Biomedical subjects

E Adachi

Publications and source records attributed to E Adachi.

155 records · Page 9Linked to original sources

PubMedDate not supplied

Progression of cellular repopulation and collagen synthesis in fresh-frozen allograft tendons.

The progression of cellular repopulation and collagen synthesis in fresh-frozen rat patellar tendon allografts was investigated by means of indirect immunofluorescence histologic analysis and electron microscopic techniques for 8 weeks after transplantation. In each of 10 procedures, the medial half of the patellar tendon with a tibial bone block was harvested from a Wistar rat and transplanted into a corresponding defect in the medial patellar tendon of a Lewis rat. Actin filaments in the repopulating cells and newly synthesized collagen fibrils in the graft were identified with rhodamine-phalloidin stain and with a polyclonal antibody against type III collagen aminopropeptide. On the first day after transplantation, no specific fluorescence was detected in the graft. One week later, specific labeling for fibrillar-actin (F-actin) and type III collagen aminopropeptide was detected in an area extending from the adjacent granulation tissue into the proximal end of the graft. F-actin and type III collagen aminopropeptide were aligned along the longitudinal axis of the graft and extended from the proximal suture site toward the distal portion. Two weeks after transplantation, fibrillar labeling for F-actin and type III collagen amino-propeptide showed that remodeling had extended to the midportion of the graft. Labeling throughout the entire graft was detected 4 weeks after transplantation. During the entire remodeling process, the repopulated fibroblasts consistently retained their elongated shape and their alignment with the longitudinal axis of the graft. The cells developed well-organized actin bundles at their peripheries, which identified them as having a myofibroblast phenotype. Immunofluorescence detection for type III collagen aminopropeptide also showed consistent alignment parallel to the longitudinal axis of the graft and a fibrillar arrangement. Electron microscopy revealed thinner collagen fibrils in the vicinity of the fibroblasts, which were aligned in the direction of the actin bundles. These results indicate that, during the early remodeling phase, collagen synthesis and deposition in the graft proceeds while the original alignment of the graft matrix is preserved. The close association between the alignment of actin bundles in repopulated "myofibroblastic" cells and that of newly synthesized collagen fibrils along the lines of the graft matrix may represent evidence of force transmission between the actin cytoskeleton and the linking extracellular matrix in vivo.

Journal Article↗

PubMedDate not supplied

CD34 expression in endothelial cells of small hepatocellular carcinoma: its correlation with tumour progression and angiographic findings.

The angiogenic process plays an important role in tumour growth and metastasis during hepatocarcinogenesis, but it is still uncertain when the process begins during tumour formation. Forty-two small hepatocellular carcinomas (HCC) that measured either less than or equal to 2 cm in diameter were studied by comparing the histologic findings with the angiographic findings, and with immunohistochemical expression of endothelial marker QB-end/10 (QB), a new monoclonal antibody raised against CD34, in the sinusoidal wall. Twenty (91%) of 22 moderately or poorly differentiated HCC revealed a positive reaction for QB, while only eight (40%) of 20 well differentiated HCC demonstrated a positive reaction (P < 0.01). In the tumours showing a 'nodule in nodule' appearance, the less differentiated areas were more reactive for QB. Twenty-three (82%) of 28 QB positive tumours were hypervascular, while only three of 14 (21%) QB negative tumours were hypervascular (P < 0.01) by angiography. All six of the poorly differentiated and 13 (81%) of the 16 moderately differentiated tumours were hypervascular, while only seven (35%) of 20 well differentiated HCC were hypervascular (P < 0.01). These results indicate that as the tumour becomes less differentiated, the QB positive areas become wider and angiography demonstrates hypervascularity. We therefore speculate that the HCC sinusoids acquire the characteristics of capillary and precapillary blood vessels during de-differentiation from well to moderate, and thus the tumour begins to reveal hypervascularity on angiography. The above process may be correlated with the stepwise progression of HCC.

Antigens, CD34↗

PubMedDate not supplied

Hepatocellular carcinoma with pyrexia: report of a case.

Reported here is a case of an unusual type of hepatocellular carcinoma (HCC). Since this patient with liver mass exhibited continuous pyrexia, an inflammatory pseudotumor or abscess was strongly suspected. Two-phased incremental CT, MR with and without Gd-DTPA administration, and angiography demonstrated peripheral enhancement of the hepatic mass. Histologically, the tumor proved to be HCC with sarcomatoid degeneration. When one encounters a patient with a mass clinically and radiologically mimicking an inflammatory pseudotumor or an abscess, poorly differentiated HCC with sarcomatoid degeneration should be suspected.

Aged↗

PubMedDate not supplied

Histopathologic correlation of two-phased dynamic incremental CT in hepatocellular carcinomas using multivariate analysis.

In order to grade pathologic factors that influence CT findings in hepatocellular carcinomas (HCCs), the CT-pathologic correlation was assessed statistically using univariate and multivariate analyses of 75 lesions. CT findings of early and delayed phase scans using two-phase dynamic incremental CT (TDICT) were compared with pathologic findings in resected specimens to calculate a category score for each pathologic finding. According to category scores, histopathologic differentiation and growth pattern were the major determinants of tumor density. Determinants of the internal structure of tumors were cytological variants, histologic differentiation, and macroscopic classification, in that order. Macroscopic classification, histologic differentiation, fibrous capsule characteristics, and growth pattern were important in descending order for tumor margins. Histologic differentiation was the most important factor for determining TDICT findings in HCCs. The CT findings were modified by parenchymal liver disease and cytologic variants.

Adult↗

PubMedDate not supplied

Intrahepatic peripheral cholangiocarcinoma: two-phased dynamic incremental CT and pathologic correlation.

To elucidate the characteristic CT findings of intrahepatic peripheral cholangiocarcinoma, two-phased dynamic incremental CT scans of 20 cholangiocarcinomas in 16 patients were carefully analyzed. Dynamic incremental CT scanning was performed after intravenous administration of 100 ml iodinated contrast medium at a rate of 2 ml/s using a power injector. The CT scans (8-16 sections) were obtained during 45-110 s (early phase) and 6-7 min (delayed phase) after commencement of the injection of the contrast medium. On CT, 55% (11 of 20) of intrahepatic peripheral cholangiocarcinomas appeared hypodense in both phases. Most of the tumors (80%) appeared hypodense in the early phase and had increased CT numbers in their delayed images. Lymphadenopathy was observed in 69% (11 of 16) of patients whose main tumors exceeded 3 cm in diameter. All tumors appeared irregular or indistinct. Twenty percent (4 of 20) of the cholangiocarcinomas were difficult to distinguish from hepatocellular carcinomas or hemangiomas.

Adenoma, Bile Duct↗

PubMedDate not supplied

Argyrophilic nucleolar organizer regions (AgNOR) of resected intrahepatic cholangiocellular carcinomas.

BACKGROUND/AIMS: Thxe argyrophilic nucleolar organized resion (AgNOR) is loop DNA encoded for rRNA production on the nucleoli, which controls cell proliferation and protein synthesis (1,2). Based on numerous studies, it has been suggested that the AgNOR number correlates with both cellular kinetics and the malignant grade of the tumor. MATERIALS AND METHODS: The argyrophilic nucleolar organized regions (AgNOR) of 14 operated cases with intrahepatic cholangiocellular carcinoma (IHCCC) were examined. RESULTS: The number of AgNOR per nucleus (the AgNOR score) was found to be related to both the level of carcinoembryonic antigen (CEA) (r = 0.63, P = 0.016) and the size of the tumor (r = 0.62, P = 0.017). Regarding the age, sex, the presence or absence of lymph node metastasis, the grade of TNM classification, and the main location of the tumor, no statistical significance was recognized. On the other hand, both histological difference and differentiation were observed to remarkably reflect the AgNOR score (P = 0.03). The cancer-free survival and survival rate showed no relationship to the AgNOR score, but patients with an AgNOR number lower than 2.0 showed a poorer cancer-free survival rate as well as a poorer survival rate. Two patients with a long survival, who have been free from cancer for more than 5 years, showed a low AgNOR score (1.6, 1.7). CONCLUSIONS: The AgNOR method is simple, low-cost and can easily be applied to paraffin-embedded sections. Therefore, this score is considered to be useful in identifiying malignant potentiality in intrahepatic cholangiocellular carcinoma.

Aged↗

PubMedDate not supplied

Early recurrence after surgery of hepatocellular carcinoma.

BACKGROUND/AIMS: In 231 patients with hepatocellular carcinoma who underwent liver resection from 1986 to 1992 to determine the significance of alpha-fetoprotein (AFP) levels. MATERIALS AND METHODS: There were 13 patients (5.6 per cent) with early recurrence within six months after hepatectomy. RESULTS: Preoperative serum alpha-fetoprotein (AFP) levels were significantly higher in patients with early recurrence (p < 0.01). Postoperative histological examination revealed that there were significant correlations between patients with early recurrence and intrahepatic metastasis (p < 0.01), and portal vein infiltration (p < 0.01). There were significant correlations between patients with early recurrence and preoperative diagnosis of intrahepatic metastasis (p < 0.01), however, preoperative diagnosis of portal vein infiltration could not be detected enough. Eight (73%) of 11 patients with over 1000 ng/ml of AFP and preoperative diagnosis of intrahepatic metastasis had early recurrence (p < 0.01). CONCLUSIONS: We found that patients of hepatocellular carcinoma with over 1000 ng/ml of AFP and preoperative diagnosis of intrahepatic metastasis are the most important factors in the preoperative clinical data linked to early recurrence type of HCC after hepatectomy.

Aged↗

PubMedDate not supplied

Prognosis of well differentiated small hepatocellular carcinoma--is well differentiated hepatocellular carcinoma clinically early cancer?

BACKGROUND/AIMS: The purpose of this study is to examine whether or not well differentiated (w-d) hepatocellular carcinoma (HCC) is indeed clinically early cancer. MATERIALS AND METHODS: Seventy six patients with solitary small HCCs up to 3 cm in diameter, who underwent hepatectomy, were observed for at least 2 years for possible recurrence. These patients were divided into two groups: 10 patients with w-d HCCs (Edmondson and Steiner's grade I) and 66 patients with less differentiated (l-d) HCCs (Edmondson and Steiner's grade I-II, II-III, and III). RESULTS: The histological analysis revealed that w-d HCCs had lower incidences of fibrous capsule formation (P<0.01), when compared to l-d HCCs. There were no significant differences in the incidence of intrahepatic metastasis, or portal vein invasion. In a resected specimen of w-d HCC, barium sulfate and gelatin were injected into portal vein and a transparent specimen was made. The transparent specimen showed that the portal vein in the tumor seemed to be intact. Microscopically, cancer cell infiltration into the fibrous frame of the portal tract was present. There were no significant differences in the disease free survival between the two groups. An analysis of tumor volume doubling time in recurrent foci suggested that minute cancerous foci had been present at the time of operation. CONCLUSIONS: W-d HCCs were clinically demonstrated not to be early cancer, because there was no significant difference in disease free survival between the patients with w-d and l-d HCCs.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Circulating intercellular adhesion molecule-1 in patients with hepatocellular carcinoma before and after hepatic resection.

BACKGROUND/AIMS: We recently demonstrated that an activated inflammation in a non-tumorous portion was a significant risk factor for recurrence in patients with small hepatocellular carcinoma. The purpose of this study is to provide further proof for this mechanism by explaining the relation ship between the post-operative hepatitis state and intrahepatic recurrence. PATIENTS AND METHODS: We used an enzyme-linked immunosorbent assay to detect cICAM-1 in the serum of 18 patients with hepatocellular carcinoma before and after hepatic resection. RESULTS: A complete surgical resection of the tumor masses did not result in a significant reduction of cICAM-1 levels. The levels of aminotransferase after hepatic resection in patients with an increased level of cICAM-1 in the post operative period (n = 7) were much higher than in patients with a decreased level of cICAM-1 (n = 11) (p < 0.05). The 1-, 2- and 3- year disease free survival rates in the former group were 42.9%, 14.3% and 0%, respectively, and those in the later group were 72.7%, 54.5% and 54.5%, respectively (p < 0.05). CONCLUSIONS: The enhancement of inflammation in the remnant liver tissue is related to intrahepatic recurrence after hepatic resection through adhesion molecules, such as cICAM-1.

Aged↗

PubMedDate not supplied

Clinicopathological characteristics of stage 1 gastric cancer: comparison of macroscopic and microscopic findings.

BACKGROUND/AIMS: Laparoscopic surgery or endoscopic mucosal resection for early stages of gastric cancer have been introduced recently in many regions. In such cases, a precise diagnosis is needed prior to treatment, since understaging of gastric cancer may lead to treatment failure and impairment of curability and prognosis. The clinicopathological features of understaged cases in macroscopic Stage 1 gastric cancer have not been clarified yet. MATERIAL AND METHODS: We examined 435 patients with intra-operative findings of macroscopic Stage 1 gastric cancer and compared clinicopathological features of 354 patients (Group A) with both macroscopic and histological stage 1 cancer and 81 patients (Group B) with macroscopic Stage 1 but histologically proven to be more advanced cancer. RESULTS: Among 435 patients with macroscopic Stage 1, there were 81 (18.6%) with histologically more advanced stages (44 of stage 2, 34 of stage 3, and 3 of stage 4). There were no statistical differences in age, sex, operative procedure, and extend of lymph node dissection between the groups. Carcinomas in the 81 Group B patients tended to have larger tumors (> 4 cm), located in the middle third and along the lesser curvature of the stomach, appeared to be Borrmann V type (unclassified type) and were histologically more often associated with undifferentiated type, INF-gamma, lymphovascular invasion, lymph node metastasis, and invasion into a layer deeper than submucosa, all of which resulted in significantly poorer prognosis. CONCLUSIONS: Pre-operative and intra-operative assessment of the stage for gastric cancer was not always accurate enough and about one fifth cases with macroscopic Stage 1 gastric cancer were understaged. Thus, we recommend gastrectomy plus radical lymphadenectomy (at least D2) for the treatment of choice, from the points of view of curability and prognosis when gastric carcinoma is associated with the above mentioned characteristics.

Age Factors↗

PubMedDate not supplied

Hepatocellular carcinoma of the intrabiliary growth type.

BACKGROUND: To determine the optimal surgical therapy for patients with the intrabiliary growth type of hepatocellular carcinoma (HCC). METHODS: We evaluated 257 patients with HCC who underwent liver resection from 1981 to 1990 in Kyushu University Hospital. RESULTS: There were 13 (5.1 per cent) with the intrabiliary growth type of HCC. Total bilirubin and r-glutamyl transpeptidase levels were higher (p < 0.05), and diameter of these tumors was larger in patients with intrabiliary growth type of HCC (p < 0.05). There were significant correlations between patients with the intrabiliary growth type of HCC and intrahepatic metastasis (p < 0.01), and portal vein infiltration (p < 0.01). Survival time of patients with the intrabiliary growth type was significantly shorter than that in the control group (p < 0.05). Nevertheless, two of three patients with the intrabiliary growth type of HCC who underwent resection of more than a 10 mm surgical margin survived for 5 years, respectively. CONCLUSIONS: A large number of patients with the intrabiliary growth type of HCC were advanced HCCs with intrahepatic metastasis or portal vein infiltration. However, we favour the view that patients have had a better prognosis if hepatectomy of more than a 10 mm surgical margin had been done.

Adult↗