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T Teratani

Publications and source records attributed to T Teratani.

29 records · Page 2Linked to original sources

[Percutaneous tumor ablation therapy for the advanced stage of HCC].

We have performed percutaneous tumor ablation (PTA) including percutaneous ethanol injection therapy (PEIT) for 90% of the patients with hepatocellular carcinoma. Until December 1998, the 793 patients received PTA, 5 years survival rate reached 39.8%. Excluding the patients with Child C whose hepatic function were extremely low, 5 years survival rate reached to the level of 41.2%. Since 5 years survival rate in stage IV-A reached 24.4%, the patients of stage IV-A may be considered to have an indication for PTA. We have confirmed the effectiveness of the local treatment including radiotherapy for advanced hepatocellular carcinoma with portal vein invasion. We are attempting to perform PTA for the extra-hepatic lesions that had no indication of other treatment. However the indication of PTA is limited by the presence of diffuse nodules, exacerbation of the hepatic function, or tumor invasion to portal vein, bile duct, inferior vena cava.

Carcinoma, Hepatocellular↗

Endoscopic variceal ligation is a sufficient procedure for the treatment of oesophageal varices in patients with hepatitis C liver cirrhosis: comparison with injection sclerotherapy.

AIMS: Endoscopic variceal ligation (EVL) is a recently developed alternative to endoscopic injection sclerotherapy (EIS) for the treatment of oesophageal varices. Endoscopic variceal ligation and EIS were compared in an attempt to clarify the efficacy and safety of EVL for patients with cirrhosis due to hepatitis C. METHODS: Endoscopic variceal ligation was performed in 60 patients and EIS in 30. Varices were eradicated in all patients by EVL and 87% (26 out of 30) by EIS. RESULTS: There was no significant difference between EVL and EIS in relation to the incidence of bleeding and the 5 year survival rate after treatment. There were no severe complications except mild substernal pain after EVL, while pulmonary embolism occurred in one patient receiving EIS. CONCLUSIONS: Endoscopic variceal ligation is a safe and effective technique for eradicating oesophageal varices in patients with hepatitis C cirrhosis.

Esophageal and Gastric Varices↗

Quantitative analysis of ras gene mutation in pancreatic juice for diagnosis of pancreatic adenocarcinoma.

It has recently been demonstrated that mutant ras gene was also detected in patients with mucinous cell hyperplasia without adenocarcinoma, indicating that the presence of the mutation could not be a definite marker for pancreatic adenocarcinoma. The present study was performed to differentiate pancreatic adenocarcinoma from others by quantification of mutant ras gene in pancreatic juice. By measuring mutant ras gene by polymerase chain reaction (PCR) during its logarithmic phase, the amount was semiquantitatively evaluated between 0.1 and 10% of total DNA that was extracted from pancreatic juice obtained via endoscopy. Semiquantitative analysis revealed that the mutant gene occupied more than 1% of total DNA in eight of 15 patients (53%) with pancreatic adenocarcinoma, and in all three patients (100%) with intraductal papillary neoplasm of the pancreas, but in only two of 19 cases (11%) without neoplasm. Semiquantitative analysis may provide a clinical tool for the differential diagnosis of pancreatic carcinoma.

Adenocarcinoma↗

Power Doppler sonography for hepatocellular carcinoma: factors affecting the power Doppler signals of the tumors.

AIMS/BACKGROUND: A recent advancement in Doppler ultrasonography (US) is power Doppler for detecting low-velocity blood flow at the microvascular level with angle independence. The present study was performed to characterize the factors contributing to the power Doppler signals of hepatocellular carcinoma (HCC). METHOD: Correlation of Doppler signals of HCC in 114 patients with 178 HCC nodules was analyzed in relation to the findings of CT and angiography, tumor characteristics (size, echo pattern, and histological differentiation of tumor), viral markers and severity of liver disease. RESULTS: The sensitivity of power Doppler US was superior to that of CT and angiography (each p<0.05; McNemar's test). The detection rate of power Doppler signal was significantly higher in tumors with diameter > or =2 cm (vs <2 cm in diameter), and with low/mixed echo pattern (vs high echo appearance), and with moderately/poorly differentiated HCC (vs well-differentiated HCC). Univariate analysis revealed that echo pattern, tumor size and histological differentiation of HCC in addition to CT and angiographic findings were significant. Multivariate analysis showed that tumor size and differentiation were significant. CONCLUSION: These results indicate that tumor characteristics play an important role in power Doppler signals and that these could be assessed by the presence or absence of power Doppler signals.

Angiography↗

Percutaneous hepatic infarction therapy for hepatocellular carcinoma.

OBJECTIVE: We percutaneously injected ethanol into small vessels afferent to tumor nodules to induce hepatic infarction in areas of tumor caused by hepatocellular carcinoma. CONCLUSION: Percutaneous hepatic infarction therapy holds promise as a new method of treating large hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

[Percutaneous ethanol injection therapy for small hepatocellular carcinoma].

Hepatocellular carcinoma is different from other solid tumors. Because of concomitant cirrhosis or multiple lesions, most hepatocellular carcinoma is unresectable. Still worse, hepatocellular carcinoma frequently recurs after surgical resection; the 5-year cumulative recurrence rate is 70-90% even after curative hepatectomy. The situation is similar in small hepatocellular carcinoma 2 cm or less in diameter. Thus, non-surgical treatment plays an important role. At present, we think that percutaneous ethanol injection therapy (PEIT) is best for the treatment of hepatocellular carcinoma because of its local curativity, minimal adverse effect on liver function, and the easy feasibility of repeated treatment for recurrence. We have recently treated about 85% of hepatocellular carcinoma cases by PEIT and have achieved satisfactory long-term results. Here we describe our results in PEIT for small hepatocellular carcinoma. By the end of December 1995, we performed PEIT on 410 patients with hepatocellular carcinoma. Among them, 140 patients were diagnosed as having small hepatocellular carcinoma 2 cm or less in diameter. The 1-, 3-, 5-, 7-, and 10-year survival rates of the 140 patients were 93%, 73%, 55%, 51%, and 32%, respectively. Furthermore, in 83 patients who had a single, small hepatocellular carcinoma 2 cm or less in diameter, the 1-, 3-, 5-, 7-, and 10-year survival rates were 92%, 82%, 72%, 66%, and 66%, respectively. Thus PEIT achieved satisfactory long-term survival rates in the treatment of small hepatocellular carcinoma.

Adult↗

Characteristic difference of hepatocellular carcinoma between hepatitis B- and C- viral infection in Japan.

Characteristics of 205 consecutive patients with hepatocellular carcinoma (HCC) admitted during 1990 to 1993 have been analyzed from the standpoint of hepatitis viral infection in Japan. Among 205 HCC patients, 71% of the patients showed positivity for hepatic C virus (HCV) antibody alone, 13% showed positivity both for HCV and HBV (HCV/HBV) antibody, 11% demonstrated HBsAg alone, and negativity of both HCV and HBV antibody in 4% only. Positivity to both HCV antibody and HBsAg was demonstrated in 1% only. Mean detection age of HCVAb-positive HCC as well as both HCV/HBV antibody-positive HCC was 62 +/- 7 years, in contrast to 52 +/- 13 years in HCC with HBsAg (P < .05). Male-to-female ratio among HCVAb-positive HCC was 3.3:1, in contrast to 5.5:1 among the HCV/HBVAb-positive HCC and 7:1 among HBsAg-positive HCC, but there was no significant difference in the gender distribution between these groups. More than 60% of HCVAb-positive HCC and HCV/HBVAb-positive HCC were classified into the stage of Child B and C, whereas 65% of HBsAg-positive HCC was at the stage of Child A. The severity of liver disease was confirmed by liver histology, indicating that more than 70% of the HCVAb-positive HCC and the HCV/HBVAb-positive HCC showed cirrhosis, in contrast to 50% among the HBsAg-positive HCC. Three-year survival rate of HCV Ab-positive HCC and HBV/HCVAb-positive HCC was 68% and 56%, respectively, in contrast to 47% in HBsAg-positive HCC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Essential thrombocythemia in pregnancy].

A 30-year-old woman was admitted to our hospital because of thrombocythemia during pregnancy. Her leukocyte count was 10,000/microliters, Hb was 11.7 g/dl, and platelet count 181.9 x 10(4)/microliter. Bone marrow aspirate showed an increase in megakaryocytes (255/microliters). Both Ph1 chromosome and bcr rearrangement were negative. She was diagnosed as having essential thrombocythemia (ET) with pregnancy, and was treated with aspirin (150 mg/day). Her pregnancy was uneventful, but she was readmitted because of overterm pregnancy. A caesarean section was performed, and a healthy male infant weighing 3,672 g was delivered, with a platelet count of 25.5 x 10(4)/microliter. However, the uterine was atonic, and atonic hemorrhage occurred. Supravaginal hysterectomy was performed. Subsequently, intrabdominal gross hemorrhage occurred, but the bleeding was halved by platelet transfusion. Microscopic examination showed uterine infarction. We suggest that platelet count should be reduced by means of plateletpheresis or interferon-alpha throughout pregnancy with ET.

Adult↗

Circumscribed endometrial stromatosis of the uterus with marked epitheliogenesis.

A 75-year-old female suffered from continuous abnormal genital bleeding; endometrial biopsy was interpreted as stromal hyperplasia. Simple total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. A circumscribed tumor covered by atrophic endometrium was found in the uterine fundus, bulging into the endometrial cavity; histological pictures revealed endometrial stromatosis with marked epitheliogenesis having a papillary formation and sex-cord-like differentiation. No recurrence or metastasis was detected postoperatively.

Aged↗

Primary ovarian pregnancy in a cystic teratoma.

Hemoperitoneum was identified by culdocentesis in a 26-year-old woman suffering acute abdominal pain. A pregnancy test was positive. Operation indicated a ruptured ovarian pregnancy, and histologic examination revealed primary intrafollicular ovarian pregnancy in a cystic teratoma. Ovarian pregnancy in an ovarian tumor is exceedingly rare.

Adult↗

Immunohistochemical investigation of S100A9 expression in pulmonary adenocarcinoma: S100A9 expression is associated with tumor differentiation.

S100 protein A9 is associated with myeloid cell differentiation and is also expressed in some epithelia. However, there have been few studies on S100A9 in specific types of carcinomas, except for squamous cell carcinoma (SCC) because the expression in normal epithelia is limited to squamous epithelia. Recently, S100A9 gene expression has been detected in cultured human adenocarcinoma (AC) cells derived from various organs. In this study, we also detected S100A9 gene expression in human pulmonary AC cell lines by reverse transcription-polymerase chain reaction. Furthermore, using the monoclonal antibody against S100A9, we carried out an immunohistochemical evaluation of S100A9 protein expression in 70 cases of resected pulmonary AC and examined the relation of S100A9 expression to tumor differentiation. S100A9 immunopositivity was 0/21 (0%) in well differentiated ACs, 12/30 (40%) in moderately differentiated ACs and 19/19 (100%) in poorly differentiated ACs, and the poorly differentiated ACs showed a significantly greater positive reaction. The immunopositivity in the moderately differentiated ACs was marked in specific cytologic subtypes. In the controls, conspicuous S100A9 immunopositivity was observed in pulmonary SCCs, regardless of the degree of differentiation, but not in adenomatous hyperplasia or normal surface epithelia. These above results suggest that the S100A9 protein is also expressed in pulmonary AC and that the expression rate in pulmonary AC shows higher correlation in poorly differentiated carcinomas, in agreement with our recent results regarding liver carcinoma. We believe S100A9 is also closely related to the differentiation of carcinomas of glandular cell origin.

Adenocarcinoma, Papillary↗