[Technic of collecting pure pancreatic juice and its enzymatic analysis].
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Biomedical subjects
Publications and source records attributed to H Harada.
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The correction of air temperature effect and the amendment of underestimation are two difficult problems for accomplishment of prediction of maximal oxygen intake from a simple submaximal test. The purpose of this study was to develop the prediction equation applicable over a wide range of air temperature conditions with no tendency of underestimation. Submaximal data were obtained from short exposure experiments to 20 degrees C, 30 degrees C and 40 degrees C of air temperature in a climatic chamber. The most valid prediction equation for young adult females was developed as VO2 max =[95.182VO2/(0.763Ve-1.092Wt-1.542Yr+16.82VO2+0.361OR+0.110Ht+63.655)]+0.126, and the one for young adult males was determined as V02 max =[87.919VO2/(0.484Ve-0.583Wt-1.354Yr+0.295OR+12.15VO2-0.110Ht+81.009)]+0.434 using the oxygen intake (VO2), pulmonary ventilation (Ve), ratio of oxygen removal (OR) during submaximal test work and body weight (Wt), stature (Ht) and age (Yr) of subjects.
To elucidate early biochemical changes of pancreatic juice and their reversibility in chronic alcoholics, pure pancreatic juice was collected from 23 chronic alcoholics by endoscopic retrograde catheterization of the papilla. Samples were collected at 1 minute intervals for 20 minutes after intravenous injection of secretin (Eisai, 1 U/kg) and for 10 minutes after CCK-PZ injection (Boots, 1 U/kg). Volume, bicarbonate concentration, protein concentration and three hydrolases were determined. Following results were obtained. (1) Five patients showed hypersecretory state. Four of the five patients showed hyperconcentration of protein. (2) Seventeen patients showed hyposecretory state. Lipase secretion was most frequently affected (94%). Maximal bicarbonate concentration was the next to be affected (82%). Amylase and chymotrypsinogen secretion were less frequently affected (65%). Flow rate was least frequently affected (24%). (3) It was suggested that exocrine dysfunction in chronic alcoholics is reversible in an early stage and that sequence of events with advancement of the stage is hypersecretion, hyperconcentration of protein, normalization of water secretion with a decrease in lipase secretion and maximal bicarbonate concentration, a decrease in amylase and chymotrypsinogen output, and finally a decrease in flow rate.
A new synthetic substance, N-Benzoyl-L-tyrosyl-p-aminobenzoic acid, is specially cleaved by pancreatic chymotrypsin after oral administration and the released p-aminobenzoic acid (P.A.B.A.) is absorbed and excreted in the urine. The P.A.B.A. recovery in the urine was examined to evaluate its diagnostic value as an exocrine pancreatic function test. The data permit the following conclusions: 1. There is a significant correlation between this test and maximal bicarbonate concentration, amylase output and volume of P.Z./C.C.K. secretin test. 2. More than one-half to two-thirds proximal or one-third distal of the pancreas must be removed before one can expect an abnormal result in this test. 3. This is a simple and useful test to detect exocrine pancreatic insufficiency of more than moderate degree but normal results may be obtained in minimal to mild exocrine pancreatic insufficiency. Only six of 11 cases (54.5%) with one abnormal factor of P-S test showed decreased P.A.B.A. recpvery, whereas 22 of 23 cases (95.7%) with two or three abnormal factors of P-S test showed decreased or borderline P.A.B.A. recovery.
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Clinical studies on apalcillin (APPC), a new broad spectrum semisynthetic penicillin developed in Japan, were carried out, and the following results were obtained. APPC was administered to three patients with serious biliary tract infections by intramuscular or intravenous injection at daily dosage of 2. Therapeutic responses were excellent in all cases, and no side effects and abnormalities of laboratory findings were observed. APPC was considered to be an excellent drug for the treatment of biliary tract infections.
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Pure pancreatic juice was collected from 8 control subjects, 12 patients with chronic pancreatitis and 4 patients with cancer of the pancreas by endoscopic retrograde cannulation of the papilla. Samples were collected at 1 minute intervals for 20 minutes after rapid intravenous injection of secretin (Eisai, 1 U/kg) and for 10 minutes after rapid intravenous injection of CCK-PZ (Boots, 1 U/kg). Determinations of volume, bicarbonate concentration and three hydrolases (amylase, chymotrypsinogen and lipase) were made. Our tentative conclusions are (1) pancreatic enzymes are likely to be affected one after another, not in parallel fashing, in chronic pancreatitis and in cancer of the pancreas, (2) bicarbonate concentration and chymotrypsinogen or lipase are most susceptible in chronic pancreatitis and lipase secretion seems to be more susceptible than other parameters in cancer of the pancreas. Amylase is the least affected enzyme in both pancreatic diseases, and (3) determinations of chymotrypsinogen and/or lipase should be preferably performed among hydrolytic enzymes in the evaluation of exocrine pancreatic function in chronic pancreatitis and cancer of the pancreas.
Pure pancreatic juice was collected from 8 subjects by endoscopic retrograde cannulation of the papilla. Samples were collected at 1 minute intervals for 20 minutes after rapid intravenous injection of secretin (Eisai, 1u/kg) and for 10 to 15 minutes after rapid intravenous injection of CCK-PZ (1 U/kg). Three hydrolases (amylase, chymotrypsinogen and lipase) showed nonparallel secretory pattern. Lipase was proportionally more stimulated than chymotrypsinogen and chymotrypsinogen was more stimulated than amylase by CCK-PZ stimulation. However, in one subject the secretion of three hydrolases was parallel and in another subject lipase and chymotrypsinogen showed parallelism. Samples collected at "wash out" period showed quite high enzyme and protein concentration with specific activity and enzyme ratio not different from those of samples collected at peak period of CCK-PZ stimulation. Normal ranges were estimated in peak flow rate per minute, peak enzyme concentration, specific activity of enzymes, maximal enzyme output per minute and maximal bicarbonate concentration.
This report is concerned with studies on duodenofiberscopic examinations with aspiration cytology endoscopic retrograde cholangio-pancreatography (ERCP) in 44 patients with cancer of the pancreas. Aspiration cytology alone was diagnostic in 91% of cancer of the head of the pancreas, 55% of cancer the body and tail of the pancreas and 100% of cancer of the whole pancreas. ERCP alone was diagnostic in 59% of cancer of the head of the pancreas, 75% of cancer of the body and tail of the pancreas and 100% of cancer of the whole pancreas. By combining these two approach a diagnostic result was obtained in 95% of cancer of the head of the pancreas and 90% of cancer of body and tail of the pancreas. It is concluded that the combined diagnostic approach has enhanced diagnostic accuracy of malignant lesions of the pancreas and that it has not yet led to an improvement resectability and mortality.
Aspiration cytology and ERCP were evaluated in 66 patients with cancer of the hepato-biliary tract. Cytology was diagnostic in 100% of ampullary cancer, 83% of cancer of extrahepatic bile duct, 0% of cancer of intrahepatic bile duct, 25% of cancer of gall bladder and 0% of cancer of liver. ERCP was diagnostic in 65% of ampullary cancer, 90% of cancer of extrahepatic bile duct, 100% of cancer of intrahepatic bile duct, 25% of cancer of gall bladder and 25% of cancer of liver. Endoscopic findings was diagnostic in 77% of cancer of ampullary region. By combining these approaches, a diagnostic result was obtained in 100% of ampullary cancer, 96.5% of cancer of extrahepatic bile duct, 100% of cancer of intrahepatic bile duct, 50% of cancer of gall bladder and 25% of cancer of liver. It is concluded that the combined diagnostic approach has enhanced the diagnostic accuracy of malignant lesions of the hepato-biliary tract and that it has not yet led to an improvement in resectability and mortality.
Role of ERCP in the diagnosis of inflammatory lesions of the pancreas was evaluated and following conclusions were obtained. 1) Following criteria were considered to be practical for clinical diagnosis of chronic pancreatitis by ERCP; a) More than moderate irregularity or rigidity of margin, dilatation, or irregularity in caliber of PDS, whether extensive or localized, or b) Cyst formation or c) Obstruction of PDS. These criteria permit to diagnose 100% of pancreatolithiasis, 82% of chronic pancreatitis without pancreatolithiasis and 64% of histologically diagnosed chronic pancreatitis but about 13% of "false positive results" must be taken into consideration. 2) ERCP plays an important role in detecting and locating localized or scattered lesions without noticable abnormalities in P-S test. It is also useful in deciding an indication for surgical intervention. However, it has limitations in detecting minimal to moderate pancreatitis. Some of these cases are often picked up by P-S test. 3) Combined approach with ERCP and P-S test is required for diagnosis of inflammatory lesions of the pancreas and either one is incomplete by itself.
alpha-Fetoprotein was investigated in nonhepatoma patients, whose definitive diagnoses had been confirmed at surgery. Its changes in serum level and localization in tissues were reported and the possible etiology and pathogenesis of these diseases were discussed with an emphasis on morphological observation.
In order to examine both the site and the muscle responsible for inward movement of the lateral pharyngeal wall, the following 3 observations were made. 1. Radiographic observation of the lateral wall by pasting a lead marker to the torus tubarius. 2. Cinematographic analysis of the lateral wall movement in relation to the velar elevation. 3. Anatomical observation of the levator muscle and the torus. Our conclusion was that the lateral wall movement was an inward displacement of the torus tubarius caused by contraction of the levator veli palatini muscle.