Acute hepatitis B in a patient previously positive for antibody to surface antigen (anti-HBs) determined by radioimmunoassay. Case report and review of the literature.
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Acute Disease↗
Biomedical subjects
A Takeda
Publications and source records attributed to A Takeda.
Detection of serum p53 antibodies in patients with esophageal squamous cell carcinoma: correlation with clinicopathologic features and tumor markers.
The significance of serum p53-Abs in patients with esophageal squamous cell carcinoma was determined. Examination of clinicopathological features and assessment of tumor marker sensitivities of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag) and CYFRA21-1 were performed. Thirty-three (58%) of 57 patients were positive for serum p53-Abs, however, no relation with cancer progression existed. Fourteen of the 33 sero-positive patients revealed normal levels of all tumor markers tested. Thus, serum p53-Abs appears to be a useful marker for the detection of esophageal squamous cell carcinoma.
Aged↗
Breast-conserving therapy for ductal carcinoma in situ.
This retrospective analysis evaluates the treatment results and prognostic factors of 114 patients with ductal carcinoma in situ (DCIS) undergoing breast conserving therapy (BCT) at Keio University Hospital Department of Radiology, between 1988 and 1997. A total of 132 patients with DCIS of the breast came to our hospital between 1988 and 1997, and 114 cases were suitable candidates for BCT. All of the patients were female and ranged in age from 26 to 81 years (median 46). Ninety-one patients were premenopausal, and 23 were postmenopausal. Median clinical tumor size was 2.0 cm (0-8.0 cm). Postoperatively 48 cases received 50 Gy/25 fractions of external irradiation to the whole breast via tangential ports. The follow-up period after treatment ranged from 11 to 162 months (median 46.7). The local relapse-free rate and overall survival rate of the 114 patients were 89.5% and 100%, respectively. Local failure and regional nodal failure occurred in 12 and 1 patient, respectively. Radiotherapy was a significant risk factor for local failure (p=0.05). No postmenopausal patients developed local failure, but the difference did not reach statistical significance (p=0.103). The 12 recurrent cases underwent additional surgery and all remain alive without recurrence, to date, i.e., at least 16 months. Breast-conserving surgery plus irradiation is appropriate treatment for DCIS patients.
Adult↗
Initial daily interferon administration can gain more eradication of HCV-RNA in patients with chronic hepatitis C, especially with serum intermediate viral load.
BACKGROUND/AIMS: We studied the effect of initial daily administration of interferon for the treatment of chronic hepatitis C, especially in patients with intermediate viral load. METHODOLOGY: Consecutive patients who met the inclusion criteria were randomly enrolled into two groups in this study. All patients analyzed could be treated with interferon-alpha for 6 months. Patients in group A were administered 6 million units of interferon-alpha subcutaneously daily initially for 2 weeks and then thrice weekly. Patients in group B were treated with the same dose of interferon-alpha thrice weekly from the first administration. We decided the criteria of complete remission as the absence of serum HCV-RNA at both points of the end of interferon treatment and 6 months later. RESULTS: Due to the relationship between the efficacy and serum viral load, we decided the criteria of the intermediate load as the quantitative value of serum HCV-RNA to be not lower than 10(5.0) and not higher than 10(6.5) copies/ml. Seventy-six and 78 patients, whose genotype and quantitative value of serum HCV-RNA could be measured before treatment, were analyzed in group A and B, respectively. The rate of complete remission in group A (40.8%) was higher than that in group B (25.6%), significantly (p = 0.046). In the intermediate viral load group, the rate of complete remission in group A (52.3%) was significantly higher than that in group B (29.3%) (p = 0.045). In the patients with genotype 1 b virus, the rate of complete remission had a tendency to be higher in group A (33.3%) than in group B (17.4%) (not significant). In the patients with genotype 2, the rate of complete remission was higher in group A (77.8%) than in group B (41.2%) (significant, p = 0.041). CONCLUSIONS: These results suggest that the initial daily interferon administration is necessary to gain a higher rate of serum HCV-RNA eradication in patients with intermediate viral load in chronic hepatitis C.
Adult↗
Lymph node metastasis with adenocarcinoma of the gastric cardia: clinicopathological analysis and indication for D1 dissection.
PURPOSE: To establish the indications for proximal resection with dissection of perigastric lymph nodes in order to treat adenocarcinoma of the gastric cardia. METHODS: We analyzed the clinicopathological features of 110 resected adenocarcinomas of the gastric cardia with respect to the appropriate operative method and extent of lymphadenectomy for treatment. RESULTS: Of the 110 patients, 93 underwent curative resection. The D2 group (total gastrectomy with dissection of extended regional lymph nodes) revealed higher morbidity and mortality rates compared to the D1 group (proximal resection with dissection of perigastric lymph nodes). The risk of lymph node metastasis was determined by depth of invasion, size of tumors, and gross findings of tumors. CONCLUSION: The appropriate operative method for adenocarcinoma of the gastric cardia requires: (i) tumor size less than 4 cm; and (ii) gross findings indicating a superficial type of lesion, which are recommended for proximal resection with dissection of perigastric lymph nodes.
Adenocarcinoma↗
A case of Crohn's disease with recurrent massive life-threatening hemorrhage from terminal ileum.
A case of Crohn's disease that underwent bowel resection two times at 3-year intervals due to life-threatening hemorrhage from ileum is presented. The bleeding sites were located in the ulcer lesions of ileum, in the oral side near to the ileum-colon transition. The first bleeding point was at the longitudinal ulcer of the terminal ileum and the secondary bleeding site was at the profound ulcer of ileum appearing in the oral side near to the ileo-colic anastomosis. This is the first case of Crohn's disease with recurrent life-threatening massive hemorrhage in the terminal region of ileum, for which operative bowel resections were necessary. This case suggests that we should search for the bleeding site in ileal lesions developed in the circumference of and especially the oral side near to the anastomosis due to prior resection, when intestinal massive bleeding occurs again after bowel resection, and that the careful follow-up and strict treatment with diet therapy and/or anti-inflammatory drugs are necessary for the protection of recurrence in patients with Crohn's disease.
Adult↗
Aberration of p53 and DCC in gastric and colorectal cancer.
We investigated the expression of p53 protein by immunohistochemistry and the expression of deleted in colorectal carcinoma (DCC) mRNA by the reverse transcription-polymerase chain reaction (RT-PCR) method in surgically resected tumors of gastric and colorectal cancers and compared these results to the clinicopathological features. Positive immunoreactions of p53 were observed in 21 of 42 gastric cancers (50%) and 25 of 37 colorectal cancers (67.6%). Decreased expression of DCC mRNA was observed in 15 of 38 gastric cancers (39.5%) and 10 of 28 colorectal cancers (35. 7%). There was a significant correlation between the immunoreaction of p53 and the depth of tumor invasion in gastric cancer, as well as between the decreased expression of DCC mRNA and nodal metastasis in colorectal cancer. In early cases without metastasis and invasion beyond muscularis propria, none of six gastric cancers showed a p53 immunoreaction, while seven of 9 colorectal cancers showed positive immunoreactions. On the other hand, two of 4 gastric cancers showed decreased expression of DCC mRNA; whereas, none of the seven colorectal cancers did. Alteration of p53 might occur at a later stage in gastric cancer than in colorectal cancer and be associated with the acquisition of an invasive character. In contrast to gastric cancer, decreased expression of DCC mRNA might be present in a later stage in colorectal cancer than in gastric cancer, and be related to the acquisition of metastatic character to the lymph nodes. In conclusion, alterations of p53 or DCC may play different roles in the progression of gastric cancers as compared to colorectal cancers, and the occurrence of both p53 and DCC genes mutations may cause these cancers to become more malignant.
Colorectal Neoplasms↗
Clinical significance of serum vascular endothelial growth factor in colorectal cancer patients: correlation with clinicopathological factors and tumor markers.
Vascular endothelial growth factor (VEGF) is known as a potent inducer of angiogenesis in various human cancers. Serum VEGF concentrations of colorectal cancer patients was assessed for their clinical significance as a tumor marker. Serum samples were obtained at admission from 24 healthy volunteers and 111 patients with colorectal cancer. Preoperative serum VEGF concentrations, which are significantly higher than those of healthy controls, reflect clinical stage progression, depth of invasion, liver metastasis, lymph node metastasis and lymphatic invasion. Consequently, detection of VEGF could serve as a clinically useful marker for colorectal cancer progression and metastasis independent of other markers.
Adult↗
Pleural effusion during interferon treatment for chronic hepatitis C.
A 54-year-old male patient was admitted to Osaka University Medical School Hospital for interferon treatment for chronic hepatitis C and the daily administration of recombinant interferon-alpha 2a started at the dose of 9 megaunits per day. Fourteen days later, moderate right pleural effusion was detected by abdominal magnetic resonance imaging study. He had experienced no symptom to suggest pleural effusion or any pulmonary lesions during interferon treatment. The pleural fluid was serous, showing the character of slightly bloody, turbid and positive Rivalta test, and the levels of lactic dehydrogenase and adenosine deaminase were not elevated. His serum titer of anti-nuclear antibody increased to 80 in homogenous staining, but anti-DNA antibody and anti-liver kidney microsome-1 antibody remained negative. Other laboratory tests or physical findings could not satisfy the criteria of any autoimmune diseases, such as systemic lupus erythematosus. After discontinuation of interferon administration, his pleural effusion resolved gradually and disappeared completely by use of no specific drugs. This is the first case that pleural effusion developed during interferon administration without any other clinical signs indicating autoimmune diseases. The increase of serum titer of anti-nuclear antibody prompted us to elucidate that pleuritis might be induced by immunological activation of interferon.
Antibodies, Antinuclear↗
[Clinical dosimetry and long-term therapeutic results in Cushing's disease].
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Adolescent↗
Disappearance of hepatitis B surface antigen in chronic type B hepatitis after clinical and laboratorial relapse produced by abrupt withdrawal of immunosuppressive drugs.
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Azathioprine↗
[Prevalence of hepatitis B surface antigen and its antibody in hospitalized patients of 2 psychiatric hospitals].
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Adult↗
[Hepatitis B antigens systems in schistosomiasis mansoni].
The authors have studied the antigenic systems HBs and HBe and B virus hepatitis in 155 patients with mansonic schistosomiasis and have found: a) 22,5% HBsAg positivity in patients with the hepatosplenic form of the disease which was associated with histologic liver alterations and 8,7% anti-HBs positivity in patients with the hepatointestinal form of the disease which was associated with a preserved liver histology; in controls they have found 1% positivity for HBsAg. b) HBeAg and anti-HBe were of good prognostic value.
Female↗
Membranous glomerulonephritis in patients with rheumatoid arthritis.
We investigated the cause of membranous glomerulonephritis (MGN) in 24 patients with rheumatoid arthritis (RA). The class or stage of RA was diagnosed using the criteria of the American Rheumatism Association, and MGN was diagnosed using renal biopsy. Renal biopsy and laboratory findings, including serologic analysis, were evaluated. Eighteen patients had previously received one of the following antirheumatic agents: bucillamine (n = 13), D-penicillamine (n = 3), or gold (n = 2). The renal lesions of all 24 patients resembled lesions seen with idiopathic MGN on examination by light microscopy, electron microscopy, and immunofluorescence. We concluded that patients with RA are predisposed to develop MGN, whether or not they receive antirheumatic agents.
Adult↗
The importance of initial daily administration of interferon alpha for the eradication of hepatitis C virus in patients with chronic hepatitis C: a multicenter randomized trial.
BACKGROUND/AIMS: We studied the effect of initial daily administration of interferon for the treatment of chronic hepatitis C, to clarify a more effective treatment protocol for the eradication of the hepatitis C virus. METHODOLOGY: Consecutive patients who met the inclusion criteria were randomly enrolled in two groups in this study. One hundred and five patients were randomized and assigned to two groups. Patients, who enrolled in group A, were treated with 6 million units of natural interferon-alpha given subcutaneously daily for an initial two weeks and then thrice a week for 22 weeks. Patients, who were enrolled in group B, were treated with the same dose of interferon-alpha given for 26 weeks thrice a week from the first administration. RESULTS: In groups A and B, 58 and 47 patients were analyzed, respectively. At the end of treatment, 37 patients in group A (63.8%) had negative serum HCV-RNA test, compared with 26 in group B (55.3%), but at 6 months after discontinuation of interferon administration, 27 patients in group A (46.6%), compared with 8 in group B (21.3%). The rate of complete remission in group A (46.6%) was higher than that in group B (21.3%) (P<0.01). In patients with genotype 1b virus, the rate of complete remission was higher in group A (31.3%) than in group B (12.5%) (not significantly), and the relapse rate was lower in group A (9.4%) than in group B (37.5%), significantly (p<0.05). CONCLUSIONS: This study suggests that initial daily interferon administration is necessary to gain a higher rate of serum HCV-RNA eradication in patients with chronic hepatitis C.
Alanine Transaminase↗