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Biomedical subjects

K Tanikawa

Publications and source records attributed to K Tanikawa.

At least 253 records · Page 14Linked to original sources
PubMed1993

Evaluation of first- and second-generation assays for detection of antibody to hepatitis C virus in non-A, non-B chronic liver diseases--evaluation of 1st and 2nd-generation assays in NANBH.

The positive rates of the second-generation enzyme-linked immunoassay (2nd-generation assay), and two first-generation immunoassays (C100-3 and KCL-163 assay) to test for anti-HCV antibodies in the serum of patients with non-A, non-B chronic liver disease were determined. The clinical usefulness of these assays was also evaluated. The group positive for the 2nd-generation assay alone was compared with that positive for the 2nd-generation and C100-3 assays with respect to the serum GPT levels determined simultaneously with the antibodies. The latter group showed slightly higher GPT levels. These findings suggest that the 2nd-generation assay is useful for the diagnosis of hepatitis C, and that C100-3 and KCL-163 assays are useful indicators of the activity of hepatic disorders.

Adult↗
PubMed1993

Hydroxyl radical generation and membrane fluidity of erythrocytes treated with lipopolysaccharide.

The effect of lipopolysaccharide (LPS) and/or bile acids on rat erythrocyte membranes was studied in vitro. Addition of LPS isolated from E. coli (J5 mutant) into the erythrocyte resulted in the decrease of membrane fluidity as determined by spin labelling using electron paramagnetic resonance (EPR). This was accompanied by membrane fragility. It was found that hydroxyl radicals were generated from erythrocytes treated with LPS by using DMPO spin trapping. However, pretreatment of erythrocytes with taurine-conjugated bile acids was found to modify the membrane response induced by LPS. Taurocholic acid (TCA) and tauroursodeoxycholic acid (TUDCA) prevented the decrease of membrane fluidity induced by LPS, and, as a result, the membrane integrity was maintained although no significant changes were observed in the amount of hydroxyl radicals produced by LPS addition. However, taurochenodeoxycholic acid (TCDCA) exhibited little beneficial effect on the dynamic properties and the function of the erythrocyte membranes, although the hydroxyl radical declined markedly in the erythrocytes. Therefore, it is suggested that TCA and TUDCA have a protective effect against LPS-induced membrane fragility by modulating membrane fluidity.

Animals↗
PubMed1993

Serial changes in serum alpha-fetoprotein prior to detection of hepatocellular carcinoma in liver cirrhosis.

In 49 liver cirrhosis patients with hepatocellular carcinoma in which the hepatocellular carcinoma nodule was smaller than 30 mm in size, serial changes in serum alpha-fetoprotein levels prior to the detection of the hepatocellular carcinoma were studied retrospectively, and compared with those of 70 cirrhotic patients with no hepatocellular carcinoma. The changes in alpha-fetoprotein levels were classified into the 4 types normal, low plateau, high plateau and spiky type. The spiky type (spiky elevation during a short period) was more frequently noted in the patients with hepatocellular carcinoma than in those with liver cirrhosis. In a prospective analysis of 39 patients with liver cirrhosis, hepatocellular carcinoma was detected in 6, and was also more frequently noted in the spiky type than the other types. Moreover, in the hepatocellular carcinoma patients with the spiky type of alpha-fetoprotein, hepatocellular carcinoma was suspected, on the basis of the tumor doubling time, to exist at the time of the first elevation of alpha-fetoprotein. These results suggest that the liver cirrhotics with the spiky type of alpha-fetoprotein may be considered to be a high-risk group of hepatocellular carcinoma.

Aged↗
PubMed1993

A search for the primary abnormality in adult-onset type II citrullinemia.

Deficiency of argininosuccinate synthetase (ASS) causes citrullinemia in human beings. Type II citrullinemia is found in most patients with adult-onset citrullinemia in Japan, and ASS deficiency is found specifically in the liver. Previous studies have shown that the decrease of hepatic ASS activity is caused by a decrease in enzyme protein with normal kinetic properties and that there were no apparent abnormalities in the amount, translational activity, and gross structure of hepatic ASS mRNA. In the present work, we show by sequencing analysis that there was no mutation in the ASS mRNA from two patients with type II citrullinemia. We also report RFLP analysis of a consanguineous family with type II citrullinemia, by using three DNA polymorphisms located within the ASS gene locus. In spite of having consanguineous parents, the patient was not a homozygous haplotype for the ASS gene. The RFLP analysis of 16 affected patients from consanguineous parents showed that 5 of 16 patients had the heterozygous pattern for one of the three DNA probes and that the frequency of the heterozygous haplotype was not different from the control frequency. These results suggest that the primary defect of type II citrullinemia is not within the ASS gene locus.

Adolescent↗
PubMed1993

Clinical significance of hypocitraturia in kidney stone patients.

Although a low concentration of urinary citrate is cited as one of the risk factors promoting stone formation or recurrence among patients with urinary stones, its clinical significance remains obscure. We studied 62 kidney stone patients with a low urinary citrate excretion (hypocitraturia) of less than 320 mg/day, without any apparent cause. The incidence of hypocitraturia in 722 kidney stone patients followed up at our stone clinic was 14.6%. Among the 62 patients, 37 had an uncomplicated hypocitraturia as the sole abnormality, while 25 had other associated stone risk factors, including hypercalciuria in 11% (7/62), hyperuricosuria in 24% (15/62), hyperoxaluria in 5% (3/62) and hypomagnesuria in 24% (15/62). The rate of urinary stone recurrence was 38% (14/37) in uncomplicated hypocitraturia, and 52% (13/25) in complicated hypocitraturia, but no statistical difference was observed. Regarding the outcome of stones, more stones were managed with lithotripsy and more passed spontaneously in the hypocitraturic patients than in the control patients with normal urinary citrate excretion. The diagnosis of hypocitraturia complicated with additional stone risks urged us to treat patients more vigorously with lithotripsy and medication, resulting in a prompt cure.

Citrates↗
PubMed1993

[Multi-center cooperative phase II study of combined infusion of PJ-203 (degradable starch microspheres) into hepatic artery in metastatic liver cancer].

In the present multi-center cooperative phase II study, in which 16 institutions participated, PJ-203 and mitomycin C were concomitantly infused into the hepatic artery of patients with metastatic liver cancer and the tumor response and safety of the combined therapy were examined. Of 81 patients treated with PJ-203, 52 patients were complete cases in which bidimensionally measurable lesions could be assessed for anticancer effect in accordance with the Direct Evaluation Criteria of Chemotherapy. The number of treatments given to the complete cases until the assessment of therapeutic effect ranged from 1 to 11 times, with the mean of 3.1 times. The overall response rate was 48.1% (25/52). The response rate for each primary lesion was 68.8% (11/16) for stomach cancer, 40.7% (11/27) for colorectal cancer and 33.3% (3/9) for other types of cancer including the gallbladder. The 25 patients with CR or PR, a 50% decrease in tumor size was confirmed after the treatment ranged from 1 to 5 times, with the treatment periods of 2 to 3 weeks. Adverse reactions were found in 56 (69.1%) out of 81 patients assessed for safety. Relatively frequent symptoms were pain in 49.4% (40/81), nausea and vomiting in 33.3% (27/81), fever in 30.9% (25/81) and anorexia in 6.2% (5/81). Principal abnormal laboratory values included a transient elevation of GOT (26.3%), GPT (22.5%), LDH (12.7%) and Al-p (8.8%). Blockade of blood flow could be observed by angiography when the amount of PJ-203 infused was in the range from 180 to 900 mg as degradable starch microspheres. The blood flow blockade could be observed most frequently at the amount of 600 mg (37.7%). The period attaining over 50% of tumor response in 25 complete cases was 42 days as a median. After the treatment was initiated in 81 patients, 50% survival duration and one-year survival rate averaged 277 days and 35.7%, respectively. The corresponding figures for each primary cancer were 419 days and 51.0% for patients with liver cancer metastasized from colorectal cancer, against 239 days and 11.8% for those with liver cancer metastasized from stomach cancer.

Adult↗
PubMed1993

[Comparative clinical study in metastatic liver cancer between intra-arterial infusion of mitomycin C alone and intra-arterial infusion of mitomycin C combined with PJ-203 (degradable starch microspheres)].

In the present comparative study, we examined an intra-arterial chemotherapy combined with PJ-203 in 60 patients with liver cancer metastasized from gastrointestinal cancer, using an intra-arterial chemotherapy alone as the control. Sixty patients who had been registered by telephone contact were allocated to groups either treated with the intra-arterial chemotherapy alone or with PJ-203 combined, 30 patients each. Mitomycin C was used as the anticancer drug and given at the dose of 8mg/m2 per time. The dose of PJ-203 was 600 +/- 300 mg as degradable starch microspheres. A significantly higher response rate (CR + PR/complete cases) of 54.5% (p = 0.021) was noted in the PJ-203 combined group, as compared to 20.0% for the control group. The 50% survival duration was 282 and 214 days for the PJ-203 combined group and control group, respectively, with no significant difference being noted between the two groups. Principal adverse reactions such as pain, gastrointestinal symptoms and fever were statistically more frequent (p < 0.01) in the PJ-203 combined group than in the control group. Among the abnormal laboratory values, the incidence of decreased leukocytes was significantly lower (p = 0.022) in the PJ-203 combined group than in the control group. One of the patients concomitantly treated with PJ-203 died of drug-induced hepatitis, which was probably attributed to mitomycin C. However, overall utility assessment was significantly better (p = 0.002) in the PJ-203 combined group.

Adult↗
PubMed1993

Effects of transcatheter splenic arterial embolization on portal hypertensive gastric mucosa.

OBJECTIVES: The aim of this study was to address the effects of transcatheter splenic arterial embolization on portal hypertensive gastric mucosa. METHODS: Thirty patients with portal hypertension and hypersplenism were included in this study. Seventeen patients underwent transcatheter splenic arterial embolization and 13 did not. The latter served as controls. Gastric mucosal hemodynamics was assessed by reflectance spectrophotometry which provides gastric mucosal hemoglobin content and oxygen saturation. Portal hypertensive gastropathy was also classified into three major categories (i.e., absent, mild, or severe). These examinations were performed before and 3 months after the procedure (i.e., splenic embolization or control). RESULTS: Control had no significant changes on either gastric mucosal hemoglobin content or oxygen saturation. In contrast, splenic embolization induced a 11% reduction in gastric mucosal hemoglobin content (p < 0.01), although gastric mucosal oxygenation did not increase. Further, there was a significant difference in the rate of improvement of portal hypertensive gastropathy (splenic embolization vs. control; 71% vs. 8%, p < 0.05). CONCLUSION: These results suggest that transcatheter splenic arterial embolization has a beneficial effect on portal hypertensive gastric mucosa in patients with hypersplenism.

Embolization, Therapeutic↗
PubMed1993

Bacterial infection in cirrhosis, with and without hepatocellular carcinoma.

OBJECTIVE: The extent and type of bacterial infection occurring with liver cirrhosis has remained unknown. Further, while hepatocellular carcinoma (HCC) is known to occur mainly in patients with liver cirrhosis, no report has yet investigated the incidence of bacterial infection in HCC. The purpose of the present study was to establish the prevalence of bacterial infection in patients with HCC. METHODS: We have retrospectively investigated all 1140 patients with hepatic cirrhosis and/or HCC for any incidence of bacterial infection. RESULTS: The incidence of bacterial infection was found to be 15.4%, in 740 patients with HCC. This was approximately equal to the incidence of bacterial infection in 400 patients with cirrhosis without HCC, which was found to be 15.3%. When the severity of cirrhosis was graded according to Child-Pugh classification, the incidences of bacterial infection in Child-Pugh class A, class B, and class C were 3.3%, 11.1%, and 31.2%, respectively, in cirrhosis, and 2.3%, 9.1% and 25.6% in HCC. The incidence of bacterial infection increased with the severity of cirrhosis and severe bacterial infections occurred in Child-Pugh class B and C patients. CONCLUSION: The data suggest that the susceptibility of HCC patients to bacterial infection is mainly related to the underlying cirrhosis and not to the HCC.

Bacterial Infections↗
PubMed1993

Reduced gastric mucosal blood flow in patients with portal-hypertensive gastropathy.

Although congestive gastric mucosal circulation has been suggested in patients with portal-hypertensive gastropathy, whether it is due to "active" (overflow) or "passive" (stasis) congestion is not known. To answer this question, we assessed regional gastric mucosal blood flow with laser Doppler flowmetry in 57 patients with portal hypertension and 30 controls. Twelve patients had portal-hypertensive gastropathy of the antrum: in eight it was mild and in four it was severe. Portal-hypertensive gastropathy of the corpus was seen in 32 patients: it was mild in 24 and severe in 8. Thus prevalence of portal-hypertensive gastropathy was higher in the corpus than in the antrum (p < 0.01). In the antrum, gastric mucosal blood flow was significantly lower (p < 0.05) in patients with severe portal-hypertensive gastropathy (0.54 +/- 0.27 V) than in controls (1.12 +/- 0.44 V), whereas the values in patients without portal-hypertensive gastropathy (0.90 +/- 0.35 V) and with mild portal-hypertensive gastropathy (0.91 +/- 0.31 V) were not significantly different from the values in controls (p < 0.05 on one-way analysis of variance). In the corpus, gastric mucosal blood flow was significantly lower in patients with mild (0.75 +/- 0.25 V) or severe portal-hypertensive gastropathy (0.42 +/- 0.22 V) than in controls (1.16 +/- 0.37 V) (p < 0.01 and p < 0.01, respectively) whereas the value in patients without portal-hypertensive gastropathy (0.99 +/- 0.37 V) was not significantly different from values in controls (p < 0.01 on one-way analysis of variance).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Early detection of hepatocellular carcinoma--high risk group and mass survey].

Most hepatocellular carcinomas (HCC) in Japan are found in chronic liver diseases with persistent infection of hepatitis B or C virus. Thus, the high risk group for HCC is evident and most small HCC, less than 2 cm in diameter, are detected by a regular follow-up of every three months using ultrasonography (US) in patients with liver cirrhosis or chronic hepatitis over 40 years of age. Approximately half of localized lesions less than 2 cm in diameter found by US are not HCC. Thus, liver biopsy using fine needles is important to make a definite diagnosis in such small lesions. The most important factor in mass survey for HCC is to select people with risk factors for HCC from the whole population. We selected people for a mass survey using US who have risk factors such as 1) abnormal liver function tests, 2) past history of liver diseases, 3) HBV or HCV carrier, 4) past history of blood transfusion, and 5) excessive drinking. About one percent of the people surveyed showed HCC. The detection rate is excellent. In future, serum tumor markers for HCC such as AFP and PIVKA-II will be useful for diagnosis of small HCC because recent studies indicate that such small HCC also produce such tumor markers in about half of the cases.

Adult↗
PubMed1993

Percutaneous ethanol injection therapy for recurrent hepatocellular carcinoma.

Recently, small hepatocellular carcinoma (HCC) has been detected by following up patients with chronic liver diseases using ultrasonography (US). Most of the HCC patients have liver cirrhosis, and multinodular lesions are often found, even in cases of small HCC. Thus, surgical resection for small HCC is of limited efficacy. Our follow-up study indicated that a recurrent lesion was observed in 96.1% of small HCC cases after successful percutaneous ethanol injection therapy (PEIT). It is therefore very important to follow-up patients initially treated with PEIT with US for the detection of newly developed tumor nodules, because of the multicentric nature of HCC. A recurrence is subsequently again treated with PEIT. The 5-year survival rate of our 250 small HCC cases treated by PEIT is 46.7%. However, cases not followed by regular US after the first PEIT show significantly poorer 5-year survival rates. In future, it would appear to be of importance to search for means to inhibit or prevent recurrence.

Carcinoma, Hepatocellular↗
PubMed1993

Biliary copper excretion in acutely and chronically copper-loaded rats.

Biliary copper excretion was examined in rats with acute, continuous and chronic copper loads. Copper was excreted into bile, and the concentration peaked 40 min after a venous injection of copper sulfate (127 ng/gm body weight). The excretion was significantly inhibited by colchicine. Therefore some copper may be transported in hepatocytes by a vesicular pathway and excreted into bile. Biliary copper output increased over time and reached a plateau 180 min after a continuous venous infusion of copper sulfate (318 ng/gm body weight/hr) had started, when the concentration of copper in bile was much higher than that in plasma; the bile/plasma ratio of copper concentrations was 4.32 +/- 0.46. These data support the idea that copper transport involves a specific uptake and transport system. In chronically copper-loaded rats, hepatic copper content was significantly increased compared with controls, and reaction products for copper were observed in hepatocyte granules by light microscopic examination with p-dimethylaminobenzylidene rhodanine stain. The number of lysosomes in hepatocytes increased and the shape changed. In chronically copper-loaded rats the number of tubular lysosomes was very high. However, other organelles appeared to be normal. In these rats biliary excretion of not only copper but also acid phosphatase, a lysosomal enzyme, was significantly greater than the control. Therefore hepatocyte lysosomes may play an important role in biliary copper excretion. Furthermore, when biliary lysosomal excretion increases, the tubular lysosomes actively participate in this excretion.

Acid Phosphatase↗
PubMed1993

Clinical significance of serum HBVDNA detected by the PCR method.

Changes in serum HBVDNA and their relationship to the prognosis following interferon (IFN) therapy were examined by the polymerase chain reaction (PCR) in 4 patients with chronic hepatitis B infection undergoing IFN therapy. The disappearance of HBVDNA was confirmed by the PCR methods in 3 out of 4 patients who showed favorable subsequent courses. The remaining patient was positive for HBVDNA despite the disappearance of the HBe antigen. In this patient, the hepatitis recurred, and was accompanied by a persistent hepatic disorder. The PCR assay was also carried out to clarify the involvement of the hepatitis B virus in 12 patients who were positive for the HBe antibody and who showed fluctuating transaminase levels. The PCR method revealed that all 12 patients were positive for HBVDNA. These findings indicate the clinical usefulness of the PCR assay for hepatitis B virus infection.

Adolescent↗
PubMed1992

The morphologic transition in hepatocellular carcinoma. A comparison of the individual histologic features disclosed by ultrasound-guided fine-needle biopsy with those of autopsy.

In hepatocellular carcinoma (HCC), it has been strongly suggested that as the tumor increases in size, foci of less-differentiated malignant tissues arise in the well-differentiated tumor and increase until they replace the well-differentiated tumor tissues. It has also been suggested that tumor growth is attributed to such dedifferentiation. In the current study, the individual histologic features of ultrasound-guided fine-needle biopsy specimens, taken from 12 small HCC in an early stage, were compared with those of autopsy to confirm the dedifferentiation of HCC. In all 12 cases, autopsy was performed 6 months or more after the initial biopsy. Dedifferentiation was demonstrated in 9 of 12 cases (75.0%). Most of the biopsy specimens from minute HCC were well-differentiated. All tumors that had been well-differentiated when evaluated by biopsy were found to have become moderately differentiated at autopsy. This comparative study confirmed the dedifferentiation of HCC with tumor growth.

Aged↗