[Proceedings: 38. Relation between the electrical potential gradient and the ion transport in the glandular cell membrane (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Imamura.
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Retention of pleural effusion after hepatectomy is an important complication that may affect the postoperative course. However, there are few reports on its pathogenesis or preventive measures. We evaluated the mechanism of the development of this complication and preventive measures against it. During the past 4-year period, hepatectomy was performed in 77 patients, of whom 64 underwent liver mobilization by transecting the hepatic ligaments. A fibrin sealant was sprayed on the cut surface of the hepatic ligaments in randomly selected 25 of the 64 patients to determine whether this application can prevent postoperative retention of pleural effusion. Post-operative pleural effusion was not observed in any patient treated by fibrin sealant spraying but was observed in 13 (30%) of the other 39 patients treated with this sealant (p < 0.05). In addition, none of the 23 patients in whom the liver was not mobilized during hepatectomy showed postoperative pleural effusion. These results suggest that severance of the hepatic ligaments is a major cause of pleural effusion, and application of a fibrin sealant to the undersurface of the diaphragm around the insertion of the liver ligaments is useful for preventing this complication.
Persistent human immunodeficiency virus (HIV) infection induces an immuno-suppressive state and therefore malignant tumors are a very common complication. Hepatocellular carcinoma is very rare, however, because it is associated with chronic liver disease by the persistent infection of hepatitis B or C virus (HBV or HCV). We reported a case of HCC with HIV infection who had no evidence of HBV or HCV infection, and that had a rapid growth and active pulmonary metastases. Pathological findings of the resected liver showed moderately differentiated HCC and no chronic liver disease. Despite efforts to find potential HBV integration in tumor and non-tumor tissue, none was observed. To our knowledge, this is the first report of HCC in HIV-infected patient with no evidence of hepatitis virus infection.
Mixed type hepatoma with two components, hepatocellular and cholangiocellular carcinoma, is very rare. We encountered a case of a single and minute mixed type hepatoma developing on liver cirrhosis in a patient with persistent hepatitis C viral infection. Histologically, the two-type cancer tissue existed in a nodule with a maximal diameter of approximately 20 mm, and the cholangiocellular carcinoma occupied about 70% of the tumor. The original cell of the mixed type hepatoma is unknown, but this case suggests that a bipotential cell developing into hepatocellular and cholangiocellular carcinoma may be the origin.