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Biomedical subjects

K Hajiro

Publications and source records attributed to K Hajiro.

At least 55 records · Page 3Linked to original sources
PubMed1998

Multiple pancreatic masses associated with autoimmunity.

A 59-year-old woman was detected to have a high titer of serum gamma-globulin, positive antinuclear antibody and multiple pancreatic masses. In the course of 1 yr, Sjögren's syndrome developed, and her pancreatic masses spread diffusely and compressed the main pancreatic duct. A pancreatic biopsy by an exploration of the abdomen showed that many CD4 positive T-lymphocytes had infiltrated to the ducts and acinar cells expressing HLA-DR antigens. This suggested a diagnosis of autoimmune-related pancreatitis. She was treated with oral prednisolone, and a marked improvement of the above abnormal findings followed. In this report, a case of autoimmune-related multiple pancreatic masses associated with Sjögren's syndrome is presented, and a possible mechanism is discussed.

Administration, Oral↗
PubMed1998

Antilactoferrin antibodies in autoimmune liver diseases.

OBJECTIVE: Lactoferrin, an immunoregulatory protein in mucosal secretions, is one of the target antigens to perinuclear antineutrophil cytoplasmic antibodies (P-ANCAs). Circulating lactoferrin is cleared in the liver, but little is known about the implication of lactoferrin in hepatic inflammation. To evaluate the implication of immunological response to lactoferrin, we examined antilactoferrin antibodies in autoimmune liver diseases. METHODS: Fourteen patients with primary biliary cirrhosis (PBC), 14 with autoimmune hepatitis (AIH), five with autoimmune cholangitis (AIC), six with chronic hepatitis C, and five with chronic hepatitis B were studied. We evaluated autoantibodies to lactoferrin in the sera of the patients by the Western Immunoblotting method. RESULTS: Sera of five of the 14 patients (35.7%) with PBC, four of the 14 patients (28.6%) with AIH, and five of the five patients (100%) with AIC contained autoantibodies to human lactoferrin, but none with hepatitis B or C had them. The higher prevalence of serum antibodies to human lactoferrin was shown to be higher in patients with AIC than with hepatitis B (p < 0.01), hepatitis C (p < 0.01), PBC (p < 0.05), and AIH (p < 0.05). CONCLUSION: Lactoferrin located in bile ducts and liver cells is one of the candidates of target antigens in autoimmune liver diseases, especially in AIC.

Adolescent↗
PubMed1997

Gastric inflammatory fibroid polyps: endoscopic ultrasonographic analysis in comparison with the histology.

BACKGROUND: Histologic diagnosis of inflammatory fibroid polyp is usually difficult on routine endoscopic examinations. The aim of this study was to describe endoscopic ultrasonographic features of gastric inflammatory fibroid polyps. METHODS: Endoscopic ultrasonography was performed in 10 patients with gastric inflammatory fibroid polyps before resection. All lesions were resected by either endoscopic removal or gastrectomy and then confirmed histologically as inflammatory fibroid polyps. To evaluate the diagnostic value of endosonography, endoscopic ultrasonographic images of the lesions were analyzed and compared with resected specimens retrospectively. RESULTS: All lesions were located in the second and/or third sonographic layer of the gastric wall without involvement of the fourth layer. The most frequent endoscopic ultrasonographic features were an indistinct margin (90%), and a hypoechoic (80%), homogeneous (90%) echo pattern. Histologically, inflammatory fibroid polyps developed in the deep mucosa and/or submucosa by proliferation of fibrous tissue, but did not have a capsule. CONCLUSIONS: The characteristic endoscopic ultrasonographic attributes of gastric inflammatory fibroid polyps are indistinct margin, hypoechogenicity, homogeneous appearance, and location within the second and/or third layer. These findings correlate very closely to the histologic findings.

Adult↗
PubMed1996

Endoscopic resection of gastrointestinal submucosal lesions: a comparison between strip biopsy and aspiration lumpectomy.

BACKGROUND: Endoscopic diagnosis and treatment of gastrointestinal submucosal lesions is still not established. We evaluated the clinical usefulness of two resection methods for submucosal lesions, using a "nonrandomized surgeon" design. METHODS: The strip biopsy method was evaluated at Tenri Hospital and the aspiration lumpectomy method was used at Kyoto University Hospital. The inclusion criteria for selecting patients were endosonographic findings indicating a tumor location within the submucosa. RESULTS: Seventy-seven patients were treated. The size of the specimens (mean +/- SEM) was 20.7 +/- 0.9 mm for the aspiration lumpectomy group and 14.0 +/- 0.8 mm for the strip biopsy group (p < 0.01). Aspiration lumpectomy was adequate for a definitive histologic diagnosis in 95% of the cases (36 of 38) as compared with 77% (30 to 39) of the cases treated by strip biopsy (p = 0.047). The eradication rate was 87% for the aspiration lumpectomy group, and 74% for the strip biopsy group (p = 0.274). The complication rate resulting from these procedures (hemorrhage, mean 5%) was acceptable. Repeated endoscopic examinations revealed no recurrence except for one lymphangioma. CONCLUSIONS: Endoscopic resection, especially aspiration lumpectomy, provides a significant benefit for accurate final diagnosis and eradication of submucosal lesions.

Adolescent↗
PubMed1996

Endoscopic features of gastric inflammatory fibroid polyps.

OBJECTIVES: The inflammatory fibroid polyp (IFP) is a rare benign lesion that can occur throughout the digestive tract. The aim of this study is to describe endoscopic features of gastric IFPs and to determine the clinical value of endoscopic removal. METHODS: Upper gastrointestinal endoscopy was performed in 13 patients with gastric IFPs. The IFPs were resected either by endoscopic removal or gastrectomy, and confirmed histologically as IFPs. To evaluate the diagnostic value, endoscopic features of the lesions were analyzed. RESULTS: The most frequent features were semi-pedunculated protrusions (61.5%), covered with a smooth surface of normal mucosa (100%), and located in the antrum or prepyloric region (100%). Bridging folds were observed in three of the 13 lesions (23.1%). The central surface of all 10-mm or larger lesions had an erythematous depression (three lesions), ulceration (five lesions), or white cap on the polyp (one lesion). Endoscopic biopsies failed to confirm IFP in any lesions. CONCLUSIONS: IFPs are commonly visualized as semi-pedunculated elevations, covered with a smooth surface of normal mucosa, and located in the antrum or prepyloric region. The 10-mm or larger lesions have central changes. Endoscopic removal of gastric IFPs is a useful method for both accurate diagnosis and treatment in view of negative results with the use of standard biopsy forceps.

Endoscopy↗
PubMed1995

Focal nodular hyperplasia of the liver without central scar.

An unusual case of focal nodular hyperplasia (FNH) of the liver is presented. A 31-year-old male was admitted to our hospital for the evaluation of an hepatic mass 10 cm in diameter located in segment 4. Routine examinations including liver function tests were all normal. Hepatitis B surface antigen, hepatitis C virus antibody, alpha-fetoprotein were all negative. Imagining studies could not detect specific findings of FNH such as a central scar structure or a spoke-wheel appearance due to dilated tumor vessels coursing centrally followed by radiating peripheral coursing vessels. Extensive left lobectomy of the liver was performed. Histological examination of the specimen cut into 1-cm-thick slices revealed no central stellate scars. Preoperative diagnosis of FNH with imaging studies was difficult because of the absence of central scars.

Adult↗
PubMed1995

Eosinophilic gastroenteritis involving the entire digestive tract.

Eosinophilic gastroenteritis, an inflammatory disease of unknown etiology, commonly involves the stomach and small intestine with eosinophilic infiltration. Herein we describe an unusual case of eosinophilic gastroenteritis involving the entire digestive tract. A 24-yr-old woman came to our hospital presenting with diarrhea with marked peripheral eosinophilia. Stool specimens were negative for parasites, ova, bacteria, and fungi. Barium and endoscopic studies showed thickened edematous folds of the duodenum and small intestine. Biopsy specimens of the esophagus, stomach, duodenum, ileum, and colon showed eosinophilic infiltration. A diagnosis of eosinophilic gastroenteritis involving the entire digestive tract was made, and therapy with prednisone was started. Symptoms and peripheral eosinophilia rapidly resolved, and biopsies of the digestive tract demonstrated no eosinophilic infiltration. This case illustrates the expanded spectrum of the disease to the entire digestive tract and emphasizes the diagnostic usefulness of endoscopic biopsies. The initial presentation of patients with eosinophilia requires the evaluation of the entire digestive tract. It is worth noting that eosinophilic gastroenteritis can involve the entire digestive tract.

Adult↗