[Experimental study on the pathogenesis of acute ulceration in obstructive jaundice--with reference to gastric mucosal blood flow]

We prepared obstructive jaundice models in rats in order to study the mechanism of acute ulceration in obstructive jaundice centering on impediments to gastric wall blood flow and changes in gastric mucosal NA and PGE2 when the rats were subjected to water immersion restraint stress. The results were: In the obstructive jaundice 2 weeks group, when subjected to water immersion restraint stress, gastric mucosal NA reached a dried up stage from the incipient stage, causing gastric mucosal impediments at the same time, showing a significant decrease of gastric mucosal PGE2. Intragastric pH was at a similar level of excessive acidity in all groups; gastric acid is believed to be a secondary factor promoting ulceration. Gastric mucosal PGE2 showed a significant decrease coinciding with the increase in ulceration index, being a possible factor of ulceration; it is also presumed to regulate gastric wall blood flow alternatively with gastric mucosal NA. Pre-treatment with PGE2 prior to loading stress resulted in a decrease in gastric wall blood flow being significantly controlled. The administration of PGE2 brought about an improvement in gastric wall blood flow and a consequent increase in gastric mucosal NA, being judged effective for acute ulceration in obstructive jaundice.

Completely thrombosed giant aneurysm of the angular artery

An unusual case of a completely thrombosed giant aneurysm arising from the angular artery is reported. A 69-year-old women developed a subarachnoid hemorrhage with a large intracranial hematoma. Computed tomography scans and cerebral angiography could not detect the aneurysm. The rarity of aneurysms in this position is stressed and the difficulty of diagnosis in this case is discussed.

Stimulatory effect of an endogenous peptide in rat pancreatic juice on pancreatic enzyme secretion in the presence of atropine: evidence for different mode of action of stimulation from exogenous trypsin inhibitors

A new factor which activated the secretion of pancreatic enzymes was discovered and purified from rat bile-pancreatic juice. A fraction below M.W.10,000 of rat bile-pancreatic juice enhanced trypsinogen secretion by injection into anesthetized rat duodenum. The factor was purified from this fraction using its biological activity as an index by Sephadex G-50, SP Sephadex C-50 and HPLC. This factor was a peptide of which molecular weight was about 6,000 and had trypsin inhibitory activity. From these and some other findings, it was suggested that the peptide was identical with the "Kazal type" inhibitor. In the anesthetized and atropine-treated rat, of which intestinal trypsin was removed by thoroughly washing with saline containing 5 microM soybean trypsin inhibitor (SBTI), pancreatic secretion became basal state, and was not stimulated by injection of SBTI into its duodenum any longer. Under this condition, however, injection of this purified peptide brought about markedly stimulation of pancreatic enzyme secretion. These results suggest that this peptide has a certain function which enhances pancreatic enzyme secretion by the different manner from exogenous trypsin inhibitors such as SBTI.

Clinical features of 22 cases with "inter-sterno-costo-clavicular ossification". A new rheumatic syndrome

We present 22 cases with inter-sterno-costoclavicular ossification. Clinical and pathological findings show that abnormal ossification observed in this situation is due to non-suppurative chronic inflammation of the soft tissues around the sterno-costo-clavicular region such as the costo-clavicular ligament. We have classified X-ray findings into three stages according to the extent of the ossification; localized, generalized, and hyperostotic, and show that the disease progressed in this sequence. A considerable number of the patients showed abnormal X-ray findings in the spine or the sacro-iliac joint. Frequent association of pustulosis palmaris et plantaris was noted in this disease. Most of the cases were treated effectively with anti-inflammatory drugs, but a few cases required surgical resection of the ossified mass with the clavicle or the first rib in order to relieve the severe pain.