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Biomedical subjects

S Iwama

Publications and source records attributed to S Iwama.

At least 37 records · Page 2Linked to original sources

Liver-specific F antigen in the serum of patients with liver diseases and the detection of early stage hepatocellular carcinoma.

Liver-specific F antigen was detected in serum using human-specific guinea pig antiserum, in 75 out of 121 patients with various liver diseases. The antigen was detectable in most of the patients (86.7%) with hepatocellular carcinoma, and the levels of F antigen were often high in these patients. There was no correlation between the levels of F antigen and alpha-fetoprotein. Temporal changes of serum F antigen level were also studied in patients with hepatocellular carcinoma. In 8 out of 13 patients with hepatocellular carcinoma, serum F antigen level remained continuously high, and in these patients, it had been significantly high for several months to one year before hepatocellular carcinoma became clinically detectable. Extracts of hepatocellular carcinomas obtained by necropsy was examined for the presence of F antigen, and it was found that most of hepatocellular carcinomas contained the human-specific determinant of F antigen, but lacked the species non-specific determinant of the antigen. The use of human-specific anti-F antiserum may facilitate early detection of hepatocellular carcinoma in some patients.

Adult↗

Arterial chemoembolization of hepatocellular carcinoma with mitomycin C microcapsules.

Chemoembolization by selective intra-arterial infusion of mitomycin C in microcapsule form exerts potential therapeutic effects through infarction and prolonged activity. Of 20 patients with inoperable hepatocellular carcinoma (HCC) treated with one or more courses via a hepatic arterial catheter, a change in tumor size could be measured in 16. Measurable tumor regression amounting to greater than 50% was shown in 6 patients (38%), 25-50% in 3 (19%), and less than or equal to 25% in 6 (38%), while tumor increased in 1. Serum alpha-fetoprotein, which was greater than 300 ng/ml before treatment in 13 patients, clearly fell after treatment in 10 (77%). The survival rate at 3, 6, and 12 months after treatment was 75%, 65%, and 24%, respectively, for all patients, and 92%, 85%, and 38% in 11 patients without a tumor cast in the portal vein or its major branches. Systemic toxicity was mild, and all patients tolerated treatment well. These results indicate that chemoembolization with mitomycin C microcapsules is a useful palliative measure for treatment of inoperable HCC.

Adult↗

Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Observations in ten patients.

A total of 155 patients with hepatocellular carcinoma were studied by celiac and superior mesenteric angiography. Complete (9 patients) or near complete (1 patient) obstruction of the portal vein and formation of hepatopetal collateral veins in the porta hepatis, or the so-called cavernous transformation of the portal vein, were seen in 10 patients. In 4 patients, the first angiogram did not show cavernous transformation, but on the follow-up angiograms cavernous transformation was present. The suggested interval between obstruction of the portal vein and formation of cavernous transformation was no more than 5 wk. The mechanism of cavernous transformation and its clinical implications are briefly discussed.

Carcinoma, Hepatocellular↗

Effects of intra- and extrahepatic portal systemic shunts on insulin metabolism.

To study the effects of intra- and extrahepatic portal-systemic shunts on insulin degradation, 11 patients with liver cirrhosis and 7 noncirrhotic patients with liver disease were studied with percutaneous transhepatic catheterization. Insulin levels in portal and peripheral blood were measured simultaneously for 1-2 hr after intravenous administration of glucose. The degrees of intra- and extrahepatic portal-systemic shunting were measured with this technique using 131I-macroaggregated albumin and 99mTc-macroaggregated albumin. The amount of insulin secreted and insulin degraded were assessed from the areas under blood concentration curves for portal and peripheral blood. Insulin degradation was significantly reduced in cirrhotics compared to noncirrhotics with liver disease, although there was no difference in the amount of insulin secreted between these two groups. It was also correlated significantly with the degree of intrahepatic shunting but not with the degree of extrahepatic shunting. These results suggest that intrahepatic shunting plays an important role in the reduction of insulin degradation in cirrhosis.

Glucose Tolerance Test↗

The effect of chronic habitual alcohol intake on the development of liver cirrhosis and hepatocellular carcinoma: relation to hepatitis B surface antigen carriage.

To study the effects of habitual alcohol intake on the latency period for the development of liver cirrhosis and hepatocellular carcinoma (HCC), 158 patients with cirrhosis and 79 with HCC were analyzed with respect to age at the time of diagnosis. They were classified into four groups based on hepatitis B surface antigen (HBsAg) in serum, and the history of intake of more than one small bottle of Japanese "sake" or an equivalent per day for more than 10 years. The average age of HBsAg positive male cirrhotics with a drinking habit (n = 10) was 38.8 years, 10.5 years younger than that of those without a drinking habit (n = 8) (P less than 0.05). The average age of HBsAg negative cirrhotics with a drinking habit (n = 97) was 47.9 years, eight years younger than that of those not drinking (n = 36) (P less than 0.001). There was no significant difference in the laboratory data between these groups. The average age of the HBsAg positive HCC patients with a drinking habit (n = 20) was 48.9 years, nine years younger than that of those without a drinking habit (n = 12) (P less than 0.05). The average age of HBsAg negative male HCC cases with habitual intake of more than 126 ml of ethanol per day was 51.0 years (n = 8), ten years younger than that of nondrinking male HCC cases (n = 11) (P less than 0.05). These data suggest that habitual alcohol intake may promote the development of liver cirrhosis and HCC, especially in HBsAg carriers.

Adult↗

Hepatitis B virus antigens in liver tissue in hepatocellular carcinoma and advanced chronic liver disease-relationship to liver cell dysplasia.

Hepatitis B surface (HBs) and core (HBc) antigens (Ag) were studied in liver tissue in HBsAg seropositive patients with chronic liver disease complicated (n = 32) and not complicated (n = 36) by hepatocellular carcinoma. Both groups were matched by age, sex and underlying disease. There was no qualitative and quantitative difference in tissue HBsAg between the two groups. However, HBcAg was significantly less in quantity in hepatocytes of patients with hepatocellular carcinoma compared to chronic liver disease without cancer. Serum hepatitis B e antigen tested by radioimmunoassay was also less frequently positive in patients with hepatocellular carcinoma. These findings seem to suggest that hepatitis B virus replication becomes less active in the process of hepatocarcinogenesis. The relationship between intrahepatic hepatitis B antigens and liver cell dysplasia was also studied. In hepatocellular carcinoma, tissue hepatitis B antigens often coexisted in the same liver having liver cell dysplasia, but no such association was observed in chronic liver disease without cancer. However, no indication was obtained that the dysplastic cells harbor HBsAg more frequently than non-dysplastic cells.

Carcinoma, Hepatocellular↗

Clinico-pathological study of acute non-A, non-B post-transfusion hepatitis: histological features of liver biopsies in acute phase.

A follow-up study of acute non-A, non-B post-transfusion hepatitis with a mean follow-up period of 30 months was carried out in 24 patients in whom liver biopsy was done within 3 months of onset. Of the 24, 13 patients (54%) developed chronic biochemical liver disease with elevated serum aminotransferases for more than 6 months, and in 11 the elevated liver enzymes were normalized within 6 months. Although there were no statistically significant differences in the mean peak values of liver enzymes, length of incubation period and number of transfusions between the chronic and resolved groups, the former tended to have a slow rise and multiple peaks of serum liver enzymes. Analysis of the liver biopsies made in the acute phase revealed that limiting plate erosion, hepatocellular degeneration, and poor regenerative activities were indicative of subsequent transition to chronicity. Multiple biopsies were taken in five patients who were followed for an average of 29 months, and the subsequent histological diagnosis was chronic persistent hepatitis in two, chronic active hepatitis in two and cirrhosis in one.

Acute Disease↗

[Therapeutic effect of midecamycin on Mycoplasma pneumoniae pneumonia in adults (author's transl)].

The clinical efficacy of a macrolide antibiotic, midecamycin, was studied in 12 adult cases with Mycoplasma pneumoniae pneumonia. The therapeutic effects were excellent or good in 9 cases and fair in 2 cases. On defervescence and disappearance of shadows on chest X-ray the therapeutic effect was satisfactory, but on disappearance of cough therapeutic effect was not clear in some cases. Taking into consideration the antimicrobial activity of midecamycin against Mycoplasma pneumoniae, serum concentration and side effects of midecamycin, this antibiotic is expected to be effective in the treatment of Mycoplasma pneumoniae pneumonia.

Adolescent↗