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  • 1
    Electronic Resource
    Electronic Resource
    Analysis of anxiety in cancer patients: The effects of telling the truth (1996)
    Springer
    International journal of clinical oncology 1 (1996), S. 113-117 
    Details
    ISSN: 1437-7772
    Keywords: anxiety ; cancer ; cancer disclosure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background The mental distress suffered by cancer patients after telling them the truth about their diagnosis, is one of the main reasons why disclosure of cancer is not becoming more common in Japan. Using the State-Trait Anxiety Inventory (STAI), a self-rating scale, we assessed the anxiety level among cancer patients given information about their disease. Methods One hundred and sixty-one patients were solicited for participation in this study and complete answers to the Inventory were obtained from 118 patients. The STAI was administered twice, on the day of admission and after a precise explanation of the patient's disease, and was later compared. The information the patients had been given about their disease prior to admission, and the later explanations from the 8 attending physicians, given at the time of informed consent to treatment, were reviewed. The patients were divided into the following 4 groups according to the explanations given by the doctors; (1) 32 patients needed treatment for benign diseases, (2) 18 patients (all had cancers of digestive organs) were told euphemistically that they had tumors that required treatment, (3) 23 patients were newly diagnosed with cancer after admission, and (4) 41 patients had the same diagnosis of cancer as they had before admission. The remaining 4 patients were excluded because of an incorrect diagnosis. Results Many patients showed high State (43–72%) and Trait (21–46%) anxiety levels on admission. There was, however, no difference in the STAI scores between the 4 groups. The State anxiety scores in most of the patients with benign diseases were reduced to the normal range after explanation. Scores for those patients told euphemistically about their condition were also decreased significantly after admission, but their overall anxiety levels were still high. The patients diagnosed with cancer before admission and those newly diagnosed showed no significant changes in their STAI scores. Conclusion Anxiety remains high in cancer patients after clear or even euphemistic disclosure of cancer. This study demonstrated that giving patients an ambiguous explanation about their disease did not bring about additional emotional stability, and the anxiety already present did not get worse, even when the diagnosis was changed from tumors with the possibility of cancer to definite cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02348277
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  • 2
    Electronic Resource
    Electronic Resource
    Extensive liver metastasis of gastric cancer effectively treated by hepatic arterial infusion of 5-fluorouracil/cisplatin (2000)
    Springer
    Gastric cancer 3 (2000), S. 110-115 
    Details
    ISSN: 1436-3305
    Keywords: Key words Gastric cancer ; 5-Fluorouracil ; Cisplatin ; Hepatic arterial infusion ; Pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Most gastric cancer patients with jaundice caused by extensive liver metastasis show no tumor shrinkage response to systemic chemotherapy, while often showing severe adverse reactions. Their prognosis is very poor. We experienced two patients for whom hepatic arterial infusion (HAI) of 5-fluorouracil (5-FU) and cisplatin through an implantable port was effective for treating extensive liver metastasis. One patient had jaundice (serum bilirubin level before HAI therapy, 12.4 mg/dl) caused by metachronous liver metastasis, and prior systemic chemotherapy with 5-FU and irinotecan had not been effective. The other patient had gastric cancer with synchronous liver metastasis and also exhibited jaundice (serum bilirubin level before HAI therapy, 11.8 mg/dl). Both patients were treated with HAI of cisplatin, 20 mg/m 2 for 30 min on day 1, and continuous intraarterial infusion of 5-FU, 300 mg/m 2 , from day 1 to day 4 every week. Their metastatic liver tumors were significantly reduced in volume and the jaundice disappeared. They survived for 30 and 27 weeks, respectively. A pharmacokinetic study conducted during the period of partial remission revealed that the extraction ratios of 5-FU and cisplatin in the liver were 0.89 and 0.024, respectively, suggesting a favorable first-pass effect of 5-FU. Although our findings here suggest that the successful local control of liver metastasis could improve the deteriorated condition and prolong the survival in some patients with far advanced cancer, it is essential to pay much attention to possible adverse effects during the treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011695
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  • 3
    Electronic Resource
    Electronic Resource
    Evaluation of endoscopic injection sclerotherapy with and without simultaneous ligation for the treatment of esophageal varices (1999)
    Springer
    Journal of gastroenterology 34 (1999), S. 159-162 
    Details
    ISSN: 1435-5922
    Keywords: Key words: EIS ; EVL ; esophageal varix ; combination method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: For more effective and simple endoscopic injection sclerotherapy (EIS) for esophageal varices, we developed an EIS procedure with ligation (EISL) that is non-invasive, in which EIS and endoscopic variceal ligation (EVL) are performed simultaneously. In this study, we compared EISL and EIS in a randomlized sample of patients (n = 14 for each procedure). For EISL, EVL was performed, including the injection site, after the injection of 5% ethanolamine oleate with iopamidol (EOI) into a varix. The mean number of treatment sessions required for eradication of esophageal varices was 2.3 ± 0.5 for EISL and 3.9 ± 0.8 for EIS (P 〈 0.001); the mean number of treatment sites was 6.2 ± 2.2 for EISL and 14.0 ± 5.0 for EIS (P 〈 0.001); the mean total amount of EOI used was 13.8 ± 5.2 ml for EISL and 26.3 ± 9.8 ml for EIS (P 〈 0.001). There were no significant differences in rates of recurrence of varices or in bleeding between the two groups. For EISL, fewer treatment sessions and less sclerosant were sufficient, probably because the sclerosants were more effective due to the blockage of variceal blood flow by the ligation. This method should provide a novel modification of EIS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005350050237
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  • 4
    Electronic Resource
    Electronic Resource
    Circulating vascular endothelial growth factor (VEGF) is a possible tumor marker for metastasis in human hepatocellular carcinoma (1998)
    Springer
    Journal of gastroenterology 33 (1998), S. 376-382 
    Details
    ISSN: 1435-5922
    Keywords: Key words: circulating VEGF ; hepatocellular carcinoma ; metastasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Vascular endothelial growth factor (VEGF) is closely related to angiogenesis in various human cancers. However, little is known of its circulating levels in hepatocellular carcinoma (HCC). We examined circulating VEGF levels in chronic liver disease to assess their clinical significance. Plasma VEGF concentrations were determined, by enzyme immunoassay, in patients with chronic hepatitis (CH; n = 36), liver cirrhosis (LC; n = 77), and HCC (n = 86) for a cross-sectional study. Plasma VEGF levels in healthy controls (n = 20) and CH, LC, and HCC patients were 17.7 ± 5.4 (mean ± SD), 30.6 ± 22.8, 34.4 ± 27.0, and 51.1 ± 71.9 pg/ml, respectively. The levels were significantly elevated in the HCC group, compared with the control, CH, and LC groups. Plasma VEGF levels in stage I, II, III, IVA, and IVB HCC patients were 27.6 ± 16.1, 26.5 ± 13.7, 35.8 ± 15.3, 45.4 ± 39.4, and 103.1 ± 123.2 pg/ml, respectively. The stage IVB patients with remote metastasis showed significantly marked elevation compared with the patients at the other stages. Platelet numbers were weakly correlated with plasma VEGF levels in the HCC group. Plasma VEGF level was highly elevated in patients with HCC, particularly those with metastatic disease. We consider that plasma VEGF is a possible tumor marker for metastasis of HCC. Circulating VEGF may be derived mainly from the large burden of tumor cells, and partly from platelets activated by the vascular invasion of HCC cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005350050099
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  • 5
    Electronic Resource
    Electronic Resource
    Immunohistochemical study of the distribution of intercellular adhesion molecule-1 and lymphocyte function-associated antigen-1 in chronic type B hepatitis (1994)
    Springer
    Journal of gastroenterology 29 (1994), S. 164-171 
    Details
    ISSN: 1435-5922
    Keywords: adhesion molecule ; intercellular adhesion molecule-1 ; lymphocyte function-associated antigen-1 ; hepatitis B virus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The expression of intercellular adhesion molecule-1 (ICAM-1) and lymphocyte function-associated antigen-1 (LFA-1) in the livers of 11 patients with chronic hepatitis B was studied immunohistochemically by light and electron microscopy to clarify the role of these adhesion molecules in tissue damage in chronic hepatitis B. On hepatocytes, ICAM-1 expression was confined to the bile canalicular surface when the liver inflammation was mild. In contrast, when the liver inflammation was severe, ICAM-1 was distributed on the entire surface of the hepatocyte, including the sinusoidal and lateral membranes; lymphocytes which were mostly positive for LFA-1, were often observed invading deeply among these hepatocytes. The degree of ICAM-1 expression on the hepatocytes was also related to the expression of HLA class 1 antigen. In liver showing diffuse expression of ICAM-1 on the hepatocytes, strong expression of HLA class 1 antigen was observed, and amounts of HBV in the liver were decreased. Diffuse expression of ICAM-1 and HLA class 1 antigen was mostly observed after acute exacerbation of liver inflammation. These results suggest that the ICAM-1/LFA-1 pathway is involved in the immunological mechanism, responsible for liver cell damage in chronic hepatitis B.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02358678
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  • 6
    Electronic Resource
    Electronic Resource
    Localization of hepatitis C viral RNA and capsid protein in human liver (1993)
    Springer
    Digestive diseases and sciences 38 (1993), S. 882-887 
    Details
    ISSN: 1573-2568
    Keywords: Hepatitis C virus ; type C chronic hepatitis ; hepatitis C virus RNA ; hepatitis C virus capsid protein ; in situ hybridization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the livers of patients whose sera contained antibodies to C100-3 antigen (anti-HCV) and hepatitis C virus (HCV) RNA, the presence of HCV RNA and HCV capsid protein (CP) antigen was demonstrated byin situ hybridization and immunohistochemistry, respectively. It was found that occasional hepatocytes in four of ten livers from patients whose sera were positive for both anti-HCV and HCV RNA hybridized with antisense as well as sense oligonucleotide DNA probes, whereas the probes did not hybridize with livers from patients whose sera were negative for anti-HCV and HCV RNA. Monoclonal antibody against a synthetic oligopeptide with amino acid sequence of HCV CP reacted with occasional hepatocytes in six of 14 livers from patients whose sera contained these HCV markers, but not with livers from patients whose sera were negative for both of them. These results suggest that HCV proliferates within hepatocytes since both antisense and sense probes hybridized with cytoplasm of the hepatocytes and that the virus matures in the cytoplasm as the capsid proteins were also found in the hepatocytes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01295915
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