The natural course for liver cancer.
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Breast Neoplasms↗
Biomedical subjects
S Bengmark
Publications and source records attributed to S Bengmark.
Temporary dearterialization combined with intra-arterial infusion of oncolytic drugs in the treatment of liver tumors.
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Antineoplastic Agents↗
Ethanol-induced microaggregate formation in pig and rabbit blood. An in vitro study.
Increased microaggregate formation was found after mixing ethanol with blood from pig and rabbit in vitro, measured with Swank's Screen Filtration pressure method. Final ethanol concentrations were in the range found in ethanol-intoxication in man. No rise in SFP was noticed when plasma with 10,000 platelets/microliter was used. It is therefore doubtful that altered plasma proteins caused the rise in SFP. It is suggested that if a direct effect of ethanol upon platelet aggregation exists in vivo, it may be of importance in acute ethanol intoxication and in chronic alcoholism.
Alcoholic Intoxication↗
Total pancreatectomy for cancer. An appraisal of 65 cases.
Sixty-five patients operated with total pancreatectomy were reviewed with respect to factors influencing operative mortality and morbidity, long-term survival, and metabolic sequelae. The diagnoses were pancreatic cancer in 58 patients, periampullary cancer in three, cancer of the bile duct in two and leiomyosarcoma of the duodenum and cystadenocarcinoma of the pancreas in one patient, respectively. In nine of the 58 cases with cancer of the caput, the histological examination revealed multicentricity of the tumor. In 44%, there were signs of degeneration and fibrosis in the distal part of the gland. Hospital mortality was 23% for the entire series. After 1970 the hospital mortality was 17%, and among patients operated by senior surgeons especially trained in pancreatic surgery, the hospital mortality was 12% during the whole period. The peroperative bilirubin levels seemed to influence survival time. Among 24 patients operated before 1975 in whom the operating surgeon judged the operation as radical, a five year survival of 21% was recorded. In patients without detectable lymph node metastases, the mean survival time was 25 months. The postoperative exocrine insufficiency and diabetes were possible to control. A blood sugar level above 10 micromol/l was found to significantly decrease the frequency of hypoglycemic attacks. Total pancreatectomy appears to be the surgical procedure preferred when radical treatment is selected.
Aged↗
Influence of physiological saline, dextran 70, hydroxyethyl starch, degraded gelatin, and fat emulsion solutions on screen filtration pressure.
The effect of 0.9% NaCl solution, dextran 70, hydroxyethyl starch, degraded gelatin and fat emulsion on Hb, Hct, platelet count and screen filtration pressure has been studied in the rabbit. Dextran 70, hydroxyethyl starch and degraded gelatin caused hemodilution and decreased platelet count. Screen filtration pressure increased after infusion of degraded gelatin and tended to decrease after dextran 70 and hydroxyethyl starch. 0.9% NaCl and fat emulsion caused less pronounced changes. Intraportal infusion of 7 ml/kg body weight of the same solutions gave results which at present are difficult to interpret.
Animals↗
Heme catabolism in liver cirrhosis with portal hypertension after shunt surgery.
Endogenous production of carbon monoxide (VCO), total and direct reacting serum bilirubin (TSB, DRB) were determined in 26 patients with liver cirrhosis and portal hypertension to evaluate the effect of various shunt operations on total heme catabolism. The material was divided into 3 groups. In group I, 11 patients not operated upon, mean VCO (+/- S.D.) was 18.4 +/- 6.0 micronmol/mmol total body heme per day (reference value 12.6 +/- 2.9). In group tii, 7 patients operated upon with subcutaneous transposition and a subtotal resection of the spleen, mean VCO (14.4 +/- 4.7) was not significantly raised. In group III, 8 patients operated upon with a modified distal splenorenal shunt, the highest mean VCO (26.1 +/- 9.0) was found. Mean TSB in the three groups was 34.8 +/- 29.2, 11.2 +/- 3.0, and 46.4 +/- 41.0 micronmol/l, respectively, and mean DRB 18.2 +/- 20.8, 3.7 +/- 1.0, and 26.8 +/- 34.1 micronmol/l, respectively. Estimated from preoperative laboratory values there was no difference in liver function between the three groups. The conclusion drawn is that heme catabolism, increased by 50% in liver cirrhosis complicated by portal hypertension probably due to a slight decrease in erythrocyte survival, tends to normalize after subcutaneous transposition and subtotal resection of the spleen. After spleno-renal shunting, on the other hand, a further increase in heme catabolism is seen. And so the increase in serum bilirubin often seen after the latter type of surgery is mainly related to a raised bilirubin production and not to a further decrease in liver function.
Adult↗
Staging laparotomy with splenectomy in Hodgkin's disease.
The series includes 91 patients with Hodgkin's disease who underwent a staging laparotomy with splenectomy during the years 1971-1976, in 82% of them as part of the initial evaluation before therapy. Positive abdominal lymph nodes were found in 29% of the patients, a positive spleen in 37%, and a positive liver in 10%. Follow-up of patients who lacked abdominal involvement at laparotomy indicate that sampling error was only of marginal importance. Evaluation of the therapeutic implications of the operation indicated that 41% of the patients benefited from the procedure; 31% by changing stage and 10% by changing radiation therapy port. Five patients had minor surgical complications. The mortality rate was nil.
Abdominal Neoplasms↗
[Subcutaneous transposition of the spleen: an experimental and clinical study (author's transl)].
The growing scepticism about the use of portocaval anastomosis operations to prevent renewed bleeding of esophageal varices has led to the testing of new methods. This report describes subcutaneous transposition of the resected spleen in normal experimental animals with the Vena porta constricted with Ameroid rings and liver cirrhosis induced by DMNA. The report also covers 9 patients operated on from 1972 to 1973 with subcutaneous transposition of the spleen. A 77-year-old woman died postoperatively, one patient died after 2 years 4 months, and one had slight bleeding. All the other patients are alive 2-4 years after the operation, with no signs of renewed bleeding. The advantage of subcutaneous transposition of the spleen is that it eliminates hypersplenism.
Adult↗
Liver metastases found by follow-up of patients operated on for colorectal cancer.
One hundred and twenty-six patients earlier operated on for colorectal cancer were followed-up once yearly with serum screening tests. The activities of alkaline phosphatase (AP) and gammaglutamyltranspeptidase (GT) were recorded. 58 patients had positive tests. The majority of the patients with liver metastases (20/21) was possible to encircle with these simple serum tests. 38 of the 58 "screening positive patients" were further investigated with celiac angiography and/or liver scintigraphy and liver metastases were very suspect in 29 of these patients. 18 of them were laparotomized and the suspicion was verified in 8.7 of these patients could be subjected to surgery against their liver tumours and 2 of them have then survived more than 2 years. The authors suggest a follow-up system with shorter interval between the examinations.
Adult↗
Transposition of the spleen in rats with portal hypertension.
Portal hypertension was induced in rats by progressive occlusion of the portal vein or by dimethylnitrosamine (DMNA) cirrhosis. Portasystemic venous connections did not develop in relation to the spleen when this organ was intraperitoneal, but after subcutaneous transposition most of the collaterals were parasplenic and the portal venous pressure fell.
Animals↗
Plasma activities of lysosomal enzymes after hepatic dearterialization in man.
Six patients with liver metastases from carcinoid or colon carcinoma underwent hepatic derterialization. This operation, known to cause both tumor necrosis and liver cell damage, caused considerable increases of several lysosomal acid hydrolases in the circulation. Thus, beta-glucosidase showed a small temporary increase during the operation, followed by a slower but higher reaction reaching a maximum 12 to 36 hours postoperatively. Similar reactions were noted for beta-glucuronidase, acid phosphatase, beta-galactosidase, arylsuphatase A, and N-acetyl-beta-glucosaminidase while no reactions were found for cathepsin D. Very high enzyme levels occurred in a patient dying from bleeding complications in the postoperative period.
Acid Phosphatase↗
An attempt to induce portal hypertension and esophageal varices in the rat.
An attempt to induce portal hypertension using Ameroid constrictors and shunt operations is described. 1 week after the application of the Ameroid constrictor around the portal trunk, it was completely occluded and portal venous pressure was elevated to a level about twice of normal range. Angiographically, splenorenal collaterals and collaterals overbridging the Ameroid constrictor were observed in all examined rats. However, esophageal varices could not be found in any rat. In the second series of the experiment, an end-to-side cavoportal shunt was created before the application of the Ameroid constrictor. This operation model was devised to increase the portal venous flow. At the same time this operation should inhibit the development of splenorenal collaterals and as expected collaterals to the superior vena cava system developed instead. However, they were not located in the esophageal wall but retroperitoneally.
Animals↗
Effect of splenectomy on anemia in patients on regular dialysis treatment.
Splenectomy was performed in 7 patients on regular hemodialysis treatment who had disabling anemia. All patients had a short 51Cr red cell survival time and an increased splenic uptake of red cells verified by external counting and computer-aided scintigraphy. The need for blood-transfusions was eliminated in all except one. In all patients the hemoglobin concentration rose after splenectomy. This was probably an effect of a reduced plasma volume and the removal of a large pool of non-circulating red cells. No consistent changes in the red blood cell survival time or the red cell volume were observed. The white cell and the platelet counts in the blood rose to twice the preoperative value. No adverse effect of the splenectomy was observed.
Adolescent↗
[Current aspects of surgery in portal hypertension].
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Esophageal and Gastric Varices↗
[Effiency in surgery (author's transl)].
Increase in the cost of medical care force us to adopt "medical rationalisation" instead of as previously "hospital rationalisation". This medical rationalisation constitutes a new, well-thought out way of putting questions about diagnosis, therapy and after-care. We must abandon the opinion that the prestige of a surgical department rests in the number of beds. Instead we must use other yardsticks such as the greater use of ambulant care, the shortest hospital stay for routine operations, the shortest preoperative waiting times and an increased operation frequency. Moreover, we need a diagnosis fixed from the start, a large enough operation capacity and sufficient possibilities for postoperative care, stringency in keeping agreed admittances and discharges as regards elective routine surgery and intimate co-operation between doctors, hospital economists, nursing staff and other experts.
Aftercare↗
Results of liver dearterialization combined with regional infusion of 5-fluorouracil for liver cancer.
40 patients with primary or metastatic liver malignancies have been treated with hepatic dearterialization, 19 of them in combination with regional infusion with 5-fluoroacil. The survival was longer than expected from untreated materials. This was especially shown to be valid for patients with primary liver cancer and liver metastases from cancer coli-recti, in which the prolongation of survival was associated with an acceptable quality of life. The long term results were correlated with the "aggressiveness" in therapeutic approach. Only studies of prospective randomized series can settle whether the results depend on the specific measures against the liver tumours or on the general treatment.
Adult↗
Liver resection for cancer.
Liver resection was performed for primary and secondary cancer in 46 patients. Left lobe resection was performed in 11 patients, right lobe resection in 22 and extended right lobe resection in 13. There was no post-operative mortality after left lobe resection, 9 after right lobe and 5 after extended right lobe resection. Ten patients have survived two years after the liver resection. This surgical procedure seems to be of benefit especially for patients with primary liver cancer and with metastases from cancer coli-recti.
Adult↗