Biomedical subjects

Hidetomo Muto

Publications and source records attributed to Hidetomo Muto.

4 recordsLinked to original sources

PubMed2006

Severe alcoholic hepatitis with extremely high neutrophil count successfully treated by granulocytapheresis.

We report a severe alcoholic hepatitis (SAH) patient with an extremely high WBC count, high serum bilirubin and low prothrombin time (PT) successfully treated with granulocytapheresis. After neutrophil-elastase inhibitor failed to reduce WBC count, methylprednisolone pulse therapy was performed. However, WBC count continued to be elevated to 97,190/microl (neutrophils 97.0%) despite improvement of total bilirubin and PT. After 5 sessions of granulocytapheresis and ulinastatin administration, increased serum IL-6, IL-8, neutrophil-elastase and WBC count gradually decreased. We could conclude that granulocytapheresis and ulinastatin can be very effective in reducing cytokines and neutrophil-elastase, and in improving the general status of SAH patients.

Adult↗

PubMed2006

Useful parameters for distinguishing nonalcoholic steatohepatitis with mild steatosis from cryptogenic chronic hepatitis in the Japanese population.

BACKGROUND/AIMS: As detecting mild steatosis is difficult by abdominal ultrasonography (US), nonalcoholic steatohepatitis (NASH) with mild steatosis may sometimes be confused with cryptogenic chronic hepatitis. We aimed to test this possibility and to isolate factors that may indicate NASH. METHODS: First, 53 Japanese patients diagnosed as having cryptogenic chronic hepatitis by laboratory examination and US were enrolled. These patients were histologically divided into NASH and non-NASH groups, and their clinical features were compared. Second, the diagnostic accuracy of predictors of NASH was examined prospectively. RESULTS: Fifteen patients (28%) were histologically diagnosed as having NASH with mild steatosis. Multivariable analysis revealed that body mass index (BMI) and serum ferritin level were independent predictors of NASH. The best cutoff values to detect NASH were assessed by using receiver-operating characteristic curves: BMI>25.2 kg/m(2) and serum ferritin level >142 ng/ml. When both markers were concomitantly negative, the negative predictive value to detect NASH was 100%. CONCLUSIONS: In cases of mild steatosis, US is not a perfect tool for the accurate diagnosis of NASH. BMI and serum ferritin level are useful discriminators of NASH from cryptogenic chronic hepatitis, and might be helpful markers for diagnosing NASH more accurately in Japanese patients.

Adolescent↗

PubMed2005

Assessment of KL-6 as a tumor marker in patients with hepatocellular carcinoma.

AIM: To investigate the clinical significance of KL-6 as a tumor marker of HCC in two different ethnic groups with chronic liver disease consecutively encountered at outpatient clinics. METHODS: Serum KL-6 was measured by the sandwich enzyme immunoassay method using the KL-6 antibody (Ab) as both the capture and tracer Ab according to the manufacturer's instructions (Eisai, Tokyo, Japan). Assessment of alpha fetoprotein (AFP) and protein induced vitamin K deficiency or absence (PIVKA-II) was performed in both groups using commercially available kits. RESULTS: A significantly higher mean serum KL-6 (556+/-467 U/L) was found in HCC in comparison with non-HCC groups either with (391+/-176 U/L; P<0.001) or without (361+/-161 U/L; P<0.001) liver cirrhosis (LC). Serum KL-6 level did not correlate with either AFP or PIVKA-II serU/Levels. Using receiver operating curve analysis for KL-6 as a predictor for HCC showed that the area under the curve was 0.574 (95%CI = 0.50-0.64) and the KL-6 level that gave the best sensitivity (61%) was found to be 334 U/L but according to the manufacturer's instructions; a cut-off point of 500 U/L was used that showed the highest specificity (80%) in comparison with AFP and PIVKA-II (78% vs 72% respectively). Combining the values of the three markers improved specificity of AFP for HCC diagnosis from 78% for AFP alone; 93% for AFP plus PIVKA-II to 99% for both plus KL-6 value (P<0.001). Mean serum alkaline phosphatase level was significantly higher in KL-6 positive (564+/-475) in comparison with KL-6 negative (505+/-469) HCC patients (P = 0.021), but such a difference was not found among non-HCC corresponding groups. CONCLUSION: KL-6 is suggested as a tumor for HCC. Its positivity may reflect HCC-associated cholestasis and/or local tumor invasion.

Adult↗

PubMed2004

Types of human leukocyte antigen and decrease in HCV core antigen in serum for predicting efficacy of interferon-Alpha in patients with chronic hepatitis C: analysis by a prospective study.

BACKGROUND: A prospective study was conducted to evaluate the influence of host factors, including human leukocyte antigen (HLA), and viral factors, including hepatitis C virus (HCV) core antigen, on the response to interferon (IFN)-Alpha. METHODS: Natural IFN-Alpha was given to 66 patients with chronic hepatitis C at a dose of 9 million units per day for 2 weeks, followed by 9 million units three times a week for 22 weeks. RESULTS: Sustained virological response without detectable HCV RNA in serum 24 weeks after the end of IFN therapy was achieved in 21 patients, while it was not in 32 patients; the remaining 13 patients were not evaluated. HCV core antigen and HCV RNA started to decrease 1 and 4 weeks, respectively, after the commencement of IFN in responders ( P = 0.02 and P = 0.05, respectively). On univariate analysis, age of 50 years or less ( P < 0.001); lack of HLA DR6 ( P = 0.018) or DR52 ( P < 0.041); platelets more than 14 x 10(4)/mm(3) ( P = 0.031); HCV core antigen 500 fmol/l or less ( P = 0.001); and HCV RNA 100 KIU/ml or less were predictive of response. On multivariate analysis, age 50 years or less (odds ratio [OR], 4.009; P = 0.039); lack of HLA DR6 (OR, 8.130; P = 0.027); IFN-naive (OR, 11.63; P = 0.016); HCV core antigen 500 fmol/l or less (OR, 10.61; P = 0.007); and genotypes other than 1b (OR, 8.929; P = 0.010) were predictive of response. CONCLUSIONS: Lack of HLA DR6 determined the response to IFN. HCV core antigen was useful in predicting and monitoring the response to IFN.

Adult↗