H Ishikawa

Osaka Medical Center for Cancer and Cardiovascular Diseases, Ōsaka, Ōsaka, Japan

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Publications (25)106.25 Total impact

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    ABSTRACT: Pathologic diagnostic criteria for intrahepatic nonmalignant nodules using needle biopsy are controversial. To evaluate the cytodiagnostic criteria for dysplastic nodules using aspiration biopsy, a follow-up study of nonmalignant nodules was performed. Fifty-one intrahepatic nodules diagnosed histologically and cytologically as nonmalignant using an aspiration biopsy in 39 patients were followed up without treatment. The outcomes of the nodules were investigated using the Kaplan-Meier method and Cox's multivariate analysis. The cumulative rates of development to HCC at the 2nd year were 0%, 18%, and 53% in the non-dysplastic nodules, the low-grade dysplastic nodules, and the high-grade dysplastic nodules, respectively; and significant differences were seen among them (P= 0.0001). Multivariate analysis showed that cytologic grade was a significant risk factor for development to HCC (P=0.020). In conclusion, aspiration cytology was useful for diagnosis of the dysplastic nodules to predict risks of development to HCC.
    Journal of experimental & clinical cancer research: CR 10/2004; 23(3):425-31. · 1.50 Impact Factor
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    ABSTRACT: To determine whether the colonic epithelial proliferation rate is useful as a marker for colorectal cancer, we measured the Ki-67 labeling index (LI) in normal-appearing mucosa from the sigmoid and ascending colon in patients with two or more tumors (early cancers, which are defined as tumors the depth of invasion of which is limited to mucosal layer or submucosal layer, adenomas, or both). The association of baseline LI with the risk of development of colon tumors 2 years after endoscopic removal was assessed by cohort analysis. The presence of two or more tumors was defined as occurrence. One hundred and six specimens from the sigmoid colon and 130 from the ascending colon from 246 subjects (203 males and 43 females) were used for analysis. The patients with higher upper-third LI in the normal-appearing mucosa in the sigmoid colon, but not in the ascending colon, had significantly more tumors at follow-up colonoscopy 2 years later (risk ratio, 3.6; 95% confidence interval, 1.2-10.6). Moreover, multivariate analysis showed that it was an independent factor. We concluded that the higher upper-third Ki-67 LI of normal-appearing mucosa in the sigmoid colon indicates a high risk for colorectal cancer.
    Cancer Epidemiology Biomarkers &amp Prevention 10/2001; 10(9):925-30. · 4.56 Impact Factor
  • H Ishikawa, T Suzuki, T Ioka, T Otani
    Nippon rinsho. Japanese journal of clinical medicine 10/2000; 58 Suppl:325-9.
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    ABSTRACT: This study was designed to determine if the hepatocyte growth factor (HGF)-Met system is involved in the repair process of inflamed mucosa of ulcerative colitis (UC) and in the development of UC-associated colorectal cancer. HGF and c-met gene expressions were quantified in colonic mucosal specimens from healthy control subjects, patients with UC and patients with UC-associated colorectal cancer, using the competitive reverse transcription-polymerase chain reaction. Expression of HGF protein was determined by immunoblot analysis. Expression of c-Met protein was analyzed immunohistochemically. HGF and c-met gene expressions were increased in inflamed mucosa of UC, compared with control subjects. Gene expression of HGF was also increased in the surrounding inflamed mucosa of UC-associated cancers. In cases in which the HGF gene expression was increased, an apparent increase in protein levels of HGF in inflamed mucosa of UC were observed by immunoblot analysis. The c-met gene was overexpressed in UC-associated cancers and a high level of immunoreactivity of the c-Met protein was immunohistochemically detected within the cancer cells. We showed that HGF and c-met expression is increased in the inflamed mucosa of UC and that c-met is overexpressed in UC-associated colorectal cancers. These observations suggest HGF-Met system is involved in the repair process of the inflamed mucosa of UC and provide further support for the view that the inappropriate expressions of both HGF and c-met genes predispose to the development of colorectal cancer in patients with UC.
    Inflammation Research 08/2000; 49(7):320-4. · 1.96 Impact Factor
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    ABSTRACT: The aim of this study was to determine the characteristics of patients with chronic hepatitis C showing long-term normalization of alanine aminotransferase (ALT) without eradication of HCV RNA, as well as to investigate the incidence of hepatocellular carcinoma (HCC) in such patients. Four hundred and nineteen patients with histologically-proven chronic hepatitis C who had received interferon (IFN) therapy were studied. Complete response (CR) was defined as persistent normalization of ALT levels with eradication of serum HCV RNA (n= 126). Long-term biochemical response with positive HCV RNA (HCV-positive BR) was defined as a normal ALT level at 6 months after IFN therapy with further persistent normalization of ALT levels for 2 or more years without eradication of serum HCV RNA (n=49). All other patterns were classified as non-response (NR, n=244). Mean follow-up periods of CR, HCV-positive BR and NR groups were 4.9, 5.2 and 4.9 years, respectively. The HCV-positive BR group had significantly higher serum HCV RNA levels and a higher rate of HCV serological group 1 classification than the CR group. The other characteristics of the HCV-positive BR group were lower histologic activity, lower ALT levels, and a higher rate of females when compared with both the CR and NR groups. Histologic staging in the HCV-positive BR group was significantly lower than that in the NR group. Cumulative incidences of HCC estimated by the Kaplan-Meier method in both the CR and HCV-positive BR groups were significantly lower than those in the NR group (log-rank test, CR vs NR p<0.001, HCV-positive BR vs NR p=0.026). The patients with HCV-positive BR were virologically different from those with CR, and had lower ALT levels and histologic activity when compared to those with CR and NR.
    Liver International 08/2000; 20(4):290-5.
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    ABSTRACT: Because endoscopic en bloc resection of large, sessile colorectal polyps is technically difficult, they are usually resected piecemeal. However, piecemeal resection makes it difficult to evaluate the completeness of the resection histopathologically. In this study the efficacy of endoscopic piecemeal resection of large, sessile colorectal polyps was investigated after follow-up greater than 1 year. We removed 56 sessile colorectal polyps 2 cm or greater in diameter in 56 patients by using an endoscopic submucosal saline injection technique. Endoscopic examinations were repeated at 3, 6, and 12 months and longer after initial endoscopic resection. If no residual tumor was found endoscopically and histologically, the patient was considered to be "cured." Of the 56 polyps, 14 (25%) were resected en bloc, and 42 (75%) were resected piecemeal. Of the 42 patients treated with piecemeal resection, 23 (55%) required additional endoscopic or surgical interventions. In patients followed 1 year or longer after initial treatment, the cure rate by en bloc resection was 100% (14 of 14) and that by piecemeal resection was 83% (35 of 42). Arterial bleeding occurred in 4 patients (7%) during or after endoscopic resection. In 3 of them, bleeding was stopped by endoscopic clipping, but 1 patient required emergent laparotomy. Endoscopic piecemeal resection after submucosal saline injection with an intensive follow-up program is a safe and effective treatment for large, sessile colorectal polyps.
    Gastrointestinal Endoscopy 07/2000; 51(6):697-700. · 5.21 Impact Factor
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    ABSTRACT: We evaluated the usefulness of carcinoembryonic antigen (CEA) concentrations in colonic effluent as a high-risk marker for colorectal carcinoma (CRC). After 213 patients ingested 1,800 ml of a 5% isotonic solution of magnesium citrate, colonic effluent was collected from them before routine colonoscopy from February through June 1992. Of these patients, 27 who had undergone colonoscopy after a mean of 2.6 years were selected as subjects. The relationship between the CEA concentration in the colonic effluent and the occurrence of new colorectal tumors was examined. The CEA concentration in colonic effluent was adjusted on the basis of alkaline phosphatase activity. New colorectal tumors were noted significantly more frequently (P = .006) in patients with a high CEA level in colonic effluent (5 of 5; 100%) than in those with low a CEA level (6 of 22; 27%). The CEA concentration in colonic effluent is a simple and practical biomarker for identification of patients at high risk for CRC.
    Cancer Detection and Prevention 02/2000; 24(3):290-4. · 2.52 Impact Factor
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    ABSTRACT: We investigated the effect of antibiotics for the prevention of infectious complications subsequent to endscopic treatment of the colon and rectum. Thirty-three patients who underwent endoscopic polypectomies and/or hot-biopsies were divided into two groups: (A, n = 17) with and (B, n = 16) without prophylactic administration of antibiotics. The oral lavage solution method with isotonic magnesium citrate was used for bowel preparation. For group A, 250 mg of kanamycin was administered orally four times, at 30-min intervals, after the oral lavage solution of isotonic magnesium citrate was administered, and 3.2 g of clavulanic acid-ticarcillin was administered by drip infusion after the endoscopic treatment. Latent inflammatory reactions were assessed based on blood cell analysis, erythrocyte sedimentation rate, serum C-reactive protein, and serum phospholipase A2 activity before and the day after the endoscopic treatment. Postoperative platelet, white blood cell, and neutrophil counts were significantly increased in group B, while increases in these parameters were all suppressed in group A. These results suggested that bacterial infections developed subsequent to endoscopic surgery on the colon and rectum. Although we do not need to administer antibiotics to all patients, in patients at high risk of infection, such as those with leukemia or diabetes mellitus, endoscopic polypectomy or hot-biopsy of the colon and rectum should be performed with the administration of antibiotics.
    Journal of Infection and Chemotherapy 07/1999; 5(2):86-90. · 1.55 Impact Factor
  • Annals of the New York Academy of Sciences 02/1999; 889:244-6. · 4.38 Impact Factor
  • Annals of the New York Academy of Sciences 02/1999; 889:253-5. · 4.38 Impact Factor
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    ABSTRACT: To establish new criteria for cytodiagnosis of hepatocellular carcinoma by comparing cytologic findings of hepatocellular carcinoma with those of liver cirrhosis. Review of cytologic findings of hepatocellular carcinoma on preoperative aspiration biopsy of 31 lesions from 27 patients who underwent surgical resection and comparison of these findings with those of liver cirrhosis in 17 patients. In the 11 lesions of moderately and poorly differentiated hepatocellular carcinoma, significant cytologic findings included monotonous and abundant cytoplasm, thick cytoplasm, increased nuclear/cytoplasmic ratio, irregular nuclear contours, increased chromatin density, intranuclear vacuoles and naked nuclei. In the 20 lesions demonstrating well-differentiated hepatocellular carcinoma, significant cytologic findings included monotonous and scant cytoplasm, well-defined cytoplasmic borders, thick cytoplasm, eccentric nuclei, increased nuclear/cytoplasmic ratio, thick nuclear membranes and increased chromatin density. We established the criteria for moderately and poorly differentiated hepatocellular carcinoma as including three cytologic parameters: increased nuclear/cytoplasmic ratio, irregular nuclear contours and increased chromatin density. We also established the criteria for well-differentiated hepatocellular carcinoma as including six cytologic parameters: monotonous cytoplasm, scant cytoplasm, well-defined cytoplasmic borders, thick cytoplasm, eccentric nuclei and increased nuclear/cytoplasmic ratio. For all 31 hepatocellular carcinoma lesions, including 27 lesions that were < or = 2 cm in diameter, both sensitivity and specificity were 100% by concurrently employing both criteria. The new criteria for cytodiagnosis we established were useful for differentiating hepatocellular carcinoma from liver cirrhosis. In particular, our criteria ensured appropriate diagnostic accuracy for well-differentiated hepatocellular carcinoma.
    Acta cytologica 01/1999; 43(4):610-6. · 0.69 Impact Factor
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    ABSTRACT: The inhibitory effect of n-3 polyunsaturated fatty acids on human colorectal cancer has been speculated on from epidemiological data and animal studies. We conducted a long-term trial of docosahexanoic acid (DHA)-concentrated fish oil capsules for patients in a high-risk group for colorectal cancer. During this trial, we experienced three patients with familial adenomatous polyposis (FAP) diagnosed as having malignant lesions. Three patients with FAP and two patients with multiple (more than 30) colorectal polyps were administered DHA-concentrated fish oil capsules_Hlk427554600[2.2 g of DHA and 0.6 g of eicosapentanoic acid (EPA) per day] for one or two years. Compliance with DHA-concentrated fish oil capsules was more than 90% in four patients and 61% in one patient. A marked increase or decrease in the number of polyps was not observed. Three patients with FAP developed endometrial cancer after 12 months, colon cancer after 24 months and lung cancer after 12 months, respectively. All cancers were diagnosed at an early stage and were resected curatively. We thought that the possibility of developing cancer from the long-term administration of fish oil capsules to patients with FAP needs to be investigated further, and that we should report these cases.
    Japanese Journal of Clinical Oncology 01/1999; 28(12):762-5. · 1.90 Impact Factor
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    ABSTRACT: The pathogenesis of ulcerative colitis is unclear, but cytotoxic T lymphocytes infiltrating the mucosa have been implicated in mucosal damage. The Fas ligand (FasL), expressed on cytotoxic T lymphocytes, induces apoptosis in cells expressing Fas. To analyse FasL expression in affected colonic mucosa to ascertain Fas-FasL interaction in ulcerative colitis. FasL mRNA was quantified in colonic mucosal specimens from healthy subjects and patients with ulcerative colitis or Crohn's disease, using the competitive reverse transcription polymerase chain reaction. FasL mRNA localisation was determined by in situ hybridisation. Expression of Fas in colonic mucosa was analysed immunohistochemically. Phenotypes of lamina propria lymphocytes that expressed FasL were analysed by flow cytometry. FasL mRNA was strongly expressed in active ulcerative colitis lesions, but not in those associated with active Crohn's disease or active proctitis-type ulcerative colitis. In situ hybridisation showed that FasL mRNA expression occurred in mononuclear cells infiltrating lesions. Fas was expressed in epithelial cells in ulcerative colitis and Crohn's disease, and in normal subjects. Cytometry showed that FasL was expressed in CD3 lymphocytes infiltrating the lamina propria in active lesions. FasL is expressed in CD3 lymphocytes infiltrating into ulcerative colitis but not Crohn's disease lesions, suggesting that Fas-FasL induced apoptosis participates in the mucosal damage of ulcerative colitis.
    Gut 08/1998; 43(1):48-55. · 10.73 Impact Factor
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    ABSTRACT: The effect of interferon therapy on the incidence of hepatocellular carcinoma in chronic hepatitis C is poorly defined. To compare the incidence of hepatocellular carcinoma in interferon-treated patients with chronic hepatitis C to that of historical controls and to examine whether response to therapy is related to incidence of hepatocellular carcinoma in patients with chronic hepatitis C. Retrospective cohort study. One university hospital and seven university-affiliated hospitals. 419 consecutive patients with chronic hepatitis C who started interferon therapy between January 1992 and December 1993 (interferon group) and 144 patients with chronic hepatitis C who had liver biopsy between January 1986 and December 1989 and did not receive interferon (controls). Patients in the interferon group received human lymphoblastoid interferon, recombinant interferon-alpha2a, or recombinant interferon-alpha2b for 6 months. The end point was development of hepatocellular carcinoma on abdominal ultrasonography or computed tomography. Sustained response was defined as persistent normalization of alanine aminotransferase (ALT) levels during interferon therapy and follow-up. Relapse was defined as a normal serum ALT level at the end of treatment with an increase to an abnormal level after cessation of treatment. Nonresponse included all other ALT patterns. Median follow-up in the interferon and control groups was 47.6 and 46.8 months, respectively. During follow-up, hepatocellular carcinoma was found in 28 interferon-treated patients and 19 controls. Cox proportional hazards regression analysis that included all patients revealed that interferon therapy (P=0.041), older age (P=0.003), greater histologic activity (P=0.029), and higher histologic stage (P=0.049) were independent factors associated with the development of hepatocellular carcinoma. The risk ratios for development of hepatocellular carcinoma in patients with sustained response, relapse, and nonresponse were 0.06 (95% CI, 0.01 to 0.46), 0.51 (CI, 0.20 to 1.27), and 0.95 (CI, 0.48 to 1.84), respectively, compared with controls. The incidence of hepatocellular carcinoma was lower in patients with sustained response to interferon therapy than historical controls and nonresponders. Interferon therapy may decrease the risk for hepatocellular carcinoma in patients with chronic hepatitis C.
    Annals of internal medicine 08/1998; 129(2):94-9. · 13.98 Impact Factor
  • Gastrointestinal Endoscopy 04/1998; 47(3):305-7. · 5.21 Impact Factor
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    JNCI Journal of the National Cancer Institute 10/1997; 89(18):1381. · 14.34 Impact Factor
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    ABSTRACT: There is presently no consensus on how long treatment of gastric ulcers should be continued to prevent ulcer recurrence. Therefore, we investigated the histologic state of healing, and the recurrence of gastric ulcers with Helicobacter pylori infection classified by gastric mucosal microvascular architecture as completely and incompletely healed. We obtained biopsy specimens from healed gastric ulcers in 71 patients who had been treated for eight weeks with omeprazole. The gastric mucosal microvascular architecture of the biopsy specimens was observed by the alkaline phosphatase staining method. We found a significant correlation between the mucosal microvascular architecture in the biopsy specimens and the histologic state of ulcer healing Recurrences were significantly more frequent in ulcers classified by microvascular architecture as incompletely healed than in completely healed ulcers. Observing the microvascular architecture of healed gastric ulcers is very useful for judging the state of healing, and therapy should be continued until ulcers are classified by this method as completely healed.
    Hepato-gastroenterology 01/1996; 43(10):866-872. · 0.77 Impact Factor
  • H Ishikawa, I Akedo, T Suzuki, T Otani, T Sobue
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    ABSTRACT: We established a protocol for an interventional randomized controlled trial for prevention of colorectal cancer by attaching special importance to feasibility. The subjects were patients with multiple colorectal tumors. Two regimens were formulated for prevention of colorectal cancer. One was dietary guidance alone (Regimen I), and the other was dietary guidance plus eating wheat bran biscuits (Regimen II). The main end points of the trial were examinations for recurrence of colorectal tumors after 2 and 4 years. The target number of patients was 200 in total, i.e. 100 for each group. During the 18 months from the beginning of recruiting of subjects (up to November 1994), 28 (97%) of the 29 patients recruited for Regimen I and 32 (97%) of the 33 patients recruited for Regimen II agreed to participate in the trial. The trial progressing well.
    Japanese journal of cancer research: Gann 09/1995; 86(8):707-10.
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    ABSTRACT: Ultrasonography should be used for screening of hepatocellular carcinoma, but there are few reports on the relationship between liver ultrasonographic findings and the development of hepatocellular carcinoma (HCC). Using prospective follow-up studies, we examined the role of liver with a hypoechoic nodular pattern as a high-risk factor in HCC. The study was performed by follow-up on 593 patients with chronic liver disease recorded at our hospital. The ultrasonographic pattern of the liver parenchyma was classified either as a small or large hypoechoic nodular pattern or as a nonnodular pattern. Patients were followed up from the time of initial ultrasonographic examination (1985-1987) until January 1, 1991. During the follow-up period (average, 4.2 years, range, 0.3-6.0 years), 62 patients were found to have HCC (12%). Patients whose livers showed small or large hypoechoic nodular pattern had a significantly higher risk of HCC than did patients whose livers showed a nonnodular pattern (rate ratios were 14.0 and 20.0, respectively, adjusted for age, sex, hepatitis virus markers, ICG R15, alpha-fetoprotein concentration, and ultrasonographic pattern of the liver). Liver showing a hypoechoic nodular pattern is a major risk factor in HCC.
    Gastroenterology 07/1995; 108(6):1778-84. · 12.82 Impact Factor
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    ABSTRACT: Effects of rat and porcine galanin on rat intestinal ion transport were examined in vitro. In the rat distal colon, a sustained increase in short-circuit current (Isc) was produced by the serosal addition of rat galanin at a concentration as low as 10(-9) M, and a maximal increment was observed at 10(-7) M. Porcine galanin was approximately 100 times less potent than rat galanin. In the rat jejunum, rat galanin produced only a slight and transient decrease in basal Isc. The response to rat galanin was not influenced by atropine, hexamethonium, or amiloride, but was virtually abolished by tetrodotoxin or furosemide. Rat galanin did not significantly influence the increase in Isc elicited by electrical field stimulation in the rat colon and jejunum. Transmural unidirectional 22Na and 36Cl fluxes in the rat colonic mucosa were measured under short-circuited conditions, and rat galanin significantly decreased net sodium and net chloride absorption. These findings suggest that galanin acts as a secretory modulator in the rat colon via noncholinergic neural transmission.
    The American journal of physiology 11/1992; 263(4 Pt 1):G502-7. · 3.28 Impact Factor

Publication Stats

437 Citations
106.25 Total Impact Points


  • 1995–2001
    • Osaka Medical Center for Cancer and Cardiovascular Diseases
      Ōsaka, Ōsaka, Japan
  • 2000
    • Osaka University
      • Department of Integrated Medicine
      Ōsaka-shi, Osaka-fu, Japan
  • 1999
    • Japan Research Institute
      Ōsaka, Ōsaka, Japan