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Query: UMLS:C0012739 (
disseminated intravascular coagulation
)
8,673
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Six cases of unresectable hepatic cancer in infant were treated with intra-arterial infusion therapy. The histological types were
hepatoblastoma
and hepatocellular carcinoma, 3 cases respectively. The clinical stages were 1 recurrent case in I, 1 in IIIA, 2 in IIIB and 2 in IV. Seldinger method and cannulation at laparotomy were employed in 4 cases and 2 cases, respectively. In the eldest case, a catheter with dual lumen reservoir developed in our department was inserted, making it possible to infuse drugs into hepatic artery and cutting off hepatic arterial blood flow temporarily. The anticancer drug used was ADM, CDDP, 5-FU, THP-ADM, and MMC; antiAFP-anticancer drug conjugate missile therapy was employed in 4 cases. According to image diagnosis, reduction or necrosis of tumor was observed in 5 cases. In all cases, AFP scores decreased. In 5 dead cases, 4 cases died of tumor enlargement (average survival time 16.3 months); 1 case died of
DIC
during chemotherapy. The other case could eventually undergo complete resection and is now alive. Intra-arterial infusion therapy seemed to be useful for patients of infant unresectable hepatic cancer.
...
PMID:[Clinical study of intrahepatic arterial infusion of unresectable hepatoblastoma and hepatocarcinoma in children]. 247 63
Recombinant activated factor VII (rFVIIa) was given to three children with acute bleeding resulting from liver failure and
disseminated intravascular coagulation
. Cases I and II (girls aged 3 years and 6 years, respectively) were diagnosed with Dengue hemorrhagic fever and prolonged shock. Case III, a boy aged 9 months, underwent left lobe hepatectomy for a
hepatoblastoma
, during which 60% of his liver was removed. This case was complicated by myoglobinuria, liver and renal impairment and early
disseminated intravascular coagulation
. All three patients exhibited active bleeding. Cases I and II received rFVIIa combined with other blood component replacement, while Case III received rFVIIa as the only hemostatic agent. A bolus of 40-180 microg/kg b.w. was administered followed by 16.5-33 microg/kg b.w. per h continuous infusion. As a result, bleeding was controlled, the prothrombin time was shortened and FVII clotting activity was significantly increased. In conclusion, rFVIIa has shown some efficacy in controlling acute bleeding in children with liver failure and
disseminated intravascular coagulation
.
...
PMID:Recombinant activated factor VII in children with acute bleeding resulting from liver failure and disseminated intravascular coagulation. 1085 May 73
Hepatic resection is the main treatment modality for hepatic tumors in childhood. Advances in diagnostic technique, preoperative preparation, surgical technique, and postoperative management increased the success rate. The aim of this study is to report our experience in hepatic lobectomy, which is relatively rare procedure in childhood. Medical records of 25 patients who underwent hepatic lobectomy between January 1977 and June 2002 were reviewed retrospectively. Age, gender, diagnosis, physical examination findings, results of preoperative laboratory investigations, radiological examination, resectability criteria, preoperative biopsies, chemotherapies, radiotherapies, postoperative pathological results, incisions, operation technique, intraoperative transfusions, drains used, antibiotic prophylaxes, and intraoperative and postoperative complications were evaluated for all patients. Out of 25 patients with hepatic tumor seven patients with
hepatoblastoma
and four patients with hepatocellular carcinoma were given 5.7 +/- 0.3 cycles of chemotherapy before the operation. Right lobectomy (n = 12), left lobectomy (n = 5), extended left lobectomy (n = 4), and extended right lobectomy (n = 3) and right lobectomy with enucleation of two masses from left lobe (n = 1) were performed. Intraoperative blood transfusion of 30.7+/-6.0 ml/kg body weight was necessary. Pathological examination of resected tumors revealed
hepatoblastoma
(n=11), mesenchymal hamartoma (n = 5), hepatocellular carcinoma (n = 4), hemangioendothelioma (n=1), malignant mesenchymal tumor (n = 1), hemangioma (n = 1), cyst adenoma (n = 1), and metastasis of cellular mesoblastic nephroma (n = 1). Patients were observed in the intensive care unit for 3.4 +/- 0.3 days. Postoperative complications were sepsis (n = 1),
disseminated intravascular coagulation
(n = 2), fever (n = 3), jaundice (n = 3), intraabdominal abscess (n = 3), ileus (n = 2), and subdiaphragmatic abscess with pleural effusion (n = 1). Hepatic lobectomy is a major operation, which is feasible yielding curative results in children. Safe hepatic resections with acceptable blood loss can be performed by a technique relying on good anatomic dissection and surgical control.
...
PMID:Hepatic lobectomies in children: experience of a center in the light of changing management of malignant liver tumors. 1639 9
We discussed the diagnostic and treatment value and clinical significance of computer assisted surgery system (Higemi) in precision surgeries for pediatric complex liver tumors. A total of 21 pediatric cases receiving hepatectomy for tumors in the portal vein and giant liver tumors from June 2012 to January 2015 were analyzed. Higemi was used for 3-dimensional (3D) reconstruction of thin-slice CT images and surgical planning. Tumors were precisely located and blood vessel neighborhood was determined so as to evaluate surgical feasibility. In addition, pathological classification, surgical time, intraoperative blood loss, transfusion rate and complications were predicted. After 3D reconstruction using Higemi, the neighboring relationship of tumors with blood vessels and the running direction of the blood vessels were clearly visualized. Of 21 cases, 10 cases had tumors located in the left lobe, 5 cases in the right lobe, 3 cases showing involvement of right trilobes, and 3 cases in the middle lobe. Lobes exceeding one third of the total liver volume were resected in 18 cases. Postoperative pathological examination indicated 10 cases of
hepatoblastoma
, 3 cases of hepatocellular carcinoma, 3 cases of hamartoma, 3 cases of infantile hemangioendothelioma, 1 case of teratoma and 1 case of undifferentiated malignant mesenchymoma. The surgical time was 90-240 min with an average of 130 min; the medium intraoperative blood loss was 60 ml and the minimum blood loss was 3 ml; the transfusion rate was 42.9% (9/21). Surgeries were successful in 20 cases, who were discharged after recovery. However, one case had giant liver tumor combined with severe obstructive jaundice and hepatic insufficiency and died of postoperative liver failure and
DIC
. 3D reconstruction of CT data using Higemi can clearly visualize the running direction of blood vessels and the neighboring relationship with tumors. Higemi can improve the precision and safety of complex hepatectomy.
...
PMID:Application value of computer assisted surgery system in precision surgeries for pediatric complex liver tumors. 2677 Apr 45