Biomedical subjects

Seikan Hai

Publications and source records attributed to Seikan Hai.

26 records · Page 2Linked to original sources

PubMed2003

Secondary hemocholecyst after radiofrequency ablation therapy for hepatocellular carcinoma.

A 65-year-old Japanese man underwent radiofrequency ablation (RFA) therapy of a hepatocellular carcinoma. Hemobilia from the intrahepatic bile ducts adjacent to the tumor developed on the fifth day after the RFA therapy. Ultrasonograms and computed tomograms showed swelling of the gallbladder, which was filled with a clot, suggesting the diagnosis of hemocholecyst. The hemobilia resolved with conservative therapy, but a cholecystectomy was performed to manage postprandial abdominal pain. The resected gallbladder was filled with a clot, but injury or ulceration of the gallbladder was absent, suggesting that the hemocholecyst developed secondary to the hemobilia. Secondary hemocholecyst is a rare complication of RFA therapy. The number of cases of secondary hemocholecyst is likely to increase as hepatocentestic therapy becomes more common. Cholecystectomy is indicated for hemocholecyst because spontaneous liquefication and drainage of a clot in the gallbladder usually does not occur.

Aged↗

PubMed2003

Intrahepatic cystadenocarcinoma with pleural dissemination: a case report.

A 40-year-old Japanese woman, who previously had undergone choledocho-jejunostomy in childhood for a congenital choledocal cyst, presented with right-sided chest pain. Computed tomography and ultrasonography demonstrated a right pleural effusion and a 10-cm unilocular hepatic cystic lesion with no solid component. These findings suggested a non-neoplastic cyst or cystadenoma. However, intracystic fluid aspirated had high concentrations of carbohydrate antigen 19-9 and carcinoembryonic antigen. Cytology of the pleural effusion demonstrated malignant cells. During exploratory laparo- and thoracotomy, a hepatic cystadenocarcinoma with invasion of the diaphragm and pleural dissemination was discovered. This case demonstrates that malignancy should be ruled out when a patient with an intrahepatic unilocular cystic lesion presents with atypical symptoms and findings, such as chest pain, pleural effusion, and high serum concentration of tumor markers. We believe that intrahepatic cystic lesions should be approached aggressively, including the use of exploratory laparotomy/laparoscopy to be certain that cancer is not present.

Adult↗

PubMed2002

Amelioration of cisplatin toxicity by a fermented grain food product.

The most noticeable hypothesis regarding the pathogenesis of cisplatin toxicity, seen mainly in kidney and intestine, is oxidative stress, an imbalance between free-radical generating cisplatin and radical scavenging systems. This paper describes the role of the antioxidant system in cisplatin-induced toxicity and the protective effect by a processed grain food (Antioxidant Biofactor: AOB), which has been shown to exhibit strong antioxidant activity. Male Fischer 344 rats were used. They were pre-fed either a basal diet (control, 15 g/day) or the diet supplemented with AOB to provide 6.5% or 20% of total diet throughout the experiment. Cisplatin (5 mg/kg, i.v.) was administered at the start of the experiment, and the animals were sacrificed 5 days later. Blood urea nitrogen (BUN) and plasma creatinine, NO2(-) and NO3(-) (NOx) were determined from the plasma. The levels of 4-hydroxy-2-nonenal (a lipid peroxidation product), 8-hydroxy-deoxyguanosine (8-OHdG, an oxidatively modified DNA adduct) and nitrotyrosine were histologically analyzed. The cisplatin administration resulted in a loss of body weight and elevations of BUN, serum creatinine and NOx levels, whereas AOB supplement reversed these effects. The severe morphological damages induced in the kidney and intestine by the cisplatin administration were markedly improved in the AOB group. The levels of lipid peroxidation, 8-OHdG, and nitrotyrosine all paralleled the morphological damage. The AOB effect was dose dependent. In conclusion, the present study suggests that certain food additives like AOB may be of benefit against the side effects of cisplatin.

8-Hydroxy-2'-Deoxyguanosine↗

PubMed2002

Relationship between response to previous interferon therapy and postoperative recurrence of hepatitis C virus-related hepatocellular carcinoma.

Although interferon (IFN) therapy suppresses the development of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC), the relationship between response to previous IFN therapy and postoperative outcome has not been clarified in patients who underwent curative resection for HCC. Of 175 patients who underwent curative hepatic resection for HCV-related HCC, 24 patients had HCC detected after IFN therapy. 11 patients who had a biochemical response (a normalized alanine aminotransferase (ALT) activity with or without disappearance of serum HCV RNA) were classified as the response group, while 13 patients were classified as the non-response group because they had no decrease in their ALT activity and had persistence of serum HCV RNA. The non-IFN group included 151 patients who had not received previous IFN therapy. The clinicopathologic findings and surgical outcomes were compared among these three groups. The serum activities of the aspartate aminotransferase and ALT just before surgery were significantly lower in the response group than in the other groups. Although no significant differences were noted in the other clinicopathologic findings or the operation method among these groups, the tumor-free survival rate of the response group was significantly higher than that of the two other groups. By multivariate analysis, the response group had an independently lower risk for postoperative recurrence (risk ratio, 0.07; P=0.0072). Hepatic resection offers hope for low incidence of postoperative recurrence in patients with HCC, especially when previous IFN therapy has controlled their active hepatitis associated with HCV.

Journal Article↗

PubMed2002

Usefulness of three-dimensional computed tomography in a living-donor extended right lobe liver transplantation.

Although living-donor liver transplantation (LDLT) of right lobe graft is becoming a popular option for adult patients, management of venous outflow remains controversial. We report a successful extended-right lobe liver transplantation using a recipient's left portal vein as a graft from the middle hepatic vein. Preoperative three-dimensional computed tomography (3D-CT) of the donor revealed a small right hepatic vein (RHV) without inferior RHV and a large middle hepatic vein (MHV) draining segments 5 and 8. During the donor operation, right lobe graft was harvested with the MHV, preserving the drainage vein from segment 4. The donor recovered uneventfully except for mild transient hyperbilirubinemia. The recipient's condition rapidly improved, and was discharged from hospital 49 days postoperation. A 3D-CT after LDLT also clearly revealed successful vascular anastomosis. Preoperative and postoperative 3D-CT was useful for determination of the vascular anatomy and the decision about the line of transection in the donor hepatectomy, as well as for evaluation of the vascular anastomoses after transplantation.

Adult↗

PubMedDate not supplied

Hepatectomy with transcatheter arterial embolization for large hepatoma in the caudate lobe.

The prognosis of hepatocellular carcinoma originating from the caudate lobe (caudate HCC) is generally poor, and surgical treatment for caudate HCC is difficult to perform due to the location. We postulate that a combination of surgical resection and transcatheter arterial embolization improves the prognosis, and that operative procedure is straightforward. We examined three cases of large solitary caudate HCC. Three patients (a 68-year-old woman, 65-year-old man, and 71-year-old man) with caudate HCC and viral chronic hepatitis were treated with preoperative transcatheter arterial embolization and partial resection of the caudate lobe. After transcatheter arterial embolization, the solitary hepatocellular carcinomas decreased in size (9 to 6, 10 to 8, and 7 to 5 cm in diameter, respectively) which simplified surgical resection (1120, 3010, and 2110 cc blood loss; 4.5, 7, and 7 hours of operative time, respectively). All the hepatocellular carcinomas were poorly differentiated, and had infiltrated microscopically into the portal vein. The outcome was satisfactory (18, 16, and 10 months after the operation, two cases were alive, and one dead, respectively). The combination of preoperative transcatheter arterial embolization and partial resection for caudate HCC, especially large solitary caudate HCC, works well as a multimodal therapy.

Aged↗

PubMedDate not supplied

Postoperative survival in intrahepatic cholangiocarcinoma showing intraductal growth.

Clinicopathologic variables favoring recurrence after hepatic resection for intrahepatic cholangiocarcinoma showing intraductal growth remain unclear. We investigated various clinicopathologic features in three patients who underwent resection for this type of intrahepatic cholangiocarcinoma. All underwent extended left hepatectomy plus resection of the caudate lobe and lymph node dissection. Lymph nodes showed no pathologic involvement. Although no cancer cells were seen in the mucosal layer by intraoperative pathologic examination at the bile duct stump in any patient, pathologic examination of resected specimens showed cancer cells invading beyond the mucosal layer in connective tissues surrounding the bile duct stump (interstitial invasion) of the Glisson's sheath in 2 patients. One of them died of cancer recurrence near the bile duct stump, while the third patient, without interstitial invasion, has survived for 10.6 years. In the intraductal growth type of intrahepatic cholangiocarcinoma, absence of cancer cells should be confirmed by intraoperative pathologic examination of not only the mucosal layer of the bile duct but also the connective tissue surrounding the bile duct, since interstitial invasion may be a risk factor for cancer recurrence.

Bile Ducts↗

PubMedDate not supplied

Bowel injury associated with liver surgery for hepatocellular carcinoma.

BACKGROUND/AIMS: Bowel injury associated liver surgery is rare but can be fatal if not adequately treated. The contribution of underlying liver disease and previous hepatectomy to bowel injury in hepatectomy for hepatocellular carcinoma is unknown. METHODOLOGY: Clinical records of 531 patients who underwent hepatic resection without combined resection of the biliary tract or intestine for hepatocellular carcinoma during 13 years were reviewed. Differences in incidence of bowel injury according to presence or absence of liver cirrhosis, technique of hepatectomy, and history of hepatectomy were investigated. Outcome after treatment also was reviewed. RESULTS: Bowel injury occurred in 5 patients (0.9%). Previous hepatectomy history was associated with an increased incidence of bowel injury [repeat hepatectomy, 3/91 (3.3%), and first hepatectomy, 2/440 (0.5%), p = 0.038]. Injury was recognized intraoperatively in two patients and postoperatively in three. In the former two patients, the injured bowel was repaired immediately but a fistula still developed in one patient. One patient with a fistula eventually required temporary fecal diversion and eventually limited colectomy. The other three patients were treated by continuous external drainage, but two of them required debridement or colic sleeve resection. CONCLUSIONS: Previous hepatectomy increases the risk for bowel injury during hepatectomy. Care must be taken to prevent adhesion to the hepatic cut surface. Careful use of electrocautery to prevent burn injury also should be taken.

Adolescent↗