Biomedical subjects

Shigetoshi Fujiyama

Publications and source records attributed to Shigetoshi Fujiyama.

23 records · Page 2Linked to original sources

PubMed2002

Interferon therapy prolonged life expectancy among chronic hepatitis C patients.

BACKGROUND & AIMS: The effects of interferon therapy in chronic hepatitis C patients on survival are unclear. Our objective was to analyze survival among a large cohort of chronic hepatitis C patients. METHODS: We used a retrospective cohort study design in the setting of 7 university hospitals and 1 regional core hospital in Japan. Our study included 2889 patients with histological-proven chronic hepatitis C: 2430 patients received interferon therapy, and 459 patients were untreated. For intervention, the median dose and duration of interferon administration was 480 million units and 137 days, respectively. For measurements, survival status was confirmed by medical records or direct questionnaires. The effect of interferon therapy on survival was assessed by standardized mortality ratio (SMR) based on published mortality among the Japanese general population and by risk ratio calculated by proportional hazards regression. RESULTS: Thirty of 459 untreated patients, 7 of 817 virologic sustained responders, and 49 of 1613 nonresponders died in 5.4-years follow-up. Fifty-eight (67%) of 86 patient deaths were due to liver diseases (39 to hepatocellular carcinoma). Compared with the general population, overall mortality was high among untreated patients (SMR: 1.9; CI: 1.3-2.8) but not among interferon-treated patients (SMR: 0.9; CI: 0.7-1.1). The risk of death was reduced, compared with untreated patients, among interferon-treated patients (risk ratio for overall death: 0.367; CI: 0.236-0.596; for liver-related death: 0.284; CI: 0.164-0.494) and among sustained responders (risk ratios: 0.148; CI: 0.064-0.343 and 0.050; CI: 0.012-0.216). The risk of liver-unrelated deaths remained unchanged. CONCLUSIONS: Interferon therapy improved survival of chronic hepatitis C patients by preventing liver-related deaths.

Adult↗

PubMed2002

Tumor markers in early diagnosis, follow-up and management of patients with hepatocellular carcinoma.

The mainstay for the diagnosis for hepatocellular carcinoma (HCC) includes serological tumor markers, such as alpha-fetoprotein, the L3 fraction thereof and PIVKA-II, in addition to imaging modalities. They do not correlate, but complement each other. Hence, a combination of them designed on the basis of their characteristics needs to be worked out. First, it is necessary to identify the patients at high risk for developing HCC, such as those with chronic hepatitis or liver cirrhosis, and in the follow-up conduct regular check-ups for serological tumor markers. Those testing positive for any marker are at the highest risk for developing HCC, even when imaging fails to disclose any space-occupying lesions. Following high-risk patients for serological tumor markers, in concert with imaging, makes accurate evaluation of the efficacy of therapies for HCC possible. Since serological tumor markers can signal the development of HCC earlier than any other laboratory tests, they offer excellent means of identifying relapsing HCC. Equally important in the management of patients with HCC are biological indicators for malignancy, the selection of therapeutic interventions and the prediction of the outcome.

Animals↗

PubMed2002

[Twenty-four weeks administration of interferon-alpha for chronic hepatitis B].

Twenty-four weeks administration of interferon-alpha has been performed to 23 patients of chronic hepatitis B. As the result, complete or partial responders reached to 47.8%, so that it was considered to be effective therapy for chronic hepatitis B. By the investigation of behaviors of HBV-DNA, the reduction of HBV-DNA below 4 x 10(2) copy/ml during the administration of interferon was considered to be one essential factor for inducing the effectiveness of interferon. Though lamivudine, which has a strong anti-viral effect, has been permitted, interferon is still considered as the good indication for relative young patients who do not have advanced hepatic fibrosis. As a newly strategy for the patients with high titer of HBV-DNA or breakthrough hepatitis, the combination therapy of interferon and lamivudine will be expected.

Adult↗

PubMedDate not supplied

Long-term follow-up of hepatic arterial chemoembolization with cisplatin suspended in iodized oil for hepatocellular carcinoma.

BACKGROUND/AIMS: We developed a method to suspend cisplatin in lipiodol (lipiodol-cisplatin suspension) for treating hapatocellular carcinoma. We evaluated the results of the long-term follow-up of lipiodol-cisplatin suspension therapy and the augmentation of its anti-cancer effect when in combination with transcatheter arterial embolization. METHODOLOGY: Hepatic arterial injection chemotherapy with lipiodol-cisplatin suspension was performed in 239 patients with hepatocellular carcinoma without distant metastases. One hundred and forty-three patients treated with lipiodol-cisplatin suspension alone were clinically compared to 96 patients treated with lipiodol-cisplatin suspension and transcatheter arterial embolization. RESULTS: Complete and partial responses were obtained in 83 cases (53.2%) in the lipiodol-cisplatin suspension alone group compared to 60 cases (62.5%) in the lipiodol-cisplatin suspension and transcatheter arterial embolization group. The survival rate of the former was 29.6% at 5 years, and of the latter was 24.2% at 5 years. The difference in survival rates between the two groups was not significant, however, in both groups excellent anti-cancer effects and prolongation of survival were seen compared to previous transcatheter arterial embolization methods. CONCLUSIONS: Lipiodol-cisplatin suspension therapy has an excellent anti-cancer effect superior to previous transcatheter arterial embolization methods and prolongs the survival rate for the patients with hapatocellular carcinoma.

Adult↗

PubMedDate not supplied

Effective interferon therapy for chronic hepatitis C patients with low viral loads.

BACKGROUND/AIMS: Possible short-term interferon therapy was investigated in chronic hepatitis C patients with genotype 2a or 2b and low viral-loads. Furthermore, initial changes of hepatic C virus RNA levels in early phase interferon therapy, and the number of pretreatment mutated clones at hypervariable region-1 were determined in order to upgrade interferon therapy efficacy prediction rates. METHODOLOGY: Study subjects were 31 patients with histologically proven chronic hepatitis C, having less than 1 Meq/mL of hepatic C virus RNA levels. Daily dose was defined as 9 MU of interferon; patients with genotype lb were treated for 26 weeks, while those with genotype 2a or 2b were treated for 16 weeks. RESULTS: Sustained response rates showed no difference in efficacy between the 2 groups (66.7% vs. 62.5%). Response rates based on the number of hypervariable region-1 clones indicated that the fewer the number of mutated clones, more significant was the increase in efficacy. Efficacy as hepatic C virus RNA in early phase treatment showed no difference in response rates between negative and positive groups at any time point from day 1. CONCLUSIONS: In a low viral-load group, the number of hypervariable region-1 clones was a critical factor influencing interferon therapy efficacy. Thus, 16-week interferon therapy was effective and economical.

Adult↗