著者

飯田 安彦

出版者

一般財団法人 日本消化器病学会

雑誌

日本消化器病学会雑誌 (ISSN:04466586)

巻号頁・発行日

vol.62, no.1, pp.29-59, 1965 (Released:2011-06-17)

参考文献数

113

被引用文献数

1

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Some etiological studies of gall stones and of cholecystitis have ever been made and discussed from various angles and now it is apparent that the infection of the bile ducts plays important roles etiologically for them, aside from the problem whether it is concerned with them primarily or secondarily. But the infection theory contains some contradiction which is pointed out by various researchers in the fact that even many ba-cteria instillated into the gall bladder do not cause the formation of gall stones or cholelithiasis so easily.On the other, Prof. Matsukura has ever noticed the fact that in cholelithiasis and cholecystitis the concentration of bile acids, particularly of dihydroxycholanic acid, is conspicuously lowered in comparison with that of normal cases and advocated the significance of the low concentration of dihydroxycholanic acid in the infection of the bile ducts, based upon various clinical and experimental studies made in his laboratory.The author made some serial clinical and experimental studies on bile acids in bile, particularly the significance of the substance “Dihydroxycholanic Acid” in the infection of bile ducts, as one part of the etiological studies of cholecystitis and gall stones undertaken in the laboratory and obtained some results as follows.1) The concentration of dihydroxycholanic acid in bile of healthy person or of patients with gastroduodenal ulcers is high, ranging from 30 to 60 mg/cc, while in cholelithiasis and cholecystitis, the levels are mostly in a range less than 20 mg/cc.2) No bacteria were detected in the bile of healthy person or of the patients with gastroduodenal ulcer. But in bile of cholelithiasis or of cholecystitis, showing the level of dihydroxycholanic acid in a range less than 20 mg/cc, bacteria were found and isolated.3) Coli-bacilli occupied the majority among the microorganisms isolated from the bile of cholelithiasis and of cholecystitis.According to these clinical and experimental studies, it can be presumed that in cholecystitis and in cholelithiasis, the colibacilli played the cardinal role and the infection of the bile ducts with coli-bacilli is closely related with the lowering of the concentration of dihydroxycholanic acid in bile.The author made a experimental study regarding the relation between the lowering of the concentration of the acid and the infection of the bile ducts in rabbit and following results were obtained.4) The level of the dihydroxycholanic acid in the normal rabbit ranged from 70 to 110 mg/cc but if the occlusion of the bile ducts was artificially made at the Vater's ampullae where the choledochus joins the duodenun, the level increased slightly on the 2nd postoperative day but then decreased gradually up to the levels of 12 to 32 mg/cc on the 8th day, showing apparently the lowering tendency.5) In normal rabbits which accepted colibacilli through the portal vein and in the group of rabbits of which liver function was damaged with carbon tetrachloride and 2, 4-diaminotoluene, coli-bacilli were detected in both of the groups but the numbers of the bacilli were markedly small and the slight increase of the bacilli was observed only in one case out of those with damage of the liver function. But in all of ten cases with the occlusion of the bile ducts, a great number of bacilli were observed. Moreover, in 8 cases, gall stones were constituted and in 2 cases bile sands were seen.6) 1. In liver of normal rabbits which were instillated coli-bacilli through the portal vein, very slight inflammatory changes were seen, but at the gall bladder no inflammatory changes were seen grossly as well as histologically.2. In livers of rabbits as well as in the gall bladder, with the damaged liver function and instillation of coli-bacilli through the portal vein, almost no inflammatory change was observed in the gall bladder.

著者

代田 明郎 富田 一男 飯田 安彦 遠藤 昌夫 松永 睦郎 恩田 昌彦 柳沢 公則 服部 博之

出版者

一般社団法人 日本アレルギー学会

雑誌

アレルギー (ISSN:00214884)

巻号頁・発行日

vol.13, no.8, pp.559-578,581-58, 1964

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From the point of allergy, the authors studied on the production of cholelithiasis and cholecy-stitis and the results obtained were as follows: 1. By agglutination reaction with the antigen of E. coli (O-6) isolated from human faeces and the normal human serum, it was found that the aggulutin in titer was so low in the infant and the titer rising up rapidly with the age to 10 years old. Thereafter the titer is coming close gradually to that of the adult. These facts suggest that tha natural sensitization by E. coli exists in the human being and it may be strengthened gradually with the age. 2. Natural sensitization by E. coli was also found in the normal rabbit and it was also observed that the natural sensitization was enphasized by the oral administration of E. coli. 3. The disturbance of the liber may produce dysbacteria of the intestinal flora and the dysbacterial condition of the intestinal flora and the disturbance of the liber-function may emphasize the natural sensitization by oral administration of E. Coli and moreover it may be an important factor in the appearance of orally administered E. Coli in the bile. 4. The bile of gastro-ulcer showihg no precipitation reaction with anti-E. Coli rabbit serum was mixed with E. Coli (O-6) and after 24 hours' incubation at room temperature the bile showed positive reaction with anti-E. Coli rabbit serum. 5. The remarkable growth of E. Coli was found in the group of rabbits blocked the bile-duct injected E. Coli via bile-duct, however no growth of bacilli was observed in the normal rabbits; moreover, the bile in the former cases showed positive reaction with anti-E. Coli rabbit serum. 6. Electromicroscopic findings show that the breaking or dissolution of cell wall or cell membrane and the prolapse of the protoplasma of E. Coli at the high concentration of Desoxycholic acid or glycodesoxycholic acid. 6. The gall-bladder isolated from the guinea pig administered orally E. Coli and showing high aggulutinin titer showed anaphylactic reaction by Schultz-Dale technique. Anaphylactic reaction of the isolated gallbladder in the guinea pig sensitized with anti-E. Coli rabbit was alse demonstrated and also the desensitization phenomenon was clearly demonstrated with the addition of the same antigen. These results suggest that allergic or anaphylactic reaction in the gall-bladder with antigen-antibody system of the components of E. Coli might be existed.