Kanzo

Intrafamilial transmission of hepatitis C virus

Yoshiyuki TAWA

1994 Volume 35 Issue 1 Pages 1-10
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.1

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To evaluate the actual condition of intrafamilial transmission of the hepatitis C virus, two hundred and seventy family members of 104 index patients with type C chronic liver diseases were investigated. Out of 270 family members, 50 (18.5%) members were positive for HCV-related antibodies (anti-C100-3, anti-HCV core). HCV RNA was detected in 32 (64%) of 50 HCV-related antibodies positive members. Prevalence of anti-HCV was higher in siblings and spouses as compared to the children. Many family members positive for HCV RNA showed abnormal liver function tests. HCV genotype was matched within 26 index patient-family member pairs and different in other 6 pairs. These results suggest that intrafamilial transmission may be one of the important infectious routes of HCV, but other environment factors also may be taken into consideration.

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Clinical evaluation of the hepatic hemodynamics using ^99mTc-DTPA-HSA scintiangiography in patients with viral chronic liver disease

Kentaro SHIMADA

1994 Volume 35 Issue 1 Pages 11-18
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.11

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^99mTc-DTPA-HSA scintiangiography was performed in 81 cases of viral chronic liver disease, and a time-activity curve (TAC) of the liver was classified into three types (I, II, III). Furthermore, portal component of the total hepatic blood flow was calculated. The results were compared with those of ^99mTc-phytate scintiangiography. The TAC type changed from I through III according to the histological developement of the liver. Esophageal varices was seen frequently in patients of type III, and in none of type I. The portal component significantly decreased in the order of chronic hepatitis without lobular distortion, with lobular distortion, and liver cirrhosis. However, the portal component obtained by using ^99mTc-phytate did not show a significant difference between chronic hepatitis without and with lobular distortion. ^99mTc-DTPA-HSA scintiangiography was thought to be an useful diagnostic procedure in patients with chronic liver disease.

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Clinicopathological study on resected hepatocellular carcinoma (HCC) with chronic hepatitis

Masafumi YASUNAGA

1994 Volume 35 Issue 1 Pages 19-28
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.19

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Clinicopathological features of 94 resected cases of hepatocellular carcinoma (HCC) with chronic hepatitis (CH group) were retrospectively studied in comparison with those of 156 cases of HCC with cirrhosis (LC group).
There was no significant difference in the positive rates of serum hepatitis B surface antigen (HBsAg) and heptitis C antibody (HCVAb) between the two groups. The prevalenece of HBsAg-positive HCCs and HCVAb-positive HCCs were 18.0% and 62.5% in CH group, and 17.6% and 76.2% in LC group, retrospectively. In CH group, the average age of HBsAg-positive HCCs was significantly younger than that of HCVAb-positive HCCs. In the cases of small liver cancer, the incidence of well-differentiated type was significantly higher in LC group (74.5%) than in CH group (50.0%).
On the other hand, moderately and poorly differentiated types were more frequently observed in CH group (moderately differentiated type, 40.0%; poorly differentiated type, 10.0%) than in LC group (moderately differentiated type, 21.6%; poorly differentiated type, 3.8%).
CH group had higher incidence of tumor invasion into portal vein branches, intrahepatic metastasis and capsule invasion. The association of adenomatous hyperplasia and well-differentiated HCCs in the vicinity of the resected HCCs suggested of multicentric origin of HCC was not observed in CH group.
Conclusively, it is predicted that HCCs in CH group may dedifferentiate in the earlier stage than HCCs in LC group, and most of them may be unicentric origin. These findings suggest that HCCs with chronic hepatits seem to be biologically different from LC group, and many of them seem to be more aggressive.

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Immunohistochemical study on the regeneration of nerve fibers of rat liver after surgical severance

Fumihiko TADOKORO

1994 Volume 35 Issue 1 Pages 29-38
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.29

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As liver transplantation advances, growing attentions have been paid to the analysis of nerve regeneration. We have examined regeneration process of the hepatic nerve by means of light and electron microscopic immunohistochemistry of anti-GAP-43 antibody after cutting at 8mm proximal to the portal fissure. In unoperated control rats, GAP-43 immunoreactivity localized in the circumferences of several unmyelinated axons. Immediately after the severance, GAP-43 immuno-reactivity disappeared from the nerve fibers, followed by gradual reapperance 2 days after the operation. GAP-43 immunoreactivity was getting stronger and reached maximal level at 14-21 days after the operation, when all axons showed positive reaction. GAP-43 positive axons decreased in number and recovered to the control level during 42-56 days. Electron microscopic immunohisto-chemistry revealed that the GAP-43 positive axons to correspond to the newly formed ones. These results pointed out that regeneration of severed nerve axons starts at 2 days and completed at 42-56 days after the operation.

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Experimental study on pathophysiology after hepatectomy for dogs with obstructive jaundice under occlusion of hepatic blood inflow

Keisuke TAKAGI

1994 Volume 35 Issue 1 Pages 39-51
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.39

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When 40% hepatectomy was performed under 10-minute complete occlusion of hepatic inflow for dogs with obstructive jaundice at 2 weeks after ligation of the common bile duct and cholecystectomy, the content of lipid peroxide increased significantly in the remnant liver with reduction of SOD like activity, while xanthine oxidase activity did not change. The levels of endotoxin and β-NAH in peripheral blood had significantly increased, and phagocytic index had markedly decreased after 3 hours. Survival rate at 7 days was only 23.1%, and many dogs died of liver failure. After hepatectomy under occlusion of the hepatic blood inflow for jaundiced dogs, Kupffer cells in the remnant liver are activated by endotoxin raised in the portal venous blood, inducing the production of free radicals, which in turn damage Kupffer cells with reduction of endotoxin clearance. Lastly, impaired functional reserve in the remnant liver provokes liver failure.

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Recurrence of hepatocellular carcinoma after medical treatment

Hitoyoshi OHTA, Kazuhiko MURAZUMI, Akinori MATSUMOTO, Motoyuki OHHIRA, ...

1994 Volume 35 Issue 1 Pages 52-59
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.52

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A total of 49 patients with hepatocellular carcinama (HCC) in our department since 1987 were reviewed to determine recurrent factors and recurrent mode of HCC.
Recurrent rate was not influenced by patient's background factor nor therapeutic modalities. Important factor is to able to perform satisfactory therapy to the HCC lesions. And HCC lesions with "single nodular type with extranodular growth" had worse prognosis concerning about tumor recurrence compared with "single nodular type".
Recurrent mode of HCC after transcatheter arterial embolization (TAE) (n=17) was 5 local recurrences, 3 newly developed lesions and one diffuse-type recurrence. On the other hand, recurrent mode of HCC after percutaneous ethanol injection therapy (PEIT) and TAE-PEIT combined therapy (n=20) was no local recurrence, 11 newly developed lesions and one diffuse-type recurrence.

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Prognosis after hepatic resection in patients with hepatocellular carcinoma on the bases of the morphometry and gross classification

Yoji KAWAI, Kotohito TAKESHIGE, Masatoshi NUNOME, Hirofumi KURODA, Hir ...

1994 Volume 35 Issue 1 Pages 60-66
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.60

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Micromorphometric values in 84 cases of hepatocellular carcinoma (HCC) treated by hepatectomy were studied using image analyzer. The survival rates in cases with coefficient of variance of nuclear form factor (NCV) less than 5.5% were significantly low. In cases with cell area more than 150μmμm2 or nucleo-cytoplasmic area ratio (N/C) less than 0.28, vascular invasion was less frequent. In those with NCV less than 5.5%, intrahepatic metastases were less frequent. In stage III, the survival rates in cases with N/C less than 0.28 or NCV less than 5.5% were significantly high. Among the cases treated by relative curative hepatectomy, intrahepatic metastases were less frequent in cases with N/C less than 0.28. After relative non-curative hepatectomy, the survival rates in cases with N/C less than 0.28, in which vascular invasion was less frequent, were significantly high. These results indicate that N/C and NCV may be useful as a prognostic factors.

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A resected case of well-differenciated hepatocellular carcinoma, 6.0mm in diameter with capsule and lipiodol accumulation

Toshiyuki OKAMOTO, Toru KASHIWAGI, Hiroyuki MASTUDA, Hideo HOSHIRO, Ka ...

1994 Volume 35 Issue 1 Pages 67-71
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.67

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A 32-year-old male had been followed for Hepatitis C virus antibody positive liver cirrhosis. He was pointed out elevation of AFP and hospitalized for further examinations. Angiography revealed no tumor stain in the liver, but lipiodol infused from hepatic artery was accumulated in the postero-inferior segment of the right lobe. The size was 6mm×6mm. Thus this lesion was diagnosed as HCC and was resected.
The tumor was well-differentiated HCC (Edmondson's grade I-II), 3.0mm in diameter and had capsule histologically. It is rare that such a small HCC has a capsule and lipiodol accumulation. This case elicits a matter of great concern about imaging diagnosis of early HCC and correlation with tumor diffferentiation and size.

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A case of jejunectomy for the solitary peritoneal dissemination from hepatocellular carcinoma

Tatsuo KUROKAWA, Kenji FUJISAWA, Eiichi YOSHIDA, Masakichi UMEDA, Hisa ...

1994 Volume 35 Issue 1 Pages 72-77
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.72

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The patient was a female aged 48 years and undertook a resection of the left lobe of the liver to remove a large tumor found in the lobe during the follow-up of hepatitis B. Histopathology showed she had bepato cellular carcinoma (HCC) of Edmondson III Type. About 18 months later, a fist-sized tumor was resected in the jejunum 30 cm apart from the Treiz, which was diagnosed to be a metastasis of HCC. AFP which gradually rose after the intial surgery returned normal after the second operation, keeping the value of 3ng/ml still now. This means the recurrent lesion could be radically removed. Such solitary metastasis of HCC to the small intestine is hardly cured and the path of the metastasis drew much attention.

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A resected case of malignant lymphoma of the liver

Hideki NAKAHARA, Toshimasa ASAHARA, Yuzo OKAMOTO, Makoto OCHI, Kouji K ...

1994 Volume 35 Issue 1 Pages 78-84
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.78

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51 years old male patient was admitted to our hospital because of epigastralgia. On admission, liver tumor was demonstrated in the segment 4 and 7 in the abdominal ultrasonogram, CT and angiography. Metastatic liver tumor or lymphocytic malignant tumor was suspected before operation. Thus partial resection of the liver was done for each tumor. Histological diagnosis of the resected tumors were malignant lymphoma (non-Hodkin diffuse lymphoma, B cell type). The chemotherapy after the operation was done by the protocol of VP and subsequently by CHOP. There were few resected cases of malignant lymphoma of the liver. Only 23 cases were reported in the world.
In the case of malignant lymphoma locating only in the liver, conbination of hepatic resection and chemotherapy is the expective treatment to get a good prognosis.

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[title in Japanese]

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

1994 Volume 35 Issue 1 Pages 85-86
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.85

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[title in Japanese]

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

1994 Volume 35 Issue 1 Pages 87-88
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.87

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[title in Japanese]

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

1994 Volume 35 Issue 1 Pages 89-90
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.89

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[title in Japanese]

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

1994 Volume 35 Issue 1 Pages 91-92
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.91

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[title in Japanese]

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

1994 Volume 35 Issue 1 Pages 93
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.93

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[title in Japanese]

[in Japanese], [in Japanese]

1994 Volume 35 Issue 1 Pages 94
Published: January 25, 1994
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.35.94

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