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T Shuto

Publications and source records attributed to T Shuto.

90 records · Page 5Linked to original sources
PubMed1991

Synthetic inositol 1,3,4,5-tetrakisphosphate analogues.

Inositol 1,3,4,5-tetrakisphosphate [Ins(1,3,4,5)P4] analogues were synthesized and their effects on [3H]Ins(1,3,4,5)P4 5-phosphatase, [3H]Ins(1,3,4,5)P4 3-phosphatase and [3H]inositol 1,4,5-trisphosphate [3H]Ins(1,4,5)P3] 5-phosphatase activities were examined. The Ins(1,3,4,5)P4 analogue with the aminobenzoyl group at the 2-position of Ins(1,3,4,5)P4 inhibited the hydrolysis of 5-phosphate of [3H]Ins(1,3,4,5)P4 catalysed by erythrocyte ghosts, with a lower Ki value than seen with Ins(1,3,4,5)P4, whereas the analogue with the aminocyclohexanecarbonyl group at the same position had a higher Ki value. The Ins(1,4,5)P3 analogues that we had previously synthesized were also capable of inhibiting this process, with the same tendency as Ins(1,3,4,5)P4 analogues. Such differences in the potency among Ins(1,3,4,5)P4 and Ins(1,4,5)P3 analogues were applicable to other phosphatase activities, namely [3H]Ins(1,3,4,5)P4 3-phosphatase and [3H]Ins(1,4,5)P3 5-phosphatase. These results suggest that the active sites of these enzymes may catalyse the dephosphorylation in a similar fashion.

Erythrocyte Membrane↗
PubMedDate not supplied

High prevalence of infection with hepatitis B and C viruses in patients with hepatocellular carcinoma in Japan.

BACKGROUND/AIMS: Hepatitis B and C viruses are closely associated with hepatocellular carcinoma. We studied the prevalence of infection with either virus in patients with this cancer by examination of sera and tumor tissue. METHODOLOGY: Serum samples obtained before treatment from 330 patients with hepatocellular carcinoma were assayed for antibodies against hepatitis C virus and against hepatitis B surface and core antigen. Tumor tissues from 65 patients were examined for hepatitis B virus RNA. RESULTS: Of the 330 patients, 87 had anti-hepatitis C alone; 161 had anti-hepatitis C and anti-hepatitis B (core); 13 had anti-hepatitis C and anti-hepatitis B (surface); 39 had anti-hepatitis B (surface) alone; and, 19 had anti-hepatitis B (core) alone. Eleven patients had none of these. Hepatitis B virus genes were detected in tumor tissue in all 13 patients with anti-surface antibody, in 21 of 30 patients with anti-core antibody, and in 9 of 22 patients without hepatitis B antibodies. Viral genes were detected in tumor tissue in 5 of 11 patients with neither B nor C virus markers in their sera; viral markers were found in either serum or tumor tissue in 324 of 330 patients (98.2%). CONCLUSIONS: The prevalence of hepatitis B or C virus infection in patients with hepatocellular carcinoma in Japan is extremely high. The prevalence of co-infection with both viruses is also high.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Efficacy of major hepatic resection for large hepatocellular carcinoma.

BACKGROUND/AIMS: A large hepatocellular carcinoma (HCC) generally carries a poor prognosis despite curative hepatic resection. However, some cases have had good outcomes without recurrences. In this study, we investigated the factors which predicted a good prognosis. METHODOLOGY: Sixty-six patients with large HCC greater than 5 cm who underwent curative hepatic resections were divided into two groups. There were 55 patients who had recurrences within 5 years after surgery (group A) and 11 patients who did not have recurrences at the fifth year after surgery (group B). We compared the clinicopathological features between the two groups. RESULTS: No differences were seen in the pre-operative liver function tests and the incidence of histological cirrhosis. The incidence of positive rate of histological recurrence factors, such as intrahepatic metastasis and incomplete surgical margins, was significantly less in group B. Five (45%) and 10 (91%) of 11 patients in group B underwent pre-operative portal vein embolization and major hepatic resection, respectively, while 10 (18%) and 29 (53%) of 55 patients in group A underwent these procedures (p < 0.05). CONCLUSIONS: In order to increase tumor-free survival rates for patients with large HCC greater than 5 cm, major hepatic resection after portal vein embolization with complete surgical margins should be performed.

Aged↗
PubMedDate not supplied

Adenomyoma of the common bile duct.

An unusual case of adenomyoma of the common bile duct is reported. A 31 year-old woman with intermittent epigastralgia was found to have cholestasis and stenosis of the common bile duct. A malignant tumor could not be excluded. Resection of the common bile duct with the tumor was performed with choledochojejunostomy reconstruction. The tumor consisted of glandular hyperplasia and proliferation of smooth muscle fibers and fibrous connective tissue. The patient was well at the 30-month follow-up. Although the benign tumors of the extrahepatic bile ducts are rare, the clinical importance lies in the recognition that they can cause biliary tract obstruction. Intra-operative frozen section for histologic examination is required to make the diagnosis and plan the surgical procedure. Complete extirpation of the lesion is recommended. A radical operation is not necessary.

Adenomyoma↗
PubMedDate not supplied

Hyperplastic foci as a prognostic factor after resection of hepatocellular carcinoma.

BACKGROUND/AIMS: Since chronic liver disease is generally considered a pre-malignant condition, recurrence in the residual liver after hepatic resection for hepatocellular carcinoma may be related to the malignant potential of the underlying liver disease. METHODOLOGY: We studied non-cancerous regions of hepatocellular carcinomas that were 3 cm or smaller in diameter from 170 patients who underwent curative hepatic resection. The presence of clusters of hyperplastic small cells, which we called hyperplastic foci, was investigated microscopically. The nuclei of the cells in hyperplastic foci were normal, but the nuclear/cytoplasmic ratio was high, cellularity was increased compared with neighboring regions, and the hepatic trabeculae were somewhat thick. We also calculated the labeling index in hyperplastic foci areas by proliferating cell nuclear antigen and compared this to that of hepatocytes without cellular atypia. RESULTS: In 59 of 170 patients (35%), hyperplastic foci were found. The labeling index in hyperplastic foci was significantly higher than in control regions (p = 0.0016). As of December 1995, 113 patients (63%) were found to have a recurrence. When hyperplastic foci were found, the tumor-free survival rate was significantly lower (p = 0.0443). CONCLUSIONS: Hyperplastic foci represent an important predictor of recurrence after hepatic resection for a small hepatocellular carcinoma.

Adult↗
PubMedDate not supplied

Post-operative blood tests and multicentric recurrence of hepatocellular carcinoma.

Second hepatic resections (SHR) were performed in 2 patients with recurrent hepatocellular carcinoma (HCC) with hepatitis C virus (HCV) more than 10 years after initial curative resections. Appearance on imaging studies of the late recurrences thought to be multicentric primary tumors, was preceded by fluctuating laboratory abnormalities such as increased alanine aminotransferase activity (ALT), increased serum alpha-fetoprotein (AFP), and decreased platelet counts by as long as 2 years. Therefore, serial changes of blood tests after resection of HCC with HCV might be useful predictors of late multicentric recurrence.

Aged↗
PubMedDate not supplied

Patterns of and risk factors for recurrence after liver resection for well-differentiated hepatocellular carcinoma: a special reference to multicentric carcinogenesis after operation.

BACKGROUND/AIMS: We studied the patterns of, and risk factors for, recurrence after resection of well-differentiated hepatocellular carcinoma to make a strategy for such carcinoma. METHODOLOGY: The subjects were 36 patients who underwent liver resection for well-differentiated hepatocellular carcinoma. Multicentric carcinogenesis after the operation (multicentric recurrence) was diagnosed when a recurrent tumor included a component of well-differentiated hepatocellular carcinoma. Tumor-free survival rates of patients with various risk factors were calculated and differences between groups were evaluated. For multivariate analysis, Cox's proportional hazard model was used. RESULTS: All recurrent tumors after operation were of multicentric origin. Univariate analysis showed a history of blood transfusion, high alpha-fetoprotein concentration (> 20 ng/ml), and low platelet count (< 10(5)/mm3) to be significant factors. By multivariate analysis, a history of blood transfusion and a low platelet count were independent risk factors. Nonanatomic resection was not a risk factor. CONCLUSIONS: In patients with well-differentiated hepatocellular carcinoma, especially with risk factor(s) for multicentric recurrence, not only anatomic but also nonanatomic resection (partial resection) are indicated for a primary tumor, because almost all recurrent tumors are of multicentric origin. After resection of well-differentiated hepatocellular carcinoma, careful monitoring for multicentric recurrence is important in patients with risk factors.

Adult↗
PubMedDate not supplied

Surgery for mixed hepatocellular and cholangiocellular carcinoma.

BACKGROUND/AIMS: Mixed tumors composed of hepatocellular carcinoma and cholangiocellular carcinoma are rare. In this report, the clinicopathologic characteristics and treatment outcome of four patients with mixed hepatocellular and cholangiocellular carcinomas are described. METHODOLOGY: Of 539 patients with primary liver cancer who underwent hepatic resection in our department over a 17-year period, 4 were diagnosed with mixed hepatocellular and cholangiocellular carcinoma. The clinicopathological features and treatment outcomes of these 4 patients were investigated. RESULTS: All 4 patients were positive for hepatitis C virus antibody and had hypervascular tumors. Tumor resection was performed for all patients. Three underwent lymph node dissection. At the time of this study, 1 patient was alive without recurrence 12 months after surgery. The other patients died within 28 months of surgery. CONCLUSIONS: Mixed tumors should be considered in patients with a liver mass and increased serum carcinoembryonic antigen and carbohydrate antigen 19-9 concentrations, a low alpha-fetoprotein concentration, and hypervascularity. The cholangiocellular carcinoma component appears to determine the prognosis.

Bile Duct Neoplasms↗
PubMedDate not supplied

Resected cases of hepatocellular carcinoma detected after interferon therapy for chronic hepatitis C.

BACKGROUND/AIMS: Interferon therapy decreases the incidence of hepatocellular carcinoma in patients infected with hepatitis C virus. However, hepatocellular carcinoma was detected after interferon therapy in some patients. METHODOLOGY: Of the 167 patients who underwent liver resection for hepatitis C virus-related hepatocellular carcinoma between 1993 and September 1998, the carcinoma was detected after interferon therapy in 11 patients. The clinicopathologic findings in these 11 patients were studied. RESULTS: The response to interferon was complete (n = 4), partial (n = 4), or no response (n = 3). Hepatocellular carcinoma was detected 2 months to 3 years 9 months, after interferon therapy. The interval period from the end of interferon therapy to the detection of the carcinoma were significantly correlated with the longest diameter of the main tumor (P = 0.0043), indicating that most carcinomas have already developed before the end of interferon therapy. In one non-responder, multicentric carcinogenesis occurred after liver resection for primary hepatocellular carcinoma. Another patient with advanced hepatocellular carcinoma died of the recurrence. CONCLUSIONS: Surveillance for hepatocellular carcinoma must be performed even in patients successfully treated with interferon because occult carcinoma may have developed before or during the therapy.

Alanine Transaminase↗
PubMedDate not supplied

Resection of a non-functioning islet cell carcinoma occupying the entire pancreas.

A 46-year-old woman with jaundice was found to have enlargement of the entire pancreas on computed tomography. Endoscopy revealed a tumor at the papilla of Vater, although examination of biopsy specimens did not demonstrate a malignancy. The jaundice resolved spontaneously, but reappeared at 7 months. Also noted was increased swelling of the papilla. The serum pancreatic endocrine and exocrine hormone concentrations were within the reference ranges. At surgery, a hard mass was found occupying the entire pancreas. Examination of incisional biopsy specimens from the pancreatic mass and papilla of Vater revealed an islet cell tumor. A total pancreatectomy was performed. The tumor extended from the pancreatic tail to the papilla of Vater. Histopathologic and immunopathologic examination revealed a non-functional islet cell carcinoma. There was no evidence of recurrence at 3 years. A good outcome can be achieved with resection of non-functioning islet cell carcinomas, even if they are advanced.

Ampulla of Vater↗
PubMedDate not supplied

Indications for, and effectiveness of, a second hepatic resection for recurrent hepatocellular carcinoma.

BACKGROUND/AIMS: Second hepatic resection (SHR) for recurrent hepatocellular carcinoma (HCC) appears to have a better prognosis than other treatments; however, it is not clear whether this is the result of the procedure, or of the underlying condition of patients undergoing this treatment. MATERIALS AND METHODS: Consecutive hepatic resection for 13 years, many patients suffered from recurrence in the remnant liver. After detection of recurrence, these lesions were treated in various ways including SHR. In this communication, recurrent patients were divided into SHR patients and non-SHR patients. In these two groups, we analyzed clinicopathologically. RESULTS: After 341 curative hepatic resections for HCC, recurrences presented in 193 patients (57%). SHR was performed in 31 patients (16%), while the other 162 patients (84%) underwent other treatments. At first resection, the group did not significantly differ in sex, age, evidence of hepatitis infection, liver function tests, tumor size, presence of portal vein invasion and evidence of histologic cirrhosis. SHR patients had more tumor-free days following first resection than non-SHR patients (p < 0.05). The survival rate following recurrence for SHR patients was better than that of non-SHR patients (p < 0.05). Among the non-SHR patients, 23 patients met criteria for the procedure. Survival rate for the 31 SHR patients also was better than that of these 23 patients (p < 0.05). CONCLUSION: Since SHR is safe, effective, and offers an improved prognosis for recurrent HCC, it should be the treatment of choice whenever possible.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Differences of resected hepatocellular carcinoma with hepatitis B or C virus.

BACKGROUND/AIMS: The purpose of this study was to clarify the clinicopathologic differences of hepatocellular carcinoma associated with the hepatitis B versus the hepatitis C virus. METHODOLOGY: One hundred and sixty-eight patients with resected hepatocellular carcinoma were tested for viral hepatitis. Ten (6%) had both the hepatitis B surface antigen and antibodies to the hepatitis C virus. Thirty-three (20%) had neither marker. Sixteen (9%) had only the hepatitis B surface antigen (group B), and 109 (65%) had only antibodies to the hepatitis C virus (group C). We compared groups B and C clinicopathologically. RESULTS: The mean tumor diameter was larger in group B than in group C (6.3 cm vs 3.4 cm), while group B patients were younger than group C (48 yrs vs 62 yrs, p<0.0001). Poor liver function, histologic cirrhosis and chronic active hepatitis were frequently found in group C. The 1- and 2-year tumor-free survival rates following surgery in group B were 67% and 33%, and those in group C were 73% and 49%. The 1-, 2-, and 3-year survival rates following surgery in group B were 78%, 68%, and 0%, while those in group C were 92%, 83%, and 76% (p=0.0189). CONCLUSIONS: Hepatocellular carcinoma with concomitant hepatitis B viral infection was found to present as larger tumors in younger patients with less severe liver dysfunction. Hepatocellular carcinoma with concomitant hepatitis C viral infection was often detected in follow-up studies when it was small.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

GB virus C infection by blood transfusion during and following liver surgery.

BACKGROUND/AIMS: GB virus C has been associated with some cases of fulminant hepatitis and post-transfusion hepatitis. We examined transfusion-related infection with this virus. METHODOLOGY: Of 150 patients undergoing liver resection, 108 received a homologous blood transfusion. Serum samples before and after surgery were examined for GB virus C RNA by a nested polymerase chain reaction with reverse transcription. We also studied the post-operative course of patients infected with GB virus C by blood transfusion. RESULTS: Viral RNA was detected in sera taken after transfusion in 4 (4%) patients receiving homologous transfusions. Viral RNA was not detected after surgery in the 42 patients given autologous transfusions or not receiving homologous blood. Post-operative courses in the 4 infected patients were uneventful. CONCLUSIONS: As 4% of homologous transfusions resulted in GB virus C infection in our small surgical study, autologous transfusion is recommended when circumstances permit.

Blood Transfusion↗