1.Clinical studies of liver cirrhosis with special reference to its etiology and prognosis.
Akihiko YUMINO ; Koichi YAMASHITA ; Shigefumi SHIMIZU ; Koji ISOMURA ; Shusuke NATSUKAWA ; Kazuyoshi ONISHI ; Shigenobu TERASHIMA ; Shinji SASAKI
Journal of the Japanese Association of Rural Medicine 1986;35(4):755-764
A total of 194 cases of liver cirrhosis, which had been treated in our hospital during the past 5 years, were calssified by the causes into the following four groups:(I) hepatitis B virus, (II) alcoholic, (III) special origins, and (IV) reasons unknown. They each accounted for 23.2%, 35.6%, 1.5% and 39.7%, of the total.
Their clinical features and prognosis were examined. To be noted is the finding that many patients in group IV had had blood transfusions. This suggests that non A non B hepatitis viruses might be involved in the occurrence of the liver disease. On the whole, the five-year survival rate was 45.6%. There was not any significant difference among the four groups. However, prognoses were poor in groups II, I and IV, in that order.
As regards the cause of death, rupture of esophageal varice and hepatic failure showed a gradual decline, but complications of hepatocellular carcinomas sharply increased. Especially, in group I, this mortality was as high as 31.1%.
2.A study on anti-ATLA antibody in Nagano Prefecture.
Kijo Deura ; Masako Moteki ; Ariko Kodaira ; Masanobu Ikeda ; Toshiaki Ishibuchi ; Akihiko Yumino ; Kiyoshi Shimizu ; Keisuke Minato ; Masanori Shimoyama
Journal of the Japanese Association of Rural Medicine 1985;33(5):920-924
A study was made on and-ATLA antibody among general inhabitants, those with hematologic disease and those with hepatic disease in Nagano Prefecture.
Among 2, 299 inhabitants (990 males and 1, 309 females), anti-ATLA antibody was found to be positive in two males (0.1 %)
The number of patients with hematologic disease was 155. Of them, malignant lymphoma accounted for 50 (T: 24.3 %, B: 37.8 %), acute leukemia 32 and other hematologic malignancy 28. No ATL was found among them. It was revealed that 56 of them underwent transfusion ranging from 2 to 346 units of blood, averaging at 49.7 units. The number of person whose anti-ATLA antibody was positive was one only, who was diagnosed as AML and was transfused 170 units.
Of 42 patients with hepatic disease, HB virus-related liver disease (hepatitis, cirrhosis, hepatocellular carcinoma) accounted for 10, non-B group HBAg (-) for 18, alcoholic liver dysfunction 5 and other hepatic disorders 9. Three out of these 42 patients were found to be positive for anti-ATLA antibody, each three patients belonged to the “non-B” group (3/18, 16.6 %).
The total number of positivist was thus six. Of them, five had a history of transfusion, and all five positivists excluding the one with AML were suffering from hepatic disease with HBAg (-).
From the above, it was considered that in Nagano Prefecture, those whose anti-ATLA antibody was positive were conspicuously small in number, but main cause of the positivity was attributable to the transfusion. Most of the positivists were suffered from non-B hepatic disease with a history of transfusion, and the number of positivist was significantly greater even when compared with patients with hematologic disease with frequent transfusion. Accordingly, it is suggested that some of the hepatic diseases with HBAg (-) might be associated with HTLV.