We investigated the absorption routes of endotoxin derived from the intestine of rabbits with or without thoracic duct lymph drainage (TDLD). The intestinal circulatory disorders induced were superior mesenteric artery occlusion (SMAO) and superior mesenteric vein occlusion (SMVO). Detection and quantitation of endotoxin in plasma and lymph were carried out using a synthetic chromogenic substrate (peptide-4-methyl-coumarin amide, MCA). In the SMAO group, endotoxin levels in portal plasma exceeded levels in lymph from the thoracic duct throughout the experiment, and in the SMVO group, the relationship was reversed. In peripheral arterial blood, endotoxin levels were significantly lower in rabbits with TDLD than in those with intact lymphatic system. Intestinal lymphatics probably play an important role in appearance of systemic endotoxemia in non-septic shock.

Although the pathogenesis of endotoxins shock is still a matter of speculation, we attach importance to chemical mediators in endotoxin shock. We measured chemical mediators such as histamine, serotonin, bradykinin and catecholamines and investigated the anti-toxic effects of aldosterone and dexamethasone on rabbits in endotoxin shock. Histamine, serotonin and catecholamines were measured by fluorometric assay. Bradykinin was measured by bioassay using rat uteri. The blood concentration of chemical mediators after endotoxin administration was elevated. Aldosterone and dexamethasone inhibited the release of chemical mediators, thereby preventing endotoxin shock.

No abstract

In an attempt to determine the etiological mechanism of anisakiasis, immunological studies were performed using guinea pigs and rabbits. In order to carry out these examinations, we used a specific antigen, hemoglobin of Anisakis larva. We demonstrate that the etiological mechanism of anisakiasis involves anaphylactic reaction as well as Arthus reaction in the digestive tract. Cell-mediated immune reaction also have to consider the relation of establishment of allergic condition in experimental anisakiasis. These results suggest that the three types allergic reaction may play the main role in clinical symptomes of human anisakiasis.

An extremely unusual case of gastric outlet syndrome, otherwise known as Bouveret's syndrome, caused by a large gallstone impacted in the duodenum due to a cholecystoduodenal fistula (CDF), is described herein. Another large gallstone impacted in the CDF itself was also detected. As endoscopic extraction of the gallstone from the duodenum proved unsuccessful, and a laparotomy was required. Our patient, being 88 years old, is probably the oldest patient recorded in the literature of this syndrome. The methods of establishing a correct diagnosis by endoscopy and recent therapeutic strategies are discussed following the case report.