Kanzo

Significance of IgA type of anti-Hbc in children with chronic HBV infection

Seiichi KAGIMOTO, Satoshi FUJITSUKA, Masahiro ONOUE, Keiji KINOSHITA, ...

1992 Volume 33 Issue 8 Pages 585-590
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.585

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Significance of IgA type of anti-HBc (IgA-HBcAb) was studied in 47 children with chronically infected HBV. As liver damages developed, titers of IgA-HBcAb elevated regardless of age, sex, and status of HBe antigen/antibody system. Anti-HBc measured by RIA or PHA, IgA₁, IgA₂, and secretory component of IgA type of anti-HBc correlated with IgA-HBcAb, but they had weaker relation to liver damage than IgA₁ which had strong correlation with IgA-HBcAb. IgA-HBcAb declined swiftly in accordance with recovery of liver damage in a child with chronic hepatitis. IgA-HBcAb remained at low levels when hepatitis C occurred in an asymptomatic carrier child having HBV. IgA-HBcAb, having good specificity and sensitivity as an indicator of liver damage due to HBV infection, is clinically useful.

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Evaluation of the antiviral effect of interferon therapy for chronic hepatitis C

Toshiro KONDO

1992 Volume 33 Issue 8 Pages 591-599
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.591

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Among patients with chronic hepatitis C who had been treated with IFN, 14 responding patients with persistently normalized serum ALT levels for over 1 year and 14 non-responding patients with non-normalized ALT levels were randomly selected, and chronological changes in the presence of HCV-RNA in the serum as well as changes in titer of anti-C100-3, anti-KCL-163, anti-CP-9 and anti-CP-10 were investigated in these patients. Only 8 patients from the responders group became negative for HCV-RNA 12 months after termination of treatment. In responders, 10 out of 11 anti-C100-3 positive patients and 12 out of 13 anti-KLC-163 positive patients experienced reduction of the antibody titers toless than 25% of the pretreatment values during the period from 12 to 18 months after discontinuationof treatment. Moreover, in 7 out of those 8 responders who became negative for HCV-RNA, anti-CP-9 and anti-CP-10 titers were declined to less than 25% of the pretreatment values, while no significant change in anti-core titers was observed in responders who remained positive for HCV-RNA. On the other hand, no apparent change in each antibody titer was observed in non-responders. Above results indicate that changes in anti-core antibodies are accurately reflecting HCV-RNA status in the serum, and therefore these antibodies are considered to be useful in monitoring the antiviral effect of IFN.

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Bovine papilloma viral gene transfection into human hepatoma cells: Cloning and analysis of the plasmid replicating in the transformant

Yoshikazu KOSHITA, Minoru TAKAHASHI, Sumio SAKAMAKI, Yoshiro NIITSU

1992 Volume 33 Issue 8 Pages 600-610
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.600

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Bovine papilloma virus (BPV) is known to replicate extrachromosomally in its recipient cells. However, So far, the recipient cells of this vector have limited to rodent cells.
On the basiS of recent findings of the authors that transfection of the linearized BPV-1 plasmid pYK₈N₂L, containing the chloramphenicol acetyltransferase (CAT) gene driven by chicken β-actin promotor, into human hepatoma (Mahlavu) cells resulted in CAT expression, present study was undertaken to characterize the episomally replicating plasmid.
Southern analysis of episomal DNA from the transformant (Mahlavu) revealed that the foreign gene was replicating extrachromosomally as a circular plasmid. Cloning of this plasmid (pMYK) and its restriction map showed that the size of pMYK was smaller (8.6kb) than the orignal pYK₈N₂L (13.7 kb), indicating that it waS rearranged with deletion. In addition, it was found that none of the sequences in pMYK were derived from the chromosomal DNA of the host cells.
pYK8N2L may serve as a means of transfesting genes into human hepatoma cells without integratlon.

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Radiotherapy for advanced hepatocellular carcinoma

Kazuo NOTSUMATA, Atsushi OKAZAKI, Takanori YOKOYAMA, Tadao YAMAZAKI, M ...

1992 Volume 33 Issue 8 Pages 611-616
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.611

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Ten patients with advanced hepatocellular carcinoma (HCC) irradiated over 50 Gy were studied. In the patient with multiple HCCs, arterial embolization or ethanol injection were given previously. In 9 of the 10 lesions were decreased in tumor size. Histological examination for 6 lesions suggest remarkable radiation effects. In 1 patients, disappearance of tumor of the truncus portal vein was observed. In another 2 patients, disappearance of arterio-portal shunt was observed, making an additional arterial embolization performmable. The present findings revealed that radiotherapy was useful to treat progressive HCC.

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A case of spur cell anemia with alcoholic liver cirrhosis successfully treated with flunarizine hydrochloride

Mamoru YOSHIDA, Hiroshi NAKAJIMA, Osamu WADA, Kiroyuki ETO, Jyumei TOM ...

1992 Volume 33 Issue 8 Pages 617-621
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.617

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The patient was a 53-year-old woman who admitted to our department for a close examination for jaundice, and anemia. Through peritoneoscopic examination and liver biopsy, the liver surface pattern and histologic findings of liver specimen are compatible with alcoholic liver cirrhosis. An examination of the peripheral blood smear showed spur cell anemia. As a result of alcoholic liver cirrhosis complicated with spur cell anemia was diagnosed. The administration of 20 mg/day of flunarizine hydrochloride (anti calcium antagonist) resulted in an improvement of anemia and jaundice, with the disappearance of spur cells. Spur cell anemia often develops in patients with alcoholic liver cirrhosis, and associated with acute, accentuated hemolytic attacks. Its prognosis is believed to be poor and its therapeutic modality has not yet been established. The present case showed an improvement in anemia and jaundice following the administration of flunarizine hydrochloride. Thus it was concluded that this agent was effective in the treatment of spur cell anemia complicated with alcoholic liver cirrhosis in this case.

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Hepatic angiosarcoma and hepatocellular carcinoma in a single patient with histological characteristics similar to idiopathic portal hypertension

Makiko TANIAI, Masahiko TOMIMATSU, Noriko ISHIGURO, Kingo YOSHIDA, Ets ...

1992 Volume 33 Issue 8 Pages 622-627
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.622

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A 59-year-old man without any history of thorotrast injection, inhalation of vinyl chloride or any other specific causes, visited our hospital because of further examination of giant tumors of the liver detected by abdominal ultrasonography (US). On admission, his laboratory data showed thrombocytopenia and a prolonged prothrombin time. Endoscopic examination revealed esophageal varices and cardial varices. CT imaging and US demonstrated two giant tumors of the liver. He died of hepatic failure and respiratory failure in three months after admission. The autopsy findings disclosed hepatic angiosarcoma and hepatocellular carcinoma with fibrosis similar to idiopathic portal hypertension and metastases of angiosarcoma in both lungs and bone marrow.

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A case of giant hepatic biloma after transcatheter arterial embolization therapy (TAE) for small hepatocellular carcinoma (HCC)

Hiroyuki WATANABE, Ikurou MOURI, Takashi OKAI, Norio SAWABU, Toshikuni ...

1992 Volume 33 Issue 8 Pages 628-635
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.628

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A 74-year-old man was admitted to our hospital because the HCC 1.5cm in size was detected in the posteroinferior area (S₆) of the liver by CT scan, MRI, and angiography. Super selective TAE was performed to the HCC with a mixture of 15 mg doxorubicin, 5mg mitomycin, and 1.5 ml Lipiodol before embolization with little of Gelform. After TAE, hepatobiliary emzymes elevated about ten times higher than normal three weeks later. Various visual diagnoses revealed hepatic infarction and hepatic biloma 10cm in size in S₆ and the severe stenosis of the common bile duct at the porta hepatis. Although percutaneous biliary drainage was performed, one year later the patient died of cholangitis and hepatic dysfunction. It can be suggested that hepatic biloma developed because of the bile duct necrosis, rupture, and bile congestion due to the prolonged occlusion of peribiliary plexus in the posteroinferior artery (A₆) by Lipiodol-TAE.

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Three cases of primary hepatic lipomatous tumors

Ichiro OHASHI, Yo SASAKI, Shingi IMAOKA, Seizo MASUTANI, Shinnichi IWA ...

1992 Volume 33 Issue 8 Pages 636-642
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.636

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We carried out hepatic resections for lipomatous tumors diagnosed by preoperative imaging. Histological examinations after surgery showed a lipoma in case 1, an angiolipoma in case 2, and a hepatocellular caricnoma (HCC) in case 3, respectively. The characteristics of imaging modalities of lipogenic tumors and HCC were examined retrospectively. All cases were demonstrated as hyper echoic tumors on ultrasonogram (US), low density areas on computed tomogram (CT), and hypervascular tumors on angiogram. Although, in HCC (case 3) mosaicy pattern was seen on US, CT, and MRI, and the existence of capsular formation was seen on US, angiogram, and dynamic MRI, the lipogenic tumors did not have these findings on imaging modalities. Consequently these findings seemed to be discrimitive points between HCC and lipogenic tumors.

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A case report Middle-aged congenital hepatic fibrosis followed up as idiopathic portal hypertension

Noriko KOJIMAHARA, Etsuko HASHIMOTO, Makiko TANIAI, Kiyomasa KOBAYASHI ...

1992 Volume 33 Issue 8 Pages 643-648
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.643

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We report a 48-year-old female with congenital hepatic fibrosis (CHF) who was followed up for 3 years under the presumptive diagnosis of idiopathic portal hypertension (IPH). She consulted us in 1990 with a chief complaint of general fatigue. She had no family histories suggestive of CHF. The patient presented mild splenomegaly and no anemia, but the platelet count was low and she had a giallt spleno-renal shunt due to portal hypertension. No hepatic disease causative of the portal hypertension was found and after cirrhosis was ruled out by laparoscopy and other imaging techniques, a probable diagnosis of IPH was made. Liver biopsy was performed but the diagnosis was difficult to make due to tissue damage. Later on liver biopsy was repeated in preparation for a porta-caval anastomosis. At this time, the diagnosis of CHF was established, because of such characteristic hepatic histology as; diffuse increase of the interlobular bile ducts and hypoplastic portal triads.
In our country, about 70 cases of CHF have been reported until today. Hematomesis as the onset is common in patients under 20 year of age, while in patients over 30, the disease has never been fasted and diagnosed incidentally during physical check-ups. Experiences in this case tell that the diagnosis of IPH in adult life needs careful examination before it's made.

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An autopsy case of Wilson's disease complicating fatal acute liver failure and hemolytic anemia after discontinuation of therapy

Yasuhiro ASAHINA, Naoya SAKAMOTO, Toshinori KAMIYAMA, Junichi TAZAWA, ...

1992 Volume 33 Issue 8 Pages 649-653
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.649

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A16-year-old girl was admitted to our hospital because of general malaise and icterus. She had been diagnosed as Wilson's disease for 5 years proved by family examination when her senior brother was diagnosed as this disease. She had been doing well without symptoms by taking D-penicillamine until self-discontinuation of the medication eight months ago. She presented progressive hepatic failure and hemolytic anemia and died on the 10th hospital day. The clinical course of this case is rare in Japan. Physicians, together with patients and the family, should recognize that discontinuation of therapy might result in fatal outcome in this disease.

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[title in Japanese]

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

1992 Volume 33 Issue 8 Pages 654
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.654

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[title in Japanese]

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

1992 Volume 33 Issue 8 Pages 655-656
Published: August 25, 1992
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.33.655

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