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Biomedical subjects

M Monden

Publications and source records attributed to M Monden.

At least 469 records · Page 26Linked to original sources
PubMed1980

Hemobilia after percutaneous transhepatic biliary drainage.

Hemobilia after the inception of percutaneous transhepatic biliary drainage (PTBD) has been reported as an uncommon, but sometimes fatal, complication. We examined the incidence, pathogenesis, and management of hemobilia in 94 patients who received PTBD. There were seven cases (7.4%) with transient and six (6.4%) with severe hemobilia; one patient (1.1%) of the latter group died. There was no correlation between hemobilia and hemostatic or hepatic insufficiency. Angiography during PTBD was performed in 47 patients, and abnormalities restricted to arterial changes were noted in nine (19.1%). All but one patient with hemobilia showed angiographic abnormalities. Our findings indicate that hemobilia occurs more often than has been suspected and that it is usually due to intrahepatic vessel injury rather than to hemorrhagic diathesis or hepatic insufficiency. The primary management of hemobilia consists of maintaining continuous patency of the drainage catheter.

Adult↗
PubMed1980

Hepatocellular carcinoma in a case of Dubin-Johnson syndrome treated successfully with right extended lobectomy.

A 57-year-old man with hepatocellular carcinoma and liver cirrhosis combined with Dubin-Johnson syndrome was successfully treated by extensive right hepatic lobectomy. While the preoperative serum bilirubin level is one of the criteria in determining the indication for radical hepatic resection, it does not play a decisive role in the case of combined Dubin-Johnson syndrome.

Bilirubin↗
PubMed1980

Wound coverage by a sheet of epidermal cells grown in vitro from dispersed single cell preparations.

Epidermal cells have been grown into multilayered sheets resembling full-thickness human epidermis using a new tissue culture technique. To evaluate their viability in an in vivo situation, such cells were transplanted under the kidney capsule and into a subcutaneous position in the nude mouse. In both locations cells survived and limited growth was observed. Maturation of the epidermal cells resulted in the appearance of keratohyalin granules and cell desquamation. To assess the potential use of tissue cultured cells for wound treatment in man, the same method was used to grow dog cells in vitro. Sheets of multilayered dog epidermal cells grown in vitro from a single cell suspension were used to cover fresh or granulating wounds. The epidermal cells transplanted in this way remained viable and wound coverage was achieved within 1 week. No clinical or histological signs of rejection of allograft tissue were observed during a 6-week period of observation.

Animals↗
PubMed1980

[Transhepatic biliary drainage as a method in the diagnosis and treatment of obstructive jaundice].

Percutaneous transhepatic biliary drainage was performed on eleven jaundiced patients, who had obstruction of the bile duct, in order to determine the exact site and nature of the obstruction and to alleviate the jaundice. In the present series, six patients were treated with external biliary drainage. Four of them received this treatment prior to radical surgery. In the remaining two cases the external drainage was a palliative procedure. In five patients, the drainage catheter was internalized through the obstructed bile duct (internal biliary drainage). One of these patients was subsequently treated with radical surgery. In two cases, the internal biliary drainage was palliative. In the two remaining cases, intraluminal selective irradiation was introduced via Iridium 192 flexible wires. Severe hemobilia occurred in one patient, who was successfully treated by lithotomy and "T" tube drainage. We conclude that the simplicity and low cost of these drainage procedures recommend them as extremely useful for the diagnosis and treatment of obstructive jaundiced patients.

Adult↗
PubMed1978

A role of anti-"LD" antibody in induction of active enhancement in rat heart allografts.

Heart allografts from S-D to Wistar rats pretreated with 5 x 10(7) spleen cells taken from donor strain 1 or 2 weeks before, survived indefinitely. Sera taken from the pretreated rats showed high lymphocytotoxic titers and obvious blocking activity against LMC of immunized Wistar spleen cells. Even though the sera were exhaustively absorbed with RBC, this blocking activity was not impaired, although CDC was reduced. The active prolongation of graft survival, therefore, correlates with the presence of anti-LD antibody.

Animals↗
PubMedDate not supplied

Treatment of 37 patients with anaplastic carcinoma of the thyroid.

BACKGROUND: Most patients with anaplastic carcinoma of the thyroid die within several months of diagnosis, and aggressive treatment is uncommon. We evaluated the effect of active multimodal treatment (surgery, radiotherapy, and chemotherapy) on this disease, including one patient treated with autologous bone marrow transplantation and high-dose chemotherapy. METHODS: The outcome was assessed in 37 patients with anaplastic thyroid carcinoma treated between 1971 and 1993. Patients without distant metastasis when initially seen underwent surgery followed by radiotherapy. From 1984, conventional radiotherapy was replaced by hyperfractionated radiotherapy. RESULTS: All but three patients died within 1 year of diagnosis. Patients with primary lesions less than 5 cm in diameter who had complete resection and radiotherapy survived significantly longer than the other patients, and hyperfractionated radiotherapy was effective for local control. CONCLUSION: Active multimodal therapy is indicated for early-stage anaplastic carcinoma of the thyroid.

Adult↗
PubMedDate not supplied

Contrast-enhanced MR imaging of intrahepatic cholangiocarcinoma: pathologic correlation study.

The authors describe the enhanced magnetic resonance (MR) imaging appearance of intrahepatic cholangiocarcinoma. The MR images of eight patients with intrahepatic cholangiocarcinoma who underwent MR examination within 3 weeks before partial hepatectomy were retrospectively studied. The MR images, including a dynamic study, were compared directly with pathologic and histologic findings. The peripheral region of the medullary subtype of cholangiocarcinoma, with many tumor cells, showed greater enhancement relative to liver parenchyma in the early phase. The peripheral region of the scirrhous subtype, with fewer tumor cells showed less enhancement in the early phase. In one patient, the thin rim of the medullary tumor showed less enhancement in the late phase, and this rim corresponded to the peripheral region of the medullary tumor with many tumor cells. The central region of tumors with a large amount of fibrous tissue showed prolonged enhancement in the late and delayed phases. The thin rim of liver parenchyma around the tumor showed less enhancement in the early phase and greater enhancement in the late phase; this rim corresponded to congestive liver parenchyma with dilated sinusoids. Intrahepatic cholangiocarcinoma shows various enhancement patterns, which depend on both the histologic subtype and the degree and distribution of fibrosis within the tumor.

Aged↗
PubMedDate not supplied

Experimental hepatic dysfunction: evaluation by MRI with Gd-EOB-DTPA.

To investigate the potential of gadolinium (Gd)-ethoxybenzyl (EOB)-diethylenetriamine-pentaacetic acid (DTPA) for evaluating liver function, chemically induced hepatitis animal models were studied. The rats in group 1 underwent intraperitoneal administration of 2.0 ml/kg and those in group 2 underwent intraperitoneal administration of .5 ml/kg of 50% (V/V) carbon tetrachloride (CCl4) solution. The rats in group 3 served as controls. For rats of each group, the signal intensity of the liver was measured on T1-weighted spin-echo MR images acquired before and until 60 minutes after an intravenous injection of Gd-EOB-DTPA. The remaining rats in each group underwent indocyanine green test, serologic examination, or measurement of prothrombin time. Liver enhancement was compared with results of the other examinations. The degree of liver enhancement with Gd-EOB-DTPA was decreased and the washout of contrast was prolonged in the CCl4-administered groups. In this animal model, both hepatic dysfunction and liver enhancement were dose-dependent. MRI with Gd-EOB-DTPA has the potential to evaluate hepatic function.

Animals↗
PubMedDate not supplied

MR imaging of mixed hepatocellular and cholangiocellular carcinoma.

Two patients with mixed hepatocellular and cholangiocellular carcinoma underwent partial hepatectomy after magnetic resonance (MR) imaging. Correlation is made with the histopathologic manifestations. In both cases the tumors showed relative low signal intensities on T1-weighted spin-echo (SE) images and high signal intensities on T2-weighted SE images. Dynamic MR imaging showed the enhancement from the periphery of the tumor to the inner area gradually and the enhancement continued into the delayed phase. With both cases fibrosis was marked in the inner area of the tumor compared to the peripheral area. The extent and degree of fibrotic tissue is considered to reflect the enhancement on dynamic MR imaging.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Transcatheter arterial embolization for metastatic liver tumors: a study in resected cases.

We evaluated histologically the effect of transcatheter arterial embolization (TAE) in five metastatic liver tumors from gastrointestinal cancer, which were resected at surgery or removed at autopsy after TAE. TAE was carried out with cubes of gelatin sponge; in 2 cases, iodized oil was used as peripheral embolic material. Histological examination revealed three tumors to be completely necrotized. Approximately 80% of the remaining two tumors were necrotic. Our data suggest that TAE holds promise in the treatment of metastatic liver tumor from gastrointestinal cancer.

Adult↗
PubMedDate not supplied

Hepatocellular carcinoma: efficacy of transcatheter oily chemoembolization in relation to macroscopic and microscopic patterns of tumor growth among 100 patients with partial hepatectomy.

PURPOSE: To evaluate the efficacy of transcatheter oily chemoembolization (TOCE) for hepatocellular carcinoma (HCC) on the basis of microscopic and macroscopic findings postembolization. METHODS: HCCs ranging in size from 0.5 to 13 cm (mean 3.6 cm) were obtained from partial hepatectomies of 100 consecutive patients who had undergone TOCE between 20 and 246 days (mean 59.5 days) prior to surgery. The efficacy of TOCE was assessed on the basis of the necrotic to live cell ratio of the tumors. The microscopic pattern of tumor growth was grouped into expanding type (complete capsule formation) and replacing type (incomplete or no capsule). There were five types of macroscopic groupings: single nodule, single nodule with extranodular growth (SNE), contiguous and noncontiguous multinodular, and massive growth type. RESULTS: Among 79 cases with the expanding type, 29 (37%) had 100% HCC necrosis, but none with 100% necrosis were in the replacing type. By macroscopic grouping, the efficacy of TOCE decreased from the single nodule type (50% of patients had 100% necrosis) to the SNE type (21%), and the other types (9%). CONCLUSION: TOCE appears to be most efficacious for HCC with the expanding growth pattern and HCC forming single nodules. Poor results are to be expected in HCC of replacing growth type and multinodular or massive growth types.

Carcinoma, Hepatocellular↗