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Biomedical subjects

J Uchino

Publications and source records attributed to J Uchino.

At least 73 records · Page 4Linked to original sources
PubMed1995

Age-related, different clinicopathologic features of hepatocellular carcinoma patients.

OBJECTIVE: The authors attempted to clarify the clinicopathologic differences of hepatocellular carcinoma (HCC) patients, according to age distribution, and to investigate whether these differences contribute a certain hepatocarcinogenesis. SUMMARY BACKGROUND DATA: Hepatitis-associated viruses causing HCC have been investigated, and the infection of the viruses and etiologically, the peak age of the disease vary according to geographic barriers. However, a correlation between clinicopathologic differences and the age distribution of the patients is not well understood. METHODS: The authors reviewed their institutional experience from 1978 to 1990 in treating 428 patients with HCC. The carrier rate for hepatitis B surface antigen (HBsAg), the frequency of occurrence of high serum alpha-fetoprotein (AFP) of 2000 ng/mL, the degree of liver damage represented by the retention rate of indocyanine green dye at 15 minutes (ICGR15), and the incidence of accompanying liver cirrhosis were investigated and compared in each decade of age. RESULTS: The HBsAg carrier rate and the frequency of high serum AFP values were significantly prominent in the younger patients (20-49 yrs). The degree of liver damage and the incidence of liver cirrhosis were prominent in the elderly patients (older than 70 yrs) or the middle-aged patients (50-69 yrs); however, these four values in the middle-aged patients were intermediate with respect to those observed in the other two age groups. In addition, there was a positive correlation between the HBsAg carrier rate and the frequency of high serum AFP values or between the degree of liver damage represented by ICGR15 and the incidence of liver cirrhosis, showing that the former correlation was inversely related to the latter. CONCLUSIONS: The authors' study indicates that there are age-related differences of clinicopathologic features in HCC patients, suggesting that there are different steps or mechanisms of hepatocarcinogenesis according to the patient's age-distribution.

Adolescent↗
PubMed1995

Allopurinol effects in rat liver transplantation on recovery of energy metabolism and free radical-induced damage.

Rat livers were orthotopically transplanted after 90-min cold ischemia (group 1) or after 20-min warm and 70-min cold ischemia without (group 2) or with (group 3) allopurinol treatment (AT) (50 mg/kg i.v. 10 min prior to warm ischemia into the donor, flush perfusates with 1 mmol/l). Recovery processes were followed up for 60 min of reperfusion. Liver tissue levels of ATP and total adenine nucleotides were restored in group 1 to almost preischemic ranges within 15-30 min, remained significantly reduced by 30 and 20%, respectively, in group 2, and recovered with AT within 60 min in group 3 to almost the same extent as in group 1. A massive increase in the tissue malondialdehyde concentration, indicative of lipid peroxidation, occurred in the beginning of reperfusion of warm-ischemically damaged donor livers, which in group 3 with AT tended to be less pronounced than in group 2 without AT. The GSSG/GSH ratio reflecting intracellular oxidant stress averaged 3.3 x 10(-3) in group 1 between 15 and 60 min reperfusion. In group 3 AT resulted in comparably low values averaging 3.8 x 10(-3), while in warm-ischemically damaged livers without AT of group 2 this ratio was significantly and continuously elevated averaging 5.8 x 10(-3).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenine Nucleotides↗
PubMed1995

[The study of chemotherapy via the reservoir to colo-rectal cancer patients with liver metastases].

From January 1986 to December 1994, we administered intra-arterial chemotherapy via the reservoir to 26 colo-rectal cancer patients with liver metastases. The protocol of this chemotherapy was administration of ADM 30 mg/body/4 wks, MMC 10 mg/body/2 wks and 5-FU 500 mg/body/2 wks. Responses to this chemotherapy were PR in 8 cases, NC 3 cases, PD 14 cases and unknown 1 case. The rate of response was 32.0%. Side effects were shown in 12 cases (46.2%), and trouble with the reservoir in 5 cases (20.8%). Survival times of patients were from 5 months to 42 months (average 13.6). We think that this intra-arterial chemotherapy via the reservoir was effective for patients with liver metastases from colo-rectal cancer.

Adult↗
PubMed1995

[Chemosensitivity test for thyroid cancer by in vitro MTT assay].

In vitro MTT assay was applied for examining chemosensitivity with 50 thyroid cancers; 47 papillary cancers, 1 follicular cancer, 1 anaplastic cancers, and 1 medullary cancer. Anticancer drugs examined were 5-fluorouracil (5-FU), cisplatin (CDDP), adriamycin (ADM), etoposide (VP-16) and ifosfamide (IFO) (active type). Their efficacy was as follows: 5-FU 0%, CDDP 40.9%, ADM 0%, VP-16 5.3%, IFO 48.5%. Anaplastic cancer and medullary cancer showed no sensitivity to all tested drugs. We compared the chemosensitivity between cancer tissue and normal tissue. CDDP was more effective in cancer tissue than in normal tissue. Chemosensitivity of CDDP depended on the drug concentration but 5-FU did not. CDDP and IFO might be useful against human differentiated thyroid cancer.

Antineoplastic Agents↗
PubMed1995

Influence of warm ischemia on isolation and primary culture of hepatocytes from rat liver for a hybrid artificial liver.

To assess the possibility of using hepatocytes from ischemic liver, as a bioreactor of a hybrid artificial liver, we investigated the influence of warm ischemia on the isolation and culture of hepatocytes in rats. Warm ischemia was induced by clamping the liver hilus and the animals were divided into 3 groups according to the duration of ischemia: group A (no ischemia), group B (10 minutes) and group C (20 minutes). Hepatocytes were isolated by the collagenase perfusion method and cultured for 5 days. The yield and viability of the isolated hepatocytes were lower in group C. Rate of attachment was decreased as the duration of ischemia increased. There was no significant difference observed in functions in culture. Sufficient hepatocytes, as a bioreactor, can be isolated and cultured from warm ischemic liver within 10 minutes. Though the number of available hepatocytes were diminished, hepatocytes procured from longer warm ischemic liver could be utilized as a bioreactor.

Analysis of Variance↗
PubMed1995

[Effects of intraarterial chemotherapy after hepatectomy in hepatic cancer patients].

We conducted a retrospective study on the effects of intra-hepatic arterial chemotherapy in patients with liver cancer, and 118 patients with stage II hepatocellular carcinoma (HCC) who had undergone hepatectomy were enrolled. Patients were divided into three groups: group R (n = 41) was treated by intraarterial infusion of Epi-adriamycin 30-40 mg/body and CDDP 100 mg/body via reservoir every two weeks post-operatively; group O (n = 57) was given one-shot infusion of Epi-adriamycin or adriamycin, and group N (n = 20) served as the control. No significant differences were observed among the three groups in postoperative disease-free survival rates. The better prognosis of survival rates found in group R suggested the influence of treatment on the recurrent lesions. Six of 14 long-term survivors were in group N. The selection of the patients group should be studied more in order to obtain the full potential of postoperative intraarterial chemotherapy in stage II HCC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[DNA ploidy pattern, p53 immunohistochemical overexpression and PCNA labeling index in "single nodular" human hepatocellular carcinomas from the viewpoint of biological malignant potential].

Nuclear DNA ploidy analysis, p53 immunohistochemical overexpression and PCNA Labeling Index (PCNA LI) were studied in 80 cases of resected "single nodular" human hepatocellular carcinoma (HCC) tissue sections. Aneuploid pattern was found in forty-six cases (57.7%) and p53 overexpression in fifteen cases (18.8%). The rate of aneuploid pattern was significantly higher in patients with carcinomas more than 2 cm in diameter, fc-inf positive growth and more than Stage II. p53 overexpression was not found in patients with well-differentiated HCCs and Stage I. Positive rate of p53 overexpression was significantly higher in patients with HCV-Ab positive and PCNA LI > or = 40%. It was high in patients with vp-positive, vv-positive and aneuploid pattern. PCNA LI of HCCs were significantly higher in patients with HBs-Ag positive, high serum AFP level, massive type and single nodular type with proliferation into surrounding area, fc-inf positive, im-positive, Stage III + IV, aneuploid pattern and p53 overexpression. The postoperative prognoses of patients with aneuploid pattern and PCNA LI > or = 40% were significantly poorer than those of the diploid one and PCNA LI < 40% in cumulative survival rates. Those prognoses were remarkably poorer in the early postoperative period. Patients with p53 overexpression had poorer prognosis than those with no p53 overexpression in the early postoperative period. These results suggest that nuclear DNA ploidy analysis, p53 immunohistochemical overexpression and PCNA LI were useful markers of biological malignant potentials in "single nodular" human HCCs.

Carcinoma, Hepatocellular↗
PubMed1995

[Primary hyperparathyroidism in young patients].

Five young patients with primary hyperparathyroidism were treated in our hospital. Male to female ratio was 3 to 2 and the mean age was 12.2 years old. Hypercalcemia due to a single adenoma of the parathyroid gland was found in all cases. They showed various clinical symptoms, such as abdominal pain, nausea, convulsions and disturbance of walking. Parathyroid tumors usually could be easily identified with ultrasonography or CT scan or thyroid subtraction scintigraphy. But in two cases parathyroid tumor was not found during operation. Angiography and/or venous sampling were performed and they showed the right localization.

Adolescent↗
PubMed1995

[Effect of continuous infusion of 5-fluorouracil and daily low-dose cisplatin for inoperable recurrent cancer of the stomach and colon].

With the use of cisplatin to enhance the effect of 5-FU, a combined approach was designed to treat patients with inoperable recurrent cancer of the stomach (15) and colon (6). This CDDP-5-FU therapy consisted of intermittent infusion of CDDP at a dose of 6 mg/m2 every day and continuous infusion of 5-FU at a daily dose of 200 mg/m2 for 2 weeks with a 2-week interval in between. There were 1CR and 6PR, and the overall response rate was 40.0%. Toxicity was manifested in slight nausea or vomiting in two patients (10.0%), but there was no nephrotoxity. Thrombocytopenia of Grade 4 was found in 1 patient and leucopenia of Grade 3 in another. The efficiency of performance status was in 14 patients (66.7%). Combination of daily low-dose cisplatin and 5-FU is a tolerable treatment for patients with inoperable recurrent stomach and colon cancer. It is suggested that CDDP plays a role as not only an effector but also a modulator in biochemical modulation of 5-FU in this therapy. The infusion schedule is also suitable for chemotherapy of outpatients. Further studies on the appropriate infusion of CDDP and 5-FU are needed.

Aged↗
PubMed1995

[Calcium metabolism in porcine liver transplantation].

The influence of warm ischemia on calcium metabolism in liver transplantation (LTX) was investigated using temporary portal vein arterialization (PA) technique. Group I pigs were added no warm ischemia (n = 6). In group II, donors were killed by KCl, and the livers were left in situ for 60 min (n = 6). After anastomosing the suprahepatic vena cava, revascularization was carried out employing PA. Initial reperfused blood was collected through the infrahepatic vena cava. All pigs survived more than 4 days in group I, whereas all died within 2 days in group II. In group II, Ca2+ levels of initial reperfused blood were significantly lower than those of arterial blood. Ca2+ levels of initial reperfused blood in group II were significantly lower than those in group I. Within 90 min after revascularization, biliary output and biliary calcium content and excretion in group I recovered to 30%, 100% and 40% of normal, respectively, but in group II only 2 animals could excrete bile. In conclusion, in the liver with 60 min warm ischemia, Ca2+ influx occurred immediately after revascularization followed by decreased calcium excretion in bile, which suggested that accumulation of calcium might be one of the causes of warm ischemic injury.

Animals↗
PubMed1994

Treatment of lymph node recurrence in patients with hepatocellular carcinoma.

The clinicopathological features and results of lymph node dissection were investigated in four patients with hepatocellular carcinoma (HCC) who developed lymph node recurrence following hepatectomy. One patient was found to have metastasis in the periportal lymph nodes at the time of a second laparotomy, while the other three developed posterior pancreaticoduodenal lymph node metastasis. All four patients had concomitant cirrhosis of the liver and were negative for hepatitis B surface antigen. No relationship between the site of the primary lesion and the location of lymph node metastasis was found. Two of the four patients are alive and in good health 4 years and 3 months, and 7 years and 3 months after their first operation, respectively. Thus, we conclude that the posterior pancreaticoduodenal lymph nodes are the most common site of lymph node recurrence of HCC, and that dissection of the affected lymph nodes offers the best chance of long-term survival.

Carcinoma, Hepatocellular↗
PubMed1994

What is the benefit of aggressive chemotherapy for advanced neuroblastoma with N-myc amplification? A report from the Japanese Study Group for the Treatment of Advanced Neuroblastoma.

In 1985, a nationwide single protocol (cyclophosphamide, vincristine, tetrahydropyranyl Adriamycin, and cisplatin) for the treatment of advanced neuroblastoma was begun in Japan and was found to significantly increase the 3-year survival rate--to 70% for stage III, and to 45% for stage IV. In this study, the authors investigated the efficacy of this protocol for advanced neuroblastoma with or without N-myc amplification. In 159 of the 233 patients with advanced neuroblastoma treated with this protocol (between January 1985 and March 1993), genomic amplification of N-myc was determined. These 159 patients were divided into two groups according to the number of N-myc copies, ie, those with fewer than 10 copies (105 patients) and those with 10 or more copies (54 patients). The survival curves for the two groups were significantly different. The 5-year survival rate for patients with 10 or more copies was 43.9%; this is surprisingly high in comparison to results of previous studies in which no survivors were expected in cases of advanced neuroblastoma with highly amplified N-myc. Persistent bone marrow suppression was common, but there were no deaths attributable to drug side effects. Five patients with fewer than copies of N-myc amplification died more than 3 years after initial treatment. Three of the five had tumors with an unfavorable Shimada classification, and two had diploid nuclear DNA content. The authors conclude that the protocol resulted in dramatic improvement in the patients with advanced neuroblastoma, even with high N-myc amplification.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

Liver resection in children, using a water-jet.

The water-jet method has been used during hepatic resection in children. The instrument cuts the hepatic tissue by means of a high-pressure fine water-jet, while the exposed intrahepatic vessels are spared injury. Physiological saline was used for the jet water, and pressure of 12 to 15 kilograms of force per square centimeter (kgf/cm2) through a 0.15-mm-diameter nozzle was found to be optimal for cutting the liver parenchyma. The authors evaluated the usefulness of the water-jet dissector (n = 8) during bisegmentectomy or trisegmentectomy in comparison to the Cavitron Ultrasonic Surgical Aspirator (CUSA) (n = 5). The mean operation time was 4.08 +/- 0.87 hours for the water-jet group and 5.08 +/- 1.33 hours for the CUSA group. The mean blood loss was 602 +/- 659 mL for the water-jet group and 1,036 +/- 521 mL for the CUSA group. Although there were no significant differences with respect to operation time, blood loss, or postoperative complications, the liver parenchyma was dissected more easily using the water-jet. The authors believe that the mechanical simplicity and safety of the water-jet method will lead to its more widespread use in liver resection in children.

Blood Loss, Surgical↗