Postoperative changes in protein-induced vitamin K absence or antagonist II levels after hepatectomy in patients with hepatocellular carcinoma: relationship to prognosis.

BACKGROUND: alpha-Fetoprotein (AFP) has been used as a marker for hepatocellular carcinoma (HCC). However, AFP levels are often high in patients with chronic hepatitis or cirrhosis. Protein-induced vitamin K absence or antagonist II (PIVKA-II) is more sensitive for the diagnosis of HCC and prediction of patient survival. Changes in these markers after treatment may reflect treatment curability and patient outcome. METHODS: We conducted a retrospective analysis of prognosis of 63 HCC patients with high preoperative levels of AFP and PIVKA-II who underwent hepatectomy and examined the relationship between postoperative changes in both markers at 1 month and patient survival. Subjects were divided into three groups according to changes in these tumour markers after hepatectomy: normalization (N) group, decreased but still above the normal level (D) group and unchanged (U) group. RESULTS: There were no significant differences in the numbers of patients who developed tumour recurrence between changes in AFP and PIVKA-II. Survival analysis showed no significant differences in tumour-free and overall survivals between groups with respect to AFP level. The PIVKA-II-N group showed significantly better tumour-free and overall survival compared with the D and U groups (p<0.01). Multivariate analysis that included other prognostic factors identified changes in PIVKA-II level as a significant and independent prognostic factor associated with overall survival. DISCUSSION: Although changes in AFP did not correlate with patient prognosis, normalization of PIVKA-II was significantly associated with good patient survival after hepatectomy. Normalization of PIVKA-II after hepatectomy reflected the efficacy of treatment and is a suitable predictor of prognosis in HCC patients.

A new volumetric evaluation of partial splenic embolization for hypersplenism in biliary atresia.

BACKGROUND/PURPOSE: Partial splenic embolization (PSE) has become an important therapeutic modality in the management of hypersplenism in biliary atresia (BA). Fifty percent to 80% of spleen is usually devascularized by embolization. The functional outcome, however, has not been correlated with embolized volume of the spleen. The authors propose a new, reliable method of predicting functional outcome using nonembolized volume of the spleen (NEVS) as an index. METHODS: Between January 1993 and July 2000, 11 children with BA (2 boys and 9 girls, aged 5 to 10 years) underwent 12 PSE procedures. The follow-up period ranged from 6 to 77 months. The NEVS was calculated by enhanced computed tomography (CT) images, and an index was calculated by dividing NEVS with the predicted splenic volume for body weight (standardized NEVS ratio) 2 weeks after PSE. RESULTS: Splenic volumes before PSE ranged from 312 to 1,201 cm(3) (mean, 875.8 cm(3)). NEVS ranged from 140 to 485 cm(3) (mean, 340 cm(3)). Standardized NEVS ratio ranged from 2.21 to 7.22 (mean, 4.25). The platelet counts with standardized NEVS ratio below 5.0 (group I) and above 5.0 (group II) were 15.1 x 10(4)/mm(3) and 7.2 x 10(4)/mm(3) at 6-month follow-up, respectively. CONCLUSIONS: (1) Nonembolized volumetric evaluation is useful in predicting the functional outcome of PSE. (2) Reembolization is indicated for the patients with standardized NEVS above 5.0.

T cells are necessary and critical for xenograft rejection in new concordant cardiac xenotransplant model.

BACKGROUND: A new vascularized concordant xenotransplant model using the Chinese hamster as donor and mouse as recipient species is reported. This model takes advantage of the wealth of informative immune reagents and knockout and transgenic backgrounds available for the mouse. METHODS: Heterotopic auxillary cardiac transplantation was performed. The mean survival time was assessed by daily palpation. Xenoreactive antibody production was measured by flow cytometry, and cardiac xenografts were examined by light microscopy. RESULTS: The tempo of xenograft rejection in this model is consistent with concordant species combination. IgM and IgG3 responses were not critical for the concordant xenograft rejection. Long-term survival (>100 days) of the concordant cardiac xenografts was observed without any immunosuppression in nude mice. Reconstitution of nude mice with CD3+ T cells induced the xenograft rejection in 5.7 days (P<0.01). CONCLUSION: This new concordant cardiac xenotransplant model demonstrates that T-dependent xenogeneic immune response is necessary and critical for the xenograft rejection.

[Detection of chromosomal aberration using fluorescence in situ hybridization in DNA diploid colorectal carcinomas].

Numerical aberrations of chromosomes can be detected by fluorescence in situ hybridization (FISH), using chromosome-specific probes. It is possible to observe this in solid tumors from which it is very difficult to obtain metaphase nuclei. The present study employed surgical specimens from 15 cases of colorectal carcinoma, all of which showed DNA diploidy. In the same samples, we analyzed chromosomal numerical aberration by FISH according to the method of Pinkel et al. Biotinylated DNA probes specific to chromosome #7, #11 and #17, were used. The hybridization spots were observed by fluorescent microscopy. As a result, the numerical aberrations of chromosomes detected by FISH were found in DNA diploid cases by FCM. They were trisomy and monosomy. These results indicate that FISH is useful to detect the chromosomal aberrations of DNA diploid cases.