Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 29, Issue 3
Displaying 1-27 of 27 articles from this issue
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  • The natural history of HBV carriers
    Seroconversion and seronegative of HBs
    Izumi YOSHINO, Toshihiko IUIMA, Toshihiko NAMIHISA, Koshi SAKUMA, Akir ...
    1988 Volume 29 Issue 3 Pages 289-293
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.289
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    The aim of this study was to clarify the relationship between the HBs seroconversion rate and the HBsAg clearance rate, and to define the characteristics of the HBs seroconversion cases.
    Fifty-nine cases, who cleared HBsAg, among 1, 196 male HBsAg carriers were investigated in this study. Ajusted annual clearance rate of HBsAg was 9.9/1, 000 person years. Twelve cases of them cleared HBsAg and then developed anti-HBs. Ajusted annual HBs seroconversion rate was 2.0/1, 000 person years.
    Annual clearance rate of HBsAg increased with age, especially above 45 yo. Annual HBs seroconversion rate, however, did not increase with age.
    A higher rate of acute deterioration of liver function and a lower rate of alcoholic drinker were shown in the HBs seroconversion cases compared with 1, 110 cases with continued positive HBsAg (p<0.005).
    These results suggested that a variety of mechanisms worked on HBs seroconversion in HBsAg carriers.
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  • Long-term follow-up Study of chronic hepatitis B virus carriers of company employees
    Toshihide SHIMA, Yoshifumi SETO, Yoshikuni SAKAMOTO, Toshikazu NAKAJIM ...
    1988 Volume 29 Issue 3 Pages 294-300
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.294
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    Chronic hepatitis B virus carriers (HBV carriers) of company employees have been studied. The incidence of HBV carriers was 986 (1.17%) of 84, 456 company employees, of whom 157 (15.9%) had elevated GPT levels. The male and young HVB carriers had higher incidence of the elevated GPT level. Of 808 HBV carriers who were followed up during about 6 years, 280 were HBeAg-positive and 528 negative at the initial examination. Of 280 HBeAg-positive carriers, 39 became seronegative (SN) and 20 were seroconverted to anti-HBe (SC). Serum GPT was elevated in all the cases before SN or SC developed and since then, returned to the normal level in most of the cases. Of carriers with persistently positive HBeAg, HBeAg titer was higher in the normal GPT carrier (4.88±1.30) than in the elevated GPT carrier (4.14±1.42). Of carriers with persistently positive anti-HBe, persistently elevated GPT values had been noted in 25 (6%). Some of them were implicated in fatty liver or post-transfusion NANB hepatitis.
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  • Detection of duck hepatitis B virus Pre-S1/S2 and core polypeptides in the liver
    Analysis of experimentally infecteed duckings
    Osamu YOKOSUKA, Masao OMATA, Yoshimi ITO, Katsuo UCHIUMI, Nahoko HAYAS ...
    1988 Volume 29 Issue 3 Pages 301-305
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.301
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    We have already shown that in the early phase of duck hepatitis B virus (DHBV) infection, supercoiled DNA appear at 6hr, then RNA at 12hr, and single and double stranded DNA at 24hr after the DHBV inoculation. This time, we detected the sequential appearance of DHBV Pre-S and core polypeptides in the liver from experimentally infected ducklings (6hr-10 days) by immunoblot method. DHBV core polypeptide was detectable at 35 kilodalton (kd) after 24hr postinoculation. DHBV Pre-S1/S2 polypeptides were detectable at 37kd/28kd after 3 days postinoculation. DHBV DNA reverse transcribed from DHBV RNA is thought to be encapsulated with DHBV core polypeptide at 24 hr, then encapsulated with S and Pre-S1/S2 polypeptides at 3 day and completed as mature virion. The biological functions of c, Pre-S1/S2 polypeptides may be elucidated by using these techniques.
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  • Pathological study of chronic hepatitis B with interferon treatment with special reference to the histopathological features predicting the efficacy of interferon treatment
    Tadao OKUNO, Michiko SHINDO, Masayuki MATSUMOTO, Makoto TAKEDA, Ken AR ...
    1988 Volume 29 Issue 3 Pages 306-314
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.306
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    The histopathological features of chronic hepatitis B were evaluated in 35 biopsy specimens from the 25 patients who had been treated with interferon (IFN). Twenty five biopsies were taken before IFN treatment. These 25 histological diagnoses were chronic active hepatitis (CAH) in 11, CAH with bridging necrosis (BN) in 10, chronic persistent hepatitis in 3 and cirrhosis in 1. In 10 patients, HBeAg was persistently lost after IFN treatment (effective group)and in 15, HBeAg remained positive or transiently lost (ineffective group). The pretreatment biopsies showed a significantly higher incidence of piecemeal necrosis and BN in the effective group than those in the ineffective (p<0.01 and p<0.05, respectively). The cases effective to IFN treatment had two or more histopathological features of PN, BN and/or hepatocellular ballooning in the pretreatment biopsy (p<0.01 or p<0.05). The posttreatment biopsy was done in 8. There was marked histological improvement after treatment.
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  • Serum adenosine deaminase (ADA) activity in patients with liver diseases
    Comparison with serum type III procollagen peptide and with liver histology
    Etsuji UCHIDA, Yasuji MIYATA, Takashi MATSUURA, Akihide MASUMOTO, Shun ...
    1988 Volume 29 Issue 3 Pages 315-320
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.315
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    Serum adenosine deaminase (ADA) activity was measured in patients with various liver diseases, and the values were compared with liver function tests, serum levels of type III procollagen peptide (P III P) and liver histology. Compared to normal controls, ADA activities were significantly higher in patients with acute hepatitis, chronic hepatitis, liver cirrhosis (LC), hepatocellular carcinoma and primary biliary cirrhosis. ADA activities were positively correlated with glutamic oxaloacetic transaminase, P III P and γ-globurin levels and were inversely correlated with cholinesterase and lecithin cholesterol acyltransferase activities. ADA activities were significantly higher in chronic active hepatitis compared with chronic inactive hepatitis, and in decompensative LC as compared with compensative LC. The histological examinations showed that ADA activities were well correlated with the degree of liver fibrosis and inflammation. Thus, serum ADA activities in patients with liver diseases showed hepatocellular damage in acute hepatitis and histological severities in chronic liver disease, especially degrees of hepatic fibrosis.
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  • Biochemical analysis of liver regeneration following after galactosamine-induced liver cell injury
    Tetsuro HANTA
    1988 Volume 29 Issue 3 Pages 321-328
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.321
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    Simultaneous administration of glucagon and insulin has shown to stimulate DNA synthesis in liver cell, both in vivo and in vitro studies. However, it is fairly known whether synergistic action of these pancreatic hormones play an important role in the process of liver regeneration or repair in the rats carrying severe liver injury. Therefore, in order to clarify the interaction of both hormones to injured rat liver, galactosamine in a dose of 1, 000mg/kg b.w. was administered intraperitoneally into the fasted animals, and these were killed at several critical points for studing on changes of pancreatic hormones in plasma, cyclic nucleotides of liver tissues. ODC activity and number of glucagonreceptor on plasma membrane isolated from these livers. These parameters were depressed in the process of cell necrosis with galactosamine, while those were restored in phase of repair or regeneration nearly to the levels of the control. From these results, it will be concluded that administration of pancreatic hormones might be reasonable for increase of the capacity to regenerate even in the chemically induced rat liver injury.
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  • Effect of dibutyryl cyclic AMP and glucagon on carbohydrate metabolism in rats with D-galactosamine induced hepatitis
    Yukio MATSUO, Eiichi TAKEZAKI, Shoichi SUEMORI, Kouichi KOMATSU, Touru ...
    1988 Volume 29 Issue 3 Pages 329-335
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.329
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    Comparative study of the effect of dibutyryl cyclic AMP (DBcAMP) and glucagon on carbohydrate metabolism was carried out in rats with D-galactosamine (GalN) induced hepatitis.
    It was showed that DBcAMP was more effective on gluconeogenesis than that glucagon. On the contrary, it was showed that glucagon was more effective on glycogenolysis than that DBcAMP, suggesting the different mechanism between DBcAMP and glucagon on carbohydrate metabolism in GalN treated rats.
    These data suggest the effects of DBcAMP on the prevention of disturbance of hepatic carbohydrate and energy metabolism in rats with GalN induced hepatitis.
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  • Alterations of renal arachidonate metabolism in rabbits with D-galactosamine-induced acute hepatic failure
    Masami INADA, Sumio KAWATA, Seiichiro TARUI
    1988 Volume 29 Issue 3 Pages 336-340
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.336
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    Renal arachidonate and prostaglandin metabolism was investigated in the rabbits with D-galactosamine (GalN)-induced acute hepatic failure. Urinary excretion of prostaglandin E2 (PGE2) for 24h after intravenous injection of GalN (1g/kg) was significantly elevated in relation to increased plasma levels of norepinephrine and epinephrine. This suggest that the GalN-treated rabbits have compensatory augmentation of the renal synthesis of PGE2 to maintain renal blood flow against vasoconstrictors. Twenty-four h after GalN-treatment, renal cortical PGE2 content was significantly smaller than that in non-treated rabbits, suggesting that PGE2 production in renal cortex was impaired at this stage. Arachidonate content of tissue homogenate was significantly reduced in renal cortex of the GalN-treated rabbits. This may result from consumption of arachidonate by increased renal synthesis of prostaglandins and/or from decrease of its supply from the injured liver.
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  • Investigation of lymph node metastases in autopsied cases of hepatocellular carcinoma
    comparison between with and without liver cirrhosis
    Yasuo MIYOSHI, Shingi IMAOKA, Yo SASAKI, Takashi SHIBATA, Osamu ISHIKA ...
    1988 Volume 29 Issue 3 Pages 341-346
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.341
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    The incidence and mode of lymph node metastases were investigated in 103 autopsied cases of hepatocellular carcinoma (HCC), and compared between 90 cases with liver cirrhosis and 13 without liver cirrhosis. Following are the results obtained.
    1. Lymph node metastasis was more frequent in cases without liver cirrhosis.
    2. Lymph node metastases were mostly unidirectional, either cranial or caudal, in cases with liver cirrhosis. On the contrary, metastases occurred bidirectionally in many cases without liver cirrhosis.
    3. The group 4 lymph nodes were more frequently involved in cases with liver cirrhosis.
    4. In 30% of cases with liver cirrhosis, only one lymph node was involved.
    The above results suggested that HCC with liver cirrhosis undergoes a different pattern of lymph node metastasis, compared to HCC without liver cirrhosis, due to increased lymph production and obstruction of lymphatic vessels by liver fibrosis.
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  • Significance of activation of reticuloendothelial system on hepatectomy
    Kunitoshi NAKAGAWA, Yasuo OWADA, Kiyoaki OUCHI, Masanori SUZUKI, Tsuyo ...
    1988 Volume 29 Issue 3 Pages 347-352
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.347
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    The prognosis of patients after massive hepatectomy is poor in certain cases whose hepatic reserve, including reticuloendothelial function, is deteriorated. We administered OK-432 before 70% hepatectomy on rats to activate the reticuloendothelial system and studied its effect on postoperative course. The elevations in plasma endotoxin, GOT, and GPT were attenuated, and the deterioration of the complement activity after hepatectomy was greatly improved by OK-432 treatment. The RNA content in the liver was significantly increased by OK-432 administration. These findings suggest that activation of the reticuloendothelial system at the time of massive hepatectomy enhances endotoxin clearance from blood and thereby contributes in lessening the magnitude of hepatic injury, maintaining the serum complement, and improving liver protein synthesis.
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  • Studies on the hepatosplenic volume and the accumulation rate of 99mTc Sn colloid in patients with liver cirrhosis by using of single photon emission computed tomography
    Shizou SATO, Hisashi MIMURA, Takuo NODA, Keisuke HAMAZAKI, Norio TAKAK ...
    1988 Volume 29 Issue 3 Pages 353-357
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.353
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    The method using single photon emission computed tomography (SPECT) for measurement of the hepatosplenic volume and the accumulation rate of 99mTc Sn colloid was studied, and applied to patients with liver cirrhosis.
    The hepatosplenic volume calculated by this method was well correlated with that by computed tomography (r=0.938). The accumulation rate obtained by this method was almost equal to that by whole body scintigraphy.
    In liver cirrohsis (Child B and C group) the liver volume was atrophic and the splenic volume hypertrophic. The liver accumulation rate was decreased corresponding with the degree of liver cirrohsis, but the accumulation rate per volume was decreased in Child B and C. The splenic accumulation rate was increased in Child B and C, but the accumulation rate per volume was not significant between control group and liver cirrohsis.
    The measurement of the hepatosplenic volume and accumulation rate by SPECT is useful to evaluate the hepatosplenic function.
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  • Distribution of substance P in the human liver-light and electron microscopic study by the immunohistochemical techniques
    Takato UENO, Sadataka INUZUKA, Takuji TORIMURA, Yasuhiro SIBMOTSUURA, ...
    1988 Volume 29 Issue 3 Pages 358-364
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.358
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    Light and electron microscopic immunohistochemical techniques were used to examine the distribution and ultrastructure of substance P-containing nerves in the human liver.
    On the light microscopy, substance P-containing nerve fibers were present around the portal vein, bile duct and hepatic artery, along the sinusoid and hepatocytes, and around the central vein.
    On the electron microscopy, substance P-containing nerve endings which contain small and large round vesicles were present close to the fibroblast, Ito cell, Myofibroblast and endothelial cell around the portal vein, sinusoid and central vein.
    Moreover, substance P-containing nerve cell bodies were observed in the portal area, Disse's space and connective tissue around the central vein.
    These results suggest that substance P-containing nerves may play important roles in the contraction of the fibroblast, Ito cell, myofibroblast and endothelial cell, and in the regulation of hepatic hemodynamics.
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  • Three dimentional examination on the hepatocyte cytoskeleton of phalloidin-treated rats by quick freezing and deep-etching replica method
    Atsuhiko NARAMOTO
    1988 Volume 29 Issue 3 Pages 365-376
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.365
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    As the model of intrahepatic cholestasis, administration of phalloidin has been known to induce predominant increase of microfilaments (MF) around intrahepatic bile canaliculi. We observed ultrastructually hepatocyte cytoskeleton on phalloidin-treated rats' liver by quick freezing and deepetching replica method, and compared with the findings in thin sections by conventional transmission electron microscopy. In phalloidin 1 week group, three dimentional architecture of microfilamentous network could be visualized clearly around bile canaliculi and at cell border. Filaments are about 7 nm in diameter, and attached directly to cell membrane (end-to-membrane). In phalloidin 4 weeks group, bundles of intermediate filaments (IF) increased outside of bile canalicular MF (BCMF) seemingly for the reaction to long-term cholestasis. It is suggested that proliferative BCMF zone by phalloidin treatment disturbs bile secretion to bile canaliculi and results in cytoskeletal reorganization chiefly consisted of IF, which seemed to alter the structure and arrangement of various intracytoplasmicorganelle.
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  • Expression of proto-oncogenes during liver regeneration
    Shunichi FURUSAWA, Norio HAYASHI, Takashi YASHIMA, Akinori KASAHARA, Y ...
    1988 Volume 29 Issue 3 Pages 377-381
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.377
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    We investigated the expression of proto-oncogenes during liver regeneration. The expression of c-myc increased 8 fold between 3-6 hrs following the increase of c-fos m-RNA 30min after partial hepatectomy. Also, the expression of c-fos was induced in primary culture of hepatocytes by the addition of EGF or the serum obtained fron hepatectomized rats, but c-myc m-RNA increased only by the serum after partial hepatectomy. These results suggest that the proto-oncogenes have an important role in the process of liver regeneration.
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  • Liver sinusoidal large granular lymphocytes and liver associated natural killer activity
    M. TANAKA, H. OGATA, K. NOGUCHI, M. YOSHITAKE, M. SATA, M. ABE, H. ABE ...
    1988 Volume 29 Issue 3 Pages 382-388
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.382
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    Liver sinusoidal large granular lymphocytes (LGL) of Wistar rat were obtained by two step perfusion method via the portal vein. Pre-perfusion was performed with low pressure (below 5 cmH2O) by Ringer's solution, and the second step perfusion was done with high pressure (12-15 cmH2O) by Hanks' balanced.salt solution containing 0.05% collagenase. The perfusate was collected from the hepatic vein. Cellular components of the perfusate were 234.5±95.2×105 mononuclear cells/10g liver (n=4) and the percentage of LGL was 20.9±3.1% (i.e. the yield of LGL was 49.2±21.6×105 cells/10g liver) respectively.
    The natural killer activity of liver sinusoidal mononuclear cell, venous blood mononuclear cell and splenic mononuclear cell was studied by 4 hr 51Cr release assay against YAC-1 cell line. % cytotoxicity of liver sinusoidal mononuclear cell was 43.0±5.2% (effector target ratio 20:1) and significantly (p<0.01) higher than those of venous blood and spleen. It was supposed that the liver sinusoidal perfusate contained rich liver-associated LGLs with high natural killer activity.
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  • A case report: liver cirrhosis associated with marked hypoxemia and secondary erythrocytosis
    Hiroshi SHIJO, Shusuke HISANO, Shigeyasu AOYAMA, Masanori SHIMIZU, Sei ...
    1988 Volume 29 Issue 3 Pages 389-393
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.389
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    A 57-year-old female patient with liver cirrhosis complicated with marked hypoxemia and secondary erythrocytosis was reported.
    She was admitted to our hospital because of cyanosis at nail bed and lips. Arterial oxygen tension under room air was 33mmHg, arterial carbon dioxide tension was 45mmHg. Hematological examination showed marked erythrocytosis (RBC was 591×104 and Hb was 19.7g/dl). Laparoscopic and histologic findings proved to be the liver cirrhosis. The pulmonary perfusion scanning by 99mTc MAA showed significant uptake not only in lungs but also in spleen, thyroid glands and both kidneys. Furthermore, dynamic pulmonary perfusion scanning revealed gradually decrease of uptake in lungs. However, the "shunt ratio" measured after 100% oxygen inhalation was 6.9% when the standard shunt equation was utilized. We speculated that this discrepancy might be due to the abnormaly dilatated alveolar-capillary vesseles. Erythrocytosis was considered to be the secondary change resulted from hypoxemia.
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  • A case of non-cirrhotic portal hypertension with occluded centrtal veins which was caused by pyrrolizidine alkaloid in an herb tea
    Kazuo NOTSUMATA, Hideyuki RYORIN, Ryoyo OHMIZO, Akihiko FURUSAWA, Yats ...
    1988 Volume 29 Issue 3 Pages 394-399
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.394
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    A 37-year old woman was admitted to our hospital because of ascites and leg edema. She was administered "Takugo" an herb tea, which included pyrrolizidine alkaloid, for about ten years. Liver function test and the findings of angiography and hepatic venography were demonstrated nearly normal, but she had portal hypertension (the dilatations of portal vein and umbilical vein, gastroesophageal varices). The finding of peritoneoscopy was demonstrated "large white liver". A needle biopsy specimen of the liver showed the findings of occluded central veins. She had already administered the sum of 2g of pyrrolizidine alkaloid. So, we concluded it may be non-cirrhotic portal hypertension with occluded central veins, so called veno-occlusive disease of the liver, which was caused by pyrrolizidine alkaloid in an herb tea.
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  • Detection of anti-double stranded (ds) DNA antibodies in chronic liver diseases by using a ELISA method
    Kimiaki TSUCHIYA, Kendo KIYOSAWA, Haruhiko IMAI, Yukio GIBO, Takeshi S ...
    1988 Volume 29 Issue 3 Pages 400-401
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.400
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  • Hepatitis B infection among homosexual men in Japan
    Masashi MIZOKAMI, Hiroshi TOKUDA, Etsuro ORITO, Osamu NOJIRI, Nobutosh ...
    1988 Volume 29 Issue 3 Pages 402-403
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.402
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  • The growth pattern of woodchuck hepatocellular carcinoma
    Analysis of abdominal echogram pattern and WHV DNA integration pattern
    Hiromu AOYAMA, Junji SHIGA, Shin OHNISHI, Michio IMAWARI, Keiji MITAMI ...
    1988 Volume 29 Issue 3 Pages 404-405
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.404
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  • Plasma abnormal prothrombin (PIVKA-II) and vitamin K levels in patients with hepatocellular carcinoma
    Haruhiko IMAI, Kazuyuki UEMURA, Kendo KIYOSAWA, Seiichi FURUTA
    1988 Volume 29 Issue 3 Pages 406-407
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.406
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 3 Pages 408
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.408
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 3 Pages 409
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.409
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 3 Pages 410
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.410
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 3 Pages 411
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.411
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1988 Volume 29 Issue 3 Pages 412
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.412
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  • [title in Japanese]
    1988 Volume 29 Issue 3 Pages 413-456
    Published: March 25, 1988
    Released on J-STAGE: July 09, 2009
    DOIhttps://doi.org/10.2957/kanzo.29.413
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