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M Unoura

Publications and source records attributed to M Unoura.

At least 55 records · Page 3Linked to original sources
PubMed1993

Eosinophilic infiltration of the liver in primary biliary cirrhosis: a morphological study.

Eosinophils and their secretory proteins are important in necroinflammatory processes. In this study we surveyed eosinophilic infiltration of the liver in 176 liver biopsy specimens from patients with primary biliary cirrhosis. A considerable number of eosinophils were found in the portal tracts in 51 of these specimens (29%), whereas this finding occurred in only 2 of 50 (4%) specimens from patients with viral chronic active hepatitis. Eosinophilic infiltration of the portal tracts was focal. These eosinophils were immunohistochemically shown to contain the secreted form of eosinophilic cationic protein. Grades of eosinophilic infiltration of the portal tracts were higher in those livers with higher grades of lymphoplasmacytic infiltration, granulomas and florid duct lesion in the portal tracts, and they were lower in those livers with higher grades of bile duct disappearance and orcein-positive granuoles in hepatocytes. In the livers of patients with primary biliary cirrhosis, eosinophils were abundant around the damaged bile ducts, around the portal vein branches and at the marginal regions, and they were scattered in the portal tracts, whereas only the last pattern was seen in viral chronic active hepatitis. Peripheral blood eosinophils tended to be increased in primary biliary cirrhosis patients with higher grades of eosinophilic infiltration of the portal tracts. Eosinophilic infiltration of the portal tracts may play a role in immunological injuries of the interlobular bile ducts in primary biliary cirrhosis.

Adult↗
PubMed1992

Sequence comparisons for a hepatitis C virus genome RNA isolated from a patient with liver cirrhosis.

The nucleotide (nt) sequence was determined for an isolate of hepatitis C virus (HCV) derived from cirrhotic tissue of a patient with hepatocellular carcinoma. The 9408-nt sequence (EMBL Acq. No. X61596) showed homology of 90.7-91.4% on the nt level, as compared to two Japanese isolates from patients with a high titer of serum transaminase, 78.4-78.8% to those obtained in the United States, and 65.0% to that from an asymptomatic Japanese carrier. The phylogenetic tree of the six isolates classified them into three groups.

Genome, Viral↗
PubMed1992

Clearance of HBsAg in seven patients with chronic hepatitis B.

The natural history of chronic hepatitis B patients who spontaneously cleared serum HBsAg was investigated. A total of 351 patients with chronic hepatitis B were observed in our hospital for at least 3 yr. Seven of these patients became HBsAg negative during the follow-up period. HBsAg disappeared within 6 mo (range = 11 to 169 days, mean = 70 days) after acute elevation of ALT. ALT levels as high as 500 IU were found in three patients, whereas such elevation was not demonstrated in the other four patients. After the disappearance of HBsAg, ALT levels returned to normal in all patients. With one exception, all patients seroconverted to antibody to HBsAg; however, hepatitis B virus DNA remained detectable in serum using the polymerase chain reaction in five patients. The titer of percent inhibition of antibody to HBcAg gradually decreased to less than 70% when a 1:200 dilution of the serum of six patients was used. Four of the patients had active liver disease develop: two had chronic active hepatitis and two had cirrhosis. Three of these four patients subsequently had hepatocellular carcinoma develop. These findings suggest that patients may suffer complications of chronic hepatitis even after normalization of transaminase activities and after the clearance of HBsAg. Thus hepatitis B virus should be considered as a possible factor associated with hepatocellular carcinoma even in the absence of HBsAg, particularly if serum hepatitis B virus DNA persists.

Base Sequence↗
PubMed1992

Quantitation of hepatitis C virus RNA by competitive polymerase chain reaction.

Since the amount of hepatitis C virus (HCV) RNA might be correlated with the degree of severity of hepatitis and response to treatment, quantitation of HCV RNA in serum was established using competitive polymerase chain reaction (PCR). Known amounts of a plasmid containing HCV-cDNA were co-amplified with a standard dilution series of a competitive template which shared the primers' sequences but differed from the wild type cDNA in having a deletion. Accurate quantitation was obtained by comparing the amount of both products. Quantitation of serum HCV RNA was carried out in two patients' serum samples which were also used to infect chimpanzees. The concentration of HCV RNA in these two sera was calculated to be 1 pg/ml (non-infectious at 10(-3) dilution) and 1-10 pg/ml (infectious at 10(-5) dilution). The procedure was subsequently used to analyze serial changes in serum HCV RNA in three patients who were treated with alpha-interferon. During treatment, the levels of alanine aminotransferase showed a significant decrease in all patients and the amount of HCV RNA fell from 1 fg/ml, 1 pg/ml, and greater than 10 pg/ml to 0.1 fg/ml, 100 fg/ml, and 1 pg/ml, respectively. The decrease in the amount of HCV RNA after treatment was related to the initial amount of serum HCV RNA. These results suggest that quantitation of HCV RNA may be useful not only for understanding the course of HCV infection but also for evaluating treatment for HCV infection.

Base Sequence↗
PubMed1992

Clinicopathologic study of alcohol-like liver disease in non-alcoholics; non-alcoholic steatohepatitis and fibrosis.

Alcohol-like liver injury (ALLI) in non-alcoholics has not been elucidated in Japan. The present study attempted to characterize the clinicopathologic features of ALLI in routine liver biopsies. ALLI was found in 1% of 561 biopsy cases obtained from 1988 to May, 1991 at Kanazawa University Hospital. Laboratory data characteristically showed only a mild to moderate degree of dysfunction, and none of the cases exhibited jaundice. Hepatic histology showed a mild to moderate degree of perivenular, pericellular and/or portal stellate fibrosis with a varying degree of fatty change and inflammatory cell infiltration. Portal stellate fibrosis with a varying degree of cell infiltration was more severe than the centrilobular or pericellular fibrosis in all cases. Intralobular inflammatory cell infiltration was associated with spotty or single hepatocyte necrosis, but extensive hepatocyte necrosis was not observed. Neutrophil infiltration was absent or minimal, and lymphocytes predominated in all cases. Mallory bodies were rare and were found in a few hepatocytes of only one of the 7 cases. The above histologic findings in ALLI were very similar to those seen in liver disease in Japanese alcoholics, and were somewhat different from ALLI reported in Western countries. In cases in which hepatic fibrosis, characterized by pericellular, perivenular or portal stellate fibrosis dominated without apparent hepatic necrosis and inflammation, the term "non-alcoholic steatofibrosis" is more suitable to depict its liver histology, being very similar to the alcoholic fibrosis frequently seen in Japanese alcoholics.

Adult↗
PubMed1992

Discordant hepatic uptake of Tc-99m NGA and Tc-99m PMT in a patient with hepatoma.

The authors report discordant hepatic uptake of Tc-99m NGA and Tc-99m PMT in a patient with hepatoma. Tc-99m PMT uptake was delayed and Tc-99m NGA concentrated in another area, thereby demonstrating that the uptake mechanisms for Tc-99m NGA and Tc-99m PMT are different. Tc-99m NGA imaging may be useful in characterizing the focal hepatic lesion of Tc-99m IDA or Tc-99m PMT concentration.

Albumins↗
PubMed1991

Argyrophilic nucleolar organizer regions and alpha-fetoprotein in adenomatous hyperplasia in human cirrhotic livers.

Recently, adenomatous hyperplasia (AH) of the liver has been suspected as a precancerous lesion in human hepatocarcinogenesis. The authors examined 75 cases of AH from 42 cirrhotic livers, using staining of argyrophilic nucleolar organizer regions (AgNORs). These reflect proliferative cell activity. Findings in AH were compared with those seen in hepatocellular carcinoma (HCC) and other chronic liver diseases. Expression of alpha-fetoprotein (AFP) was also examined immunohistochemically. The authors classified AH into three types: ordinary (OAH), atypical (AAH), and AH with focal malignancy (FM). OAH implies a lack of atypia; AAH represents AH with structural and cellular atypia but without the features of overt carcinoma; and FM denotes AH with foci of overt HCC. Forty of the 75 cases of AH were categorized as OAH, 19 as AAH, and 16 as FM. The noncancerous areas of FM had features of AAH. The mean number of AgNORs in AH was intermediate between that seen in cirrhosis (2.93) and HCC (6.18) and showed a step-wise increase in the following order: OAH (2.95), AAH (3.89), noncancerous areas in FM (4.58), and malignant foci in FM (5.71). There was no significant difference in AgNOR counts between OAH and cirrhosis. AgNOR counts in AAH and FM were significantly higher than those of OAH, and lower than those of HCC. AFP was positive in 12 of 25 HCCs and in malignant foci of 3 FM lesions, but it was absent in OAH and AAH. These data suggest that OAH has a limited capacity for proliferation but that AAH and FM are much more replicative. The latter two conditions are probably preneoplastic lesions or early forms of HCC.

Adenoma↗
PubMed1991

Benign and malignant nodules in cirrhotic livers: distinction based on blood supply.

The blood supplies of nodular lesions associated with liver cirrhosis were analyzed in vivo with various imaging modalities. The portal blood supply was evaluated with computed tomography (CT) during arterial portography (CTAP); the arterial blood supply was evaluated with hepatic angiography, CT angiography, CT following intraarterial injection of iodized oil, or ultrasound following intraarterial injection of carbon dioxide microbubbles. A total of 84 surgically confirmed hepatocellular carcinomas (HCCs) (less than or equal to 3 cm) and 25 areas of adenomatous hyperplasia (AH) were included in the study. At CTAP, a portal blood supply was seen in 96% of cases of AH and only 6% of HCCs (chi 2, P less than .005). In contrast, an arterial supply greater than that of the surrounding liver was verified in 94% of the HCCs and only 4% of the cases of AH (chi 2, P less than .005). The blood supply of areas of AH with atypical hepatocytes and the blood supply of well-differentiated HCCs (Edmondson grade 1) tended to be intermediate between that of AH without atypia and that of HCC that was Edmondson and Steiner grade 2 or greater. Evaluation of the blood supply of the nodular lesions associated with liver cirrhosis is considered to be useful in the differential diagnosis and treatment of early-stage HCC.

Carcinoma, Hepatocellular↗
PubMed1991

[Clinical course of patients with hepatocellular carcinoma after surgical resection, with emphasis on the occurrence of hepatic failure].

Postoperative course including serial changes in values of liver function tests and occurrence of hepatic failure was investigated in 59 patients with hepatocellular carcinoma. Eleven cases out of 59 patients were associated with chronic hepatitis (CH group), while remained 48 cases were with liver cirrhosis (25 cases of group A and 23 of group B in Child's classification). There was no significant difference in survival rate or recurrence rate after operation among these three groups. Hepatic failure within one year after hepatectomy was observed in 9%, 28% and 91% of patients in groups CH, Child's A and Child's B, respectively, and the frequency of occurrence of hepatic failure in Child's B group was significantly higher than those of groups CH and Child's A. Hepaplastin test and serum albumin levels recovered from the decline after hepatectomy in groups CH and Child's A. On the other hand, no recovery was found in Child's B group as well as lower levels before operation and that was thought to be the major reason for the frequent occurrence of hepatic failure in Child's B group.

Adult↗
PubMed1991

Hepatocellular and biliary expression of HLA antigens in primary biliary cirrhosis before and after ursodeoxycholic acid therapy.

Recently, there have been reports that ursodeoxycholic acid (UDCA) therapy has a beneficial effect on liver function in patients with primary biliary cirrhosis. However, information regarding the effects of UDCA therapy on hepatic histology remains insufficient. Aberrant expression of HLA antigens on hepatocytes is regarded important in the progression of hepatocellular damages mediated by cytotoxic T-cells in primary biliary cirrhosis. In this study, we examined immunohistochemically hepatocellular expression of HLA antigens on hepatocytes before and after UDCA therapy in four patients with asymptomatic primary biliary cirrhosis. Piecemeal necrosis, intralobular focal necrosis, and portal inflammation, as well as infiltration of activated T-lymphocytes and expression of HLA class I antigens on hepatocytes, disappeared, or diminished in parallel after the therapy. In two of four patients, expression of HLA-DR on some periportal hepatocytes before the therapy also disappeared after the therapy. These observations imply that UDCA therapy decreases the hepatocellular expression of HLA antigens and thereby reduces or abolishes T-cell-mediated hepatocellular necrosis in primary biliary cirrhosis.

Adult↗