Sixty-eight consecutive patients with chronic hepatitis B received 702 million units of recombinant interferon-α2a. Of the 24 patients negative for hepatitis B e antigen (HBeAg) in serum, the ...normalization of serum transaminase occurred in 14 (58%) at the completion of interferon therapy and in 13 (54%) at 12 months thereafter; it was normalized in 17 (39%) and 13 (30%), respectively, of the 44 HBeAg-positive patients. Of the HBeAg-negative patients, hepatitis B virus DNA was cleared from serum in six (25%) at the completion and in one (4%) at 12 months thereafter, in contrast to only one (2%, p < 0.05) and none of the HBeAg-positive patients, respectively. The 1896th nucleotide of G (G1896) for codon 28 for tryptophan or A (A1896) for the stop codon 28 in the precore region was determined by restriction fragment length polymorphism. The ten HBeAg-negative patients with A1896 only in the precore region had lower pretreatment levels of viral markers, which decreased more rapidly and extensively after interferon than in the 14 HBeAg-negative patients with a mixture of G1896 and A1896 or in the 44 HBeAg-positive patients. These results indicate that patients with HBeAg-negative chronic hepatitis B may respond better to interferon than HBeAg-positive patients, and that the precore mutant with the stop codon 28 may be sensitive to interferon.
Conflicting results have been reported concerning the effect of endoscopic injection sclerotherapy upon the long-term survival of cirrhotic patients with esophageal varix. The recurrence and ...rebleeding of esophageal varices seems to be an important factor influencing long-term survival. We investigated the long-term survival of patients after complete eradication of esophageal varices.
Forty patients treated by endoscopic injection sclerotherapy for acute esophageal variceal bleeding were studied. The recurrence rate of varices and the long-term survival of patients in whom complete eradication of esophageal varices was obtained were compared with those of patients in whom the eradication of varices was incomplete.
The frequency of the recurrence/deterioration rate of varices and rebleeding in the complete eradication group was significantly lower than that in the incomplete eradication group (10.7% vs. 100%, 0% vs. 58.3%, respectively, p < 0.01). Accumulated 5-year survival rate of the complete eradication group was significantly higher than that of the incomplete eradication group (68.2% vs. 43.2%, p < 0.05).
Complete eradication of esophageal varices by endoscopic injection sclerotherapy is effective both in preventing variceal re-bleeding and in improving the survival of cirrhotic patients with esophageal varices.
Between 1983 and 1992, endoscopic injection sclerotherapy (EIS) using 5% ethanolamine oleate according to the so-called traditional method was performed in 170 patients with esophageal varices. In ...1993, we adopted a new method, tentatively called the “waiting method”, in which additional EIS was withheld (“waiting”) until variceal inflammatory swelling caused by the former EIS disappeared. Between 1993 and 1998, the waiting method was employed in 48 patients. The disappearance rate of esophageal varices by EIS in cases of no hepatocellular carcinoma treated by the waiting method was 93.9% (traditional method; 65.3%) and the recurrent rate was only 2.9% (traditional method; 8.0%). Compared to the traditional method, the amount of sclerosant (35.6 ± 15.4 vs 53.2 ±26.4 ml; p <0.01), frequency of EIS (3.0 ± 1.1 vs 4.8 ±2.3; p < 0.001), duration of hospitalization (89.6 ±33.2 vs 118.0 ± 42.0 days; p <0.001), and complications (2.1 vs 28.2%; p <0.001) decreased in patients treated with the waiting method. We propose that because EIS employing the waiting method has numerous merits compared to conventional EIS, it should be regarded as the first choice of treatment for esophageal varices.
The growth of rat ascites hepatoma cells (AH 66) in vitro was inhibited and the amount of α-fetoprotein (AFP) in the culture medium was increased in the presence of dibutyryl adenosine 3'-5' cyclic ...monophosphate (DBc-AMP). Electronmicroscopically, AH 66 cells that had been incubated with DBc-AMP showed an increase in polysomes on rough endoplasmic reticulum (RER), and some mitochondria appeared to be completely surrounded by RER. AFP in untreated cells was found to be localized on ribosomes of RER, free ribosomes and occasionally also on microvilli of cell membranes by electronmicroscopic and immunohistochemical analysis. After DBc-AMP treatment, increased staining of AFP was identified on ribosomes of RER and microvilli of cell membranes as well as on nuclear membranes. These results suggest that DBc-AMP accelerates the production and release of AFP in cultured rat ascites hepatoma cells.
We report an outbreak of pulmonary tuberculosis (TB) in a dormitory of construction labors, and this outbreak is suspected to have been caused by exogenous reinfection, based on the restriction ...fragment length polymorphism (RFLP) analysis and other findings. After a patient entered our hospital with active TB, 12 new other patients were discovered by contacts examination. These patients lived together in the same dormitory. They were all male and single, and were aged from 43 to 63 years old. Except one patient (No.3) previously treated for TB for three months about 2 years ago and was suspected to be the index case of this outbreak, 12 other patients did not have a medical history of TB. The bacilli cultured from 11 patients (No.1-11) were tested by RFLP analysis, three patterns were identified, and the fingerprints from 9 patients (No.1-9) were identical, and the patterns of incomplete resistance of some antituberculous drugs were quite similar between No.1-9 and No.12 and between No.10 and No.13, respectively. The locations of the main lesions of TB on chest X-ray pictures were the apico-posterior segments of bilateral upper lobes. No signs suspected to indicate primary tuberculosis were detected. Considering the rate of tuberculous infection in Japan among the middle age and above as well as the identical RFLP results, most of patients in this outbreak except the index case No.3 were suspected to have TB due to the exogenous reinfection.
A 67-year-old woman was diagnosed as having acute appendicitis and underwent an appendectomy. The appendix was significantly red in color and swelled which were compatible with acute phlegmonous ...appendicitis macroscopically. Postoperative histology demonstrated that goblet-cell-like tumor cells extensively infiltrated to the submucosa with perineural invasion. These cells were mucin-producing and were diffusively shown as argyrophilic. Since the same treatment as in advanced cancer was considered appropriate, a right hemicolectomy with lymph node dissection and bilateral oophorectomy were added. No metastasis or residue was observed, but a minor ovarian papillary cystic tumor of borderline malignancy was noted. Goblet cell carcinoid of the appendix is known to be almost as malignant as cancer. Metastasis to the ovary is often found in patients with goblet cell carcinoid of the appendix, but concomitant primary ovarian tumor seems rare like in this patient.
A rat hepatoma cell line, FF101, established in serum-free, protein-free medium, synthesizes a growth factor(FF-GF). FF-GF was purified by gel filtration chromatography, cation-exchange ...chromatography and isoelectric focusing. Purified FF-GF was revealed as a single band on SDS-gel electrophoresis and its molecular weight was estimated to be 70 KDa. FF-GF stimulated DNA synthesis of various cells from different origins. The growth-promoting activities of FF-GF were abolished by treating with protease, dithiothreitol, acid and heating, whereas its activity was not inhibited by antibodies against acidic and basic fibroblast growth factors. These results indicate that FF-GF is a novel growth factor.
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