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Biomedical subjects

K Iwamura

Publications and source records attributed to K Iwamura.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Liver cirrhosis in Asia and Africa].

Whereas in Europe and North America high alcohol consumption is a very frequent cause of cirrhosis of the liver, im many Asian and African countries hepatitis B virus is the most important etiologic agent. Own observations in 345 patients with liver cirrhosis serve to illustrate the etiologic factors, age, sex and causes of death of this disease in Japan. 25 of the patients also had primary hepatocellular carcinoma. Hepatitis B virus infection appears to be a frequent cause of cirrhosis of the liver and hepatocellular carcinoma in Asia and Africa.

Adult↗
PubMed1983

Influence of long-term administration of serum albumin on the prognosis of liver cirrhosis in man.

To investigate the efficacy of long term administration of salt-poor albumin in the prognosis of cirrhotic patients with ascites, we administered albumin for more than six months at regular intervals to nine cirrhotic patients who had been confirmed to have ascites for the first time, and maintained their serum albumin levels above 3.0 g/dl. The other 11 cirrhotic patients who had also developed ascites for the first time were treated with diuretics only, as a control group. In the albumin treated group, one patient developed a hepatoma, and another had acute viral hepatitis after transfusion during splenectomy, and they were excluded. In the control group, one developed chronic liver failure after an operation for choledocholithiasis, and she was excluded from the study. All seven patients who had been administered albumin survived for more than two years, whereas three out of 10 in the control group died of chronic liver failure within two years. In the patients who showed a B.S.P. retention rate of more than 35% at the beginning of the study, all five treated with albumin survived for more than two years, whereas three out of four in the control group died within two years (P less than 0.025). In the albumin treated patients, the increase in serum albumin level was generally accompanied by an increase in the choline-esterase level. Long term administration of serum albumin to cirrhotic patients with ascites appears to lead to a better prognosis.

Adult↗
PubMed1983

A case of porphyria cutanea tarda with hemangioma of the liver.

The clinical incidence of porphyria cutanea tarda is apparently less in Japan than in European countries and the U.S.A.. In the last 7 years, porphyria cutanea tarda was encountered in the dermatologic clinic of Tokai University Hospital at the rate of one in twelve thousand patients with various kinds of skin diseases. This case is the first case in our medical clinic at Tokai University Hospital in the past 7 years, among 2,456 cases of liver diseases in which laparoscopy with needle biopsy of the liver was performed. The physiopathological aspects remain obscure. Unexpectedly, a hemangioma was disclosed under laparoscopic observation but it was clear that the hemangioma had no significant relation to the thrombopenia-hemangioma syndrome in this case.

Adult↗
PubMed1983

Clinical study on latent cirrhosis of the liver.

Although the pathogenesis of liver cirrhosis is complex and not clearly understood, it can be assumed that the morphologic changes in the liver do not occur suddenly in a short space of time and that the morphogenesis goes on insidiously. Therefore, the physician discovers liver cirrhosis coincidentally during evaluation of some other unrelated disease in 20% of cirrhotic patients. Moreover, the diagnosis of liver cirrhosis is established initially at autopsy in 13.5-40% of the patients. The clinical aspect of these cases of latent cirrhosis of the liver was investigated and the patients in this category accounted for 30% of the cases.

Adult↗
PubMed1982

Clinical significance of blood biochemical liver function tests in asymptomatic chronic HBs Ag carriers.

To date we have had 31 asymptomatic chronic HBs Ag carriers in whom the time of HBV infection can be assumed, HBs Ag in sera persisted for at least 6 months, laparoscopy with liver biopsy was performed within 6 to 21 months after the assumed HBV infection, and the clinical course after performance of laparoscopy with liver biopsy ranged from 6 months to 5 years has been observed, while with the lapse of time, blood biochemical liver function tests were examined once every 4 weeks. In 16 out of 31 cases, the results of blood biochemical liver function tests remained always in the normal range and in the remaining 15 cases, blood biochemistries fluctuated sometimes pathologically, but transiently. In the former group, the results of blood biochemical liver function tests showed no pathologic findings, although the histologic inflammatory processes were outstanding in cases of chronic aggressive hepatitis and liver cirrhosis. In the remaining 15 cases, blood biochemistries fluctuated transiently and slightly, although morphological findings corresponded to chronic aggressive hepatitis and liver cirrhosis. The dissociation between blood biochemistries and morphologic findings needs to be further clarified.

Adult↗
PubMed1982

A contribution to early diagnosis of primary hepatic cell carcinoma occurring in patients with liver cirrhosis.

In cases where liver cirrhosis can be diagnosed, we must give the occurrence of primary hepatic cell carcinoma careful consideration because most cases of hepatoma are associated with liver cirrhosis. Among 311 patients with liver cirrhosis, in whom the diagnosis was made laparoscopically and histologically in the past 6 years and the clinical course was observed for at least 1 year after initial diagnosis, primary hepatocellular carcinoma developed in 20 patients, in whom alpha-fetoprotein in the serum, sonography and scintigraphy, computed tomography, selective angiography and echo or laparoscopy guided needle biopsy of the liver were utilized regularly after initial diagnosis of liver cirrhosis. Based on our own experience, we wish to stress that the combination of sonography, scintigraphy, computed tomography and selective angiography can contribute to early diagnosis of primary hepatocellular carcinoma occurring in patients with liver cirrhosis.

Adult↗
PubMed1982

Clinicopathological aspects of primary hepatocellular carcinoma occurring in patients with liver cirrhosis.

In Japan, most cases of primary hepatocellular carcinoma are associated with liver cirrhosis. Therefore, we must carefully consider the occurrence of hepatocellular carcinoma in cases where liver cirrhosis can be diagnosed. Among 333 patients with liver cirrhosis in whom the clinical course was observed for at least one year after initial diagnosis in the author's clinic, primary hepatocellular carcinoma developed in 20 patients. In this paper, the author intends to elucidate the clinicopathological aspects of these 20 patients with primary hepatocellular carcinoma to delineate clinical features of primary hepatocellular carcinoma in its early stage and to find a clue to carcinogenesis in the cirrhotic liver.

Adult↗
PubMed1982

Laparoscopical and histological abnormalities of the liver in chronic HBs ag (hepatitis B surface antigen) carriers.

Previously, I have reported the laparoscopical and histological findings of 16 chronic HBs Ag carriers in whom the time of HBV infection could be assumed, HBs Ag in the sera persisted for at least 6 months, and laparoscopy with liver biopsy was performed. In these carriers, no abnormal results of liver function tests were found and early history of hepatitis was unknown. Besides these 16 HBs Ag carriers, I have encountered 15 chronic HBs Ag carriers in whom the time of HBV infection could be assumed, HBs Ag in the sera persisted for at least six months, and laparoscopy with liver biopsy was performed. In these carriers, no early history of hepatitis could be found and normal results of liver function tests were observed at least at the time of the first laparoscopy with liver biopsy, but blood chemical analyses resulted in slightly abnormal values at rare intervals during the clinical observations after the first laparoscopy with liver biopsy. In six cases of 15 chronic HBs Ag carriers, laparoscopy revealed a white liver; in four cases, a multicolored liver and in the remaining five cases, a nodulated liver. Histology of the white liver in six cases showed chronic persistent hepatitis (CPH) in three cases, chronic aggressive hepatitis (CAH) in one case and chronic persistent hepatitis with fatty metamorphisis in two cass. Histology of the nodulated liver showed liver cirrhosis in five cases. Histology of the multicolored livers showed CAH in all four cases. The question remains unanswered as to how such morphological alterations of the liver developed in these chronic HBs Ag carriers with normal liver chemistries.

Adult↗
PubMed1982

Clinical aspects of bile acid metabolism in liver diseases.

For a long time, it has been assumed that the liver plays an important role in the formation and excretion of bile acids and that the metabolism of bile acids, therefore, can be disturbed to some extent in liver diseases. Pathophysiological aspects of the disturbed metabolism of bile acids remained obscure at the time when procedures of qualitative and quantitative analyses, identification and estimation of bile acids began to be utilized in practice 20 years ago. Since then, the metabolism of bile acids has been clarified in individuals under normal as well as pathological circumstances. Because of a functionally and morphological close relation between hepatic epithelial cells and the metabolism of bile acids, the pathophysiological aspects of the disturbed metabolism of bile acids in parenchymatous inflammatory diseases of the liver, fatty liver, cholestasis and primary hepatocellular carcinoma are attracting considerable attention. First applied to the measurement of human bile acids in blood plasma in 1965, gas-liquid chromatography has been utilized as a standard method in medical practice. Recently, radioimmunoassay and enzyme linked radioimmunoassay have been utilized. This progress in the estimation of bile acids has awoken our interest in the pathophysiological significance of bile acids in liver diseases. The author reviewed the information on bile acid metabolism in liver diseases which has been reported up to the present.

Bile Acids and Salts↗
PubMed1982

Clinical study on etiologic aspects of primary hepatocellular carcinoma.

In spite of many animal experiments and clinical observations, the etiologic aspects of primary hepatocellular carcinoma remain obscure. In 20 cases of primary hepatocellular carcinoma occurring in cases of liver cirrhosis, the author clarified the etiologic aspects. In 10 out of 20 cases of primary hepatocellular carcinoma, an early history of blood transfusion could be detected. In eight cases, an early history of acute viral hepatitis including three cases of posttransfusion hepatitis could be clarified. In the five remaining cases, etiologic factors were unknown but an early history of anicteric hepatitis could not be ignored. In four out of 20 cases, HBs Ag in the serum could be detected. In spite of these findings, the close relationship between hepatitis virus infection and the pathogenesis of primary hepatitis virus infection and the pathogenesis of primary hepatocellular carcinoma must be taken into consideration. The period of time from blood transfusion and/or the onset of acute viral hepatitis to initial diagnosis of primary hepatocellular carcinoma appears to be reasonable for the occurrence of the disease. The question remains open as to what role hepatitis virus plays in the pathogenesis of primary hepatocellular carcinoma.

Acute Disease↗
PubMed1982

Changes of bile acid and lipid composition in blood and bile in the clinical course after the initiation of cheno- and ursodeoxycholic acid therapy in patients with cholesterol gallstones.

In spite of many reports which suggested the efficacy of chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) on cholesterol gallstone dissolution, problems still remain to be solved, such as the ideal dosage and duration of treatment to obtain maximal benefit with minimal untoward effects. The author reports in this paper a comparative study on changes of bile acid level and lipid composition in blood and bile during the clinical course after initiation of CDCA and UDCA therapy in effectively and ineffectively responding groups of patients with cholesterol gallstones in the gallbladder.

Adult↗
PubMed1981

A clinical evaluation of serum alpha-1-antichymotrypsin levels in liver disease and cancers.

The serum levels of alpha-1-antichymotrypsin (ACT) were studied in 168 patients with various liver diseases and cancers in conjunction with other liver function tests, serum sialic acid, AFP and CEA. The ACT levels in acute viral hepatitis and chronic hepatitis were not significantly altered compared with the normal level (220 +/- 40 microgram/ml), although the level was slightly increased or decreased temporarily during the acute phase of the former. In liver cirrhosis, the mean level was significantly lower than the normal in spite of the absence of signs of hepatic decompensation (168 +/- 51 microgram/ml, p less than 0.001). In contrast to cirrhosis, the levels were increased to various extents in 65% of cases with hepatoma, in spite of the association of liver cirrhosis in the majority of them. Much higher levels were observed in all cases of metastatic liver cancers and cancers of the pancreas and the biliary tract. The elevations were observed even in cases without the increase of AFP or CEA. Both in cirrhosis and cancers, ACT levels were not correlated with any of serum bilirubin and serum enzyme activities, but were positively correlated with the levels of plasma fibrinogen and serum sialic acid. The measurement of serum ACT level can be taken advantage of for the diagnosis and monitoring of liver cirrhosis and liver cancers, particularly of hepatoma without AFP elevation.

Blood Sedimentation↗
PubMed1981

Acute type B viral hepatitis due to accidental transfusion of blood containing HBs Ag in a patient with liver cirrhosis.

Patients with liver cirrhosis have the opportunity of receiving blood transfusions rather frequently. Accidental transfusion of blood containing HBs Ag occurred in such a case. Recently, we encountered a case of hepatocellular carcinoma based on posthepatitic cirrhosis in which an emergency blood transfusion because of massive hematemesis from a gastric ulcer was followed by acute B type viral hepatitis. The remainder of the transfused blood was preserved an we tested it serologically when the symptoms of acute viral hepatitis were manifested. We are able to detect hepatitis B surface antigen in the serum. In this patient, the preceding liver cirrhosis did not influence on the clinical course of acute B type viral hepatitis and conversely, the acute B type viral hepatitis did not have any influence on the subsequent clinical course of the liver cirrhosis.

Carcinoma, Hepatocellular↗
PubMed1981

Therapeutic utilization of laparoscopy in liver abscess cases.

Recently, the authors encountered a case of a bacterial pyogenic abscess of the liver in which the localization of a solitary abscess in the right hepatic lobe could be delineated on the basis of the findings of a physical examination, sonography, scintigraphy, computer tomography and selective angiography. The popularization of endoscopic surgery and chemotherapy encouraged us to attempt drainage of the pus out of the pyogenic abscess under laparoscopic observation. The patient has been progressing favorably thereafter and now about ten months have passed since he returned home. He is in good health. Clinical utilization of laparoscopy is possible from a therapeutic standpoint in solitary abscess of the liver.

Drainage↗
PubMed1981

Laparoscopic an histologic abnormalities of the liver in chronic asymptomatic hepatitis B surface antigen carriers.

In most cases, Hepatitis B surface antigen (HBs Ag) in sera can be incidentally detected in patients with liver diseases at the time of medical examinations. It is rather difficult to assume how long HBs Ag has persisted in the sera of these patients before the medical examination. However, we have encountered 16 asymptomatic HBs Ag carriers in whom the time of HBV infection can be estimated, HBs Ag in sera persisted for at least 6 months (actually up to 5 years), and laparoscopy with liver biopsy was performed. In 11 out of these 16 asymptomatic HBs Ag carriers, laparoscopy revealed a white liver and in the remaining five cases, a multicolored liver. Histology of the white liver showed minimal inflammatory changes of the liver in two cases, chronic persistent hepatitis in eight cases and chronic aggressive hepatitis in one case. Histology of the multicolored liver including transitional change to the nodulated liver in five case showed chronic aggressive hepatitis in two cases and liver cirrhosis in three cases. The question remains open as to how such morphological alterations of the liver developed in these asymptomatic HBs Ag carriers with normal liver chemistries although none of these 16 cases developed overt acute hepatitis, either of type A or non A non B, 6 to 21 months after the assumed HBV infection.

Adult↗
PubMed1980

Separation of serum cholinesterase isozymes by an improved polyacrylamide gel electrophoresis and its application for the study of liver diseases (Part I).

A method for separation of serum (pseudo) cholinesterase isozymes was studied in order to take advantage of it for clinical research. By employing modifications on a previously reported method, analytical time was shortened to a half (1.5 days) of the original method without abolishing qualitative and quantitative accuracy. Thus, the present method facilitated its clinical application for the study of this isozyme. A normal pattern of the isozyme in Japanese in this method was determined by the analysis of sixteen normal subjects, which appeared to be very consistent in each individual under the present conditions. The distribution of relative activities of respective isozymes measured on a densitogram coincided well with that measured calorimetrically. Abnormalities of the zymogram were newly found in patients with liver cirrhosis and metastatic liver cancer, which seemed to be characteristic to the respective diseases. Isozyme patterns in the liver and ascites were also measured and compared with those in serum.

Cholinesterases↗