Hideo Nishimura

Complete necrotization of hepatocellular carcinoma by chemotherapy and subsequent intravascular coagulation: a case report.

A 45‐year‐old man with hepatocellular carcinoma who developed intravascular coagulation following complete tumor regression by chemotherapy is described. After 2 doses of 10 mg of Mitomycin C given into the hepatic artery at the time of selective angiography, and 16 intravenous doses of 5‐fluorouracil and Mitomycin C, 2 doses per week, subjective symptoms and hepatomegaly disappeared. Alpha‐fetoprotein became negative and a remarkable change in tumor size and vasculature was noted in the arteriogram. Three months after chemotherapy, the patient developed thrombocytopenia, intravascular hemolysis, and acute renal failure. Autopsy disclosed a 8 × 7 × 5 cm solitary, encapsulated hepatocellular carcinoma in the right lobe. The tumor was surrounded by a thick capsule and completely necrotized. Neither intrahepatic invasion nor extrahepatic metastasis was observed. In the kidney, generalized fibrin thrombi were seen in the afferent arterioles of glomeruli as accounted for by intravascular coagulation.

Representation of T cell functions in liver bearing hepatocellular carcinoma

SummaryThymus-derived cells (T cells) were stained by the immunofluorescent technique, and found to predominate around the cancer cell nests, in the interstitium, and in the lumen of the sinusoid of the liver bearing hepatocellular carcinoma (hepatoma). The marked T cell predominance in the liver obtained at autopsy in 9 of 13 patients with hepatoma indicates that specific T cell-mediated immunity may be maintained even in the terminal stage of cancer in these patients.

Degree Adverbs in the Corpus of Early English Correspondence Sampler

The present article investigates the rise and fall of full, right and very by analysing the Corpus of Early English Correspondence Sampler (CEECS). Special emphasis is laid on the extent of grammaticalisation of very. The first part deals with the distribution of the three adverbs and the second part examines the collocational patterns of very. The analysis reveals that the text type ‘correspondence’ is innovative in the use of degree adverbs. The data obtained display that 1) the fall of full occurs earlier than so far believed, and 2) very shows varied collocational patterns even in the Late Middle English period, which illustrates that the grammaticalisation process of very is well advanced even at an early stage.

Clinical course on patients with primary hepatocellular carcinoma surviving longer than one year.

当内科において,1969年から1975年まで化学療法をうけた原発性肝癌患者70例中12例は少なくとも1年以上の長期生存例であった.ここ2～3年,このような長期生存患者数は増加傾向にあった.これは早期診断と治療法の進歩による. 長期生存12症例について,既往歴,臨床経過,臨床生化学的所見ならびに病理解剖所見を検討した.8例は慢性肝疾患の経過観察中に発見されたもので,これら患者の5例は糖尿病を合併していた.長期生存例12症例中7例にHB抗原が認められた.したがって,HB抗原陽性,また糖尿病合併慢性肝疾患を厳重に追跡すべきである. 患者の血清アルブミン値や末梢血リンパ球数は末期では初期に比し有意に低下し,AFPや血清ビリルビンは増加した.これらは患者の予後判定因子として有用であろう.

Symposium (I): Immuno-biochemical diagnosis of hepatoma

About 80% of hepatoma associate with liver cirrhosis and hepatoma is found in about 50% of liver cirrhosis. This is the characteristic feature of cirrhosis and hepatoma in Japan. This study is carried out to investigate HB antigen, which is now considered as one of the causative agents of hepatoma, AFP and hepatoma ALP, these are specific markers of hepatoma, and putrescine, which may reflect the malignancies, in chronic hepatitis, liver cirrhosis and hepatoma. Methods : The analysis of HB antigen and antibodies were carried out by Dr. Mayumi, Jichi Univ., using reverse passive hemagglutination (RPHA) (HBsAg), PHA (anti-HBs), IAHA (anti-HBc). AFP was determined by RIA and SRID. Hepatoma ALP was studied by polyacrylamide disc electrophoresis. Serum putrescine was determined by high speed liquid chromatography, using fluotescamine labelled putreseine, separated from the serum by deproteinization and CMC chromatography procedures. Results : 1) About 50% of the cases with hepatoma are shown to be closely related with HB virus infection. The mean survival age of cirrhotics with positive HBsAg is 49-year-old and the association of hepatoma is 100~ Otherwise, the mean age of survival of cirrhotics with negative HBsAg is 59-year-old and these cirrhotics associated with hepatoma in 69% cases. 2) Hepatoma ALP was observed in 31% of the cases with hepatoma. This is uniquely found in hepatoma, and not found in other diseases. Hepatoma ALP was observed even in the case of hepatoma with negative AFP test. This suggests that the combination of Hepatoma ALP and AFP tests may be useful for the diagnosis of hepatoma. 3) Serum levels of AFP continuously exceeding 400 ng/ml were observed in 70% of the cases with hepatoma. About 3% of cirrhotics showed the elevated levels of serum AFP exceeding 400 ng/ml, but these were only transiently. AFP levels higher than 400 ng/ml are strongly suggestive of the presence of hepatoma. 4) Serum putrescine level was high in one case with hepatoma. This test is not specific for hepatoma, but the elevation of serum putrescine is considered to be suggestive of the presence of malignancies. Further investigations are undergoing.

Histochemical demonstration of carbonic anhydrase activity in the parietal cells of the rat stomach :relation to the secretion of HCL

The purpose of this paper is to discuss some of the morphological histological charac te r i s t ics of prot rac ted gas t r ic ulcer derived f rom surgical specimens in twenty eight cases. The histological findings in these series disclosed tha t there were considerable numbers of ulcers accompanied by t ransverse ly extending scars which could not be proved macroscopically. Out of 12 cases of pers i s ten t type, 10 showed histologically ulcers wi th l inear or t r ansve r se ly extending scars and only 2 showed round ulcers [and scars , a l though macroscopical ly round ulcers were found in 5, t r ansverse ly oval ones in 3 and l inear ones in 4. In the r ecu r ren t type, on the contrary, all 12 cases except one wi th l inear scar showed round or oval ulcers and scars both macroscopically. T he histological fea tures of ulcerous scar found in 4 cases of t rans i t iona l type were s imi la r to those of pers is tent type. It is no tewor thy to s ta te tha t the mos t of the l inear ulcers or scars were found in pers i s ten t and t rans i t iona l type of ulcers wi th only single exception in the present seires. I t has been well accepted tha t l inear ulcers are different in heal ing and we believe t ha t is t rue. But our resu l t s seem to show tha t the pers is tence of ulcers i tself will make one of the main courses for the development of l inear scars, a l though the fo rmal genesis of them is not yet solved.

Transfer into the blood stream following retrograde infusion of bsp in the common bile duct

Thin layer chromatography was applied to analyse direct react ing bi l i rubin in the human bile. Azo pigment in the h u m a n bile, which was prepared by adding ani l ine diazo-reagent, was separated into three f ract ions Rf 0.79, 0.33 and 0.19 with th in layer chromatography under solvent system of n-BuOH-C~H~COOH-H20 (10 : 1 : 1, V/V). Unconjugated bi l i rubin Azo pigment was found in f ract ion I (Rf 0.79) and Azo pigment of bi l i rubin glucuronide was in fract ion II (Rf 0.33). Identification of f rac t ion III (Rf 0.19) was still uncer ta in . Gallbladder bile obtained from cases with the disease not involving bi l iary t ract contained Azo pigment of b i l i rubin glucuronide as much as 51.8N88.8% (82.5%) on the contrary from cases with the biliary t r ac t disease 27.0~96.5% (72.3%) and hepatic bile of the cases with the bil iary t rac t disease consisted of 43.2~94.0% (66.9%) azopigment of bi l i rubin glucuronide. In conclusion, over 70% bil irubin glucuronide was found in the normal human bile and only minimal difference was encountered in pathological bile except for a few samples.