Diagnosis of small hepatocellular carcinoma by computed tomography: Correlation of CT findings and histopathology

The diagnostic value of computed tomography (CT) scans in small hepatocellular carcinoma (HCC) (less than 5 cm) was studied in 82 patients. Dynamic scan was also made in 66 of them. Combined unenhanced and enhanced scans detected 87% of the lesions greater than 2 cm, but the detection rate was only 25% for lesions less than 1.5 cm. Diagnostic failure was due to isodensity of the mass and to technical artefacts. Diagnosis of the surrounding capsule and internal septa (partition) and demonstration of the typical pattern of density enhancement by dynamic scan proved useful in differentiating HCC from secondary cancers. On unenhanced CT, the density of the interior was subject to the histological changes of tumour such as bleeding, necrosis and fatty metamorphosis. Similarly, enhanced CT showed density changes suggestive of these histological changes. Dynamic scan proved particularly useful for lesions less than 3 cm because the typical density enhancement was frequently demonstrated in the arterial phase. It was concluded that unenhanced CT combined with dynamic scan has a high diagnostic value in small HCC and reflects histological changes.     

Bone resorption in periodontal diseases: role of bacterial factors

Summary. The bone resorbing activity of lipopolysaccharides from oral bacteria has been investigated in vitro. Further, the resorbing activity appeared to be reduced by serum, except in the case of lipopolysaccharide from Bacteroides gingivalis. This micro-organism is commonly associated with periodontal disease in adults. The significance of lipopolysaccharides stimulating bone resorption in vivo has not yet been resolved.     

Clinical utility of a simple quantitative determination of hepatitis B e antigen

The titre of serum hepatitis B e antigen (HBeAg) was determined by using a simple quantitative system which is a slight modification of a commercially available enzyme immunoassay, and the relationship of serum HBeAg titre, hepatitis B virus (HBV)-associated DNA polymerase activity and HBV DNA level was evaluated. The HBeAg titre was found to have a significant correlation with DNA polymerase activity (r= 0.8153) and HBV DNA level (r= 0.8001). In 12 acute exacerbations of hepatitis in 10 patients with chronic type B hepatitis, these three parameters were found to be elevated either prior to or concurrent with the elevation of serum alanine aminotransferase, and the HBeAg titre peaked either simultaneously with or 1–4 weeks after the peaks of DNA polymerase activity and HBV DNA level, with average time lags of 1.00 weeks (s.d. = 1.29) and 1.08 weeks (s.d. = 1.25), respectively. Quantified HBeAg can be considered as a serum marker indicative of HBV replication, as is the case with DNA polymerase and HBV DNA. Furthermore, the HBeAg assay has the advantages of simplicity and low cost and it does not require special equipment. Therefore, quantification of HBeAg should be employed widely in clinical practice.     

Adenosine increases anagen hair growth and thick hairs in Japanese women with female pattern hair loss: A pilot,double‐blind,randomized, placebo‐controlled trial

Adenosine upregulates the expression of vascular endothelial growth factor and fibroblast growth factor‐7 in cultured dermal papilla cells. It has been shown that, in Japanese men, adenosine improves androgenetic alopecia due to the thickening of thin hair due to hair follicle miniaturization. To investigate the efficacy and safety of adenosine treatment to improve hair loss in women, 30 Japanese women with female pattern hair loss were recruited for this double‐blind, randomized, placebo‐controlled study. Volunteers used either 0.75% adenosine lotion or a placebo lotion topically twice daily for 12 months. Efficacy was evaluated by dermatologists and by investigators and in phototrichograms. As a result, adenosine was significantly superior to the placebo according to assessments by dermatologists and investigators and by self‐assessments. Adenosine significantly increased the anagen hair growth rate and the thick hair rate. No side‐effects were encountered during the trial. Adenosine improved hair loss in Japanese women by stimulating hair growth and by thickening hair shafts. Adenosine is useful for treating female pattern hair loss in women as well as androgenetic alopecia in men.     

Alkaline Phosphatase Isoenzymes in Carcinoma Tissue of Gastro-intestinal Tract

The enzymological and immunological properties of alkaline phosphatase (ALP) isoenzymes in carcinoma tissues of the gastro-intestinal tract were compared with those of purified human intestinal, placental and hepatic ALP's to investigate the gene expression of gastro-intestinal cancer cells. The results were as follows: ALP obtained from carcinoma tissues of 77 patients was separated into 6 bands (ALPa, ALPb, ALPc, ALPd, ALPe and ALPf) by polyacrylamide-gel disc electrophoresis. It was concluded that ALPa was similar in its enzymological and immunological properties to hepatic-type ALP, ALPb was similar to placental-type ALP (Regan ALP or Nagao ALP), ALPc to intestinal-type ALP (metaplasia ALP), ALPd to hepatoma-type ALP (Warnock's variant ALP), ALPe to intestinal-type ALP except for electrophoretic mobility, and ALPf was similar to hepatic-type ALP except for neuraminidase sensitivity. ALPb appeared in 16 out of 55 cases (29%) of gastric carcinoma, and 2 out of 21 cases (10%) of colonic carcinoma. ALPd appeared in 4 out of 55 cases (7%). ALPe appeared in 2 out of 55 cases (4%) of gastric, and 3 out o 21 cases (14%) of colonic carcinoma. ALPf appeared in 1 out of 55 cases (2%) of gastric, and 1 out of 21 cases (5%) of colonic carcinoma. These ALP isoenzymes (ALPb, ALPd, ALPe and ALPf) probably originate from the cancer cells themselves and may represent an abnormal gene expression of cancer cells in the process of onco-developmental differentiation.     

Changes of serum aminotransferase activities in relation to serum hepatitis Be antigen levels in chronic type B hepatitis

The purpose of this study was to determine the level of serum hepatitis Be antigen (HBeAg) during hepatitis B virus carriage and its clinical significance. The mean level of serum HBeAg, quantitated by solid-phase enzyme immunoassay, was 5924 units in asymptomatic carriers (s.d. = 5534, n= 100), 3044 units in patients with chronic persistent hepatitis (s.d. = 4826, n= 34), 3599 units in chronic active hepatitis (s.d. = 4953, n= 45) 1348 units in liver cirrhosis (s.d. = 2379, n= 25) and 766 units in hepatocellular carcinoma (s.d. = 1257, n= 18). In the 10 HBeAg-positive patients with chronic active hepatitis, the fluctuation in HBeAg level was followed by changes in alanine aminotransferase (ALT) activity. Among the 36 peaks of HBeAg and ALT, HBeAg peaks preceded ALT peaks in 22 and simultaneous peaks were present in 14. The changes of HBeAg level were closely related to increase in disease activity as estimated by ALT activities; therefore, HBeAg quantitation can be a useful predictor of disease activity in chronic hepatitis B.     

Inverse Relation of Body-Surface Activation-Recovery Interval and Recovery Time to Activation Time in Normal Subjects: Stronger Correlation and More Heterogeneous Distribution in Activation-Recovery Interval Than in Recovery Time

The activation-recovery interval (ARI), measured directly from the myocardium, has shown a good correlation with the action potential duration (APD) in experiments. APD has been reported to be inversely related to the activation time (AT). However, no studies have examined the correlation between the body-surface ARI and AT in normal subjects. Fifty normal subjects (25 men and 25 women) were studied to elucidate the relationship between the body-surface ARI and AT. The body-surface AT was defined as the duration between the QRS onset and the minimum dV/dt of the QRS wave, and ARI as the interval between the minimum dV/dt of the QRS wave and the maximum dV/dt of the T wave in each lead of an 87 unipolar lead system. We also measured the recovery time (RT) defined as the duration between the QRS onset and the maximum dV/dt of the T wave. ARI was inversely correlated with AT (r = -0.73). RT was also inversely correlated with AT (r = -0.61), however, RT had a less heterogeneous distribution than ARI (148 ms vs 159 ms). There were no differences between male and female subjects in the relation between ARI and RT or in the body-surface distribution of ARI and RT. These findings suggest that the body-surface ARI may reflect recovery properties over the cardiac surface and that APD may distribute inhomogsneously over the human cardiac surface with a longer RT over an area with a shorter AT. ARI calculated from body-surface ECG may be a useful noninvasive and repeatedly measurable estimate of APD.     

The effects of antiviral agents on serum hepatitis B e antigen levels in chronic type B hepatitis

In the present study, aiming at the evaluation of the effects of antiviral therapy on hepatitis B e antigen (HBeAg) levels, serum HBeAg concentration was determined serially by a quantitative assay in 44 patients with chronic hepatitis B who received a total of 73 courses of antiviral treatment. The posttreatment HBeAg levels were significantly lower than pretreatment baseline in all treated groups, not only at the end of treatment but also 6 months after the completion of therapy. The proportional decrease in treated patients was significantly greater than in 15 untreated controls. Six months after the completion of treatment, serum HBeAg became negative in seven out of 25 treatments with interferon, seven out of 28 with adenine arabinoside, and five out of 20 with adenine arabinoside 5'-monophosphate. All patients who became negative for HBeAg had normalization of alanine aminotransferase as well. A progressive decrease in HBeAg in patients treated with multiple courses of drug was observed, and the frequency of negative tests increased, paralleling the number of courses of treatment. These results suggest that antiviral therapy may alleviate inflammatory changes in the liver by promoting clearance of HBeAg from the serum, and may eventually shorten the natural course of hepatitis associated with chronic hepatitis B virus infection.