Kanzo

Natural seroconversion of HBe antigen to anti-HBe in HBs antigen carrier children

from the difference of the modes of HBV transmission

Mineo KOJIMA, Masanori YASUDA, Hiroshi TANAKA, Nobuyuki ADACH, Masaru ...

1985 Volume 26 Issue 9 Pages 1139-1145
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1139

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Natural seroconversion of HBeAg to anti-HBe was studied in thirty seven HBeAg carrier children, aged from 7 to 15 years at the final testing of HBeAg and anti-HBe, who had been followed up for more than two years and examined for serum GPT more than 4 times. Their parents had been examined for HBsAg.
HBeAg carrir children were divided into two groups: group 1, nine children whose mothers were HBsAg carrir. Group 2, twenty eight children whose mothers were not HBsAg carrier.
In group 1, seven (77.8%) of the 9 children were positive for HBeAg, while two (22.2%) of them had anti-HBe at the final testing. On the other hand, in group 2, nine (32.5%) of the 28 children were positive for HBeAg, while fifteen (53.6%) of them had anti-HBe and the other four cases were HBeAg/anti-HBe negative at the final testing. Frequency of seroconversion of HBeAg to anti-HBe was higher in group 2 than in group 1 (p<0.05).
Three of the 9 children in group 1 showed abnormal GPT (more than 50 KU), while twenty two of the 28 children in group 2 showed abnormal GPT throughout the observation period. The occurence rate of abnormal GPT in childhood in group 2 than in group 1 (p<0.005).
It suggest that natural course of HBsAg carrir children is different between horizontal infection and vertical transmission.

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On glucagon loading test for evaluation of total liver function

Takanobu YOSHIDA, Nobuo OKAZAKI, Masahiro YOSHINO, Hiroshi HASEGAWA, S ...

1985 Volume 26 Issue 9 Pages 1146-1150
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1146

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Glucagon test was performed to 13 patients with focal liver disease who received hepatectomy, 8 patients as surgical control without liver manipulation and 7 volunteers as normal control. Levels of plasma c-AMP were significantly reduced just after hepatectomy and its rate of decrement was significantly related to the parenchymal resection rate of the liver. In patients as surgical control, the response of c-AMP to glucagon showed no remarkable changes after operation.
These results indicate that glucagon test is an useful tool for determining the total liver function.

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Clinical assessment of plasma retinoid concentration in patients with liver diseases

with special reference to the appearance of retinyl ester in plasma of patients with severe parenchymal damage

Hisataka MORIWAKI, Masayuki NOMURA, Masataka OKUNO, Kanji TAKAGI, Mits ...

1985 Volume 26 Issue 9 Pages 1151-1158
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1151

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Plasma concentrations of vitamin A derivatives (retinoids) were investigated by high performance liquid chromatography in the patients with liver diseases. In all of 10 controls and in 128 out of 133 cases with liver diseases, only retinol was detectable in the plasma obtained after overnight fasting. Retinol was found to be significantly decreased in the patients with acute hepatitis, fulminant hepatitis, chronic hepatitis, liver cirrhosis and hepatocellular carcinoma as compared with control. Elevated plasma concentrations of retinol were observed in 3 cases of fatty liver. Significant correlations were obtained between plasma retinol concentration and prothrombin time, hepaplastin test, albumin, choline esterase, ICG R15 or RICG. Hence, it was suggested that plasma retinol was clinically valuable as one of indicators of functioning liver mass. In addition, the appearance of retinyl palmitate was demonstrated in LDL fraction of plasma in 4 cases with decompensated liver cirrhosis and in one case of fulminant hepatitis (subacute type), possibly due to impaired uptake of "remnant" by the damaged liver.

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The protective effect of inducer on galactosamine hepatitis

Toshihiko MURASE, Rie MASUDA, Takaya SAWAMURA, Yasuko SHIOZAKI, Yoshik ...

1985 Volume 26 Issue 9 Pages 1159-1167
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1159

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We examined the effect of inducers on galactosamine (gal) hepatitis in rat. We first induced S.D. male rat by polychlorinated biphenyl (PCB), phenobarbital (PB) and 3-methylcholanthrene (3MC), respectively, and administerd single intraperitoneal injection of gal, then periodically observed the change of drug metabolizing activity.
In gal only administered rat, the content of cytochrome P-450 decreased to 34.7% of control three days after, but PCB, PB, 3MC induced group, decrement of activity was suppressed, minimal value were 96.3%, 89.1%, 63.8% of control, respectively. The content of cytochrome b5 and the activity of NADPH-cytochrome c reductase showed the same change with P-450. Metabolizing activities of aminopyrine, benzo(a)pyrene, anilin were also protective from gal, and histological study also supports this phenomenon.
We found the protective effect of inducers on gal hepatitis, the intensity of that effect was PCB, PB, 3MC in order.

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A study on the distribution of 3-methylcholanthrene-induciblecytochrome P-450 within the hepatic lobulus of rats

Shinji TAMURA, Sumio KAWAT, Yoshiaki INUI, Masami INADA, Shuzo NODA, R ...

1985 Volume 26 Issue 9 Pages 1168-1173
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1168

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The effect of 3-mehylcholanthrene (MC) on the distribution of MC-inducible cytochrome P-450 (cytochrome P-450MC) within the hepatic lobulus of rats was investigated by the indirect fluorescent antibody staining technique. Rabbit antiserum produced against cytochrome P-450MC was used in this experiment. The effect of chronic ethanol feeding on the distribution of cytochrome P-450MC in the hepatic lobulus was also studied. In the control rats, the specific fluorescence was barely observed, being slightly more intense in the centrilobular and the midzonal hepatocytes than in the periportal hepatocytes. The effect of MC on the distribution of cytochrome P-450MC was investigated at 6, 12, 24 and 48 hours after peritoneal injection of 20mg MC/kg body weight. The intensity of the specific fluorescence increased with time and was almost equal among the three zones of the hepatic lobulus in all the stages investigated. No difference was observed between chronic ethanol feeding rats and control rats in the intensity and distribution of the specific fluorescence.

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Suppression of immune responses by soluble extract

from rat liver:Studies in vitro

Atsumi MATSUNO

1985 Volume 26 Issue 9 Pages 1174-1182
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1174

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A inhibitor of phytohemagglutinin (PHA) mitogen response has been reported to exist in the soluble fraction of the liver. In this paper, to clarify the origins of the inhibitor, hepatocytes and non-parenchymal cells were semipurified from rat liver. Inhibitory activity was found only in the soluble extract of hepatic parenchymal cells. The inhibitor had an organ specificity and localized mainly in the liver and a small atnount in the kidney and small intestine. The inhibitor was released from cultured parenchymal cells according to the decrease of their viabilities and increase of GPT concentrations in the culture soiution.
Beside the inhibition of PHA mitogen response of rat spleen cells, liver extract also showed the activities of suppression of concanavalin A (Con A) and lipopolysaccharide (LPS) mitogen responses and primary antibody response of rat spleen cells and antibody dependent cell-mediated cytotoxicity (ADCC) of human peripheral lymphocytes, with no effects on the cytotoxicity of lymphocytes.

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Defective production of Interleukin 1 and Interleukin 2 in patients with primary biliary cirrhosis

Toshiji SAIBARA, Takashi MAEDA, Masanao FUJIKAWA, Akira TOMITA, Hirosi ...

1985 Volume 26 Issue 9 Pages 1183-1187
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1183

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This study was achieved in order to define some causes of the immunologic impairment of primary biliary cirrhosis (PBC). Blood monocytes and mononuclear cells from 6 patients with PBC were stimulated to produce Interleukin 1 (IL-1) with lipopolysaccharide and Interleukin 2 (IL-2) with phytohemagglutinin. And the amount of cytokines produced was compared with that of 8 patients with chronic active hepatitis type B, 8 healthy HBsAg-carriers, and fifteen healthy volunteers. A defective production of of IL-1 and IL-2 was observed only in PBC. Impaired IL-2 production in PBC was restored to almost normal level by adding purified human IL-1. Defective production of these regulatory cytokines may therefore be important in the pathogenesis of PBC.

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Modulation of choleatatic factor production from the activated lymphocytes by Kupffer cells

Yasuhiro MIZOGUCHI, Takayuki ARAI, Hiroko TSUTSUI, Keiji MIYAZIMA, Yos ...

1985 Volume 26 Issue 9 Pages 1188-1192
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1188

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The cholestatic factor which induces intrahepatic cholestasis was produced from the tuberculin-sensitized guinea pig lymphocytes by stimulation with the purified protein derivative (PPD) in vitro. This cholestatic factor production was significantly reduced by adding the culture supernatant of the isolated Kupffer cells to the lymphocytes simultaneously with PPD. However, decrease in cholestatic factor production by Kupffer cell culture fluid was partially recovered by pretreatment of Kupffer cells by indomethacin.
These results suggested that the suppression of cholestatic factor production by Kupffer cells was attributable at least partially to the prostaglandin.

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Anatomy of the caudate lobe with special reference to portal vein and bile duct

Masamitu KUMON

1985 Volume 26 Issue 9 Pages 1193-1199
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1193

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The development of the hepato-biliary surgery and diagnostic imagings have necessitated full appreciation of intra-hapatic topography. In the literature, the caudate lobe seems to be well studied especially by Healey and Shroy and Couinaud. However, since they didn't describe clearly the border between the right lobe and caudate lobe, there is confusion concerning the region of the caudate lobe. Considering this fact, in our study on the bile duct and portal vein of the caudate lobe using 23 cases of corrosion liver casts, we divided the caudate lobe into 3 parts: (1) the so-called Spiegel lobe, (2) the caudate process portion and (3) para-caval portion. the portal branches of the Spiegel lobe ramified mostly from the left and main portal veins, but the biliary branches are more frequently drained to the right ductal system. The portal branches of the process portion ramified from the main and right portal veins except for the early ramifiying type of the right posterior branch. All the bile ducts of the caudate process is drained into the right ductal system, mainly into the posterior branch. The portal branches of the para-caval portion ramified from the left portal branch in 70% of cases and from the right portal branch in 30%. The biliary branches of the para-caval portion drained in to the right and left ductal systems at equal frequency. The branches of the para-caval portion are big enough to pass through between the roots of the right and middle hepatic veins in more than 50% of cases and reached up to the surface of the liver just beneath the diaphragm. From the standpoint of surgery, the para-caval portion is most important because the Spiegel lobe and caudate process are not difficult to resect, but the branches of the para-caval portion can not be resected completely by the conventional right or left lobectomy.

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Evaluation of transcatheter arterial embolization (TAE) as a therapy for recurrence of heputocelluler carcinoma after hepatic resection

Syoji NAKAMORI, Shingi IMAOKA, Yo SASAKI, Osamu ISHIKAWA, Hiroaki OOHI ...

1985 Volume 26 Issue 9 Pages 1200-1206
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1200

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We analized nineteen patients suffering from recurrent hepatocellular carcinoma after hepatic resection. They were divided into two groups by postrecurrence therapy, performed with transcatheter arterial embolization (TAE) or not. TAE was performed in twelve patients (TAE group) and the other therapies were performed in seven patients (non-TAE group). On the hepatic resection and recurrence there was no significant difference in the several factors for prognosis between the groups of TAE and non-TAE. Nevertheless, one-and two-year survival rate after recurrence were 91%, 57% in the TAE group, respectively. There was significant difference (p<0.05) in the survival rates between the two groups. In the all patients of TAE group serum AFP values decreased after TAE. In the non-TAE group, there were only two patients decreased with AFP values after therapies.
We concluded that TAE was the more effective therapy for recurrent hepatocellular carcinoma of residual liver after hepatic resection.

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Pathological study on hepatocellular carcinoma

A study of histological changes after transcatheter arterial embolization

Kenichiro MATSUO

1985 Volume 26 Issue 9 Pages 1207-1216
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1207

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The pathological changes in hepatocellular carcinoma (HCC) treated with transcatheter arterial embolization (TAE) were investigated in 21 autopsy cases and 13 surgical cases at the 1st pathological department of Kurume University Hospital during the recent 36 months. 24 autopsy and 9 surgical cases without TAE and one-shot injection chemotherapy were studied as a control. 28 autopsy and 7 surgical cases treated with one-shot injection chemotherapy were also studied comparatively.
The results were as follows;
1. The average survival time of 21 autopsy cases treated with TAE was 9.9 months, and comparative figure for a control group was 2.9 months with a stastical significance (t-test p<0.01). However, there was no significant difference between the cases treated with TAE or one-shot injection chemotherapy.
2. The average rate of necrosis in the tumor among the cases treated with TAE was higher than that of controls. Higher incidence of tumor necrosis among the cases treated with TAE was recognized in encapsulated HCC than replacing and sinusoidal HCCs. The rate of necrosis of tumor thrombus with the portal vein of the cases treated with TAE was not different from that of controls.
3. Histologically, it was suspected that encapsulated or replacing type might transform sinusoidal type following several times of TAE treatments.
4. The incidence of appearance of xanthoma cell around tumor necrosis in the cases treated with TAE was higher than that of controls.
5. Although in the cases treated with TAE, the hepatic arteries showed intimal thickening, stenosis, and thrombus formation in varying degrees.
The frequency of these findings was not significantly different from that of the cases treated with one-shot injection chemotherapy.

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Various imaging methods in the detection of small hepatomas

Haruki NAKATSUKA, Toshio KAMINOU, Kazumasa TAKEMOTO, Sumio TAKASHIMA, ...

1985 Volume 26 Issue 9 Pages 1217-1223
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1217

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Fifty-one patients with small hepatomas under 5cm in diameter were studied to compare the detectability of various imaging methods. Positive finding was obtained in 50% of the patients by scintigraphy, in 74% by ultrasonography and in 79% by CT during screening tests. Rate of detection in retrospective analysis, after the site of the tumor had been known, were 73%, 93% and 87% respectively. Rate of detection was 92% by celiac arteriography and 98% by selective hepatic arteriography.
In 21 patients, who had the tumor under 3cm, the rate was 32% for scintigraphy, 74% for ultrasonography and 65% for CT during screening, whereas it was 58%, 84% and 75% retrospectively. By celiac arteriography, it was 85%, and by hepatic arteriography, 95%.
Rate of detection of small hepatomas in screening tests differed remarkably from that in retrospective analysis. No single method of imaging can disclose reliably the presense of small hepatoma, therefore more than one method should be used in screening.

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Two cases of ticlopidin hydrochloride induced hepatic injury

Kazumichi MOTEGI, Shoji YAMADA, Seiji SAKURAI, Takeshi TAKEHARA, Takea ...

1985 Volume 26 Issue 9 Pages 1224-1228
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1224

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Two cases of ticlopidine induced hepatic injury were presented.
Case I: A 70-year-old man was admitted to a hospital because of jaundice after administration of ticlopidine, 300mg/day for one week. Laboratory data was follows, GOT 32mu/ml, GPT 63mu/ml, T. Chol. 116mg/dl, T. Protein 6.4g/dl and so on. Ticlopidine induced hepatic injury was diagnosed by LST. Liver biopsy specimens showed the hepatocellular damage with cholestasis.
Case 2: a 80-year-old woman was admitted to a hospital because of cerebral infarction. She was poineted out hypertransaminasemia after administration of ticlopidine, 300mg/day for one month. 548% on LST for ticlopidine was positive.
Recently, the incidence of application for anti-platelet agents has been increasing associated with increasing of adult diseases. It is necessary for us to consider the presence of hepatic injury when we administrate the anti-platelet agents.

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A case of lupoid hepatitis observed from acute hepatitis to hepatocellular carcinoma for 7 years

Toshio TANABE, Satoaki MIMA, Teruki HANEW, Hitoshi Mizuo, Hiroshi KANA ...

1985 Volume 26 Issue 9 Pages 1229-1235
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1229

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A case of lupoid hepatitis whose initial symptom was of acute hepatitis and complicated heaptocellular carcinoma 7 yars later of protracted disease A case of lupoid hepatitis whose initial symptom was of acute hepatitis and complicated heaptocellular carcinoma 7 yars later of protracted disease course was described. The patient developed jaundice at the age of 16 and clinical evidence i.e. hypergammaglobulinemia (2.8g/dl), positive LE cells, ANF, SMA, remission by steroid therapy, supported the diagnosis of lupoid hepatitis.
Continued observations by peritoneoscopy and needle liver biopsy have been made throughout the entire course. Acute inflammatory change characterized by bridging necrosis, gradually proceeded to chronic active hepatitis with lobular reconstruction and to macronodular liver cirrhosis type.
7 years after onset and 2 years later of liver cirrhosis type progressed, hepatocellular carcinoma developed and several therapeutic trials were without success and the patient succumbed to liver insufficiency at the age of 25.
HBV markers have been negative throughout the course of the disease.

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A case of sarcomatoid hepatocellular carcinoma showing high fever

Masatoshi MIYAMOTO, Seiji TANOUE, Hisayuki ARIGA, Hitoshi KUWANA, Yasu ...

1985 Volume 26 Issue 9 Pages 1236-1241
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1236

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A 60-year-old male was admitted to the hospital with chief complaints of fever of 37-38°C, right hypochondrial pain and epigastric tumor. Although tenderness in the precordial region and tumor accompanied by a heat sensation were recognized, liver cirrhosis was denied by blood chemistry tests. Various tumor markers were negative, and no definite findings suggesting malignant tumor were obtained by image diagnoses using ultrasound, CT, abdominal angiography, etc. No positive findings were also obtained by ultrasonic cell aspiration, which was performed under the suspicious diagnosis of abscess. The surgical operation was done since the fever continued and the tumor in the precordial region became larger; however, it resulted in exploratory laparotomy because of notable adhesion between the hepatic lesion and surrounding organs. Pathological examinations of a para-aortic lymph node revealed anaplastic carcinoma. The patient died of cachexia and pneumonia one month later. Autopsy revealed a mostly necrotic tumor occupying a large area of liver. Histological diagnosis was hepatocellular carcinoma of sarcomatoid type.

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A case of biliary cystadenocarcinoma diagnosed by liver aspiration biopsy under ultrasonographic guidance

Tomohiro KATO, Hirofumi KOMORI, Shoko IWAI, Yasushi FUKUTOM, Hiroshi M ...

1985 Volume 26 Issue 9 Pages 1242-1247
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1242

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Biliary cystadenocarcinoma is a very rare disease. A 55-year-old woman was admitted to the hospital because of epigastric pain and vomiting. Physical examination revealed only slight hepatomegaly. Liver function test showed slight elevations of GOT, Al-P, GPT and LAP. CEA and AFP were within normal limits. Hepatic ultrasonography and computed tomography showed a small cyst with a septum and a few papillary processes in the left lobe. Liver aspiration biopsy under ultrasonographic guidance showed malignancy and, therefore, left lobectomy was performed. Histological examination revealed that the cyst was well differentiated papillary adenocarcinoma, 3.5×3.5×2.0cm in size, which was the smallest biliary cystadenocarcinoma ever reported. The postoperative course was satisfactory. She has been uneventfully rehabilitated.

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[title in Japanese]

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

1985 Volume 26 Issue 9 Pages 1248
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1248

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[title in Japanese]

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

1985 Volume 26 Issue 9 Pages 1249
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1249

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[title in Japanese]

[in Japanese], [in Japanese], [in Japanese], [in Japanese]

1985 Volume 26 Issue 9 Pages 1250
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1250

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[title in Japanese]

[in Japanese]

1985 Volume 26 Issue 9 Pages 1251
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1251

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[title in Japanese]

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

1985 Volume 26 Issue 9 Pages 1252
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1252

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[title in Japanese]

1985 Volume 26 Issue 9 Pages 1253-1292
Published: September 25, 1985
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.26.1253

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