Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 29, Issue 10
Displaying 1-19 of 19 articles from this issue
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  • Clinical significance of IgA anti-HBc in acute and chronic infection with hepatitis B virus
    Yoshiki MIYAZKI
    1988 Volume 29 Issue 10 Pages 1319-1329
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1319
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    The clinical significance of IgA anti-HBc was investigated by enzyme-immunoassay using monoclonal antibody in the sera from 6 patients with acute hepatitis type B (AH) and 100 chronic HBV carriers. The titers of anti-HBc such as IgA, IgA1, IgA2 and sIgA classes were significantly higher in the sera of AH and chronic liver disease than those in the sera of AsC. In the clinical course, the titers of IgA anti-HBc became higher when transaminase was elevated. Inversely, as transaminase was lowered, the titer of sIgA anti-HBc decreased most rapidly, but the titers of IgA and IgA1 anti-HBc showed a tendency to remain at a high level. IgA, IgA1 and IgA2 anti-HBc, especially IgA2 anti-HBc, were best correlated with ZTT, while sIgA anti-HBc was best correlated with s-GPT. Histological examination revealed the best correlation between IgA2 anti-HBc and HAI score (Knodell) in 29 patients with chronic hepatitis. These results suggested that the local immune system was activated in HBV infection.
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  • Prospect of IFN-α effects for chronic hepatitis, type B by multivariate analysis
    Michio KATO, Manabu MASUZAWA, Takumasa OKUYAMA, Akira TERADA, Masahiko ...
    1988 Volume 29 Issue 10 Pages 1330-1336
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1330
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    IFN-α was administrated at a dose of 6.8×106 to 90×106I.U. in 64 patients with HBeAg positive chronic heptitis, and the relation between various conditions before administration of the drug and its effects was determined by multivariate analysis of six categories including age, sex, HBeAg C.I., DNA-P activity, GPT and histological diagnosis, on the basis of quantification theory of the second type. The efficacy of the drug was the gratest in patients aged under 25 years, followed by those with GPT of more than 350 and those with HBeAg C.I. of less than 3.5, in that order. The efficiency was the least in patients with GPT of less than 150, followed by those aged 36 years or over and those with a histological diagnosis of CIH.
    When patients were classified into three groups (high, moderate, and low scoring groups) on the basis of the sample score, that is, the sum of the weight of the six categories, the respective rates of HBeAg abolished six months, one year and two years after administration were 76.5%, 88.2%, 100% in the high scoring group and 16.7%, 35.3% and 67.7% in the moderate scoring group. None of the antigens were abolished after administration in the low scoring group. Thus, the high scoring group seemed to be the most appropriate for IFN-α administration, whereas almost no effect was expected from administration in the low scoring group, necessitating other method or treatment.
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  • Application of a numerical scoring system for evaluating the histological outcome in patients with chronic hepatitis B and non-A, non-B before and after interferon treatment
    Tadao OKUNO, Michiko SHINDO, Ken ARAI, Masayuki MATSUMOTO, Makoto TAKE ...
    1988 Volume 29 Issue 10 Pages 1337-1345
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1337
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    A numerical scoring system was applied to assess the histological outcome in 22 HBeAg-positive patients with chronic hepatitis B (CH-B) and 8 patients with chronic hepatitis non-A, non-B (CH-NANB) before and after interferon treatment. Fourteen histological findings including 8 intralobular and 6 portal as well as periportal histological findings are assessed and scored. Histological analysis disclosed that intralobular necrosis, bridging necrosis and Kupffer cell mobilization in the initial specimens were significantly improved after treatment (0.05<p<0.001). In portal and periportal lesions, piecemeal necrosis and portal inflammation as well as fibrosis were also significantly improved (0.02<p<0.001). These histological improvements in CH-B were not correlated to the loss or persistence of HBeAg. Serum ALT levels returned to normal in 6 patients with CH-NANB after treatment and in 5 of them histopathological findings were markedly improved.
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  • Appearance of middle molecular substances in serum associated with increased permeability of blood-brain barrier in experimental models of acute hepatic failure
    Jun-ichi SUGIHARA, Koshiro SAITO, Eiichi TOMITA, Yasutoshi MUTO
    1988 Volume 29 Issue 10 Pages 1346-1356
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1346
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    Recent studies from our laboratory have revealed that HPLC peak areas of middle molecular substances (MMS) significantly increased both in serum and in cerebrospinal fluid (CSF) of patients with acute hepatic failure (AHF), and that some portions of MMS inhibited in vitro the activity of rat brain microsomal Na+, K+-ATPase. The present study was conducted to further elucidate the changes of MMS levels in sera and to investigate functional integrity of blood-brain barrier (BBB) in rat-and dog-AHF models, with special respect to the pathogenesis of hepatic encephalopathy and brain edema (BE).
    HPLC analysis of sera obtained from AHF models showed marked increaSes of several MMS peaks (in particular, below 4, 000 daltons) in parallel with developing grades of hepatic coma. Since HPLC peak areas of these MMS showed significant positive correlations with plasma levels of methionine and aromatic amino acids in AHF models, it is conceivable that serum levels of MMS are relevant to the extent of massive hepatic necrosis. In addition, AHF models showed the elevation of brain water contents and gradual increaSe of permeability of BBB to inulin (approximately 5, 200 daltons), sucrose and L-glucose which are reported to be impossible to transport acrosS the BBB in physiological conditions.
    These results strongly suggest that, in AHF models, increased MMS in circulation enter the brain across the "leaky" BBB and are presumably involved in the development of BE by interfering the function of sodium pump located along the cell membrane.
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  • Studies on the mechanisms of development of autoimmune hepatitis
    Eiki MATSUSHITA, Masashi UNOURA, Akihiko FURUSAWA, Yoshiharu MOTOO, No ...
    1988 Volume 29 Issue 10 Pages 1357-1361
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1357
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    53 patients with autoimmune hepatitis were studied the clinical features and the process from the onset of liver injury to the diagnosis. 6 males were mean 68.3±4.5 years and 47 females were mean 51.2±15.4 years. Not a few patients had severe symptoms and signs related to hepatitis. Liver injury had been pointed out in 34 patients (64.2%) before the diagnosis of autoimmune hepatitis and the interval to the diagnosis was mean 36.1±39.5 months. Processes to the diagnosis were classified in 3 types. 26 cases were insidious. 22 cases were acute hepatitis, in which 8 cases were diagnosed as autoimmune hepatitis at the recrudescence, 6 cases were done after persistence of inflammation and 8 cases were diagnosed because of the appearance of auto-antibody and/or hypergammaglobulinemia during the follow up periods. 5 cases were chronic hepatitis, in which autoimmune hepatitis were diagnosed based on the appearance of auto-antibody and/or hypergammaglobulinemia during their clinical course.
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  • Relationship between hepatic glutathione S-transferase activity and indocyanine green kinetics in liver diseases
    Nagaki SHIMADA, Motonobu SUGIMOTO
    1988 Volume 29 Issue 10 Pages 1362-1367
    Published: October 25, 1988
    Released on J-STAGE: January 19, 2010
    DOIhttps://doi.org/10.2957/kanzo.29.1362
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    We have studied the relationship between hepatic glutathione S-transferase (GST) activity and plasma indocyanine green (ICG) kinetics in patients with variuos liver diseases. The enayme activity was measured in samples of hepatic cytosol obtained from 52 patients. ICG kinetic parameters were determined using the two compartment open model in 17 patients who were given the dye (0.5mg/kg) intravenously. ICG coloration on the liver surface was laparoscopically judged as the ICG score in 38 patients who were given the dye (3mg/kg) intravenously. Correlations between the enzyme activity and liver function tests, ICG kinetic parameters and ICG coloration score were evaluated.
    Following results were obtained. (1) The enzyme activities were high in alcoholic liver disease and fatty liver, and low in cirrhosis. (2) The enzyme activities were positively correlated with serum cholinesterase activity, serum albumin level and hepaplastin tests, and negatively correlated with ICG retention rate at 15 minutes. (3) The enzyme activity was positively correlated with hepatic ICG distribution volume (VL). (4) The enzyme activity was positively correlated with ICG coloration score.
    The results are consistent with the role of the GST as ligandins in intracellular storage of dyes. Evaluation of the kinetic parameter VL and the coloration score is thought to be useful in assessing the functioning liver cell mass.
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  • Calculation of ICG kinetics by two simultaneous differential equations and non-linear least square method
    Yutaka SAGAWA, Toshiko YOSHIKATA, Nagaki SHIMADA, Motonobu SUGIMOTO
    1988 Volume 29 Issue 10 Pages 1368-1373
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1368
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    A computer program that calculate plasma ICG distribution volume (VP), maximal hepatic extraction rate (Rmax), Michaelis constant (Km), plasma-liver (a), liver-plasma (b) and liver-bile (h) transfer rates from plasma ICG levels measured after loading ICG was tested to 38 patients with liver diseases. Two simultaneous differential equations were introduced from a two compartment model, in which Rmax/(Km+CP) was substituted for "a". The equations are solved by Runge-Kutta-Gill method after giving initial values to the parameters. The parameters are changed repeatedly by damping Gauss-Newton method, compareing calculated plasma levels of ICG with measured ones by least square method, until final values for parameters were obtained. A single load of 3-4mg/kg was enough to get reliable values of the parameters, although it was more reliable when data of both 0.5-1 mg/kg and 3-4mg/kg loads were used. VP, a, b, h were very close to the values obtaine by simple two compartment analysis for 0.5mg/kg load. Rmax and Km correlated significantly to those measured by Paumgartner's method, although the values of the former were lower than the values of the latter.
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  • Early detection of small hepatocellular carcinoma
    Analysis of the first diagnostic clue in 235 patients performed hepatectomy
    Tadatoshi TAKAYAMA, Masatoshi MAKUUCHI, Kenichi TAKAYASU, Morikazu KIM ...
    1988 Volume 29 Issue 10 Pages 1374-1381
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1374
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    A total of 235 patients with small hepatocellular carcinomas, all smaller than 5 cm in diameter, underwent hepatectomy during the last 11 years (1977-1987) were retrospectively evaluated to investigate the diagnostic circumstances especially about the first diagnostic clue for tumor detection. In 69 patients (29.4%), serum alpha-fetoprotein (AFP) values were within normal range, and only 64 patients (27.2%) had the values over 400ng/ml. As a whole, the lesions were revealed by abnormal AFP values in 82 patients (34.9%), and by ultrasonography in 112 patients (47.7%). In the first years of the study, AFP served a clue in 63% of 32 patients, but by the end ultrasonography did in 64% of 133 patients. The contribution rates of AFP decreased and those of ultrasonography have been increasing with a statistically significant difference (p<0.01). These findings ascertain that ultrasonography has become to play a leading role instead of AFP in early detection of small hepatocellular carcinomas.
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  • Per-rectal portal scintigraphy for the evaluation of portal circulation in patients with primary biliary cirrhosis
    Susumu SHIOMI, Shuichi SEKI, Shigeyoshi HARIHARA, Tetsuo KUROKI, Kenzo ...
    1988 Volume 29 Issue 10 Pages 1382-1388
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1382
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    Portal circulation in patients with chronic liver diseases was evaluated by a new method named per-rectal portal scintigraphy. Following instillation of a solution containing 10mCi of 99mTcO-4 into the upper part of the rectum, serial scintigrams were taken sequentially. At the same time, the radioactivity curves over the liver and the heart were recorded sequentially. Per-rectal portal shunt indices were calculated from serial radioactivities on the liver and the heart.
    1) Per-rectal portal shunt indices (SI) were ranged from 1.9% to 5.2% (mean 4.1%) in the healthy subjects. In patients with hepatitis the mean SI was 6.9%, in patients with cirrhosis it was 52.9%, in patients with PBC it was 46.8% and in patients with IPH it was 54.4%.
    2) The SI was higher in cirrhotic patients with esophageal varices than in those without (p<0.001). The SI was higher in cirrhotic patients with encephalopathy than in those without (p<0.01).
    3) A good correlation (r=0.774) was obtained between SI and ICGR-15. But in the patients with PBC and IPH, ICGR-15 was lower than that of the patients with chronic liver diseases who show same SI as the patients with PBC and IPH. A good correlation (r=-0.716) was obtained between SI and cholinesterase. But in the patients with PBC and IPH, cholinesterase was lower than that of the patients with chronic liver diseases who show same SI as the patients with PBC and IPH.
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  • Changes of hepatic and renal tissue blood flow in rat with obstructive jaundice
    Tsuneaki FUJIYA, Kiyoaki OUCHI, Yasuo OWADA
    1988 Volume 29 Issue 10 Pages 1389-1396
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1389
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    This study examines the changes of hepatic and renal tissue blood flows in obstructive jaundice. In addition, and atempt was made to determine the effects of hypotention on blood flows and energy metabolism.
    The hepatic blood flow was found to decrease with increase of the duration of obstructive jaundice. On the contrary, renal blood flow did not change significantly. In short-term-jaundice rats, hepatic and renal tissue blood flows and energy charge returned to the control level following reinfusion of shed blood. On the other hand this trend was not found in long-term-jaudice rats.
    Therefore, it is suggested that the prolongation of the jaundice disturbes hepatic tissue blood flow, and that hypotention is one of the causes of hepatic and renal failure.
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  • A case of primary biliary cirrhosis with thymic hypertrophy and with evidence of HLA-DR2 in peripheral blood and intrahepatic bile duct epithelium
    Hiroshi SERIZAWA, Masaya ODA, Hirokazu KOMATSU, Akiko IINO, Kotaro KAN ...
    1988 Volume 29 Issue 10 Pages 1397-1403
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1397
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    In a case of primary biliary cirrhosis (PBC) with Sjögren syndrome and Raynaud phenomenon the progression from stage I to stage II was confirmed by repeated liver biopsy during four years. Indirect immunoperoxidase method using anti-Leu series and anti-HLA-DR2 antibody was applied to the unfixed cryostat sections of liver biopsy samples obtained from this PBC patient. Leu 2a-positive cells (cytotoxic/suppressor T cells) were found to be closely associated with the medium-sized bile duct epithelium. HLA-DR2, major histocompatibility complex (MHC) class II antigen, was evident both in peripheral blood of the patient and in the bile duct epithelium in the liver biopsy specimens. Pneumomediastinography revealed hyperplasia of the thymus, possibly inducing a self-recognition impairment of T cells to HLA antigens. The above findings suggest that HLA-DR2 intensely expressed in the bile duct epithelium may trigger the abnormal immune response of cytotoxic T cells to the bile duct epithelium with the background of thymic abnormalities, leading to bile duct destruction in PBC. Accumulation of PBC cases examined as in the present case is essential for clarifying the pathogenesis of PBC.
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  • An autopsied case of primary hepatic malignant lymphoma with cirrhosis and hepatocellular carcinoma
    Chiaki KAWAMOTO, Kenichi IDO, Ken KIMURA, Atsushi TAKAHASHI
    1988 Volume 29 Issue 10 Pages 1404-1409
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1404
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    A 58-year-old man developed general fatigue 4 years prior to admission, being diagnosed as liver function disorders. He was admitted to the hospital with complaint of hematemesis. On admission, anemia, icterus, vascular spider, moderate hepatosplenomegaly and ascites were physically detected.
    The serum bilirubin was 5.7mg/dl, GOT 3, 730mU/ml, GPT 890mU/ml, Al-p 815mU/ml, LDH 17, 108 mU/ml (type 5 isozyme was 30.8%), AFP 272ng/ml and CEA 3.1ng/ml.
    Ultrasonographic findings showed multiple hypoechoic tumors (2cm-3 cm in diameter) in the both lobes, and a large hyperechoic tumor (5.3×4.6cm) in the right lobe of the liver.
    The patient died of hematemesis 2 days, after admission.
    A postmortem examination disclosed multiple medullary yellowish tumors in the cirrhotic liver. These tumors were histologically diagnosed as diffuse small cell lymphoma.
    Furthermore, hepatocellular carcinoma was seen in the posterior segment of the liver.
    It seems quite rare to experience such primary hepatic malignant lymphoma with cirrhosis and hepatocellular carcinoma.
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  • A case of inflammatory pseudotumor of the liver
    Shinsuke OHURA, Kouhi SAI, Takeshi TANAKA, Isamu WATANABE, Kuniaki KOJ ...
    1988 Volume 29 Issue 10 Pages 1410-1415
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1410
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    A case of inflammatory pseudotumor of the liver with sigmoid colon cancer was diagnosed in a 50 year-old man who was admitted in order to evaluate a mass in the right hepatic lobe. Since liver abscess or metastatic tumor were suspected clinically, hepatectomy of the right lobe was performed.
    The cut surface of the tumor was yellowish-white in color, there were multiple tumor in the cut section of resected right hepatic lobe.
    Histologically the lesion was composed of fibrous connective tissue with chronic inflammatory cells among which mature plamsa cells predominanted.
    These findings yielded a diagnosis of inflammatory pseudotumor. Inflammatory pseudotumor is a rare benign lesion and is difficult to diagnose preoperatively.
    Since pathological examination can provide a definitive diagnosis careful attention should be paid to this unusual condition from both clinical and histopathological points of view.
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  • Clinico-pathological study on fulminant and acute hepatitis severe form in patients with hyperthyroidism
    Kazuo NOTSUMATA, Masashi UNOURA, Fumiaki MATSUSHITA, Mitsuhiro TERADA, ...
    1988 Volume 29 Issue 10 Pages 1416-1422
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1416
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    Three cases of fulminant hepatitis and one case of acute hepatitis severe form occurring in the course of hyperthyroidism were studied clinico-pathologically.
    Case 1 was so-called thyroid crisis, died in the acute course of encephalopathy. Cases 2 and 3 developed fulminant hepatitis in the course of control of hyperthyroidism with antithyroid preparations. Case 4 presented hyperthyroidism combined with acute hepatitis severe form and cardiac insufficiency.
    Pathological studies of the liver showed coagulation necrosis of central ones in case 1, submassive necrosis in cases 2 and 3 and focal necrosis with features of venous congestion in case 4.
    It seemed that, in addition to the direct action of thyroid hormone, other factors such as the decrease of resistance to hepatotoxic substances, change of drug metabolism and cardiac insufficiency due to hyperthyroidism may be involved in aggravation of hepatic disorder in these patients.
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  • Growth factor receptors in human hepatoma cell lines
    Yoshiharu MOTOO, Nobuyoshi TANAKA, Hirofumi KITAGAWA, Kenichi KOBAYASH ...
    1988 Volume 29 Issue 10 Pages 1423-1424
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1423
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  • Immunohistochemical study of hepatitis B core and e antigens in hepatocellular carcinoma
    Yoshihiro KUWABARA, Keiichi AOYAMA, Shuji NAMBU, Kyoichi INOUE, Hirosh ...
    1988 Volume 29 Issue 10 Pages 1425
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1425
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 10 Pages 1427
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1427
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 10 Pages 1428
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1428
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 10 Pages 1429
    Published: October 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.1429
    JOURNAL FREE ACCESS
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