S. Hanaoka

Studies on Au-antigen in serum and hepatic tissue in liver diseases

ConculusionThe frequency of tissue Au-antigen in acute hepatitis of convalescent stage was similar to that of Au-antigen in sera in its acute stage. As the histological findings of hepatitis progressed to cirrhosis or hepatoma, the incidence of tissue Au-antigen was much higher. And hepatoma cells also had Au-antigen.These results suggested that chronic viral infection might play some important roles for the progression of hepatitis to cirrhosis.

Clinicopathological studies on subacute hepatitis

137 grams. Subacute hepati t is is a clinical te rm having morphological bases of subacute hepatic necrosis. From these clinical and morphological points, it is easy to differentiate subacute hepatit is from fu lminant hepatit is (acute hepatic necrosis in base) or acute exacerbation of liver cirrhosis. When some special clinical or laboratorial findings are observed, it is better to add concerning term (for example, Hyper g a m m a globulin).

Studies on prognosis and treatment of hepatitis (IX) the immunological effects on liver cell regeneration

6-MP was given to patients with chronic hepatitis (26 cases), active form of chronic hepati t is (23), and early hepatic cirrhosis (26), in doses start ing with 40 to 75 mg/day and gradually reduced, or in small doses (10 mg/day) throughout. Azathioprin was prescribed continually for chronic hepatit is (2), active form of chronic hepatitis (3) or early cirrhosis (3), to make a total of 83 cases treated with either drug. The t reatment was effective in 44, but in 8 additional cases the initial response failed at several months to over a year (5) or the condition was aggravated in a similar period (3). The medications were utterly ineffective in 14 cases, and interpreted as aggravating in 10 others. Evaluation was impossible in 7, since the t rea tment was discontinued because of untoward reaction or adrenocortical steroids were administered concomitantly. Of the 13 aggravated patients, 8 responded to the withdrawal, but 2 died of complications and 3 of hepatic failure. In the 3 patients who lapsed into fatal liver failure (1 early cirhotic & 2 active form chronic hepatitics), the serum t ransaminases came down on 6-MP, whereas, after several months, serum bilirubin rose high, ascites appeared and death ensued. Autopsies revealed submassive liver necrosis or postnecrotic cirrhosis histologically. These changes were not conclusive as to their 6-MP etiology. Nevertheless, as the disease was definitely aggravated while on the drug and bed rest, and the deterioration could be ascribed to no other possible cause, and further, there were 8 patients who improved after the cessation of therapy, 6-MP or Azathioprin presumably acted like hepatotoxins. Pre t rea tment liver profiles in many aggravated cases had showed elevated serum bilirubin, high transaminases, marked BSP retention, and low cholinesterase. The drugs therefore were probably not indicated in pronounced hepatic dysfunction such as acute reactivation of chronic hepatitis. The effects seemed comparable with those of steroids, although the apFearence of not a few refractory or aggravated cases af ter initial favorable response should be emphasized. The risk being as aforementioned, cases must carefully be selected to avoid serious side effects.

Studies on the prognosis and treatment of hepatitis (iii) exercise tolerance test

regenerat ion became conspicuous around a month and some of the cases showed the findings of cirrhosis in about a year. The subacute stage was considered to fall on the period between about a month and a year. Serum bilirubin level was high part icular ly in this subacute stage and serum total cholesterol was generally low in all s tages. Zinc sulfate turbidi ty test increased as the stage advanced. There is a possibility that a part of so-called subacute hepati t is is included in this subacute stage of serious hepati t is .