PubMed Health⌕ Search

Biomedical subjects

T Unuma

Publications and source records attributed to T Unuma.

At least 37 records · Page 2Linked to original sources

HBs antigen subtypes among acute hepatitis patients in Japan: evidence of imported hepatitis.

HBs antigen subtypes were determined among 137 acute hepatitis patients in Japan. The distribution among the 99 male patients was 40 adr, 37 adw, one ayw, and 21 undetermined while that among the 38 female patients was 19 adr, 11 adw, and eight undetermined. The distribution among the male patients was different from that among HBs antigen carriers in Japan, suggesting that they were exposed not only to domestic HBs antigen carriers, but also to other sources. Thirty-one (29 males and two females) of the 137 patients (22.6%) were found to have been abroad at some time during the incubation period. The distribution among them was seven adr, 21 adw, and three undetermined. The majority had the same subtypes that are prevalent in the countries they visited, supporting the hypothesis that most of them had contracted the disease overseas. The remaining 106 patients had a distribution of the subtypes similar to that of domestic HBs antigen carriers. "Imported hepatitis" would be an important cause of acute type B hepatitis in Japan.

Acute Disease↗

Hepatic epithelioid hemangioendothelioma in a young female.

Epithelioid hemangioendothelioma in a young female is reported. Her symptoms were right upper quadrant pain and low-grade fever. Laboratory examinations showed an increased number of white blood cells and an elevated erythrocyte sedimentation rate. Plasma factor VIII:C was increased. The hepatic lesions were demonstrated as low-density areas by CT scan, and multiple nodules with central depression on the surface of the liver were identified by peritoneoscopy. The biopsy specimens showed spindle-shaped tumor cells set in the fibrous and myxohyalinous tissue. The tumor cells were positive for factor VIII-related antigen and Weibel-Palade bodies. The patient received transcatheter arterial embolization therapy using Gelfoam and mitomycin C following which the plasma level of factor VIII was normalized and regression of the tumors was observed.

Adolescent↗

Effects of habitual alcohol intake and cigarette smoking on the development of hepatocellular carcinoma.

To study the effects of habitual alcohol intake and cigarette smoking on the latency period for the development of hepatocellular carcinoma (HCC), 455 patients with HCC were analyzed with respect to age at diagnosis. They were divided into hepatitis B virus (HBV) positive and negative patients based on HbsAg and high titer anti-HBc in serum. HBV-positive and negative HCC patients were further subdivided into four subgroups based on the history of drinking more than one small bottle of Japanese "sake" or its equivalent per day for more than 10 yr and the history of smoking more than one cigarette per day for more than 10 yr. Among HBV-positive HCC patients, the average age of those with a drinking and a smoking habit (50 +/- 10 yr) was younger compared with that of patients with a drinking habit but without a smoking habit (56 +/- 14 yr, not significant, NS), of those who were smokers and nondrinkers (55 +/- 10 yr, NS) and of those who did not drink nor smoke (59 +/- 8 yr, p less than 0.005). Among HBV-negative HCC patients, patients with drinking and smoking habits (57 +/- 9 yr) were younger compared with those with a drinking habit without smoking (59 +/- 9 yr, NS), those who were smokers and nondrinkers (62 +/- 9 yr, p less than 0.005), and those who were nondrinkers and nonsmokers (63 +/- 12 yr, p less than 0.005). These data suggest that habitual alcohol intake may promote the development of HCC if the patients smoke cigarette regardless of the status of HBV seromakers.

Adult↗

Percutaneous ethanol injection in the treatment of liver neoplasms.

The effectiveness of percutaneous ethanol injection therapy was investigated in 30 patients who had hepatocellular carcinoma (18 had a single lesion and 12 had multiple lesions). In patients who had a single lesion, ethanol injection was especially effective. Histopathologic examination, performed in nine cases in this group, showed that the tumor was completely necrotic in six cases, 90% necrotic in two cases, and 70% necrotic in the remaining case. In eight other cases with a single tumor, follow-up angiography showed complete disappearance of the tumor stain. In the other case, CT showed the nonenhanced low-density area. In the 12 patients with multiple lesions, ethanol injection was performed as part of an integrated treatment plan. Eleven were still alive at the end of the study (the mean follow-up period was 5.8 months). We conclude that ethanol injection may be a valuable treatment for hepatocellular carcinoma.

Adult↗

Acute hemolysis associated with hepatitis A.

A 62-yr-old woman, admitted to Mitsui Memorial Hospital with complaints of jaundice, general malaise and anorexia, was diagnosed as acute hepatitis A by positive IgM anti-HA. On the 13th hospital day, indirect hyperbilirubinemia (total bilirubin 57 mg/dl, indirect bilirubin 38.5 mg/dl) and splenomegaly were noted. Hemoglobin concentration decreased to 8.4 g/dl and reticulocytes increased to 6%. Bone marrow showed hyperplastic marrow with erythroid hyperplasia. Coombs test was negative. After administration of prednisolone 40 mg daily for 30 days, hemoglobin concentration increased to 11.9 g/dl and total bilirubin was decreased to 0.4 mg/dl. The liver biopsy specimen obtained on the 62nd day, revealed recovery stage of acute hepatitis. Jaundice with increased indirect bilirubin, anemia with reticulocytosis, elevated plasma hemoglobin concentration and predominance of LDH1 were indicative of hemolysis. The enzyme activities in the red blood cells, which were taken 1 year after the onset, were within normal limits. Scanning electron microscopy of the red cells showed no significant abnormalities in their shape and the nature of the surface.

Anemia, Hemolytic↗

Diffuse hepatic calcification as a sequela to shock liver.

A 31-yr-old Japanese woman who was on chronic hemodialysis for 3 yr died of intractable congestive heart failure. Three years before death, the patient was in a state of shock for 48 h due to ventricular tachycardia and gastrointestinal bleeding, which was followed by marked elevation of serum transaminase. Four months later, abdominal plain radiography demonstrated diffuse hepatic calcification. At autopsy, microscopic examination of the liver revealed parenchymal necrosis and tiny calcifications in the central to midzonal area of the lobule. Calcification in the degenerative area of the hepatic lobule occurred subsequent to parenchymal ischemia after overt shock that lasted for 2 days. Although a definitive explanation for the calcification was not obtained, it may be related to the disturbances of intracellular Ca2+ homeostasis as a result of ischemic liver injury or it may be related to an elevated calcium-phosphorus product in the uremic state.

Adult↗