[Show abstract][Hide abstract] ABSTRACT: Lipiodolization, a selective regional cancer chemotherapeutic modality using lipiodol plus anticancer drugs, can prolong the survival time of patients with unresectable liver cancer. A preliminary study was conducted with adjuvant lipiodolization before a potentially curative hepatectomy for patients with metachronous colorectal liver metastases. The ultimate aim of this study was to improve the long-term survival after hepatectomy.
Twenty-one consecutive patients with colorectal hepatic metastases were included in this study. Seven patients underwent preoperative lipiodolization, while the remaining 14 patients did not receive any preoperative adjuvant therapy. The clinicopathological features and prognoses of these patients were investigated. The median follow-up period after a curative hepatectomy was 56 months.
The clinicopathological factors did not differ markedly between the 2 groups. However, the cumulative survival rate of the 7 patients receiving preoperative lipiodolization was significantly (P < 0.05) better than that in those not receiving any preoperative treatment.
Based on the above encouraging findings, we therefore propose that a prospective randomized trial should be carried out to confirm the beneficial effects of our adjuvant chemotherapeutic modality on patient survival following a curative hepatectomy for the patients with colorectal liver metastases.
No preview · Article · Jan 2001 · Hepato-gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Combined hepatocellular carcinoma and cholangiocarcinoma is a rare tumor. In addition, both hepatocellular carcinoma and cholangiocarcinoma are rarely associated with cystic lesions. We herein present a 62-year-old Japanese woman with combined hepatocellular carcinoma and cholangiocarcinoma which was associated with a rapidly enlarging cystic lesion. Both abdominal ultrasonography and computed tomography revealed a cyst with a solid portion in the left hepatic lobe. A partial hepatectomy was performed on the basis of a tentative diagnosis of a cystadenocarcinoma of the liver, while the diagnosis based on immunohistochemical studies was combined hepatocellular carcinoma and cholangiocarcinoma with cystic formation. The patient died of tumor recurrence, such as intrahepatic metastases and extensive lymph node metastases, 6 months after the operation. The prognosis of this entity, which has never been reported in the English medical literature and is difficult to preoperatively differentiate from hepatic cystadenocarcinoma, therefore seems to be extremely poor.
No preview · Article · May 2000 · Hepato-gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Platelet aggregation is one of the most important mechanisms for acute myocardial infarction during exercise. We sought to evaluate the effect of ticlopidine (TP) on platelet aggregation (PA) during exercise in patients with ischemic heart disease (IHD). We studied 38 patients with IHD, 26 patients with effort angina pectoris, and 12 patients with a previous myocardial infarction. In protocol I, subjects were divided into two groups. Drugs altering platelet aggregation were withheld 2-4 weeks before the study in 25 patients (control group). TP (200 mg/day) was administered for 7 days in 13 patients (ticlopidine group). A symptom-limited modified Bruce protocol treadmill exercise test was performed. PA was measured at rest and after exercise by using optical densitometry induced by adenosine diphosphate (ADP). PA ratio (percentage of maximum) was compared. In protocol II, in 12 patients, treadmill exercise test and PA measurement were performed with and without TP. PA significantly increased after exercise in control (from 51.7+/-23.3% to 64.4+/-27.7%, p < 0.01) and ticlopidine (from 31.9+/-10.5% to 42.0+/-20.4%, p < .01) groups; however, its grade was lower in the ticlopidine group than in the control group. After exercise, PA was lower in the ticlopidine group than in control group (42.0+/-20.4% vs. 64.4+/-27.7%; p < 0.01). In the same patients, PA was lower with TP than without TP after exercise. Treadmill exercise-tolerance time was greater in the ticlopidine group than in the control group, but not statistically significant (762.3+/-139.2 vs. 711.6+/-169.6 s; NS). Exercise-tolerance time was significantly greater with TP than without TP in same patient (791.7+/-98.9 vs. 733.3+/-152.8 s; p < .05). TP suppressed the increase of PA during exercise and increased the exercise-tolerance time in patients with IHD.
No preview · Article · May 1999 · Journal of Cardiovascular Pharmacology
[Show abstract][Hide abstract] ABSTRACT: A 65-year-old woman with hepatocellular carcinoma underwent right hepatic lobectomy. Her alpha-fetoprotein levels significantly dropped from 285,000 ng/ml to 3,100 ng/ml for one month without any preoperative treatment. The tumor thrombus in the portal vein showed complete necrosis, and lymphocytes infiltration around the main tumor were present microscopically. However, there was no necrotic area in the main tumor. This patient is living with no evidence of recurrence for 3 years and 6 months following hepatic resection.
No preview · Article · Feb 1998 · Fukuoka igaku zasshi = Hukuoka acta medica
[Show abstract][Hide abstract] ABSTRACT: Laparoscopic cholecystectomy is widely accepted by patients and physicians despite the lack of controlled trials comparing this technology with conventional cholecystectomy. The cystohepatic ducts represent accessory bile ducts of variable size which frequently travel within the gallbladder fossa or in the posterior wall of the gallbladder. These ducts can be injured during laparoscopic cholecystectomy and can result in bile collection if transected. Recently, we have experienced two cases of injury to the bile duct during operation. One case was a transection of the accessory bile duct, the other one was an injury to the common hepatic duct. We present herein the clinical course of the two cases, in which biliary leakage, following laparoscopic cholecystectomy, was successfully managed by the end to end anastomosis of the bile duct.
No preview · Article · Feb 1998 · The Kurume Medical Journal
[Show abstract][Hide abstract] ABSTRACT: A case of primary splenic lymphoma in a patient with chronic hepatitis C is reported. A 69-year-old man with chronic hepatitis C was admitted to Fukuoka City Hospital for evaluation of an enlarging splenic tumour. In the spleen, ultrasonographic examination revealed a hypoechoic tumour and computed tomography demonstrated a non-enhancing low density area measuring 7 cm in diameter; coeliac angiography revealed a hypovascular tumour. Gallium scintigraphy showed uptake of the radioisotope in the splenic tumour. A splenectomy was performed and the morphological and immunohistochemical findings of this tumour were compatible with those of non-Hodgin's B cell lymphoma. Recently, cases of malignant B cell lymphoma associated with hepatitis C virus infection have been reported. Lymphotropism of hepatitis C virus may play a pathological role in the development of non-Hodgkin's lymphoma. We emphasize the importance of considering lymphoma in the differential diagnosis of extrahepatic disorders during the course of chronic hepatitis C virus infections.
No preview · Article · Sep 1996 · Journal of Gastroenterology and Hepatology
[Show abstract][Hide abstract] ABSTRACT: A 62-year-old man was admitted to our hospital for treatment of HCC with a thrombus growing from the right branch to the trunk of the portal vein. His hepatic functional reserve was fairly good. Serum levels of AFP and PIVKA-II were elevated to 1,780 ng/ml and 27 AU-ml, respectively. The hepatic arteriogram showed a hypervascular tumor approximately 4 cm in diameter in the right anterior segment and many ill-defined small tumor stains around the main tumor. Portal phase of superior mesenteric arteriogram revealed filling defect in the portal trunk, and no visualization of the right branch of portal vein. SMANCS-Lipiodol was infused via right hepatic artery, and Spongel was infused via right anterior branch of hepatic artery. Three months after the first therapy, the tumor markers normalized. A computed tomography scan showed that the main tumor and the tumor thrombus were markedly decreased in size, whereas the hepatic angiogram revealed tumor stains around the main tumor. SMANCS-Lipiodol was again infused via proper hepatic artery. He has remained well for 16 months after the first treatment. The combination of the arterial infusion of SMANCS-Lipiodol with the selective TAE was very effective for this case, probably because his hepatic functional reserve was fairly good and the left branch of portal vein was patent. It was suggested that SMANCS-Lipiodol with the selective TAE could be one therapy to be considered for a patient like this case.
No preview · Article · Aug 1996 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: We report unique features of computed tomography (CT) and magnetic resonance (MR) imaging in the metastatic lesion of the liver in a case of gastric leiomyosarcoma. A CT scan and MR image demonstrated presence of a huge multilocular cystic lesion in the liver, of which finding were unlike to those of usual smooth muscle tumors, but mimicked to those of cystadenomatous tumors. In addition, this case had an extremely long elapsing time over ten years from the radical operation for the primary site.
[Show abstract][Hide abstract] ABSTRACT: Microwave coagulo-necrotic therapy (MCN) was performed in 21 patients with small hepatocellular carcinoma less than 5cm in diameter and this therapeutic method was determined to be effective from the following results. 1) A marked low density area was seen in the region receiving the therapy and no enhanced findings were observed by enhanced CT one month postoperatively. 2) Recurrence appeared in 5 patients (23.8%) and only one patient died 1 year and 6 months after the operation. However, the other 20 patients survived for a maximum of 3 years and 2 months postoperatively. 3) The levels of total bilirubin and GOT in these patients were similar to those of patients who underwent hepatectomy. However, the levels of prothrombin time and hepaplatin test in patients with MCN changed less than in those who received hepatectomy. 4) Tendency of the renal failure was seen in 2 patients, and the other 19 patients did not have any complication postoperatively.
No preview · Article · May 1993 · Nippon Geka Gakkai zasshi