Showing papers by "Hidefumi Higashi published in 2005"
TL;DR: The present study demonstrated a close association between TAM infiltration and both the VEGF expression and MVD, which suggested that the prognostic implications of TAM infiltration are due to the involvement of TAMs in tumor angiogenesis.
Abstract: Stromal cells, within and around the tumor, as well as tumor cells are both involved in angiogenesis which is an important step in tumor growth and metastasis. Among such stromal cells, macrophages are known to play various roles in tumor angiogenesis and have thus been called tumor-associated macrophages (TAMs). The TAM density, vascular endothelial growth factor (VEGF) expression and the microvessel density (MVD) were immunohistochemically evaluated in 249 paraffin-embedded sections of invasive ductal carcinoma of the breast. The TAM density and MVD were assessed as the average density of three hot spots at a magnification of x400 and x200, respectively. The TAM density showed a significant correlation with both the VEGF expression and MVD, while a significant correlation was also found between the VEGF expression and MVD. The TAM density was also associated with the nuclear grade, estrogen receptor status and MIB-1 count. Patients with a high TAM density had a significantly (p=0.0025) worse disease-free survival (DFS) prognosis than those with a low TAM density, while univariate analyses also indicated both the MVD (p<0.0001) and VEGF expression (p=0.0152) to be prognostic factors for DFS. A multivariate analysis indicated MVD (p=0.0057), as well as lymph node metastasis and the MIB-1 count, to be independently significant prognostic factors for DFS. In conclusion, the present study demonstrated a close association between TAM infiltration and both the VEGF expression and MVD. The prognostic significance of MVD was the strongest among these three factors in breast cancer. These findings suggested that the prognostic implications of TAM infiltration are due to the involvement of TAMs in tumor angiogenesis.
343 citations
TL;DR: The inactivation ofPTEN, demonstrated by a reduced expression of PTEN protein by immunohistochemistry, was found in about one third of all breast cancers, and the reduced expression correlated with lymph node metastases and a worse prognosis in the patients with breast cancer.
Abstract: Objective: The PTEN tumor suppressor gene has been demonstrated to be inactivated in a variety of human tumors. In breast cancer, the PTEN gene mutation is not commonly found wherea
104 citations
TL;DR: Serial measurement of serum α‐fetoprotein (AFP) was useful for the detection of recurrences, however, the levels of AFP seem to be a non‐specific, unreliable test for such patients since this tumour marker showed different ranges before the primary surgery and at the time of recurrence in 5 of the 41 patients.
Abstract: Curative resections were performed on 121 patients with primary hepatocellular carcinoma from 1975 to 1986 at Kyushu University Hospital, Japan. Up to August 1987 there was a recurrence in 41, detected between 4 and 86 (mean 20) months after surgery. Intrahepatic recurrences were the most common (82 per cent). There was no statistically significant correlation between size of the primary tumour and interval from surgery to detection of recurrence (r = -0.09). Serial measurement of serum alpha-fetoprotein (AFP) was useful for the detection of recurrences. However, the levels of AFP seem to be a non-specific, unreliable test for such patients since this tumour marker showed different ranges before the primary surgery and at the time of recurrence in 5 of the 41 patients (12 per cent). Postoperative chemotherapy with oral 5-fluorouracil had no apparent preventative effect on the recurrence. A second curative resection was effective in four patients, and three survived for over 2 years; the longest survival time is 9 years after the second procedure.
88 citations
TL;DR: It is concluded that ethanolamine seems to be safer and more efficacious than STD for sclerosing oesophageal varices.
Abstract: Forty-five cirrhotic patients with oesophageal varices underwent endoscopic injection sclerotherapy in a prospective randomized trial carried out to compare two sclerosing agents (5 per cent ethanolamine oleate and 2 per cent sodium tetradecyl sulphate (STD] with respect to safety, efficacy and complications. Twenty-three patients were allocated to the ethanolamine group and twenty-two to the STD group. The rate of control of acute bleeding was 100 per cent (6/6) in the ethanolamine group and 75 per cent (3/4) in the STD group. There was a significantly lower rate of postinjection bleeding after the over-tube was removed at the initial session of sclerotherapy when ethanolamine was injected 0/23 versus 7/22, 32 per cent; P less than 0.01) and at the second session there was a significantly (P less than 0.01) higher rate of jet-like bleeding from injection sites in the STD group (6/21, 29 per cent) than in the ethanolamine group (0/22). The disappearance rate of red colour signs 1 week after the initial session of sclerotherapy in the ethanolamine group was 100 per cent and 62 per cent in the STD group. Early oesophageal ulcers developed less frequently in the ethanolamine group (0 and 9 per cent) than in the STD group (24 per cent and 43 per cent both after the initial (P less than 0.05) and the second session of sclerotherapy (P less than 0.01]. Early bleeding from an oesophageal ulcer occurred only in the STD group (5/21, 24 per cent) before the third session of sclerotherapy (P less than 0.05). The rate of early mortality did not differ between the two groups. We conclude that ethanolamine seems to be safer and more efficacious than STD for sclerosing oesophageal varices.
39 citations
TL;DR: Patients with HCC and hepatitis B without seroconversion as well as hepatitis C frequently have active hepatitis, which may impair liver function and play an important role in operative morbidity and mortality.
Abstract: The influence of associated viral hepatitis status on 119 patients with primary hepatocellular carcinoma (HCC) undergoing hepatic resection was investigated. Operative morbidity and mortality were examined in three patient groups: 31 patients (group B) positive for hepatitis B surface antigen (HBsAg), 14 (group Be) positive for both HBsAg and hepatitis B e antigen, and 74 (group C) positive for hepatitis C virus antibody (HCVAb). Preoperative liver function in groups Be and C was similar and more impaired than that of patients in group B; combined active hepatitis was seen most frequently in group C (68 per cent). The tumour size in group B was significantly greater than that in groups Be and C. Postoperative complications occurred more frequently in group C (39 per cent) and early postoperative deaths, other than those from cancer, were seen in nine patients positive for HCVAb, of whom three developed postoperative liver failure. Patients with HCC and hepatitis B without seroconversion as well as hepatitis C frequently have active hepatitis, which may impair liver function and play an important role in operative morbidity and mortality.
26 citations
TL;DR: There was a significantly higher control of variceal bleeding when the over‐tube technique was used and no significant difference between the two techniques with regard to the frequency of endoscopic injection sclerotherapy for eradication of oesophageal varices.
Abstract: The safety, efficacy and complications of two techniques of endoscopic injection sclerotherapy were examined in 102 consecutive patients, using either a totally transparent over-tube or the free-hand technique. The choice of treatment was at random. There was a significantly higher control of variceal bleeding when the over-tube technique was used (100 per cent versus 77 per cent, P less than 0.05). The frequency of re-bleeding before the eradication of oesophageal varices was significantly less in the over-tube group than in the free-hand group (P less than 0.01), although all re-bleedings were well controlled with additional injections of 5 per cent ethanolamine oleate. There was no significant difference between the two techniques with regard to the frequency of endoscopic injection sclerotherapy for eradication of oesophageal varices. The over-tube technique is safer than the free-hand technique and takes less time to accomplish; at the initial session of treatment, time and bleeding during these techniques were 11.5 +/- 2.3 min (mean +/- s.d.) and 7.3 +/- 5.9 ml in the over-tube technique, and 20.4 +/- 4.1 min and 45.1 +/- 30.0 ml in the free-hand technique (P less than 0.001, in both time and bleeding).
20 citations
TL;DR: It is concluded that intra‐operative elimination of the varices will not prevent recurrence and that a closer follow‐up using endoscopy more than three times a year is a significant aid in the management of these patients.
Abstract: Intra-operative and postoperative endoscopy were used in 16 patients with portal hypertension to investigate whether intra-operative elimination of oesophageal varices by oesophageal transection with devascularization leads to prevention of variceal recurrence and rebleeding. Intra-operative elimination of the varices was achieved in 12 patients. In ten patients the varices recurred and in two cases rebled, during the follow-up period of 6-43 months (average 25 months). of the ten patients with recurrent varices, eight (including the two who bled acutely in the postoperative period) successfully underwent endoscopic injection sclerotherapy. Postoperative endoscopy was performed at 5-monthly intervals. It is concluded that intra-operative elimination of the varices will not prevent recurrence and that a closer follow-up using endoscopy more than three times a year is a significant aid in the management of these patients.
19 citations
TL;DR: It is necessary to be cautious regarding the transmission of HCV during liver surgery when using the ultrasonic dissector in HCV RNA seropositive patients, because the irrigating solution aspirated by this device appears to be highly infectious.
Abstract: Hepatitis C virus (HCV) RNA was detected in the irrigating solution aspirated by the ultrasonic dissector system used in liver surgery with a reverse transcription polymerase chain reaction technique and was then compared with HCV RNA in the serum to clarify the risk of viral transmission to hospital personnel. The positivity of HCV RNA in the aspirated irrigating solution was approximately equal in all patients whose serum was positive for HCV RNA. However, viral RNA was not detected in the aspirated irrigating solution of any patient who was seronegative for HCV RNA. These results indicate that it is necessary to be cautious regarding the transmission of HCV during liver surgery when using the ultrasonic dissector in HCV RNA seropositive patients, because the irrigating solution aspirated by this device appears to be highly infectious.
6 citations
TL;DR: Thomboxane B2 and 6‐keto‐prostaglandin F1α, both stable products of thromboxane A2 and prostacyclin respectively, showed significant temporary increases after the sclerotherapy, which may be related to the marked limitation in platelet aggregation.
Abstract: Platelet aggregability and the coagulative and fibrinolytic systems were examined in 45 patients who underwent endoscopic injection sclerotherapy for oesophageal varices. Five per cent ethanolamine oleate, the sclerosant used, was injected into the oesophageal varices. There were significant increases in the concentrations of fibrinopeptide A, fibrinopeptide B-beta-15-42 and fibrin degradation products-E after the sclero-therapy. At 1 h after the sclerotherapy the mean(s.e.m.) platelet aggregation was significantly suppressed to 71.9(4.2) per cent of that before the treatment (P less than 0.01). There was a gradual recovery within 1 week to the same level seen before the sclerotherapy. Thromboxane B2 and 6-keto-prostaglandin F1 alpha, both stable products of thromboxane A2 and prostacyclin respectively, showed significant temporary increases after the sclerotherapy (P less than 0.01). The peak increase in the level of thromboxane B2 was noted within 1 h after the sclerotherapy and earlier than that for 6-keto-prostaglandin F1 alpha. This increased ratio of prostacyclin and thromboxane A2 may be related to the marked limitation in platelet aggregation.
3 citations
TL;DR: The objective is to evaluate the usefulness of treatment with a transanal ileus tube for acute obstruction in patients with cancer of colon and rectum.
Abstract: Background/Aims: To evaluate the usefulness of treatment with a transanal ileus tube for acute obstruction in patients with cancer of colon and rectum.
Materials and methods: In 12 patients with colorectal obstruction due to cancer treated between 1999 and 2001, lesions were located in the transverse colon, descending colon, sigmoid colon and rectum. Transanal ileus tube insertion was attempted for initial treatment and diagnosis.
Results: Insertion of a transanal ileus tube was successful in eight (67%) of 12 patients. Symptoms of obstruction were resolved and one-stage operations were performed in-all eight cases. In two cases, insertion failed and temporary colostomy was used before a two-stage operation. Perforation of the rectum and sigmoid colon occurred during the insertion procedure in another two cases. These two cases underwent emergency tumor resection and colostomy.
Conclusion: Insertion of transanal ileus tube effectively relieved acute colonic obstruction. Furthermore, tube insertion allowed patients to undergo a one-stage operation. However, tube insertion is not appropriate in all obstructive cases and the risk of severe complication must always be considered.