Hepatocellular carcinoma with situs inversus.
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Adult↗
Biomedical subjects
T Matsumata
Publications and source records attributed to T Matsumata.
Small liver cancer.
We report eight cirrhotic patients with liver cancer of less than 2 cm in diameter, and who were successfully treated by surgery. The sensitivities of diagnostic procedures for small lesions showed that alpha-feto-protein (AFP) was 75 per cent, radionuclide scanning 25 per cent, CT 33 per cent, ultrasonography 40 per cent and angiography 88 per cent. Serial measurement of AFP appears to be the most helpful for detection of hepatocellular carcinoma at the early stage, particularly in cirrhotic patients. Although hepatic imagings are of limited value for small hepatic tumors, those tools are often useful as a back-up for the routine tests but not for initial procedures. It should also be kept in mind that hepatic arteriography performed in the high risk group often leads to detection of small cancers. In cirrhotic patients with small hepatocellular carcinoma, surgical resection should be done, providing the clinical status and hepatocellular reserve are adequate.
Carcinoma, Hepatocellular↗
Minute liver cancer and concomitant esophageal varices: detection and successful surgical treatment.
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Adult↗
Vascular access for intra-arterial chemotherapy for nonresectable hepatic tumor.
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Antineoplastic Agents↗
Successful treatment of early hepatocellular carcinoma and concomitant esophageal varices.
Twenty-two cirrhotic patients with hepatocellular carcinoma (HCC) and concomitant esophageal varices underwent aggressive hepatic resection accompanied by simultaneous devascularization, perioperative endoscopic injection sclerotherapy, or both (group A). To evaluate this treatment, 37 cirrhotic patients without esophageal varices who underwent hepatic resection for small HCC (2 cm or less) during the same period (group B) were studied to compare clinical data, preoperative laboratory data, pathologic findings, disease-free rates, and survival rates. The operative time, blood loss, and resected liver weight did not differ between the two groups; however, the tumor size of group A (2.7 +/- 1.6 cm, mean +/- SD) was significantly larger than that of group B (1.5 +/- 0.3 cm). The preoperative liver function of group A was also more severe than that of group B except for prothrombin time. Despite these disadvantages, the 1-, 3-, and 5-year disease-free rates of the two groups were 72% versus 94%, 48% versus 54%, and 38% versus 45%, respectively, and the 1-, 3-, and 5-year survival rates were 91% versus 97%, 79% versus 79%, and 54% versus 67% (group A versus group B), respectively, which showed no significant differences. Furthermore, there was no variceal bleeding in group A after treatment. Based on the above findings, for treatment of HCC and concomitant esophageal varices, aggressive hepatic resection accompanied by simultaneous devascularization, perioperative endoscopic injection sclerotherapy, or both is the preferred form of treatment.
Adult↗
MR imaging of hepatocellular carcinomas: effect of Cu and Fe contents on signal intensity.
BACKGROUND: To elucidate the metallic factors contributing to the signal intensities of hepatocellular carcinoma (HCC) on T1-weighted magnetic resonance (MR) images and to determine whether or not changes in signal intensity contribute to the diagnosis of histological grading of HCC. METHODS: In 35 patients immediately after surgery, the quantities of water, lipid, copper (Cu), iron (Fe), and manganese (Mn) were determined in HCCs and the surrounding hepatic parenchyma. The correlations among these findings, the histopathological findings, and the signal intensities of T1-weighted MR images were evaluated. RESULTS: Among the 35 HCCs, 12 (34%) were of high intensity, 14 (40%) were isointense, and 9 (26%) were of low intensity on T1-weighted images versus the surrounding hepatic parenchyma. The paramagnetic ions, which contributed to the signal intensity patterns, were assumed to be Cu in HCCs (30.5 +/- 52.9 microg/g ww), and Fe in the livers (106.2 +/- 86.8 microg/g ww) and HCCs (87.7 +/- 49.1 microg/g ww). In 12 HCCs with high intensity, one was grade I, eight were grade II, and three were grade III according to Edmondson-Steiner's histopathological classification. CONCLUSIONS: Signal intensity and signal intensity patterns alone cannot be signs of low-grade malignancy because of the Fe in livers and in HCCs.
Aged↗
MRI of primary lymphoma of the liver.
OBJECTIVE: The MR findings in two cases of primary lymphoma of the liver (PLL) are presented. MATERIALS AND METHODS: MR of two cases of primary lymphoma of the liver were reviewed and its features were estimated. RESULTS: Both cases showed a solitary large liver mass. On T1-weighted imaging the tumor was isointense in one and homogeneously hypointense to the liver parenchyma in the other. On T2-weighted imaging both tumors were homogeneously hyperintense. In one case the margin of the tumor was poorly defined, and portal branches were identified within the tumor, an unusual finding in other liver neoplasms. CONCLUSION: In patients with liver masses with homogeneous intensity on MR but without liver dysfunction and other malignancies, PLL should be included in the differential diagnosis.
Aged↗
A long-term survivor of ruptured hepatocellular carcinoma after hepatic resection.
We treated a patient who had previously undergone a hepatic resection for ruptured hepatocellular carcinoma (HCC) but developed a solitary peritoneal recurrence at the site of the incision 8 years and 9 months later. Since no other recurrence was evident, we resected the tumour. The primary tumour was 2.5 cm in size and histological examination revealed HCC without any histological risk factors for intrahepatic recurrence. The peritoneal tumour consisted of less differentiated cancer cells than those found in the primary tumour. The positive rates of Ki-67 were 10% in the primary tumour and 23.3% in the peritoneal recurrence. The DNA indexes in both tumours were considered to be identical. The comparison between the primary and peritoneal tumours suggested that the histological differentiation and proliferation activity can change after recurrence, in spite of consistent DNA ploidy contents. Clinically, a patient who undergoes a hepatic resection for ruptured HCC can survive for a long time, such as 10 years, if they have good liver function and small HCC without any histological risk factors for intrahepatic recurrence. However, since late recurrence is possible, a follow up for as long as 10 years is recommended.
Aneuploidy↗
Effects of doxorubicin and/or cilostazol on cancer cells during liver regeneration after two-thirds hepatectomy in rats.
A rat model of liver metastases generated by intraportal injection of syngeneic tumor cells after two-thirds hepatectomy to determine the optimal benefit of doxorubicin and/or cilostazol for early hepatic metastases. Four groups of WKA rats had viable tumor cells injected directly into the portal vein after two-thirds hepatectomy. Group A underwent to further treatment. Group B had doxorubicin injected 24 h post-operatively. Group C had cilostazol administered prior to two-thirds hepatectomy. Group D received cilostazol, and doxorubicin injections. The mean survival period in each group was 22.2, 20.0, 28.8, and 22.8 days, respectively. The mean survival was significantly longer in group C than in groups A, B and D (p < 0.05). Based on these findings, we believe that during the phase of liver regeneration adjuvant chemotherapy is not recommended. Cilostazol exerts an important antiproliferative effect on liver metastases after hepatectomy.
Animals↗
A comparative study on effects of doxorubicin alone or mixed with lipiodol given through the hepatic artery or portal vein for liver tumors in rats.
Vascular feeding of metastatic liver tumors at early stage is uncertain. It is controversial whether anticancer agents should be given through the hepatic artery or portal vein. In order to clarify this point, a rat model of liver metastases generated by an intraportal injection of syngeneic tumor cells was used to determine the optimal regional chemotherapeutic modality for early hepatic metastases. The rats given the tumor cells through the portal vein were placed into 5 groups: In groups I and II, Adriamycin (ADR) 4 mg/kg alone was given either into the hepatic artery or into the portal vein, respectively, 24 h after the inoculation of tumor cells. In groups III and IV, ADR mixed with lipiodol (lipiodolized ADR) 4 mg/kg was given into the hepatic artery or into the portal vein, respectively, 24 h after inoculation. For the group V rats, no treatment was given after inoculation of the tumor. When a comparison was made with regard to the forms of anticancer drug administered, statistically significant differences in survival rates were recognized between groups I and III (p < 0.001), and groups II and IV (p < 0.05). The anticancer agent not mixed with lipiodol and given through the hepatic artery had a more preventive effect than that given through the portal vein. Thus, we conclude that administration of ADR not mixed with lipiodol and given through the hepatic artery is the preferred modality for treating early metastatic liver tumors.
Animals↗
Endoscopic placement of a long intestinal tube-device in order to reduce the distress of patients with intestinal obstruction.
We have designed the newly devised endoscopic procedure for inserting and placing the intestinal tube into the duodenum in order to reduce the distress of patients with intestinal obstruction.
Duodenal Obstruction↗
Ileus with incarceration of Spigelian hernia.
An 85 year-old female with ileus due to incarceration of Spigelian hernia, which was diagnosed pre-operatively with the findings of the abdominal computed tomography and plain radiographic pictures, is reported. A simple hernioplasty was made by suturing the internal oblique and transverse muscles to the rectus sheath. The post-operative condition is satisfactory without any recurrence of hernia.
Abdominal Muscles↗
Carcinoid tumor of the ileum with intestinal obstruction.
An 83 year-old female presenting with intestinal obstruction due to a carcinoid tumor of the small intestine is herein reported. The intra-operative findings revealed a stenotic lesion and ischemic changes of the ileum. A segmental jejunotomy was performed and a submucosal tumor was recognized as a causal lesion. Histopathological investigation demonstrated the features of carcinoid tumor.
Aged↗
The effect of octreotide on morphological hepatic regeneration and hepatic functional recovery after a two-thirds hepatectomy in rats.
BACKGROUND/AIMS: The aim of this study was to clarify the effect of octreotide on either morphological hepatic regeneration or hepatic function after a two-thirds hepatectomy in rats. METHODOLOGY: The rats were separated into two groups as follows: group 1 received 100 microg of octreotide acetate subcutaneously every 6 hours from 24 hours before hepatic resection until sacrifice; group 2 received 0.9% saline solution instead of octreotide as a control. Morphological hepatic regeneration, protein synthesis and mitochondrial function were all studied. RESULTS: The regenerative rate in liver volume and the BrdU labeling index in group 1 were significantly lower than those in group 2. The levels of glutamic acid dehydrogenase were significantly lower in group 1 than those in group 2 at 24 (64.2+/-14.6 and 77.8+/-8.3 IU/l, respectively), 36 (46.1+/-14.4 and 60.6+/-5.9 IU/l, respectively) and 48 hours (39.7+/-13.7 and 51.0+/-11.8 IU/l, respectively) after hepatectomy. At 24 hours after hepatectomy, the levels of arterial ketone body ratio was higher in group 1 than in group 2 (0.67+/-0.05 and 0.51+/-0.07, respectively), and the energy charge of the liver was also higher in group 1 than in group 2 (0.662+/-0.031 and 0.605+/-0.053, respectively). CONCLUSIONS: Our results suggest that morphological hepatic regeneration is not necessarily synchronized with hepatic functional recovery. In addition, hepatic functional recovery was preserved by keeping the energy metabolism in hepatocytes, even when the use of octreotide suppressed morphological hepatic regeneration.
Animals↗
Volvulus of the ileum in adult diagnosed pre-operatively by helical 3-dimensioned computed-tomography.
A 46 year-old male who was strictly diagnosed as having volvulus of the ileum based on the pre-operative information brought by computed tomography (CT) and helical (spiral) 3-dimensioned computed tomography was surgically treated. The post-operative course was satisfactory and the patient is now under observation without any exacerbation of symptoms one year after surgery.
Humans↗
Dieulafoy-like lesions of colon and rectum in patients with chronic renal failure on long-term hemodialysis.
Two rare cases with Dieulafoy-like ulcer bleeding of the colon and rectum are reported. The patients have been suffering from chronic renal failure (CRF) on long-term hemodialysis (HD), and they were brought to Saiseikai Yahata General Hospital with anal bleeding. In both patients, colonoscopy was performed, showing arterial bleeding from a protuberant vessel on the mucosa of the rectum in Case 1 and gradual arterial bleeding from the protuberant vessel on the ascending colon in Case 2. For both cases, endoscopic clipping treatment was done for hemostasis and was successful.
Aged↗
Serum level of C-reactive protein may be a marker for proliferation of esophageal carcinoma.
We herein show the significance of the serum level of C-reactive protein as an indicator of proliferation in esophageal carcinoma. The patient was a 70-year-old male with advanced squamous cell carcinoma in the lower location of the esophagus, and in whom an esophagectomy and reconstruction with a gastric tube through the intrathoracic route was performed. When he was later hospitalized again due to recurrent tumor, the serum C-reactive protein level was 5.0 mg/dL and it later increased to 10.8 mg/dL along with the proliferation of the tumor. After performing chemotherapy, the concentration of the serum C-reactive protein decreased to the negative level with a simultaneous improvement in his cachexic condition and the eventual disappearance of the tumor.
Aged↗
Partial resection for leiomyoblastoma of stomach.
We herein report the case of a 51-year-old male with a submucosal tumor of the stomach which was histopathologically demonstrated to have features compatible with leiomyoblastoma. As the submucosal tumor of the posterior wall of the antrum, which was initially found in the upper gastrointestinal series done during a health examination, had grown 3.8 cm in diameter, the partial resection of the full thickness of the gastric wall containing the tumor with a sufficient tumor margin was performed.
Humans↗