Shigeru Morichika

Expression of ABH and lewis blood group antigens in combined hepatocellular-cholangiocarcinoma. Possible evidence for the hepatocellular origin of combined hepatocellular-cholangiocarcinoma

Expression of ABH, Lewis, and sialyl Lea antigens was studied in five combined hepatocellular‐cholangiocarcinomas. Formalin‐fixed liver tissues were immunostained for those antigens using well‐characterized monoclonal antibodies and an avidin‐biotin‐peroxidase complex (ABC) method. Results were compared with those obtained in normal liver tissues and cholangiocarcinomas, and also with the previous observations of the authors on hepatocellular carcinomas. Although not detected in normal parenchymal liver cells, A, H, Lewis, and sialyl Lea antigens were found in combined hepatocellular‐cholangiocarcinoma cells. Incompatible A antigen also was detected in one blood type O patient. Distribution and intensity of the antigens were similar to those in hepatocellular carcinomas and different from those in cholangiocarcinomas. No preferential accumulation of blood‐group antigens could be found in the area of cholangiocarcinoma‐like differentiation of the combined hepatocellular‐cholangiocarcinoma. The observations suggested that.

Molecular hybridization methods for determination of serum HBV-DNA

SummaryMolecular hybridization methods for determination of hepatitis B virus DNA (HBV-DNA) in serum were studied. A simple method by which serum was treated with sodium hydroxide, followed by dot hybridization procedure on filter sheets provides a sensitive and direct result for detecting HBV-DNA. Another method in which DNAs extracted from Dane particle fraction were subjected to the molecular hybridization method on a filter membrane, provided similar results although this method is time consuming. The third method in which serum was directly spotted on filter sheets, followed by alkalinetreatment seems to be less sensitive. Three filter papers, NC filter, Zeta-Probe and Biodyne, on which molecular hybridization was performed, gave similar sensitivity.

Clinical evaluation of autoantibodies to liver cell membrane specific antigen, liver specific lipoprotein, and Tamm-Horsfall glycoprotein in autoimmune chronic active hepatitis

SummaryAn enzyme-linked immunosorbent assay was developed to detect circulating autoantibodies to three liver cell membrane surface antigens, i.e., liver cell membrane specific antigen (LCM), liver specific lipoprotein (LSP), and Tamm-Horsfall glycoprotein (THGP). In autoimmune chronic active hepatitis (autoimmune CAH), the positive rate and mean titer (normal range, less than 5.5 units) for anti-LCM were 100% and 13.5 units before corticosteroid treatment and 100% and 9.9 units during the treatment. The corresponding values for anti-LSP were 84% and 11.8 units, and 81% and 8.9 units, and those for anti-THGP were 84% and 12.3 units, and 81% and 7.9 units. In an autoimmune CAH patient, elevation of the plasma levels of autoantibodies during the treatment apparently preceded the elevation of alanine aminotransferase (ALT). However, the ALT elevation induced by transcatheter arterial embolization was not associated with the elevation of these autoantibodies in an autoimmune CAH patient with hepatocellular carcinoma. In primary biliary cirrhosis, drug-induced hepatitis, and non-hepatic immunological disorders, the production of the three autoantibodies did not directly correlate with liver cell damage. These findings suggest that the elevation of autoantibodies against LCM, LSP, and THGP can be a useful guide for the prednisolone treatment of autoimmune CAH.

Differential diagnosis of liver parenchymal diseases by likelihood method using 12 laboratory data and age

SummaryLiver parenchymal diseases were statistically diagnosed by likelihood method using 12 routine liver function tests and age. 444 cases of liver diseases were classified into 8 groups by histological diagnosis. A score diagnosis table was made from the data of these cases. For the likelihood diagnosis, data of each case were adapted to the score table and the probable diagnosis was calculated. Correct diagnosis rate of the first probable diagnosis was 50 % in all cases and that of the first and the second was 71%. Descending order of the correct diagnosis rate of the first diagnosis was fatty liver (76%), liver cirrhosis (67%), slight histological changes (61%), acute hepatitis (51%), alcoholic liver injury (48%), chronic aggressive hepatitis 2A (43%), chornic persistent hepatitis (40%) and chronic aggressive hepatitis 2B (26%). In conclusion, differential diagnosis of liver parenchymal diseases was made easily with the score table of 13 informations with a considerable success.

Ranking of liver tests for differential diagnosis of liver parenchymal diseases

SummaryLiver function tests were ranked in the order useful to differentiate 8 liver parenchymal diseases in combination of tests by forward selection and backward elimination procedures in the likelihood method using a microcomputer. The orders were almost same in both procedures: indocyanine green plasma disappearance rate, glutamic pyruvic transaminase (GPT), zinc turbidity test, alkaline phosphatase, age, HBsAg, RA test, glutamic oxaloacetic transaminase (GOT)/GPT ratio, GOT, cholesterol, total protein, total bilirubin, albumin/globulin ratio and γ-globulin. The first 9 tests had almost all informations of all tests. The first likelihood diagnosis using the 9 tests was correct in 53% and the first or the second diagnosis was correct in 71 % of 444 cases of 8 liver parenchymal diseases. A score table of likelihood diagnosis using the 9 tests was presented for manual application to new cases.