Biomedical subjects

K Tanikawa

Publications and source records attributed to K Tanikawa.

432 records · Page 24Linked to original sources

PubMedDate not supplied

Lack of hepatic benefit by oxygen inhalation during vasopressin infusion in patients with cirrhosis.

Vasopressin has been found to impair hepatic function in patients with cirrhosis. The aim of this study was to investigate whether oxygen inhalation could improve hepatic function during vasopressin infusion. Vasopressin (0.3 iu/min) was infused into eight patients with cirrhosis for 50 min. During the first 30 min they were ventilated by room air and for the following 20 min by oxygen (approximate 50% of FiO2). The extra oxygen inhalation caused a typical increase in arterial (+7%, P less than 0.01), portal venous (+8%, P less than 0.05), and hepatic venous (+9%, P less than 0.01) oxygen content. No effect was noted in arterio-hepatic venous and portal venous-hepatic venous oxygen content difference in comparison with the values after vasopressin alone. The hepatic perfusion remained unchanged. These results suggest that the extra oxygen did not increase hepatic oxygen uptake. Similarly, intrinsic clearance of indocyanine green did not improve. It is concluded that oxygen supplement in this setting has no hepatic benefit in patients with cirrhosis.

Adult↗

PubMedDate not supplied

Sinusoidal capillarization in small hepatocellular carcinoma.

The morphological and phenotypic changes of sinusoidal endothelial cells in hepatocellular carcinoma were investigated along with the hemodynamic changes. Hepatocellular carcinomas, which were 10-20 mm in diameter, were obtained by liver aspiration biopsy. Twenty specimens of well differentiated and 20 specimens of moderately differentiated hepatocellular carcinoma were used. These were classified into two groups of hepatocellular carcinoma: with and without hypervascularity. Electron microscopy, immunohistochemistry using antibodies against factor VIII-related antigen, type IV collagen and laminin and lectin histochemistry using Ulex europaeus agglutinin I (UEA-I) were performed. Factor VIII-related antigen and UEA-1 binding sites were present in the sinusoidal endothelial cells in two groups. In hepatocellular carcinoma with hypervascularity, type IV collagen and laminin were present corresponding to basement membranes along the endothelial cells, which had few fenestrae. In another group, although type IV collagen was present along the endothelial cells that had a few fenestrae, laminin and basement membranes were rarely observed. These results suggest that the sinusoidal endothelial cells tend to show phenotypic changes in the early stage of hepatocarcinogenesis. As the arterial blood supply for hepatocellular carcinoma increases, the sinusoidal endothelial cells may form basement membranes and take on the morphological appearance of capillaries.

Adult↗

PubMedDate not supplied

Carboplatin as an anticancer agent for transcatheter arterial chemoembolization in patients with hepatocellular carcinoma.

Transcatheter arterial chemoembolization (TACE) is a conservative treatment in patients with hepatocellular carcinoma (HCC). In the present study, 30 patients with unresectable HCC underwent TACE using carboplatin (300 mg), and their clinical results were evaluated. After TACE, 18 (60.0%) of 30 patients demonstrated tumor size reduction rates > or = 50%. Of 23 patients with pretreatment serum alpha-fetoprotein (AFP) levels >20 ng/ml (cutoff), 14 (60.9%) showed AFP reduction > or = 75%. The 1-, 2-, 3- and 4-year survival rates were 82.9, 68.1, 45.1 and 37.6%, respectively. The median survival was 2.3 years. The only notable adverse reaction accompanying TACE was a transient myelosuppression. Carboplatin is thought to be a useful anticancer agent in patients with HCC treated with TACE.

Aged↗

PubMedDate not supplied

Local recurrence of early esophageal carcinoma after endoscopic mucosal resection.

We performed endoscopic mucosal resection on 25 patients with early esophageal carcinoma where the depth of invasion was limited to in the lamina propria mucosae (m2) and we observed local recurrent cancer in 2 patients (8%). To reduce the rate of local recurrent cancer, the method of resection was aimed at pathological negative stumps and establishment of a strict standard of judgement on clinically complete resection were considered to be necessary. Furthermore, complete cure was possible even in patients with pathologically positive stumps in cases where no recurrent cancer was observed over a 1 year period following endoscopic mucosal resection.

Aged↗

PubMedDate not supplied

Hepatic arterial infusion chemotherapy with continuous low dose administration of cisplatin and 5-fluorouracil for multiple recurrence of hepatocellular carcinoma after surgical treatment.

To date, conventional treatments for multiple intrahepatic recurrence of hepatocellular carcinoma (HCC) after surgery are unsuccessful. The aim of this retrospective study was to evaluate the prognostic effectiveness of a new infusion chemotherapy of cisplatin (CDDP) and 5-fluorouracil (5-FU) via hepatic artery for HCC with multiple intrahepatic recurrence. Fifty-two patients, who had postoperative multiple recurrence of HCC (more than 3 tumors), were enrolled in this study. Thirty-one patients were treated by hepatic arterial infusion chemotherapy via a subcutaneously implanted injection port. A one-week course of this treatment consisted of daily administration of cisplatin (10 mg for 1 h on days 1-5) and subsequent daily administration of 5-fluorouracil (250 mg for 5 h on days 1-5). Three to six sequential one-week courses were performed (the CDDP,5-FU group). Twenty-one patients underwent conventional interventional therapies including transcatheter arterial chemoembolization, lipiodolization (the conventional group). The complete response rate and the effective response rate in the CDDP,5-FU group were 29.0% and 71.0%, respectively. The 5-year survival rate in this group was 45.7%, which was significantly better than that in the conventional group. Based on multivariate analysis, CDDP,5-FU hepatic arterial infusion chemotherapy was found to be significant in prolonging survival, and this treatment achieved favorable therapeutic results for multiple recurrence of HCC. As part of a multidisciplinary approach this treatment is expected to improve the prognosis of patients with advanced HCC.

Adult↗

PubMedDate not supplied

A simultaneous monitoring of Lens culinaris agglutinin A-reactive alpha-fetoprotein and des-gamma-carboxy prothrombin as an early diagnosis of hepatocellular carcinoma in the follow-up of cirrhotic patients.

To elucidate the risk factors for developing hepatocellular carcinoma (HCC) during the follow-up of patients with liver cirrhosis (LC), outpatients with LC were examined periodically by means of serum biochemical assessments, ultrasonography, and computed tomography. Risk factors for HCC were statistically analyzed. We also examined an efficacy of Lens culinaris agglutinin A-reactive profiles of alpha-fetoprotein (AFP-L3%) and des-gamma-carboxy prothrombin (DCP) value using a highly sensitive DCP determination kit (ED036) for the early recognition of HCC. The AFP-L3% and the ED036 value were retrospectively determined with stored serum samples. HCC was diagnosed in 21 of the 78 patients with LC during the follow-up period (mean follow-up period: 42 months). The estimated cumulative incidence of HCC was 25% with 3 years and 48% with 5 years. The most significant risk factor for the development of HCC in LC patients was found to be the mean serum AFP concentration from the year before the HCC detection (p=0.02). At the time of the recognition of HCC, the positive rates of the tumor markers were: serum AFP concentration 14%, serum DCP value 5%, AFP-L3% was 33%, and that of ED036 43%. The positive rate in collaborative use of AFP-L3% and ED036 was 67%. The simultaneous determination of the AFP-L3% and the ED036 value was shown to be effective for the early detection of HCC.

Aged↗

PubMedDate not supplied

Budd-Chiari syndrome complicated by hepatocellular carcinoma with no evidence of infection with hepatitis virus: a case report.

Hepatocellular carcinoma occurs in patients with Budd-Chiari syndrome. However, the etiology of hepatocellular carcinoma accompanied with Budd-Chiari syndrome has not been elucidated. We report a case of Budd-Chiari syndrome with membranous obstruction of the inferior vena cava complicated by hepatocellular carcinoma in an 80 year-old man. There was no evidence of co-infection with hepatitis A, B, C, D, E, and G virus. Histologically, the non-cancerous liver tissue showed chronic venous congestion with no evidence of hepatitis virus-associated liver cirrhosis. This case suggests that chronic venous congestion of the liver may be one of the pathologic conditions that occurs in hepatocellular carcinoma.

Aged↗

PubMedDate not supplied

Successful treatment for bronchial bleeding from invasive pulmonary metastasis of hepatocellular carcinoma: a case report.

Pulmonary metastasis is frequently seen in patients with advanced hepatocellular carcinoma. However, information is limited concerning life-threatening complications and effective treatment of pulmonary metastasis because of the poor prognosis of patients with advanced hepatocellular carcinoma. Recent remarkable progress in detection and treatment of hepatocellular carcinoma has improved prognosis, making management of pulmonary metastasis an important clinical issue. We describe a 68-year-old man with pulmonary metastasis of hepatocellular carcinoma and sudden onset of hemoptysis from bronchial invasion. Transcatheter embolization was performed successfully via the bronchial artery with disappearance of bloody sputum. Peribronchial pulmonary metastasis of hepatocellular carcinoma can cause life-threatening hemoptysis. Transcatheter arterial embolization may be one of therapeutics for hemoptysis from invasive pulmonary metastasis of hepatocellular carcinoma.

Aged↗

PubMedDate not supplied

A long-term investigation of transcatheter splenic arterial embolization for hypersplenism.

BACKGROUND/AIMS: This study investigated longterm changes in the parameters of blood and liver function tests following TSAE. PATIENTS AND MATERIALS: Twenty-five patients received transcatheter splenic arterial embolization (TSAE) as a treatment for hypersplenism, and their post- TSAE conditions were monitored for over a year. We evaluated changes in blood and liver function tests, and examined changes of platelet associated immunoglobulin G (PA-IgG), liver and spleen volumes and hemodynamics in order to consider the mechanism of liver function improvement following TSAE. RESULTS: In blood tests, platelet and WBC counts significantly increased one year after TSAE and this increased level continued up to the fifth year. In liver function tests, levels of serum total protein, albumin, total cholesterol, and results of the hepaplastin test significantly improved after the one year, and these levels remained even over one year. CONCLUSIONS: Results of this study indicated involvements of decreased platelet pool in the spleen and probable immunological mechanisms in association with PA-IgG in platelet count increase. Indocyanine green clearance (15') were improved in 5 of 8 patients (62.5%) after TSAE. These points may indicate an involvement of hemodynamic changes in the improvement of liver function parameters.

Blood Proteins↗

PubMedDate not supplied

Serum hyaluronate predicts response to interferon-alpha therapy in patients with chronic hepatitis C.

BACKGROUND/AIMS: The response to interferon therapy for chronic hepatitis is known to decrease with progression of the hepatic fibrosis. On the other hand, serum hyaluronate reflects hepatic sinusoidal capillarization or liver cirrhosis, and also serum type IV collagen, which is one of the main components of the basement membrane, rises with the progression of hepatic fibrosis. In this study, the relationship between the degree of hepatic fibrosis and the response to interferon-alpha was determined retrospectively in patients with chronic hepatitis C. In addition, whether the measurement of serum hyaluronate and type IV collagen before interferon-alpha therapy was useful for predicting the response to interferon-alpha therapy in chronic hepatitis C was determined. MATERIALS AND METHODS: Thirty-seven patients with elevated serum ALT levels for at least 6 months and histologically determined chronic hepatitis were studied. All patients were positive for anti-HCV and negative for hepatitis B surface antigen. Twenty-eight healthy adults with normal blood biochemical data, who were negative for hepatitis B antigen and HCV antibody tests, had limited alcohol intake were used as controls. The test group was given IFN-alpha by intramuscular injection for 14 days, and then were treated 3 times per week for 24 weeks. RESULTS: The extent of hepatic fibrosis, particularly, perisinusoidal fibrosis (P < 0.01) was significantly greater in nonresponders than in responders. The mean serum hyaluronate and type IV collagen levels were more elevated in nonresponders than in responders, especially, the serum hyaluronate level showed a significant difference (P < 0.01). Most of the patients having a serum hyaluronate level of more than 100 ng/ml were nonresponders who had chronic active hepatitis with bridging necrosis on liver biopsy. Serum hyaluronate and type IV collagen levels showed significant positive correlation with degree of the portal fibrosis (P < 0.01), perisinusoidal fibrosis (P < 0.001) and focal necrosis (P < 0.01) in histological findings of liver biopsy specimens. CONCLUSION: These results suggest that serum hyaluronate and type IV collagen levels reflect the extent of the hepatic fibrosis in chronic hepatitis C and also that serum hyaluronate level predicts the response to interferon-alpha therapy in patients with chronic hepatitis C.

Adult↗

PubMedDate not supplied

Effects of omeprazole and lansoprazole on fasting and postprandial serum gastrin and serum pepsinogen A and C.

BACKGROUND/AIMS: The aim of this study was to examine effects of two H+/K(+)-ATPase antagonists (omeprazole and lansoprazole) on fasting and postprandial serum gastrin and serum pepsinogens A and C. MATERIALS AND METHODS: In 8 healthy volunteers, either 20 mg of omeprazole or 30 mg of lansoprazole once daily for 7 days were administered in a double blind and randomized design. After a two-week period to "wash out" the drug, each treatment was then crossed over. Fasting and postprandial serum gastrin and serum pepsinogens A and C levels were measured at baseline and at the end of the treatment. RESULTS: Omeprazole increased fasting levels of serum gastrin and serum pepsinogen A and C. A similar finding was observed after lansoprazole administration. The test meal increased serum gastrin level but did not serum pepsinogens A and C either before or after omeprazole and lansoprazole administration. In addition, the integrated meal stimulated incremental serum gastrin were not modified after omeprazole and lansoprazole administration. CONCLUSIONS: This data suggests that both omeprazole and lansoprazole increase fasting serum gastrin and serum pepsinogen A and C levels, but have no effects on postprandial serum gastrin and pepsinogens levels.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMedDate not supplied

The effect of spleen volume on liver regeneration after hepatectomy--a clinical study of liver and spleen volumes by computed tomography.

BACKGROUND/AIMS: The relationship between liver regeneration and spleen volume after partial hepatectomy was studied with computed tomography (CT) in 13 patients with chronic liver disease (chronic active hepatitis: 2, pre-liver cirrhosis: 3, liver cirrhosis: 8). MATERIALS AND METHODS: Liver and spleen volumes were measured by abdominal CT before hepatectomy and 1 and 2 years after operation, and the percent volumes of the liver and spleen of abdominal capacity were compared. RESULTS: While the residual liver volume increased in all patients after 1 year, it continued to increase in 7 patients (percent recovery: 102 +/- 4.8%) but had decreased in 5 patients (90.0 +/- 4.8%) after 2 years. The mean spleen volume 2 years after hepatectomy was 2.8 +/- 0.9% in the former, and 6.0 +/- 1.2% in the latter. The percent increase in liver volume was inversely related to the spleen volume (r = -0.707). In a case of transcatheter splenic arterial embolization, the liver volume continued to be increase despite splenomegaly. CONCLUSION: Splenic volume is suggested to be related to the process of recovery of the liver.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Increased serum IgM class anti-lipid A antibody and therapeutic effect of ursodeoxycholic acid in primary biliary cirrhosis.

BACKGROUND/AIMS: There is as yet no explanation for the increased serum IgM level observed in patients with primary biliary cirrhosis. METHODOLOGY: The serum IgM class anti-lipid A antibody was determined in patients with primary biliary cirrhosis using Elisa and Western blot techniques. RESULTS: Using enzyme-linked immunosorbent assay, we found the concentration of serum IgM class anti-lipid A antibody was the highest in 21 patients with PBC as compared to 29 patients with other liver diseases and 19 controls. Using western blotting, IgM class anti-lipid A antibody was detected as a clear band in patients with primary biliary cirrhosis. The level of this antibody correlated significantly (p < 0.005) with that of total IgM. Treatment with ursodeoxycholic acid improved not only the routine biochemical profile but also the level of IgM class anti-lipid A antibody (p < 0.005). CONCLUSIONS: Since the lipid A plays a primary role in the biological activities of lipopolysaccharide (a component of gram-negative bacteria), bacterial antigen may participate in the elevation of serum IgM levels in patients with primary biliary cirrhosis. Ursodeoxycholic acid treatment may improve the cholestasis, and this may have altered the response to stimulation by gut derived bacterial antigens.

Antibodies, Bacterial↗

PubMedDate not supplied

The incidence of hepatocellular carcinoma in patients with chronic hepatitis C after interferon treatment.

To determine whether serum hepatitis C virus (HCV) RNA disappearance after interferon (IFN) treatment prevents development of hepatocellular carcinoma (HCC), we evaluated retrospectively the incidence of HCC in patients with chronic hepatitis C. A total of 213 patients were monitored for more than 6 months after completion of IFN treatment. Sixty-three of the 213 patients (29.6%) achieved a complete response (CR) to treatment and 150 (70.4%) had no response (NR). HCC developed in 12 (5.6%), all of whom were NR. Logistic analysis showed age, alpha -fetoprotein, and staging of histological finding before IFN treatment were independent factors to development of HCC. The fact that there was no HCC development from CR provides a basis for IFN treatment in chronic HCV infection.

Adult↗

PubMedDate not supplied

Long-term evaluation of interferon therapy in hepatitis C virus-associated cirrhosis: does IFN prevent development of hepatocellular carcinoma?

During the course of long-term follow-up, we examined the efficacy of interferon (IFN) in the improvement of liver function and prevention of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) associated cirrhosis patients. Fifty-five cirrhotic patients, in whom HCC nodules in the liver were not detected by ultrasonography (US) or computed tomography (CT), received 3 or 6 million units of human lymphoblastoid IFN daily for two weeks and 3 times a week for 22 weeks. Complete response (CR) was defined as normalization of serum alanine aminotransferase (ALT) together with negative HCV RNA at 6 months after IFN therapy completion. Any other pattern of response was defined as non-response (NR). After IFN therapy the patients were followed up every 1-3 months for at least 1 year (average follow-up period, about 40 months) with serological tests and US or CT. In the 8 CR patients, the serum ALT levels remained normal and HCV RNA remained negative. Platelet count, white blood cell count, serum albumin and zinc turbidity test have recovered to the normal range at final follow-up. Ten of the 47 patients with NR have developed HCC, whereas no patients with CR has developed HCC during follow-up. We conclude that IFN improves the liver function and may prevent the development of HCC even in cirrhotic patients who show CR to IFN therapy.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Immunohistochemical demonstration of alpha-fetoprotein in small hepatocellular carcinoma.

We demonstrated immunohistochemical staining of a-fetoprotein (AFP) in small hepatocellular carcinoma (HCC). Fifty-six patients with HCC less than 2 cm in diameter were studied. Twenty-five HCCs (44.6%) were positive for AFP-staining. The positive rate of AFP-staining in HCC tissue was higher in the patients with serum AFP concentration above 20 ng/ml than that of the patients with below 20 ng/ml. AFP-staining was demonstrated on the rough endoplasmic reticulum of HCC cells by immuno-electron microscopy. AFP-staining of tissue specimens obtained by fine needle biopsy is useful in the histologic diagnosis of HCC.

Aged↗

PubMedDate not supplied

Monitoring of serum levels of HCV RNA in early phase of IFN therapy; as a predictive marker of subsequent response.

BACKGROUND/AIMS: To determine whether the initial response to interferon (IFN) therapy predicts the long-term response, monitoring of HCV RNA level in the early phase of IFN therapy was performed. METHODOLOGY: Sixty-seven patients with chronic hepatitis C virus (HCV) infection were investigated. Patients received 6 MU of human lymphoblastoid IFN daily for 2 weeks and then three times weekly for 22 weeks (total dose; 480 U). These were 34 complete responders (CR) and 33 non-responders (NR). Serum levels of HCV RNA were assayed before therapy and at weeks 1 and 2, using the AMPLICOR HCV Monitor kit. RESULTS: Serum levels of HCV RNA were below the detection limit in 33 (97.1%) of 34 CR compared with 13 (39.4%) of 33 NR at week 1, and in 100% of CR compared with 17 (51.5%) of NR at week 2 (P < P0.05). These observations were independent with viral genotypes. CONCLUSION: A complete response to IFN therapy results primarily from a rapid decrease in the serum levels of HCV RNA and a further decrease to below the detection limit by week 2 of the therapy. In spite of a viral genotype, early monitoring of serum levels of HCV RNA during IFN therapy are predictive of a subsequent long-term response to IFN in patients with chronic HCV infection.

Adult↗

PubMedDate not supplied

Biliary secretion of endotoxin and pathogenesis of primary biliary cirrhosis.

Previous studies suggested endotoxin, derived from the intestine through the portal blood to the liver, was predominantly metabolized by Kupffer cells. In the present study, fluorescent-labeled endotoxin injected into the rat portal vein was demonstrated not only in Kupffer cells but also in hepatocytes. Furthermore a great amount of labeled endotoxin was recovered in bile. In the livers of patients with primary biliary cirrhosis (PBC), immunohistochemistry demonstrated significant retention of endotoxin in the biliary epithelial cells, and treatment with ursodeoxycholic acid significantly reduced the retention in those cells. The study for detection of apoptosis demonstrated increased rates of apoptosis in hepatocytes and biliary epithelial cells in PBC liver, and the rate of apoptosis in biliary epithelial cells was significantly reduced after treatment with ursodeoxycholic acid. Immunohistochemistry in PBC liver demonstrated significant reduction of fluorescence intensity for a 7H6 antigen in biliary epithelial cells, indicating the increased paracellular permeability of bile ducts, because cellular immunolocalization of that antigen has been shown to be inversely correlated with the paracellular permeability of the tight junction. These results suggest that, in biliary epithelial cells, retention of endotoxin, increased apoptosis, and increased permeability of tight junctions may be involved in the pathogenesis of PBC.

Animals↗