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At least 1,063 records · Page 59Linked to original sources
PubMed1989

[Limitation of oily chemoembolization against hepatocellular carcinoma and arterioportal segmental chemoembolization].

Emulsion of adriamycin and lipiodol added with Gelfoam has been used for the transcatheter oily chemoembolization against hepatocellular carcinomas. This therapy resulted in significantly increased cumulative survival as compared with chemoembolization therapy using anti-cancer drugs and Gelfoam. However, it was revealed to have the following limitations: Insufficient efficacy against micrometastases and extracapsular invasion; impossible to perform sufficient treatment for patients with severe hepatic disorders; and there were cases in which lipiodol was hardly retained. In order to overcome the limitations described above, we have performed segmental hepatic chemoembolization simultaneously from the hepatic artery embolization simultaneously from the hepatic artery and portal vein. This method works on the basis of the fact that excess amount of lipiodol emulsion infused from the hepatic artery flows into the portal vein. Gelfoam embolization is also added in this method. Though subjects appropriate for this newly developed method are restricted, all the tumors in the objective segment of the liver can undergo necrosis. The efficacy is comparable to the effects of hepatectomy. In addition, since the other segments of the liver are able to be kept in reserve, this method is able to be applied to patients with severe hepatic disorders.

Aged↗
PubMed1989

[Prognosis of intra-arterial chemo-embolization in metastatic liver cancer].

We treated 63 patients (pts) suffering from metastatic liver cancer with intra-arterial infusion chemotherapy, and analysed 44 of their for survival since the first treatment with regard to the primary foci of cancer and the method of intra-arterial therapy. Via the superficial femoral artery, we performed superselective hepatic catheterization by Seldinger's method. Three types of intraarterial therapy were used: Gelfoam embolization with mitomycin-C (MMC) in 12 pts (GS-TAE), capillary chemo-embolization with MMC-Lipiodol emulsion in 28 pts (LP-TAI) and "one-shot" slow infusion of MMC or cisplatinum in 4 pts. Fifty-percent survival was 189 days in pts with metastases from colo-rectal cancer (n = 20), 109 days from gastric cancer (n = 9), 100 days from pancreatobiliary cancer (n = 5) and 240 days from breast cancer (n = 7). More than one-year survival was obtained in 13 out of the 40 pts (32.5%). Survival of 12 pts, treated with GS-TAE regimen, was not significantly superior to that of 28 pts with LP-TAI regimen. Hence, we conclude that LP-TAI is the treatment of choice in chemo-embolization for unresectable liver metastases, because it causes less damage to the hepatic arterial beds, and facilitates repeat intraarterial therapy in these pts.

Cisplatin↗
PubMed1989

[Adjuvant surgery to enhance therapeutic effects of chemo-embolization in advanced hepatocellular carcinoma].

Different kinds of adjuvant surgery were carried out in three patients with advanced hepatocellular carcinoma (HCC) to enhance the therapeutic effects of chemo-embolization (TAE). The first patient, who had multiple foci localized in the right lobe, underwent ligation of the right portal vein in order to eliminate the small intrahepatic spreads and to protect against transportal metastasis to the left lobe. Afterward, TAEs were repeated a total of 5 times. The patient is still alive 24 months after the surgery with partial remission of the lesions. The second patient with severe cirrhosis had received TAE twice. Since one of the tumors, which existed in the hepatic hilus, did not respond to TAE, only the non-respondent tumor was removed surgically. This patient remains alive 28 months after the surgery with complete remission of the lesions. In the third patient, repeated TAEs resulted in collateral feeding arteries. Permanent decollateralization using silicone rubber sheeting was carried out following ligation of collaterals. Thus adjuvant surgery to enhance the therapeutic effects of TAE may be a significant palliative treatment for HCC.

Carcinoma, Hepatocellular↗
PubMed1989

[Hepatic artery embolization for primary hepatic carcinoma].

Twenty patients with primary hepatic carcinoma (PHC) treated by hepatic arterial embolization in our department from Dec. 1986 to Mar. 1987 are reported. There were 15 males and 5 females. The ages ranged from 34 to 75 years with an average of 50.7. Preoperative diagnosis and localization of the tumor were done by AFP, B-us, CT and angiography (right lobe 15 cases, left lobe 1 case, both lobes 4 cases). Celiac and superior mesenteric angiography was carried out by femoral artery approach and then highly selective hepatic catheterization was utilized for hepatic arterial embolization. Antitumor agent (5-Fu, adriamycin), iophendylate and foamy gel sponge were used for peripheral and proximal embolization. Manifestations were improved in most of the patients after embolization, such as relief of abdominal pain, improvement of appetite, decrease of tumor size. Total necrosis of the tumor was found in 2 patients who underwent surgery 1 month after embolization. The side effects of the posthepatic embolization such as, nausea, vomiting, abdominal pain and fever could be relieved by symptomatic treatment. No severe complications, such as gangrene of the gall bladder, hepatic failure, liver abscess, intestinal necrosis or pulmonary embolization were found except 3 patients who died of renal failure after the procedure. The liver dys-function returned to normal within 2 weeks. Hepatic arterial embolization provides an alternative treatment for the patients with PHC who has compensated liver function without severe systemic diseases, especially renal endocrine problems and severe portal hypertension. They should have patent portal system as proved by angiography. The authors considered that this therapeutic embolization with hepatic chemotherapy infusion is safe and effective in the management of PHC. It may increase the resectability and provide palliative means for the advanced and terminal cases.

Adult↗
PubMed1989

[Successful therapy with tegafur and lentinan after TAE for hepatocellular carcinoma--a case report].

A 46-year-old male (performance status 1) with hepatocellular carcinoma (HCC), which diffusely involved the anterior segment of the right lobe, occluded the second portal branch and metastased to the left lobe (stage IV-A), was on combined therapy with TAE of lipiodol (LPD), mitomycin C (MMC) 10 mg and gelatin sponge at the time of angiography on March 16, 1987. Immunochemotherapy with tegafur suppository (Teg sp) 1,000 mg/day and OK432 i.m. was performed for one month after TAE. Instead of OK432, lentinan (LNT) 2 mg in 20% glucose sol. 20 ml i.v./wk was combined with Teg sp 1,000 mg/day from May 13, 1987. Teg sp was reduced to 1,000 mg/2 days from June of the same year, and since then the same therapy of Teg + LNT has been continuing even now. Serum AFP values showing 150 X 10(4) ng/ml at maximum were decreased down to less than 20 ng/ml 13 months after this therapy (total doses: Teg ca. 250 g, LNT 108 mg), remaining still normal. Marked reduction in the size of the lesion (PR) by the therapy has also been proved by the body CT. His PS is now in grade 0. Although in this case the initial steep decline in AFP values was possibly brought about by TAE, the successive antitumor effect indicated by persistent low AFP values may have been mainly due to Teg + LNT. Collection of data on the therapy is needed to clarify this point.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Prevention of postlaminectomy membrane: experimental and clinical observations.

An animal experimental study was performed to investigate the prevention of scar formation after laminectomy by applying Gelfoam, a free-fat graft and steroids as interposing material between the dura and muscles. There were 52 adult guinea pigs equally divided into four groups. They were sacrificed 2 weeks, 4 weeks and 12 weeks respectively after surgery. In the control group, there was young fibrous tissue at 2 weeks, which became more mature at 4 weeks. At 12 weeks, it became mature with varying thickness and canal extension. In the steroid group, it showed the same picture as the control group. In the Gelfoam group, there was foreign body reaction with disintegration of Gelfoam at 2 to 4 weeks. At 12 weeks, however in the free-fat graft group, viable fat graft could be seen at the laminectomy site with little fibrous tissue overlying the dura. In the clinical part, from September 1981 to September 1984, one of the authors (PQC) performed 100 laminectomies on patients with various causes of low back pain. A piece of free subcutaneous fat was laid on dura before wound closure. At follow-up, there was no adverse effect pertaining to its application. Most patients had considerable pain relief after the surgery. From the above observation, we believe that a free-fat graft is a simple and effective way to prevent postlaminectomy membrane. Steroids and Gelfoam do not have such advantage.

Adipose Tissue↗
PubMed1978

[Animal experimental studies on the biocompatibility of resorbable gelatin sponges and dry fibrin foam].

Histologic specimens taken from the implantation site and the regional lymph nodes up to four weeks after subcutaneous implantation of Gelastypt S (Höchst AG), Gelfoam (Upjohn), and Fibrospum (Promonta) into the upper hind leg of guinea pigs were examined. Similar tissue reactions were observed with Gelastypt S and Gelfoam; the reactions did not differ appreciably from those normally occurring in the context of wound healing. The predominance of round cell infiltrate and the appearance of giant cells in connection with Fibrospum may indicate an immunogenetic potency of the substance. No signs of beginning resorption could be observed four weeks later.

Animals↗
PubMedDate not supplied

Experimental study of hepatic artery embolization: evaluation of various embolic materials.

Transcatheter arterial embolization was performed in a group of rabbits bearing VX2 tumor in the liver by injecting gelatin sponge (GS) with or without an anticancer agent (ACA) or Lipiodol with or without ACA. The antitumor effects as evaluated by tumor size and histological examination revealed that GS with or without ACA was most effective, followed in order by Lipiodol-ACA, aqueous solution of ACA and Lipiodol alone. On the other hand, severe normal tissue damage (necrosis of the liver and gallbladder) with elevation of plasma GOT, GPT, and LDH levels was more commonly observed in GS with or without ACA. Pharmacological analysis of plasma and tissue revealed that the antitumor effect of Lipiodol-ACA was due to prolonged release of ACA in addition to the embolization effect of Lipiodol, while the chemotherapeutic role of ACA was of little importance in GS-ACA.

Alanine Transaminase↗
PubMed1979

[Immune reaction as a cause for necrotizing epitheloid cell inflammation].

Disturbed wound healing following dentoalveolar procedures may be due to various causes. Necrotizing inflammations with epitheloid cells may easily be mistaken for specific inflammations. Atypical granulomas represent a response to foreign body material (e.g., gelatin sponges). The possibility of sensitization with Gelastypt was tested using immunologic methods.

Apicoectomy↗
PubMed1988

[Effectiveness of preoperative transcatheter arterial embolization for improved survival rates in patients with hepatocellular carcinomas (sandwich therapy using ethiodized oil, cisplatin and gelatin sponge].

The effect of hepatic transcatheter arterial embolization (TAE) therapy was evaluated in 153 patients with hepatocellular carcinomas who underwent radical hepatectomy. They were divided into 3 groups. Group A (n = 56) received preoperative TAE using ethiodized oil, cisplatin and gelatin sponge (sandwich therapy). Group B (n = 29) received preoperative TAE using adriamycin + gelatin sponge, ethiodized oil + adriamycin + gelatin sponge or adriamycin + degradable starch microsphere. Group C (n = 68) did not receive TAE preoperatively. The 3-year disease-free survival rates in Group A, B, and C were 56%, 34% and 32%, respectively. The rate was significantly higher in Group A than Group C (p less than 0.05). The 1-year disease-free survival rates after partial hepatectomy were 89% in Group A (n = 22), 53% in Group B (n = 15) and 67% in Group C (n = 22). The 3-year survival rate of these patients in Group A was significantly higher (95%), compared to Group C (70%) (p less than 0.05). Preoperative TAE using ethiodized oil, cisplatin and gelatin sponge (sandwich therapy) was considered a useful therapy for improvement of disease-free survival rates or survival rates after hepatectomy in patients with hepatocellular carcinomas.

Aged↗
PubMed1988

[Transarterial segmental hepatic chemo-embolization in patients with hepatocellular carcinoma].

We can administer a Lipiodol-adriamycin emulsion transarterially into the portal vein, because more than a certain amount of Lipiodol injected into the hepatic artery enters the portal vein through arterioportal communications without arterioportal shunting. When Gelfoam embolization is followed by portal venous administration of this emulsion, hepatic chemoembolization is performed from both artery and portal vein simultaneously. But this chemoembolization must be in a limited area of the liver, since such treatment of the whole liver is lethal. We encountered a segmental hepatic chemoembolization in four patients with hepatocellular carcinoma by the catheterization of a hepatic segmental artery. In two cases operated after segmental chemoembolization, complete necrosis was certified in the main tumor and daughter nodules. Hepatic segmental atrophy and infarctions were also noted in the treated segment. In two non-operated cases, hepatic segmental atrophy and excellent antitumor effects were demonstrated by CT and radioisotope liver scan. Thus, we call this treatment "transarterial partial hepatectomy".

Aged↗