Kanzo
Online ISSN : 1881-3593
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Volume 25, Issue 11
Displaying 1-23 of 23 articles from this issue
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  • Epiological study of an outbreak of hepatitis A in Aomori prefecture
    Hideyasu NARA, Michiro AIZAWA, Hiroyasu KAWABE, Yoichi HAGA, Kenro TAK ...
    1984 Volume 25 Issue 11 Pages 1377-1384
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1377
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    Six hundreds and thirty two patients of epidemic hepatitis A broken out in Aomori Prefecture from January to April, 1983 were studied. This was the largest outbreak of Hepatitis A diagnosed by determination of IgM-HA antibody in the world. The male to female ratio of patients was 1:7. Although the age distribution was from 0 to 74 years old, 75% of patients were between 20 to 39. Five male fulminant hepatitis were found and three of them were fatal.
    Seventy five percent of patients had eaten raw oyster before onset and it was significantly higher than healthy people in the same period. Oyster farmed in Mutsu Bay was suspected as the infectious vehicle. The prevalence of positive HA antibody investigated in healthy people in Aomori Prefecture was similar to those reported in Japan.
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  • Detection of IgManti-HBc in the cases of HBsAg-positive chronic liver disease with acute exacerbations
    Kazuhiko KOIKE, Shiro IINO, Kiyohiko KURAI, Hiroshi SUZUKI, Keiji MITA ...
    1984 Volume 25 Issue 11 Pages 1385-1393
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1385
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    Sixty-six acute exacerbations in 45 HBsAg carriers with chronic liver disease were studied for IgManti-HBc by radioimmunoassay. 42 (63.6%) of 66 were positive for IgManti-HBc. Although in a greater part of these cases, titers of IgManti-HBc were lower than those in acute hepatitis B, in 11 (16.7%) of 66 exacerbations the titers were as high as those in acute hepatitis B and it seems difficult to differentiate chronic from acute infection in such cases.
    The positivity of IgManti-HBc in cases with whom anti-HBe was persistently positive during acute exacerbations was higher than in HBeAg-positive cases. And because the elevations of IgManti-HBc was observed in all of the former cases, it is suggested that exacerbations in these cases are associsted with the active replication of hepatitis B virus.
    Both the maximum values of transaminase level and HBeAg concentration in acute exacerbations had no correlation with the titer of IgMant-HBc.
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  • Long-term follow-up study of chronic hepatitis B virus carriers with and without hepatitis
    Kiyohiko KURAI, Shiro IINO, Hiroshi SUZUKI, Keiji MITAMURA, Naomi TANA ...
    1984 Volume 25 Issue 11 Pages 1394-1405
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1394
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    Two hundred ninety-two cases of chronic hepatitis B virus (HBV) carrier have been followed prospectively for 5-12 years (mean 7.0 years) with serial serological and biochemical tests.
    1) In HBeAg positive cases: The yearly rate of seronegativity for HBeAg (S.N.) and seroconversion to anti-HBe (S.C.) were 5.0%, 3.2%, respectively in asymptomatic HBV carriers with normal liver function (ASC) and were 10.8%, 4.8%, respectively in the patients with chronic liver disease. Improvement of hepatitis following S.N. or S.C. was observed in 25 (96.2%) out of 26 cases of ASC, in 20 (74.1%) out of 27 patients with chronic hepatitis (CH) and in one (16.1%) out of six patients with liver cirrhosis (LC) during the follow-up period. Its rate in LC was significantly low compared with that in ASC and CH.
    2) In anti-HBe positive cases: Mild liver dysfunction was observed transiently in nine (6.5%) out of 138 cases of ASC and hepatitis improved in seven (30.4%) out of 23 patients with CH but in all four patients withe LC, hepatitis had persisted during the follow-up period.
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  • Ultrastructure of Leu-7 positive cells (NK/K cells) in the liver tissue and peripheral blood of the patients with type B chronic active hepatitis
    Ichinosuke HYODO, Gotaro YAMADA, Takashi NISHIHARA, Hiroaki OKUSHIN, K ...
    1984 Volume 25 Issue 11 Pages 1406-1411
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1406
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    To evaluate the immunopathological role of natural killer (NK) cell and killer (K) cell (effector cell of ADCC) in type B chronic hepatitis, liver biopsy specimens and peripheral blood lymphocytes obtained from 15 patients were investigated by immunoperoxidase staining methods.
    The majority of Leu-7+ cells in the liver and peripheral blood were round or spherical in shape and the cell size ranged from 7μm to 11μm in diameter. They had irregular surfaced membrane formed by many projections like villus. The cytoplasm contained a few electron dense granules and vesicles. The nucleus presented reniform and had dense heterochromatin.
    Leu-7+ cells were occupied only 5.8% of mononuclear infiltrates in the liver and scattered throughout the hepatic lobules. There was no clustering of Leu-7+ cells located at the sites of piecemeal necrosis and focal necrosis. On the other hand Leu-2a+ cells infiltrated to these sites.
    In the electron microscopic observation, Leu-7+ cells were mainly distributed in the sinusoids of the liver and their contact with the hepatocytes was not recognized.
    There was no finding which suggested Leu-7+ cell cytotoxicity (natural killing and/or ADCC) against the hepatocytes in vivo.
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  • Immunohistochemical study of intrahepatic distribution of lymphocyte subsets in cases with non-A, non-B chronic hepatitis
    Takashi NISHIHARA, Gotaro YAMADA, Ichinosuke HYODO, Yuji SAKAMOTO, Shi ...
    1984 Volume 25 Issue 11 Pages 1412-1419
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1412
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    Intrahepatic distribution of lymphocyte subsets (Leu-1, Leu-2a, Leu-3a, Leu-7, and Leu-10 positive cells) was studied in 17 cases with non-A, non-B chronic hepatitis by peroxidase-labeled antibody method and was compared with that in cases with type B chronic hepatitis. Leu-2a positive cells were occupied in 32.2±8.0 (Meam±SD) % of mononuclear cells infiltrating in the liver and Leu-3a positive cells were demonstrated in 33.9±6.2% of them. Leu-3a/Leu-2a ratio shows 1.13±0.41. Leu-7 positive cells consisted of only 9.5±4.3% and were scattered in the liver. Leu-2a positive cells were not only distributed in sites of piecemeal necrosis in the periportal area but in sites of focal necrosis of parenchyma. In cases with highely elevated s-GPT (>400IU/L), Leu-2a positive cells were more increased than in cases with low level of s-GPT (<100IU/L) and Leu-3a/Leu-2a ratio was decreased. These results suggest that T cell cytotoxicity may also play an important role in the pathogenesis of liver cell necrosis in non-A, non-B chronic hepatitis as well as in type B chronic hepatitis.
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  • Ultrastructural study on microvasculature of portal tract in chronic hepatitis
    With special reference to portal veins
    Junichi SUDO
    1984 Volume 25 Issue 11 Pages 1420-1432
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1420
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    The ultrastructure of portal veins in the portal tract of the liver in 15 patients with HBspositive chronic hepatitis was studied and compared with normal controls.
    The portal veins examined in normal liver and chronic hepatitis were less than 80μm in diameter and belonged to their terminal branches. In normal liver the ultrastructure of the portal veins was similar to that reported in the literature, and neither a endothelial fenestra nor a interendothelial gap was observed. In chronic hepatitis one or more fenestrae were found in the endothelial cytoplasm. Such fenestrae were usually 20-500nm in diameter with or without a diaphragm. There was no formation of interendothelial gaps in the endothelial lining. In the fenestrated area of the portal vein, the subendothelial space was irregularly dilated and contained electron-dense flocculent material similar to that seen in the vessel lumen. This material was observed also outside the basement membrane that appeared interrupted. Mononuclear cells, predominantly lymphocytes migrated in the subendothelial space. These findings suggest that, in chronic hepatitis, the inflammatory infiltration in the portal tract takes plae through these fenestrae of the portal vein.
    The portal veins with afore-mentioned changes were observed in 2 of 5 patients with CPH (or 2 of 14 portal veins examined on an electron microscope) and in all five patients with CAH 2A and 2B (or 17 of 25 and 14 of 21 portal veins respectively). Such abnormalities of the portal veins were significantly more frequent in both CAH 2A and 2B than in CPH, but not significantly different between CAH 2A and 2B.
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  • Studies on fractionated parenchymal cells of the rat liver
    Hajime SUJINO, Tomokazu MATSUURA, Sadamu HOMMA, Satoshi HASUMURA, Kiyo ...
    1984 Volume 25 Issue 11 Pages 1433-1443
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1433
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    Isolated hepatocytes were sub-fractionated by low gravity centrifugal technique in a new linear density gradient (1.03-1.09g/ml) of Percoll.
    According to their position in the gradient, the cells from fed and fasted rats were divided into four discrete bands, and that from 70% partial hepatectomized rats showed two or three bands.
    In order to determine acinar zonal derivation for each fractionated cells, the distribution of fluorescein diacetate in cells fractionated from liver per-perfused was studied, and fractionated cells were examined morphologically by transmission and scanning electron microscopy. It was found that lighter hepatocytes corresponded to the centrilobular cells, whereas heavier hepatocytes represented the periportal cells.
    Soluble proteins and activity of glucose-6-phesphatase in fractionated cells were quantitatively measured. The fractionated cells were cultured in medium with serum, and were observed electron microscopically.
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  • Heterogeneity of ICG uptake and bile acid excretion within the hepatic lobule
    Masahide TOSA, Takeshi OGASAWARA, Yoshinori KATSUMA, Masahide HORISHI, ...
    1984 Volume 25 Issue 11 Pages 1444-1451
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1444
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    The contribution of periportal and pericentral hepatocytes to ICG uptake and bile acid excretion was studied in male Wistar rats using hemoglobin-free non-recirculating liver perfusion.
    ICG (0.6mg/100g·BW) infused via portal vein was taken up by hepatocytes creating a decreasing concentration gradient from periportal to pericentral zone. While, retrograde (hepatic to portal) infusion of ICG created a "reverse" pericentral to periportal gradient. These findings suggest that the celular concentration gradients created by ICG are the consequence of the sequential extraction of ICG by zonal hepatocytes rather than that of different functions of zonal ones.
    Taurocholate (0.8μmol/min/100g·BW) infused via portal vein enhanced the biliary excretion of ICG taken up by both periportal and pericentral hepatocytes. With the lower concentration of taurocholate (0.1μmol/min/100g·BW), the excretion of ICG taken up by periportal hepatocytes was stimulated, while ICG in pericentral zone was not affected. These results suggest that the heterogeneity of bile acid uptake and excretion exists and that under the physiological conditions, periportal hepatocytes are the most active in extracting and excreting bile acid than the remaining cells within the lobule.
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  • Nonthyroidal illness: studies on chronic liver diseases
    Hitomi TAKAHASHI, Shoji YAMADA, Takeaki NAGAMINE, Shunichi SAEKI, Take ...
    1984 Volume 25 Issue 11 Pages 1452-1460
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1452
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    Serum concentrations of various thyroid parameters were measured in 10 patients with chronic persistent hepatitis (CPH), 23 with chronic aggressive hepatitis (CAH), 26 with liver cirrhosis (LC) and 14 nornal controls. Serum thyrotropin (TSH) and triiodothyronine (T3) responses to synthetic thyrotropin-releasing hormone (TRH, 500μg i.v.) were evaluated. I, The mean free thyroxine (FT4) value was significantly lower only in patients with LC. The mean free triiodothyronine (TF3) values were significantly reduced in patients with CPH, CAH and LC in the order. And the values of FT4 and FT3 were correlated with those of ICGR15 (%), prothrombin time (%) and serum albumin respectively. Therefore the level of FT, seems to indicate the degree of liver damage. II. In TRH test, the differences in the maximal increase of TSH above the baseline (ΔTSH) among four groups were not significant. But the patients with LC showed abnormally low serum T3 responses to TRH. That suggests liver-thyroid functional relationship.
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  • A case of primary biliary cirrhosis with Sjogren's syndrome
    Histological evaluation of the pancreas with biopsied specimen
    Kiyoshi YAMAZAKI, Shunichi SATO, Kazuomi NAKAZAWA, Toshimi YOSHIDA, Ta ...
    1984 Volume 25 Issue 11 Pages 1461-1467
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1461
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    A 55-year-old housewife was hospitalized with symptoms of pruritus and jaundice. Total bilirubin and transamiase values were slightiy high, and Al-P, γ-GTP and IgM levels were markedly elevated. Anti-mitochondrial antibody was positive, and liver biopsy showed a typical picture of chronic non-suppurative cholangitis (PBC, Stage I). She had xerostomia and xerophthalmia, and histological features of salivary gland were that of Sjogren's syndrome. Serum and urinary amylase levels were elevated with predominancy of pancreatic isoamylase. Her sister also contracted asymptomatic PBC, and two other sisters had hyperamylasenemia.
    To evaluate the pancreatic damage histologically, biopsy of the pancreas was performed simultaneously with surgical liver biopsy. Biopsied specimen of the pancreas revealed diffuse mononuclear cell aggregates in the parenchyma. Prominent degeneration of the acinar cells were also observed associating with mononuclear cell infiltration. Altough histological findings of the pancreas were not as specific as those of PBC or Sjogren's syndrome, the possibility that the pancreatic damage was associated with these two diseases can not be excluded.
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  • Remarkable regression of hepatocellular carcinoma by reduced glutathion: A case report
    Nobuhiro KAWANO, Takeshi NAGAO, Ryuhei SETOYAMA, Yasuhiko MORIOKA
    1984 Volume 25 Issue 11 Pages 1468-1473
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1468
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    A case of hepatocellular carcinoma (HCC) snccessfully treated with reduced glutathion (GSH) was reported. A 59 year-old female was admitted to our department due to hepatomegaly. Serum AFP was 11357.5ng/ml, and angiogram, CT scan and echogram disclosed the presence of HCC (diffuse type) which was subsequently confirmed by liver biopsy. These tumors occupied more than 50% of the whole liver and surgical intervention was not indicated. Oral GSH therapy, experimentally suggested effective for HCC by Novi, was applied to this patient and she has been followed up for 18 months at the outpatient clinic by liver function test, serum AFP, echogram and CT. Three months after the beginning of GSH administration, remarkable decrease of AFP was observed with general improvement and disappearance of tumors in the liver on CT and echogram. Eighteen months after GSH treatment started, the tumors have regressed to below 5% of the whole liver on CT and this patient has fulfilled perfect social rehabilitatiom. This is the first clinical report of snccessful treatment of HCC by GSH, and the meckanism of GSH to HCC was also discussed.
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  • Two autopsy cases of hepatic fungal abscesses associated with acute leukemia
    Hirohisa KOYATA, Shuji NANBU, Yukihiro SHIMIZU, Chiharu MIYABAYASHI, T ...
    1984 Volume 25 Issue 11 Pages 1474-1482
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1474
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    Two autopsy cases of hepatic fungal abscesses in acute leukemia were presented. The first case was a 48-year-old female patient with acute promyelocytic leukemia. She was treated with intensive chemotherapy. Her clinical course was complicated by high fever, jaundice and hypoalbuminemia. In spite of jaundice, serum transaminase levels remained in almost normal range. She was suffered from pneumonia and died of respiratory failure. Necropsy revealed hepatic fungal abscesses caused by Candida species. The second case was a 59-year-old male patient with acute myelomonocytic leukemia. His clinical course was similar to the first case. Necropsy showed hepatic abscesses caused by Mucor species.
    Recently, the incidence of deep mycoses has been increasing because of combination therapy of newly deviced antibiotics, anticancer agents and corticosteroid. It is necessary for us to consider the presence of hepatic fungal abscesses if high fever and liver dysfunction develop in a neutropenic patient with acute leukemia.
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  • A case of obstructive jaundice due to deep mycoses
    Yasuo TAKEDA, Shinichi NUNODA, Jiro SUDO, Hideo KOSHIDA, Toshio UENO, ...
    1984 Volume 25 Issue 11 Pages 1483-1488
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1483
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    A 31-year-old man was admitted to our hospital with complaint of jaundice, and he had been suffering from a ringworm infection of Trichophyton rubrum for one year.
    On admission, obstructive jaundice was seen. ERCP revealed irregular filling defect in the common bile duct and dilatation of the intrahepatic duct. At exploratory laparatomy, many swelling lymphnodes were revealed adhering the common bile duct. Their histology were granulomas with necrotic tissue, and PAS stain positive, many septate mycelial fragments were observed in the center of the lymphnodes. Lymphnodes were resected surgicaly followed by compress of griseofulvin. But, inspite of the therapy of T-tube drainage and other antimycotic drug, the patient has been persistent jaundice and the histology of liver was revealed biliary cirrhosis.
    It seems quite rare to experience such obstructive jaundice due to the external obstruction of the common bile duct by the granulomatous lymphnodes, which were probably formed by lymphogenous infection after suffering from a ringworm infection of the skin.
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  • A case study of fascioliasis with special reference to immunoserological tests and diagnostic imagings
    Shuji NAMBU, Takafumi ICHIDA, Takashi KOJIMA, Keiichi AOYAMA, Shunjiro ...
    1984 Volume 25 Issue 11 Pages 1489-1497
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1489
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    We reported a case of fascioliasis diagnosed by immunological methods and various kinds of diagnostic imaging technique (ultrasonography, computed tomography and angiography). While the presence of ova or parasites was not confirmed, the diagnosis was ascertained by the improvement of clinical symptoms during the bithionol treatment.
    A 28 year-old man was admitted to our hospital because of epigastric colicky pain. The examinations revealed hepatomegaly, marked eosinophilia, elevated serum IgE and hepatic dysfunction. The diagnostic imaging showed characteristic tumors in the right hepatic lobe, especially on CT. CT revealed polycystic low density areas. Laparoscopy demonstrated a white nodule on the right hepatic lobe and the biopsy specimen obtained from the nodule showed scars and portal fibrosis with marked eosinophilic infiltration. The laboratory data and diagnostic imaging suggested a parasitic disease. The examination for feces and bile juice revealed no parasite egg. However, fascioliasis was diagnosed due to prominent positive reaction for fasciola antigen by Ouchterlony double immunodiffusion test. The administration of bithionol (total 89.6g) normalized the laboratory data except for the elevated serum IgE after three months course of the treatment. The sequential study of CT scan had shown disappearance of low density areas after the treatment.
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  • [title in Japanese]
    [in Japanese], [in Japanese]
    1984 Volume 25 Issue 11 Pages 1498
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1498
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1984 Volume 25 Issue 11 Pages 1499
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1499
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1984 Volume 25 Issue 11 Pages 1500
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1500
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  • [title in Japanese]
    [in Japanese]
    1984 Volume 25 Issue 11 Pages 1501
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1501
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  • [title in Japanese]
    [in Japanese], [in Japanese], Phillps M. James
    1984 Volume 25 Issue 11 Pages 1502
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1502
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1984 Volume 25 Issue 11 Pages 1503
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1503
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1984 Volume 25 Issue 11 Pages 1504
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1504
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese]
    1984 Volume 25 Issue 11 Pages 1505
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1505
    JOURNAL FREE ACCESS
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  • [title in Japanese]
    1984 Volume 25 Issue 11 Pages 1506-1510
    Published: November 25, 1984
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.25.1506
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