Kazuhiko Shimamoto

Ischemic colitis during interferon-alpha treatment for chronic active hepatitis C

Between 1991 and 1994, at Hoshigaoka Koseinenkin Hospital, we treated 280 patients with chronic hepatitis C with interferon (IFN), and ischemic colitis occurred in two patients (0.7%) during the treatment. Melena appeared in case 1 in the 2nd month after the initiation of IFN-alpha treatment, and in case 2 in the 6th month. In both patients, longitudinal ulcerations in the descending colon were revealed by urgent colonoscopy, and these resolved within 2 weeks after discontinuation of the IFN treatment. It appears that ischemic colitis was associated with the IFN treatment, suggesting that attention should be paid to this possible complication.

Progressive jaundice due to lymphangiosis carcinomatosa of the liver : CT appearance

In a case of progressive jaundice, contrast-enhanced CT demonstrated unevenly distributed areas of periportal low attenuation throughout the liver that were demonstrated to be dilated lymphatics with multiple carcinomatous thrombi at postmortem study. This CT appearance may be characteristic of lymphangiosis of the liver.

Differential diagnosis of polypoid lesion of stomach

ConclusionIn 82 surgically resected cases of elevated lesions of the stomach, we have evaluated and discussed the findings in malignant lesions and their morphology according to our classification of protruding lesions. We can summarize as follows :1.All cases of the dish-like type are early gastric cancers. And when this lesion has a depression on its surface, cancerous changes usually infiltrate to the submucosa.2.There is no malignancy in smooth elevated lesion except in a few case of sacroma.3.All lesions of the spherical non-pedunculated type over 2 centimeters in diameter are malignant.4.In the spherical pedunculated type, the malignancy rate is high, when the diameter of the lesion is over 3 centimeters.5.Advanced cancer is found in lesions with a large nodular surface.

A case report of non-alcoholic steatohepatitis associated with tiopronin-induced liver injury.

症例は43歳,男性,飲酒歴はない.検診で軽度の肝機能異常と高脂血症を指摘され脂肪肝として経過観察中に肝機能が増悪したため,前医にて非A非B型急性肝炎と診断され,チナプロニン300mgを10日間投与された.入院後も肝機能は悪化し,総ビリルビンの最高値は39.1mg/dlで,著明な胆汁うっ滞が約4ヵ月間持続した.第30病日に腹腔鏡下肝生検を施行し,組織は小葉中心性の肝線維化とMallory bodyを伴う脂肪変性に胆汁うっ滞を合併した像で,アルコール性肝炎と極めて類似した組織像であった.臨床経過およびチオプロニンに対するリンパ球幼若化試験が陽性であり,チオプロニンによる肝障害を合併したnon-alcoholic steatohepatitisと診断した.

Mucin metabolism in intestinal metaplasia of gastric mucosa

SummaryThe incorporation of35SO4 and Glucose-3H has been autoradiographically investigated in human gastric mucosa, especially in intestinal metaplasia, applying in vivo local labelling method during the operation of gastro-intestinal tract. The fact that sulfated mucin is actively secreted in gastric mucosa of various animals is already known, but little about the mucin metabolism of human stomach itself. In intestinal metaplasia of human gastric mucosa, markedly high metabolism of sulfated mucin have been observed compared with its low metabolism in normal gastric mucosa. In detail observation of intestinal metaplasia, columnar cells, which were considered to be absorptive cells, play an active and primary roll in the production of mucin. The goblet cells are to be considered rather as retentive cells with a slow turnover of mucin. Intestinal metaplasia occuring in the pyloric gland are, is suggestive of adaptation ability of gastric mucin for the disturbed mucin metabolism of pyloric glands to protect the gastric mucosa.

Study of gastric area

We studied about 11 cases of opera ted giant hyper t rophic gastritis and 17 cases of the giant hyper t rophic gastritis which were observed by X-ray, gastroscopy and biopsy. There were 7 cases of male and 4 cases of female. The oldest pa t ient was 61 years old three and youngest one was 23 years old. These patients have hypoprote inemia . Gastric acidity of 5 cases of 6 cases showed hypoand, or anacidity. Eight cases were observed diffuse giant rugae and 3 cases were localized rugae. Five cases showed the gylus like rugae of bra in and the rugae were 13 m m across in m a x im um and 6 m m across in min imum. The histological findings showed remarked hyperplasia of the gastric mucosa and elevation of the rnuscularis mucosae and 6 cases showed metaplastic gastritis. Three cases complicated the adenoearcinoma. The histological findings by gastroscopic biopsy showed tile superficial changes in 11 cases of 17 cases and the atrophic changes in 7 cases of 17 cases.