Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
Volume 31, Issue 10
Displaying 1-22 of 22 articles from this issue
  • Kazuhiro KATAYAMA, Norio HAYASHI, Tetsuro TAKEHARA, Takahiro TOWATA, N ...
    1990 Volume 31 Issue 10 Pages 1139-1142
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    We studied the relationship between the expression of HLA class I antigen on hepatocytes and liver cell damage (hepatitis). The serum levels of GPT of patients positive for HLA class I antigen were significantly higher (p<0.01) than those of patients negative for it. Furthermore, the γ-IFN production of PHA-stimulated PBMCs from patients with active liver disease was enhanced in response to α-IFN. The responsiveness of PBMCs in response to α-IFN may be a cause of liver cell damage, by enhancing the expression of HLA class I Ag.
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  • Hitoshi SATA, Mikio ZENIYA, Masami SAKAGUCHI, Sanae OKUYAMA, Tomonobu ...
    1990 Volume 31 Issue 10 Pages 1143-1151
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    The relation between positive cell ratio of HBV related antigen in hepatocytes and the disribution of lymphocyte subpopulation was studied in biopsied liver of the chronic hepatits B patients. In case both Po-L3/T8 and Pa-T8/T1 were high rate, HBc antigen positive rate was high, view of intensive inflammation were observed in parenchyma and ALT showed the tendency to be high. These results indicate that in case of liver cell injury on hepatitis B virus, Po-L3/T8 reacts to HBc antigen in liver cell and participates in the change of Pa-T8/T1 simultaneously.
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  • Hiroyuki SHIRASAWA
    1990 Volume 31 Issue 10 Pages 1152-1158
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    This study was performed to examine the state of imparied liver regeneration in so called acute on chronic type liver failure (AOC) which is known to be a fatal condition. For this purpose, the rat model of AOC was prepared by intraperitoneal injection of d-galactosamine (D-Gal) in rats with chronic liver damage. In this model, blood chemistry, histology, DNA synthesizing hepatocyte, EGF receptor of liver microsomal fraction and intrahepatic EGF concentration were estimated and compared with the same parameters in rats with acute liver failure induced by D-Gal (control).
    Serum GPT level rose faster in AOC than that in control. With regard to histological findings in AOC, pseudo-bile-ducts and massive hepatic necrosis were noted 48 hours and 72 hours after D-Gal injection respectively. Labelling index was significantly less in AOC than that in control 48 hours after D-Gal injection. EGF receptor was significantly less in AOC than that in control 24 hours after D-Gal injection. Intrahepatic EGF concentration was significantly less in AOC than that in control 48 hours after D-Gal injection.
    In conclusion, the examined parameters indicated that in AOC, hepatocytes were highly susceptible to necrotic agent and its capacity for the liver regeneration was impaired compared with the acute liver failure model.
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  • Shin-ichi OHKAWA, Kazuo TARAO, Akio SHIMIZU, Masaoki HARADA, Setsuo TA ...
    1990 Volume 31 Issue 10 Pages 1159-1163
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    In vitro BrdU labeling indices of liver cells in biopsied specimens from 21 male cirrhotic (LC) patients, 14 female LC patients, 32 male chronic active hepatitis (CAH) and from 19 female CAH patients, were studied by BrdU-anti BrdU immunostain. The means BrdU L.I.±S.E. of male LC, female LC, male CAH and female CAH were 2.2±0.3%, 1.1±0.3%, 1.2±0.2% and 0.9±0.2%, respectively. Interesting enough, there was a significant difference (p<0.02) between male LC and female LC. While no statistical difference existed between male and female CAH. These cirrhotics were not accompanied by hepatocellular carcinoma (HCC) at the time af first examination. In these cirrhotics, follow up studies over 2 years were performed mainly by ultrasonography and computed tomography. In 6 cases out of 14 male LC, HCC developed, while none of 7 female LC developed. Conclusion: The DNA synthesis was markedly increased in male LC.
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  • Kiyoharu WATANABE
    1990 Volume 31 Issue 10 Pages 1164-1175
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    The purpose of this study is to elucidate an architectural change of hepatic lymphatic vessels in human liver cirrhosis, and to investigate the relationship between the change of hepatic lymphatics and ascites production. Thirty-eight cirrhotic livers from pathological autopsy of our and affiliated institutions were submitted for this study. Macroscopically recognizable capsular lymphatics were injected with barium contained 5% gelatin solution using 30G sized lymphangiographic needle under manual pressure. The results obtained were as follows. In the cirrhotic liver, (1) decrease of mesh-like networks of hepatic lymphatic capillaries (HLC) and collecting tubes of HLC (HCT) was a remarkable finding especially on the protruded capsular surface of the pseudolobules of hepatic capsule. On the other hand, an increased number of hepatic lymphatic vessels (HLV) and hepatic lymphatic trunks (HCT) was seen in the depressed interpseudolobular stroma. (2) HLV around pseudolobules were destributed irregularly and sparsely, and formed irregular loop structures. Most of HLV were flattened at the protruded surface of pseudolobules, on the contraly, a number of HLV was found gatheredly in the interpseudolobular stroma. (3) Most of HLT showed almost normal running pattern, however, in accordance with the progression of hepatic atrophy in the liver cirrhosis, their zigzagged running pattern became predominant. This finding was seemed to be morphologically compatible with the outflow block of hepatic lymph. (4) Fine lymph vessels were recognized in some of lymph cysts. Discussions were made on the pathogenesis of lymph cysts and on relationship between lymph cysts and ascites production. (5) No lymphatic vessels were detected in tumor nodules of hepatocellular carcinoma associated with liver cirrhosis.
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  • Minoru SHIBATA, Yukihisa UENO, Yasukiyo SUMINO, Naoya YOSHIDA, Takaaki ...
    1990 Volume 31 Issue 10 Pages 1176-1180
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    The purpose of this study was to evaluate the prognosis value of Pugh's score, modification of the Child-Turcotte classification (CTC), in patients (pts.) with liver cirrhosis. We investigated Pugh's score, CTC, and Fisher's ratio (MR) in the clinical course of 225 pts. with liver cirrhosis. Using CTC, 39% of the pts. showed grade C at the time of one year before death. However, certain numbers of pts. showed grade C from more than 5 years before death. MR of those pts. declined gradually up to 3.5 years before death, but after that, showed no decrease until death. Therefore, it was suggested that CTC and MR were not adequete tools to estimate the precise prognosis of liver cirrhosis cases.
    On the other hand, Pugh's score of those pts. remained low points such as 5 to 6 until one year before death, and after that, increased remarkably until the time of death. The one year mortality of the pts. who showed more than 9 points in Pugh's score was approximately 90%. It was concluded that among Pugh's score, CTC and MR, Pugh's score was the most useful to estimate the prognosis of the pts. with liver cirrhosis especially to know whether they would die within one year or not.
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  • Kunihide ISHII, Michio SATA, Ryukichi KUMASHIRO, Tatsuya IDE, Hitoshi ...
    1990 Volume 31 Issue 10 Pages 1181-1185
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    To investigate the causes of hepatocellular carcinoma (HCC) associated with alcoholic liver cirrhosis (ALC), the incidence of hepatitis C virus (HCV) infection was studied in 18 alcoholic cirrhosis with HCC. HBs antigen was negative in all cases. Anti-HCV antibody was assayed by the Ortho ELISA method.
    Anti-HCV was positive in 14 of 18 cases (77.8%). 3 cases (75%) of 4 anti-HCV negative cases continued to drink until the diagnosis of HCC, while 9 cases (63.8%) of 14 anti-HCV positive cases developed HCC during 1 to 10 years after abstinence.
    In the cases who continued to drink until the diagnosis of HCC (drinking cases), the mean age was 3 years younger in the anti-HCV positive case than that of negative case.
    In the anti-HCV positive case, the mean age was 6 years younger in the drinking cases than that of the cases who developed HCC after abstinence, however total alcohol consumption was significantly more in the drinking cases. These results suggest that the infection of HCV plays an important role for the development of HCC in ALC, especially in the case who developed HCC after abstinence.
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  • Analysis by Cox's proportional hazard model
    Keiji KAMINO, Norio NAKAO, Mitsunori OHNISHI, Kohi MIURA, Takashi MIUR ...
    1990 Volume 31 Issue 10 Pages 1186-1190
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Using the Cox's proportional hazard model, we retrospectively and statistically analyzed 120 cases of primary hepatocellular carcinoma treated with transcatheter arterial embolization during the period from 1984 to 1989 to define the usefullness of LipiodolTM (LP) in TAE. The cases were divided into Gelfoam Sponge (GS) group (49 cases) and GS+LP group (75 cases) according to the embolic material used. The analysis by Cox's proportional hazard model revealed that the corrected survival rate for the GS group was 59.1% at 1 year and 25.1% at 2 years whereas the rate for GS+LP group was 80.8% at 1 year, 61.1% at 2 years, and 17.5% at 3 years, suggesting favorable effect of the concomitant use of LP on the prognosis of hepatocellular carcinoma. The risk ratio of TAE without LP to that with LP was 1.624.
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  • Akira KANEKO, Norio HAYASHI, Yuji TANAKA, Toshikazu FURUSAWA, Kazuhiro ...
    1990 Volume 31 Issue 10 Pages 1191-1196
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Many hormones and growth factors exert their actions on liver by generating certain compounds termed second messengers. Recently, it has become clear that Ca2+ can also act as a second messenger, and some hormones exert their actions through Ca2+. The increase in intracellular Ca2+ causes a very large number of cellular changes. To clarify the significance of Ca2+ signalling in hepatocytes, we measured Ca2+ response to hormones in primary cultured hepatocytes. There was remarkable Ca2+ response to vasopressin and phenylephrine early after seeding, but the Ca2+ response weakened, delayed and disappeared during culture. It is known that the numbers of V1-vasopressin and α1-adrenergic receptors on the surface of hepatocytes decrease during culture. This decrease in receptor numbers will reduce Ca2+ response in hepatocytes, and this change in signal transductian will induce the alteration of the generation of physiological response in growth and differentiation.
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  • measurement using magnetic resonance imaging
    Hisato HOMMA, Tadanori SAITOH, Naoaki SHINTANI, Johji KAWANISHI, Yasus ...
    1990 Volume 31 Issue 10 Pages 1197-1203
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    The direct bolus imaging (DBI) technique using magnetic resonance imaging (MRI) was used to compare portal blood flow velocity and flow volume in 11 healthy adults and 40 patients with chronic hepatic diseases. Portal blood flow measured by the DBI method decreased from healthy adults to chronic hepatitis patients to hepatic cirrhosis patients, in that order. Moreover, blood flow velocity tended to decrease with proximity to the primary bifurcation of the portal vein, and also tended to diminish with increasing severity of hepatic fibrosis. These results indicated that measurement of portal blood flow velocity using MRI constitutes a useful technique for the assessment of morbidity in chronic hepatic disease.
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  • Kazunari MASUDA, Yasuyuki WATANABE, Toshio NAKANISHI, Yoshihiro IKEMOT ...
    1990 Volume 31 Issue 10 Pages 1204-1209
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    To evaluate the various influences of neonatal thymectomy on galactosamine (Gal-N) induced tiver injury in A/J mice, we serially observed histological changes in the liver and serum autoantibody to liver-specific membrane lipoprotein (LSP) in normal mice, mice thymectamized 2-3 days after birth (Tx 2-3 mice), and those thyrnectornized 5 days after birth (Tx 5 mice). In the normal and Tx 2-3 mice, massive hepatocyte necrosis was observed in the acute stage. Then in the normal mice, hepatitis healed 1 week after Gal-N administration, and autoantibody to LSP was always negative. However, in Tx 2-3 mice, considerable mononuclear cell infiltration in the portal area was frequently observed even 3 months after Gal-N administration, and the serum level of autoantibody to LSP remained high. On the other hand, Tx 5 mice showed findings similar to those in the normal mice. These results suggest that healing of Gal-N induced liver injury is delayed by thymectomy 2-3 days after birth due to sensitization with LSP preparations.
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  • Ultrastructural and immunohistochemical study
    Kojiro HATA
    1990 Volume 31 Issue 10 Pages 1210-1217
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    Twenty-one cases of hepatocellular carcinoma were examined by immunohistochemistry and electron microscopy to clarify the characteristics of the tumor sinusoidal wall. The sinusoidal endothelial cells possessed Weibel-Palade bodies, a few fenestrae and intercellular tight junctions. In the Disse's space like space, incontinuous and multi-layered basal laminae were observed. The sinusoidal wall positive for Factor VIII related antigen was not stained by OKM5. Furthermore, the deposition of laminin was observed on the basal laminae in the Disse's space like space and also in the endothelial cells. In three among four cases of OKM5 positive endothelial cells, the size of tumor was under 3cm in diameter. On the contrary, Factor VIII was revealed in larger tumors over 3cm in diameter and highly frequently found in the cases of poorly differentiated histology when compared with those of OKM5 positive cases.
    These findings may suggest that the sinusoidal wall of hepatocellular carcinoma is constituted by sinusoidal endothelial cells in early stage, and then has a character as capillary vessels according as tumor growth.
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  • Atsuyoshi ONITSUKA, Yutaka OZEKI, Akitsugu HINO, Kei WATANABE, Shoshi ...
    1990 Volume 31 Issue 10 Pages 1218-1222
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    We reported a resected case of hepatocellular carcinoma (HCC) with liver cirrhosis (LC), nonhemolytic unconjugated hyperbilirubinemia (NUH) and remarkable retention of both indocyanine green test (ICG) and sulfobromophthalein test (BSP). The patient was 48-year-old male who was pointed out a liver tumor. The serum total bilirubin concentration was 2.3mg/dl with predominance of unconjugated bilirubin. Although the patient was classified as Child A, the plasma retention rate of ICG (R15) was 82% and K ICG was 0.017. And the plasma retention rate of BSP (45 min) was 40%.
    The patient was diagnosed as having a HCC with LC. The discrepancy between the hyperbilirubinemia with remarkable retention of both ICG and BSP and other liver function tests were attributed to the constitutional depressed hepatic dye clearance. And the partial resection of S8 was successfully carried out. This case is the first report of HCC with LC, NUH and remarkable retention of both ICG and BSP to our knowledge.
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  • A case report
    Masahiro IJIRI, Shigetaka SUGIARA, Osamu NAKASHIMA, Kazumitsu KIYOMATS ...
    1990 Volume 31 Issue 10 Pages 1223-1227
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    We report a resected case of hepatocellular carcinoma (HCC) presenting "nodule in nodule" pattern reflecting a three-layered structure. The patient was a 55-year-oid male with cirrhosis. Histologically, the tumor, which was 2.7×2.2cm in size, cansisted of three layers of HCC tissue with different histologic features. Every boundary of its layers was irregular due to invasive growths of the inner and the outer layers into the intermediate layer. In this case, it was considered that the intermediate layer might have existed first, and the less differentiated tissues of the inner and the outer layer might have developed.
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  • Shuichi OKADA, Gaku HAYASHI, Osamu MATSUZAKI, Susumu WAKATSUKI, Masato ...
    1990 Volume 31 Issue 10 Pages 1228-1234
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    A case of 79-year-old man with combined hepatocellular and cholangiocellular carcinoma (CHCC) was reported. He was admitted to our hospital because of further exmination of the mass in the epigastric area. On admission, laboratory findings revealed moderate abnormality in his hepatic function and elevation of serum tumor markers such as AFP, CEA, CA19-9 and PIVKA-II. Ultrasonography demonstrated an isoechoic mass with a thin sonolucent rim in the right lobe and an ill-defined mixed-echoic area accompanied by peripheral dilatation of intrahepatic bile ducts in the left lobe. Enhanced X-ray CT showed that the mass in the right lobe was stained by contrast medium. PTC showed that dilated intrahepatic bile ducts of the left lateral segment were almost completely obstructed in the proximal portion. Based on these clinical findings, the ante mortem diagnosis of CHCC (hepatocellular carcinoma in the right lobe and cholangiocellular carcinoma in the left lobe, separately) was made. Although he was treated with the anti-cancer drug, he died of the cancer in 8 months after the diagnosis. The diagnosis of CHCC was confirmed by the autopsy pathologically. It is considered that various imaging modalities make the clinical diagnosis of CHCC possible.
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  • Motoko SASAKI, Tadashi TERADA, Yasuni NAKANUMA, Tokio WAKABAYASHI, Gor ...
    1990 Volume 31 Issue 10 Pages 1235-1239
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
    A 72 year-old Japanese woman with cilated hepatic foregut cyst was reported. She had been followed up for chronic hepatitis. In October 1989, ultrasonogram revealed SOL in liver and she was admitted to Kanazawa National Hospital. Computed Tomography revealed 3 cm-sized HCC nodule in the S8 and small cystic lesion just under the Glisson's capsule in the S4 of liver. Partial hepatectomy (S4, 5, 8) was performed for HCC and the cystic lesion was also removed. Grossly, the cyst was 1.8cm-sized, unilocular and located just under the Glisson's capsule. Histologically, the lining epithelium of the cyst was pseudostratified ciliated cells and mucous cells. The cyst wall contained smooth muscle layer characteristically. The cyst was diagnosed as ciliated hepatic foregut cyst.
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  • An immunohistochemical study
    Mitsugu TANAKA, Tomohisa ISHIKAWA, Yumiko FUJITA
    1990 Volume 31 Issue 10 Pages 1240-1241
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • Yoshiyuki NAKANO, Yasuharu IMAI, Takeshi SODEYAMA, Kiyoshi FURUTA, Eij ...
    1990 Volume 31 Issue 10 Pages 1242-1243
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • Naoaki HASHIMOTO, Tsuyoshi WATAMABE, Gotaro TODA, Yusei IKEDA, Haruki ...
    1990 Volume 31 Issue 10 Pages 1244-1245
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1990 Volume 31 Issue 10 Pages 1246
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1990 Volume 31 Issue 10 Pages 1247
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1990 Volume 31 Issue 10 Pages 1248
    Published: October 25, 1990
    Released on J-STAGE: July 09, 2009
    JOURNAL FREE ACCESS
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