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Biomedical subjects

T Beppu

Publications and source records attributed to T Beppu.

At least 37 records · Page 2Linked to original sources
PubMed2001

[A promising new treatment strategy for advanced hepatocellular carcinoma--"multi-ablation therapy" consisting of radio-frequency ablation (RFA), microwave coagulation therapy (MCT) and ethanol injection therapy (EIT)].

We introduce a new treatment strategy (multi-ablation therapy) for advanced hepatocellular carcinoma (HCC). The therapy consists of radio-frequency ablation (RFA), microwave coagulation therapy (MCT) and ethanol injection therapy (EIT). We assessed the efficacy of the therapy in 20 patients with advanced HCCs, including 10 patients with stage III and 10 patients with stage IV. The average tumor diameter was 3.6 cm (max: 6.6 cm) and the average tumor number was 3.6 (max: 11). RFA, MCT and EIT were performed in 20, 14 and 9 cases, respectively. A percutaneous, endoscopic and open approach was applied in 2, 11 and 7 cases, respectively. The average number of times treated on initial admission was 1.1. The response rate, calculated by the tumor necrosis effect, was 100%. The cumulative two-year recurrent rate in the treated sites was 33% and the 2-year cumulative survival rate was 90%. Complications were encountered in two patients (liver failure and pyothorax). Multi-ablation therapy provides an excellent prognosis for advanced HCC patients whose condition could not be controlled with conventional therapeutic modalities.

Carcinoma, Hepatocellular↗
PubMed2001

[Lymph node excision with laparotomy and chemo-radiation therapy for a hepatocellular carcinoma patient with multiple lymph node metastases].

We reported a case of hepatocellular carcinoma (HCC) with multiple lymph node metastases. The patient was a 67-year-old male with C type liver cirrhosis. He underwent microwave coagulation therapy (MCT) for HCC (5 cm and 1.5 cm) 1.5 years before admission. Abdominal CT scan revealed a well-enhanced tumor (2 cm) in caudate lobe of the liver and excessive lymph node metastases, locating in the inferior phrenic, periportal and para-aortic area. The preoperative serum AFP and AFP-L3 levels were 41.9 ng/ml and 93.1%, respectively. At laparotomy, systematic dissection of the enlarged lymph nodes and MCT of the hepatic tumor was performed. After operation, residual inferior phrenic lymph node was treated with irradiation therapy (total 50.4 Gy). The lymph node showed complete response (CR) for about a year and the AFP-L3 level returned to the normal range. After 9 months, a supra-clavicular lymph node was detected on abdominal CT scan. Irradiation therapy (total 45 Gy) in combination with CDDP (100 mg) and 5-FU (4,000 mg) was applied. The lymph node had been assessed as partial response for 6 months. The patient lived quite well after these therapies, but died of hepatic failure 32 months after the initial operation. In conclusion, we recommend this therapeutic strategy using operative excision and chemo-radiation therapy for HCC with multiple lymph node metastases.

Aged↗
PubMed2001

[A case report of advanced hepatocellular carcinoma successfully treated with surgical multi-ablation therapy based on radio-frequency thermal ablation].

We report a patient with advanced hepatocellular carcinoma (HCC) who was successfully treated with multi-ablation therapy by the surgical method of laparotomy and partial thoracotomy. A 67-year-old man, who had undergone transcatheter arterial embolization (TAE) three times for advanced HCC with hepatitis C, presented at our hospital in May 2001. Although TAE had been performed 3 times starting 2 years earlier, interventional therapy for recurrent tumors is difficult because of stenosis and obstruction of regional hepatic arteries. Computed tomography of the liver revealed five tumors in both lobes and the tumor in segment VIII presented difficulty for percutaneous ablation treatment due to its closeness to the trunk of the hepatic vein. Multi-ablation therapy consisting of radio-frequency ablation, microwave ablation and ethanol injection was selected for this patient. By laparotomy and partial thoracotomy, we performed multi-ablation therapy safely and accurately for each tumor. After this treatment, 5 tumors in both lobes showed no viability on dynamic CT and the patency of the right hepatic vein was preserved. Six months after the treatment, one remnant mass appeared in segment V. An additional two sessions of percutaneous RFA were performed for this tumor. At the end of these treatments, enhanced CT revealed no viability of the tumors, and serum alpha-fetoprotein and PIVKA-II level dropped to the normal range. This case suggests that multiple ablation therapy with a surgical method is feasible and useful in cases of advanced hepatocellular carcinoma.

Aged↗
PubMed2001

[Complete response (CR) in a case of advanced hepatocellular carcinoma by percutaneous multi-ablation therapy].

A 56-year-old male patient was diagnosed with hepatocellular carcinoma by abdominal ultrasonography. The tumor was located in segment 7-1 and was 7 cm in diameter. Two transcatheter arterial chemoembolizations (TACE) were not effective. The patient had experienced more than ten fractures because of fibrous dysplasia of the bone. Laparotomy was very risky, so we decided to perform multi-ablation therapy. This therapy consists of percutaneous radiofrequency ablation (RFA) and percutaneous ethanol injection therapy (PEIT). PEIT was applied to the lesion where extrahepatic the Glisson's capsule was near the tumor. After two sessions with these therapies, the tumor with the surrounding liver parenchyma turned necrotic. A complete response was obtained and the patient has been disease-free for 6 months. We conclude that our multi-ablation therapy is effective for patients with advanced hepatocellular carcinoma who have therapeutic limitations because of some preoperative complications.

Carcinoma, Hepatocellular↗
PubMed2000

Development of applied microbiology to modern biotechnology in Japan.

Development of modern biotechnology in Japan is characterized by unique contributions from applied microbiology and bioindustry. This review tries to summarize these original contributions with special emphasis on industrial production of useful substances by microorganisms. In the first part, development of applied microbiology and bioindustry in the last half of the twentieth century is summarized with a brief overview of the traditional background. In the second part, recent progress is reviewed with citation of typical achievements in biotechnology, applied enzymology, secondary metabolites, genetic engineering, and screening of microbial diversity, respectively.

Amino Acids↗
PubMed2000

Early diagnosis of postoperative infection: assessment of whole blood chemiluminescence.

Whole blood chemiluminescence (CL), which allows for the evaluation of both the oxygen radical release by phagocytes and the serum opsonin activity using very small amounts of blood, is considered to be a useful means of assessing the host defense against infection. We measured the whole blood chemiluminescence in 59 patients before and after open surgery (surgery by a laparotomy) for gastrointestinal disease. Early postoperative infection was detected in 12 (20.3%) of the 59 patients. These 12 patients all had significantly higher white blood cell counts compared with the noninfected patients on the third and subsequent days after surgery (P < 0.01). The peak CL in the early postoperative infected group was also significantly higher than that in the noninfected group on the day of surgery (P < 0.0001), 1 day after surgery (P < 0.0001), and 3 days after surgery (P < 0.01). Whole blood CL may therefore be a useful modality for the early detection of postoperative infection in the future.

Adult↗
PubMed2000

Significant changes in the serum levels of IL-6, h-HGF, and type IV collagen 7S during the perioperative period of a hepatectomy: relevance to SIRS.

We analyzed the changes in the serum levels of both interleukin-6 (IL-6), human hepatocyte growth factor (h-HGF), and type IV collagen 7S (7S) during the perioperative period of a hepatectomy and evaluated their relationship with systemic inflammatory response syndrome (SIRS). The study subjects consisted of 40 patients who underwent a hepatectomy. In 14 out of 40 patients, postoperative SIRS(+) was observed. Between the SIRS(+) and SIRS(-) cases, there were significant differences in the preoperative values of prothrombin time, hepaplastin test, cholinesterase, and indocyanine green retention at 15 min (P < 0.01). Compared with the SIRS(-) cases, the IL-6, h-HGF, and 7S of the SIRS(+) cases fluctuated in a higher range and remained significantly higher after postoperative day 1 (P < 0.05). Eight out of 14 SIRS(+) patients had postoperative complications. In the 8 SIRS(+) patients with postoperative complications and in the 4 patients in which the SIRS(+) state lasted 3 days or longer, the 7S levels were significantly higher during the perioperative period (P < 0.05). In the SIRS(+) cases, the postoperative levels of IL-6 and h-HGF, as well as pre- and postoperative levels of 7S, were elevated. We therefore consider these levels to be risk factors for complications during the perioperative period of a hepatectomy.

Collagen↗
PubMed2000

A case of subcortical meningioma.

Subcortical meningioma, which has been reported as meningioma without dural attachment, a cerebral subcortical lesion, is extremely rare. Very few findings of radiological examination of subcortical meningioma have been described. Pre-operative differentiation of this lesion is generally difficult. We characterize the peritum oural oedema adjacent to the meningioma in this region, and we suggest that radiological findings of peritum oural oedema contribute to differential diagnosis of subcortical meningiomas.

Brain Neoplasms↗
PubMed2000

Serum alpha-glutathione S-transferase: a new marker of hepatocellular damage associated with hepatectomy.

Serum concentrations of alpha-glutathione S-transferase (alphaGST) were determined before and after hepatectomy to examine the clinical usefulness of alphaGST as a marker of hepatocellular damage compared with the conventional liver function tests. Prior to hepatectomy, serum alphaGST concentrations correlated significantly with serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT). In patients who had a good postoperative course, serum alphaGST concentrations rose significantly to a peak immediately after surgery, followed by a rapid fall to the normal range within 1 week, yielding a monophasic pattern. Serum alphaGST concentrations reached a peak earlier than other parameters of liver function, and peak serum alphaGST concentrations correlated with peak serum concentrations of AST and ALT. The mean decrease rate of serum alphaGST concentration from peak values was significantly more rapid than that of serum AST and ALT, indicating an early return of alphaGST concentrations to the normal range. These findings suggest that serum alphaGST may be a more sensitive marker of hepatocellular damage than transaminases and may therefore be useful for rapid monitoring of the extent and persistence of liver injury after hepatectomy.

Journal Article↗
PubMed2000

A phase II study of nimustine hydrochloride, cisplatin, and etoposide combination chemotherapy for supratentorial malignant gliomas.

Twenty-eight patients who were previously treated by aggressive surgery and radiation and were diagnosed with supratentorial malignant gliomas received a combination of nimustine hydrochloride; 1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU), cisplatin and etoposide (ACE therapy) as primary treatment. Cisplatin and etoposide were given at doses of 20 and 60 mg/m2/day for 5 days, respectively, ACNU doses 80 mg/m2/day on the first day. Treatment was repeated at 4-week intervals for up to 3 cycles. Seventeen patients (60.7%) complained of nausea. Grade 3 or 4 hematological toxicity occurred in 11 patients (39.3%), and grade 3 or 4 renal toxicity occurred in 2 patients. The percentage of patients who showed complete or partial response was 28.6% (8/28). The median time of tumor progression was 40 weeks, and the median survival time was 146 weeks. There were some long-surviving patients who may have benefited from ACE combination. This study demonstrated the effects of ACE combination in patients with supratentorial malignant gliomas.

Adult↗
PubMed2000

Carbon-source-dependent transcriptional control involved in the initiation of cellular differentiation in Streptomyces griseus.

Carbon source is one of the environmental factors that affects cellular differentiation of Streptomyces. We have identified the craA gene as a putative negative regulator involved in the carbon-source-dependent initiation of cellular differentiation in Streptomyces griseus. Carbon-source-dependent transcriptional repression of craA, which is caused by binding of a putative repressor protein to its promoter region, is proposed to result in the initiation of aerial mycelium formation. The presence of a craA homologue in the chromosome of Streptomyces coelicolor A3(2) implicates the existence of a similar regulatory mechanism in this organism. The repression of craA-promoter activity in glucose media could be alleviated not only by replacing glucose with maltose but also by supplying copper, which suggests that the stimulatory effect of copper on cellular differentiation in Streptomyces is excerted via abolishment of glucose-repression of craA.

Amino Acid Sequence↗
PubMed2000

Desmoplastic cerebral astrocytoma of infancy intermingling with atypical glial cells.

Despite the rarity of desmoplastic cerebral astrocytoma of infancy (DCAI), it has distinct clinical and pathological features. The present case is a typical DCAI except for its detection and operational age and intermingling with pleomorphic glial cells. In this case, although a cystic lesion of the right temporal lobe was noticed when the patient was 6 months old, it was not regarded as a tumor and wasn't removed until he was 9 years old. It is quite unusual that a DCAI was able to exist in the cerebrum for 9 years. However, no metastasis occurred and distinct macroscopic and microscopic features of the tumor were not different from typical DCAI except for an intermingling with pleomorphic glial cells. Furthermore, even in the pleomorphic areas, the absence of necrosis and an MIB-1 index of 2.9% indicated non-aggressive growth. These features of the present case may provide additional information as to the character of DCAI, which generally has a favorable prognosis.

Antigens, Nuclear↗
PubMed2000

Relationship between plasma cytokine concentration and multiple organ failure in patients with acute pancreatitis.

The dynamic aspects of circulating cytokines and cytokine modulators and their relationship with development of multiple organ failure (MOF) in patients with acute pancreatitis were analyzed. All cytokine and C-reactive protein levels in the circulation were higher than those in the MOF group. In particular, plasma concentrations of soluble tumor necrosis factor receptors (sTNF-RI and sTNF-RII) were significantly higher in patients with MOF than in those without even at admission. Furthermore, plasma concentrations of sTNF-Rs and interleukin-1 (IL-1) receptor antagonist (IL-1ra) were much higher than those of their counterparts, TNFalpha and IL-beta, respectively. These results suggest that the plasma concentrations of sTNF-Rs are useful predictors for the development of MOF, and actions of TNF-alpha and IL-1beta could be regulated by their modulators (soluble receptor and receptor antagonist, respectively) in the pathologic condition of severe acute pancreatitis.

Acute Disease↗
PubMed2000

Symbiobacterium thermophilum gen. nov., sp. nov., a symbiotic thermophile that depends on co-culture with a Bacillus strain for growth.

A Gram-negative and tryptophanase-positive thermophile, whose growth is dependent on co-culture with an associating Bacillus strain, had been reported and tentatively named Symbiobacterium thermophilum strain T(T). Axenic culture of strain T(T) was recently established by dialysing cultures with the supporting bacterial strains or adding their culture broth. Phylogenetic analysis of strain T(T), based on the 16S rDNA sequence, was conducted for the validation of S. thermophilum. The sequence of strain T(T) was located at the outermost position in the high-G+C Gram-positive group distinctly isolated from any other branches hitherto known. Ten sequences identical to that of strain T(T), and one sequence closely related to it, were identified for the first time from soil and compost samples. The outer membrane of strain T(T) had a three-layered structure, outside the cytoplasmic membrane, which is similar to the S-layer in the cells of members of the Bacillaceae. Chemical analysis of the cells revealed that menaquinone-6 is a major component of the quinone system. According to these results, along with several previous observations (i.e. a G+C DNA content of 65 mol% and the identification of iso-C15:0 and iso-C17:0 acids as major cellular fatty acids), the new taxon Symbiobacterium thermophilum gen. nov., sp. nov. is proposed. The type strain is S. thermophilum strain T(T) (= IAM 14863T).

Bacillus↗
PubMed2000

[Treatment strategy for cervical node metastasis from squamous cell carcinoma of the oropharynx].

The purpose of this study is to ascertain the role of neck surgery and radiation therapy for cervical lymph node metastasis in oropharyngeal cancer patients. We reviewed 217 previously untreated patients with squamous cell carcinoma of the oropharynx who were treated at the Cancer Institute Hospital in Tokyo between 1971 and 1995. The N stage distribution was; N0: 83(38.2%), N1: 42(19.4%), N2a: 23(10.6%), N2b: 27(12.4%), N2c: 33(15.2%), and N3: 9(4.2%). A predominance of cervical node metastases in level II and III was revealed and there were no skip metastases outside of level II and III. The control rate of cervical metastasis for each N stage was; N0: 96.9%, N1: 90.0%, N2a: 76.5%, N2b: 62.5%, N2c: 50.0%, and N3: 0%. Definitive irradiation provided sufficient treatment for small nodes, when the primary tumor growth was well controlled by radiation therapy. Neck dissection was necessary for more advanced neck metastases. Selective limited neck dissection (level II and III) is recommended for N0 and N1 patients, and modified or classical RND is considered to be better for most cases with N2 and N3.

Adult↗
PubMed2000

[Ultrasonographic evaluation of metastatic cervical lymph nodes in head and neck cancers].

This study evaluates the use of ultrasonography (USG) to diagnose metastatic cervical lymph nodes. Three-hundred and one lymph nodes were removed from 58 patients with squamous cell carcinomas of the head and neck. None of the patients had received any preoperative treatments for cancer. The lymph nodes were then histopathologically examined: 139 metastatic lymph nodes and 162 non-metastatic nodes were found. USG was then used to evaluate the size, internal echo, and margin of each lymph node. Size was found to be the best criteria for distinguishing metastatic lymph nodes from non-metastatic lymph nodes in all cervical regions (78% accuracy). Superior internal jugular lymph nodes and submandibular lymph nodes larger than 7 mm and mid and inferior internal jugular lymph nodes larger than 6 mm were regarded as metastatic. Internal echoes were classified into five patterns: homogeneous hypoechoic, homogeneous hyperechoic, heterogeneous, eccentric hyperechoic, and centric hyperechoic. Homogeneous hyperechoic and heterogeneous patterns were characteristic of metastatic nodes, while eccentric hyperechoic patterns were characteristic of non-metastatic nodes. Homogeneous hypoechoic patterns were observed in both metastatic and non-metastatic nodes. Regular margins were found in 81% of the metastatic nodes. Of the 22 lymph nodes with irregular margins, however, 91% were metastatic. Evaluations using a combination of USG and clinical feature criteria were compared with evaluations using only thickness as a criterium. Although thickness is the single most important factor in diagnosing metastatic nodes, the combination of USG and clinical feature criteria improved the accuracy of diagnosis to 83%. Thus, diagnostic methods involving a combination of several criteria are more accurate than methods involving only a single criterium.

Carcinoma, Squamous Cell↗