Kanzo

[title in Japanese]

[in Japanese]

1995 Volume 36 Issue 4 Pages 195-198
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.195

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Changes of brain acetylcholine and monoamines concentrations in mice with thioacetamideinduced acute hepatic failure

Masakatsu IWAI, Osamu MORIAI, Kazuyuki SUZUKI

1995 Volume 36 Issue 4 Pages 199-207
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.199

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Using a high-performance liquid chromatography with electrochemical detection, we measured the concentrations of choline (Ch) and acetylcholine (ACh) and monoamines in six brain regions (frontal cortex, striatum, hippocampus, hypothalamus, midbrain, and medulla oblongata) of mice with thioacetamide-induced acute hepatic failure (AHF). In AHF mice, Ch and ACh levels were significantly decreased both in most brain regions, while significant increased in monoaminergic metabolites in all brain areas. It was not found the relative correlation between the brain ACh concentration and ammonia in AHF mice loaded with ammonium acetate. These data suggest that, in AHF, the cholinergic neurotransmitter system is suppressd, while the monoaminergic neurotransmitter system is activated. Further study is necessary to clarify the mechanism of dcreased brain ACh levels in AHF.

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Survey and follow-up study of primary liver cancer in Japan

Report 11

Liver Cancer Study Group of Japan

1995 Volume 36 Issue 4 Pages 208-218
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.208

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The Liver Cancer Study Group of Japan analyzed 11, 916 patients with primary liver cancer diagnosed from Jan. 1, 1990 to Dec. 31, 1991 in 536 hospitals throughout the country. They comprised 11379 cases of hepatocellular carcinoma, 322 of cholangiocellular carcinoma, 24 of cystadenocarcinoma, 30 of mixed carcinoma, 8 of hepatoblastoma and 7 of sarcoma in clinical diagnosis. This article revealed the current status of primary liver cancer in Japan, particularly, that of hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC) in the aspects of the epidemiology and the clinicopathological features. The survival rates of the HCC patients who received hepatic resection, transarterial embolization (TAE), and percutaneous ethanol injection (PEI) were calculated based on follow-up from Jan. 1, 1978 to Dec. 31, 1991. Three year-and five year-survival rates of the patients who underwent hepatic resection were 57.5% and 40.8%, respectively, and those of TAE were 19.5% and 8.0% respectively. Three year-survival rate of the patients with PEI was 53.2%.
Furthermore, Cox's multivariate analysis and the stepwise method were performed to determine significant prognostic variables and to investigate the appropriate combination of these variables for predicting prognosis.

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A case of type C chronic hepatitis associated with epitheloid granulomas

Shinichiro YAMAMOTO, Kenji OHMOTO, Seiji IDEGUCHI, Keiko TAKATORI, Mas ...

1995 Volume 36 Issue 4 Pages 219-222
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.219

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A case of type C chronic hepatitis with the presence of epitheloid granulomas was reported. The patient was a 47-year-old man who received a blood transfusion of 600ml because of bleeding after surgery for an intestinal obstruction in February 1985. Three months later he developed posttransfusion hepatitis and his transaminases continued to flucture. In December 1992, he received interferon (IFN) therapy using IFNα-2b with a total dose of 456 mega units. His liver function has improved markedly with negative HCV-RNA. In June 1994, one year after IFN therapy, a percutaneous liver biopsy was performed. Histologically, the liver biopsy specimens showed lymphoid aggregates in the portal area and epitheloid granulomas. Granulomas were also noted in the hepatic lobule. The granulomas were not accompanied by necrosis and the acid-fast stain was negative. Serum angiotensin-converting enzyme (ACE) and lysozyme levels were within normal range. Serum antimitochondrial antibody was undetectable. The incidence of epitheloid granulomas in liver biopsy specimens in type C chronic hepatitis between 1992 and 1994 was 3 out of 352 cases (0.85%) in our laboratory. The role of HCV infection in the genesis of epitheloid granulomas is of interest and should be investigated.

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A case report of liver cell adenoma

Masaru KONISHI, Munemasa RYU, Taira KINOSHITA, Noriaki KAWANO, Takahir ...

1995 Volume 36 Issue 4 Pages 223-229
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.223

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A case of liver cell adenoma in a 21-year-old woman is reported. She had never taken any hormonal drugs. A huge liver tumor, 24cm in size, in the right lobe was resected by a right trisegmentectomy. She is alive and well at two years after surgery. Analysis of 84 reported cases in Japan indicated that liver cell adenoma was difficult to distinguish from well differentiated hepatocellular carcinoma because the diagnosis of 11 cases was changed to hepatocellular carcinoma after histological review. Fifteen cases were reported with no details. In remaining 58 cases, final diagnosis of liver cell adenoma was confirmed. There were only three cases with a history of oral contraceptives usage. Liver cell adenoma in the patients without predisposing factors (37 cases) was mainly single and more than 10cm in size. Moreover, some ruptured cases were reported. It was difficult to distinguish adenoma from hepatocellular carcinoma because of one recurrent case of adenoma. Therefore, we recommend a resection of the tumor for such cases. On the other hand, liver cell adenoma with predisposing factors such as glycogen storage disease or use of hormonal drugs, other than oral contraceptives, (18 cases) was observed in younger patients and had a tendency to present multiple nodules. Indication of operation for the patients with glycogen storage disease is not conclusive because of the high risk of postoperative recurrence.

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A case of intrahepatic portosystemic shunt via portal vein aneurysm

Noritomo SHIMADA, Mariko ITSUBO, Tomonobu KAWABE, Hiroki TAKAHASHI, Jo ...

1995 Volume 36 Issue 4 Pages 230-234
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.230

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A 77-year-old man was pointed out an irregular shaped cystic lesion in the posterior-inferior segment of the liver by ultrasonography. Plain-CT revealed a low density lesion in the segment which was enhanced by the contrast medium. Digital subtraction angiography (DSA) was done for definite diagnosis, under a suspicious diagnosis of portal vein aneurysm.
Portogram of celiac angiography revealed a portal vein aneurysm measuring 2.8cm in maximum diameter of the peripheral posterior-inferior branch of the portal vein and the posterior-inferior branch of the portal vein communicated with the branch of the right hepatic vein via the portal vein aneurysm. In this case it was difficult to define the communication between the portal vein and the hepatic one by Doppler ultrasonography. The hemodynamics was most clearly observed by the monitor of DSA in this case. A small amount of shunt was supposed to be because of normal range of plasma ammonia. Therefore he should have passed asymptomatically. The pathogenesis of this case is considered to be congenital. Though portosystemic venous shunt has been thought to be rare, the number of patients with portosystemic shunt would be increasing by the prevalence of imaging diagnosis, and then causal relation between the portal vein aneurysm and the portosystemic venous shunt should be expected to be clarified.

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Intracaval endovascular ultrasonography useful for precise diagnosis of intracaval tumor thrombus and IVC invasion in an advanced hepatocellular carcinoma

Tetsuya KANEKO, Akimasa NAKAO, Soichiro INOUE, Shuji NOMOTO, Akio HARA ...

1995 Volume 36 Issue 4 Pages 235-240
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.235

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We report the clinical usefulness of intracaval endovascular ultrasonography (ICEUS) for hepatocellular carcinoma (HCC). A 49-year-old man was admitted to the hospital because of an advanced HCC at the posterior superior segment of the right lobe of the liver. The HCC was 9cm×10cm in diameter. The tumor compressed the inferior vena cava (IVC) at the draining portion of the right hepatic vein on CT scan and inferior cavography. An intracaval tumor thrombus at the caudal portion of the IVC was suspected. For the precise diagnosis of IVC invasion and intracaval tumor thrombus, ICEUS was performed. The IVC wall was visualized as an echogenic band. From observing the wall of the IVC, the diagnosis distinguishing between compression and invasion could be made. In this case, the echogenic band of the IVC remained intact, and the finding of the IVC wall was compression. In the diagnosis of an intracaval tumor thrombus, one can determined between floating thrombus and non-floating thrombus by observing the respiratory movement of the thrombus. In this case, the respiratory movement of the thrombus was poor and the tumor thrombus adhered to the drainaing portion of the IVC. The ICEUS finding was subsequently confirmed by surgical exploration, and hepatic right lobectomy, extraction of the intracaval tumor thrombus and partial resection of the IVC were performed. It is concluded that ICEUS is valuable for the precise diagnosis of the IVC invasion, compression and intracaval tumor thrombus, and provides important information for the strategy of hepatic surgery.

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[title in Japanese]

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

1995 Volume 36 Issue 4 Pages 241-242
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.241

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[title in Japanese]

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

1995 Volume 36 Issue 4 Pages 243
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.243

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[title in Japanese]

1995 Volume 36 Issue 4 Pages 244-257
Published: April 25, 1995
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.36.244

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