Search PubMedSearch

Biomedical subjects

Y Karino

Publications and source records attributed to Y Karino.

At least 19 recordsLinked to original sources

Evaluation of magnetic resonance angiography in detection of gastric varices.

We evaluated the detection of gastric varices, inflowing blood vessels to gastric varices, and outflowing blood vessels from gastric varices via magnetic resonance (MR) angiography in 31 patients with gastric varices. Twenty-four patients had F2 type varices and 7 had F3 type, classified according to the Japanese Research Society for Portal Hypertension. Seventeen patients had cardiofornical varices, and 14 had fundal varices. All patients were examined with an MR system operating at 1.5T. MR angiography was performed using the two-dimensional time-of-flight method. With MR angiography, the imaging of gastric varices was clearly delineated in 28 of the 31 patients (90.3%). From the images of MR angiography, flow direction itself cannot be determined. The outflowing blood vessels of gastric varices were reported to be the gastro-renal shunt and the subphrenic vein, and angiographic findings have shown the inflowing blood vessels to be the left gastric vein (LGV), the short gastric vein (SGV), and the posterior gastric vein (PGV). In 25 of the 31 patients (80.7%), the outflowing blood vessels from gastric varices were detected (gastro-renal shunt in 24; subphrenic vein in 1). MR angiography provided clear images of the inflowing blood vessels to gastric varices in 18 of the 31 patients (58.1%). These inflowing vessels were categorized as SGV in 7 patients, LGV in 5, LGV and SGV in 4, and LGV and PGV in 2. We suggest that MR angiography be used as a routine method for detecting and diagnosing collateral veins in patients with gastric varices.

Adult

Early loss of serum hepatitis C virus RNA can predict a sustained response to interferon therapy in patients with chronic hepatitis C.

OBJECTIVES: We evaluated whether the loss of serum hepatitis C virus (HCV) RNA early in interferon (IFN) therapy would indicate a subsequent response to IFN therapy. METHODS: One hundred fourteen patients with chronic hepatitis C were treated with IFN-alpha for 24 weeks. All patients were positive for anti-HCV antibodies and serum HCV RNA. Serum HCV RNA was measured by highly sensitive and specific RT-PCR (modified Amplicor HCV). RESULTS: Of 114 patients who were treated with IFN-alpha for 24 weeks, 22 of 29 patients (75.9%) who lost HCV RNA at the first week of treatment, 5 of 14 patients (35.7%) who lost HCV RNA at the second week, and 2 of 16 patients (12.5%) who lost HCV RNA at fourth week were judged as sustained responder (SR). The SR rate was significantly higher in patients who lost HCV RNA at the first week of therapy (p < 0.05). On the contrary, none of 55 patients who retained HCV RNA during the first 4 weeks of IFN therapy were judged as SR. Concerning the patients who lost HCV RNA at the first week of therapy, there were no significant differences in the SR rate in either HCV genotype (1b, 2a, and 2b). CONCLUSIONS: Our study confirms that the early response to IFN (loss of HCV RNA at the end of the first week of IFN therapy) can be a predictor of the subsequent sustained response to IFN therapy. Additionally, positivity of HCV RNA at the fourth week of IFN therapy can be a predictor of the subsequent nonsustained response to IFN therapy.

Adolescent

Nucleotide sequences of the hepatitis C virus core region in patients without anti-core antibody.

Second-generation assays for detection of hepatitis C virus (HCV) infection that include reactivity of antibodies to core, NS3, NS4 are used because of their high sensitivity. Among these antibodies, anti-core antibody seems to be the most sensitive. However, there are some patients without anti-core antibodies, although HCV RNA is detectable by reverse transcription-polymerase chain reaction and branched DNA assay. The mechanism for the absence of anti-core antibody on its own is unclear. We therefore determined the nucleotide and deduced amino acid sequences of the core region obtained from two anti-core antibody-negative patients with HCV RNA (genotype 1b) and compared them with those of four anti-core antibody-positive patients and a previously reported sequence. Amino acids spanning 1-47, which seemed to exist in major B cell epitopes, were found to be completely conserved among these patients. Furthermore, the predictive binding motif to HLA DR4 (a.a 81-90) was completely conserved in both of the anti-core antibody-negative patients. There were various mutations in the residual amino acids spanning 49-108, but specific mutations could not be found in anti-core antibody-negative patients. These data indicate that the absence of anti-core antibody in two patients is not due to the presence of some formerly unknown viral variants, but due to a possible defect in the host's immune system.

Amino Acid Sequence

[Classification of hepatitis C virus into two major groups in serologic activity: correlation with response to interferon].

Genotypes of HCV have been reported to be one of the predictors of response to IFN therapy in patients with chronic hepatitis C. HCV genotypes were determined enzyme-linked immunoblot assay based on group I and II specific recombinant peptides of the NS-4 region (amino acid No. 1676-1670). We examined the correlation between HCV groups and response to IFN in patients with chronic hepatitis C. Among the 84 patients with chronic hepatitis C who underwent IFN treatment, 16 of 51 (31.4%) patients with group I and 12 of 23 (52.2%) patients with group II showed complete sustained response. These results suggest that HCV group assay may improve the ability to predict IFN treatment outcomes.

Chronic Disease

[Interstitial pneumonia induced by interferon therapy in type C hepatitis].

Interstitial pneumonia is known as one of the serious side effect of drugs. Recently, many investigators have reported that interstitial pneumonia (IP) which occurred during interferon (IFN) therapy for type C chronic hepatitis, and its appearance rate is considered to be more than 0.2% of patients who receive IFN. Though the mechanisms of IP during IFN therapy remains to be elucidated, one of the possible explanations is that excessive focal immune response in the lung derived from IFN might leads to the inflammation. For safe treatment, we must recognize that IFN induces IP during IFN therapy and give attention to its occurrence.

Adult

Significance of 2',5'-oligoadenylate synthetase activity and HCV genotype in IFN therapy for type C chronic hepatitis.

Although the mechanisms of elimination of HCV by IFN have not been fully elucidated, the 2-5A system was reported to be one of the mechanisms of the anti-viral effect of IFN. Therefore, the relationship between HCV genotype, induction of 2-5AS and clinical effect was investigated. As for the anti-viral effect during IFN therapy, in type III or IV, most patients lost HCV-RNA regardless of serum 2-5AS induction even in high HCV-RNA concentration cases. In contrast, in type II, the negativity rate of HCV-RNA became high along with an increase of serum 2-5AS activity, but in patients with high HCV-RNA concentration, HCV-RNA was persistently positive. As for the long term clinical effect of IFN therapy judged 6 months after completion of IFN therapy, HCV genotypes were closely related to the effect; that is, the patients with type III or type IV HCV genotype showed a higher complete response rate compared with the patients with type II HCV genotype. However, the relationship between the long term clinical effects and induction of serum 2-5AS during IFN therapy was obscure. These results suggest that induction of 2-5AS is closely related to the anti-viral effect during IFN administration, but the viral factors appeared to be related to long term clinical effects after cessation of IFN therapy.

2',5'-Oligoadenylate Synthetase

[Evaluation of the blood flow in tumors before and after irradiation with color Doppler flow imaging].

The blood flow in tumors of three patients with lung cancer, cancer in oral cavity and metastatic lymphnode was respectively evaluated before and after irradiation with color Doppler flow imaging. The arterial pulsating flow in lung cancer disappeared after 30 Gy irradiation and that in cancer of oral cavity disappeared after 15 Gy irradiation with intraarterial infusion chemotherapy. But the arterial pulsating flow in metastatic lymphnode was detected during irradiation and disappeared after 40 days post- irradiation. Therefore color Doppler flow imaging seemed to be useful for evaluation of the blood flow in tumors before and after irradiation.

Aged

[Mechanisms of the effect of interferon (IFN) therapy in patients with type B and C chronic hepatitis].

The relationship between 2', 5'-oligoadenylate synthetase (2-5AS) and HLA class I antigen in the hepatocyte of patients with type B or type C chronic hepatitis with and without interferon (IFN) therapy was investigated. The expression of HLA class I antigen of hepatocytes of biopsied specimen and PBL HLA class I antigen expression showed relevancy. Then, the HLA antigen expression of peripheral blood lymphocyte (PBL) and the 2-5AS activity of peripheral blood mononuclear cell (PBMC) were analyzed. In patients with type B or type C hepatitis, the mean activity of PBMC 2-5AS was significantly higher than that of healthy controls. Also the HLA class I antigen expression of PBL was significantly intense in patients with type B or type C hepatitis compared with healthy controls. In the acute exacerbated phase of type B chronic hepatitis, the HLA class I antigen expression of PBL and 2-5AS activity of PBMC increased along with elevation of serum GPT and then decreased with the remission of serum GPT. These results suggest that endogenously produced IFN leads the lysis of hepatocyte infected with hepatitis B virus (HBV) by cytotoxic T cells, and the restriction of HBV replication by activation of the 2-5A system simultaneously, and then leads the elimination of HBV. The activity of PBMC 2-5AS and the expression of PBL HLA class I antigen increased significantly during IFN therapy. In type B chronic hepatitis, the effective cases showed relatively high activity of serum 2-5AS compared with the non-effective cases. On the other hand, there were no significant differences in PBL HLA class I antigen expression between effective cases and non-effective cases. In type C chronic hepatitis, most patients with type III and type IV HCV genotype showed disappearance of HCV-RNA regardless of serum 2-5AS activity. In patients with type II HCV genotype, the serum 2-5AS activity was related to the anti-viral effect of IFN therapy.

2',5'-Oligoadenylate Synthetase

[Hepatitis C].

Hepatitis C virus (HCV) is a major cause of post transfusion non-A, non-B hepatitis. The virus contains a positive-strand RNA genome comprised of approximately 9,400 nucleotides. HCV E2/NS1 is probably an envelope glycoprotein (E2). The E2 hypervariable domain appears to contain isolate-specific antibody-binding linear epitopes. Recently, comparative sequence analysis of all the complete and partial HCV sequences published to date indicates that known genotypes of HCV can be classified into six basic groups. We report here that the prevalence of HCV-I, HCV-II, and a mixed form are 77.2%, 11.4%, and 11.4%, respectively. Patients with anti-HCV and HCV-RNA positive chronic active hepatitis received 6MU of interferon-alpha or beta everyday for two weeks followed by 6MU thrice a week for 14 weeks. Complete response to interferon treatment was defined as an ALT level normalized within six months after the end of treatment and maintained within the normal limit for an additional six months. Complete response was found in 42.9% of patients treated for 16 weeks. In a six month follow-up of the complete responders, clearance of viremia was observed in 90.3% at the end of interferon treatment and in 71.0% six months after the end of interferon treatment.

Chronic Disease

Treatment of chronic non-A, non-B hepatitis with interferon.

The efficacy of interferon therapy (IFN) was investigated in 46 patients with chronic non-A, non-B (NANB) hepatitis, of would 40 (87.0%) were positive for anti-HCV antibody (Ab) (C-100-3). Three kinds of IFN were used; human lymphoblastoid interferon (HLBI), interferon alpha-2b and interferon beta. Total doses of IFN ranged from 1 million units (MU) to 10 MU and treatment duration ranged from 2 weeks to 144 weeks. Of 46 patients 34 (73.9%) responded to IFN. Nine patients have maintained normal ALT levels and 5 patients have maintained near-normal ALT levels for more than 6 months after cessation of IFN treatment. In these cases the titers of anti-HCV Ab had decreased significantly at the end of IFN therapy and 6 months after IFN therapy respectively. The mean age was young and the mean disease duration was short in effective cases. As for doses and treatment duration of IFN, low doses of IFN requires long treatment duration to acquire continuous efficacy and high doses of IFN requires rather short treatment durations. Therefore, early IFN treatment, higher doses and longer periods of IFN treatment may improve the response rate of patients with chronic NANB hepatitis.

Adult

[CT findings of malignant lymphoma of the anterior mediastinum--differentiation from invasive thymoma].

CT findings were compared retrospectively between 9 cases with malignant lymphoma of the anterior mediastinum and 8 cases with invasive thymoma. CT findings of malignant lymphoma were as follows: 1) The majority of the tumors were bilateral and extended beyond the anterior mediastinum to the other mediastinum compartments. 2) Their margin was either smooth or lobulated. 3) Their density was either homogeneous or heterogeneous. In the case with heterogeneous density, ring, triangle and/or band-like low density areas, just like interspace of fused lymph nodes, were demonstrated. Calcification or cysts could not be shown. 4) Patent inherent vessels without deviation were occasionally demonstrated running through the tumors. 5) The tumors faced and contacted widely to anterior chest wall and often pressed the lung laterally at the anterior parietomediastinal pleural reflection. 6) Pleural implants were not demonstrated.

Adolescent

Serum 2'-5'oligoadenylate synthetase as a monitoring marker of anti-viral effect during interferon therapy for chronic type B hepatitis.

We evaluated the usefulness of serum 2'-5'oligoadenylate synthetase (2-5AS) activity assay in monitoring the anti-viral activity of chronic type B hepatitis patients during IFN therapy. The serum 2-5AS activity was rapidly increased during the above therapy and was maintained at a medium-to-high level throughout the therapy period, although the capacity for increase reflected differences among individuals. The kinetics of serum 2-5AS activity during the therapy was almost consistent with that of the PBMCs 2-5AS activity. 2-5AS activity had an inverse correlation with DNA-P; i.e. DNA-P often disappeared from serum after interferon treatment in patients with a marked response in serum 2-5AS activity. The enhancement of serum 2-5AS activity during IFN therapy seemed to correlate with an increase in anti-viral activity. The results suggest that the serum 2-5AS activity assay is a useful probe for monitoring the anti-viral activity of chronic type B hepatitis patients during interferon therapy.

2',5'-Oligoadenylate Synthetase

[Allogeneic bone marrow transplantation after the treatment of alpha-IFN and high-dose SNMC in two cases of acute myeloblastic leukemia with post-transfusional non-A, non-B hepatitis].

Two patients of acute myeloblastic leukemia (M2) with post-transfusional hepatitis (non-A, non-B) were treated with alpha-IFN and high-dose SNMC before allogeneic bone marrow transplantation. Bone marrow transplantation from HLA identical and MLR negative sibling donor was carried out when their hepatic functions were almost normalized. In the early phase after bone marrow transplantation, the hepatic function in both two cases has been stable, thus indicating that this treatment should be tried for reducing hepatic dysfunction and for safety bone marrow transplantation.

Adult