminal velocity profile proved by laser Doppler velocimeter

Measurement of the intraluminal velocity profile within an artery may provide insight into predicting the prognosis of arterial reconstruction. To confirm the results of the computer simulation method a laser Doppler velocimeter using an optical fiber was applied to canine femoral arteries with good or poor runoff, and the intraluminal velocity profile was measured directly. Under normal flow conditions, remarkable fluctuation was obtained at the layer adjacent to the wall, whereas under poor runoff conditions, stagnation of flow was seen at the layer adjacent to the wall. These results showed that our computational simulation method which calculates the intraluminal velocity profile was a reliable, valid method of on-line analysis of the intraluminal velocity profile.     

Hyperthermo-chemo-radiotherapy as a definitive treatment for patients with early esophageal carcinoma.

Ten patients with early stage esophageal carcinoma were treated with hyperthermo-chemo-radiotherapy (HCR) without surgery. The reasons for the inoperability of these patients included medically inoperable unresectable cancers, advanced age, and/or refusal to undergo surgery. The diagnosis of early esophageal carcinoma was determined by esophagograms, endoscopy, and ultrasonography. Squamous cell carcinoma was histopathologically confirmed in each case. Each patient underwent four to nine sessions of hyperthermic treatment combined with external irradiation and chemotherapy using bleomycin; eight of these patients received additional radiation, and two terminated treatment after the HCR therapy. The tumors in all patients showed either a complete response (CR) or a partial response (PR) after HCR therapy; in two patients viable cancer cells remained, but later disappeared after additional radiation. Five patients experienced no local recurrence for 12 to 70 months and are now alive and doing well, three died of other medical conditions without any evidence of esophageal cancer, and two died of recurrent esophageal cancer 20 to 27 months after initial admission. All ten patients tolerated the HCR well without any systemic side effects. However, in two patients, esophageal erosion was recognized endoscopically. HCR therapy therefore deserves serious consideration when treating patients with small malignant lesions of the esophagus who, for various reasons, are unable to undergo surgery.     

Takayasu arteritis in Japan

Takayasu arteritis is a disease on which many investigations have been conducted to determine its causes, clinical features and treatment, since 1908 when it was reported by Dr. Takayasu.The first nationwide epidemiological survey on Takayasu arteritis was conducted over 3 years from 1973 through 1975 by a research group on aortitis syndrome, a disease specified by the Ministry of Health and Welfare. Another nationwide survey on this disease over a period of 3 years was carried out from 1982 through 1984 by a research group focusing on systemic vascular lesion, another disease specified by the Ministry of Health and Welfare.     

Solitary Peutz-Jeghers type polyp of the stomach in the absence of familial polyposis coli in a teenage boy

We treated a male teenager with a solitary gastric Peutz-Jeghers type (hamartomatous) polyp showing neither mucocutaneous pigmentation nor inheritance. X-ray studies of the upper gastro-intestinal tract, small intestine and barium enema revealed a solitary thumb tip-sized polypoid mass in the posterior wall of the gastric body, with no evidence of any associated lesion. Histologically, the polypoid mass showed typical features of a Peutz-Jeghers type (hamartomatous) polyp. This may be the first documentation of a "solitary" gastric Peutz-Jeghers type polyp, in the absence of familial polyposis coli and mucocutaneous pigmentation.     

“Skull punch” for craniotomy in neonates and infants

We have designed a new instrument that we have called a skull punch, which is useful and safe for making a burr hole for a purely osteoplastic craniotomy in neonates and infants. The instrument is described in detail.     

DNA aneuploidy assessment of the effectiveness of hyperthermo-chemo-radiotherapy for esophageal carcinoma

The relationship between DNA ploidy and effects of preoperative hyperthermo-chemo-radiotherapy were investigated in 118 patients who underwent esophageal resection and reconstruction for carcinoma of the esophagus, including 56 treated with hyperthermo-chemo-radiotherapy (HCR therapy) and 62 treated with chemo-radiotherapy (CR therapy). DNA ploidy patterns were grouped into low and high ploidies, according to the degree of dispersion and the peak value on the DNA histogram. In the low ploidy group, there were no significant differences in the prognosis and histologic effects between the HCR and CR therapies. In the high ploidy group, however, the difference in survival curves was statistically significant, the 3-year survival rates of patients given HCR therapy and CR therapy being 26.7% and 10.7%, respectively (P less than 0.05). The HCR therapy increased the rate of "markedly effective" in the resected tissue compared with findings in cases of CR therapy. These findings show the positive effects of the HCR therapy for carcinoma of the esophagus, especially for patients with an aneuploid profile and a poor prognosis.     

Heat interaction parameter of polystyrene solutions determined by inverse gas-liquid chromatography

The interaction between polymer and solvent in highly concentrated polymer solutions was studied by inverse gas-liquid chromatography as a function of the molecular weight of polymer. The heat interaction parameter was estimated for the systems polystyrene(PS)-benzene, -toluene, -pyridine, -ethylbenzene, and -anisole. It was found that the heat interaction parameter for the concentrated polystyrene systems PS-toluene, PS-pyridine, and PS-benzene exhibits a similar behavior as in the dilute polystyrene solutions determined by calorimetry at 298,15 K. Further, the heat interaction parameter in both the concentrated and dilute polymer solutions is considerably dependent on the molecular weight of polymer.     

Changes in blood pressure and muscle sympathetic nerve activity during water drinking in humans

To investigate the possible involvement of the sympathetic nervous system in pressor response during water drinking, muscle sympathetic nerve activity (MSNA), blood pressure (BP), and heart rate (HR) were continuously measured in healthy young volunteers throughout the experiments of a 5-min control, 2 min of drinking 500 ml water, and a 28-min recovery. To avoid the effects of water passing through the oropharyngeal and esophageal regions and/or effects of swallowing, an equal amount of water was directly infused to the stomach through a stomach tube for 2 min. Water drinking caused a transient increase in mean arterial pressure (MAP) and HR immediately after drinking (DeltaMAP, 12.6 +/- 2.1 mmHg; DeltaHR, +19.9 +/- 1.7 beats/min at the peak). An abrupt decrease of MSNA was observed directly during water drinking (Deltaburst rate, -6.9 +/- 1.3 bursts/min; Deltatotal activity, -2,606 +/- 491 U/min), and it increased to the baseline level thereafter. Gastric infusion had little or no effect on MAP, HR, and MSNA. The present study demonstrated that a pressor response during water drinking was associated with the attenuation of MSNA and not generated by gastric infusion of water at the same rate as in this drinking manner. In conclusion, the rapid rise in BP might be caused through stimulations from the oropharyngeal region, swallowing-induced factors, and/or a feedforward mechanism by a central descending signal from the higher brain centers.     

Colchicine-induced Inhibition of Fat Globule Development in Hepatocytes of Rats Injected with Ethionine

To examine the effect of colchicine on ethionine induced fatty liver, adult female rats were starved overnight and then injected i.p. with 1 g kg ethionine at 11th hour of fasting; then a half of the rats were also injected i.p. with 2.5 mg kg colchicine twice at 3 and 6 h after the single administration of ethionine. Similarly, fasted control rats were injected i.p. with vehicle alone at the above times. All of the rats were sacrificed after a 20 h fast, and the hepatocytes in periportal areas were observed ultra-structurally. In addition, total lipids in the liver tissue were extracted and determined biochemically. Although similar significant increases of triglyceride were observed in the liver tissue of all ethionine-injected rats, the hapatocytes in the group treated with both chemicals had fewer cytoplasmic fat globules (CFG) than those in the group treated with ethionine only. On the other hand, the diameters of markedly increased membrane-bound lipid particles (MLP) in the double treated group were distributed mainly in the range 0.2–0.4 μm, compared with those (0.1-0.2 μm) in the other groups. These findings indicate that colchicine inhibits the development of CFG in ethionine injured hapatocytes. Acta Pathol Jpn 39: 281∼288, 1989.