Kanzo

A prospective cohort study of hepatitis B surface antigen carrier

Toshihiko IIJIMA, Masaji NAMBU, Izumi YOSHINO, Hiroshi JITSUKAWA, Kosh ...

1986 Volume 27 Issue 7 Pages 873-878
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.873

JOURNAL FREE ACCESS

Show abstractHide abstract

An investigation on the risk related development into primary liver cancer (PLC) in chronic hepatitis B surface antigen carrier state (HBsAg carrier) was made using a cohort of 32, 177 healthy male worker aged 40, 45 and 50 at the beginning of the study. The follow-up periods ranged from 4 to 10 years with average of 5.5 years. The causes of death were monitored from death certificantes.
The cases of HBsAg carrier were 495 (cohort 1) and HBsAg negative were 31, 682 (cohort 2). During the observation period, the deaths totalled 15 of cohort 1 and 370 of cohort 2. For all causes of the death, the expected mortality based on cohort 2 was 5.93, therefor the observed/expected (O/E) rate ratio was calculated at 2.5 (15 to 5.93). The O/E rate ratio was 36.4 (8 to 0.22) (p<0.01) for PLC, 1.1 (2 to 1.82) for the other malignant neoplasm, 9.5 (2 to 0.21) for liver cirrhosis and 1.7 (2 to 1.18) for cerebrovascular diseases.
The results of this present study based on internal control in large scale indicate that HBsAg carrier state is etiologically related to the development of PLC.

View full abstract

Download PDF (339K)
Immunohistochemical analysis of HLA class 1 antigens on hepatocytes in patients with chronic hepatitis B

Koji MANABE, Gotaro YAMADA, Ichinosuke HYODO, Takashi NISHIHARA, Hiroa ...

1986 Volume 27 Issue 7 Pages 879-884
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.879

JOURNAL FREE ACCESS

Show abstractHide abstract

In order to determine whether the expression of HLA class 1 antigens is related to the expression of hepatitis B virus (HBV)-associated antigens in the liver and the positivity of serum HBeAg/anti-HBe, HLA class 1 antigens on hepatocytes were studied in liver biopsies from 12 patients with chronic hepatitis B using immunoperoxidase method. Stronger staining of HLA class 1 antigens on hepatocytes was observed in patients without membranous HBsAg or HBcAg in hepatocytes than in patients with these HBV antigens. No relation was observed between the expression of HLA class 1 antigens on hepatocytes and the positivity of serum HBeAg/anti-HBe. These results suggest that HLA class 1 antigens on hepatocytes play an important role in the immune response against the HBV-infected hepatocytes.

View full abstract

Download PDF (1909K)
The study on the prevalence of hepatitis B virus (HBV) infection and the efficacy of HB vaccination in S orphanage

Naoto MARUYAMA

1986 Volume 27 Issue 7 Pages 885-894
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.885

JOURNAL FREE ACCESS

Show abstractHide abstract

A seroepidemiological investigation was performed on the prevalence of HBV infection and the efficacy of HB vaccination in S orphanage. Pre-vaccination study revealed a high incidence (10.0-21.4%) of e-antigen positive HBV carrier with an uniform subtype of adw and development to HBV carrier state in 2 children older than 10 years old, suggesting of the horizontal infection. HB vaccine was administered to those without any markers for HBV. The yearly HBV infection rate was significantly decreased from 21.2% (before vaccination period) to 5.7% (2 of 35) in the first year and then to 2.9% (1 of 35) in the second year after vaccination. Of these 3 children with HBV infection, 2 were not vaccinated and 1 showed a poor response to vaccination. These data suggest the effectiveness of vaccination in preventing the horizontal infection of HBV and the necessity of booster vaccination for the low or no responder.

View full abstract

Download PDF (1307K)
Protein kinase C in regenerating rat liver

Yasuyuki OKAMOTO, Hiroshi NAKANO, Kimio NISHIMURA

1986 Volume 27 Issue 7 Pages 895-899
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.895

JOURNAL FREE ACCESS

Show abstractHide abstract

Serial changes of protein kinase C (PK-C) activity and 12-o-tetradecanoyl phorbol-13-acetate (TPA) binding activity in regenerating rat liver were studied with special reference to DNA synthesis. Effect of TPA administration on DNA synthesis was also studied. DNA synthesis did not increase at 12 hours and reached a peak value at 24 hours after partial hepatectomy (HPX). PK-C activity in soluble fraction of regenerating liver decreased at 24 hours (p<0.01) and increased at 48 hours (p<0.05) after HPX. TPA binding activity in soluble fraction increased at 48 hours (p<0.05), but no significant change of TPA binding activity was observed in precipitate fraction of the partial hepatectomized liver. Intraperitoneal administration of TPA at the time of HPX caused a significant reduction of DNA synthesis at 24 hours (p<0.01) after HPX.
These observations suggest that PK-C may have an inhibitory effect on the regeneration of rat liver.

View full abstract

Download PDF (310K)
Diagnosis and treatment of small hepatocellular carcinoma-Study of 60 cases-

Genjiro YAMAGUCHI, Masahide ABE, Kimihiro SHIRAISHI, Takafumi FUJIMOTO ...

1986 Volume 27 Issue 7 Pages 900-907
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.900

JOURNAL FREE ACCESS

Show abstractHide abstract

Sixty patients with hepatocellular carcinoma (HCC), smaller than 3cm in diameter, were studied. They were 43 males and 17 females. The mean age of them was 58.4. HBs-Ag was positive in 15% of them. Serum α-fetoprotein was normal in 34% and above 200 ng/ml in 36%. 37 cases (62%) were detected using ultrasonography (US) for high risk group of HCC, thus US seemed very useful to detect small HCC, The relationship between the therapy methods and their survival rates was as follows: (1) In 16 patients with "resection", the survival rates in one year, two years and three years were 75%, 60% and 51% respectively; (2) In 25 patients treated with TAE, 94%, 72%, 45%; (3) In 9 patients treated with arterial one shot injection of anticancer drugs (one shot), 58%, 23%, -; (4) In 10 patients with systemic chemotherapy, 70%, 52%, -, The survival rate of TAE was significantly higher than that of "one shot" (p<0.05).

View full abstract

Download PDF (1440K)
Effect of histamine H₂-receptor antagonists on the total hepatic blood flow in patients with chronic liver diseases

Kouichi AKAMATSU, Souichiro MIYAUCHI, Kenya MURASE, Yuji WATANABE, Nob ...

1986 Volume 27 Issue 7 Pages 908-914
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.908

JOURNAL FREE ACCESS

Show abstractHide abstract

The effect of histamine H₂-receptor antagonists -cimetidine, ranitidine and famotidine- on the total hepatic blood flow were studied by determining the disappearance-rate of ¹³³Xe from the liver. Hepatic blood-flow readings were obtained from the semilog replots of the isotope disappearance curves according to the calculation used by J.R. Rees (1966). Seven mCi of ¹³³Xe was administered through a catheter in the portal vein or in the common hepatic artery. Twenty-three patients were subjected to the measurement of hepatic blood flow; 5 hospital controls (2 cholelithiasis, 1 idiopathic portal hypertension, 1 cholangioma and 1 gastric ulcer), 4 patients with chronic hepatitis (1 hepatocellular carcinoma) and 14 patients with liver cirrhosis (8 hepatocellular carcinoma). Total hepatic blood flow in hospital controls, in chronic hepatitis and liver cirrhosis was 85±22.2ml/100g/min, 78.4±18.3ml/100g/min and 44.3±13.1ml/100g/min, respectively. When total hepatic blood flow 60 minutes after an intravenous administration of each histamine H₂-receptor antagonist was compared with the value before dministration the latter was found to be slightly decreased; 6mg/kg of cimetidine, 1.5mg/kg of ranitidine and 0.3mg/kg of famotidine decreased heaptic blood flow by 4.0±3.5%, 10.1±4.2% and 3.8±5.6% respectively.
These changes were not statistically significant, but when six patients were administered with all of the histamine H₂-receptors with a one- or two-day interval between administration of each one, a significant decrease of 11% was observed after the administration of ranitidine.

View full abstract

Download PDF (746K)
Portal hemodynamics in cirrhosis

Kunihiko OHNISHI, Masayuki SAITO, [in Japanese], Nobuyoshi CHIN, [in J ...

1986 Volume 27 Issue 7 Pages 915-923
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.915

JOURNAL FREE ACCESS

Show abstractHide abstract

To define the respective role of portal venous flow and of portal vascular resistance in the initiation and maintenace of portal hypertension, 49 cases of cirrhosis were studied by portal and hepatic vein catheterization in comparison with 21 normal subjects and 5 patients with chronic persistent hepatitis. Portal venous flow, splenic venous flow, portal vascular resistance and intrahepatic shunt index were measured. In conclusion: The increase of portal vascular resistance as fibrosis and nodule formation, is primarily responsible for the beginning portal hypertension and its perpetuation. Subsequently, in some cases an increase of portal venous flow partly due to spillover of the increased splenic venous flow, a natural outcome of hyperplasia of the spleen plays a role in the maintenace of portal hypertension despite the reduction of portal vascular resistance following development of intrahepatic shunt.

View full abstract

Download PDF (893K)
Enumeration of I region associated (Ia) antigen bearing monocytes in chronic liver diseases

Yoshimasa YAMASHITA

1986 Volume 27 Issue 7 Pages 924-933
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.924

JOURNAL FREE ACCESS

Show abstractHide abstract

The number of I region associated (Ia) antigen bearing monocytes in patients with chronic liver diseases was enumerated by using monoclonal antibody. The mean value of Ia antigen bearing monocytes in chronic inactive hepatitis (CIH) and chronic active hepatitis (CAH) was not different from control subjects. However, the value of chronic hepatitis with sublobular necrosis (CHcSN), liver cirrhosis (LC) and hepatocellular carcinoma (HCC) was proved to be decreased markedly compared with control subjects (p<0.005).
During corticosteroid treatment, the number of Ia antigen bearing monocytes was decreased. But, by either interferon-α or interferon-β injection, the number was not affected. These results suggest that patients with CHcSN, LC and HCC are found to be in decreased state of antigen presenting cells, followed with poor immune response. The expression of Ia antigen was suppressed by corticosteroid, but it was not affected by exogenous interferon.

View full abstract

Download PDF (518K)
Endotoxemia in liver diseases: Detection by a quantitative assay using chromogenic substrate with perchloric acid pretreatment

Yoshiaki YAJIMA

1986 Volume 27 Issue 7 Pages 934-944
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.934

JOURNAL FREE ACCESS

Show abstractHide abstract

With a quantitative blood endotoxin assay using chromogenic substrate with a perchloric acid pretreatment (PCA-LCT), endotoxin in plasma and ascitic fluid of various liver diseases was investigated. With PCA-LCT, recovery of added endotoxin in human plasma was nearly 90%, as evidenced by an intra- and interassay coefficient of variation of 5.7% and 11%, respectively. Because the recovery of endotoxin was not affected in severely icteric plasma, PCA-LCT proved to be applicable to patients with liver diseases where various degree of jaundice exist. In none of the plasmas from patients with chronic hepatitis, acute hepatitis without hepatic failure or liver cirrhosis without ascites did the endotoxin level exceed the normal range of less than 5 pg/ml. With the presence of ascites, however, endotoxemia became detectable, but at low levels and not in all cases. At the stage of hepatic failure complicated with renal failure or disseminated intravascular coagulation, endotoxemia was more frequent and endotoxin concentration greater. It is uncertain, at present, whether endotoxemia itself is deteriorating factor in hepatic failure or is merely concomitant phenomenon resulting from Kupffer cell failure.

View full abstract

Download PDF (613K)
A newly recognized hepatic inclusion body, "ring body"

significance of its occurence

Ryuzo HORIUCH, Toshikazu UCHIDA, Toshio SHIKATA

1986 Volume 27 Issue 7 Pages 945-952
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.945

JOURNAL FREE ACCESS

Show abstractHide abstract

Recently, we discovered new intracytoplasmic inclusion bodies in hepatocytes, Kupffer cells and macrophages. The bodies were not recognized by H & E stain but were distinctly stained in a ring-like structure (thus "ring bodies") by Victoria blue or aldehyde-fuchsin stain. They seemed to contain phospholipid and were related to lysozomes from the results of many histochemical stainings and positive acid phospahatase activity. Electron-microscopically, the "ring bodies" might correspond to markedly enlarged and vacuolic lipofusucin-like structures. A study of frequency of "ring body" in 650 cases of liver biopsies was done. The results were as follows: chronic hepatitis non-A/non-B (NANB-CH) 63/191 (33%), B-CH 6/129 (5%), alcoholic type liver disease (ALD) 32/111 (29%), ALD+NANB-CH 11/23 (48%), ALD+B-CH 1/4 (25%), primary biliary cirrhosis 0/43 (0%), lupoid hepatitis 0/17 (0%), others 2/75 (3%). In 47 cases of post-transfusion NANB-CH, "ring bodies" were found in 27 cases (57%). In 57 cases of acute hepatitis, "ring bodies" were found in only three cases (5%). These three positive cases were post-transfusion hepatitis (NANB), all of which were clinically suspected to become chronic. In conclusion, "ring body" is a newly-discovered inclusion body which may be utilized as a histological marker of NANB-CH, ALD and chronicity of NANB-AH.

View full abstract

Download PDF (3874K)
A case of chronic active hepatitis associated with progressive systemic sclerosis and Sjögren syndrome

Masahiro UEHARA, Shoji YAMADA, Takeaki NAGAMINE, Jiro TAKEZAWA, Hirosh ...

1986 Volume 27 Issue 7 Pages 953-958
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.953

JOURNAL FREE ACCESS

Show abstractHide abstract

A case of chronic active hepatitis associated with progressive systemic sclerosis (PSS) and Sjogren syndrome (SjS) was reported. A 60 year-old house wife admitted to our hospital complaining of dysphagia, exertional dyspnea and liver dysfunction. On admission, dry mouth, short sublingual frenulum, sclerodactylia, Raynaud phenomenon, muscle weakness of her hands and Velcro rales in lower chest were present. Laboratory studies revealed elevated serum transaminase, positive RA test, increased γ-globulin level, positive anti-nuclear antibody (1280×), positive anti-ENA antibody (256, 000×). Shirmer test and Gum test were both positive. Upper gastro-intestinal examination and manometric test demonstrated that esophageal and duodenal peristalsis was decreased. Histologically, arm skin showed PSS, salivary gland showed SjS and liver showed chronic active hepatitis with lobular disorganization. It was supposed that the cause of chronic hepatitis was related to the same immunological abnormality as PSS and SjS.

View full abstract

Download PDF (2439K)
A case of extra-hepatic portal venous obstruction diagnosed by magnetic resonance imaging

Fuminori MORIYASU, Osamu NISHIDA, Nobuyuki BAN, Takefumi NAKAMURA, Yas ...

1986 Volume 27 Issue 7 Pages 959-964
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.959

JOURNAL FREE ACCESS

Show abstractHide abstract

The patient was a 13-year-old male with a history of infection of the umbilical cord and operations for esophageal varices. The portal vein could not be seen on the multi-directional and multi-slice images obtained by magnetic resonance imaging (MRI). Obstruction of the main portal vein was suspected from the image obtained by scanning along the hepato-duodenal ligament. The collateral pathways were clearly visible on the images obtained using a short repetition time. These MRI findings were compatible with the angiographic findings which made the diagnosis, extra-hepatic portal obstruction, possible. The MRI imaging, which is non-invasive and provides information on blood flow, is useful in diagnosis of hemodynamic abnormalities, as in this case.

View full abstract

Download PDF (1954K)
A case report of 17-year old male with ornithine transcarbamylase deficiency

Ryukichi KUMASHIRO, Takahiro AKASHI, Kazuhisa GONDO, Sadataka INUZUKA, ...

1986 Volume 27 Issue 7 Pages 965-970
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.965

JOURNAL FREE ACCESS

Show abstractHide abstract

A 17-year old male, who had habitual headache and an avidity with beans, presented a sudden consciousness disturbance which lasted for three days until death. Labolatory data showed several changes including hyperammonemia (603μg/dl), marked elevation of plasma glutamine and glutamic acid and 2000 fold increase of urinary excretion of orotic acid. Liver histology showed a fatty degeneration of hepatocytes without a marked change in mitochondria. These findings are compatible with the ornithine transcarbamylase deficiency. And this case was thought to be a socalled "variant" type of ornithine transcarbamylase deficiency because this disease is usually inherited by X-linked dominant mode and it is very rare for male patient to survive to be 17 years of age.

View full abstract

Download PDF (1513K)
A case of idiopathic portal hypertension associated with mesenteric vein-left pulmonary vein shunt

Shigeo SUGANO, Katsunori AIKAWA, Koji ISHII, Hideo MIZUYOSHI, Kenichir ...

1986 Volume 27 Issue 7 Pages 971-975
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.971

JOURNAL FREE ACCESS

Show abstractHide abstract

A 56 years-Old female was admitted to the Toho University Hospital because of hepatic encephalopathy. She had been known to have idiopathic portal hypertension and had both esophageal transection and splenectomy about 13 years prior to the admission. Chest X-ray examination showed a small tumor like shadow on the left lower field. Laboratory data indicated a increased plasma ammonia level and a dicreased arterial oxygen concentration. Trans ileocolic vein portography showed mesenteric vein-left pulmonary vein anastomosis of moderate size. Autopsy revealed that this shunt vein was developed from small vessels in the post-operative adherent tissues. The sudden death was due to superior mesenteric artery thrombosis. The anastomosis seemed to be the cause of her encephalopathy.

View full abstract

Download PDF (1374K)
Hepatic cirrhosis complicating primary pulmonary hypertension Report of a case and a review of cases reported in Japan

Takumi ARAMAKI, Nagaharu FUKUMA, Takayuki TAKITA, Hitoshi TSUTSUI, Hid ...

1986 Volume 27 Issue 7 Pages 976-981
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.976

JOURNAL FREE ACCESS

Show abstractHide abstract

A case of 43-year-old female who was noted to have heart murmur during the course of chronic liver disease and was found to have the clinical, hemodymamic, and histological features of both hepatic cirrhosis and primary pulmonary hypertension (PPH) was reported. We have reviewed 30 documented cases of hepatic diseases complicating pulmonary hypertension reported in Japanese literature.
They consist of 19 cases of cirrhosis, including one with coexisting hepatoma, 6 of idiopathic portal hypertension (IPH), 4 of lupoid hepatitis and one of PBC. All patients but 7 with cirrhosis were female. In most cases liver disease preceded with the idagnosis of pulmonary hypertension. Pulmonary artery pressure was lower compared with ordinary non-complicating PPH. The pathogenesis of the complication, mainly as to relationship between IPH and PPH, was discussed from the immunological viewpoint.

View full abstract

Download PDF (1038K)
Malignant hemangiopericytoma associated with huge metastases in the liver and hypoglycemia -A case report-

Naomichi ARIMASA, Toshinari KOBAYASHI, Jishu ITO, Kazuyoshi YOSHIOKA, ...

1986 Volume 27 Issue 7 Pages 982-988
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.982

JOURNAL FREE ACCESS

Show abstractHide abstract

A case of malignant hemangiopericytoma in the liver associated with hypoglycemia is reported. Multiple nodules (up to 10×14cm) of the neoplasm were detected in both lobes of the liver. The tumors were considered to be metastatic from the right maxillary sinus. Frequent episodes of hypoglycemia disappeared after extirpation of the tumors in Febnuary, 1979. Four years after the operation, the recurrence and the metastasis to the lungs occurred when the patient began to notice again the symptoms of hypoglycemia. The patient suddenly died on December 3, 1984, though he had been in relatively good condition without any specific treatment. It was postulated that the hypoglycemia of the present case was caused by an increased utilization of glucose, which was induced by the receptor-reactive insulin-like substance (tentative) produced by hemangiopericytomas of the liver. It is probable, however, that the increased activities of glycolytic enzymes in both the tumor and liver tissues which were demonstrated in the present case accelerated the hypoglycemia.

View full abstract

Download PDF (1786K)
Monoclonal antibodies against human aldolase B

Masahiro ASAKA, Toshio KIMURA, Naoyuki HAYASHISHITA, Masao SAITO, Tamo ...

1986 Volume 27 Issue 7 Pages 989-990
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.989

JOURNAL FREE ACCESS

Download PDF (630K)
[title in Japanese]

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

1986 Volume 27 Issue 7 Pages 991
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.991

JOURNAL FREE ACCESS

Download PDF (57K)
[title in Japanese]

[in Japanese], [in Japanese]

1986 Volume 27 Issue 7 Pages 992
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.992

JOURNAL FREE ACCESS

Download PDF (856K)
[title in Japanese]

1986 Volume 27 Issue 7 Pages 993-1041
Published: July 25, 1986
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.27.993

JOURNAL FREE ACCESS

Download PDF (4650K)