Hikaru Oguri

Susceptibility to primary biliary cirrhosis is associated with human leukocyte antigen DRB1*0803 in Japanese patients

An association of primary biliary cirrhosis (PBC) with human leukocyte antigen (HLA) class II has been reported in previous studies based on the results of serological HLA typing. To evaluate the association between PBC and HLA class II more precisely, we performed HLA-DRB1 and DPB1 genotyping in 53 Japanese patients with PBC using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. In DRB1 genotyping, the frequency of the*0803 allele was significantly higher in patients with PBC than that in control subjects. Twenty out of 53 patients were*0803 positive (37.7%), whereas only five out of 60 controls (8.3%) had the allele (relative risk = 6.67;P < 0.001; correctedP < 0.05). In DPB1 genotyping, there was no significant difference in the frequency of the DPB1 alleles between patients with PBC and controls. Amino acid analysis of the DRβ chain revealed that the frequency of leucine at position 74 was significantly higher in patients with PBC than that in controls. These results suggest that HLA-DRB1*0803 allele and a subsequent amino acid substitution encoded by the polymorphic regions of the allele may play an important role in the pathogenesis of PBC.

Hepatitis B, C and G virus infection in patients with lymphoproliferative disorders

Abstract To define the relationship between hepatitis viruses including GBV-C/HGV and lymphoproliferative disorders, we investigated the prevalence of HBV, HCV and GBV-C/HGV infection in patients with non-Hodgkins lymphoma (NHL) and acute lymphocytic leukemia (ALL). A total of 43 subjects (26 males and 17 females, mean age 59.0 years old) consisting of 33 NHL and ten ALL patients were studied. All serum samples were tested for HBsAg, anti-HBc, HBV-DNA, anti-HCV, HCV-RNA and GBV-C/HGV-RNA. We compared these patients with two sets of control subjects. Control subjects (1) consisted of 45 age and sex matched subjects who underwent colonoscopy from July 1995 to June 1996, and control subjects (2) consisted of 10 599 subjects who received a general medical check-up in Toyama prefecture. HBsAg, anti-HBc and HBV-DNA were detected in the serum of 1/33 (3.0%), 15/33 (45.5%), and 0/33 (0%) of NHL patients, and 1/10 (10.0%), 5/10 (50.0%), and 1/10 (10.0%) of ALL patients, respectively. No significant differences were detected among each group compared with control subjects (1). Anti-HCV and HCV-RNA were detected in the serum of 4/33 (12.1%) NHL patients, but in none of the ten ALL patients. In contrast, none of the control subjects tested positive for both anti-HCV and HCV-RNA while 2/45 (4.4%) were positive for anti-HCV. Thus, the positive rate of HCV-RNA in NHL patients showed a tendency to be high compared with control subjects (1). GBV-C/HGV-RNA was not detected in the serum of lymphoproliferative disorders patients or control subjects (1). In NHL patients, the positive rate of anti-HCV was significantly higher than that of control subjects (2) ( P

Resection of distal gastric tube cancer with sentinel node biopsy: a case report and review of the literature

BackgroundThe frequency of gastric tube cancershas increased with advances in surgical techniques and improvement of survival rates in patients with esophageal cancer. However, a standard surgical treatment has not yet been established. Total resection of the gastric tube with lymphadenectomy has been considered a radical treatment, while repeat surgery with both laparotomy and thoracotomy has been associated with severe complications, including anastomotic leakage, recurrent nerve paralysis, bronchotracheal injury, and damage to other organs.Case presentationWe present a successful case of a gastric tube cancer that was treated with surgical resection in combination with sentinel node biopsy. The tumor was diagnosed as a type 0-IIc lesion with ulceration, and was located proximal to the pyloric ring. Endoscopic submucosal dissection was not indicated because the primary lesion was submucosally invasive, and undifferentiated. By the dye-guided method, sentinel nodes were detected along the right gastroepiploic artery and vein. Intraoperative pathological examination revealed no metastasis of the sentinel nodes. Resection of the distal gastric tube was safely performed with a Roux-en-Y reconstruction, preserving the right gastroepiploic artery and vein and the perfusion of the proximal gastric tube.ConclusionWe suggest distal resection of the gastric tube with sentinel node biopsy as a novel surgical method for a cT1N0 gastric tube cancer located in the abdomen.