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Biomedical subjects

H Okubo

Publications and source records attributed to H Okubo.

At least 37 records · Page 2Linked to original sources

Pseudolymphomatous folliculitis: a clinicopathologic study of 15 cases of cutaneous pseudolymphoma with follicular invasion.

We report the clinical, histopathologic, and immunohistologic features of 15 cases of pseudolymphomatous folliculitis (PLF). The patients comprised seven males and eight females (mean age, 38.6 years; age range, 2-67 years). All patients had dome-shaped or flat-elevated nodules suggestive of cutaneous lymphoid hyperplasias (CLHs). The lesions were solitary in all 15 cases, except in one case with duplex lesions. All lesions were located on the face and measured less than 1.5 cm. In 14 cases with one lesion each, five lesions showed rapid regression after incisional biopsy, whereas the remaining nine underwent excisional biopsy. In the case with duplex lesions, one regressed spontaneously after excisional biopsy of the other. Histopathologically, all PLFs showed dense lymphocytic infiltrates from the dermis to the subcutis simulating cutaneous lymphomas. The walls of hair follicles in all cases were enlarged and irregularly deformed with their epithelium blurred by lymphocytic infiltrates; we called this change "activation" of hair follicles. In nine cases, many atypical lymphocytes were intermingled; three of these cases had been misdiagnosed as cutaneous T-cell lymphoma at other institutions. Immunohistologically, 10 and 5 cases showed predominantly B cells and predominantly T cells, respectively. Remarkably, all lesions showed increased numbers of perifollicular histiocytes expressing anti-S-100 protein and CD1a, and seven lesions showed histiocytes in aggregates. We conclude that PLF is a subset of CLH with characteristic clinical and pathologic features showing perifollicular clustering of T-cell-associated dendritic cells with activation of pilosebaceous units. PLF is an entity to be differentiated from malignant lymphomas and other cutaneous pseudolymphomas.

Adolescent↗

Hepatocellular carcinomas infected with the novel TT DNA virus lack viral integration.

A novel DNA virus designated TT virus (TTV) was cloned from a patient with posttransfusion hepatitis and is thought to be a new hepatitis virus. At present, hepatitis B virus (HBV) and hepatitis C virus (HCV) are known to induce hepatocellular carcinoma (HCC). But, actually, in Japan approximately 5 to 10% of HCCs are in HBV-negative and HCV-negative (NBNC) patients. In order to study the possible role of TTV in hepatocarcinogenesis, we investigated the frequency of the TTV genome in liver tissue of 20 HCC patients. As a result, 3 of 8 NBNC HCC patients and 5 of 12 HBV- or HCV-associated HCC patients were TTV positive, and TTV was shown not to be specific for NBNC HCC. For all TTV-positive patients, we also confirmed that the TTV genome was not integrated into host hepatocyte DNA.

Aged↗

Clinical efficacy of interferon therapy for chronic hepatitis C in the Kita-Kyushu District of Japan.

The Kita-Kyushu district in Japan is one of the areas known to have a quite high prevalence of HCV infection. We analyzed the results of interferon therapy administered to 50 chronic hepatitis C patients living in this area (33 males and 17 females; ages between 28 and 65 years old). Interferon-alpha (human lymphoblast interferon, HLBI), 6 million units/day, was administered for 24 consecutive weeks. Before the therapy, the HCV levels, HCV-RNA genotype, and sequence of hypervariable region (HVR) of HCV were examined. Patients who were HCV-RNA negative and ALT < or = 30 IU/L at the completion of therapy and in the 6th month after the completion of therapy, were determined as complete responders (CR). In this study, 10 of 50 patients (20%) were CR. Among male patients, there were no CR in each age group, whereas among female patients aged over 40 years old, there were no CR. The number of patients with low virus levels was larger in the genotype 2a/2b cases than in the genotype 1b cases. HVR sequences varied extensively, and had no correlation to interferon efficacy. Multivariate analysis showed that the pre-treatment HCV level is the most important predictor.

Adult↗

[Clinicopathological study on early recurrent hepatoma and its treatment].

Early Recurrence of Hepatoma: PCNA Labeling Index and DNA Ploidy Pattern Sixty-four cases of recurrent hepatocellular carcinoma (HCC) after hepatectomy were divided into two groups; E-group with recurrence within one year, and L-group with recurrence after 1 year. Clinicopathological features and surgical curability were the same in both groups. E-group had significantly higher positive rates of portal invasion, intrahepatic metastasis and rate of patients with more than 40% on PCNA labeling index. While the similar recurrence mode and the same treatment modalities were done, cumulative survival rates after recurrence in E-group had a poorer prognosis than L-group. These results suggest the possibility of lower response for the treatment on the recurrent lesion would be manifest in the E-group. New modalities for prevention of early recurrence of HCC after resection should be developed.

Aged↗

Effect of isosorbide on distortion-product otoacoustic emissions and endocochlear DC potential in experimentally induced hydropic ears.

The effects of isosorbide on distortion-product otoacoustic emissions (DPOAEs) and endocochlear DC potential (EP) were examined in experimentally induced endolymphatic hydropic ears and untreated control ears using 20 albino guinea pigs. DPOAEs and EP in the hydropic ears decreased after obliteration of the endolymphatic duct and sac. The administration of isosorbide restored DPOAEs to the normal level, whereas EP was further reduced. In control ears there was no significant change in DPOAEs and EP after the administration of isosorbide. The results obtained in the present study indicate that the effect of isosorbide on DPOAEs is different from that on EP, and the recovery of DPOAEs in hydropic ears is not a secondary phenomenon due to the recovery of EP.

Acoustic Stimulation↗

[Prognosis and preoperative imaging of patients with small hepatocellular carcinoma].

We conducted a retrospective study on the relation of the preoperative imaging patterns to the prognosis of patients with small HCC after hepatectomy. Forty patients with small HCC less than 2 cm in diameter without vascular invasion were enrolled in this study. There were no significant differences in the signal intensity of T1WI on MRI, and angiographic findings such as neo-vascularity or tumor stain. Ultrasonographical images of the internal of tumor were classified into two groups. Six cases with homogeneous pattern were significantly worse in cumulative survival rate than 28 cases with heterogeneous pattern (p = 0.0012). The same results were obtained with respect to limitation of cases treated by relative curative operation (p = 0.0041). It was concluded that histopathological grading and malignant potential of small HCC could be evaluated by classification of the pattern of internal ultrasonographical images, and complete locoregional therapy, and that intense course observation for cases with ultrasonographical homogeneous pattern would be important.

Carcinoma, Hepatocellular↗

[An analysis of pelvic and para-aortic lymph node metastasis in ovarian carcinoma by systematic retroperitoneal lymph node dissection].

We performed a systematic retroperitoneal lymph node dissection (RPLND) on 137 patients with primary ovarian carcinoma, of whom 97 had undergone RPLND during the primary surgery before chemotherapy and 40 had undergone RPLND during the secondary cytoreductive surgery after preoperative chemotherapy. The tentative staging of the ovarian carcinoma used in this study was determined according to the FIGO criteria without considering the pathologic findings of retroperitoneal lymph nodes. Nodal metastasis was seen in 21.9% (30/137) of them. Thirteen had positive pelvic lymph nodes (PLN) but no positive para-aortic nodes (PAN). Eleven had both positive PLN and positive PAN. Six had positive PAN but no positive PLN. The PAN was the most frequent site of metastasis (17/137). Next were the common iliac, obturator, and lateral group of deep inguinal nodes. Solitary metastasis in the patients who had undergone RPLND during the primary surgery was seen in a PAN and a common iliac node. Among 24 patients with PLN metastasis, there was a significant (p < 0.05) difference in the number of positive PLN between the patients with PAN metastasis (5.27 +/- 3.00) and the patients without PAN metastasis (2.62 +/- 1.66). These results indicate that the PAN and common iliac nodes are the most important site of nodal metastasis in ovarian carcinoma. The metastasis to PLN such as obturator node and internal iliac node seems to occur independently of the PAN metastasis, and the PAN metastasis occurs not only through the direct route but also as a consequence of extension of PLN metastases. Systematic retroperitoneal lymph node exploration therefore seems to be necessary to clarify the lymph node status.

Aorta↗

[The effects of preoperative transcatheter arterial chemoembolization (TAE) for the recurrence of hepatocellular carcinoma (HCC) from the viewpoint of consecutive tumor necrosis effect].

From 1990 to 1994, seventy-seven patients with HCC below 10 cm in tumor diameter underwent hepatic resections after TAE. They were divided into two groups: group C, complete necrosis (over 90% histologically at the maximum cutting surface of the specimen): group I, incomplete necrosis (under 90%). There were no significant differences in clinical background of patients, histopathological features and total disease-free survival rate (DFR) between the two groups. Nevertheless, DFR of patients in group C was significantly better than that of patients in group I, limiting the patients for curative resection. It was suggested that the recurrence of HCC after resection might be inhibited by curative operation following preoperative TAE with complete necrosis of tumor.

Adult↗

[Role of reservoirs in intraarterial chemotherapy for recurrent hepatocellular carcinoma after hepatectomy].

We conducted a retrospective study on the role of reservoirs in intraarterial chemotherapy for recurrent hepatocellular carcinoma (HCC) after hepatectomy. Ninety-two out of 170 patients with HCC who underwent hepatectomy from 1987 to 1992 in our institute were enrolled in this study. HCC recurred in 55 patients. A rate of good patency of the catheter of the reservoir at the time of recurrence was found in 72.7% of the patients. Transcatheter arterial embolization (TAE) for recurrent tumor was not feasible in 3 patients, because of occlusion of the hepatic artery (3.3% of patients with reservoir, 5.5% of patients with recurrence). Eleven patients were treated by intraarterial chemotherapy using the reservoir and TAE or TAE and PEIT (group R), and 11 patients were treated only with TAE and/or PEIT (group NR). Although there were no significant differences between the two groups in the number of recurrent lesions and operative procedures, tumor-free interval was shorter in group R. Cumulative survival rates after recurrence were not significant. The frequency of TAEs was lower in group R, which shortened the hospitalization for postrecurrence therapy. Thus, intraarterial chemotherapy using reservoir contributed to improvement of the quality of life of patients with recurrent HCC.

Carcinoma, Hepatocellular↗

Distortion-product otoacoustic emissions in experimentally induced hydropic ears.

The postoperative changes of distortion-product otoacoustic emissions (DPOAEs) and cochlear potentials were examined using 15 albino guinea pigs in which endolymphatic hydrops was induced by obliterating the endolymphatic sac. DPOAEs (geometric mean: 4,6 and 8 kHz) were measured once before and every week after surgery. At the 2nd (n = 5), 4th (n = 5) and 12th (n = 5) postoperative weeks, endocochlear potential (EP) and compound action potential (CAP) were measured. Although the reduction in DPOAEs at 8 kHz was first detected at the 12th week, the amplitude of DPOAEs at 4 and 6 kHz was already reduced at the first week and decreased gradually thereafter. In contrast to these results, the CAP threshold was not elevated at the 2nd week and a slight increase was first detected at the 4th week. The results obtained in the present study suggest that DPOAEs are more sensitive than CAP in detecting the presence of hydrops.

Action Potentials↗

Circadian variation in fibrinolytic activity in patients with variant angina.

BACKGROUND: Coronary artery spasm induces activation of the coagulation system. Turnover and maintenance of thrombus depend not only on formation but also on lysis. The relation between coronary spasm and fibrinolytic system has not been elucidated. OBJECTIVE: To examine whether there is impairment of or a circadian variation in fibrinolytic activity in patients with variant angina. METHODS: Plasminogen activator inhibitor (PAI) activity and concentrations of tissue plasminogen activator (t-PA) antigen were measured in venous plasma samples taken at 2200, 0600, and 1400 and 24 h Holter tapes were recorded in 15 patients with variant angina, 12 patients with stable exertional angina, and 12 controls. RESULTS: There were significant circadian variations in PAI activity and t-PA antigen with peak values at 0600 in all three groups. Mean (SEM) PAI activity (IU/ml) at 2200, 0600, and 1400 was 6.1 (1.1), 11.0 (1.3), and 4.4 (0.6) in the variant angina group; 1.8 (0.7), 5.6 (1.1), and 1.2 (0.3) in the stable exertional angina group; and 1.1 (0.5), 4.5 (0.8), and 0.7 (0.3) in the control group. Furthermore, both plasma PAI activity and t-PA antigen concentrations were significantly higher in the variant angina group than in the stable exertional angina group and the control group at each sampling time. CONCLUSIONS: In patients with variant angina there was a circadian variation in fibrinolytic activity, which was lowest in the early morning, and impaired fibrinolytic activity particularly in the early morning, when attacks of angina occur most frequently.

Aged↗

[Modified CHOP and radiation therapy in an aged patient with angioendothelial lymphoma].

A 77-year-old man was admitted because of high fever and general malaise. Whole-body CT showed large bilateral adrenal masses and para-aortic lymphadenopathy. Needle biopsy of the adrenal mass revealed mononuclear tumor cells within the lumens of small vessels, indicating the features of angioendothelial lymphoma. Immunohistochemically, these tumor cells were B cell lineage (positive for LCA, Mx-pan B, MB-1, and negative for factor VIII-related antigen, UEA-1, QB/ENDO 10). We used a modified CHOP therapy (500 mg of cyclophosphamide, 40mg of 4'-o-tetrahydropyranyl doxorubicin, 2mg of vindesine, and 50 mg of prednisolone) due to the patient's advanced age and general condition. Following the first course of this modified CHOP, the adrenal masses and para-aortic lymph nodes decreased dramatically in size, and his subjective symptoms also improved remarkably. Following three courses of modified CHOP, the patient developed dementia and disturbance of consciousness. Brain MRI revealed enhanced multiple nodular lesions. A diagnosis of multiple brain metastasis was made and modified CHOP and radiation therapy were begun, which relieved his symptoms for some time. However, he later died of pneumonia with severe leukopenia. A postmortem examination was performed. Microscopic examination showed no residual tumor cells in the adrenal gland. brain lymph nodes, or other organs. These results suggest that modified CHOP and radiation therapy may have beneficial anti-tumor effects against angioendothelial lymphoma.

Adrenal Gland Neoplasms↗