PURPOSE: The purpose of this study was to investigate hemodynamic changes in the hepatic artery after glucose ingestion. METHODS: We used color Doppler sonography to measure hemodynamic changes in the right hepatic artery and the right portal vein in response to glucose ingestion (225 ml, 300 kcal) in 25 healthy subjects and 25 patients with cirrhosis. RESULTS: In healthy subjects, the peak systolic and end-diastolic velocities in the right hepatic artery decreased (33 +/- 3% and 53 +/- 3%) from baseline velocities measured in the fasting state. The resistance index of the right hepatic artery and the velocity in the right portal vein in these subjects significantly (p < 0.01) increased (14 +/- 2% and 32 +/- 2%) from baseline values after glucose ingestion. Glucose ingestion produced significantly (p < 0.01) smaller changes in cirrhotic patients. The maximum decrease in the peak systolic and end-diastolic velocities in the right hepatic artery were 13 +/- 2% and 25 +/- 3% from baseline velocities, and the maximum increases in the resistance index of the right hepatic artery and the velocity in the right portal vein were 6 +/- 1% and 10 +/- 3% from baseline values. CONCLUSIONS: The decrease in blood flow velocity in the right hepatic artery after glucose ingestion is presumably a homeostatic mechanism to maintain constant hepatic perfusion. This reciprocal response was reduced in cirrhotic patients.

Administration, Oral↗

PubMedDate not supplied

Comparisons of the pharmacokinetics and the leukopenia and thrombocytopenia grade after administration of irinotecan and 5-fluorouracil in combination to rats.

BACKGROUND: Irinotecan (CPT-11) has been used recently for the treatment of several cancers in combination with 5-fluorouracil (5-FU). Preliminary data on this combination therapy in humans demonstrated no drug interactions between CPT-11 (or its metabolite, SN-38) and 5-FU however, because there is so little information on the combination, the possibility for an interaction still exists. MATERIAL AND METHODS: CPT-11 and 5-FU were injected intravenously into rats and the pharmacokinetics of CPT-11 and SN-38 and alternations in blood cell count were investigated. RESULTS: In the group of rats administered 5-FU prior to CPT-11, the area under the concentration-time curve (AUC) of CPT-11 was approximately eight-fold larger compared with the group administered CPT-11 prior to 5-FU. On the other hand, the grade of leukocytopenia or thrombocytopenia was not significantly different among the two groups. CONCLUSION: In rats, the conversion of CPT-11 into SN-38 is possibly delayed by prior administration of 5-FU.

Animals↗

PubMedDate not supplied

Combination therapy of percutaneous mitoxantrone injection, percutaneous ethanol injection, and transcatheter arterial embolization for intrahepatic hepatocellular carcinoma and adrenal metastasis.

We treated a 63-year-old man who had recurrent large hepatocellular carcinomas (> 5 cm in diameter) and left adrenal metastasis with the combination approach of percutaneous intratumoral chemotherapy with mitoxantrone, percutaneous ethanol injection, and transcatheter arterial embolization. He received repeated transcatheter arterial embolization and percutaneous ethanol injection combination therapy for intrahepatic hepatocellular carcinomas, which controlled his disease for 6 months from the first treatment. After that, left adrenal metastasis was detected by biopsy specimen. Therefore, we repeated more transcatheter arterial embolization and percutaneous ethanol injection to the liver and left adrenal gland, but this combination therapy could not control the hepatocellular carcinomas in these organs. With the patient's consent, he was treated with the combination approach of percutaneous intratumoral chemotherapy with mitoxantrone, percutaneous ethanol injection, and transcatheter arterial embolization for hepatocellular carcinomas of the liver and left adrenal gland. After this combination therapy, we followed-up the viable lesions by color Doppler ultrasonography and computed tomography examination. However, we could not detect these viable lesions of hepatocellular carcinomas in his body until one month before he died. When the degree of hepatic failure worsened due to the natural course of cirrhosis, this combination therapy was stopped 7 months before he died. He died of pulmonary tumor emboli from metastasis of inferior vena cava 24 months after the combination therapy started. However, on autopsy there was almost no remaining hepatocellular carcinoma found in the main lesions of liver and left adrenal gland. We suggest that a combination approach of percutaneous intratumoral chemotherapy with mitoxantrone, percutaneous ethanol injection, and transcatheter arterial embolization may be indicated in elderly cases of intrahepatic large hepatocellular carcinoma and adrenal metastasis, which are not under control only by transcatheter arterial embolization and percutaneous ethanol injection.

Adrenal Gland Neoplasms↗

PubMedDate not supplied

A long-term survival case of pancreatic poorly differentiated adenocarcinoma with transcatheter arterial embolization and combination chemotherapy.

A 66-year-old woman complained of supraclavicular lymph node swelling during her initial visit to an outpatient clinic. Computed tomography revealed a hypervascular tumor in the uncus of the pancreas (2.0 x 2.0 cm), therefore a needle biopsy of the pancreas was performed. A poorly differentiated adenocarcinoma was identified. Transcatheter arterial embolization using adriamycin and gelatin sheet was performed. To alleviate her symptoms (movement disorder of neck, etc.), initial chemotherapy; FP (5-fluorouracil and cisplatin intravenously) was continued for 6 cycles with her consent, and subsequently MF (methotrexate and 5-fluorouracil intravenously) for 14 cycles. This patient survived with transcatheter arterial embolization, FP and MF combination chemotherapies for 24 months after presenting with the symptoms. To our knowledge, this is the longest surviving case of pancreatic poorly differentiated adenocarcinoma (Stage IV). In conclusion, this present case suggests that transcatheter arterial embolization, FP and MF combination therapy may have an effect at prolonging survival in poorly differentiated pancreatic adenocarcinoma.

Adenocarcinoma↗