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Biomedical subjects

S Fujiyama

Publications and source records attributed to S Fujiyama.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Intra-arterial injection of cisplatin suspension in lipiodol (LPS) for the treatment of advanced hepatocellular carcinoma (stage IV)].

We established a preparation method for the suspension of cisplatin in Lipiodol (LPS) and applied it by intra-hepatic artery injection for the treatment of advanced hepatocellular carcinoma. We defined that stage IV carcinoma as characterized by tumor spread more than one lobe (H4) or by tumor emboli in the major branches of the portal vein (Vp3) or by distant metastasis (M1). According to this definition, 20 patients of stage IV were treated by this therapy, and evaluated the survival using Kaplan-Meier method. A reduction in tumor size more than 25% was observed in 11 of 20 patients (55%). In 4 of these cases (20%), over 50% of tumor reduction was obtained. In 15 patients whose serum alpha-fetoprotein (AFP) levels were higher than 400 ng/ml, a decrease more than 50% was noted in 9 of the 15 patients (60%). Sixty per cent survival rate was obtained at 6 month. A statistical by significant difference was obtained in the survival patterns between this therapy and other intra-arterial chemotherapy. The factors that influenced on the survival significantly were AFP levels (over 10,000 ng/ml), Vp3 and M1. However, tumor size and intrahepatic metastasis, etc. were not significant factors. LPS therapy seemed to be effective to even stage IV hepatocellular carcinoma and could be applied further.

Carcinoma, Hepatocellular↗
PubMed1989

[Intra-arterial injection of cisplatin suspension in Lipiodol (LPS) in the treatment of hepatocellular carcinoma].

Cisplatin suspension in Lipiodol (LPS) was prepared for the treatment of hepatocellular carcinoma by intra-hepatic arterial injection. In a rabbit liver cancer model, concentrations of cisplatin in tumor were more than 20 times higher than those in a nontumorous part of the liver at 5 min after LPS injection into the hepatic artery. Cisplatin at high concentrations was detected at 7 days after injection. The concentrations in other organs were lower except in the gall-bladder. In clinical trials for 71 patients with hepatocellular carcinoma, partial response was observed in 33 cases (46.5%) and minor response in 20 cases (28.2%). The survival rate was 77% at 6 month and 55% at one year. Although fever, nausea, vomiting and epigastralgia were observed as side effects, these were temporary. Acute gastroduodenal mucosal lesions, cholecystitis, pancreatitis, delayed jaundice and hepatic encephalopathy were observed as complications and super selective cannulation was necessary for their prevention.

Animals↗
PubMed1988

Plasma abnormal prothrombin (des-gamma-carboxy prothrombin) as a marker of hepatocellular carcinoma.

Des-gamma-carboxy prothrombin [DCP], a protein induced by vitamin K absence or antagonist-II and also abbreviated PIVKA-II, was evaluated as a serologic marker for hepatocellular carcinoma (HCC). Its plasma levels were measured by enzyme immunoassay (E-1023) using an anti-DCP monoclonal antibody in 514 patients with various diseases. Of 120 patients with HCC, 76 (63%) had abnormal DCP levels greater than 0.1 arbitrary unit (AU)/ml and 58 (48%) showed levels greater than 0.3 AU/ml. When a diagnostic minimum level of 0.3 AU/ml was applied for DCP, false-positive cases of HCC were virtually eliminated. In some patients with HCC, plasma DCP levels normalized after surgical resection of the tumor. However, they rose again later with recurrence of the disease. The sensitivity of DCP in the diagnosis and monitoring of HCC was increased by serial and simultaneous determinations of alpha-fetoprotein (AFP), because high DCP levels were observed more often in low AFP-producing HCC patients. Elevated plasma DCP levels were not related to low vitamin K concentration in the serum. In fact, in many patients vitamin K administration resulted in only a moderate reduction of DCP levels. These results suggested strongly that DCP was synthesized by the hepatoma cells.

Adenoma, Bile Duct↗
PubMed1988

The seroprevalence of anti-HTLV-1 antibodies in patients with various liver diseases.

The prevalence of antibodies to human T-cell leukemia virus type 1 (HTLV-1), which is linked to the etiology of adult T-cell leukemia (ATL), was examined in 380 patients with various liver diseases in Kumamoto Prefecture, southwestern Japan, which is one of the most endemic area for HTLV-1. Eighteen patients with acute hepatitis (AH), 201 chronic hepatitis (CH), 93 liver cirrhosis (LC) 40 hepatocellular carcinoma (HCC) and 28 with other liver diseases were examined. Among these patients, 110 patients had histories of blood transfusion. HTLV-1 specific antibodies were assayed by the ELISA method and the Western blotting method. The rate of positive reaction was 8.9% in all, 5.6% in AH, 6.0% in CH, 10.8% in LC, 17.5% in HCC and 14.3% in the cases of other liver diseases. The prevalence of anti-HTLV-1 antibodies in about 62,000 healthy blood donors in this area was 4.7%. The overall sero-prevalence in the patient group was significantly higher (p less than 0.001), than in healthy blood donors, particularly in the LC and HCC groups. Although the occurrence increased with age, no difference between sex was observed. Patients who had received blood transfusions were found to have a higher rate (17.2%), than those who had not (5.9%), and healthy blood donors. No difference was found between the two groups regarding family history of liver disease. This study indicates that blood transfusions may be an important route to the HTLV-1 infection.

Adolescent↗
PubMed1986

Clinical evaluation of plasma abnormal prothrombin (PIVKA-II) in patients with hepatocellular carcinoma.

The clinical usefulness of plasma abnormal prothrombin, defined as a protein induced by vitamin K absence or antagonist-II: PIVKA-II, as a tumor marker for hepatocellular carcinoma (HCC), was evaluated. Plasma PIVKA-II concentration was determined by an enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody specific for PIVKA-II. Forty-one (65%) out of 63 patients with HCC had an abnormal PIVKA-II level above 0.13 arbitrary units (AU)/ml; the level was above 0.3 AU/ml in 33 patients (52%) and above 0.5 AU/ml in 27 patients (43%). On the other hand, most of the 282 patients with various liver diseases other than HCC had normal or slightly elevated levels of PIVKA-II. Their values were all below 0.5 AU/ml, with the exception of 2 patients with decompensated liver cirrhosis. The patients with PIVKA-II values above 0.5 AU/ml were strongly suspected of having HCC. Plasma PIVKA-II levels were not related to serum alpha-fetoprotein (AFP) levels, but were above 0.5 AU/ml in 14 (44%) out of the 32 patients whose serum AFP levels were below 400 ng/ml. In some patients with HCC, PIVKA-II was increased throughout the course of the disease, and in others it normalized after surgical resection of the tumor. We conclude that the plasma PIVKA-II assay by the ELISA method using a monoclonal antibody is a useful diagnostic tool for monitoring HCC, particularly in HCC patients with low AFP levels.

Adenoma, Bile Duct↗
PubMed1986

[A resectable case of juvenile hepatocellular carcinoma in an asymptomatic HBV carrier].

A 28-year-old man was admitted to our hospital in October 1983 as he was found to have HBs-antigenemia at the time of blood donation. Since he had no symptoms and showed normal liver function, HBeAg(-), HBeAb (+) and HBcAb 87% (200x), he was diagnosed as an asymptomatic HBV-carrier. Unexpectedly, high serum AFP (13,500 ng/ml) was detected. Subsequently, computed tomography, angiography and ultrasonography demonstrated a tumor, 4.5 X 4.0 cm in diameter, in the left lobe of the liver. On Feb. 24, 1984, the tumor was radically resected. The postoperative course was excellent. This case suggested the relationship between hepatoma and asymptomatic HBV carriers and the importance of screening hepatoma patients to detect asymptomatic carriers.

Adult↗
PubMed1985

An epidemic of hepatitis A related to ingestion of raw oysters.

An epidemic of hepatitis A occurred around Hondo City, Kumamoto Prefecture in Japan during the first six months of 1982. Clinical, immunological and epidemiological studies were carried out in 225 cases. Cases were distributed over a relatively wide area, and in small numbers of young children and school children. More than half of the patients were in their twenties or thirties. The clinical course was generally favorable with rapid resolution. No episode lasted more than six months. There was only one fatality in a cure which was a carrier of HBs antigen with liver cirrhosis. Titers of IgM anti-HAV measured by radioimmunoassay (RIA) or enzyme immunoassay (EIA) reached a peak during the second week after onset, followed by a gradual decrease. Conversion to negative results was never experienced within two months. We found a good correlation between RIA and EIA in terms of detecting IgM anti-HAV. The route of infection was thought to be fecal-oral in nature, with ingestion of raw oysters the major etiologic factor.

Adolescent↗
PubMed1985

A case of primary sclerosing cholangitis.

A case of primary sclerosing cholangitis (PSC) is reported. A 16 year-old female developed right hypochondralgia and nausea without jaundice. Examination on admission showed elevation of SGOT, SGPT, Al-P, gamma-GTP and LAP activities, but T-Bil, AFP and CEA were within normal limits. Peripheral eosinocytes increased by 10%, and tests for HBsAg, antiHBs, antimitochondrial antibody and anti-smooth muscle antibody were all negative. ERCP revealed a narrowing of the proximal portion of the common the hepatic duct, and beading of the intrahepatic bile ducts. Liver scintigram and CT revealed no tumors in the liver, biliary tract or pancreas. Laparoscopy showed a smooth liver without swelling and a slightly swollen gallbladder. Histologically, the liver biopsy specimen showed ductal proliferation of small interlobular bile ducts and periductal fibrosis. No bile plugs, granuloma or distinct cholangitis were observed. No abnormal findings, including evidence of inflammatory bowel disease, were detected by barium enema. At present, one year after discharge, although her symptoms and liver function test abnormalities continue, she has been attending high school. Although 58 cases of PSC have been reported in Japan, juvenile cases occurring before the third decade number only 3 including ours.

Adolescent↗
PubMed1985

Enzyme immunoassay for detection of total and IgM-specific antibodies to hepatitis A virus and its clinical application.

Antibody to hepatitis A virus (anti-HAV) and IgM class antibody to HAV (IgM anti-HAV) in sera from 73 patients with hepatitis A and from 550 normal subjects were measured by enzyme immunoassay (EIA) and the results were compared with those of radioimmunoassay (RIA). Since RIA has the disadvantage of requiring radioisotopes and special equipment, the clinical applicability of EIA and possible methodological problems were evaluated. The EIA for anti-HAV showed an excellent correlation with RIA, indicating its usefulness for the demonstration of the immune status in these subjects. Positive results of anti-HAV were obtained in the early stage after the onset of hepatitis A. However, pretreatment for inactivation of samples was required. False-positive reactions were found in sera to which sodium azide was added as preservative. In the measurement of IgM anti-HAV, a fundamental study revealed quite satisfactory results, correlation with the results of RIA was excellent. In patients with hepatitis A, the titers reached a peak in the second to third week, followed by a gradual decline. Changes to a negative reaction were never encountered within three months. We concluded that the EIA is an useful tool in the diagnosis of hepatitis A and can replace RIA.

Adolescent↗
PubMed1985

An unusual case of gastric carcinoma initially presenting bone metastasis and later transverse myelopathy.

A 44-year-old man with Borrmann type III gastric carcinoma initially presenting bone metastasis and later transverse myelopathy is reported. Chest and skull roentgenograms showed multiple punched-out lesions. A bone scintigram showed multiple abnormal uptake. Histological examinations of biopsy and autopsy materials revealed signet-ring cell carcinoma of the stomach. Disseminated carcinomatosis of the bone marrow was ruled out histologically and neither microangiopathic hemolytic anemia nor disseminated intravascular coagulopathy was observed. Because this patient with bone metastasis did not have metastasis to the liver and lungs we propose that a nonportal route through the vertebral venous plexus might be an alternative to the portal route of bone metastasis from gastric carcinoma. During the last 20 years, only 10 such cases including this one have been reported in Japan. Their prognosis was quite poor and in most of them the malignancy was either undifferentiated adenocarcinoma or signet-ring cell carcinoma. If a bone metastasis is found as the initial sign, physicians should keep in mind that the primary lesion might be in the stomach, or in the thyroid, kidney, lung or prostate as another point of search.

Adenocarcinoma, Mucinous↗
PubMed1984

Hepatic granuloma. Report of a case successfully treated by hepatectomy and antituberculous therapy.

A 62 year-old male presented with high fever, weight loss and painful hepatomegaly. The clinical presentation, results of laboratory studies, angiography and laparotomy suggested hepatic abscess or cholangiocarcinoma. He underwent left lobe hepatectomy, and pathological examinations revealed granuloma. Acid-fast bacilli, fungi and parasites were not identified by special stainings. Hepatic tuberculosis was considered most likely because, after operation, an intermediate-strength purified protein derivative (PPD) skin test gave strongly positive results and his subsequent response to antituberculous treatment was excellent. His complex clinical features and the diagnostic difficulties were outlined.

Antitubercular Agents↗
PubMed1984

Thyroid antibodies in healthy blood donors.

The frequency of thyroid antibodies was investigated in 1314 healthy blood donors. Twenty-three of 870 males (2.6%) were positive for thyroglobulin antibody (TA), 34 (3.9%) for thyroid microsomal antibody (MA) and 19 (2.2%) for both TA and MA. Thirty-four of 484 females (6.2%) were positive for TA, 46 (9.5%) for MA and 29 (6.0%) for both TA and MA. Eighty-six of 1314 blood donors were positive for TA and/or MA. There was no difference in liver function tests between AAT and controls. In females, the incidence of thyroid antibodies tended to increase with age. However, the subjects aged under 19 showed another peak of incidence of thyroid antibodies. The values of total T4, T3 and free T4 were not different between 86 subjects with positive thyroid antibodies (asymptomatic autoimmune thyroiditis, AAT) and 86 sex- and age-matched controls without thyroid antibodies, whereas serum TSH of AAT was significantly higher than that of controls. Nine of 86 (10.5%) subjects with AAT had apparently increased basal TSH level.

Antibodies↗