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Biomedical subjects

Y Tameda

Publications and source records attributed to Y Tameda.

At least 37 records · Page 2Linked to original sources
PubMed1996

Long-term administration of natural interferon-alpha in patients with chronic hepatitis C: relationship to serum RNA concentration, HCV-RNA genotypes, histological changes and hepatitis C virus.

To virologically assess the efficacy of interferon therapy in chronic hepatitis C, either 5 or 10 MU/day natural interferon-alpha (IFN alpha) was administered to 57 patients with chronic hepatitis C for 38 weeks. A complete and sustained response (CR-SR), as evidenced by the absence of serum hepatitis C virus (HCV)-RNA during the administration period and at 6 months after the final administration of IFN alpha and normal GPT level at 6 months after final administration, occurred in 42.6% (23/54) of subjects. Liver tissue was histologically evaluated using the histological activity index (HAI) score before and after the administration period. In CR-SR cases, significant improvements (P < 0.01) occurred in periportal necrosis, intralobular necrosis, portal inflammation and total score. A comparison, by HCV genotypes, revealed that CR-SR occurred in 60% (9/15) of subjects with type 2a and 30.3% (10/33) of subjects with type 1b. A comparison by virus concentration revealed that CR-SR occurred in 71.4% (15/21) of those subjects having a virus concentration of < 10(5) copies/mL, but in only 24.2% (8/33) of those having a virus concentration of > 10(5) copies/mL. Analysis by a multiple logistic model revealed a strong correlation between the therapeutic effect of interferon therapy and the pre-administration virus concentration (P = 0.0061) and genotype (P = 0.0015). These results suggest that the pre-administration virus concentration and genotype are both key factors affecting the therapeutic effect of interferon therapy in chronic hepatitis C and that the therapeutic effect of interferon is satisfactorily high, irrespective of virus concentration, in subjects with type 2a HCV, but varies depending on virus concentration in subjects with type 1b.

Aged↗
PubMed1996

[Hepatitis viruses].

The existence of five kinds of hepatitis viruses such as hepatitis A, B, C, D and E has been convinced since 1967 when Blumberg discovered hepatitis B virus. The confirmation of virus which induces hepatitis has mainly depended on the measurement of antigen/antibody system. However, in order to grasp the entity of liver disease in more detail, analysis of virus nucleic acid is required. Especially, in case of patients who showed persistent infection of hepatitis B virus or hepatitis C virus, genetical analysis of hepatitis virus is required to make clear the liver disease, to determine the therapeutic method and to predict the prognosis. Recently, there are several reports which suggest the existence of new hepatitis virus that induces acute hepatitis or chronic hepatitis. Among these not determined viruses, GB agent is going to be recognized as a new hepatitis virus (HGV) which provoke hepatitis.

Flaviviridae↗
PubMed1995

Hepatocyte regeneration in chronic hepatitis C and interferon treatment: analysis of immunohistological identification of proliferating cell nuclear antigen (PCNA).

To evaluate the usefulness of proliferating cell nuclear antigen (PCNA) immunostaining in the assessment of the efficacy of interferon (IFN) therapy in chronic hepatitis C, we investigated the proliferative activity of hepatocytes in 67 patients with chronic hepatitis C, using this immunostaining method. The percentage of PCNA-positive hepatocytes was 2.4% in patients with chronic persistent hepatitis, 2.5% in those with chronic aggressive hepatitis 2A, and 3.9% in those with chronic aggressive hepatitis 2B. The PCNA count increased with the progression of the liver disease. Patients were classified as complete, partial, and non-responders to IFN; the percentage of PCNA-positive hepatocytes before IFN therapy was 1.6% in the complete responders, 3.9% in the partial responders, and 4.9% in the non-responders. There was a significant negative correlation between the percentage of PCNA-positive hepatocytes and the response to IFN treatment. Thirty-two of 53 cases (60.4%) in which the PCNA labeling index (LI) was less than 5.0 were complete responders compared with 13 of 14 cases (92.9%) in which the PCNA LI was higher than 5.0, representing partial responders or non-responders (P < 0.001). Most complete responders had a low PCNA LI, irrespective of HCV genotype. Our findings indicate that PCNA immunostaining is a simple and reliable index of cell proliferation in liver regeneration, and may be a useful predictor of the response to IFN treatment in chronic hepatitis C.

Adult↗
PubMed1995

Hemolytic anemia provoked by recombinant alpha-interferon.

A 30-year-old female with chronic hepatitis C treated with recombinant alpha-interferon developed serious hemolytic anemia after receiving 10 million units a day for 4 weeks. The results of Coombs' tests were negative before and after interferon therapy. The hemolytic anemia gradually improved after the withdrawal of recombinant alpha-interferon and the administration of methyl-prednisolone. The clinical course suggested that the recombinant alpha-interferon had provoked the hemolytic anemia.

Adult↗
PubMed1995

Late onset hepatic failure due to hepatitis B virus with mutations in the pre-core region.

A 60-year-old man complained of severe general fatigue on October 11, 1992. Pertinent laboratory findings were: aspantate aminotransferase (AST) 1920 IU, alanine aminotransferase (ALT) 2050 IU, and total bilirubin (T. Bil) 124 micromol/l (normal range, 0-17 micromol/l). Virological assay revealed that hepatitis B surface antigen (HBsAg), anti-hepatitis B e (HBe), anti-HBc, and immunoglobulin M (IgM) anti-HBc were positive, and anti-HBs, HBeAg, and anti-delta antibody were negative. A diagnosis of acute hepatitis due to hepatitis B virus was made. Despite a decrease in transaminase, jaundice worsened and prothrombin time was prolonged. On the 60th day of hospitalization, massive ascites developed, but the patient's consciousness was not impaired. Although, albumin and diuretics were given, the ascites further increased. Paracentesis of 2000 ml of ascitic fluid was performed twice a week. On the 120th day of hospitalization, the patient passed black stools and he exhibited renal failure 3 weeks later. Although severe jaundice persisted, he was still alert. On the 150th day of hospitalization, massive gastrointestinal bleeding occurred, due to hemorrhagic gastritis. Despite receiving intensive care, the patient died. Determination of the HBV DNA sequence revealed two point mutations in the pre-core region; these have not been reported elsewhere.

DNA, Viral↗
PubMed1995

A clinical study of lectin-reactive alpha-fetoprotein as an early indicator of hepatocellular carcinoma in the follow-up of cirrhotic patients.

Levels of two types of lectin-reactive alpha-fetoprotein (AFP), designated AFP-L3 and AFP-P4+P5, were analyzed with Lens culinaris agglutinin A and AFP-P4+P5 with erythroagglutinating phytohemagglutinin, respectively, in an attempt to determine the utility and significance of these macromolecules as early indicators of hepatocellular carcinoma during the periodic follow-up of cirrhotic patients. The subjects were 51 of 190 consecutive cirrhotic patients in whom hepatocellular carcinoma developed during a 6-year follow-up period and 21 cirrhotic patients without hepatocellular carcinoma. Serum AFP levels were of limited value to diagnose and predict hepatocellular carcinoma. The relative levels of AFP-L3 and AFP-P4+P5 in patients with hepatocellular carcinoma at the time of tumor detection were significantly higher than those in patients with cirrhosis. The sensitivity was 61%, and the specificity was 90%. Fourteen patients (48%) of 29 patients with small hepatocellular carcinomas less than 2 cm in diameter showed elevated percentage of lectin-reactive AFP. Retrospective examination of 21 patients who were positive for lectin-reactive AFP at diagnosis of hepatocellular carcinoma showed that 41% of them had already expressed lectin-reactive AFP 12 months before the direct detection of hepatocellular carcinoma by diagnostic imaging. These results lead us to conclude that the level of lectin-reactive AFP is a suitable predictive marker for the early recognition of hepatocellular carcinoma in the follow-up of patients with cirrhosis, and that measurements of the level of lectin-reactive AFP should be added to the screening methods that are now in use.

Biomarkers, Tumor↗
PubMed1995

[Acute pancreatitis associated with acute intermittent porphyria].

Pancreatic involvement associated with acute intermittent porphyria is rare. There were only nine cases reported until now which have pancreatic disease and AIP, one case with chronic pancreatitis, one with cystadenocarcinoma and chronic pancreatitis, one with transient macroamylasemia and the others with acute pancreatitis. The cause of these complications in these patients is uncertain. However, in our case, it is possible that AIP might have caused the acute pancreatitis, since this patient developed acute pancreatitis following the attack of AIP. It seems to be necessary to pay attention to the combination of these diseases.

Acute Disease↗
PubMed1994

[Clinical significance of determination of anti-HCV antibodies].

This study was conducted to evaluate the clinical significance of assays of hepatitis C virus (HCV) antibodies to manage the liver diseases due to HCV. To detect HCV infection accurately, the second-generation anti-HCV assays such as EIA, PHA and TND-2 were more useful than other assays such as anti-C100-3 antibody, anti-GOR antibody, and anti-JCC-2 antibody, because the second generation anti-HCV assays showed positive rates in over 90% of the cases with positive HCV-RNA. Although in some patients the determination of anti-GOR, anti-JCC-2, IgM anti-HCV and their titrations revealed the severity of liver disease and were useful to predict the effects of interferon therapy, measurements of these antibodies were not considered so useful as clinical parameters for management of patients with liver disease due to HCV. However, the fact that the changes of serum titer of anti-JCC-2 correlated well to the changes of serum transaminase levels in a few patients with IFN suggests that the clinical significance of anti-HCV core antibodies should be further discussed.

Adult↗
PubMed1994

[Development of diagnostic method for liver disease].

Advance of current methods for management of liver diseases was discussed by eight discussers in this symposium. About three theme such as; 1. what laboratory parameters were helpful for prediction of effect of interferon (IFN) for HCV positive chronic hepatitis, 2. what tests were available for early diagnosis and prediction of prognosis in fulminant hepatitis, and 3. what laboratory parameters were useful for early diagnosis and prediction of development of hepatocellular carcinoma (HCC), hot discussion was performed. It was presented that time course of titration of HCV core antibody was available for prediction of effect of interferon in some cases. In patients with low concentration of HCV-RNA and genotype III, good effect of IFN was obtained. The possibility that the measurement of HCV serotype would become more common instead of that of HCV genotype because of its simplicity in methodology was presented. The measurements of plasma amino acids and human hepatocyte growth factor (h-HGF) were useful in early diagnosis of fulminant hepatitis. As current topics in management of HCC, the utility of determination of lectin affinity alpha-fetoprotein in early diagnosis of HCC, the importance of making definite diagnosis by target biopsy of HCC in early phase and prediction of development of HCC by abdominal sonogram were reported.

Carcinoma, Hepatocellular↗
PubMed1993

Hepatitis in an adult with rubella.

Rubella was accompanied by hepatic dysfunction in a 28-year-old male. Serum aminotransferase levels were moderately elevated and LDH markedly increased, especially LDH isoenzyme 5, whereas total bilirubin and ALP remained almost normal. GOT, GPT and LDH levels were completely normalized by the 21st hospital day. Paired antibody titers of viruses which may cause hepatitis, other than rubella, were of no significance. Laparoscopy showed enlarged, red liver. Histologic and electron microscopic findings of the liver were consistent with acute hepatitis. Hepatic damage with rubella is rare, and it is possible that the hepatic dysfunction seen in adult rubella may be mediated by an immunopathologic mechanism.

Acute Disease↗
PubMed1991

A case of acute intermittent porphyria with acute pancreatitis.

A case of acute pancreatitis in a 29-year-old female associated with an attack of acute intermittent porphyria (AIP) is reported. Following the attack of AIP, serum pancreatic amylase originating from the pancreas increased transiently, and mild swelling of the pancreas was detected by ultrasonography. On this basis acute pancreatitis was diagnosed. Additionally, this patient had mild hepatic dysfunction. Laparoscopy disclosed diffuse slightly dark bluish pigmentation on the irregular surface of the liver. Mild fibrous dilatation of the portal area with lymphocytic infiltration was seen histologically. Acute pancreatitis and hepatic damage with AIP is extremely rare, however it is possible that these findings are etiologically connected in this patient.

Acute Disease↗
PubMed1988

Antithrombin III concentrate in the treatment of fulminant hepatic failure.

Twenty-six patients with fulminant hepatic failure were treated with daily infusions of antithrombin III concentrate until recovery of consciousness or death. Seven patients were alive (group A), 7 survived 17 to 47 days after treatment (group B), and 12 died within 9 days (group C). Decreased plasma antithrombin III levels increased on the day after treatment, irrespective of the pretreatment levels in all patients. Continuous or temporary normalization was seen in all patients in groups A and B, but in only 5 in group C patients whose bleeding was extensive (p less than 0.05). An abrupt drop in peripheral platelet counts occurred when plasma antithrombin III levels were below normal. General bleeding accompanied this drop. These results suggest that maintained normal plasma antithrombin III levels are beneficial for prolonged survival time in fulminant hepatic failure, probably through controlling intravascular coagulation, and that antithrombin III infusion may be useful for such treatment.

Antithrombin III↗