Masami Sakaguchi

The pathogenesis of biliary atresia in Japan: Immunohistochemical study of HBV-associated antigen

An immunohistochemical study of HBV‐associated antigen in the liver of 16 Japanese infants with biliary atresia revealed positive findings in 13 of the cases for HBc and/or HBs antigens. The positive cells were mainly small liver cells distributed in the peripheral zone of the lobule, and a few lymphocytes were observed in contact with or around the positive liver cells for HBV‐associated antigen. Again, HBc antigen was demonstrated almost exclusively in the cytoplasm of positive liver cells. As these findings suggest the possibility of destruction and drop‐out of cells constituting the interlobular bile duct in the junctional area by an immunological mechanism, the probability of HBV infection being an important factor in causing and accelerating biliary atresia cannot be denied.

Changes of the serum level of IL-1 receptor antagonist (IL-1ra) in the patients with type C chronic hepatitis during interferon therapy

Abstract Serum level of interleukin-1 receptor antagonist (IL-1ra) before and during interferon (IFN) therapy was measured by sandwich ELISA. Serum IL-1ra level was significantly increased in chronic hepatitis C (CH-C) patients as compared with healthy control subjects. There was no significant correlation between serum IL-1ra and ALT level. In CHC patients, IFN treatment elevated serum IL-1ra level significantly in 2 weeks after start of the treatment. The alteration of serum IL-1ra level during treatment of IFN was compared between complete responders (CR), in whom hepatitis C virus (HCV) was eradicated, transient responders (TR), whose ALT levels transiently decreased during the treatment, and relapsed and non-responders (NR), in whom the virus was not eradicated. In TR or NR, the level in 2 weeks after the start of treatment is significantly higher than that before the treatment and in 3 months after its start. In CR, however, this transient elevation of IL-1ra level was not observed. These changes of serum IL-1ra during IFN therapy might reflect the immunological or inflammatory changes of IFN-treated CHC patients and influence the efficacy of IFN therapy.

Imaging and clinical features in cirrhotic patients complicated with hepatocellular carcinoma with a large spontaneous splenorenal shunt.

巨大脾腎静脈短絡路を伴った小型肝細胞癌合併肝硬変症6例について,短絡路を伴わない症例をコントロールとして,画像および臨床像の特徴を検討した.特徴的な画像情報としては血管造影像より,門脈本幹径/脾静脈径は短絡路群では1以下でコントロール群より有意に小さかった.この事実,すなわち門脈本幹径が脾静脈径より小さいことは,画像検査の最初に行われる超音波断層検査の際に脾腎静脈短絡路を見出だすきっかけになりうると考えられた.内視鏡検査より脾腎静脈短絡路の発達は食道静脈瘤増悪の抑制効果が示唆されたが,一部の症例に伴っていた胃腎静脈短絡路の発達は胃静脈瘤形成への関与が推測された.臨床経過より短絡路群では肝性脳症が起こりやすいことが明らかであり,癌治療時のTAEやTAIなども誘因になりやすいため,この点留意すべきと考えられた.