The effects of the transcatheter arterial embolization (TAE) to natural killer (NK) activities and NK cell surface markers in 36 cases with hepatocellular carcinoma (HCC) were investigated. Results ...were summerized as follows. 1) NK activities were transiently decreased significantly after TAE, accompanied by the decrease of the number of NK surface marker positive cells. Four weeks after TAE, NK activities and the number of NK surface marker positive cells returned to previous level. 2) Effective hepatic blood flow after TAE, determined by indocyanine green clearance rate was decreased in parallel with NK activities. 3) The decrease of NK activities was not related to the extent of tumor necrosis as well as the serum cortisol levels. These results suggested that transient decrease of NK activities after TAE may reflect the hepatic ischemia and that the liver may play an important role in the regulation of NK activities and NK cells.
A 76-year-old woman with chief complaints of general fatigue and proximal muscle weakness was admitted to Hamamatsu University Hospital in March 6th 1986. Elevated transaminase (GOT 117KU, GPT 37KU) ...and γ-globulin (2.3g/dl), positive auto-antibodies (ANA 320-fold, ADNA 640-fold, ASMA 640-fold, LE cell (+)) and histological findings of liver biopsy were compatible with lupoid hepatitis. Abdominal imagings including CT, echography, angiography disclosed a 4cm- diameter tumor in the left hepatic lobe. Presence of Edmondson Type II hepatocellular carcinoma was confirmed by needle biopsy. In addition, gastric fiberscopy disclosed Type IIc+III gastric cancer in the antrum of the stomach and the histology was well differentiated adenocarcinoma. Furthermore, the presence of polymyositis was diagnosed from proximal muscle weakness, the high CPK value and the histology muscle tissue. A rare case of lupoid hepatitis accompanied with polymyositis, gastric cancer and hepatocellular carcinoma was reported.
A 46-year-old male had been treated for duodenal ulcer. Upper gastrointestinal (G. I.) endoscopy revealed a submucosal tumor on the opposite side of the papilla Vatar in the second portion of the ...duodenum in October, 1991. Biopsy specimens, under endoscopic examination at several sites, showed only normal duodenum mocosa. He suffered melena occasionally from June, 1992, but the melena continued for two days from December 3 to 5, 1992. Emergency upper G. I. endoscopy revealed bleeding from a small ulcer on top of a submucosal tumor. The bleed-ing was stopped by HS-E injection to the mucosa around the ulcer. He received gastro-duodenec-tom y in January, 1993. The submucosal tumor, 2.7×2.0×2.8cm, had developed into the duodenum and revealed a defect of the mucosa in part on the mucosal surface. Diagnosis of the leiomyoma of the duodenum was made because of the tumor was composed of spindled smooth muscle cells withrod nuclei.
Ofloxacin, a synthetic antibacterial pyridone-carboxylic acid derivative, was used in the treatment of intractable pulmonary tuberculosis. In this study, the therapeutic effect of Ofloxacin on ...pulmonary tuberculosis and Ofloxacin resistance were analyzed. All patients had been hospitalized in eight national sanatoria in Kinki district, and were excreting tubercle bacilli resistant to various anti-tuberculosis drugs agents. Ofloxacin was given to 118 patients orally at a daily dose of 300mg to 600mg for more than 3 months. A few anti-tuberculosis drugs, which had failed in the negative conversion of bacilli previously, were used in combination. By Ofloxacin, 23 patients (19.5%) showed negative conversion of tubercle bacilli in sputum culture within 5 months, and they remained culturenegative for at least 6 months after conversion. Side-effects were observed in 2 patients. One complained of arthralgia and the other felt abdominal fullness. But both were not serious. From these results, it was concluded that Ofloxacin was effective for intractable pulmonary tuberculosis. The resistance of tubercle bacilli to Ofloxacin increased significantly after it was used.
Endoscopic injection sclerotherapy (EIS) using 5% ethanolamine oleate mixed with contrast medium was done to treat esophageal varices in 166 patients of group A or B by the Child-Pugh's criteria. An ...avascularization balloon was attached to the endoscopy to prevent the spread of sclerosant toward oral side. The rate of complete disappearance of varices was 95.8%, cumulative recurrence rate at 17 years after EIS was 6.5%, and bleeding after EIS was found only in 1.3%. There was no death due to EIS. Minor complication such as esophageal ulcer and mild stenosis of esophagus occurred in only 4.2%. Major complication involving other organs did not occur at all. Six cases with remarkable pipeline varices were treated by EIS successfully with complete disappearance of the varices and no recurrence during follow-up. These results suggest that EIS is effective and safe, and can be regarded as the first choice for the treatment of esophageal varices.
Back ground of the patients who died within 1 year after admission to the hospitals in kinki district were analyzed. 90 patients out of 1459 newly admitted patients were dead within 1 year after ...admission to the hospital. Among these 90 cases, 42.2% were dead within 1 month, and 71.1% were dead within 3 mounth after admission. 49 patients (54.5%) of 90 dead cases were older than 70 years. As concerns with the cause of death, about one third of the patients were died of tuberculosis and the remaining two third were died of other than tuberculosis. The most frequent cause of death was pulmonary tuberculosis (38.9%), and then lung cancer(15.6%), chronic respiratory failure (13.3%)and pneumonia (12.2%). Many patients were suffered from tuberculosis during the chemotherapy for malignant disease resulting in immunocompromized condition. It should be emphasized that the prevention in such patients from falling to tuberculosis is extraordinary important.
Changes of liver functions associated with endoscopic sclerotherapy (EST) was investigated in 50 cirrhotic patients with remarkable esophageal varices. The indices used for the evaluation of hepatic ...function was the increase of total bilirubin (ΔT. Bil.) in cases who were treated by paravariceal injection of sclerosant and the ratio between the increase of total bilirubin and the increase of LDH (I.I.) in cases treated by intravariceal injection of sclerosant. In a group of patients with preserved hepatic reserve (Group I, 28 cases), Δ T.Bil. was 0.44±0.37mg/dl and I.I. 0.28±0.19, respectively. In contrast, in patients who showed diminished hepatic reserve prior to EST (Group III, 8 cases), a significant deterioration of liver function was observed after EST (Δ T. Bil. 1.65±0.68mg/dl, I.I. 1.01±0.70, p<0.01). Among the patients who revealed hepatic reserve between that of Group I and Group III (Group II, 14 cases), the extent of the deterioration of liver function after EST was also between Group I and III. Recovery of increased serum bilirubin after EST to pre-treatment level was delayed in Group III. It is concluded that the deterioration of liver function can occur after EST among cirrhotic patients especially those with diminished hepatic reserve prior to EST.
A 55 year-old man was admitted with massive ascites. Although the laboratory data on admission were compatible with hepatic cirrhosis and remarkable esophageal varices were observed during endoscopy, ...the imaging findings such as computed tomography and ultrasonographic examination did not confirm hepatic cirrhosis. The patient had no history of alcohol abuse, blood transfusions or acute hepatitis. Serological markers related to viral and autoimmune hepatitis were all negative. Seven years ago, the patient had undergone an operation for colon cancer and has been taking tegafur since then for a total of 55 months. Tegafur was suspected as the causative agent for the liver dysfunction of this patient and the administration of tegafur was stopped. His laboratory data improved gradually and the ascites vanished. The first liver biopsy performed 6 months after discontinuation of tegafur still revealed chronic active hepatitis. However, at the liver biopsy performed 18 months after withdrawal of tegafur, inflammatory activity had subsided and the third liver biopsy, performed 34 months thereafter, revealed further improvement of the pathological changes that had occurred in the liver. We therefore conclude that the administration of tegafur may have caused chronic active liver injury with portal hypertension manifested as ascites and esophageal varices.
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