Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report describes 636 patients with portal hypertension in whom esophageal transections with paraesophagogastric devascularization were performed for the management of esophageal varices. The procedure was a prophylactic measure in 185 patients, elective surgery in 349, and an emergency procedure in 102. Portal hypertension was due to cirrhosis of the liver in 464 patients (40 alcoholic and 424 cryptogenic), idiopathic portal hypertension in 99, extrahepatic portal vein occlusion in 38, hepatoma in 22, and other causes in 13. The operative mortality rates were as follows: emergency 13.7%, elective cases 3.2%, prophylactic cases 4.3%, and overall 5.2%. There were no deaths in the 233 patients in Child's clinical class A; 232 class B patients had a 2% mortality rate, and 171 class C patients had a 17% mortality rate. The 10-year actuarial survival rates in patients with cirrhosis of the liver were 55% in emergency cases and 72% in both prophylactic and elective cases. In patients without cirrhosis the survival rates were 90%, 96%, and 95%, respectively. Recurrence of variceal bleeding or varices was less than 5%. We conclude that the Sugiura procedure is safe and effective in controlling esophageal varices and prolongs the long-term survival of patients with portal hypertension.
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PMID:Results of six hundred thirty-six esophageal transections with paraesophagogastric devascularization in the treatment of esophageal varices. 609 Jul 15

Portal blood flow (PBF) can be measured quantitatively using a B-mode combined pulsed Doppler (BCD) system. This system combines a real time B-mode linear type electroscanner and a pulsed Doppler (D-mode) flowmeter. Since both modes are displayed in realtime, Doppler blood flow signals can be retrieved at will from any depth. The blood flow velocity determined by the Doppler spectrogram and the vascular cross-sectional area measured from the B-mode tomographic image enables the quantitative calculation of blood flow volume. Using this system, PBF was measured quantitatively in 88 healthy adults, 54 patients with chronic hepatitis, 65 with cirrhosis of the liver, 27 with primary hepatoma and 12 with idiopathic portal hypertension (IPH). Results of PBF volume measurement were as follows: 889 +/- 284 ml/min (mean +/- S.D.) for healthy adults, 851 +/- 237 ml/min for patients with chronic hepatitis, 870 +/- 289 ml/min for cirrhosis of the liver, 966 +/- 375 ml/min for primary hepatoma and 1,047 +/- 381 ml/min for IPH. These preliminary results demonstrated that this ultrasonic Duplex system is clinically useful to determine the quantitative amount of PBF.
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PMID:Quantitative measurement of portal blood flow in patients with chronic liver disease using an ultrasonic Duplex system consisting of a pulsed Doppler flowmeter and B-mode electroscanner. 609 10

The function of polygonal liver cells can be estimated by using liver specific dyes such as labelled BSP or bengalrosa and labelled X-ray contrast media. Various methods are available: clearance with blood counting or external monitoring, whole body clearance and retention measurement. These tests are of value for following the course of liver diseases. Blood flow measurements either with labelled colloids or 133 Xe are mainly used for scientific purposes. Portosystemic shunts can be detected by injection of labelled microspheres in the spleen and lung monitoring or scanning. With the dynamic scintigraphy portosystemic shunts can be visualized ( radionuclide splenoportography). The measurement of the praecordial appearance time after rectal instillation of 133 Xe permits the functional evaluation of a surgical portosystemic shunt. Dynamic scintigraphy makes possible the estimation of the arterial part of liver blood flow after i.v. injection of 99m Tc and this together with the radionuclide splenoportography allows the assessment of disturbed blood flow in patients with portal hypertension. I. v. applied parathyroid hormone increases the arterial hepatic blood flow. Preliminary results indicate that patients with portal hypertension and a good response to parathyroid hormone seem to have a good prognosis after shunt operation. The determination of red cell survival with 51 Cr is helpful in the differential diagnosis of jaundice. The specificity of liver scanning with labelled colloids for malignant diseases can be reasonably increased by additional 67 Ga-scintigraphy. In the diagnosis of hepatoma with both colloid and Galliumscan and the evaluation of alpha-fetoprotein a 90% accuracy can be achieved. The hepatobiliary transport can easily be visualized with 99m Tc labelled IDA-compounds and also in patients with severe jaundice where the X-ray cholangiopathy is impossible. This examination is indicated in patients with bile duct observations (also intrahepatic), after cholecystectomy, for the differential diagnosis of jaundice, for the demonstration of refluxes etc. The most important radioimmunological in vitro methods for the investigation of liver diseases are only briefly described.
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PMID:[Nuclear-medical methods in hepatology]. 616 31

The high incidence of hepatic lesions in sarcoidosis contrasts with the extreme rarity of portal hypertension. The mechanism of the latter is as obscure as the pathogeny of the disease. The liver may contain many or very few tuberculoid follicles, and its structure may be normal and non-fibrotic (as in our first two patients) or sclerotic, though rarely cirrhotic. In most cases the spleen is enormous, which raises the problem of portal hypertension by overload. Our third patient seems to be an unique case of progressive change to malignant hepatoma with osseous metaplasia, complicated with cervical metastases.
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PMID:[Portal hypertension in sarcoidosis. Three cases including one with liver fibrosis and malignant hepatoma with osseous stroma (author's transl)]. 624 4

Six hepatic angiosarcomas, one hepatoma and one hepatic "fibrosis" with portal hypertension in patients chronically exposed to vinyl chloride monomer (VCM) are reported. The industrial methods of synthesis and current knowledge concerning the carcinogenic role of VCM are reviewed. Histogenetic and pathogenetic concepts of "fibrosis" and angiosarcomas of liver are exposed.
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PMID:[Hepatic lesions caused by vinyl chloride monomer in humans. Study of eight clinicopathological cases (author's transl)]. 625 69

Portal hypertension associated with hepatocellular carcinoma in the absence of cirrhosis of the liver has not been clearly recognized in the past. While the incidence of this association is unknown, its occurrence does not appear to be rare. This case report describes a 49-year old male with hepatocellular carcinoma, ascites and measured portal hypertension but no cirrhosis of the liver. The portal hypertension was secondary to microscopic invasion of central veins and small portal veins. Hepatocellular carcinoma in the absence of cirrhosis should be added to the differential diagnosis of portal hypertension.
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PMID:Portal hypertension associated with hepatocellular carcinoma with cirrhosis. 626 84

The two main indications for liver grafting are primary malignancy and parenchymatous liver disease. In both cases orthotopic transplantation remains the preferred technique. Since graft rejection was considered not to be the main problem in clinical liver transplantation, recent improved survival rates were reported to be due to a more aggressive diagnostic management and consequent treatment of postoperative complications nonrelated to graft rejection. Because of the limited number of organs available for organ grafting sometimes technical modifications may become necessary. This was the case in a 40-year old male patient suffering from primary malignant hepatoma. The donor was a child, and during operation a great difference between organ size and length and diameter of the hepatic vessels became evident. Orthotopic transplantation was performed using an unusual method of caval vein anastomosis. Initially the patient did very well, but later on liver function deteriorated and the patient died in the eighth postoperative week because of hepatic artery thrombosis. The autopsy showed that all other vascular anastomosis were patent and no signs of portal hypertension were evident. The surgical technique used in this case is described in detail and some interesting aspects are discussed.
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PMID:[Clinical experience in a case of orthotopic liver transplantation by use of an atypical caval vein anastomosis (author's transl)]. 626 20

The intrahepatic portal system was studied by superior mesenteric angiography in 80 patients with hepatic masses. The portal study helped to identify the highly significant portal signs of malignancy (amputations, irregular stenosis, portal hypertension), and, among the malignant tumors, the specific signs of hepatoma (portal trunk amputation, ill-defined hepatographic lacunae, association of portal hypertension with proximal portal amputation). It is concluded that the intrahepatic portal study is essential in pretherapeutic staging. It is better than superselective hepatic arteriography in assessing the involvement of one hepatic lobe when a hypervascular tumor involves the other lobe, and it is indispensable if embolization is planned.
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PMID:The value of a portal study in determining the etiology of hepatic masses in the adult. 628 Feb 34

A case of hepatoma associated with previously treated portal hypertension and calcification of the portal veins, collaterals, and superior mesenteric veins was demonstrated by CT, as was the patent splenorenal shunt and ascites. Computed tomography successfully demonstrated all these aspects of the case by plain scans and the use of angiotomography with rapid sequential sections using the multiple bolus technique of contrast enhancement.
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PMID:Computed tomographic demonstration of "coronary" collateral vein calcification and patent spleno-renal shunt--a case report. 631 83

In attempts to obtain complete control of bleeding esophageal varices, terminal esophago-proximal gastrectomy (TEPG) and its modification proximal gastric transection (PGT) were performed, under endoscopic assistance, in 42 patients with cirrhotic portal hypertension. Complete disappearance of varices was confirmed in all patients at surgery and 4 weeks after surgery, and this condition was maintained for up to 60 months in 15 patients of TEPG and 16 of PGT. Recurrent varices in 3 (17 per cent) TEPG and 8 (34 per cent) PGT were attributed to the advance in the liver cirrhosis in 7, hepatoma in 3 and portal vein thrombosis in 1. In 8 of 11 recurrences, type C variceal blood circulation drained into the cervical veins. Endoscopic assistance during surgical treatment for bleeding esophageal varices plays a decisive role.
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PMID:Endoscope assisted surgery for the treatment of bleeding esophageal varices. 633 68


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