Measurement of plasma potential of liquid-He-free superconducting electron cyclotron resonance ion source.

The plasma potential of liquid-He-free superconducting electron cyclotron resonance ion source was measured as a function of minimum strength of mirror magnetic field (B(min)) and gas pressure with the method based on the retarding electric field. We observed that the plasma potential decreased with increasing B(min) up to 0.5 T and then gradually increased again. The plasma potential increased with increasing gas pressure. When we add the O(2) gas to the Ar plasma (gas mixing method), plasma potential gradually decreased with increasing the O(2) gas pressure.

Deconjugation of bilirubin accelerates coprecipitation of cholesterol, fatty acids, and mucin in human bile--in vitro study.

To examine the initial step of brown pigment gallstone formation, sterile human gallbladder bile samples were incubated with or without beta-glucuronidase in vitro. Enhanced bilirubin deconjugation achieved by adding beta-glucuronidase significantly accelerated the formation of a precipitate that contained bilirubin (28.2 +/- 3.8% of dry weight), cholesterol (14.3 +/- 5.2%), free fatty acids (12.0 +/- 1.3%), and glycoprotein (10.0 +/- 6.7%). Both the composition and scanning electron microscopic appearance of the precipitate were similar to these features in brown pigment gallstones. The cholesterol saturation index and nucleation time in the supernatant did not change with various incubation periods. The weight ratios of bilirubin to cholesterol in the precipitates correlated with those in bile (r = 0.76; P = 0.017). Gel chromatography of the precipitate showed high molecular weight glycoprotein to be the major constituent. Bilirubin, cholesterol, fatty acids, and mucin were found to coprecipitate in accordance with bilirubin deconjugation, which process may play an important role in an early stage of the formation of brown pigment gallstones.

Study of angiotensin II-induced hypertensive chemotherapy for ovarian cancer in rats.

We investigated the usefulness of angiotensin II (AT II)-induced hypertensive chemotherapy for adenocarcinoma of the ovary, which was induced with dimethylbenzantracene (DMBA) in rats. Ovaries with DMBA-induced cancer had poor blood flow, while normal ovaries had abundant brood flow when blood pressure was normal. The brood flow of the normal ovaries was suppressed by AT II-induced hypertension, while the blood flow in ovarian cancer was more than doubled. Tissue levels of the anticancer drug cisplatin (CDDP) were almost the same in the normal ovary in the presence or absence of induced hypertension. However, the CDDP level in ovarian cancer tissue was significantly higher with AT II-induced hypertension than with normotension. Comparison of the ratio of the enlarged tumor to the primary tumor and the histopathologic antitumor effects, showed that AT II-induced hypertension treatment with CDDP was highly effective. Angiotensin II-induced hypertensive chemotherapy for adenocarcinoma of the ovary in rat was highly effective in comparison with normotension.

Carcinoma of the ampulla of Vater synchronously associated with early gastric cancer--a report of two cases.

We report two cases of carcinoma of the ampulla of Vater synchronously associated with early gastric cancers. The gastric lesions were diagnosed pre-operatively in one patient and at the time of examination of the resected specimen following pancreatoduodenectomy in the other. Specific problems in the diagnosis and management of these multiple primary carcinomas are discussed. Careful evaluation of the stomach prior to the surgical treatment for ampullary carcinoma is recommended.

Regulation of bile acid synthesis in the rat: relationship between hepatic cholesterol 7 alpha-hydroxylase activity and portal bile acids.

Bile acid biosynthesis has been believed to be regulated by negative feedback control; however, recent experiments have cast considerable doubts on the concept. The aim of the study was to examine the consensus of the negative feedback regulation of bile acids by clarifying the correlation between the portal bile acids and the rate-limiting enzyme of bile acid biosynthesis, hepatic microsomal cholesterol 7 alpha-hydroxylase. We measured the enzyme activity and the portal bile acids in male Wistar rats that were orally administered three different bile acids or cholestyramine for 2 weeks. The serum level of 7 alpha-hydroxycholesterol was also determined to verify whether it would be a parameter of bile acid synthesis rate in the rat. The activity of cholesterol 7 alpha-hydroxylase increased about threefold in rats treated with cholestyramine when compared with controls. On the other hand, in rats fed ursodeoxycholic, chenodeoxycholic, and deoxycholic acids, the enzyme activities decreased to 40%, 26%, and 28%, respectively. Treatment with cholestyramine had no significant effect on the portal bile acid concentration. Administration of ursodeoxycholic and chenodeoxycholic acids resulted in a significant increase in the concentration of portal bile acids, whereas deoxycholic acid feeding did not significantly affect it. In the control group, conjugated cholic acid constituted a major part of the portal bile acids while the administered bile acid and its metabolites became predominant in each bile acid feeding group. Treatment with ursodeoxycholic acid made the portal bile acids more hydrophilic, but, by contrast, administration of chenodeoxycholic, deoxycholic acids, and cholestyramine made the portal bile acids more hydrophobic.(ABSTRACT TRUNCATED AT 250 WORDS)

Rapid cholesterol nucleation time and cholesterol gall stone formation after subtotal or total colectomy in humans.

Changes in biliary lipid composition, pH, ionised calcium, total and unconjugated bilirubin, and cholesterol nucleation time of gall bladder bile samples were examined in six patients who had undergone subtotal or total colectomy between five months and seven years previously, and values were compared with those in control patients with no gall stones. The colectomy group mainly comprised patients with ulcerative colitis and familial adenomatosis coli, in whom only a short length of the terminal ileum (mean (SEM) 2.25 (0.57) cm) had been resected. The reconstruction procedures were ileoanal anastomosis in two patients, terminal ileostomy in two, ileorectal anastomosis in one, and J shaped ileal pouch-anal anastomosis in one patient. The distributions of age, sex, and relative body weight were similar in the two groups. The gall bladder bile was lithogenic in the post colectomy group--these patients had a significantly increased cholesterol saturation index (p < 0.01) and rapid cholesterol nucleation time (p < 0.05) compared with the control group. A significant increase in the molar percentage of cholesterol and a decrease in that of total bile acid associated with significantly decreased secondary bile acids (p < 0.05) were observed in the post colectomy group. Gall stones formed in two of six patients after colectomy were cholesterol stones containing more than 80% cholesterol by dry weight. Total and unconjugated bilirubin, pH, and ionised calcium values were similar in the two groups. The results indicate that after total or subtotal colectomy the composition of gall bladder bile increases the risk of cholesterol gall stone formation.

[Dynamic CT under angiotensin II-induced hypertension--application for the differential diagnosis between benign and malignant solid ovarian tumors].

Dynamic CT was applied to 9 patients with solid ovarian tumors of an unknown nature after ultrasonography and tumor marker tests with CA125, TPA and IAP. Dynamic CT was performed under the condition of normotension and angiotensin II (AT II)-induced hypertension. The results obtained were as follows. 1. Intratumoral blood flow increased 25 percent in patients with malignant tumors, decreased 7 percent in tumors of low potential malignancy, and increased 6 percent in patients with benign tumors due to the pressor effect of AT II. 2. Changes in intratumoral blood flow were not uniform in various parts of a malignant tumor. 3. Differential diagnosis of malignant and benign tumors and tumors of low potential malignancy was possible by this method. 4. The results indicated that chemotherapy under AT II-induced hypertension would have a better effect on the treatment of malignant ovarian tumors.

Significance of serum delta bilirubin during obstructive jaundice in dogs.

BACKGROUND: delta-Bilirubin, a nonenzymatic covalently bound complex with albumin, is nonenzymatically formed in serum and has a long half-life irrespective of hepatorenal function. The aim was to examine if delta-bilirubin reflects the duration of obstructive jaundice and efficacy of biliary drainage. MATERIALS AND METHODS: Obstructive jaundice was developed in 17 dogs either for 4 (short term; n = 9) or 11 (long term; n = 8) days and then external biliary drainage was performed. Serum total, direct, and delta-bilirubin fractions were analyzed by high-performance liquid chromatography. RESULTS: delta-Bilirubin was not detectable in serum before biliary obstruction. The serum total and direct bilirubin levels increased rapidly and reached a plateau within 2 days after the biliary obstruction, whereas the concentration and proportion of delta-bilirubin gradually increased and significantly correlated with the duration of obstructive jaundice. Before biliary drainage, the proportion of delta-bilirubin was 28.9 +/- 2.4% in the short-term and 42.5 +/- 2.4% in the long-term obstruction group. The decline indices of serum total, direct, and total minus delta-bilirubin in the short-term group (-0.17, -0.19, and -0.26, respectively) were significantly (P < 0.05) greater than those in the long-term obstruction group (-0.10, -0.10, and -0.13). The decline index of delta-bilirubin itself was similar between the groups. CONCLUSIONS: The concentration and proportion of delta-bilirubin in serum reflect the duration of jaundice. Because delta-bilirubin is not excreted into bile and urine and is not toxic to organs, a decline index of total bilirubin minus delta-bilirubin, the excretable bilirubin fraction might be better to assess the efficacy of biliary drainage.

[Histomorphological studies of Krukenberg tumor on early ovarian metastatic lesion].

In ten cases of "early" Krukenberg tumor with only slight swelling of the ovary, histomorphological studies were performed to clarify the process of the formation of Krukenberg tumor. 1) The histological features of early metastatic lesion were classified into 3 types; lymph vessel permeation only, solid alveolar structure, and diffuse infiltration type. 2) Lymph vessel permeation in the ovarian hilum was observed in all cases. 3) In the diffuse infiltration type, signet-ring cells extended diffusely and radially via the lymph vessels, and, in the periphery, tumor cells leaked from the lymph vessels, infiltrating the stroma. At this stage, the response of ovarian stroma was slight, and signet-ring cells were present more abundantly in the vicinity of the infiltrated area. 4) In the solid alveolar type, the stroma was interposed in these lesions. 5) CEA staining revealed many CEA positive tumor cells in the proliferated stroma in which tumor cells failed to be detected. In summary, tumor cells infiltrate via the lymph vessels and leak into the stroma. Following the destruction of signet-ring cells, the mucus leaks into the stroma and it produces stromal edema and proliferation, eventually leading to a swollen ovary.

A study of drug efficacy in the treatment of ovarian cancer.

One hundred and nine cases of common epithelial ovarian cancer treated in our department during the past decade were entered into this study, which dealt with direct therapeutic effects and prognosis, comparing the groups administered cisplatin with those administered other anticancer drugs. 1) In 38 patients with measurable lesions, high response rates were achieved through the administration of anticancer drugs containing cisplatin in both the primary cancer and recurrent cancer groups. 2) Preventive chemotherapy was performed in patients in whom complete surgery was achieved at the initial operation. No significant difference in prognosis was observed through the administration of cisplatin and other anticancer drugs. 3) In patients in whom reduction surgery was carried out to the maximum possible degree at the initial operation, an improvement in prognosis was observed through the administration of cisplatin. These results imply that a cisplatin-based regimen should be aggressively used, except in cases that underwent complete debulking surgery.

Gallstone formation and gallbladder bile composition after colectomy in dogs.

A high prevalence of gallstones has been described in patients following colectomy. The aim of this study was to examine whether lithogenicity is attributed to colectomy. In the present study, changes in gallbladder bile composition and the mechanism of gallstone formation after colectomy were examined in dogs. Ten mongrel dogs underwent restorative proctocolectomy. Seven dogs which received sham operations served as controls. Over a 12-week postoperative period, samples of gallbladder bile, formed gallstones and serum were collected and analyzed. In 7 of the 10 (70%) colectomized dogs, gallstones were found in the gallbladder, while the control dogs had no stones. Macroscopically the gallstones were similar to black pigment stones observed in humans. Chemical analysis and Fourier transform-infrared spectroscopy examination revealed that the stones were composed mainly of sodium bilirubinate and proteins, with minor amounts of calcium salts and cholesterol. Significant increases in biliary pH and concentrations of ionized calcium and unconjugated bilirubin were observed in the gallbladder bile of the colectomy group compared with that of the control group. The total bile acid and total bilirubin concentrations were significantly decreased in the colectomy group. Cholesterol crystal nucleation did not occur. The inhibitory effect of gallbladder bile on calcium carbonate precipitation in an in vitro assay system was preserved even after colectomy. In conclusion, proctocolectomy increases the concentration of unconjugated bilirubin in gallbladder bile and induces pigment gallstones which are composed mainly of sodium bilirubinate and proteins since calcium ions and cholesterol are stabilized in dogs.

[Second look operations in ovarian cancer--a clinical study on the detection of recurrent tumors and the judgment on termination of treatment in 84 cases].

Various investigations were conducted on 84 patients undergoing a second look operation (S.L.O.) intended to detect any recurrent tumors and determine the timing of the cessation of therapy. The following conclusions were obtained: Tumors were found in 18 patients (21.4%) whose preoperative diagnosis was neither subjectively nor objectively abnormal. Patients who received S.L.O. had a considerably better 5 year survival rate than the control group. S.L.O. can safely be omitted only in patients with Stage I border line ovarian tumors. S.L.O. is essential in cases where basic surgical procedures were not carried out during the initial operation. No occlusion could be reached as to the best time to perform S.L.O. In almost all of the patients who died, the site of recurrence was somewhere outside the abdominal cavity, but no recurrent tumors had been found during S.L.O. S.L.O. is still a more efficient follow-up method than CA125, TPA or IAP tumor markers, although the preoperative results of these tests reflected the laparotomy findings relatively well.

Significance of serum delta-bilirubin in patients with obstructive jaundice.

BACKGROUND: Delta-bilirubin is a bilirubin covalently bound with albumin, which is nontoxic and excreted neither in urine nor in bile. We previously reported that the percentage of delta-bilirubin increased after biliary drainage and that the rapidly excretable bilirubin fraction (total minus delta-bilirubin) was a better parameter to predict the effectiveness of biliary decompression in the dog model. The aim of the present study was to elucidate whether it is applicable to humans. MATERIALS AND METHODS: The serum bilirubin concentration was measured and its fractions were analyzed by high-performance liquid chromatography in 22 patients with obstructive jaundice before and after biliary drainage. In addition, the patients were subgrouped into good and poor drainage groups according to the decline index of serum bilirubin to examine the significance of delta-bilirubin. RESULTS: The concentration of total bilirubin decreased from 14.1 mg/dl before biliary drainage to 5.4 mg/dl 28 days after drainage. During this period, the percentage of conjugated bilirubin steeply declined from 47.1 to 8.8% and that of excretable bilirubin from 63.4 to 28.6%. In contrast, the proportion of serum delta-bilirubin increased from 36.6 to 71.4%. There was an inverse correlation between percentage of delta-bilirubin and total bilirubin concentration (r = -0.69, P < 0.01). In the good drainage group, the percentage of delta-bilirubin increased above 60% within 7 days after biliary drainage, but it did not reach 60% by 28 days in the poor drainage group. A decreasing rate of total bilirubin minus delta-bilirubin, the excretable bilirubin fraction, was a better index than that of total bilirubin to assess the efficacy of biliary drainage (P< 0.01). CONCLUSIONS: The increase in the percentage of serum delta-bilirubin indicates an effectiveness of biliary drainage in man. An analysis of serum delta-bilirubin for 7 days can distinguish the good drainage patients from the poor drainage patients.

Serum 7 alpha-hydroxycholesterol reflects hepatic bile acid synthesis in patients with obstructive jaundice after external biliary drainage.

To examine the hypothesis that serum levels of 7 alpha-hydroxycholesterol reflect bile acid synthesis in the liver, we analyzed serum 7 alpha-hydroxycholesterol and bile acid output in 13 patients with obstructive jaundice after relief of biliary obstruction. Before biliary drainage, the serum level of 7 alpha-hydroxycholesterol was 92 +/- 12 pmol/ml (mean +/- S.E.M.) and was significantly lower than the control value (226 +/- 26 pmol/ml, p < 0.01). After biliary drainage, serum 7 alpha-hydroxycholesterol level and biliary bile acid outputs began to rise in some patients, indicating reversible liver dysfunction. In other patients, serum 7 alpha-hydroxycholesterol levels and bile acid outputs did not increase, suggesting severe or irreversible liver dysfunction. On and after the third day of biliary decompression, serum 7 alpha-hydroxycholesterol levels correlated well with bile acid excretion (p < 0.01, r = 0.93). Other liver function parameters, such as serum bilirubin, serum bile acids, albumin, and bile flow, also revealed significant correlation with serum 7 alpha-hydroxycholesterol levels. We conclude that the serum 7 alpha-hydroxycholesterol level clearly reflects bile acid synthesis in the liver and that it may serve as a useful parameter for the assessment of hepatic functional recovery in patients with obstructive jaundice after biliary drainage.