Biomedical subjects

T Itoshima

Publications and source records attributed to T Itoshima.

At least 55 records · Page 3Linked to original sources

PubMed1984

Two cases of constitutional unconjugated hyperbilirubinemia with marked retention of indocyanine green.

Two cases of chronic unconjugated hyperbilirubinemia and marked retention of indocyanine green (ICG) are described. Since bilirubin uridine diphosphate (UDP)-glucuronyl transferase activities were depressed in their liver, the patients seemed to have bilirubin metabolism similar to that in Gilbert's syndrome. However, the ICG fractional disappearance rates of the cases were rather low (0.018 and 0.019) compared to the rates reported for Gilbert's syndrome. These results suggest that the patients had a new metabolic disorder which results in constitutional unconjugated hyperbilirubinemia and ICG intolerance.

Adult↗

PubMed1984

Effects of sake and bourbon on liver histopathology and function in rats.

Sake or bourbon (8g ethanol/kg body weight) was intragastrically administered to rats for 12 days. An equal dose of ethanol in water or an isocaloric glucose solution was administered to control groups. Food was withheld, but water freely provided. Neither mortality nor liver and body weights were different between the alcohol-treated groups. Glutamic oxaloacetic transaminase and glutamic pyruvic transaminase were more elevated in the sake group than in the other groups. Additionally, liver fibrosis was more pronounced, and vacuole formation or steatosis was less in this group. These results suggest that sake is more fibrogenic. Some components other than ethanol, such as long-alkyl chain alcohols, may have been responsible for the differential histopathology.

Alcoholic Beverages↗

PubMed1984

Diagnosis of hepatocellular carcinoma in patients with liver cirrhosis using liver function assays.

Sex, age and 21 routine liver function assays were analyzed by stepwise selection and the best-of-all-possible-combinations method to identify a small group of assays valuable in establishing which liver cirrhosis (LC) patients have a high risk of hepatocellular carcinoma (HCC), when alpha-fetoprotein (AFP) is not elevated. Data was obtained from 115 HCC and 122 LC patients on admission. Tumor size correlated with AFP (0.73), alkaline phosphatase (ALP, 0.47), leucine aminopeptidase (LAP, 0.42), lactic dehydrogenase (LDH, 0.42), and the glutamic oxaloacetic transaminase (GOT)/glutamic pyruvic transaminase (GPT) ratio (GOT/GPT, 0.41). The mean of the correct diagnosis rates (CDR) of HCC and LC utilizing AFP as the sole parameter (89%) was markedly higher than those of the other parameters. The best-of-all-possible-combinations method presented a more powerful combination than stepwise selection. The best combination of 7 parameters (LAP, GOT/GPT, choline esterase, one-hour erythrocyte sedimentation rate, age, albumin/globulin ratio, and total bilirubin) presented a mean CDR of 80%, HCC CDR of 77%, and false positive rate of 18%. LC patients statistically diagnosed as having HCC by these 7 parameters are proposed as high risk patients. Fourteen (78%) of 18 HCC patients who were AFP-negative were statistically diagnosed. This analysis can be applied to LC patients to distinguish those that should be followed closely by imaging diagnostic techniques.

Adult↗

PubMed1984

Clinical studies of resistant ascites in liver cirrhosis.

Resistant ascites was studied in 34 patients with liver cirrhosis and ascites. The patients were initially divided into 3 groups on the basis of the weekly cumulative ascites retention curve: patients relieved of ascites within 3 weeks of admission, patients relieved between 4 and 12 weeks and patients with ascites persisting beyond 13 weeks. "Resistant ascites" was defined as "ascites persisting for more than 13 weeks after admission to the hospital". The patients were then reclassified into 3 groups : Group A being those patients relieved of ascites within 12 weeks, Group B being those with resistant ascites and group C being those who died within 12 weeks of admission. There were no differences in age and sex distribution, etiology of liver cirrhosis, past medical history or physical findings among the 3 groups. However, Group B had higher levels of serum creatinine and blood urea nitrogen than Group A on admission. Serum bilirubin was higher and serum albumin was lower in Group C than in Group B, which indicates that Group C had greater liver cell failure.

Adult↗

PubMed1984

Clinical studies of hepatocellular carcinoma with liver cirrhosis and ascites.

A comparison was made of the clinical findings of 59 patients with liver cirrhosis (LC) accompanied with hepatocellular carcinoma (HCC) (of which 35 had ascites and 24 did not at the time of admission) and 164 patients with LC, but without HCC (of which 39 had ascites and 125 did not). HCC patients were older and more often had hepatomegaly, vascular spider and pleural effusion than LC patients. Ascites was more frequently observed in HCC than in LC patients when the serum albumin level and the indocyanine green disappearance rate were relatively well maintained and when peripheral edema was absent. There was no difference in the ascitic protein concentration between LC and HCC patients. Malignant cells were detected in ascites only in 14% of the HCC patients. These facts indicate the presence of ascites-inducing factors in HCC patients which have no direct relation to serum colloid osmotic pressure and effective hepatic blood flow. Almost all of the HCC patients with ascites (96%) died with ascites, whereas 54% of the LC patients with ascites recovered from the ascitic condition.

Adolescent↗

PubMed1984

Lack of uptake of indocyanine green and trypan blue by hepatocellular carcinoma.

Experimental hepatocellular carcinoma (HCC) in rats did not take up intravenously administered indocyanine green (ICG) and trypan blue, while surrounding tissue did. The lack of ICG uptake was also observed by peritoneoscopy in patients with HCC. The contrast between ICG-stained cirrhotic nodules and HCC tumors was intensified with infrared photography. Non-uptake of dyes by HCC cells may enable discrimination between tumors and normal cells.

Animals↗

PubMed1984

Scanning electron microscopy of Ito's fat-storing cells in the rat liver.

The whole body including extended processes of Ito's fat-storing cells was observed by scanning electron microscopy in rat liver injured with lithocholic acid (LCA). Necrotic foci developed in the midlobular zone 48 h after LCA administration. Demonstration of Ito cell bodies around the foci was probably facilitated by easy detachment of hepatocytes from Ito cells. The body and the processes were located mainly between the sinusoidal endothelium and hepatocytes; sometimes they were between hepatocytes. Ito cells often were proximate to collagen fiber bundles and sometimes were attached to them. The cell body was flatly round or elliptic, 7 to 12 micron in diameter. Its surface was finely undulated with microvillous projections about 0.1 micron in length. Branching patterns of the processes resembled a fern-leaf mantling the sinusoidal endothelium. The trunks of the processes were about 2 micron in diameter and 20-30 micron in length. These processes tapered, branching into thinner processes, with the most peripheral being 0.1 micron in diameter. Ito cells and their branching processes likely strengthen sinusoidal walls and control blood flow in the sinusoids.

Animals↗

PubMed1984

A case of cornstarch granuloma.

A 57-year-old female was diagnosed as having asymptomatic cornstarch granuloma. The disseminated small nodules over the peritoneum were incidentally discovered at operation for cholelithiasis, when she was misdiagnosed as carcinomatosis peritonei. Histological observations revealed a characteristic finding of tuberculoid granuloma with caseous necrosis, a rather rare histological type of cornstarch granuloma. Polarized light microscopic examination of biopsy specimens is particularly important for the diagnosis. We emphasize that cornstarch granuloma should once be considered when tuberculoid or unknown abdominal granuloma are observed in patients with history of abdominal surgery.

Female↗

PubMed1984

Scanning electron microscopy of experimentally induced hepatocellular carcinoma.

Hepatocellular carcinomas (HCC) induced in rats by diethylnitrosamine were observed by light microscopy (LM) and scanning electron microscopy (SEM). Liver cirrhosis did not develop. The tumors were of 4 types; trabecular, glandular, adenoid and hyperplastic nodular (HN). SEM demonstrated that trabecular lesions were packed with many layers of HCC cells which had in some places bile canaliculi on the intercellular surfaces with sparse microvilli. Glandular lesions were composed of gland-like structures having columnar or cuboidal cells with numerous microvilli on the hemispherical apex. Glandular lumens were bordered from intercellular spaces by the zona occludens. The glandular structures were derived from the exterior of the trabecular lesions and were closed at both ends, as confirmed by reconstruction of serial sections. Adenoid lesions, which had gland-like structures in the trabecula, were often observed between purely trabecular and purely glandular lesions. HN-type lesions composed of two-cell-thick plates were mostly located at the peripheral parts of the HCC tumor and were continuous with other lesions. HN-type lesions had markedly dilated bile canaliculi and well-developed microvillous projections on the intercellular surfaces. The HN-type lesions had structures similar to those of late HN. The existence of lesions indistinguishable from late HN in the periphery of HCC tumors indicates the HCC develop from HN. In summary, the rat HCC were of 4 types of lesions which had characteristic histological and cytological structures, but which were connected with each other, changing gradually from one to the other.

Animals↗

PubMed1984

Scanning electron microscopy of experimentally induced sequential alterations of rat liver hyperplastic nodules.

Rat liver hyperplastic foci (HF) and hyperplastic nodules (HN) induced by diethylnitrosamine (DEN) according to the method of Solt and Farber were observed by light microscopy (LM) and scanning electron microscopy (SEM). Liver cirrhosis was not observed. HF, which were composed of basophilic hepatocytes arranged usually in two-cell-thick plates and occasionally one-cell-thick plates, were followed by early HN, which were composed of eosinophilic hepatocytes with enlarged nuclei and prominent nucleoli, at 4 weeks after DEN administration. SEM revealed that hepatocytes in HF had smooth surfaces and dilated bile canaliculi with a few short microvilli. Early HN (4 and 6 weeks) were composed of two-cell-thick plates of hepatocytes, whose intercellular surfaces were covered with numerous microvillous projections. Bile canaliculi were dilated and had numerous short microvilli. Late HN (6 and 8 months) were composed of eosinophilic hepatocytes, which were irregular in shape and size. Their nuclei were enlarged and nucleoli were prominent. Hepatocytes were arranged in two-cell-thick plates, but never in many-cell-thick plates. Bile canaliculi were larger than sinusoids. The bile canaliculi had numerous diverticula, but the zona occludens was present. Microvillous projections of intercellular surfaces of hepatocytes were more numerous than those of early HN. Fenestrae of the sinusoidal endothelium were lost in most parts. Kupffer cells were not seen in any stage of HN. HN progressed gradually toward hepatocellular carcinoma.

Animals↗

PubMed1983

Ranking of liver tests for differential diagnosis of liver parenchymal diseases.

Liver function tests were ranked in the order useful to differentiate 8 liver parenchymal diseases in combination of tests by forward selection and backward elimination procedures in the likelihood method using a microcomputer. The orders were almost same in both procedures: indocyanine green plasma disappearance rate, glutamic pyruvic transaminase (GPT), zinc turbidity test, alkaline phosphatase, age, HBsAg, RA test, glutamic oxaloacetic transaminase (GOT)/GPT ratio, GOT, cholesterol, total protein, total bilirubin, albumin/globulin ratio and gamma-globulin. The first 9 tests had almost all informations of all tests. The first likelihood diagnosis using the 9 tests was correct in 53% and the first or the second diagnosis was correct in 71% of 444 cases of 8 liver parenchymal diseases. A score table of likelihood diagnosis using the 9 tests was presented for manual application to new cases.

Clinical Enzyme Tests↗

PubMed1983

Peritoneoscopy of the liver stained by intravenous injection of indocyanine green-experimental and clinical studies.

Liver surface patterns were observed by peritoneoscopy after intravenous injection of indocyanine green (ICG). The normal rat liver was diffusely stained dark greenish-brown 5 minutes after the injection of ICG 25 mg/kg body weight into the tail vein. Green spots persisted longer in the centrolobular area, clearly revealing lobular markings. This regional difference in hepatocyte staining suggested differing abilities of hepatocytes to take up or excrete ICG. This dyeing technique was applied to liver disease patients. The liver was diffusely stained light greenish-brown 5 minutes after the injection of ICG 5 mg/kg body weight. In patients, especially those with obscure lobular markings before ICG injection, lobules were clearly demarcated by reddish terminal portal veins against a green background. This simplified detection of lobular distortions. Prenodular patches (Kalk's Bunteflecke) on the liver surface were stained green more intensely than surrounding areas, which supports the hypothesis that patches are composed of active hepatocytes.

Adult↗

PubMed1983

Scanning electron microscopy of a liver cavernous hemangioma.

A 39-year-old female with a large cavernous hemangioma of the liver was successfully treated by ligation of the left hepatic artery. A wedge biopsy specimen of the hemangioma was obtained after the ligation and was examined by scanning electron microscopy. The hemangioma was demarcated from the surrounding normal liver parenchyma and had a labyrinth of caves 50-150 microns in diameter. The caves were separated by fibrous septa 20-40 microns in width. Endothelial cells of the caves were spindle-shaped and arranged in parallel. The surface property of the caves resembled that of the hepatic artery and differed from that of the portal vein or hepatic vein. These findings support that the cavernous hemangioma of the liver was supplied by the hepatic artery. The labyrinthine structure of the cavernous hemangioma may explain the long standing contrast enhancement of the hemangioma after hepatic arteriography.

Female↗

PubMed1983

Computed tomographic arteriography in the diagnosis of hepatocellular carcinoma.

Computed tomographic arteriography (CTA) was performed in 30 patients with hepatocellular carcinoma (HCC). Detection of HCC by CTA was compared with that of conventional celiac or hepatic arteriography. CT scanning was performed immediately, 30 seconds and 1 min after an injection of 5 to 10 ml of contrast medium into the common or proper hepatic artery. Repeated infusions allowed whole liver sections to be visualized. HCC was localized in 28 of the 30 patients by conventional arteriography, with CTA detecting the masses in 27 of the 28 patients. CTA imaging presented the tumor mass in 1 of the 2 patients missed by arteriography. Conventional arteriography delineated the boundaries of HCC in 15 (50%) of the 30 patients. CTA clearly delineated the masses in 26 (87%) of the 30 patients including 11 patients in which the tumor borders were obscure by conventional arteriography. HCC lesions smaller than 1 cm in diameter were detected only by CTA in 6 (20%) of the patients. It was concluded that CTA is both useful and necessary in the demarcation of small HCC masses.

Angiography↗

PubMed1983

Absence of Kupffer cells in carcinogen induced liver hyperplastic nodules: demonstration by intravenous injection of indian ink.

Absence of Kupffer cells in rat liver hyperplastic nodules induced by a chemical carcinogen was demonstrated by intravenous injection of indian ink. Hyperplastic nodules appeared 4 weeks after diethylnitrosamine (DEN) was administered, and the nodules continued growing and became eosinophilic hyperplastic nodules after 5 to 6 weeks. After intravenous injection of indian ink, hyperplastic nodules were observed as carbon-free white nodules, which were macroscopically distinguishable from the black surrounding tissue. As observed by light microscopy, Kupffer cells were absent in hyperplastic nodules in contrast to being present in the surrounding tissue. Scanning electron microscopy confirmed these findings and furthermore revealed that the sinusoidal endothelium of hyperplastic nodules had no fenestrae. Injection of indian ink is a useful method for delineation and enucleation of hyperplastic nodules in the study of morphological and chemical changes of nodules.

Animals↗

PubMed1983

Peritoneoscopy of the liver after abdominal surgery.

The incidence of intraperitoneal adhesion after abdominal surgery was studied. Peritoneoscopy was performed in 933 patients with liver diseases over the 6 year 5 month period from March 1974 to July 1980. Of the patients, 352 (37.7%) had undergone an abdominal operation, and intraperitoneal adhesion was detected in 205 (58.2%) of these patients. The liver was not observable in 5 out of 61 patients with adhesions after upper abdominal operations. Whereas, the liver was clearly observable in patients with lower abdominal operations in spite of adhesions. Out of the 581 patients without any abdominal operations, 30 patients (5.2%) had adhesions in the abdominal cavity, and 6 of them had extensive adhesions that partially obscured the observation of liver surface. In all patients, peritoneoscopy was performed without complications by avoiding the surgical scar for puncture sites and ensuring a free air lumen before trocar puncture.

Abdomen↗

PubMed1983

Conductive staining of biological specimens for scanning electron microscopy with special reference to ligand-mediated osmium impregnation.

Biological specimens for scanning electron microscopy are made electron-conductive and non-charging by intense osmication with tannic acid, thiocarbohydrazide, hydrazine hydrate or other bifunctional ligands (or mordants). Such osmication also minimizes tissue shrinkage during dehydration and drying, reduces tissue damage during metal coating and scanning observations, and circumvents the use of a thick metal coating which hinders high resolution. Intense osmication when repeated eliminates the need for a metal coating and produces a well-contrasted scanning image with good resolution. Moreover, such osmication reduces tissue damage during ion implanting, enhances the depth of imaging, allows x-ray microanalysis without coated metals, and permits resin-embedded observations, as well as continuous or repeated microdissections in the scanning electron microscope without charging. Intense osmication forms a surface coat or thickens the cell membrane. This surface coat consists of electron dense deposits of 4-20 nm thickness. The hydrazine hydrate-osmium method can be used in the vapor phase. The vapor phase application has the advantage of staining even plastic samples for non-metal-coated scanning electron microscopy.

Animals↗

PubMed1982

Differential diagnosis of liver parenchymal diseases by likelihood method using 12 laboratory data and age.

Liver parenchymal diseases were statistically diagnosed by likelihood method using 12 routine liver function tests and age. 444 cases of liver diseases were classified into 8 groups by histological diagnosis. A score diagnosis table was made from the data of these cases. For the likelihood diagnosis, data of each case were adapted to the score table and the probable diagnosis was calculated. Correct diagnosis rate of the first probable diagnosis was 50% in all cases and that of the first and the second was 71%. Descending order of the correct diagnosis rate of the first diagnosis was fatty liver (76%), liver cirrhosis (67%), slight histological changes (61%), acute hepatitis (51%), alcoholic liver injury (48%), chronic aggressive hepatitis 2A (43%), chronic persistent hepatitis (40%) and chronic aggressive hepatitis 2B (26%). In conclusion, differential diagnosis of liver parenchymal diseases was made easily with the score table of 13 informations with a considerable success.

Adult↗