Osamu Murahashi

An accessory lobe of the liver disturbing closure of the umbilical ring

Abstract The authors report a small omphalocele involving an accessory lobe of the liver (ALL) embedded in a cranial portion of the amniotic sac. The pedicle of liver tissue was markedly elongated. In this case, it was reasonable to assume that the ALL was formed during development of the embryonic body-wall folds and disturbed complete closure of the umbilical ring. Surgical resection of the ALL was performed to avoid its postoperative torsion. The pertinent literature is also reviewed.

Mesenchymal hamartoma of the chest wall in infancy: 7-year follow-up

A case of mesenchymal hamartoma of the chest wall in infancy is reported. The presenting symptom was a bulging mass arising from the chest wall. Computed tomography showed the lesion to be multifocal. A large extrathoracic mass was removed and the defect in the chest wall was repaired with a Marlex mesh. Two smaller intrathoracic lesions were observed conservatively and have not enlarged during the past 7 years.

Proliferation of intrahepatic bile-duct epithelium in biliary atresia : A useful predictor of clinical outcome

Proliferating cell nuclear antigen (PCNA) and transforming growth factor α (TGFα) are considered as markers of cell proliferation. The expression of PCNA and TGFα was evaluated immunohistochemically using anti-PCNA antibody and TGFα in 31 patients with biliary atresia (BA) (15 jaundice-free and 16 with persistent jaundice) and 6 control infants. The labeling indices (LI) for PCNA- and TGFα-positive bile-duct epithelium in BA were 14.1±14.0% and 51.4±33.7%, respectively, which was significantly higher than in the controls (P <0.01). In BA, the number of PCNA-immunoreactive cells was higher in the peripheral bile ductules than in the central bile ducts of the portal tract (P <0.01). LI was not related to patient age at the time of hepatic portoenterostomy in two groups divided at the age of 60 days. Patients in the persistent jaundice group had greater expression of PCNA and TGFα (21.7±16.0% and 76.9±20.7%, respectively) compared to those in the jaundice-free group (6.0±2.7% and 24.3±20.9%, P <0.001). PCNA and TGFα expression in the bile-duct epithelium of the portal tract was closely related to prognosis in BA patients, and thus could be useful as a prognostic marker.