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Y Takeyama

Publications and source records attributed to Y Takeyama.

117 records · Page 7Linked to original sources
PubMedDate not supplied

Peripheral lymphocyte reduction in severe acute pancreatitis is caused by apoptotic cell death.

To investigate impairment of cellular immunity in severe acute pancreatitis, alterations of peripheral lymphocytes in acute pancreatitis were examined. In 48 patients with severe acute pancreatitis, the mean peripheral lymphocyte count on admission was 959 + 105/mm3, and it was significantly decreased in the patients with subsequent infection (623 +/- 90/mm3 ) in comparison to those without infection (1084 +/- 135/mm(3)). According to an analysis of lymphocyte subsets, although both B and T lymphocytes were decreased in peripheral circulation in the patients with infection, it was primarily CD8-positive lymphocytes that decreased in these subsets. Cell cycle analysis of lymphocytes collected from these patients indicated that apoptotic changes occurred after 24 hours' incubation in lymphocytes from patients with severe pancreatitis but not in lymphocytes from healthy control subjects. In a rat model of experimental necrotizing pancreatitis, total peripheral lymphocytes and T lymphocytes were significantly decreased 5 hours after induction of pancreatitis. In severe pancreatitis, peripheral lymphocytes are eliminated from systemic circulation possibly as a result of apoptosis. It has been suggested that impairment of cellular immunity due to peripheral lymphocyte apoptosis is linked to the development of subsequent infectious complications in acute pancreatitis.

Acute Disease↗
PubMedDate not supplied

Expression of thymidylate synthase in cancer of the ampulla of Vater.

The clinical and therapeutic significance of thymidylate synthase (TS) in cancers of the ampulla of Vater have not yet been reported. We immunohistochemically evaluated TS expression in 33 ampullary cancers using an anti-TS antibody. TS expression, clinicopathologic variables, and survival rates were examined and the correlations between these parameters were identified. Fifteen patients were found to express high levels of TS (high TS group), while 18 patients expressed low levels of TS (low TS group). No significant difference was found between TS expression and clinicopathologic factors. Univariate and multivariate analysis revealed that lymph node metastasis and pancreatic invasion are important variables for independently predicting post-operative survival. Although TS expression was not identified as an important factor for postoperative survival, recurrent cases in patients with chemotherapy existed only in the high TS group. In the present study, it was found that TS expression itself in cancers of the ampulla of Vater has no impact in predicting the prognosis of ampullary cancers, but a chemotherapeutic benefit of evaluating TS expression may exist.

Adenocarcinoma↗
PubMedDate not supplied

Two-staged treatment with local resection and percutaneous isolated hepatic chemoperfusion for advanced pancreatic cancer with multiple liver metastases: report of a case.

There have been disappointingly few effective treatment modalities for multiple liver metastases from pancreatic cancer. Percutaneous isolated hepatic perfusion, which was developed by us for delivering dose-intensive chemotherapy to the liver, has a high efficacy in the majority of patients with multiple primary and secondary liver tumors. We herein report the first experience of a two-stage treatment with extended local resection and subsequent two percutaneous isolated hepatic perfusions for advanced pancreatic ductal adenocarcinoma with liver metastases. The second percutaneous isolated hepatic perfusion with high-dose cisplatin and mitomycin G demonstrated a distinct regression of metastatic liver tumors. Although a long-term patient survival was not obtained due to local recurrence, liver metastases have been well controlled ever since. Given that further studies establish the efficacy of percutaneous isolated hepatic perfusion also in this field, this modality would be used as prophylaxis as well as treatment of liver metastasis in patients with advanced pancreatic ductal adenocarcinoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Proliferating cell nuclear antigen, p53, and c-erbB-2 expression in relation to clinicopathological variables and prognosis in cancer of the ampulla of Vater.

BACKGROUND/AIMS: Various clinicopathological factors have been thought to influence the prognosis of ampullary cancers. Recent advances in molecular biology should provide much useful information on the prognostic factors of ampullary carcinomas. METHODOLOGY: PCNA (proliferating cell nuclear antigen), p53, and c-erbB-2 were immunohistochemically evaluated in 30 resectable ampullary carcinomas. PCNA, p53, and c-erbB-2 expression, 6 clinicopathological variables, and prognosis were studied and correlations among these factors were investigated. RESULTS: The mean PCNA-positive rate was 39.1%. The percentages of cases positive for p53 and c-erbB-2 were 53% and 23%, respectively. No correlation was seen between PCNA, p53, or c-erbB-2 expression and clinicopathological variables. The optimum cut-off of PCNA indices influencing recurrence was decided as 40% by receiver operator characteristic curves. The cumulative disease-free survival rate of patients from the > or = 40% PCNA positive rate group was significantly poorer than that of the < 40% PCNA positive rate group (P < 0.01). p53 accumulation and c-erbB-2 expression were not correlated with prognosis. Multivariate analysis revealed that the PCNA positive rate and lymph node metastasis independently contributed to survival (P < 0.05). CONCLUSIONS: PCNA expression is a useful prognostic marker; however, p53 and c-erbB-2 overexpression are not useful as biomarkers for ampullary cancers.

Adult↗
PubMedDate not supplied

Kinetic analysis of cholesterol removal by thermofiltration.

Excellent prediction of post treatment lipid concentrations using a simple one-compartment kinetic model was shown. Higher plasma filter sieving coefficients for total cholesterol and LDL cholesterol were obtained from healthy volunteers, suggesting that in hypercholesterolemic patients the LDL fraction has a larger mean particle size. The difference in plasma filter sieving coefficients for apoprotein B and LDL cholesterol indicates a large heterogeneity in LDL particle sizes. The HDL cholesterol post treatment concentration decreased an average of 30% compared with the pretreatment concentration. However, because the total drop in cholesterol concentration was about 60%, the ratio of HDL cholesterol to total cholesterol improved substantially. Removal of LDL and total cholesterol closely approximated the theoretic 100% removal line representing plasma exchange, and a high return of HDL cholesterol was achieved. The simple kinetic model can be used for treatment planning (calculation of plasma volume to be processed) to achieve the desired post treatment macrosolute concentrations.

Adult↗
PubMedDate not supplied

Selective removal of high level cryoglobulins (CG) and immune complexes (IC) by a large pore membrane.

The investigated membranes having a pore size of 3 micron or less can retain over 95% of cryoprecipitable proteins and immune complexes with nearly complete passage of other plasma proteins at 4 degrees C. Based on this result, the G-3 module consisting of V-3000 membrane was chosen for further study. The G-3 module (0.148 m2 of surface area) processed a 10 times higher plasma volume per unit surface area with higher selectivity than the Asahi Plasmaflo AP 06M. Separation efficiency of cryoprecipitable proteins and immune complexes in cryoglobulinemic plasmas by cryofiltration at 4 degrees C is related to the composition of the cryoprecipitable protein; three of four plasmas contained cryoprecipitable proteins that were removable by cryofiltration. Cryoprecipitation was too slow in one of four plasmas. For this plasma SDS PAGE showed its light chain to be of higher molecular weight than other plasmas. Two of four plasmas had elevated amounts of IC that were removed by cryofiltration.

Adult↗
PubMedDate not supplied

Surgical treatment for severe acute pancreatitis: factors which affect the surgical results.

Surgical treatment for severe acute pancreatitis has not yet yielded satisfactory results. Several factors which might affect the surgical results of severe acute pancreatitis were analyzed in this study. The presence or absence of infection was not important as a factor determining the surgical results. The severity scores and some biochemical parameters such as CRP, IL-6, PMN-E, HGF seemed to be closely related to surgical results. It was likely that a significant decrease in lymphocyte counts in the blood on admission was closely related to the prognosis of the surgical patients. Timing and procedures for surgery should be more seriously considered in the treatment for patients with such poor general conditions.

Acute Disease↗