Rare Case of a Giant Hamartomous Polyp of Brunner's Gland

During an investigation of the upper digestive tract of a 61-year-old female patient mainly complaining of hematemesis and melena, a peduculated polyp was discovered in the duodenum, and was surgically removed. Histologically, the polyp was recognized as a hamartomous polyp of Brunner's gland. Concerning the cases reported as so-called "Brunner's gland adenoma" it seems that there is a considerable difference in the histo­logical findings between Japanese cases and Western experiences, and this point is discussed in this paper, referring mainly to our case and other cases reported in Japan

A Comparison of Pancreatectomy and Pancreatic Duct Drainage in Chronic Pancreatitis

Surgical therapy was performed in 25 cases of chronic pancreatitis at the Second Department of Surgery, Hiroshima University School of Medicine from January 1973 to October 1984. Thirteen cases were considered related to the excessive intake of alcoholic drinks, 2 cases each to acute pancreatitis and gall stones, and 8 cases to unknown etiology. Complication of pancreatic stone and marked dilatation or partial constriction of the pancreatic duct were observed in 11 of the 25 cases. Pancreaticoduodenectomy was performed in 7 cases, distal pancreatectomy in 8 cases, longitudinal pancreaticojejunostomy in 6 cases, and pancreaticoplasty in 2 cases, and biliary surgery in 2 cases. Out of 21 cases with abdominal pains, pain disappeared in 12 cases, improved in 6 cases and remained uncharged in 3 cases, the effect from surgery being almost satisfactory. No difference was observed in the effect between the surgical procedure as described above. Endocrine function tests with 50 g OGTT revealed improvement in 2 cases and aggravation in another two cases. The function remained unchanged before and after operation in the remaining 21 cases. Pancreatic exocrine function tests with PFD revealed almost no changes before and after operation and no difference between the surgical procedures. Pancreatic exocrine function was found correlated with the advanced conditions of pancreatic fibrosis rather then with the surgical procedures. Cases with less advanced fibrosis maintained the function in a more satisfactory condition both before and after operation. There occurred no cases of death directory related to operation. Four cases of death, no relating to operation itself, were observed in the pancreatectomy group. Twenty cases are now under rehabilitated conditions. Results of our surgical treatment for chronic pancreatitis are almost satisfactory in respect to pain-relieving effect but unsatisfactory in respect to improvement of the endocrine and exocrine function. It may be necessary to consider surgical operation at an early stage before the aggravation of fibrosis, because various types of drainage procedures that aim at preserving the pancreatic tissue and reducing the pancreatic duct pressure are logically capable of improving pancreatic functions

Relationship between the cAMP levels in leukocytes and the cytokine balance in patients surviving gram negative bacterial pneumonia

Lipopolysaccharide-stimulated leukocytes secrete proinflammatory cytokines including tumor necrosis factor-α and interleukin-12. Over-activation of host defense systems may result in severe tissue damage and requires regulation. Granulocyte colony-stimulating factor and interleukin-10 are candidate cytokines for inducing tolerance to lipopolysaccharide re-stimulation. We compared cytokines secreted by lipopolysaccharide-stimulated blood cells from patients who had survived gram negative bacterial pneumonia (Pseudomonas aeruginosa, Escherichia coli or Proteus mirabilis, n = 26) and age-matched healthy volunteers (n = 18). Interleukin-12p70 and tumor necrosis factor-α expression was significantly lower in patients (p = 0.0039 and p<0.001) compared to healthy controls, while granulocyte colony-stimulating factor production was markedly higher in patients (p<0.001). Levels of interleukin-10 were comparable. Granulocyte colony-stimulating factor expression was inversely correlated with interleukin-12p70 (R = −0.71, p<0.001) and tumor necrosis factor-α (R = −0.64, p<0.001) expression; interleukin-10 showed no significant correlation. In unstimulated leukocytes from patients, cAMP levels were significantly raised (p = 0.020) and were correlated inversely with interleukin-12p70 levels (R = −0.81, p<0.001) and directly with granulocyte colony-stimulating factor (R = 0.72, p = 0.0020), matrix metalloproteinase-9 (R = 0.67, p = 0.0067) and interleukin-10 (R = 0.54, p = 0.039) levels. Our results demonstrate that granulocyte colony-stimulating factor production by lipopolysaccharide-stimulated leukocytes is a useful indicator of tolerance induction in surviving pneumonia patients and that measuring cAMP in freshly isolated leukocytes may also be clinically significant

Combined immunohistochemistry of β-catenin, cytokeratin 7, and cytokeratin 20 is useful in discriminating primary lung adenocarcinomas from metastatic colorectal cancer

BACKGROUND: It is important to discriminate between primary and secondary lung cancer. However, often, the discriminating diagnosis of primary lung acinar adenocarcinoma and lung metastasis of colorectal cancer based on morphological and pathological findings is difficult. The purpose of this study was to evaluate the clinical usefulness of immunohistochemistry of β-catenin, cytokeratin (CK) 7, and CK20 for the discriminating diagnosis of lung cancer. METHODS: We performed immunohistochemistry of β-catenin, CK7, and CK20 in 19 lung metastasis of colorectal cancer samples, 10 corresponding primary colorectal cancer samples and 11 primary lung acinar adenocarcinoma samples and compared the levels of accuracy of the discriminating diagnosis by using antibodies against these antigens. RESULTS: Positive staining of β-catenin was observed in all the lung metastasis of colorectal cancer samples as well as in the primary colorectal cancer samples but in none of the primary lung acinar adenocarcinoma samples. Positive staining of CK7 was observed in 90.9% of the primary lung acinar adenocarcinoma samples and in 5.3% of the lung metastasis of colorectal cancer samples, but in none of the primary colorectal cancer samples. Positive staining of CK20 was observed in all the primary colorectal cancer samples and in 84.2% of the lung metastasis of colorectal cancer samples, but in none of the primary lung acinar adenocarcinoma samples. CONCLUSION: Combined immunohistochemistry of β-catenin, CK7, and CK20 is useful for making a discriminating diagnosis between lung metastasis of colorectal cancer and primary lung acinar adenocarcinoma. This method will enable accurate diagnosis of a lung tumor and will be useful for selecting appropriate therapeutic strategies, including chemotherapeutic agents and operation methods

Basic Studies of Anti-Recipient Alloantiserum for Immunosuppressive Properties

BALB/Cの皮膚をC3H/Heマウスに移植し,1×10ヶのBALB/C splenocyteを1週間隔で4回腹腔内注射して免疫することによりC3H/He anti-BALB/C alloantiserumを作成した。このalloantiserumはBALB/C cellに対して特異的ににcytotoxic (×128)であった。C3H/He anti-BALB/C alloantiserum (anti-recipient alloantiserum)がBALB/Cマウスに移植されたC3H/Heの皮膚の生者を延長さす能力をもつか否かを検討した。BALB/C recipientにC3H/Heの皮膚を移植する前後3回,C3H/He anti-BALB/C alloantiserumを腹腔内授与すると,1回投与量が50-300μlの量では移植皮膚の生着を延長さすことができた。in vitro studyにおいて,MLRはこのalloantiserumの存在下で特異的に抑制された。CMLも同じようにBALB/C cellをこのalloantiserumによってpriming phaseで前処置することにより特異的に抑制された。このalloantiserumによる処置はthird party alloantigenに対する反応にはintactであった。このデータから次のことが示唆される。つまり,このanti-recipient alloantiserumはskin allograftの生者に対して生者延長効果を示し,MLRとCMLに対してはspecific inhibitionを示した。これは,このalloantiserumがimmune responseのafferent archのblockをすることを示す。C3H/He anti-BALB/c alloantiserum was prepared by BALB/C skin grafting to C3H/He mice followed by a total of four injections of 1 x 10 BALB/C splenocytes on C3H/He mice at one week interval. This alloantiserum was specifically cytotoxic (x 128) to BALB/C cells. C3H/He anti-BALB/C alloantiserum (anti-recipient alloantiserum) was tested to determine whether it possessed the ability to enhance C3H/He skin graft on BALB/C mice. Injection of C3H/He anti-BALB/C alloantiserum three times to BALB/C rcipients before and after C3H/He skin grafting at a single dose between 50 to 300 μl was effective in enhancing the skin graft survival. In in vitro study, mixed lymphocyte culture response (MLR) was specifically inhibited in the presence of this alloantiserum. Cell-mediated lympholysis (CML) was also specifically inhibited by pretreatment of BALB/C effector cells at the priming with this alloantiserum. This alloantiserum treatment left intact the response to third party alloantigens. The data suggested that this alloantiserum possessed in enhancing effect on skin graft survival, specifically inhibited MLR and CML, and consequently blocked the afferent arch of immune response.広島大学医学雑誌, 32(3), 635-649, 昭59-6月(1984)広島大学(Hiroshima University)博士(医学)Medicinedoctora

Greeting of opening <Special topic: The Next University Archives : The Record of the 10th Anniversary Event of Hiroshima University Archives Establishment>

（1）開会宣言　　文書館長　小池聖一 （2）会場校あいさつ　　広島大学長　浅原利正本稿は、平成26（2014）年7月8日（火）に開催した広島大学文書館設立10周年記念公開パネルディスカッション「これからの大学文書館」（於広島大学学士会館レセプションホール（東広島キャンパス））での講演・パネルディスカッションの内容を文章化したものである

alloantibody のマウス skin graft survival に及ぼす影響

Alloantisera (anti-donor and anti-recipient alloantiserum) were prepared by skin grafting followed four inoculations of 1×10^7 splenocytes. These alloantisera were cytotoxic (×64) to target cells specifically. Anti-recipient alloantiserum was effective on enhancing skin graft survival in mice as same as anti-donor alloantiserum, when administered on the operative day, second postoperative day and fourth postoperative day between 50-200 μl at one time

アロ抗原感作および未感作リンパ球に対する低線量X線照射の効果

The effect of local graft irradiation on immune response in allograft in which acute　rejection occurs was studied using an in vitro model. Unidirectional mixed lymphocyte culture (MLC) was used as the in vitro model of acute rejection. 150 and 300 rad x-irradiation suppressed mixed lymphocyte reaction (MLR) but did not cell-mediated-lympholysis (CML) of unsensitized lymphocytes. X-irradiated alloantigen sensitized cells (ASC) generated in 6-day MLC suppressed MLR and CML of unsensitized lymphocytes. Suppressive effects of x-irradiated ASC were of the same degree by x-irradiation doses of 150-500 rad. Suppressive effect of x-irradiation was maintained for only a short period after x-irradiation. Potential function of suppressor precursor cells among unsensitized lymphocytes was abolished by x-irradiation of 300 rad