Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
Volume 22, Issue 5
Displaying 1-26 of 26 articles from this issue
  • Kimihiro AKAGI, Koichiro MURAI, Hiroshi TSUJI, Tatsuru SHIKATA, Masayo ...
    1981 Volume 22 Issue 5 Pages 621-625
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    The serum alkaline RNase levels of 159 patients with liver diseases and 28 apparently healthy persons were determined using yeast RNA as substrate. The mean values with standard deviation were 20.2±6.0 units in acute hepatitis, 20.4±3.9 in chronic hepatitis, 22.3±6.4 in liver cirrhosis and 32.9±14.6 in hepatoma, and these values were significantly higher than 15.5±2.3 units in healthy individuals (p<0.01). The enzyme levels between liver disease groups were not staristically different, but a much higher serum RNase activity was observed in hepatoma (p<0.001).
    The activity of serum RNase did not correlate with those of GOT, LDH and AlP in these disease states, there was however an inverse relationship between serum albumin and RNase levels (p<0.001), suggesting that serum alkaline RNase in patient with liver disease provides a good criterion of the protein metabolism, but not the hepatocellular damage nor hepatic dysfunction.
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  • Takashi KANO, Hideko KAWAI, Takao KOJIMA, Yasutoshi Muro, Yoshiyata TA ...
    1981 Volume 22 Issue 5 Pages 626-636
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Plasma guanosine 3', 5'-monophosphate (cyclic GMP) were measured by radioimmunoassay in 100 patients with various liver diseases, 24 normal subjects, 16 patients with various types of neoplastic disease and 3 patients with uremia. In patients with acute hepatitis, fatty liver, obstructive jaundice and intrahepatic cholestasis plasma c-GMP levels did not differ significantly from those in normal subjects.
    In contrast plasma c-GMP were significantly elevated in patients with chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, fulminant hepatitis, various types of neoplastic disease and uremia. The degree of elevation averaged threefold in patients with liver cirrhosis, fourfold in hepatocellular carcinoma and liver cirrhosis with hepatic encephalopathy and sixfold in fulminant hepatitis. In addition significant correlations between plasma c-GMP levels and liver function test (i.e., hepaplastin test, albumin and choline esterase) were observed.
    Furthermore the measurement of plasma c-GMP levels was useful for the early diagnosis and efficacy of various therapies in patients with hepatocellular carcinoma and fulminant hepatitis.
    These results suggest that determination of plasma c-GMP is of practical importance for evaluation of severity of hepatocellular damage and malignant transformation and for estimation of hepatic encephalopathy.
    The mechanism of increased plasma c-GMP content in patients with liver diseases in not clear, although both increased rate of c-GMP production in liver and/or brain tissues and diminished hepatic uptake of c-GMP could be involved.
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  • An analysis of twenty autopsy cases with emphasis on bile duct injury
    Toshiharu MATSUMOTO
    1981 Volume 22 Issue 5 Pages 637-650
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    A histopathological study of the liver lesion in paraquat poisoning was performed on twenty autopsy cases of paraquat poisoning light microscopically. Seventeen cases showed hepatocytic injury, which was the lesion previously reported by many authors.
    Eight cases revealed bile duct injury, which consisted of epithelial changes showing hydropic degeneration and necrosis. In mild injury, the epithelium showed hydropic degeneration. The injury was observed in the extrahepatic bile duct and in gallbladder as well as in the intrahepatic bile ducts which have larger caliber than the small interlobular bile ducts. According to the increasing of the injury, necrotic epithelium gradually increased, and not only those areas mentioned above but also bile ductules were injuried. The severity of the injury increased gradually from the bile ductules or small interlobular bile ducts to a intrahepatic large bile duct. The injury of the same degree was seen in the bile ducts which have larger caliber than the large bile duct and in gallbladder. In severe injury, cholestasis occurred in the interlobular and septal bile ducts. It is considered that the cholestasis was the result of epithelial necrosis in the ducts and stenosis of their lumen by debris.
    Nine cases showed centrolobular cholestasis. The cause of the cholestasis was not clearly understood in this study.
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  • Total lipid content and computed tomography number
    Yoshiaki YAJIMA, Takashi NARUI, Motoyasu ISHII, Ryuzo ABE, Masao OHTSU ...
    1981 Volume 22 Issue 5 Pages 651-655
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Fifty-three histologically proved cases of various diffuse liver diseases were studied on their computed tomography numbers (CTN). The machine used was the Ohio Nuclear's Delta Scanner 50 FS type and CTN was expressed by the Hounsfield unit (H). The mean was 66.6±2.6H for normal control (N), 63.3±6.0H for chronic hepatitis (CH), 61.8±7.0H for liver cirrhosis (LC), 44.4±10.6H for fatty infiltration (FI). There were no significant differences among them except FI group. As N group Were all above 60 H and CH and LC groups were all above 50 H, CTN below 60 H could Suggest chronic liver disease or fatty infiltration and CTN below 50 H could strongly suggest fatty infiltration. In eleven cases where total lipid content of the liver could be biochemically determined by the sulfophospho-vanillin reagent, a relation of total lipid content to CTN was studied. As a result, a significant correlation existed between them (r=-0.89; p<0.001). If the diagnostic criterion for the fatty liver was set at total lipid content above 100mg/g wet liver, CT criterion was estimated at CTN below 48 H from the regression formula.
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  • Yoshibumi AIDA
    1981 Volume 22 Issue 5 Pages 656-676
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Fourteen authentic necropsy cases with idiopathic portal hypertension (IPH) had been collected from various institutions in Kanto District. Moreover, thirteen authentic biopsy specimens and three normal necropsy livers were also submitted for this study. Macroscopical scurtiny was throughly performed, and all parts of each frontal liver slices were examined histopathologically. Histometrical study was carried out extensively i.e., dimensions of portal tracts and its hollow structures were mesured with point counting method.
    The results obtained were as follows: 1) Macroscopical findings of the IPH livers of authentic necropsy cases were described circumstantially. 2) Microscopical changes of intrahepatic portal tracts were reported systematically. It was revealed that hepatic veins, which had been assumed to have no remarkable changes in IPH, had considerable changes. 3) Histometrical study indicated that from fifth to twelveth portal vein branches, which characterized by occlusive sclerotic venopathy, showed conspicuous luminal decrease, and an increase of hepatic arterial beds. It could be deduced that scar-like fibrotic changes of the most peripheral portal tracts were one of the essential changes of IPH. 4) In analysis of trace elements of the liver by means of X-ray fluorescence spectrometry, no peculiar result for IPH was found. 5) It is the author's impression that one of the characteristic features of IPH liver was the ununiformity of distribution and grade of intrahepatic vascular changes.
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  • Kazuki MATSUMOTO
    1981 Volume 22 Issue 5 Pages 677-689
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    To clarify the factor for determination of the level of portal vein pressure in liver cirrhosis, the livers of the normal rats and the cirrhosis rats induced by carbon tetrachloride were isolated and perfused with Krebs-Ringer bicarbonate buffer solution, and were then fixed with formalin at various perfusion pressures. Portal vein pressures in vivo in the normal, the mild and the severe cirrhosis ratswere good agreement with the perfusion pressures at the minimum hepatic vascular resistance (MHVR) in correcting in terms of blood of Hct. 40%. The normal and the mild cirrhotic liver fixed at the perfusion pressure given the MHVR showed the maximum dilatation of the hepatic vascular tree (mainly the sinusoids) within the physiological range. Moreover, the dilatation of hepatic vascular tree related closely to an increase in liver volume. On the other hand, in the severe liver cirrhosis, neither the volume of hepatic vascular tree nor the liver volume was correlated significantly with the changes in perfusion pressure. This is thought that severe proliferation of connective tissue restricts the increase in liver volume and the dilatation of hepatic vascular tree.
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  • Yuro SHIBAYAMA, Katsuji NAKATA
    1981 Volume 22 Issue 5 Pages 690-700
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    The significance of the co-existence of connective tissue proliferation in the liver and hepatic cell swelling (sinusoidal stenoses) on hepatic circulation was examined.
    Connective tissue proliferation was produced by horse serum injection, and hepatic cell swelling by a choline deficient diet. Connective tissue proliferation (fibrosis) alone did not produce portal hypertension (114mmH2O); hepatic cell swelling (fatty liver) alone caused a moderate increase in the portal vein pressure (153mmH2O). Connective tissue proliferation plus hepatic cell swelling (fibrosis with fatty metamorphosis) induced severe portal hypertension (173mmH2O) and it was of the same degree as that in liver cirrhosis (173mm H2O).
    These facts reveal that connective tissue proliferation and hepatic cell swelling have little significance on portal hypertension individually. The co-existence, however, of connective tissue proliferation and hepatic cell swelling leads to a marked elevation of the portal vein pressure. This was supposed to relate to the fact that proliferated connective tissue bands restrict an increase in volume of pseudolobules resulting from hepatic cell swelling.
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  • Takeyuki MONNA, Sukeo YAMAMOTO, Kiyoshi OKUDA, Yoichi TATSUMI, Taisei ...
    1981 Volume 22 Issue 5 Pages 701-709
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    The estimation of blood ammonia concentration is of great importance in the prediction of hepatic coma, as well as in the observation of clinical courses. Although various methods have been reported for the determination of blood ammonia levels, in case of an emergency, none of these methods is without problem, because of complicated procedures.
    The authors have modified the simple and rapid method of Tada and Okuda, so that it is available for the screening of hyperammoniemia in a patient with hepatic failure in the field of internal medicine.
    In this report, we determined blood ammonia levels with the previous method and with the above-mentioned simplified method in 451 cases on patients with chronic liver diseases in six hospitals, and obtained results as follows: correlation (r=0.829, y=0.89x+1.2), intraassay reproducibility in group more than 100μg/dl of ammonia level (C.V.=10%).
    We confirm the usefulness of the newly developed reflectancemeter for determination of blood ammonia levels. The correlation, with the reflectancemeter and the enzymatic method, is observed as follows: (r=0.95, y=1.06x+2.1), intraassay reproducibility (C.V.=3.16%).
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  • Kazuo TARAO, Yasuhiko NAGAKURA, Tamaki MOROI, Takao IKEUCHI, Osamu END ...
    1981 Volume 22 Issue 5 Pages 710-716
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Broitman demonstrated that chronic neomycin administration prevented the development of cirrhosis of choline deficiency in rats. So we studied the efficacy of oral paromomycin sulfate (non absorbable antibiotics) administration in the prevention of cirrhotic process in man. After observation of serum albumin and γ-globulin level for 3 months, paromomycin sulfate, 2.0g per day, or placebo was administered for 6 months, and changes in albumin and in γ-globulin level were examined in every three months. Out of 12 cirrhotic patients treated with paromomycin, 8 showed significant increase in serum albumin as compared with none of 8 in the placebo group. While, 5 of the paromomycin group showed significant decrease in serum γ-globulin level, as compared with none in the placebo group. On the other hand, of the 9 cirrhotic patients whose endotoxemia diminished after paromomycin treatment, 6 showed significant increase in serum albumin level. So, it is suggested that paromomycin would improve the serum albumin and γ-globulin level in cirrhosis through the diminution of the endotoxemia caused by the reduction in number of the intestinal bacteria.
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  • Yasuhiro KATO, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 717-722
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    In order to examine the pathogenesis and development of primary biliary cirrhosis, we measured circulating immune complexes and liver-copper levels in 11 cases of asymptomatic primary biliary cirrhosis (group A) along with 6 cases of symptomatic primary biliary cirrhosis (group B).
    Circulating immune complexes detected by the conglutinin solid phase method were found in 70 percent of group A, while 100 percent of the group B exhibited an exceedingly high concentration.
    The mean liver-copper levels were 98±46μg/g dry liver for group A, and 1070±68.2μg/g dry liver for group B. A significant difference was obtained in the incidence of livercopper level between the two groups with primary biliary cirrhosis.
    Corrleation between the circulating immune complex and liver-copper levels in primary biliary cirrhosis was examined. The circulating immune complex and liver-copper levels were frequently associated.
    This result suggests that circulating immune complex and liver-copper levels may be important in the pathogenesis and development of primary biliary cirrhosis.
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  • Yasuhiro KATO, [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 723-728
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    A clino-pathologic study was carried out on 11 cases with asymptomatic primary biliary cirrhosis (group A) compared with 6 cases with primary biliary cirrhosis (group B). Nine patients of Group A and all patients of group B were females. The mean age of group A was 54 years, and for group B, 52 years. All cases were operative wedge biopsy. Histological features were classified by Scheuer's classification. Stage I was found in 10 patients of group A, and in 1 patient of group A, and in 3 patients of group B. Liver function tests for group A exhibited lower mean serum alkaline phosphatase, transaminase and γ-GTP than did group B. The mitochondrial antibody was positive in 10 cases of group A, and for all cases within this group the mean IgG and IgM were 1477±379mg/ml and 382±153mg/ml respectively. All cases in group B exhibited positive mitochondrial antibody. Also within group B the mean IgG and IgM were 2833±1046 and 856±636mg/ml respectively.
    These results show that asymptomatic primary biliary cirrhosis can be detected at early stage by various liver function tests as well as by immunological findings, and presumably the length of the stage is variable.
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  • Hisataka MORIWAKI, Yasutoshi MUTO, Akie ICHIHARA, Mitsuo NINOMIYA, Kaz ...
    1981 Volume 22 Issue 5 Pages 729-733
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Threshold of taste acuity was measured by electrogustometer in 3 patients with obstructive jaundice. All these patients were found to have disorder of taste acuity (elevated threshold of taste acuity), and showed a rapid fall in the threshold (improvement in acuity) after PTC-drainage. Increase of food intake was observed 3-4 days after improvement in taste acuity. Significant correlation was demonstrated between threshold of taste acuity and plasma retinol-binding protein (r=-0.863, P<0.001), prealbumin (r=-0.953, P<0.001) and total bile acid (r=-0.787, P<0.01). Important role of retinol-binding protein in development of hypogeusia was discussed in patients with obstructive jaundice.
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  • Yoshinobu HINOUE, Naohisa TOMOSUGI, Keigo NISHIMURA, Yasuhiro KATO, Ke ...
    1981 Volume 22 Issue 5 Pages 734-738
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    A case of malignant lymphoma together with fulminant hepatic failure is described. This 60 year old male first noted jaundice four days before admission. On physical examination, he was severely jaundiced and the liver was palpable 10cm below the xiphoid process, but superficial lymph nodes were not enlarged. Laboratory data revealed pronounced elevation of serum direct bilirubin and serum biliary tract enzyme activity, but abdominal ultrasonography showed no evidence of dilatation of the bile ducts. After admission, the patient ran a rapidly fatal course with fever, bleeding tendency, ascites, anuria and impaired consciousness.
    Postmortem examination revealed malignant lymphoma involving the liver, lymph nodes, spleen, adrenal, skin and submandibular gland. In the liver, ubiquitous infiltration in the portal areas, nodule formation by tumor cells and massive hepatic necrosis were observed.
    The possibility of the contribution of the univisceral Shwartzman reaction to this patient's massive hepatic necrosis is discussed.
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  • Special reference to 6 cases of benign intrahepatic arterioportal shunt demonstrated by selective celiac angiography
    Takeshi YAMAZAKI, Katuji OKUI, Shigeki KOKUBO, Norio SAITO, Isao IWASA ...
    1981 Volume 22 Issue 5 Pages 739-752
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Early opacification of intrahepatic portal branchs (so-called arterioportal shunt) was demonstrated by selective celiac angiography in 9 out of about 400 patients with various diseases, i.e. 3 out of 15 cases (20%) of hepatoma, 2 out of 12 cases (16.7%) of Banti's syndrome after splenectomy, 1 case of arteriosclerosis and drug induced hepatitis, 1 case of hemangioma and chronic active hepatitis and 2 out of 16 cases (12.5%) of iatrogenic trauma caused by percutaneous transhepatic biliary drainage (PTBD).
    Histologically, intrahepatic arterioportal communications were found in one case of Banti's syndrome and we suspected the same cause with stenosis of peripheral portal branch or a congenital malformation to be the cause of the shunt. One case of arteriosclerosis and drug induced hepatitis did not have portal hypertension and arteriosclerosis or a congenital malformation was suspected to be the cause of the shunt. One case caused by PTBD showed portal hypertension produced by a large arterioportal shunt.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1981 Volume 22 Issue 5 Pages 753
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 754
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 755
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 756
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 757
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1981 Volume 22 Issue 5 Pages 758
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 759
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 760
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 761
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 762
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1981 Volume 22 Issue 5 Pages 763
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • 1981 Volume 22 Issue 5 Pages 764-773
    Published: May 25, 1981
    Released on J-STAGE: July 09, 2009
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