| Japanese |
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| Title | 門脈圧亢進症及び胆道疾患の鑑別における131I-BSPの意義について |
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| Subtitle | 原著 |
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| Authors | 三木喬 |
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| Organization | 名古屋大学第2外科(指導:星川信教授) |
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| Journal | 核医学 |
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| Volume | 8 |
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| Number | 2 |
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| Page | 63-79 |
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| Year/Month | 1971/4 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「緒言」 肝臓は生体内最大の実質臓器であり, 肝動脈と門脈の二者による供血のもとに複雑でまた膨大な物質代謝を営んでいる. すなわち肝動脈による供血下に, 門脈から供給される消化吸収物質その他の血中含有物に対して, 合成, 分解, 貯蔵に関する代謝を行なうばかりでなく, さらに分泌臓器として胆汁の十二指腸内への供給排出も行なっているのである. これらの物質代謝過程を的確に捉えられれば, 肝病変の種類, 程度を知る上ではなはだ重要な資料となるのであるが, 肝臓の形態, 機能あるいは循環における種々の変化は, その巨大な余力, 代償能あるいは再生能に覆われて端的にとらえることは困難なものがある. 古来, 肝機能検査法として数知れぬ方式が検討されて来たのであるが, 大別すれば蛋白代謝, 糖質代謝, 脂質代謝に関する検査, 胆汁色素代謝に関連した検査, 解毒あるいは色素排泄機能検査, 酵素活性に関する検査等に区分されよう. |
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| Practice | 臨床医学：一般 |
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| English |
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| Title | Evaluation of 131I-BSP in Diagnosis of the Hepptobiliary Diseases |
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| Subtitle | |
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| Authors | Takashi MIKI |
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| Organization | The Second Department of Surgery, Nagoya University School of Medicine,, (Direcror:Prof, Shin Hochikawa) |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 8 |
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| Number | 2 |
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| Page | 63-79 |
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| Year/Month | 1971/4 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Radio-iodine-labelled bromsulfalein (131I-BSP) offered a new and reliable technique in the differential diagnosis of liver diseases. Under the minimal dosis of the dye, changes of dye concentration within the liver and also in the peripheral circulation can easily be detected continuously by external gamma-ray scintillation counting. In this study, investigations were made (using this technique) in dogs with impaired billiary passage and hepatic blood flow, as wdll as in patients with obstructive jaundice or portal hypertension. Half-time of peripheral disappearance (T1/2), peripheaal disappearance rate (K), half-time of hepatic uptake (t1/2), 30-minute retention rath (R(30)) as well as time required to reach the plateau of the hepatic uptake curve (F(t)) were simultaneously determined based on both graphic and digital recording of the gamma-ray counts and comparatively studied. Results were summarized as follows : I : Preliminary observations using hepatectomized dogs suggested that extra-hepatic removal of 131I-BSP was not a oegligible value and this must always be reflected carefully in the results obtained in the materials with longstanding hepatobiliary disorder. II. In biliary obstruction. a) Following an experimental obstruction of biliary tract, peripheral disappearance and hepatic uptake of 131I-BSP were delayed, but they returned to normal rapidly after release of the obstruction, suggesting a close correlation between the biliary flow and extraction of this compound. b) In patients with benign bilaary obstruction, delay of peripheral disappearance and hepatic uptake were of minimal degree and this change tended to retuded to normal readily following suggical correction of the obstruction. On the contrary, the delay was more pronounced and the disappearance and uptake curves showed a characteristic flattening in cases with longstanding malignant biliary obstruction. The pattern of recovery subsequent to a corrective surgery varied from case to case depending on the condition of biliary passage. This finding might suggest that the altered hemodynamics at the portal level within the sheath of Flisson were as responsible for this delayed disposal of 131I-BSP as the parenchymal damage itself caused by biliary obstruction. III. In hepatic circulatory disturbance. a) Experimental alternations of hepatic blood flow induced by ligation of hepatic artery, portal vein or hepatic vein were reflected on the results of 131I-BSP test to snme extent. It was found, that this test was not sensitive enough for representing the changes of hepatic blood flow. b) In patients with non-cirrhotic portal hypertension, abnormalities in 131I-BSP tests were of minimal degree. Surgical alteration of portal flow did not affect the results of this test appreciabl. In patients with cirrhotic portal hypertension, hoinfluence of the hemodynamic alteration itself were rather slight, and fixaxion of the abnormal values dependent on the degree of parenchymal damage was characteristic of this group. c) Following end-to-side portacaval anastomosis, flattening of 131I-BSP curves both in hepatic and peripheral areas was usually observed, but the culculated values of afore-listed parameters were so characteristic. However, it was noted that extraction of 131I-BSP in a small dosis could by compensated in a significant degree following portal diversion. It might be concluded from these findings that decrease of hepatic blood flow accompanied by hepatic parenchymal damage could be detectable by the external surface counting technique applied upon both liver and periphery using a small amount of 131I-BSP, while a possible participation of compensatory mechanism in the extraction of this dye might well by taken into consideration in cases with results of minimal change. |
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| Practice | Clinical medicine |
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