Kanzo

Morphological studies on the mechanism of hepatocellular injury in type A acute viral hepatitis.

Ultrastructural investigation and identification of T cell subsets using peroxidase antibody technique

Mitsugu SHIBATA, Takashi KOJIMA, Keiichi AOYAMA, Takehiko KONDA, Kyoic ...

1984 Volume 25 Issue 1 Pages 1-11
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.1

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Eleven specimens taken from patients with type A acute viral hepatitis within two weeks after the onset of the illness were investigated to elucidate the mechanism of hepatocellular injury under light and electron microscopy. In routine electron microscopic study, interaction of small lymphocytes with hepatocytes was detected in 8 of 11 cases. Some lymphocytes in contact with hepatocytes revealed a structure resembling activated lymphocytes. The interaction was characterized by broad or point attachement with a contact gap of 13-22nm in width. A phenomena of emperipolesis was also encountered. Peroxidase-labeled antibody technique demonstrated numerous Leu 1⁺, Leu 2a⁺ and OKT8⁺ lymphocytes infiltrating in the portal area and focal necrosis light microscopically. Furthermore, immune electron microscopic observation revealed an interaction of OKT8+ lymphocytes with hepatocytes. These findings pointed out the possibility that the infiltrated cytotoxic T lymphocyte participated in mechanism of hepatocellular injury in type A acute viral hepatitis.

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Serum DNA-polymerase activity and DNA of the duck hepatitis B virus

Osamu YOKOSUKA, Masao OMATA, Katsuo UCHIUMI, Yoshimi ITO, Fumio IMAZEK ...

1984 Volume 25 Issue 1 Pages 12-17
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.12

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DNA-polymerase activity of the 204 sera from 60 ducks was determined. Mean DNA-polymerase activity of 132 specimens from 41 duck hepatitis (DHBV) positive ducks was 4113cpm/0.2ml and that of 72 specimens from 19 DHBV netative ducks was 530cpm/0.2ml. DNA-polymerase activity was well correlated With the amount of DHBV particles semiquantitively graded by electron microscpoe. When compared with histological findings of the duck liver, DNA-polymerase activity was inversely related the severity of the liver lesions. Partial purification of DHBV was performed. Peak DNA-polymerase activity and DHBV-DNA were found in the fraction of CsCl₂ density of 1.20g/cm³ and spherical Dane particle like DHBV (type 1) was seen in this fraction. Another pleomorphic convoluted DHBV type 2 particles were seen much abundantly in CsCl₂ density of 1.17g/cm³. DNA-polymerase and DHBV-DNA of this fraction was little or absent.

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Effect of exogenous mouse interferon on murine fulminant hepatitis induced by Mouse Hepatitis Virus (MHV)-2

Yatsugi NODA, Yasuhiro KATO, Masashi UNOURA, Nobuyoshi TANAKA, Kenichi ...

1984 Volume 25 Issue 1 Pages 18-23
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.18

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We investigated the effect of exogenous mouse interferon produced by L-cell on the growth of MHV-2 in the liver tissue, the progression of liver cell necrosis, and the subsequent survival time in murine fulminant hepatitis induced by MHV-2. Murine fulminant hepatitis was made in 4-week-old male ICR (SPF) mice by the intraperitoneal inoculation of MHV-2 (10⁵/PFU/mouse). Mouse interferon (10³/IU/Mouse/day) was intraperitoneally injected every day. MHV-2 in the liver tissue was plaque assayed using DBT-cell after homogenization of the liver tissue. Exogenous mouse interferon suppressed both the growth of MHV-2 in the liver tissue and the progression of liver cell necrosis, and also prolonged survival time. Regarding survival time, the earlier the injection of mouse interferon was started, the longer survival time was increased.

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Measurement of serum type III procollagen aminopeptide as a parameter of hepatic fiborsis

Katsuya MARUYAMA, Isao OKAZAKI, Toshiji KOBAYASHI, Fumio OKUNO, Kiyota ...

1984 Volume 25 Issue 1 Pages 24-32
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.24

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Serum type III procollagen aminopeptide (Pro (III)-N-P) was measured by radioimmunoassay in patients with various liver diseases. To evaluate the diagnostic significance of serum Pro (III)-N-P with special reference to hepatic fibrosis, the correlation of serum Pro (III)-N-P with histology obtained by needle liver biopsy was examined. Compared to normal controls (8.3±2.6ng/ml (mean±SD), n=32), serum level of Pro (III)-N-P was significantly evevated in patients with acute hepatitis (11.9±2.9ng/ml, n=5), chronic active hepatitis (14.9±5.0ng/ml, n=14), cirrhosis (18.1±4.7ng/ml, n=6), and alcoholic liver diseases (16.9±9.0ng/ml, n=27), but not in fatty liver and chronic persistent hepatitis. Serum Pro (III)-N-P showed close correlation with the degree of portal fibrosis in patients with nonalcoholic chronic liver diseases (r=0.64, n=24, P<0.001) and alcoholic liver diseases (r=0.53, n=25, p<0.01), and also closely related with the degree of pericellular fibrosis in case of alcoholic liver diseases (r=0.56, n=21, p<0.01), while other clinical tests showed poor correlation with hepatic fibrosis. Measurement of serum Pro (III)-N-P could be an useful parameter of hepatic fibrosis.

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Dynamics of γ-GTP activity and glutathione level in rats in the course of the formation of hyperplastic nodules by thioacetamide

Shinya NAKAJIMA, Syuichi SEKI, Takeyuki MONNA, Sukeo YAMAMOTO, Kenji N ...

1984 Volume 25 Issue 1 Pages 33-39
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.33

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In the present study, a mild hepatocarcinogen, thioacetamide, was given to rats and changes of γ-GTP activity as well as total GSH level were followed until hyperplastic nodules were formed in liver. These biochemical changes occured during the administration of thioacetamide were correlated with gross histopathologic changes in liver. From our experimental results, it is presumed that at least three stages may exist in the induction of precancerous hyperplastic nodules by thioacetamide as following;
1) First stage: γ-GTP activity and GSH level increase togather.
2) Second stage: Both γ-GTP activity and GSH level relatively reduce. In this stage, some compensatory effect may be exhibited.
3) Third stage: γ-GTP activity increase remarkably but GSH level stays lower than that of first stage.
Hyperplastic nodules induced at this stage.

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The protective effects of Saiko-saponin on the liver cell injury induced by ADCC reaction and activated macrophages in vitro

Yasuhiro MIZOGUCHI, Hiroko SAWAI, Hiroko TSUTSUI, Yoshihiro IKEMOTO, T ...

1984 Volume 25 Issue 1 Pages 40-46
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.40

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When the isolated rat liver cells previously coated with the anti-liver cell membrane antibody were cultured with the mononuclear cells from human peripheral blood and their culture supernatants were added to the freshly prepared rat liver cells, a significant decrease in protein synthesis was demonstrated. This was also the case when the culture fluid of peritoneal exudate macrophages activated with LPS was added to the isolated liver cells. These reduction of protein synthesis in the isolated liver cells by culture supernatants were significantly blocked by pretreating the liver cells with Saiko-saponin, especially by Saiko-saponin b1. These results suggests that Saiko-saponin may exert its protective effect on liver cell injury.

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Clinical investigation of Immunosuppressive acidic protein (IAP) in various liver diseases

Hiroiku KAWAKAMI, Hiroo KAWAMOTO, Toshiziro MATSUURA, Yasuyuki WATANAB ...

1984 Volume 25 Issue 1 Pages 47-53
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.47

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In order to study the clinical significance of Immunosuppressive acidic protein (IAP), whose property is its strong immunosuppressive activity in vivo and in vitro, in the liver disease, We have measured serum levels of IAP in various liver diseases and malignant disorders.
Significantly higher levels (500μm/ml) of IAP were found in asymptomatic carrier with HBs-Ag than in normal subjects (p<0.001). On the other hand serum IAP levels in chronic liver diseases were lower than normal subjects, especially serum IAP levels in patients with cirrhosis of the liver were significantly lower than normal subjects (p<0.001). In malignant disorder, IAP levels in serum were further higher as compared with those of normal subjects.
These results suggest that the role of IAP in liver disease was different from those in malignant disorders. Decreased production of IAP in chronic liver diseases may dependent on the function of macrophage, monocyte suppressor cell activity, and inhibitory effects of asymptomatic HBs-Ag carrier serum apperars to be in part IAP, which products by macrophage.

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A study on the disorders of lipoproteins and apoproteins in patients with primary biliary cirrhosis

Yasuji MIYATA, Masaki INOUE, Akihide MASUMOTO, Shunichi KOGA, Hiroshi ...

1984 Volume 25 Issue 1 Pages 54-61
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.54

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Ten cases of primary biliary cirrhosis were subjected to analyze their abnormalities in plasma lipoproteins and apoproteins. The results were summerized as follows:
(1) Electrophoresis of serum lipoprotein revealed that disappearance of pre β-lipoprotein band and appearance of abnormal slow α-lipoprotein. (2) HDL subfraction analysis by gradient polyacrylamide gel electrophoresis showed marked decrease of HDL3. (3) By ultracentrifugal analysis of plasma lipoproteins, a decrease of very low density lipoprotein (VLDL), an increase of low density lipoprotein (LDL) and a decrease of high density lipoprotein (HDL) were observed. (4) Apoprotein analyses of ultracentrifugally isolated lipoprotein fractions showed an abnormal appearance of A-I, A-II, C and E in LDL fraction and a marked increase of apo E in HDL fraction. (5) By measurement of serum levels of apoproteins, a remarkable increase of apo E, a decrease of A-II and an increase of C-II were observed. Levels of apo A-I were not afected.

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Interleukin 1 activity in primary biliary cirrhosis

Toshiji SAIBARA, Takashi MAEDA, Hiroshi SAKAEDA, Minoru OKINO, Saburo ...

1984 Volume 25 Issue 1 Pages 62-66
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.62

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Immune responses to the specific antigen originating from bile ducts are supposed to play a key role in the pathogenesis of PBC. It may partially due to insufficient suppressor T cell function. In this paper we examined the function of monocytes from patients with PBC by assessing the Interleukin 1 activity, because Interleukin cascade system responsible for clonal expansion of activated T cells was recently reported to be impaired in autoimmune diseases.
Materials for the assay are 10 healthy controls, 4 cases with PBC, 6 with non-B chronic active hepatitis (CAH), 6 with B-CAH. Interleukin 1 production of monocytes are markedly reduced in PBC despite of the stage of Scheuer's histological classification compared with healthy controls. Subsequently not only suppressor T cells but also monocytes are proved to be impared in immunological reguration of patients with PBC.

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Ultrasonic diagnosis of the chronic liver disease

Significance of ratio of the left liver lobe volume to the right liver lobe volume and visualization level of hepatic vein

Hidekazu ITOH, Yasuhiko NAGASAKI, Shingo NISHIOKA, Isao YATAKA

1984 Volume 25 Issue 1 Pages 67-75
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.67

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According to measurements made of the livers of 109 autopsy cases, the liver volume (V) and the ratio of the left liver lobe volume to the right liver lobe volume (VR) were V=0. 64 (depth×thickness×width of the left lobe)+0.67 (depth×thickness×width of the right lobe) VR=0.64 (depth×thickness×width of the left lobe)/0.67 (depth×thickness×width of the right lobe) making approximation possible. Measurement of the liver was made by ultrasonography and the mean values of V and VR obtained by the foregoing equations were 1368ml and 0.55 in the controls (41 cases), 1345ml and 0.63 in CHI (12 cases), 1358ml and 0.72 in CHA (16 cases), 1313ml and 0.87 in type B' (10 cases), and 1091ml and 1.01 in liver cirrhosis (26 cases), respectively, indicating that VR was useful in the early diagnosis of chronic liver disease.
Blurring visualization of the hepatic vein in the ultrasonic image were observed in chronic liver disease.

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Risk factors and indication of surgical treatment for esophageal varices

Yuichiro OGAWA, Naofumi NAGASUE, Sozo HIROSE, Hirofumi YUKAYA, Yukihar ...

1984 Volume 25 Issue 1 Pages 76-82
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.76

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The factors which might reflect 3-year survival were retrospectively searched for by evaluating 22 possible items in 82 patients who had undergone surgical treatments for esophageal varices. The presence or absence of ascites, total serum bilirubin level, serum protein fraction, ICG R₁₅, plasma ammonia level, and the Child's classification were significantly correlated with 3-year survival. Also, the result of emergency operations was substantially inferior to that of elective operations. We therefore selected the followings as five most important risk factors; (1) ascites at admission, (2) ICG R₁₅ more than 35%, (3) albumin fraction less than 50% or γ-globulin fraction more than 30%, (4) total serum bilirubin more than 2 mg/100ml, and (5) emergency operation. The degree of risk for 3-year survival was assigned as follow; Risk 0: no risk factor, Risk I: one factor, Risk II: two factors, and Risk III: three or more factors. This grading scheme was useful to prospect the possibility of 3-year survival. It is likely that surgical treatments to achieve 3-yrar survival are indicated only for patients of Risk 0 and Risk I.

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A case of alcoholic foamy degeneration of the liver

Makoto YAMAMOTO, Yasuni NAKANUMA

1984 Volume 25 Issue 1 Pages 83-87
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.83

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Recently, Uchida and co-workers proposed alcoholic foamy degeneration (AFD) of the liver as a pattern of acute liver damage in the alcoholic.
We report a 31-year-old man with a history of chronic alcoholism diagnosed as AFD.
He had the first episode of hepatic decompensation with signs of jaundice and tender hepatomegaly. Laboratory studies showed marked elevation of serum transaminase activities. Acute viral hepatitis and drug hepatotoxicity were excluded respectively.
The liver biospy specimen obtained in acute phase of the illness, revealed intact lobular architecture, marked foamy fatty change in the centrolobular hepatocytes characterized by massive accummulation of microvesicular fat, and cholestasis of mild degree. Neither significant parenchymal neutrophilic exudation nor inflammatory change in the portal tracts were seen. These histological findigs were identical with AFD.
This case is the first report of AFD in Japan.

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Type IV glycogenosis -a case report

Masami YAMAMOTO, Kohtaro MURAKI, Kazuhiro UEDA, Eiichi TAHARA

1984 Volume 25 Issue 1 Pages 88-93
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.88

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A 5-year-old girl with type IV glycogenosis was reported.
At 11 months of age, she presented with hepatosplenomegaly and her laboratory data showed leukocytosis and slight elevation of GOT and GPT. At the age of 4 years and 5 months, she had an episode of hematemesis and bloody stool due to a rupture of the esophago-cardial varices.
Liver biopsy was performed at the age of 4 years and 7 months and it revealed a Nagayo's type A cirrhosis with complete disruption of normal architecture. Many liver cells contained a faintly eosinophilic material. Histochemically, this material stained intensely with PAS stain after diastase digestion and purple brown with iodine, and it was digested with pectinase. Ultrastructurally, this material was consisted of a large amount of fibrils, 65 A in diameter, and a few glycogen particles.
The deficiency of branching enzyme activity was demonstrated in leukocytes.
This is the 25th case report of type IV glycogenosis diagnosed histopathologically.

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An autopsy case of hepatocellular carcinoma presenting with obstructive jaundice

Shinichi HINO, Masahiko IGARASHI, Motohide TAKASHI, Hiroshi HORIE, Tos ...

1984 Volume 25 Issue 1 Pages 94-103
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.94

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A 53-year-old male was admitted to our hospital with progressive jaundice. Hepatic angiogram revealed two hypervascular lesions. One was seen in the anterior segment of the right hepatic lobe. Another corresponded well to the extrahepatic bile duct obstruction seen on PTC. With an antemortem diagnosis of small hepatocellular carcinoma and metastasis to the lumen of the extrahepatic bile duct, the patient died from hepatic failure.
Autopsy disclosed an encapsulated hepatocellular carcinoma measuring 25×25×20mm in the anterior segment of the right lobe of the non-cirrhotic liver. There were metastases to hepatoduodenal lymph nodes, from which the tumor had extended into the wall of the proximal common bile duct by lymphatic routes and grown continuously in a distal and proximal direction to fill the entire extrahepatic bile duct. No metastases to other organs were noted.
The discussion includes a review of the world literature on icteric type hepatoma and mechanisms of HCC-induced biliary obstruction.

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A case of autoimmune hepatitis associated with chronic thyroiditis and Sjögren syndrome

Tadaharu YAMAWAKI, Masami KAWABE, Hajime SUGIE, Toshihiko KOSAKA

1984 Volume 25 Issue 1 Pages 104-108
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.104

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A 43-year-old housewife with general malaise was diagnosed autoimmune hepatitis associated with chronic thyroiditis and Sjögren syndrome.
Laboratory findings were as follows: S-GOT, 285; S-GPT, 228; r-globulin, 3.6g/dl; RA test (++).
Thyroid function tests were within normal but thyroid test and microsome test were both positive. Different kinds of autoantibodies were examined and antinuclear, anti-DNA, anti-smooth muscle and antimitochondrial antibody were positive.
Immunoglobulin levels showed IgG of 4530mg/dl; IgA 450mg/dl; and IgM 426mg/dl.
This patient revealed characteristic features of PBC and CAH, both histologically and immunologically. It was suggested that autoimmune overlapping mechanism was related to the pathogenesis of this patient's diseases.

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A case of primary biliary cirrhosis with cutaneous granulomas

Shuichi AMAKI, Akira MIYAMOTO, Takahiko OZAKI, Masatoshi MIYAMOTO, Kiy ...

1984 Volume 25 Issue 1 Pages 109-115
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.109

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The patient was a 51-year-old female with primary biliary cirrhosis which was complicated with pathohistological granulomas appearing as nodular erythema-like skin rashes on the leg.
Upon examination, the authors observed an acceleration of the erythrocyte sedimentation rate, hypergammaglobulinemia, and an increase in biliary tract enzymes and IgM, but AMA proved negative. Needle liver biopsy revealed enlarged portal tracts due to an intense chronic inflammatory reaction and fibrous proliferation with epithelioid granulomas. Subsequently, the AMA turned positive. One year after the first examination, esophageal variceal bleeding occurred, so that esophageal transection and splenectomy were performed. Surgical wedge biopsy undertaken at this time showed changes consistent with CNSDC.
After the lapse of another year, fever and nodular erythema-like skin rashes appeared on the extensor side of the leg, and skin biopsy revealed granulomas in the corium and subcutaneous tissue similar to those confirmed in the liver, suggesting the possibility that the pathogenic mechanism of the lesions was related to that of PBC.

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...

1984 Volume 25 Issue 1 Pages 116
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.116

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...

1984 Volume 25 Issue 1 Pages 117
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.117

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...

1984 Volume 25 Issue 1 Pages 118
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.118

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...

1984 Volume 25 Issue 1 Pages 119
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.119

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Pathology of hepatocellular carcinoma

Tumor thrombus of the portal vein

Toshiro NAKASHIMA

1984 Volume 25 Issue 1 Pages 120-122
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.120

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The First Department of Pathology, Kurume University School of Medicine Hepatocellular carcinoma (HCC) accounts for approximately 80% of hepatic malignancies, and it tends to increase year by year. Despite the liver receives blood supply through both the hepatic artery and the portal vein, HCC itself and tumor thrombus of the portal vein mainly receive arterial blood supply, and the portal vein seems to play a role of an efferent vessel. Accordingly HCC tends to form tumor thrombus in the portal vein in early stage and forms abnormal shunt between the artery and the portal vein (A-P shunt). According to the introduction of transcatheter arterial embolization therapy for HCC, a long survival can be expected even in advanced cases of HCC. In long survived cases, varying degrees of organization of tumor thrombus occurs and may increase a risk of rupture of esophageal varices due to acceleration of portal hypertension.
Thus, it is predicted that management of esophageal varices in HCC will be important in future.

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[title in Japanese]

1984 Volume 25 Issue 1 Pages 123-152
Published: January 25, 1984
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.25.123

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