Kanzo

An epidemic of hepatitis A at an institution for the mentally retarded in Yamagata Prefecture

Time course of anti-HAV IgM antibody, clinical significance of anti-HAV IgA antibody test and prevention against hepatitis A with immunoglobulin

Haruhide SHINZAWA, Hitoshi TOGASHI, Hiroto WAKABAYASHI, Nobuo YAMADA, ...

1990 Volume 31 Issue 12 Pages 1371-1379
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1371

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An epidemic of hepatitis A, seemingly via transmission of virus by contact, occurred an institution for the mentally retarded (aged over 18 years) from January 1988 to April of the same year. At this institution, 43 retarded residents and 15 staff members were infected with hepatitis A virus (HAV). Most were living or working in the dormitory accomodating persons with the lowest IQ (intelligence quotient). The incidence of infection among the retarded was as high as 69%, and was particularly high in persons aged between 30 and 40 years. In retarded males, 67 days were required, on average, for normalization of disturbed liver function. In the early stage after onset of hepatitis A, anti-HA IgM antibody (IgMHA) was negative in 21 cases in spite of abnormalities in liver function. This findings indicates the necessity of repeated IgMHA tests in individuals with abnormal liver function during hepatitis A epidemics. In as many as 15 cases, IgMHA remained positive for a relatively long period (6 months). Anti-HA IgA antibody (IgAHA) was positive in all IgMHA positive cases and 33 persons related to the dormitories where the epidemic occurred. This result indicates that IgAHA testing is useful for estimating the scale of HAV infection. Human immunoglobulin therapy seems to be effective in preventing further spread of HAV infection and in relieving symptoms if done in the preclinical stage.

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Enzyme-linked immunosorbent assay (ELISA) for hepatitis C using synthetic peptide

Tomohide TAKAHASHI

1990 Volume 31 Issue 12 Pages 1380-1384
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1380

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ELISA for hepatitis C using synthetic peptide (antiSP42 assay) was established. This synthetic polypeptide (SP42) was composed of 42 amino acids which shared an identical amino acid sequence of both C5-1-1 and C100-3 (European Patent Application No. 883109225). The positive rate indicated 0% (0/10) in acute hepatitis A, 0% (0/10) in chronic hepatitis B, 0% (0/7) in acute hepatitis non-A non-B (NANB), 62.5% (55/88) in chronic hepatitis NANB and 72.2% (13/18) in hepatoma complicated by liver cirrhosis NANB.
These results suggest that SP42 is specific to anti-HCV, although the positive rate is lower than that of antiC100-3 assay in comparison. Probable reasons for the lower positive rate than antiC100-3 assay include false positivity of antiC100-3 assay caused by a recombinant fusion protein with human SOD or provoked in the purification of the antigen from yeast. Anyway, it is considered that antiSP42 assay is useful to diagnose hepatitis C.

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The in vivo effect of Chinese traditional medicine on alteration of the infection pattern of Duck hepatitis B virus in Chinese carrier ducks

Ryo FUKUDA, Yasushi UCHIDA, Naruaki KOHGE, Shuji AKAGI, Satoshi OKINAG ...

1990 Volume 31 Issue 12 Pages 1385-1391
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1385

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To investigate the effect of Chinese traditional medicine on the alteration of infection pattern of Duck hepatitis B virus (DHBV), each seven DHBV carrier duck of six month old was treated with Shen San Chi (2g/kg) and Zhu Lin Duo Tang (40mg/kg) twice a week for six months. The amount of serum DHBV-DNA during the treatment and the degree of hepatitis activity and DHBV sAg in the liver after the treatment were examined and compared to those of ducks treated with Foscarnet and control ducks. All these drugs brought the significant decrease of the amount of serum DHBV-DNA and DHBV sAg in the liver. Hepatitis activity was also reduced by the treatment of these drugs.
Shen San Chi and Zhu Lin Duo Tang seemed to have antiviral effect in vivo on DHBV infection.

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The significance of CD5 B cells in various liver diseases

Hidetake SIMIZU, Hiroshi YAMADA, Noriyuki KITAMI, Toshihiko NAMIHISA

1990 Volume 31 Issue 12 Pages 1392-1399
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1392

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Human B cell subpopulation, identifiable by the expression of the cell surface antigen CD5, was observed in peripheral blood lymphocytes obtained from patients with various liver diseases by dual two-color fluorescence flow cytometry.
A significant increase in CD5 B cells was observed in patients with autoimmune hepatitis, chronic hepatitis and liver cirrhosis. In particular the increase was noted in patients with chronic hepatitis B, who were positive for HBeAg and in whom active inflammation was present. There was no significant difference in the CD5 B cell percentage between the group of controls and the group with acute hepatitis, primary biliary cirrhosis and asymptomatic HBV carrier state.
In nonA nonB hepatitis, CD5 B cells were increased in patients with active hepatic inflammation, especially those who were autoantibody positive.
These results suggested that CD5 B cells increased in patients who were in an inflammatory state of the liver, and played an important role in the worsening of hepatic injuries.

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Clinical and clinico-pathological studies on early primary biliary cirrhosis

Minoru SHIBATA, Yukihisa UENO, Wataru YAMAMURO, [in Japanese], Syuichi ...

1990 Volume 31 Issue 12 Pages 1400-1405
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1400

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Clinical, biochemical and histological features of early primary biliary cirrhosis (PBC) were studied in this paper.
Twenty five patients with asymptomatic PBC were divided into two groups based on a serum ALP level. The early PBC (11 cases, 44%) was defined as having a serum ALP level less than twice as much as an upper level of normal range, and the classical PBC was defined as having greater serum ALP level.
Biochemical tests such as GOT, γ-GTP, IgM, AD and ESR showed significantly lower values in the eraly PBC than those in classical PBC. There was no significant difference between those two groups in sex, age, positive ratio of AMA and Scheuer's histological classification. Long term observation of 4 cases of early PBC who had a normal ALP level showed a histological abnormality and positive AMA and anti-M2 precede the appearance of biochemical abnormalities. Among the various biochemical tests, an elevation of IgM was initially observed.
We emphasized that a measurement of IgM was the most important test to find an early PBC, whereas an elevation of ALP was not indispensable to early PBC.

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Criteria of curability in the hepatectomy for hepatocellular carcinoma

Ryohei IZUMI, Kohichi SHIMIZU, Masato KIRIYAMA, Hajime HORICHI, Masaak ...

1990 Volume 31 Issue 12 Pages 1406-1410
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1406

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Prognosis of seventy nine patients who underwent hepatectomy were analyzed according to methods of operation and modes of cancer invasion, which were determined by the general rules of primary liver cancer of the Japanese Liver Cancer Study Group, to evaluate whether or not complete cure was achieved by hepatectomy. The cumulative survival curve of absolute curative hepatectomies (AC) was significantly better than that of relative noncurative hepatectomies (RNC) and absolute noncurative hepatectomies (ANC) respectively, and that of relative curative hepatectomies (RC) was better than that of RNC. Positive portal vein invasion at the operation is the most influential factor on the prognosis of patients with liver carcinoma who underwent hepatectomy. RC were separated into two categories. Relative curative hepatectomies-A (RC-A) were categolized by large tumor size (>2cm) and negative vascular invasion and relative curative hepatectomies-B (RC-B) were categolized by positive vascular invasion, and cumulative disease free survival of AC, RC-A and RC-B were calculated. The cumulative disease free surival curve of AC and RC-A were significantly better than that of RC-B respectively and no significant difference of cumulative disease free surval curves was not noted between AC and RC-A. Therefore it is difficult to mention that complete cure was achieved by hepatectomy which was performed on liver carcinoma with positive vascular invasion. Closer postoperative follow up and adjuvant chemotherapy are necessary for patients underwent hepatectomies on liver carcinoma with positive vascular invasion.

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Immunohistochemical study of glutathione S-transferases on primary liver carcinoma

Mariko ITSUBO, Haruo KAMEDA, Mitsugu TANAKA, Tomohisa ISHIKAWA

1990 Volume 31 Issue 12 Pages 1411-1417
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1411

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Immunohistochemical localization of acidic and basic form of human glutathione S-transfeases (GST) in hepatocellular carcinoma, cholangiocellular carcinoma and metastatic liver carcinoma was studied. Acidic form of GST was detected within cancer cells in most cases of cholangiocellular carcinoma, especially in differentiated type, although it was detected in almost none of hepatocellular carcinoma and in half the number of metastatic liver carcinoma. Basic form of GST was detected within cancer cells in majority of cases of hepatocellular carcinoma with relatively weak staining except some of them. Occasionally basic form of GST was hardly detected within dysplastic hepatocytes (liver cell dysplasia) although it was homogeneously stained in normal hepatocytes.
These results suggest that acidic form of GST could be not only an excellent immunohistochemical marker of cholangiocellular carcinoma but an useful marker of clinical course on cholangiocellular carcinoma supposing positive staining in cancer cells results in elevation of it's serum level. On the other hand, basic form of GST might be an useful marker of study on preneoplastic lesions of hepatocellular carcinoma.

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Serum levels of 7S collagen as a tool of detection for early stage as well as irreversible stage of hepatic fibrosis in patients with alcoholic liver disease

Katsuya MARUYAMA, Isao OKAZAKI, Toshikazu TAKAGI, Keiji OKUYAMA, Satos ...

1990 Volume 31 Issue 12 Pages 1418-1425
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1418

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Serum 7S collagen was measured in 112 patients with various alcoholic liver diseases by using RIA kits (7S-RIA: Japan DPC Corporation). The serum levels of 7S collagen were significantly high in all types of alcoholic liver diseases compared to that in healthy controls. Liver cirrhosis showed significantly high value of serum 7S collagen compared to those of all other types of alcoholic liver diseases. Frequent rate of abnormal high value even in early stages of hepatic fibrosis was observed in serum 7S collagen. Among various blood tests including type III procollagen peptide, laminin and type IV collagen using EIA, 7S-RIA showed most significant correlation with the degree of hepatic fibrosis. The patients with nodular formation showed significantly high value of serum 7S collagen compared to those without nodular formation. Among various blood tests, 7S collagen except prothrombin time could most clearly differentiate two groups with or without nodular formation.
Measurement of serum 7S collegen may be useful test for the early detection as well as irrevesible stage of hepatic fibrosis in the patients with alcoholic liver diseases.

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Platelet activating factor (PAF) and interleukin-1 synthesis by hepatic sinusoidal endothelial cells from mice with carbon tetracholoride liver cell injury

Yuzo ICHIKAWA, Yasuhiro MIZOGUCHI, Norifumi KAWADA, Hiroki SAKAGUCHI, ...

1990 Volume 31 Issue 12 Pages 1426-1432
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1426

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The changes in the levels of platelet activating factor (PAF) and interleukin-1 (IL-1) produced by hepatic sinusoidal endothelial cells from mice with carbon tetrachloride-induced liver cell injury were studied. As a result, the levels of serum transaminase significantly increased and liver cell injury was induced 24 hours after the administration of carbon tetrachloride, while the levels of PAF and IL-1 remarkably decreased 48 hours after the administration of carbon tetrachloride. At 72 hours after the administration of carbon tetrachloride, the infiltration of mononuclear cells was found in liver cell necrosis when the levels of PAF and IL-1 recovered, while extensive hepatic cell necrosis with hemorrhage was observed when the levels of PAF and IL-1 decreased. These results suggested that morphological changes of liver cell injury were connected with the function of hepatic sinusoidal endothelial cells.

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Effects of the polysaccharide chain of lipopolysaccharide in an experimental massive hepatic cell necrosis model

Yasuhiro MIZOGUCHI, Norifumi KAWADA, Yuzo ICHIKAWA, Itaru HASEGAWA, Hi ...

1990 Volume 31 Issue 12 Pages 1433-1438
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1433

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We have reported that the polysaccharide chain of lipopolysaccharide (LPS) plays an important role in the induction of massive hepatic cell necrosis in an experimental model induced by intravenous injection Propionibacterium acnes (P. acnes) and LPS using mice. In order to elucidate the mechanism by which massive hepatic cell necrosis is induced in our experimental model, we examined whether mouse liver adherent cells produce tumor necrosis factor (TNF), intreleukin 1 (IL1) and hepatocytotoxic factor or not when these cells are treated with various kinds of LPS with different polysaccharide chains. As a result, when LPS from Salmonella minnesota (SM) R345 was administered into 7 days after P. acnes was administered, the production of TNF and hepatocytotoxic factor from liver adherent cells was much compared to when LPS from SM R5 was administered. However, IL1 production was not different between mice administered with LPS from SMR345 and SMR5. These suggested that TNF and hepatocytotoxic factor play a more important role in the induction of massive hepatic cell necrosis in our experimental model compared to IL1.

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A resected case of stage IV hepatocellular carcinoma 5 years and 9 months after one shot arterial infusion chemotherapy

Masatoshi KUDO, Hiroshi TAKAKUWA, Tomohiko TANI, Jun MIMURA, Yoshihiro ...

1990 Volume 31 Issue 12 Pages 1439-1445
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1439

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A 72-year-old female was admitted to our hospital with complaints of general malaise, appetite loss, nausea, and vomiting in January, 1984. CT showed large tumor in the right lobe. Ultrasound revealed large tumor in the right lobe, tumor thrombi in the right main branch of the portal vein, and ascites. A sign of mild hepatic encephalopathy was also observed. Serum α-fetoprotein level was 25118 ng/ml. Angiography revealed multiple small hypervascular nodules in the right lobe and extremely extended arterio-portal shunting (A-P shunt), which is consistent with the diagnosis of hepatocellular carcinoma (HCC). The tumor and A-P shunt drastically disappeared on US, CT, colloid liver scan, and angiography a few months after the injection of 10mg of mitomycine C through the common hepatic artery. Five years and 9 months after one shot arterial infusion chemotherapy, the recurred HCC, measuring 1.9cm in size was treated with the second arterial infusion chemotherapy combined with lipiodol followed by a right lobectomy. The histopathology showed total necrosis of HCC, multiple organization and fibrosis in the right lobe, and thickened organized lesion with fibrosis within the portal vein.
This case is considered to be rare since stage IV HCC responded extremely well to the single arterial infusion chemotherapy as well as the scars of HCC lesion and tumor thrombi in the portal vein were recognized pathologically more than 5 years later.

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Two cases of remarkable retardation of both ICG and BSP excretion

Katsuya SHIRAKI, Hisashi MATSUMOTO, Atsuya SHIMIZU, Mutsumi KOYAMA, Mi ...

1990 Volume 31 Issue 12 Pages 1446-1451
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1446

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Two cases of marked retardation of both ICG and BSP excretion are presented. In both cases, the marked delay in plasma clearance of ICG and BSP was seen, while bilirubin was normal. The analysis of plasma disappearance curves of ICG and BSP suggested that the patients had defect of dye uptake in the hepatocytes. Histological findings were compatible with chronic active hepatitis. The family examinations revealed that two daughters of case 1 and the younger sister of case 2 had abnormal excretion of coloring substances. So, these two cases might have congenital factor of disturbed excretion of ICG and BSP, although the influence of hepatitis could not be completely excluded. These cases seemed to have new type of abnormal mechanism of dye excretion.

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A case of hepatitis occuring one year after allogenic bone marrow transplantation; Is it a form of hepatic garft-versus-host disease?

Naoki IKEDA, Masashi UNOURA, Masao HONDA, Mitsuhiro TERADA, Eiki MATSU ...

1990 Volume 31 Issue 12 Pages 1452-1457
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1452

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A 24-year-old man with chronic myeloblastic leukemia developed jaundice one year after allogenic bone marrow transplantation. Abnormal laboratory findings were obtained as follows; AST 1183IU/l, ALT 1195IU/l, ALP 979IU/l, γ-GTP 169IU/l, total bilirubin 15.4mg/dl, indicating hepatic injury and cholestasis. Lymphocyte infiltration was not noticed in skin, duodenum, salivary gland, lip, and muscle biopsy. However, anti-nuclear antibody, indirect Coombs' test and Shirmer test were positive. Liver biopsy specimen revealed centrilobular necrosis, cholestasis, and lymphocyte infiltration around the portal area.
Anisonucleosis and eosinophilic cytoplasm of the bile duct epithelium were also noticed. Viral hepatitis including Hepatitis C was ruled out and drug induced hepatitis was also unlikely based on the result of lymphocyte stimulation tests. Good clinical response was obtained with treatment for chronic GVHD (cGVHD). After the reduction of immunosuppressive agents, jaundice reappeared. The specimen of second liver biopsy showed centrilobular necrosis and mild bile duct proliferation without nuclear atypism or eosinophilic cytoplasm. Hepatitis in this patient was thought to be one of feature of cGVHD because of the response to the immunosupressive therapy and other clinical data. At the time of the evaluation of histological changes in patients during treatments for cGVHD, centrilobular necrosis dominant liver damages seen in this case might be one type of hepatic cGVHD. It seems important for the diagnosis of hepatic cGVHD to carry out the liver biopsy actively.

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A case of heptic ciliated cyst

Akira NOGAMI, Yasuharu NOMURA, Iwao YABUUCHI, Hiroshi NEGORO, Minoru N ...

1990 Volume 31 Issue 12 Pages 1458-1463
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1458

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A rare case of hepatic ciliated cyst was reported. A 44 years-old man visited to our hospital for work-up of cystic lesion adjacent to the gall bladder pointed out by ultrasonography as screening. Ultrasonography showed a solitary cyst (5×3cm) with a echogenic mass in it and CT showed a irregular low density area at the liver bed. ERC showed extrinsic pressure on the neck of the gall bladder. By ultrasonographically guided puncture of the cyst, viscous white mucous was obtained. Cystography showed a small filling defect in the oval cyst. Cystadenoma was suspected, so extended cholecystectomy was performed. The inner surface of the cyst was smooth and no tumor was found on it. Histologically, the cyst wall showed ciliated columner epithelium and smooth muscle bands, so the diagnosis of hepatic ciliated cyst was made.

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Effect of taurine administration for muscle cramp in chronic liver disease

A case of decompensated liver cirrhosis in which muscle cramp disappeared after oral administration of taurine

Yasushi MATSUZAKI, Naomi TANAKA, Takashi YAMAGUCHI, Yoshimichi CHUGANJ ...

1990 Volume 31 Issue 12 Pages 1464-1469
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1464

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Muscle cramp is one of common symptoms in chronic liver diseases (CLD). But there are very few effective treatrnents for it. We administered taurine to the patients with muscle cramp in CLD. A 64-year-old woman was admitted to the hospital because of bilateral pretibial edema and muscle cramp at upper and lower limbs. Physical examination revealed no abnormality. Liver function tests showed slight elevation of GOT, GPT, γ-GTP and LAP levels, and decreased total protein, albumin and Ch-E levels. Serum electrolytes, Ca and Cu levels were within normal range. Hepatic ultrasonography and liver syntigram showed liver cirrhosis pattern. In neurological examination, an irregular muscle discharge was found at proximal and distal leg muscle in resting. Irregular muscle contraction appeared after electric stimulation. Taurine was tried to administered postprandialy at doses of 3.0g, three times daily. Muscie cramp disappeared after taurine administration. It reappeared after treatment was discontinued. After readministratin it disappeared. And during taurine treatment, muscle cramp did not appear after electric stimulation on EMG. Furthermore, we administered taurine to other 10 patients with muscle cramp in CLD. As a result of this, muscle cramp disappeared in 7 cases, and decreased in 3 cases. In conclusion, it is speculated that the long-term administration of taurine is a safe and effective treatment for the improvement of muscle cramp in CLD.

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Functional damages of hepatic cell membrane after warm ischemia and reperfusion examined by using ³¹P-MRS and ²³Na-MRS

Takashi ORII, Nobuhiro OHKOHCHI, Susumu SATOMI, Yoshio TAGUCHI, Shozo ...

1990 Volume 31 Issue 12 Pages 1470-1471
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1470

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Occurrence of inhibitors of DNA synthesis in rat hepatocytes in fulminant hepatic failure serum

Haruki YAMADA, Gotaro TODA, Yusei IKEDA, Naoaki HASHIMOTO, Yuji YOSHIK ...

1990 Volume 31 Issue 12 Pages 1472-1473
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1472

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New complementary therapy of ascites in patients with liver cirrhosis

Body oppression therapy

Masahito UEMURA, Hiroshi FUKUI, Youji MIYAMOTO, Eiryou KIKUCHI, Kenich ...

1990 Volume 31 Issue 12 Pages 1474-1475
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1474

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Treatment with rifampicin in patients with primary biliary cirrhosis

Katsuaki UKAI, Haruhide SHINZAWA, Hitoshi TOGASHI, Hiroto WAKABAYASHI, ...

1990 Volume 31 Issue 12 Pages 1476-1477
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1476

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[title in Japanese]

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

1990 Volume 31 Issue 12 Pages 1478
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1478

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[title in Japanese]

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

1990 Volume 31 Issue 12 Pages 1479
Published: December 25, 1990
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.31.1479

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