Kanzo

Clinical significance of the circulating concentration of HBeAg and its subfraction in chronic hepatitis B virus carriers

Shuichi WADA

1986 Volume 27 Issue 3 Pages 291-302
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.291

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Clicical significance of circulating concentration of HBeAg and its subfraction precipitated at 36.5% saturation with ammonium sulfate (IgG-bound "large" HBeAg) was studied in HBeAg positive chronic HBV carriers. Serum HBeAg concentration was measured by enzyme immunoassay using monoclonal antibodies to HBeAg. Serum HBeAg concentration was significantlyhigher in asymptomatic HBV carriers (AsC) than in patients with chronic liver diseases (CLD). The ratio of large HBeAg in sera of AsC was significantly lower than in those of patients with CLD. Furthermore in AsC, HBeAg concentration decreased and the ratio of large HBeAg increased prominently with the development of acute liver injury. The sequential changes of HBeAg concentration ran in parallel with those of HBV specific DNA-polymerase activity in interferon treated cases, though with some time difference. These results indicate that quantitative assay of HBeAg and its subfraction can be useful for the evaluation of the stage and prognosis of chronic HBV infection.

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Time trends of HBeAg prevalence rate

Hideaki TSUKUMA, Isaburo FUJIMOTO, Akira OSHIMA, Hajime YAMANO, Masayo ...

1986 Volume 27 Issue 3 Pages 303-308
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.303

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In order to examine the time trends of HBeAg prevalence rate among HBV carriers in Japan, we analyzed the data on HBeAg and HBeAb of HBsAg positive volunteer blood donors (23, 560 males, and 8, 659 females) at the Osaka Red Cross Blood Center between Jan. 1977 and Mar. 1984.
Age-specific prevalence rates of HBeAg among them seemed to decrease year by year for both sexes, especially in the teen-agers and the twenties.
The prevalence rates of HBeAg continued to decrease with age, but at any given age those rates were lower for the later than for the earlier birth-cohorts.
These findings suggest that HBeAg prevalence rate among HBV carriers Will continue to decrease in Japan.

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Identification of lymphocyte subsets in chimpanzee livers with non-A, non-B acute hepatitis

Using serial needle biopsies

Masahiko SUGITANI

1986 Volume 27 Issue 3 Pages 309-316
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.309

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Serial change of the intrahepatic location of lymphocyte subsets, as defined by an indirect immunoperoxidase method using the monoclonal antibodies of Leu series (Leu 1, Leu 2a, Leu 3a, Leu 7, Leu 12), was studied in 3 chimpanzees with non-A, non-B acute hepatitis.
The lymphocytic infiltration occurred both in the portal tracts and within the lobules at about 3 weeks, increased gradually, reached the peak level at around 10 weeks when serum transaminases were most highly elevated, and continued more than 20 weeks after inoculation of the serum with strain F. The majority of infiltrating lymphocytes were always Leu 1 (pan T)-positive. The numbers of Leu 3a (helper/inducer T)-positive cells were almost equal to or slightly more than those of Leu 2a (cytotoxic/suppressor T)-positive cells in the portal tracts and within the lobules. However, areas of focal necrosis had more Leu 2a-positive cells than Leu 3a-positiveones. Leu 7 (NK/K)-positive cells were not observed through all the phases, and Leu 12 (B)-positive cells were always few in the portal areas.
By electronmicroscopy, the feature of attachment of a lymphocyte with a hepatocyte containing tubular structures was observed.
These results suggest that T lymphocytes play an important role on the pathogenesis of hepatocytolysis in non-A, non-B acute hepatitis of chimpanzees.

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Prognostic parameters indicating progression from chronic hepatitis to liver cirrhosis

Ryoji TANAKA, Tatsuya ITOSHIMA, Masahiro KITADAI, Minoru UKIDA, Toshio ...

1986 Volume 27 Issue 3 Pages 317-323
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.317

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Clinical, biochemical, peritoneoscopic, histological and therapeutic features important for progression of chronic hepatitis (CH) to liver cirrhosis (LC) were evaluated in 177 CH patients by the life table method. The cumulative progression curve of Cox's multiregression life table method resembled that of Kaplan-Meier's method and 50% progression time was 10.2 years. Parameters important for the progression were histological classification (risk ratio, 5.4), HBsAg (3.0), code number of peritoneoscopy (2.5) and indocyanine green plasma disappearance rate (1.9) in the order of importance. Patients with chronic aggressive hepatitis; activity severe (CAH2B) progressed with a risk ratio of 5.4 times of those with chronic persistent hepatitis (CPH). Corticosteroid therapy did not stop the progression. Estimated 50% progression time of cases with CAH2B, 300's code number, positive HBsAg, chronic aggressive hepatitis; activity moderate (CAH2A), 200's, negative HBsAg and CPH, were 5.0, 5.2, 5.4, 7.8, 11.2, 14.1 and more than 20 years by Cox's method.

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Effect of glucagon and dibutyryl cyclic AMP on carbohydrate metabolism in rats with D-galactosamine induced hepatitis

Eiichi TAKEZAKI, Yukio MATSUO, Shoichi SUEMORI, Yoshihiro IKEMOTO, Yas ...

1986 Volume 27 Issue 3 Pages 324-331
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.324

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Comparative study of the effect of glucagon and dibutyryl cyclic AMP (DB cAMP) on carbohydrate metabolism was investigated in rats with D-galactosamine (GalN) induced hepatitis. After injection of glucagon the increase of blood pyruvate, free fatty acid, glucose concentration and liver glucose-6-phosphatase (G6Pase) activity was observed but not blood lactate concentration. The increase of blood pyruvate, lactate, free fatty acid, glucose concentration and G6Pase activity was observed after injection of DB cAMP.
The higher increase of blood pyruvate, lactate, glucose concentration and liver G6Pase activity was observed after injection of DB cAMP than glucagon, but the lower increase of free fatty acid concentration after injection of DB cAMP, suggesting the different mechanism between glucagon and DB cAMP on carbohydrate metabolism.
Conclusively it was suggested that DB cAMP was more effective rather than glucagon on carbohydrate metabolism, especially to energy metabolism.

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The effects of cytochalasin B (CB) on the biliary secretion of Na-fluorescein in primary cultured rat hepatocytes

Masahiro TOMONO, Sumio WATANABE, Hiroyuki KURODA

1986 Volume 27 Issue 3 Pages 332-335
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.332

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We have studied on the morphological changes and the biliary secretion of Na-fluorescein using doublet cells in primary cultured rat hepatocytes with or without cytochalasin B (CB) treatment. Bile canaliculi of doublet cells have been widely opened by the CB treatment during the observation. Na-fluorescein appeared in bile canaliculi of CB treated doublet cells after 1 minute exposure of Na-fluorescein, though excretion was not observed in non-treated cells. The number of bile canaliculus which showed the pooling of Na-fluorescein significantly increased in CB treated doublet cells than that in non-treated, during the observation. From these results it was concluded that CB accelerated the Na-fluorescein secretion into bile canaliculi.

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Studies on the abnormal sialyltransferase isoenzyme activity in tumor-bearing rats

Yushiro WATANABE, Shoichi SHIMIZU, Hitoshi OKADA, Shoji FUKUI, Shinjir ...

1986 Volume 27 Issue 3 Pages 336-341
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.336

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The abnormal serum sialyltransferase isoenzyme acitvity derived from the tumor tissue was presented. In rats at two weeks after transplantation by ascites hepatoma cells (AH109A), serum sialyltransferase activity elevated remarkably. The analysis of this serum by isoelectric focusing revealed that this serum contained the abnormal sialyltransferase isoenzyme activity at pI 7.4-8.2 range. Thus, we prepared the subcellular fractions of the host liver and tumor tissue at twoweeks after transplantation, in order to elucidate the origin of this isoenzyme.
The analysis of these fractions by isoelectric focusing revealed that only soluble fraction of the tumor tissue has contained an abnormal sialyltransferase isoenzyme activity at pI ranged from 7.0 to 8.0. These results showed that the sialyltransferase isoenzyme activity in serum was derived from the tumor tissue.

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A case of alkaline phosphatase producing hepatocellular carcinoma

Takashi ISHIKAWA, Hiromu AOYAMA, Shiro IINO, Toshikazu UCHIDA, Nobuyuk ...

1986 Volume 27 Issue 3 Pages 342-346
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.342

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58 yr-old man was admitted because of mass in the liver. On admission, the serum level ofalkaline phosphatase was markedly increased to 68.2 KAU, but serum total bilirubin and γ-GTP levels were normal. The tumor was diagnosed as hepatocellular carcinoma (HCC) by angiography. After the transcatheter arterial embolization of the tumor, both the serum alkaline phosphatase and alpha-fetoprotein levels extremely decreased. But the both levels increased again later, and the patient died because of the rupture of HCC. Histologically, the tumor was well differentiated hepatocellular carcinoma (pseudoglandular type) without cirrhosis. Analysis of the serum alkaline phosphatase isoenzymes by polyacrylamide gel disc electrophoresis showed the presence of variant alkaline phosphatase (Warnock). The staining of the cancerous tissue by the indirect immunoperoxidase method using polyclonal anti-placental alkaline phosphatase antibody revealed positive staining in the cytoplasm of the tumor cells.

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A case of liver cell adenoma diagnosed in the last trimester of the pregnancy

Tadanobu CHINZEI, Shinichirou MATSUMOTO, Kazuyuki NISHIDA, Mitsuo MAED ...

1986 Volume 27 Issue 3 Pages 347-353
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.347

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A 22 year old women, para 0, who never took oral contraceptive, suddenly developed upper abdominal pain. Abdominal US disclosed a huge mass echo in the right lobe of the liver. After Cesarian section, Abdominal CT and angiography revealed a large tumor in the liver. AFP was 404ng/ml and GOT was 349 units. Needle liver biopsy showed findings compatible with liver cell adenoma. Exploration and right lobe hepatectomy demonstrated a huge encapsultated tumor with focal necrosis and hemorrhage, mesuring 14×10×6cm. Histologically, tumor was composed of vacuolated and monotonous hepatic cells without portal tract, which are characteristic features of liver cell adenoma. Increasing numbers of liver cell adenoma in young women of childbearing age and association of use of oral contraceptive have been reported in abroads. In Japan, few cases of liver cell adenoma had been reported and they did not show any relation to oral contraceptive. Our case may suggest some relation between estrogen-progesteron balance and initiation or promotion of liver cell adenoma.

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A case of hepatocellular carcinoma of pseudograndular type visualized as the hyperechoic pattern on ultrasonography

Atsushi INAYOSHI, Kenji YAMASAKI, Masakazu TOYONAGA, Toshihiko HIRATA, ...

1986 Volume 27 Issue 3 Pages 354-358
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.354

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A case of hepatocellular carcinoma with pseudograndular proliferation showed hyperechoic pattem in ultrasonogram was reported.
A 71-year-old male was admitted to our hospital with a complaint of abdominal pain in the right upper quadrant. Ultrasonogram revealed a hyperechoic mass about 6.7cm×6.2cm in the right posterior segment of the liver. At surgery, a right hepatectomy was performed and the resected liver was examined histopathologically. The pathologic diagnosis was hepatocellular carcinoma of Edmondson Gr. II without cirrhosis, and diffuse pseudograndular proliferation in the tumor was visualized.
It had been reported that the hyperechoic area in hepatocellular carcinoma reflected nonliquefactive necrosis, fatty metamorphosis and severe sinusoidal dilatation.
We suggest that a site of extensive pseudograndular proliferation should be also visualized as a hyperechoic area ultrasonographically.

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A case of hepatocellular carcinoma presenting regression of bone Metastases in the course of transcatheter arterial embolization therapy

Kenji IKEDA, Hiromitsu KUMADA, Atsuko YAMAMOTO, [in Japanese], Naoya M ...

1986 Volume 27 Issue 3 Pages 359-365
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.359

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A 53-year-old male was admitted for the therapy of multiple hepatocellular carcinoma on March 1983. Serum alpha-fetoprotein (AFP) was 430ng/ml. Though transcatheter arterial embolization (TAE) was performed repeatedly, AFP didn't become normal. Multiple bone metastases in ileum, vartebra, and ribs were physically manifested and bone pain developed on November. Bone metastases were ascertained by roentgenograms, bone scintigram, and gallium scintigram. But treatment was continued against liver tumor by TAE and intraarterial antitumor agents thereafter.
After steroid therapy followed by intraarterial Mitomycin C administration on August 1984, all bone tumors began to regress and bone pain completely dissappeared. Serum AFP returned to normal for the first time on September. Metastatic iliac bone biopsy showed no viable tumor cells but granulation tissue and newly appearing osteoblasts.
Though prominent regression of hepatocellular carcinoma as well as bone metastases were thought to be due to the host immunity against the tumor, no characteristic immunological findings were obtained.

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Advanced hepatocellular carcinoma with tumor thrombus in the right portal vein and multiple intra-hepatic metastasis-a case report of effective combined therapy with hepatic resection and transcatherter arterial embolization-

Shoji NAKAMORI, Shingi IMAOKA, Yo SASAKI, Hiroaki OHIGASHI, Osamu ISHI ...

1986 Volume 27 Issue 3 Pages 366-372
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.366

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A 63-year-old male patient sufferied from advanced hepatocellular carcinoma with tumor thrombus in the right portal vein and multiple intra-hepatic metastasis. He was treated effectively with hepatic resection, as a reduction surgery, and pre-and postoperative transcatheter arterial embolization (TAE). After 2 years from admission, he died of hepatic failure without no evidence of tumor relapse.
It is concluded that this aggressive combined therapy is one of the effective treatments for advanced hepatocellular carcinoma with portal thrombus and intra-hepatic metastasis.

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A case of focal fatty change of the liver associated with gastric carcinoma

Tomonori ISHIOKA, Hidetoshi SHIOTSU, Noriyuki KUWABARA, Yoshiro FUKUDA ...

1986 Volume 27 Issue 3 Pages 373-376
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.373

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A 39-year-old woman with focal fatty change of the liver was found with ultrasonogram and CT scan. She was performed partial resection of right hepatic lobe at the same time when subtotal gastrectomy was done due to early gastric carcinoma.
Hepatic nodle was a 2.5×2.3×1.7cm sized white yellowish subcapusular lesion. The nodule was sharply defined but showed irregular border without capsule formation and compressible growth. The nodule had localized prominant fatty metamorphosis and no fatty change in surrounding hepatocytes. The intrahepatic bile buct was not found in the nodule while relative large vessels exsited. So, this nodule was seemed to be a tumor lesion. But, it revealed trabecular pattern without cellular atipism, globular hyaline bodies and decreased reticuline fiberin the nodule.
Therefore, we diagnosed that this nodule was a focal fatty change of the liver.

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Effect of ling-term double filtration plasmapheresis for a patient with primary biliary cirrhosis

Yukitoki IKEHARA, Tsunehisa KAWASAKI, Hiroshi NAKAYASHIKI, Yoshihiro F ...

1986 Volume 27 Issue 3 Pages 377-382
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.377

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This report describes the effectiveness of repeated plasmapheresis treatment on primary biliary cirrhosis (PBC) in the case of a 41-year-old female patient who was afflicted with this disease and was treated over a period of two years.
During this period of plasmapheresis therapy, levels of immunoglobulin (IgG, IgA, IgM), GOT, Al-P hardly changed, but the bilirubin level decreased. Titres of antimitochondrial antibodies, thyroid test and microsome test as well as the levels of circulating immune complexes were not remarkably changed in spite of slight fluctuation.
However, pruritus and Raynaud's phenomenon disappeared and T-bilirubin decreased. Since, T-bilirubin concentration was decreased and antibodies as well as ciculating immune complexes were eliminated by double filtration plasmapheresis, this therapy might play a role in the prevention of PBC progression. Double filtration plasmapheresis is an efficient and safe therapeutic strategy for PBC; it decreases the use of Albumin and eliminates the need for fresh frozen plasma as well as hospitalization.

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A case of SLE associated with idiopathic portal hypertension and pulmonary hypertension

Hiroki HASUI, Toshikazu UCHIDA, Masashi YAGASAKI, Shunji HAYASHI, Tosh ...

1986 Volume 27 Issue 3 Pages 383-389
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.383

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A 14-year-old girl was admitted to the hospital complaining of arthraligia, butterfly rash of the face and fever. As anti-nuclear antibody and LE cell test were positive, she was diagnosed as SLE and was administered predonine. At operation of complicated peptic ulcers, she was noticed to have portal hypertension and then she underwent a splenectomy. Histology of the wedgebiopsied liver disclosed portal sclerosis with a preserved lobular structure, which was consistent with idiopathic portal hypertension.
Ten months after the operation, she began to complain of dyspnea on effort and clinical data showed pulmonary hypertension.
Despite of drug therapy, pulmonary hypertension progressed rapidly and she died 2 years and 6 months after the onset of symptome.
Autopsy findings of the lung disclosed hypertensive changes of pulmonary vessels but no parenchymal changes or arterial thromboembolism. A possibility is raised that immunological abnormlities played a role on an etiology of both idiopathic portal hypertension and pulmonary hypertension.

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[title in Japanese]

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

1986 Volume 27 Issue 3 Pages 390
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.390

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[title in Japanese]

[in Japanese]

1986 Volume 27 Issue 3 Pages 391
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.391

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[title in Japanese]

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

1986 Volume 27 Issue 3 Pages 392
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.392

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[title in Japanese]

1986 Volume 27 Issue 3 Pages 393-408
Published: March 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.393

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