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Biomedical subjects

K Kotoh

Publications and source records attributed to K Kotoh.

83 records · Page 5Linked to original sources
PubMedDate not supplied

Long-term prognosis and prognostic factors of liver cirrhosis in the 1980s.

The prognosis of 174 patients with cirrhosis during the 1980s (1981-89) was analysed. The estimated survival rates were 87.3% in 3 years and 68.5% in 5 years. During the follow-up period, 58 patients died: 20 of hepatocellular carcinoma (37.7%); 11 of hepatic failure (20.8%); eight of gastrointestinal bleeding (15.1%); and 14 of other causes (26.4%). Multivariate analysis revealed that serum albumin, indocyanine green retention rate at 15 min and white blood cell count were significantly associated with prognosis. The results were also compared to our previous study covering the 1970s (1971-80). The estimated survival rate was significantly improved compared to that during the 1970s (54.3% in 5 years, P < 0.001). In the 1980s, hepatic failure mortality significantly decreased (P < 0.01), and non-liver-related mortality significantly increased (P < 0.05). In summary, the prognosis of cirrhosis has improved in recent years, and changes of death cause and prognostic factors were observed. It was concluded that to evaluate the severity and prognosis of cirrhosis, new indices and appropriate classification were necessary.

Adult↗
PubMedDate not supplied

Clinical significance of urinary N1,N12-diacetylspermine levels in patients with hepatocellular carcinoma.

BACKGROUND/AIM: N1,N12-diacetylspermine (DiAcSpm), a diacetylpolyamine which was recently identified in urine, appeared to be a useful tumor marker for urogenital cancers. Here we examined the clinical significance of urinary DiAcSpm as a tumor marker for hepatocellular carcinoma (HCC). METHODS: Urine samples were collected from patients with HCC and benign liver diseases. Urinary levels of DiAcSpm were measured by ELISA, which was newly developed in order to analyze large numbers of samples. RESULTS: The appropriate threshold value was set at 325 nM/g x creatinine. The sensitivity of the DiAcSpm assay for HCC was 65.5% and the specificity calculated between HCC and liver cirrhosis was 76.0%. The percentage of DiAcSpm-positive HCC patients was similar to that for AFP or PIVKA-II. At more advanced clinical stages, the positive percentage of these three markers increased but the DiAcSpm levels appeared to move independently of AFP and PIVKA-II. In HCC patients, the DiAcSpm levels reflected the progression of disease or the effect of treatment. CONCLUSIONS: DiAcSpm levels were found to reflect the severity, activity or viability of HCC. Urinary DiAcSpm can therefore be considered one of the useful indexes for patients with HCC.

Biomarkers↗
PubMedDate not supplied

Beta-lipoproteins influence the serum level of hepatitis C virus.

Low density lipoprotein receptor (LDLR) has been proposed as a candidate receptor for hepatitis C virus (HCV). According to previous reports, free beta-lipoproteins in a human serum may regulate the rate of hepatocyte infection by competing with the virus. Therefore, serum HCV levels should be regulated by the rise and fall of serum beta-lipoproteins since the infection rate of virions influences HCV replication in hepatocytes and release of virions by hepatocytes. In this study, we examined the relationship between serum beta-lipoproteins and HCV-antigen (Ag) levels in patients with chronic type C hepatitis. Patients were selected based on strict criteria to eliminate other factors that might influence serum HCV levels. Serum concentrations of beta-lipoproteins and HCV-Ag were measured two or more times within 3 months for each patient. The result showed that HCV-Ag levels were negatively correlated with the increased beta-lipoproteins. The results support the concept that LDLR is a HCV receptor and that beta-lipoproteins competitively inhibit the infection of hepatocytes with HCV through the LDLR.

Binding, Competitive↗
PubMedDate not supplied

Primary hepatic carcinoid tumor: case report and review of 53 cases.

BACKGROUND: Primary hepatic carcinoid tumor (PHCT) is a extremely rare. The authors describe a patient with PHCT and review previously published cases of the disease. CASE REPORT: A 75-year-old man, presenting with weight loss and pain in the right upper abdomen, had multiple masses in both lobes of the liver. He was diagnosed as PHCT by radiological examination, laboratory findings with high levels of 5-hydroxyindoleacetic acid (5-HIAA) in the serum and urine, and histological findings including positive staining of tumor cells for Grimelius and chromogranin A. The patient received totally transcatheter arterial chemoembolization (TACE) five times over 27 months; this treatment provided excellent palliation and caused a decrease in urinary 5-HIAA levels. Fifty-three cases of PHCT have been reported in the English-language literature. RESULTS: Analysis of these published cases revealed that PHCT occurs in the middle age (mean age = 48.2 years) and is more frequent in females (males/females = 20/33 cases). Of the symptomatic patients, the major findings is abdominal pain, fullness, and/or a palpable mass (56% of symptomatic patients). In contrast, only 2 cases out of 53 presented with symptoms of typical carcinoid syndrome. In most cases, PHCT was detected as a hypervascular lesion by radiological examination. By histological analysis, 80% and 84% of the cases were positive for Grimelius silver stain and immunohistochemically positive for chromogranin A, respectively. Surgical resection is the treatment primarily recommended with an 18% of recurrence rate and a 74% of a survival rate after 5 years. For unresectable and recurrent cases, TACE may be recommended.

Aged↗
PubMedDate not supplied

Cytologic appearances of pheochromocytoma and medullary thyroid carcinoma occurring within a family.

The cytologic and histochemical characteristics of the tumor cells from medullary thyroid carcinoma and pheochromocytoma are described. In cell samples obtained from medullary thyroid carcinomas, amyloid deposits were detected both intracellularly and extracellularly. Medullary thyroid carcinoma cells, as well as pheochromocytoma cells, showed positive for both argentaffin and argyrophil reactions. The diagnostic significance of intracellular amyloid deposits and of positive silver and chromaffin reactions of the intracytoplasmic granules may be stressed in establishing the cytologic diagnosis of medullary thyroid carcinoma and/or pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Development of a chronic endothelialized transcatheter implantable intra-aortic graft.

The authors developed a new intraluminal aortic prosthesis (IA graft) for internal obliteration of Stanford type B dissection. The newly devised intraluminal aortic graft is a self-expandable metallic stent (Gianturco stent) outer-jacketed with a thin open-cell structured microporous film made of segmental polyurethane (0.2 mm thick, 0.1 mm pore size). Through the femoral artery, the intraluminal aortic grafts (14-20 mm diameter-, 4 cm long) were inserted into a 12 Fr catheter sheath by compression, were implanted into the descending thoracic aortas of five mongrel dogs; they were removed at the projected times of death ranging from 1 to 6 months after implantation. Histopathologic examination revealed that an elastic fiber layer had regenerated and that on the inner surface of the graft adherent and proliferating endothelial cells were observed, even at 1 month after graft implantation. Complete epithelialization was observed over the entire inner surface of the graft within 4 months after implantation. This healing process suggests that the intraluminal aortic graft is highly biocompatible and might be stable in chronic use after the obliteration of acute Stanford type B dissections.

Aortic Dissection↗