Hiroyuki Ogata

Viral and host factors that contribute to efficacy of interferon-α2a therapy in patients with chronic hepatitis C

Using conventional statistical analysis and multiple regression analysis, we investigated the viral and host factors that influence the response to recombinant interferon-α2a therapy in patients with chronic hepatitis C. A total of 36 patients was randomly assigned to three administration schedules, 12 patients in each. Response to treatment was set as the criterion variable. Four variables were statistically significant in the conventional method in predicting a good therapeutic outcome: HCV genotype III and IV, lower histology activity index (HAI) score for liver, higher total dose of interferon administration, and lower serum HCV RNA concentration. In multiple regression analysis, a combination of the above four variables resulted in a higher multiple correlation coefficient (R=0.84,P<0.0001) using a stepwise method. Of those four, HCV genotype had the highest absolute value of standard partial regression coefficient (0.51). The HCV RNA concentration was correlated with HCV genotype and HAI score, whereas HCV genotype and HAI score showed no correlation. Thus, HCV RNA concentration was not statistically significant in multiple regression analysis. These findings indicate that HCV genotype, HAI score, and schedule of administration can be important predictors of the response to interferon therapy.

Epitope analysis of SPan-1 and DUPAN-2 using synthesized glycoconjugates sialyllact-N-fucopentaose II and sialyllact-N-tetraose

Epitope analysis of Span-1 and DUPAN-2 was compared with that of CA19-9 using the synthesized glycoconjugate sialyllacto-N-fucopentaose II (SLF11, sialyl-Lewisc) and its precursor, sialyllact-N-tetraose (LSTa, sialyl-Lewis”), conjugated to human serum albumin. The CA19-9 and DUPAN-2 assay systems specifically recognized SLF II and LSTa, respectively. The Span-1 assay system recognized both SLF IIIand LSTa, although the reactivity with the former was far stronger than that with the latter. These results were, in general, compatible with those obtained from assaying these markers in the sera of two pancreatic cancer patients with definite Lewis-negative phenotype and in the sera of 39 CA19-9-negative pancreatic cancer patients. In conclusion, DUPAN-2 is the precursor of CA19-9 and is accumulated in the sera of pancreatic cancer patients with Lewis-negative phenotype and Span-1 has an advantage over CA19-9 in the diagnosis of patients with Lewis-negative phenotype, although both markers have almost the same sensitivity for this malignancy.

Pigmented dermatofibrosarcoma protuberans: report of two cases as a variant of dermatofibrosarcoma protuberans with partial neural differentiation

Two cases of so-called Bednár tumor are reported. The histopathological finding of a typical storiform pattern composed of fusiform tumor cells resembled dermatofibrosarcoma protuberans (DFSP) except for the presence of melanin-containing cells scattered within the lesion. Ultrastructurally, the predominant tumor cells in case 1 possessed extensive cytoplasmic processes, convoluted nuclei, and intercellular junctions, but lacked basal lamina. Melanocytic tumor cells contained melanosomes and were surrounded by basal lamina. Immunohisto-chemical examinations revealed a positive reaction for S-100 protein and neuron-specific enolase in the pigment-laden cells. Consequently, these two tumors were considered to be a variant of DFSP with partial neural differentiation.

Three cases of early stage carcinoma of the gallbladder

SummaryThree cases of early stage carcinoma of the gallbladder are reported. In two cases, radiolucent shadow was demonstrated on cholecystogram. The masses were papillary adenomas with foci of adenocarcinoma. In the third case, the cholecystogram did not reveal particular findings except for shadows of numerous tiny gallstones. The malignancy was completely unexpected clinically, even after gross inspection of the organ. It was an incidental finding of microscopic examination, which disclosed abundant Rokitanskγ-Aschoffs sinuses associated with foci of cytologically malignant cells in the muscular layer. It was explained as malignant change of epithelium on one of the sinuses.All three patients underwent simple cholecystectomy. So far they have been free from evidence of metastasis or recurrence. The diagnosis and treatment of early carcinoma of the gallbladder are discussed.

Glycolipid of human pancreatic cancer; the appearance of neolacto-series (type 2 chain) glycolipid and the presence of incompatible blood group antigen in tumor tissues

Glycolipid isolated from normal and cancerous human pancreatic tissues were characterized chemically and immunologically. The major neutral glycolipids in both normal and cancerous tissues were composed of globo-series glycolipids and lacto-series glycolipids. The mole percentage of fucolipids in the total neutral glycolipids of normal tissues was 20-40%, and in general the fucolipids corresponded to blood group glycolipids related to the patients blood group, however, in cancerous tissues the amount of these fucolipids was decreased. Immunostaining revealed that normal tissues contained only lacto-series (type 1 chain) glycolipids. In contrast, cancerous tissues contained the neolacto-series (type 2 chain) glycolipids as well as the lacto-series glycolipids. Incompatible blood group antigens, A active glycolipids in a blood type O patient and B active glycolipids in a blood type A patient, were also detectable in the neutral glycolipid fractions of the pancreatic cancer tissues.

Red cell transfusions after service hours in a national university hospital.

Many national university hospitals in Japan do not provide physicians with transfusion service at night and on holidays. Physicians in charge are responsible for examination of blood. In this study, we analyzed the cases of red cell transfusion after service hours in our national university hospital for six months, and evaluated what could be done by a limited number of personnel.On average there was an episode of such transfusion every 2.1 days (85 times for 80 patients). Episodes belonged to two groups: the first was 34 operation-unrelated transfusions (8 out- and 26 inpatients), and the second was 51 episodes related to surgical operation, including three subgroups: 19 transfusions during or after scheduled operation, 21 for non-gynecologic emergency operation, and 11 for caesarian section which required actually no transfusion. Massive transfusion was necessary for surgery of aortic aneurysms (3/4), ischemic heart diseases (3/3) and tumors of vertebral column (2/3), and for patients of terminal cancer (1/4). Type and screen and an on-call system for massive transfusion of more than 5 units would have helped physicians in about 70% of cases (52/74).