摘要:

ABSTRACT—In a 6‐month follow‐up study of acute hepatitis in Japan, 31 out of 41 (75.6%) cases of post‐transfusion non‐A and non‐B hepatitis (NANB‐PTH) and 14 out of 40 (35.0%) cases of sporadic non‐A non‐B hepatitis (NANB‐SPO) were found to be positive for antibody to the hepatitis C virus (HCVAb). After 12 months of follow‐up, 30 cases (81.1%) became chronic among 37 HCVAb positive acute NANB hepatitis cases. This figure shows a significantly higher rate of chronicity as compared with HCVAb negative acute NANB hepatitis. The prevalences of HCVAb in hepatitis B surface antigen (HBsAg) negative cases of chronic hepatitis and liver cirrhosis were 76.3% (200/262) and 66.7% (106/159), respectively, which were significantly different from the values of 5.1% (13/255) and 10.6% (13/123) observed in HBsAg positive cases. Of chronic liver disease cases positive for HCVAb, 45.8% (152/332) had a history of blood transfusion, in contrast to the value of 3.7% (13/352) observed in HBsAg positive cases of chronic liver disease that we

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00494.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—Thyroid dysfunction has long been reported in patients with liver disease, but limited information is available on thyroid gland size in cirrhosis. Most studies were carried out on small, selected series of patients, and no study has measured thyroid volume in relation to the etiology of liver disease. Thyroid volume was measured at ultrasound in 118 consecutive patients with cirrhosis of different etiology and 48 healthy subjects matched for age and sex. No subject had evidence of overt thyroid disease. The mean volume was increased by 17% (from 16.0 [SD 5.2] ml in controls to 18.8 [7.6]in cirrhosis; P20 mm) was present in 38% of cases, in the presence of hormone values indicative of low‐T3syndrome. No significant differences in thyroid gland size were observed in relation to the extent of liver dysfunction or to the etiology of liver disease. The prevalence of thyroid nodules was similar in controls and in patients with cirrhosis. In only 8% of cases were laboratory values indicative of hypothyroidism, with low free triiodothyronine and raised thyroid‐stimulating hormone levels; in these patients thyroid volume was decreased on average by 26%. This was mainly the case with patients with primary biliary and alcoholic cirrhosis. The largest mean thyroid volume was observed in patients with HBsAg + ve postnecrotic cirrhosis, whose thyroid volume was increased on average by 37%, and 53% of subjects had thyroid enlargement. This finding raises the question of a possible direct involvement of the thyroid in hepatitis B virus in

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00495.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—An attachment of lymphocytes to the vascular wall, a feature called “endothelialitis” (ETL) or “endotheliitis“, was investigated in various liver biopsies, including acute hepatitis (AH), hepatic infectious mononucleosis (IM), drug‐induced hepatitis, alcoholic hepatitis and fibrosis, chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), liver cirrhosis (LC), primary biliary cirrhosis (PBC), nonspecific reactive hepatitis (NSRH), and cases with a variety of diseases having almost normal liver histology as control material. Although ETL has been considered to be nearly pathognomic of graft‐versus‐host disease (GVHD) and acute transplant rejection, ETL was found in both portal and central veins with a variable incidence, not only in all categories of liver diseases, but also in the control group. The incidence of central vein ETL was significantly higher in AH, CAH, PBC, IM, alcoholic fibrosis, and NSRH than that of the control group, and that of portal vein ETL was significantly higher in AH, CPH, CAH, LC, PBC, IM, and alcoholic fibrosis. Even under the light microscope, lymphocytes attached to the endothelial cells had irregular cytoplasmic processes making contact with endothelial cells. Also lymphocytes located beneath the endothelial lining were frequently found. When ETL‐positive and ‐negative cases in the same category were compared, the levels of serum glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) were usually higher in the ETL‐positive group, and statistically significant differences were observed in CPH, CAH, LC, PBC and NSRH. In chronic hepatitis, the occurrence of portal vein ETL paralleled the histologic activity of portal inflammation, whereas central vein endothelialitis was associated with active parenchymal inflammation such as sinusoidal lymphocyte infiltration and spotty hepatocyte necrosis, indicating that ETL may be a phenomenon more frequently associated with active hepatic inflammation. Immunohistochemical observations revealed that about 70% of lymphocytes attached to the endothelial cells were T cells, while about 10% were B cells. These data indicate that ETL in the liver is not specifically pathognomonic for GVHD and rejection of liver transplants, and is universally found in a variety of liver diseases with a varying incidence and activity, related to the activity of hepatic inflammation, portal vein ETL occurring in relation to active portal inflammation and central vein ETL to parenchymal inflammation. Thus ETL is considered to be an intimate T lymphocyte‐endothelial cell interaction universally associated with active hepatic inflammation; it may be an important phenomenon leading to accumulation of cellular exudates and their reaction at the site o

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00496.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—A 67‐year‐old patient, with primary polymyositis and without previous evidence of liver disease, developed clinical and biochemical features of severe cholestasis 3 months after initiation of azathioprine therapy. Liver biopsy showed cholestasis with both cytological and architectural alterations of interlobular bile ducts. Azathioprine withdrawal resulted after 7 weeks in the resolution of clinical and biochemical abnormalities. It is believed that this is the first reported case of reversible azathioprine‐induced cholestasis associated with histological evidence of bile duct

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00497.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—To clarify the relation of pericentral fibrosis to portal hypertension, measurements of portal vascular resistancein vitroand blood pressures of several key points in hepatic vascular pathwaysin vivowere undertaken in rats given dimethylnitrosamine. Administration of dimethylnitrosamine induced tortuosity and narrowing of the peripheral branches of the hepatic vein due to pericentral fibrosis. No significant change was produced in the sinusoids and the portal vein branches. The portal vascular resistance was increased and the portal vein pressure was elevated markedly. The blood pressure gradient was steep in the intrahepatic vein, but not in the intrahepatic portal vein or the sinusoids, as compared to control. These data suggest that deformation of the peripheral branches of the hepatic vein due to pericentral fibrosis causes a marked increase in vascular resistance in the intrahepatic hepatic vein, i.e. postsinusoidal portal hypertensio

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00498.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—The appearance of α‐smooth‐muscle‐actin (α‐smA)‐positive cells during hepatic fibrosis was studied immunohistochemically in rat and human livers. In the normal rat liver, α‐smA was observed only in vascular smooth muscle cells. With the progression of fibrosis induced by CCl4injection, α‐smA‐positive cells appeared in the perisinusoidal space and the fibrous septa, and ultimately surrounded regenerative nodules. An increase of desmin‐positive cells was recognized in the fibrotic areas and the perisinusoidal area. In the human liver, α‐smA‐positive cells appeared in the fibrotic area, whereas no desmin‐positive cells were observed, except in vascular walls of the central vein and the portal tract. α‐smA is a good marker for the detection of myofibroblast‐like cells, and the appearance of α‐smA in liver mesenchymal cells seems closely related to the process o

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00499.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—In a rapid51Cr release assay, peripheral blood mononuclear cells from 12 healthy donors did not lyse the hepatitis B virus deoxyribonucleic‐acid‐transfected human hepatoma cell line 2.2.15, but under the same experimental conditions they did lyse K562 cells. Peripheral blood mononuclear cells from 10 out of 16 patients with chronic active hepatitis B exhibited cytotoxic activity against 2.2.15 cells in the presence of a relatively reduced natural killer cell activity to the K562 cell target. Enhancement of the cytotoxic activity to 2.2.15 cells was statistically significant in the group of patients being treated with leukocyte alpha‐interferon. The activity was not influenced by the degree of human leukocyte antigen type matching between effector and target, and was enhanced by depletion of T‐cells and byin vitrointerferon treatment. These results therefore support the concept of a natural killer‐like cell activated by clinical administration of interferon in chronic active hepatitis B patients. This cell effector was lytic for the virus B negative HEP‐G2 cells also. However, T‐cells purified from a few patients failed to lyse the HEP‐G2 while lysing the 2.2.15 target, thus indicating that a preferential recognition of the virus‐infected target may be exerted by certain T‐lymphocyte subsets. The use of the human leukocyte antigen type defined, highly differentiated, hepatitis B virus releasing 2.2.15 cell line as target for fresh lymphocytes in this cytolytic assay did not disclose cytolytic T‐cells in an obvious way. Further manipulation of this system perhaps using T‐cell clones may be the next step to exploit the investigative possibilities offered by the availability

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00500.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—Morphological changes in hepatic macrophages after stimulation were observed with a transmission electron microscope in rats. In the normal liver ruffle formation occupied less than 30% of the cell surface facing the sinusoidal space in 21 of 25 macrophages. When the rats received a dose of carbon tetrachloride, hepatic macrophages I day later showed ruffle formation to the same extent as in normal rats. In contrast, in rats 6 days after a dose ofCorynebacterium parvum, ruffle formation was intensified, and in 19 of 25 macrophages it was seen to occupy more than 30% of the cell surface (p<0.01); 9 of 10 macrophages with more than 70% of the cell surface affected belonged to these rats. Considering that hepatic macrophages at I or 6 days after treatment with carbon tetrachloride orCorynebacterium parvumare at the responsive or primed stages, respectively, measurement of the extent of ruffle formation in hepatic macrophages with a transmission electron microscope may provide a useful tool in estimating their stimulatory stag

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00501.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT—Information on the ultrastructure and phenotypes of proliferative hepatocytes is scarce, so we set out to detect proliferating hepatocytes immunohistochemically by use of a monoclonal antibody against DNA polymerase alpha (DNA‐PA). The findings from this method were compared with conventional features, such as mitotic figures, and hepatic regeneration after injury was considered in the light of these findings. The subjects of the basic study were 23 patients with acute hepatic failure. There were 6.8 ± 5.5 (mean ± SD) mitotic hepatocytes per 1000 hepatocytic nuclei, and 209 ± 158 hepatocytes stained for DNA‐PA per 1000 hepatocytic nuclei. By light and electron microscopy (n=4), hepatocytes stained for DNA‐PA showed various morphological features, including development of organelles, but some resembled hepatocytes in mitosis. Accordingly, this histochemical method may be useful in studies of hepatic regeneration. In acute confluent necrosis, when hepatocytic proliferation is urgently needed for survival, small hepatocytes next to necrotic areas (probably immature cells, to judge from the development of their organelles) were predominant in hepatic regeneration. These findings suggest that hepatocytes in different stages of development can easily enter the mitotic cell cycle repeatedly when rapid regeneration

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00502.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1991.tb00503.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY