[The usefulness of MRCP in the initial diagnosis of the biliary and pancreatic diseases compared with ERCP].

The purpose of this study was to determine the effectiveness and the limitation of the MR cholangiopancreatography (MRCP) in the initial diagnosis for the biliary and pancreatic diseases compared with the image of Endoscopic retrograde cholangiopancreatography (ERCP). MRCP showed higher performance toward the discovery of the choledocholithiasis of a diameter 4 mm and more. Furthermore, MRCP reflected a malignant tumor at the constrictive part and the dilated proximal part of the biliary and pancreatic duct in 23 example all. An advantage of ERCP was the ability to carry out biopsies and therapeutic procedures, such as biliary drainage and sphincterotomy, while MRCP was an important diagnostic modality in the work-up of the biliary and pancreatic diseases and could help in planning treatment. MRCP would become the examination method first used, and it would be popularized all the more from now on.

[The influence of anti-interferon-alpha 2a antibodies in initial daily four-week interferon-alpha 2a therapy for chronic hepatitis C].

Thirty-two patients with chronic active hepatitis C were initially treated with 9 million units of interferon (IFN)-alpha 2a daily for 4 weeks and then thrice weekly for 20 weeks. The incidence of development and influence on clinical effectiveness of anti-IFN alpha 2a neutralizing antibodies measured by bioassay were investigated. Thirteen (41%) of the 32 patients developed antibodies, 4 (12.5%) of whom exhibited a high titer of 128 NU or greater. There was a significant difference (p < 0.05) between responders and non-responders in the low viral load group (less than 10(5) copies/50 microliters) in the incidence of antibody development, with antibodies present in 2 of the 9 responders (22%) and 5 of the 7 non-responders (71%). There was also a significant difference between the antibody-negative and antibody-positive patients in circulating HCV-RNA, 2-5AS activity and average ALT levels at the latter half of treatment. In addition, 2-5AS activity was significantly lower (p < 0.05) at completion of treatment in the high antibody titer group (128 NU or greater) than in the low antibody titer group. These results indicate that the development of anti-IFN neutralizing antibodies had a definite influence on the clinical course of IFN treatment for chronic hepatitis C.

Application of agar-fill method to estimate compartment capacity of gastrointestinal tract in Syrian hamsters (Mesocricetus auretus).

In the present study we have developed the agar-fill method for the measurement of gastrointestinal-tract capacity (GTC) to replace the in vitro water-fill method. This would estimate GTC without using complex equipment and techniques, and can be applied to the measurement of GTC for small laboratory animals. We attempted to confirm the efficiency of the agar-fill method by investigating the relationship between dietary neutral-detergent fibre (NDF) content and GTC. The digestion trials were carried out using the Syrian hamster (Mesocricetus auretus). The trials were conducted using both sexes, two age-groups and three levels of dietary NDF with a cross-classified design. The size of each gastrointestinal organ was determined as tissue weight (TW) and GTC. The DM intake, digestible DM intake, DM digestibility, NDF digestibility, acid-detergent fibre (ADF) digestibility and digesta transit time were also measured. GTC increased with increasing NDF content of the diets. TW responded similarly to increasing NDF content, but the response was smaller than that of GTC. DM digestibility decreased with increasing NDF content of the diet. The digestible DM intake did not decrease with increasing NDF because DM intake increased with NDF content. Digesta transit time was not shorter of the high-NDF diet group but DM intake increased with increasing NDF content. NDF digestibility did not differ significantly between low- and medium-NDF diets. ADF digestibility was low in the low-NDF-diet group. The digestion characteristics were highly correlated with TW and GTC, except for TW of small intestine. These correlations were higher with GTC than with TW. The results of the present study confirm previous findings suggesting that the agar-fill method is a useful means of estimating GTC for small laboratory animals.

Endoscopic laser treatment for early gastric cancer.

Endoscopic laser treatment (ELT) has been proposed as one of the curative endoscopic therapies for early gastric cancer. We report our experience with ELT in 111 patients with early gastric cancer limited to the mucosa as diagnosed by endoscopy and/or endoscopic ultrasonography. Twelve patients subsequently underwent laparotomy after ELT and no residual tumor was found in 75% of these cases. Ninety-nine patients had no surgery for various reasons and follow-up information by endoscopy was available for 73 of them for a mean of 2.7 years (range 1 to 7 years). 81% of these patients were found to be tumor free. There was no difference in the success rate of ELT in relation to endoscopic classification, tumor location and histologic type of cancer. Recently, the indications for ELT decreased due to the development of endoscopic mucosal resection (EMR) enabling histological evaluation of a resection specimen. However, the technique of EMR cannot always be performed completely depending on the location and size of the lesions. Therefore, we employed ELT as an additional treatment technique after EMR therapy to achieve complete tumor destruction. Results in 13 patients where both techniques were employed showed complete tumor removal in 11 cases. At present, this combined application may be the most important role of laser irradiation for the treatment of early stage GI tract malignancies.

Chemoembolization for hepatocellular carcinoma via the inferior pancreaticoduodenal artery in patients with celiac artery stenosis.

Twenty-one patients with hepatocellular carcinoma (HCC) accompanied by extensive celiac artery stenosis or obstruction were treated by chemoembolization via the inferior pancreaticoduodenal artery (IPDA). The tip of the catheter was placed in the arteries in front of the confluence with the proper hepatic artery in 12 patients (group A: the proximal portion of the IPDA in 10, and common hepatic artery in 2), and in the proper hepatic artery or branches of it (group B) in 9 using a coaxial catheter system. Transient hyperamylasemia was observed in 10 of the 12 patients in group A and in 3 of the 9 patients in group B after chemoembolization. Splenic infarction developed in 8 patients in group A and in none in group B. Intrapancreatic fluid collection was present in 2 patients in group A following chemoembolization. No fatal complications were encountered. The 1-, 2-, and 3-year survival rates of the 10 patients in group A treated by only chemoembolization were 90, 57, and 23%, respectively (mean survival 780 days). The 1- and 2-year survival rates of 9 patients in group B were 85.8 and 85.8% (mean 879 days), respectively. Considering the severity of complications and the survival rates in groups A and B, chemoembolization by superselective catheterization into the hepatic artery via the IPDA is the treatment of choice. However, chemoembolization from the arteries in front of the confluence with the proper hepatic artery seems to be acceptable in cases of hypervascular HCC which fail to be superselectively catheterized.

[Evaluation of percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis].

We performed percutaneous transhepatic gallbladder drainage (PTGBD) in 71 of 129 patients with acute cholecystitis. In 70 of 71 patients, clinical symptoms and laboratory data were rapidly improved by PTGBD. In order to evaluate the degree of acute cholecystitis, the clinical symptoms, laboratory data and ultrasonographic findings of these patients were analyzed by the quantification theory of Hayashi. As a result, irregular thickening of the gallbladder wall and gallbladder swelling presented by US and physical findings with Blumberg's sing or defence in the abdomen were most important findings to assess the severity of acute cholecystitis. Based on these data, we originally introduced the Severity Score of this disease and used it a criterion of PTGBD indication. The patients with the score above 0.5 were considered to be indicative for emergent PTGBD. In high risk patients (e.g., the aged or of diabetes mellitus) with the score above 0, this procedure should be indicated. In 24 of 71 patients, Percutaneous Transhepatic Gallbladder Scope (PTGBS) were attempted to retrieve stones, and it was completely successful in 16 patients.

[Preoperative diagnosis and staging of pancreatic cancer by endoscopic ultrasonography (EUS)--a comparative study with other diagnostic tools].

Endoscopic ultrasonography (EUS), ultrasonography (US), computed tomography (CT), and angiography (Angio) were performed in 26 patients with pancreatic cancer which were all resected. Preoperative findings of each diagnostic tools were compared with histological findings. In order to discuss the effectiveness of each body imagings, the preoperative staging of pancreatic cancer was evaluated in direct invasion to the anterior pancreatic capsule and stomach (S), direct invasion to the duodenum (D), direct invasion to the retroperitoneal adjacent vessels (Rp), and regional lymph node metastasis (N). The overall accuracy rate was 77% with EUS (50% with US, 38% with CT, 56% with Angio) in S, 81% with EUS (44% with US, 38% with CT, 63% with Angio) in D, 77% with EUS (58% with US, 42% with CT, 73% with Angio) in Rp, and 65% with EUS (58% with US, 38% with CT) in N. EUS revealed high accuracy rates because EUS images of the whole pancreas, surrounding organs and major vessels were clearly visualized through the gastroduodenal walls. Also, the accuracy rates of Angio in Rp and US in N were almost the same as those of EUS in Rp and N. However, it was difficult for every procedure to diagnose the retroperitoneal perineural invasion. From these results, EUS is one of the most beneficial procedures for detecting of the extent of cancer. EUS is expected to be popularized in the diagnosis and staging of the pancreatic cancer.

[Prevalence of K-ras gene mutations in human colorectal cancers].

It has been reported that mutations in the human ras gene family convert these genes into active oncogenes. In the present study using in vitro gene amplification by the polymerase chain reaction (PCR) and mutation detection by the oligonucleotide hybridization assay, a total of 86 colorectal cancers were analyzed for the point mutations at codon 12 and 13 of K-ras genes. Mutations were present in 33 of the 86 colorectal cancers examined; 32 of the 33 mutations were at codon 12 of this gene and one of them was at codon 13. There was no apparent correlation between the presence of a ras gene mutation in a carcinoma and its anatomical location, level of differentiation, depth of invasion, degree of lymphnode metastasis or stage of progression, however, the high incidence of K-ras mutations was observed in early stage carcinomas (depth m and sm). This results support the concept that the point mutation of K-ras gene is early event in tumorigenesis of colorectal cancer.

Experimental bacterial prostatitis in rats.

Experimental acute bacterial prostatitis in rats was induced by four different routes of bacterial inoculation. The most simple and reproducible method of producing bacterial prostatitis was to instil the bacterial suspension into the prostatic urethra after the administration of an appropriate antibiotic to prevent associated pyelonephritis.

[Carcinoid tumor of the ileum with intestinal tuberculosis--report of a case].

A 65-year-old woman visited our hospital, complaining dizziness and abdominal pain. Positive fecal occur blood and an iron-deficiency anemia were found. An investigation of the GI tract was performed, and enteroclysis revealed three stenotic lesions in the ileum, the most distal one having an irregular edge. A superior mesenteric angiogram showed tumor stain and encasement in the ileal region. On laparotomy, a large tumor and multiple stenosis were found in the ileum. Histological examination of the resected specimen confirmed the diagnosis of a carcinoid tumor and healed tuberculosis of the ileum.

Immunological traits in generations 7 to 12 of two lines of Japanese quail selected for high or low antibody response to Newcastle disease virus.

Several immunological traits were compared in lines of Japanese quail selected for high and low secondary immune responses to anti-Newcastle disease virus (NDV). The high line of quail, selected for high ability to produce antibodies, was more responsive in both their primary response to NDV antigen used in the selection as well as to other antigens used in selection process including NDV (Ishi strain), tissue culture-derived Newcastle disease (TCND strain), NDV strain B1, influenza virus, sheep erythrocytes, and Salmonella pullorum than the low line, selected for low ability to produce antibody titers. Mitogenic response to phytohemagglutinin mitogen in the blood lymphocytes from high line quail was more reactive than those from low line quail. Significant line differences were also found in the number of spontaneous rosette cells produced by blood lymphocytes with both fowl and rabbit erythrocytes; the number in the high line exceeded those in the low line.

Selective breeding for high and low antibody responses to inactivated Newcastle disease virus in Japanese quails.

Two lines of Japanese quail were divergently selected for high and low antibody responses after being twice injected at 4 and 6 weeks of age with inactivated Newcastle disease virus antigen. After seven generations of selection, the serum antibody level in the high line was 24% greater than the level in the unselected control lines, whereas the low line antibody level was approximately 37% less than that in the control line. The estimated heritability (H2S + D) was approximately .12 +/- .50. The realized h2, calculated from coefficient of regression formula on seven generations (G3 to G9 ), was .07.

Correlated responses of growth traits to selection for high and low plasma alkaline phosphatase in mice.

The effectiveness of two way selection for plasma alkaline phosphatase (ALP) was investigated in order to determine its influences on growth traits through thirteen generations. The responses of the two lines selected for high (HP) and low (LP) ALP at 45 days of age were compared to that of the mice selected for large (L) and small (SM) body size. The selection responses of plasma ALP were very effective for both HP and LP lines, with average responses per generation calculated from linear regressions of 0.227±0.037 and -0.088±0.022 respectively. The final levels of ALP in HP and LP were 5.54±0.71 and 1.27±0.20 in the thirtheenth generation, while the SM, L and base population had levels of 3.49±0.08, 0.86±0.55 and 2.77±0.56 respectively. The body weight at 45 days of age in LP (31.4±1.4 g) as a correlated response was significantly higher than HP (23.4±1.8 g) at generation 10. The correlated response of milk yield, measured by weight gain up to 12 days of age, was significantly greater in the LP line than in HP, but the correlated response of gains after weaning was not so different as the response of milk yield. The response of litter size and weight in LP showed significant higher levels than that of HP, but pups' birth weight did not differ between LP and HP. It is suggested that the correlated response of milk yield contributed more to the divergence of body size between HP and LP than the gain after weaning.Realized heritabilities of ALP were 0.335±0.059 (HP) and 0.279±0.051 (LP). Realized genetic correlations between ALP and 45 days' body weight were -0.27±0.13 (HP with SM) and -0.52±0.19 (LP with L). Realized genetic correlations between ALP and milk yield were -0.95±0.03 (HP) and -0.37±0.29 (LP). Correlations between ALP and postweaning gains were fairly low.