Characteristic pancreatographic findings in chronic pancreatitis and their diagnostic value. …Studies on post mortem pancreas…

慢性膵炎25例および対照として正常例125例計150例の新鮮剖検膵を用いて膵管造影を行い，X線所見と同部位の組織所見とを厳密に対比させ，慢性膵炎における各X線所見の診断学的価値を検討した。その結果，主膵管像では不整拡張像，硬化＋辺縁不整像，狭窄＋辺縁不整像が，分枝像では不整拡張像および不整配列像が，positive predictive value（PPV），specificity（Sf），negative predictive value（NVP）ともに77.1～100％　の高率を示した。しかしsensitivity（St）は，2.1～18.1％　と低率であった。したがって，これらの所見は慢性膵炎を診断する上で組織予見性および特異性に優れた診断的価値のあるX線所見と言える。しかし一方では軽症の慢性膵炎の検出能はあまりよくないという限界が膵管造影法にはある。Postmortem pancreas tissue was prepared within 6 hours of death for the comparative study of pancreatographic findings and histological findings to define characteristic pancreatographic findings of chronic pancreatitis and determine their diagnostic value. Pancreas tissue was obtained from 25 patients with chronic pancreatitis and 125 with a normal pancreas. Among various pancreatographic findings, irregular dilatation and irregular arrangement of the branches of the pancreatic duct, and also irregular dilatation, rigidity with irregular margin and stenosis with irregular margin of the main pancreatic duct showed the highest sensitivity. specificity, positive predictive value and negative predictive value and conseqently had the highest diagnostic valus. However, the sensitivity was not high enough, indicating that the above pancreatographic findings could be absent at the site of positive histological findings in mild chronic pancreatitis

Short term effect of spa-water on gastric mucosal blood flow

臓器反射スペクトル法と内視鏡を併用して胃粘膜血流を測定し，当院温泉水飲用の消化機能に対する基礎的検討を胃粘膜血流を指標に行なった。温泉水の対照として空気と白湯を選び3群に分け検討した。その結果，温泉水は空気に比し胃粘膜血流を増加させる作用を有していることが示唆された。また温泉水は部分的ではあるが白湯にくらべても胃粘膜血流を増加させる作用があることが示唆された。よって飲泉療法の消化器疾患に対する臨床的有用性が胃粘膜血流の面からもうかがわれた。Short-term effects of spa-drink therapy on gastric mucosal blood flow were evaluated by an endoscopic organ reflex spectrophotometry, using Olympus XQ-10. Thirty-four subjects were randomly divided into three groups : 10 subjects for warm spa-water (40±C) infusion group, 10 subjects for warm tap-water infusion group, and 14 subjects for warm air infusion group. Intragastric infusion of water or air was performed through the fiberscopic infusion channel. Gastric mucosal blood flow was determined just before and 10 min after the infusion on the three points of gastric mucosa : lesser curvature of the angle, the antrum and the pylorus. Following results were obtained : 1) Spa-water exerted a beneficial effect on gastric mucosal blood flow as compared to air. The difference was statistically significant on all of the three points. 2) Spa-water tended to exert a beneficial effect on gastric mucosal blood flow as compared to tap-water. The difference, however, was significant only on the mucosa of the gastric antrum. In conclusion, it was suggested that spa-drink therapy was useful for the treatment of chronic gastritis and gastric ulcer in which impairment of gastric mucosal blood flow plays an important pathogenetic role. Studies on the long-term effects of spa-drink therapy on the gastric mucosal blood flow are now in progress