Kanzo

[title in Japanese]

[in Japanese]

1996 Volume 37 Issue 8 Pages 405-411
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.405

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Analysis of cases of negative HCV-RNA with positive anti-HCV

Izumi YOSHINO, Misako KASAI

1996 Volume 37 Issue 8 Pages 412-416
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.412

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The main purpose of this study is to investigate HCV transmission routes among anti-HCV positive cases with negative HCV-RNA. Of the 244 anti-HCV positive males detected through the 1993 annual health checkups, 66 responded to the request for further examinations of ultrasonography and laboratory tests including HCV-RNA. The subject of this study was limited to 56 of these cases, excluding 10 cases who had previously been treated by interferon. Of the 56 cases, 12 were HCV-RNA negative (the HCV-RNA negative group) and 44 were positive (the HCVRNA positive group). The mean ages of the former and the latter grop were 43±11 and 45±7 respectively.
To investigate HCV transmission routes, the related items were examined. As a result, a past history of transfusion was found in one case (8%) in the HCV-RNA negative group and in 17 (43%) in the HCV-RNA positive group. Specifically the positive trend of HCV transmission without transfusion would be found in the HCV-RNA negative cases (p=0.07). Those whose HCV transmission routes could not be identified without previous transfusion, acupuncture, and familial infection, accounted for 10 cases (84%) in the HCV negative group and 17 cases (39%) in the HCV-RNA positive group, the difference being significant (p=0.02). The rate of positive serum anti-HBs was 42% in the HCV-RNA negative group and 14% in the HCV-RNA positive group, the difference also being significant (p<0.05). The mean values of liver function tests were abnormal only for GGTP in the HCV-RNA negative group, but for ALT, AST, ZTT, and GGTP in the HCV-RNA positive group.
These findings suggest that most of the HCV-RNA negative cases were in a recovery stage in which HCV had been removed following a small amount of exposure through unidentified routes which were different from massive volume infection as experienced in a transfusion.

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Quantitative change of elements by X-ray microanalysis in degenerative and necrotic liver tissue by Shwartzman reaction

Fumihito KIKUCHI

1996 Volume 37 Issue 8 Pages 417-426
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.417

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Light and electron microscopic examination and X-ray microanalysis of 10 elements about necrotic liver tissue which were caused by endotoxin, were performed. Specimens were made by metal contact method. Sodium, magnesium, aluminum, silicon, phosphorus, sulphur, chlorine, potassium, calcium and iron were measured by X-ray microanalyser.
Not only the increases of calcium, sodium and chlorine, but also the decrease of potassium and silicon were detected in necrotic liver tissues. The increase of chlorine and the decrease of silicon were found in centrilobular region of the liver tissue without obvious necrotic change. It was interesting that silicon and aluminum which exist predominantly in centrilobular region in control, disperse equally in the lobules without necrotic change of the cases, which endotoxin were given. It suggests that these changes are important in the pathogenesis of necrosis and/or degeneration of the liver cell, which was caused by Shwartzman reaction.

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Evaluation of the liver function by 99mTc-N-pyridoxyl-5-methyltryptophan (PMT) scintigraphy

In patients with chronic viral liver diseases and in perfused rat livers

Miki YONAMINE

1996 Volume 37 Issue 8 Pages 427-434
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.427

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^99mTc-N-pyridoxyl-5-methyltryptophan (PMT) scintigraphy was perfarmed in 64 cases of chronic viral liver diseases, and in 6 normal controls. The mean hepatic transit time (MTT) calculated from the time-activity curves of ^99mTc-PMT scintigraphy in the patients with chronic hepatitis (CH2a) and liver cirrhosis showed significant delay as compared with that of control, although the hepatic extraction (LVT1/2) was disturbed only in the patients with liver cirrhosis.
In the rats with hepatic fibrosis caused by thioacetamide, when the livers were purfused with ^99mTc-PMT, the biliary excretory peak was delayed and the cumulative excretion rates were significantly less with the development of liver fibrosis. However, the effluent rates and extraction rates were not significantly different.
These results suggest that MTT was useful parameter to evaluate the minor liver dysfunction.

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A case of dual infection of hepatitis B and G viruses with rapid seroconversion of HBs antigen

Akihide MASUMOTO, Naoya TAKASUGI, Hisashi SHIROHARA, Akinari TABARU, H ...

1996 Volume 37 Issue 8 Pages 435-439
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.435

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A 23-yr-old man was admitted to our hospital because of hepatic injury (AST 1196 IU/l, ALT 2368 IU/l, T-Bil 1.9mg/dl). Virus markers on admission disclosed positive HBsAg, negative anti-HBc (IgM), low level of positive anti-HBc, negative anti-HCV (2nd), low level of positive anti-HCV (3rd), positive HCV-RNA (PCR), and negative anti-HA (IgM), showing dual infection of hepatitis B and C viruses. Liver biopsy revealed acute hepatitis. Level of anti-HCV (3rd) gradually increased and anti-HCV (2nd) turned out positive on the 36th hospital day, showing acute HCV infection. HBsAg became negative on the 15th hospital day. Subsequently anti-HBs turned positive on the 30th hospital day. Rapid seroconversion of HBsAg suggested suppression of HBV by HCV.

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A case of idiopathic portal hypertension with large intrahepatic portal-hepatic venous shunt

Tatsuhiro TSUJIMOTO, Kenichi FUKUI, Masahiko MATSUMURA, Masaki KOIZUMI ...

1996 Volume 37 Issue 8 Pages 440-446
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.440

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We report a case of idiopatic portal hypertension with large intrahepatic portal-hepatic venous shunt. A 56-year-old female was admitted to our hospital because of general fatigue and flapping tremor. Ultrasonography and Computed tomography (CT) showed large intrahepatic potal-hepatic venous shunt. Portgram showed anastomosis between the branches of hepatic vein and typical "Shidare-yanagi" sign was noted. In wedge biopsy of the liver, narrowing of the portal vein, orbicular fibrosis around the portal vein and abnormal vessels were seen. The angiography and histopathological findings were consistant with idiopathic portal hypertension. It was supposed that the intrahepatic portal-hepatic venous shunt became large as the progression of portal hypertension.

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A case of liver cirrhosis with solitary gastric varices associated with TIPSS tract and portal vein occlusion after performance of TIPSS and successfully treated with D-BRTO

Tetsuya MIKAMI, Hitoshi NISHIDA, Tomoyuki UMEDA, Akihisa ISHIKAWA, Mak ...

1996 Volume 37 Issue 8 Pages 447-455
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.447

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In addition to TIPSS, balloon occluded retrograde transvenous oblitalation (BRTO) is performed for treatment of solitary gastric varices (Lg-f) due to liver cirrhosis (LC). We treated a case of LC associated with TIPSS tract (TT) and portal vein (PV) occlusion after TIPSS performed for Lg-f by double balloon-BRTO (D-BRTO). A 68-year-old female with LC complicated by Lg-f was treated by TIPSS and six months later, occlusion of main PV (MPV) and TT developed. The occlusion was supposed to be caused by the reduction of blood flow within them due to gastrorenal shunt (GR-S). PTA of TT and D-BRTO through both TT and GR-S were performed for PV ad TT recanalization and improvement of Lg-f. After D-BRTO, Lg-f improved, and PV ad TT were recanalized without any complication. D-BRTO is effective for the treatment of PV ad TT occlusion after TIPSS for Lg-f.

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A case of epithelioid hemangioendothelioma of the liver followed by repeated surgical resection

Toshiki RIKIYAMA, Masanori SUZUKI, Kenji FUKUHARA, Nobuhide SAKAMOTO, ...

1996 Volume 37 Issue 8 Pages 456-462
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.456

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A 57-year-old woman had a cholecystectomy for cholecystolithiasis at a local hospital. Liver tumors was pointed out in the right lobe at the time of operation. Surgical liver biopsy at the initial operation suggested malignant angiogenic neoplasm. A right hepatic lobectomy for S₇ and S₈ and a partial resection of S₄ were performed at our hospital. Histological diagnosis of hepatic epithelioid hemangioendothelioma (EHE) was confirmed from the resected tumor specimens. 33 months after the hepatic resection, the patient has reccurent liver tumors in S₃ and S₄ and underwent partial resection of the liver. Intraaterial infusion chemotherapy (IAIC) with 5-FU and epirubicin was done after this operation. EHE of the liver is a very rare disease and its nature is not clear. Only 28 patients have been reported in Japan. The characteristics of the cell line established from the resected tumor of this patient suggested that the tumor cells were derived from Ito cells, which are related with the fibrogenesis of hepatic EHE. She is well for 24 months after the second hepatic resection. Most of the patients with hepatic EHE had already had multiple tumors at the time of diagnosis, which could not be surgically managed. However, this report suggest that the surgical resection of the tumor combined with IAIC may have a beneficial effect on EHE of the liver in the relatively early stage.

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[title in Japanese]

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

1996 Volume 37 Issue 8 Pages 463-464
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.463

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[title in Japanese]

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

1996 Volume 37 Issue 8 Pages 465
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.465

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[title in Japanese]

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

1996 Volume 37 Issue 8 Pages 466
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.466

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[title in Japanese]

1996 Volume 37 Issue 8 Pages 467-471
Published: August 25, 1996
Released on J-STAGE: July 09, 2009

DOIhttps://doi.org/10.2957/kanzo.37.467

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