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Biomedical subjects

H Oi

Publications and source records attributed to H Oi.

At least 37 records · Page 2Linked to original sources
PubMed1997

Appraisal of combination treatment for hepatocellular carcinoma: long-term follow-up and lipiodol-percutaneous ethanol injection therapy.

Since 1988, 124 patients with hepatocellular carcinoma were treated in our departments. Among them, 31 cases treated by surgical resection and 30 cases administered a combination therapy (Lipiodol [Laboratoire Guerbet, Villepinte, France]-transcatheter arterial embolization [L-TAE] and lipiodol-percutaneous ethanol injection therapy [L-PEIT]) were analyzed retrospectively. The 1-, 3-, and 5-year survival rates were, respectively, 89.0%, 72.7%, and 63.6% for the surgical resection group and 93.3%, 72.8%, and 42.0% for the combination therapy group. The follow-up results at less than 4 years after the procedures revealed that the survival rate with the combination therapy was slightly better than that with the surgical treatment. However, in the subsequent 4 years, the survival rate of the combination therapy group decreased rapidly. The reasons for this deterioration were local recurrence and/or new primary lesions of hepatocellular carcinoma, mainly due to inappropriate ethanol injection. To achieve adequate and accurate injection of ethanol, a 10% volume of Lipiodol was mixed with the ethanol so that the location of the injected ethanol could be easily confirmed. The effectiveness of L-PEIT was thus confirmed by computed tomography, performed on the following day. Defective Lipiodol accumulation in the tumor and/ or neighboring tissues was able to be corrected by additional ethanol injections. With this L-PEIT technique, the tumor necrosis rate is now improving. Therefore, a better prognosis is expected.

Antibiotics, Antineoplastic↗
PubMed1996

Biphasic changes in serum hepatocyte growth factor after transarterial chemoembolization therapy for hepato-cellular carcinoma.

To investigate the physiological significance of hepatocyte growth factor (HGF) after transcatheter arterial chemo-embolization (TACE), we measured serum HGF levels in 23 patients who underwent angiography (n = 3) or TACE (n = 20). HGF levels increased biphasically after TACE. It rapidly increased to 10-fold higher levels immediately after heparin-injection even before embolization. Serum HGF then decreased to below 1.0 ng/ml at 6 hours after the procedure. The second peak (a 2-fold increase) appeared 1-3 days after TACE. The first increase may be due to the injection of heparin which releases HGF from the cell-surface and extracellular matrix of the liver. Patients treated to a larger extent showed higher increase in serum HGF levels, and thus the impaired hepatic HGF clearance and size of regeneration may cause second elevation of serum HGF levels. Six out of eleven patients whose serum HGF levels before TACE were more than 0.5 ng/ml died in the follow-up period whereas no patients died with serum HGF under 0.5 ng/ml. Therefore, serum HGF levels before the procedure have the potential to be a good indicator of outcome.

Aged↗
PubMed1996

Focal residual contrast media in the kidney 24 hours after angiography.

PURPOSE: To examine the relationship between focal renal cortical retention (FRCR) and contrast-associated nephropathy (CAN). MATERIAL AND METHODS: We investigated the incidence of both phenomena in 105 patients. CAN was defined as an increase in the creatinine level > 0.3 mg/dl and > 20% on days 1, 3, or 7. We compared predisposing factors for FRCR and CAN. Serum creatinine and blood urea nitrogen (BUN) for renal function were determined on the morning of the day of the angiography. The BUN/creatinine ratio was used as an indicator of the degree of hydration. RESULTS: FRCR was demonstrated in 17 patients (16%) by delayed CT 24 h after angiography, and CAN was found in 16 patients (15%). No significant relationship between CAN and FRCR was found. We found a correlation between high total volumes of contrast and FRCR. Advanced age, high blood urea nitrogen, high creatinine, and dehydration were risk factors for CAN. CONCLUSION: Delayed CT showed a higher incidence of injury to the renal parenchyma than previously detected by conventional radiography.

Angiography↗
PubMed1996

Dynamic MR imaging and early-phase helical CT for detecting small intrahepatic metastases of hepatocellular carcinoma.

OBJECTIVE: We performed a study to evaluate the sensitivities of multislice dynamic MR imaging and early-phase helical CT as noninvasive methods for detecting small intrahepatic metastases of hepatocellular carcinomas. MATERIALS AND METHODS: Dynamic and spin-echo MR imaging and early- and delayed-phase helical CT of the liver were performed for patients with multiple hepatocellular carcinomas before transcatheter arterial chemoembolization. Forty-nine patients had 242 intrahepatic metastases less than 3 cm in diameter. Using iodized-oil CT after transcatheter arterial chemoembolization as a gold standard, the sensitivity of MR imaging for detecting intrahepatic metastases was compared with that of CT. RESULTS: Of the 242 nodules, 225 were diagnosed as hepatocellular carcinomas by iodized-oil CT. Of these, dynamic MR imaging and early-phase CT were significantly superior to those of spin-echo MR imaging (p < .0001) and delayed phase CT (p < .0001) for tumors less than 1 cm in diameter. CONCLUSION: Dynamic MR imaging and early-phase CT of the liver are the most sensitive noninvasive means of detecting small intrahepatic metastases of hepatocellular carcinoma before and after treatment.

Carcinoma, Hepatocellular↗
PubMed1996

CT and MR imaging of abdominal liposarcoma.

OBJECTIVE: CT and MR images were reviewed to correlate the histologic subtypes of abdominal liposarcoma with the radiologic findings. SUBJECTS AND METHODS: Ten patients with liposarcoma who underwent CT or MR imaging before surgery were included in this study. CT and MR imaging findings for these patients were compared retrospectively with histologic findings. RESULTS: Major histologic subtypes found in our group of patients were five well-differentiated, three myxoid, one pleomorphic, and one round-cell liposarcomas. The well-differentiated subtype consisted of lipoma-like and/or sclerosing components. The predominant attenuation and signal intensity characteristics of the lipoma-like components on CT and MR images resembled those of fat, whereas the predominant attenuation and signal intensity characteristics of the sclerosing components resembled those of muscle. The myxoid subtype showed, on unenhanced images, predominant attenuation and signal intensity characteristics that resembled those of water; on contrast-enhanced images, this subtype showed gradual reticular enhancement. The appearance of the round-cell and pleomorphic subtypes was that of heterogeneous, nonfatty tumors. Their characteristics were indistinguishable from those of other malignant soft-tissue masses. CONCLUSION: Each histologic subtype of abdominal liposarcoma showed different CT attenuation or MR imaging signal intensity characteristics. A clear understanding of these findings should prove helpful in the diagnosis of liposarcoma.

Abdominal Neoplasms↗
PubMed1995

Expression of the human urokinase-type plasminogen activator receptor in E. coli and Chinese hamster ovary cells: purification of the recombinant proteins and generation of polyclonal antibodies in chicken.

The receptor for urokinase-type plasminogen activator (uPAR) may contribute to the invasive and metastatic capacity of tumor cells by focusing the serine protease urokinase-type plasminogen activator (uPA) to the cell surface. uPA activates plasminogen to plasmin which in turn degrades extracellular matrix proteins or activates other proteases. Mature uPAR is a heavily glycosylated protein of about 284 amino acids attached to the plasma membrane via a glycosyl-phosphatidylinositol (GPI) anchor. A set of different polyclonal uPAR antibodies has been generated in order to investigate the role of uPAR in tumor spreading in more detail. For this purpose, uPAR (lacking the GPI anchor) was expressed in E. coli and Chinese hamster ovary (CHO) cells. Recombinant uPAR from E. coli (corresponding to amino acids 1-284 of human uPAR) was expressed with an N-terminal histidine-tag insertion and purified by nickel chelate affinity chromatography. Soluble uPAR, synthesized by CHO cells (corresponding to amino acids 1-277 of human uPAR), was isolated by ligand (uPA) affinity chromatography. Expression in E. coli led to a nonglycosylated form of uPAR, whereas uPAR produced by CHO cells seemed to be glycosylated to a similar extent as the naturally occurring human form of uPAR (as analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis). Prior to immunization the N-termini of the recombinant uPAR variants were determined by amino acid sequence analysis. Polyclonal antibodies were generated in chickens and purified from egg yolk. The reaction patterns of these antibodies were analyzed by Western blot analyses and flow cytofluorometry.

Amino Acid Sequence↗
PubMed1995

Serum interleukin 6 as a predicator of the therapeutic effect and adverse reactions after transcatheter arterial embolization.

To evaluate the value of serum interleukin 6 (sIL-6) for the prediction of therapeutic effect and adverse reaction after transcatheter arterial embolization (TAE), sIL-6 was measured before and after angiography or TAE in 18 patients (three after angiography and 15 after TAE for hepatocellular carcinoma). The three patients with only angiography showed no elevation of sIL-6, while a significant increase was observed after TAE in the 15 hepatocellular carcinoma patients. The sIL-6 levels of patients with a partial response to TAE were higher at 48-72 hours after the procedure than those of patients with no response (P = 0.045), and the sIL-6 levels of patients who showed adverse reactions were higher at 6-24 h than those of patients without adverse reactions (P = 0.019). sIL-6 level at 48-72 h after TAE reflects the efficacy of TAE, whereas the level at 6-24 h after TAE is related to the severity of adverse reactions. Therefore, sIL-6 may be a useful indicator for prediction of the therapeutic effect of TAE as well as adverse reactions.

Aged↗
PubMed1995

A competitive chromogenic assay to study the functional interaction of urokinase-type plasminogen activator with its receptor.

Urokinase-type plasminogen activator (uPA) converts plasminogen to plasmin which degrades various extracellular matrix components. uPA is focused to the cell surface via binding to a specific receptor (uPAR, also termed CD87). uPAR-bound uPA mediates pericellular proteolysis in a variety of biological processes, e.g. cell migration, tissue remodeling and tumor invasion. We have developed a competitive microtiter plate-based chromogenic assay which allows the analysis of uPA/uPAR interaction. The plates are coated with recombinant uPAR expressed in Chinese hamster ovary (CHO) cells. Proteolytically active uPA (HMW-uPA) is added to the microtiter plate-attached uPAR. The amount of receptor-bound uPA is then determined indirectly via addition of plasminogen, which is activated to plasmin, followed by cleavage of a plasmin-specific chromogenic substrate. Substances interfering with binding of HMW-uPA to uPAR diminish the generation of plasmin, as indicated by a reduction of cleaved chromogenic substrate. This assay was used to analyze the inhibitory capacity of a variety of proteins and peptides, respectively, on the uPA/uPAR interaction: i) uPAR and uPAR-variants expressed in CHO cells, yeast or E. coli, ii) the aminoterminal fragment (ATF) of human uPA or yeast recombinant pro-uPA, iii) synthetic peptides derived from the sequence of the uPAR-binding region of uPA, and iv) antibodies directed against uPAR. This assay may be helpful in identifying uPA and uPAR analogues or antagonists which efficiently block uPA/uPAR interaction.

Amino Acid Sequence↗
PubMed1995

Detectability of hypervascular hepatocellular carcinoma by arterial phase images of MR and spiral CT.

The ability of arterial phase images of breath-hold MR imaging and spiral CT to detect hypervascular hepatocellular carcinomas (HCCs) was evaluated. Prior to transcatheter arterial chemoembolization (TACE) with iodized oil, MR images and spiral CT during i.v. bolus injection of contrast medium (IV-MR imaging and IV-spiral CT) and spiral CT during intraarterial injection of contrast media through catheter (IA-spiral CT) of the entire liver were obtained in 24 consecutive patients with 93 HCCs. In the detection of HCCs less than 1 cm in diameter, IA-spiral CT (87.3%) was superior to IV-MR imaging (63.5%) and IV-spiral CT (54.0%) (p < 0.001). There was no significant difference in detectability in any tumor size between IV-MR imaging and IV-spiral CT. IA-spiral CT was the best for detecting hypervascular HCCs, and there was no significant difference between IV-MR imaging and IV-spiral CT.

Adult↗
PubMed1995

[MR angiography in the evaluation of endoscopic injection sclerotherapy for esophago-gastric varices].

We evaluated the utility of magnetic resonance angiography (MRA) for the detection of esophago-gastric varices and assessment of their therapeutic response to endoscopic injection sclerotherapy (EIS). MRA was performed in a total of 12 patients with esophago (E)-gastric (G) varices (V) (9 EV and 3 GV patients) both before and two-weeks after EIS. 25-35 horizontal images were obtained during single breath holding and data were reconstructed by using the two dimension time of flight method. MRA detected varicose lesions in all GV patients and in 7 of 8 EV patients of the grades F2 or higher. Varicose lesion in grade F1 EV patients were initially undetectable before EIS but became evident on MRA after EIS. The portal collaterals were equally well displayed by MRA and the superior mesenteric arteriography at its portogram phase. MRA and endoscopy were concordant for the disappearance or persistence of varicose lesions after EIS. We conclude that MRA is useful for the detection of esophago-gastric varices and other portal collaterals. MRA provides a non-invasive and workable technique in evaluation of patients with esophago-gastric varices undergoing EIS.

Adult↗
PubMed1995

[Detectability of hypervascular small hepatocellular carcinoma by dynamic spiral CT].

Thirty-one cases of small hepatocellular carcinoma (HCC) under 3 cm in diameter underwent Spiral CT with bolus injection of contrast medium (Dynamic Spiral CT). Dynamic Spiral CT was compared with CT after intra-arterial injection of iodized oil (Lipiodol-CT). The detectability of 79 nodules of small HCC on early phase images of Dynamic Spiral CT was 49.4% (32.6% for those under 1 cm in diameter, 58.3% for 1-2 cm, 91.7% for 2-3 cm). The detectability of small HCCs above the hilum of the liver was better than that below the hilum. Five lesions were detected only on delayed CT images, but not on early phase CT images. Dynamic Spiral CT is useful for detecting hypervascular small HCCs, and both early phase and delayed CT images must be obtained.

Adult↗
PubMed1994

MRI-based quantitative assessment of the hippocampal region in very mild to moderate Alzheimer's disease.

We investigated the hippocampal region in six patients diagnosed with possible Alzheimer's disease (AD), eight patients with probable AD, and eight age-matched controls, using a high-resolution magnetic resonance imaging technique. Coronal T1-weighted images were used for area measurements of the hippocampal formation (HF), parahippocampal gyrus (PHG), and temporal lobe (TL), normalised to cranial area. Both the normalised HF and PHG were significantly smaller in both AD groups than in the controls, but did not differ between patients with possible and probable AD. The normalised TL was significantly smaller in patients with probable AD than in those with possible AD and controls, but did not differ in patients with possible AD and controls. We conclude that hippocampal and parahippocampal atrophy occurs in early AD, and is more useful than neocortical atrophy for early detection of the disease. At a more advanced stage, the neocortical area is involved.

Aged↗
PubMed1994

Effective cases of transcatheter arterioportal chemoembolization with high-dose iodized oil for hepatocellular carcinoma.

By administering an excessive amount of iodized oil via the hepatic artery, anticancer drugs in the iodized oil flow into the portal vein through the arterioportal communication. This phenomenon permits chemotherapy against extracapsular infiltration by a hepatocellular carcinoma (HCC) nourished by the portal blood flow. From May 1983 through July 1992, 240 cases of HCC underwent transcatheter arterioportal chemoembolization (TAPCE) with more than 5 ml of iodized oil (mean, 15 ml) in our hospital. In all, 32 patients survived for more than 3 years, and the factors favoring the efficacy of TAPCE therapy were investigated. Doxorubicin (mean, 46 mg) was given to 31 patients and 20 mg mitomycin C was given to 1 patient. The patients included one Stage 1 case, 13 Stage 2 cases, 17 Stage 3 cases, and one Stage 4 case. The mean tumor size was 5.0 cm, and portal invasion was suggested in 8 cases by angiography. The tumors were divided into 5 types: 13 cases of the single nodular type (SN), 7 cases of the single nodular type with proliferation (SN-P), 3 cases of the multinodular fused type (MN-F), 5 cases of the multinodular type (MN), and 4 cases of the massive type. A complication of liver dysfunction was detected in 14 cases, and half of them were Child's class C. In all, 7 patients underwent hepatectomy and 6 received percutaneous ethanol injection after TAPCE. The treated area of TAPCE was classified as segmental, lobar, or total. Segmental and lobar administration of TAPCE yielded statistically effective results, and their tumor response rate was 86%. All of the MN-F and massive types showed a good tumor response. The incidence of intrahepatic distant metastasis was higher in the localized TAPCE group than in the total TAPCE group. Segmental and lobar TAPCE should be applied for localized infiltrating HCCs, even in cases associated with liver cirrhosis, but these methods have a limited capacity to prevent distant intrahepatic metastasis.

Adult↗
PubMed1994

Follow-up study of combination treatment (TAE and PEIT) for unresectable hepatocellular carcinoma.

The subjects were 35 patients with unresectable hepatocellular carcinoma. The patients were divided into a transcatheter arterial embolization group (TAE group, 18 cases) and a combination therapy group receiving both TAE and percutaneous ethanol injection therapy (TAE+PEIT group, 17 cases). The 50% survival period was 21.1 months for the TAE group and 37.8 months for the TAE+PEIT group (P < 0.05). The longest survival period in the TAE group was 89 months. In the TAE+PEIT group, one patient has survived for 59 months. The actuarial 1-, 2-, and 3-year survival rates for the TAE group were 82%, 45%, and 22%, respectively. For the TAE+PEIT group the rates were 83%, 64%, and 64%, respectively. The TAE+PEIT group showed a significantly higher survival rate in the 895- to 1,074-day period as compared with the TAE group (P < 0.05). Overall, the survival rate tended to be higher in the TAE-PEIT group (P < 0.1). The therapeutic responses of tumors were measured by the maximal reduction rate within 6 months of TAE and PEIT. In the TAE group, a PR was seen in only four cases. In the TAE+PEIT group, CRs and PRs were achieved significantly more frequently than in the TAE group. When the patients were divided into a responder group (CR, PR, and MR) and a nonresponder group (NC and PD), survival was significantly longer in the responder group. The findings of the present study suggest that the combination therapy was useful for improving the survival of patients with unresectable hepatocellular carcinoma.

Adult↗
PubMed1994

Extraserosal invasion in advanced gastric cancer: evaluation with MR imaging.

PURPOSE: To evaluate the usefulness of magnetic resonance (MR) imaging in the diagnosis of extraserosal invasion in advanced gastric cancer. MATERIALS AND METHODS: MR imaging was performed in 48 patients with advanced gastric cancer, and the results were correlated with the histopathologic findings. Images perpendicular to the gastric wall with cancer were obtained with spoiled gradient-recalled acquisition in the steady state (GRASS). The degree of serosal invasion was classified on the basis of the appearance of a low-signal-intensity band around the lesion. RESULTS: Advanced gastric cancer appeared as a thickened wall of high signal intensity after the administration of contrast material. A low-signal-intensity band disappeared or showed irregularity in the area of extraserosal invasion by the gastric cancer. The MR imaging-determined grade correlated with the histopathologic findings for 11 of 14 (79%) pT2 tumors, 23 of 24 (96%) pT3 tumors, and eight of 10 (80%) pT4 tumors. The overall accuracy was 88%. CONCLUSION: Presence of a low-signal-intensity band at MR imaging is useful for the preoperative evaluation of serosal invasion.

Adult↗
PubMed1994

[Doses of epirubicin used in oily chemoembolization of hepatocellular carcinoma].

Epirubicin (EPIR), an anticancer agent, has recently been used with increasing frequency in transcatheter oily chemoembolization (TOCE) of hepatocellular carcinoma. We conducted a dose-finding study of EPIR with regard to its safety. One hundred thirty-four patients were divided into five groups according to the EPIR doses (mg/m2), Group A (< 30 mg/m2), Group B (> or = 30 - < 40 mg/m2), Group C (> or = 40 - < 50 mg/m2), Group D (> or = 50 - < 60 mg/m2), and Group E (> or = 60 mg/m2). The number of leukocytes decreased at 2 weeks but recovered at 4 weeks with no significant differences among the groups. However, there were significantly fewer leukocytes in Group E than in Groups A to D. There were no significant differences among the groups in either the number of erythrocytes or platelets. The number of platelets tended to remain at increased levels even at 4 weeks. Liver function as represented by GOT, GPT, LDH, and total bilirubin was not aggravated, but tended to improve. GOT and LDH in Groups D and E, in particular, improved significantly at 4 weeks, probably because of the antitumor effect of TOCE. These results suggest that EPIR can be administered up to 50 mg/m2 for TOCE.

Carcinoma, Hepatocellular↗