A CLINICO-PATHOLOGICAL STUDY OF 163 UNTREATED CASES OF CHRONIC HEPATITIS C

We performed a clinico-pathological study of 163 untreated cases of chronic hepatitis C. Most of the patients were clinically asymptomatic and their physical examinations showed unremarkable or minimal changes at the time of the liver biopsy. Liver function tests tended to present slight abnormalities, involving mainly alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamil transferase (GGT) levels. In spite of these mild abnormalities, advanced chronic liver disease was histologically detected in the majority of the patients, mainly showing chronic active hepatitis. Most characteristic histological finding was an interlobular bile duct damage, which correlated with the presence of lymphoid aggregates in the portal tracts and with the development of fibrosis

Progressive Multifocal Leukoencephalopathy (PML) in A Japanese Patient with Acquired Immunodeficiency Syndrome (AIDS) : A Case Report

We report an autopsy case of progressive multifocal leukoencephalopathy (PML) of a 40 year-old Japanese male with acquired immunodeficiency syndrome (AIDS). Since he was diagnosed as hemophilia A at the age of 15 years, he had been treated with factor VIII concentrates. When he was 35 years old, the antibody against human immunodeficiency virus (HIV) was found to be positive. Four years later he was pointed out left hemiparesis. Pneumocystis carinii organisms were detected and he was diagnosed as AIDS at the age of 40 years. During his admission multiple lesions were demonstrated in the cerebral white matter by MRI and CT scan and suspected to be PML. Dyspnea aggravated rapidly and he died from respiratory failure. Autopsy examination revealed multiple necrotic foci in the cerebral white matter, which showed characteristic histological features to be confirmed as PML, namely, multiple demyelinating foci with enalrged and bizarre astrocytes, hypertrophied oligodendrocytes with intranuclear inclusion bodies and numerous lipid-laden macrophages

Malignant Mesodermal Mixed Tumor of the Bladder : A Case Report

We report an autopsy case of malignant mesodermal mixed tumor of the urinary bladder of a 67 year old male. He had been admitted to Kita Hospital under the diagnosis of Alzheimer\u27s disease since 1979. His dementia aggravated and he was confined to bed in 1985. While in the hospital, he developed hematuria and calculi and necrotic materials were sometimes noticed in his urine. Although the CT scan and intravenous urography revealed left hydronephrosis and vesical lithiasis, urinary cytological studies showed no remarkable changes. At the beginning of September 1992, he was found to have a child\u27s fist-sized tumor in his left lower abdominal cavity, which was diagnosed as a bladder tumor and left renal pelvic tumor. The tumor grew rapidly and reached a child\u27s head-size within 3 months. Several cytological examinations of his urine were performed, but all showed negative for malignancy. There was no tumor response against anti-cancer chemotherapy and he died on November 22, 1992. Autopsy revealed a bulky tumor mass which occupied the whole lower abdominal cavity. Histologically, the tumor was composed of an epithelial element of well differentiated squamous cell carcinoma and a non-epithelial element of rhabdomyosarcoma. The cross striations in rhabdomyosarcoma cells were clearly stained by PTAH. Immunohistochemically, rhabdomyosarcoma cells were positively stained by Desmin and partially by Vimentin. Therefore we diagnosed this tumor as malignant mesodermal mixed tumor of the urinary bladder

The Pattern of Pediatric Solid Malignant Tumors in Western Kenya, East Africa, 1979?1994: An Analysis Based on Histopathologic Study

This study analyzed histopathologic specimens of 600 pediatric solid malignant tumors seen during the period 1979?1994 at the histopathology laboratories of the Rift Valley Provincial General Hospital in Nakuru, the Nyanza Provincial General Hospital in Kisumu, and the Uasin Gishu Hospital in Eldoret in western Kenya. The crude incidence rate of each malignancy per 100,000 children per year was calculated. The patterns of malignancies were examined with a focus on tumor incidence, age, sex, geographic, and ethnic distribution to relate the tumors to putative environmental and genetic causative factors. The six common tumors were Burkitt\u27s lymphoma (33.5%), non-Hodgkin\u27s lymphoma (21.8%), retinoblastoma (11.5%), Kaposi\u27s sarcoma (6.1%), nephroblastoma (4.5%), and Hodgkin\u27s disease (4.1%). Significantly high crude incidence rates for lymphomas and Kaposi\u27s sarcoma showed a characteristic ethnogeographic distribution. The majority of the tumors were found concentrated around Lake Victoria and showed decreasing occurrence as one moved towards the semi-arid and highland areas. We concluded that environmental factors seem to play a major role in childhood tumors in western Kenya

Seroprevalence of Antibody to Hepatitis E Virus in Voluntary Blood Donors in Northern Thailand

We report the results of seroepidemiological study of hepatitis E virus (HEV) infection in 636 voluntary blood donors in four Provinces of Northern Thailand. The average seroprevalence of anti-HEV was 8.7%, which is lower than previous reports from HEV endemic areas and even in the central Thailand. No significant differences of the prevalence were found geographically and also by age and sex. Our findings suggest that Northern Thailand belongs to an intermediate prevalence group of HEV infection between non-endemic and endemic regions and the improvement of socioeconomic and hygienic status might control the spreading of HEV infection in this area

Short Report: Herpes-Like DNA Sequences in African-Endemic and Acquired Immunodeficiency Syndrome-Associated Kaposi\u27s Sarcoma

Recently, the unique nucleic acid closely related to the herpes-like sequences has been found in acquired immunodeficiency syndrome (AIDS)-associated Kaposi\u27s sarcoma (KS). We have confirmed the presence of herpes-like DNA sequences in six cases of AIDS-associated KS and three of the nine cases of African-endemic KS in adults, but not in eight cases of KS in children from the same area. These sequences were seen in a histologically early stage of KS. Our results suggest that herpes-like DNA sequences may play an important role in the pathogenesis of AIDS-associated KS

Seroepidemiological Survey of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Infections among The Hill Tribes in Northern Thailand

We report the results of seroepidemiological survey of Human immunodeficiency virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections among the Karen, La-Wah and Lahu-Na, designated as the hill tribes, in northern Thailand. Some of these hill tribes are living in the remote and isolated mountain areas, settling their own communities. Anti-HIV seropositive cases were found only in the Lahu-Na (2.6%). The highest incidence of Hepatitis B surface antigen (HBs-Ag) positive was found in the Karen (13.2%), followed by the Lahu-Na (2.6%) and the La-Wah (1.7%). The highest incidence of anti-Hepatitis C virus antibody (anti-HCV) positive was found in the La-Wah (3.3%), followed by the Karen and the Lahu-Na (2.6%, respectively). Two out of nine anti-HCV positive cases were from seven and 11 year-old Karenean girls, who had no previous history of surgery, blood transfusion, intravenous medication, vaccination and dental therapy. These results suggest that HIV infections have not yet reached to the hill tribes, except the Lahu-Na. One of the possible transmission routes of HCV infection is a vertical or intrahhousehold infection among the hill tribes in northern Thailand

A High Prevalence of Hepatitis C Virus Infection Among The Human Immunodeficiency Virus Seropositive Blood Donors in Chiang Mai, Thailand

We report the results of serological survey of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections among the human immunodeficiency virus (HIV) seropositive and seronegative blood donors in Chiang Mai, Thailand. Anti-HCV were positive in 17 out of 276 anti-HIV seropositive blood donors (6.2%) and six out of 844 anti-HIV seronegative blood donors (0.7%). HBs-Ag were positive in 20 out of 276 anti-HIV seropositive blood donors (7.2%) and 68 out of 844 anti-HIV seronegative blood donors (8.1%). These findings suggest that anti-HIV seropositive population belongs to a high risk group of HCV infection and there are similar transmission routes between HIV and HCV infections