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)

One hundred and fourteen consecutive patients with unresectable hepatocellular carcinoma were treated by chemoembolization using ethiodized oil (Lipiodol), anticancer agents. Ninety patients had concomitant chronic liver disease. Hepatocellular carcinoma (HCC) was diagnosed by US, contrast enhanced CT, fine needle biopsy and alpha-feto-protein level. Admission criteria were as follows: tumor confined to the liver with or without hilar nodal involvement, Child class A or B, white blood cell count above 2.000/mmc and platelet count above 75,000/mmc. All the patients underwent angiographic chemoembolization with Lipiodol and anticancer agents. In 98 patients we performed transcatheter hepatic arterial embolization (TAE) with Gelfoam or for Ivalon sponge. In 16 patients TAE was not performed because of portal thrombosis (7 cases) or technical reasons (9 cases). Mitomycin was used in 40 patients and dihydroxyanthracenedione (DADH) in 58 patients. In the TAE group 83 patients were Child A and 15 Child B. In 27 patients HCC was mononodular whereas in 71 it was multinodular. In 41 patients the tumor was more than 5 cm in diameter (in multinodular tumors only the larger lesion was taken into account). In 56 patients chemoembolization plus TAE was repeated. Seven patients died within one month after treatment: two from myocardial infarction, two from liver failure, two from digestive haemorrhage and one from necrotizing pancreatitis. Long-term survival rates were investigated in relation to prognostic factors: anti-cancer agent, number of nodes, tumor size and Child stage using Kaplan-Meier method. Survival rate at 12, 24 and 36 months are 64%, 38%, and 30% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The treatment of hepatocellular carcinoma by chemoembolization]. 802 66

The value of the superparamagnetic contrast medium AMI-25 and its clinical acceptability was investigated in a phase-III-multicenter study. 18 patients with primary and secondary hepatic tumours were studied using T2- and T1-weighted spin-echo sequences, FATSAT sequences and FLASH-2-D-breathold sequences, both before and after intravenous application of AMI-25 (0.2 mmol GE/ml 15 mmol/kg KG in 100 ml 5% glucose infusion), using a 1.5 Tesla MRT (Magnetom 63 SP, Siemens). In 6 patients the MRT findings could be correlated with in vitro results within 30 minutes following surgical resection. In 8 patients a diagnosis of metastases was made. Amongst patients with primary liver tumours (FNH 6 cases, HCC 3 cases, adenomatosis 1 case) 3 of the 10 patients showed more lesions following the injection of contrast; similarly, in 4 patients of the 8 with secondary tumours contrast increased the number of visible lesions. The absence of contrast enhancement separated primary from secondary lesions. Amongst the patients with secondary liver tumours, in vitro correlation always showed more tumours than had been visualised whereas there was exact in vivo/in vitro correlation amongst patients with primary liver tumours.
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PMID:[The value of the liver-specific superparamagnetic contrast medium AMI-25 for the detection and differential diagnosis of primary liver tumors versus metastases]. 816 44

A 76-year-old man underwent an injection of 5 ml of ethanol for the treatment of a hepatocellular carcinoma 3 cm in diameter. Shortly after the procedure, he had an attack of abdominal pain. His condition soon deteriorated and he died 5 days later. Massive hepatic necroses distant from the injection site and a myocardial infarction were found at autopsy. To our knowledge, this is the first fatality associated with percutaneous ethanol injection therapy.
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PMID:Fatal liver necrosis following percutaneous ethanol injection for hepatocellular carcinoma. 822 36

A high level of plasma fibrinogen has been shown to be an important risk factor for myocardial infarction and stroke. Thus, we were prompted to investigate regulation of human fibrinogen biosynthesis, a process wherein expression of the B beta-chain of fibrinogen appears to be rate-limiting for fibrinogen secretion. Using electrophoretic mobility shift assays with synthetic probes representing portions of the human B beta-fibrinogen promoter, we have defined several elements that bind distinct classes of transcription factors present in human hepatoma cell nuclear extracts. The contribution of each element to promoter activity was demonstrated in transfection experiments using promoter-chloramphenicol acetyltransferase constructs and human hepatoma cells. Our observations indicate that two distinct sequence elements are required for maximal induction of transcription by interleukin-6. One of these sequences is an IL-6-RE core element similar to that reported for the rat alpha 2-macroglobulin promoter and the other is a binding site for the C/EBP family of transcription factors. We also report two additional elements, one negative- and one positive-acting, that bind novel sequence-specific factors.
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PMID:Functional characterization of promoter elements involved in regulation of human B beta-fibrinogen expression. Evidence for binding of novel activator and repressor proteins. 822 73

Superparamagnetic iron oxide particles (AMI-25) were evaluated as a liver contrast agent in high-field MR imaging (1.5 T). 16 patients with up to 5 presumed focal liver lesions (liver metastases n = 8, HCC n = 5, Klatskin tumours n = 2, FNH n = 1) received 15 mumol Fe/kg BW intravenously and were examined via standard T1- and T2-weighted spin-echo sequences. Quantitative image analysis showed a post-contrast increase of the contrast-to-noise ratio (C/N) from 1.6 to 7.4 on SE 2,500/15 images (p < .05). However, C/N was in the same range on plain SE 2,500/90 scans. Blind evaluation by two independent readers revealed that AMI-25-enhanced images did not provide a significantly increased number of lesions. Two patients reported minor, self-limited side-effects (flush, back pain). We conclude that in contrast to reports at mid-field MR imagers, the use of AMI-25 at 1.5 T does not significantly improve the detection of focal liver lesions on conventional SE images.
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PMID:[The MR tomography of focal liver lesions with the superparamagnetic contrast agent AMI-25 at 1.5 tesla]. 830 92

The evidence of the effects of combined oral contraceptives (COCs) on mortality and morbidity is reviewed. All the 11 case-control studies published since 1980 reported and approximate halving of endometrial cancer risk among COC users. The CASH study showed that the protective effect was apparent after 12 months' use, and users had 40% of the risk of non-users after 2 years' use. A study showed that 5 patterns of self-perceived prolonged, heavy, frequent, irregular, or painful bleeding during menstruation were reported less frequently in COC users than in users of other methods. Benign breast disease is rarer, and functional ovarian cysts are less frequent in COC users. Lower-dose preparations may carry a lower risk of myocardial infarction. Smoking possibly potentiates the risk associated with oral contraceptive (OC) use, and it is a major risk factor for myocardial infarction. The Oxford/FPA study found a 2-3-fold increase in incidence of non-haemorrhagic stroke among current OC users. The epidemiologic data on the current risk of venous thromboembolism in relation to OC use are equivocal. New lower dose COCs have a smaller adverse effect on the lipid profile: they cause a smaller increase in low density lipoprotein cholesterol (LDL) and a variable but smaller decrease in high density lipoprotein cholesterol (HDL). The large CASH study, based on 2088 cases, found a significantly elevated relative risk (2.7) of breast cancer, but only in women who had used the OC for at least 11 years. Of 6 case-control studies of hepatocellular carcinoma and OC use published since 1983, all but one showed a large elevated relative risk of around 4-fold. Delayed return of fertility has been observed in nulliparous women 30 who had 2 years; continuous exposure to COCs, although this may not be associated with low-dose, modern OCs. Malignant melanoma, pituitary adenoma, gallbladder disease, and chronic inflammatory bowel disease have been possibly associated with adverse side effects, but results are so far inconclusive.
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PMID:Combined oral contraceptives: risks and benefits. 832 3

Resection and graft replacement of the vena cava for malignant disease is rarely performed, often because of the advanced tumor stage. Since August 1987 we have selectively performed caval replacement in conjunction with tumor resection in 11 patients. Three patients had superior vena cava reconstruction (SVCR) and eight had inferior vena cava replacement (IVCR). There were six males and five females whose mean age was 59.3 years (range 24 to 75 years). Two patients, each with superior vena cava obstruction, presented with symptoms from venous compression. Malignancies involving the superior vena cava were thyroid carcinoma in two patients and lymphoma in one. Cancers requiring IVCR were leiomyosarcoma in three patients, cholangiocarcinoma in two, and malignant fibrous histiocytoma, hepatocellular carcinoma, and colon carcinoma metastatic to the liver in one each. All IVCRs and two SVCRs were performed with expanded polytetrafluoroethylene grafts. The remaining SVCR was constructed with spiral saphenous vein. Six IVCRs involved replacement of the retrohepatic inferior vena cava in conjunction with major liver resection. Mean intraoperative blood transfusions were 5.3 units (range 0 to 10 units). There were no operative deaths. Complications occurred in four patients and included postoperative bleeding in two, myocardial infarction in one, and wound infection in one. There were no perioperative graft occlusions, but one patient developed graft occlusion 2 months after SVCR. All IVCR grafts have remained patent (mean follow-up of 8.8 months). Two patients with SVCRs have died from recurrent cancer at 3.2 and 3.4 years postoperatively. Six patients with IVCRs have developed tumor recurrence either locally (n = 1), at a distant site (n = 2), or both (n = 3). Importantly, eight of nine survivors have an excellent performance status. We conclude that vena cava reconstruction for malignancy can be performed safely, has few graft-related complications, and in some patients may offer the only possibility for tumor control.
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PMID:Vena cava replacement for malignant disease: is there a role? 851 20

The main adverse effects of tamoxifen, aspirin, oral contraceptives (OCs) and retinoids used as chemopreventive agents in humans are reviewed and quantified here. With regard to tamoxifen, there are suggestions of some excess risk of liver, and perhaps gastrointestinal, cancers. The public health impact of such associations, if any, is still unclear. Tamoxifen use is associated with endometrial and myometrial hyperplasia. Data from five studies based on 174 cases indicate that the overall relative risk (RR) of endometrial cancer in ever tamoxifen users is 1.73 (95% confidence interval = 1.1-2.6). However, there is a significant difference between the results of American and European studies, so the relationship between tamoxifen and endometrial cancer remains open to debate. The major side-effect of aspirin is gastrointestinal lesions; the risk of these is increased two- to tenfold, depending on the dose. Aspirin is also associated with an increased risk of haemorrhagic stroke, although its protection against other types of stroke and against myocardial infarction leads to a favourable pattern of risk for all cardiovascular conditions. Short-term side-effects of OCs include vascular diseases and a moderately increased risk of breast cancer. The RR of cervical cancer and hepatocellular carcinoma are also increased in OC users, although the public health impact of such associations is small. Toxicity associated with retinoid treatment is rarely serious as most effects observed are reversible on stopping use. Side-effects include changes in the skin and mucous membranes (dry skin, hair loss, dry nose, conjunctivitis), musculoskeletal symptoms, ophthalmological effects, changes in transaminase activity, changes in clinical chemistry markers (increase in serum triglycerides and decrease in high-density lipoproteins) and, rarely, central nervous system effects. A serious toxicological aspect of retinoid treatment is teratogenesis; its use should therefore be avoided in women with childbearing potential, and, in cases of use, conception should be delayed for a long time after stopping treatment. Thus, when considering side-effects of chemoprevention, the major issues of concern are the rare long-term effects (chiefly neoplasms), and the need for more precise overall risk-and cost-benefit assessment, particularly for healthy people.
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PMID:Adverse effects of preventive therapy in humans. 892 25

Oxidative stress is defined as a disturbance in the prooxidant-antioxidant balance in favor of the former and has been suggested to be a relevant factor in aging as well as in different pathological conditions, such as heart attack, diabetes, and cancer. Ubiquinol is very sensitive against oxygen radicals and gives ubiquinone as an oxidation product. Therefore, the ratio of ubiquinol to ubiquinone should be a good marker of oxidative stress because of its definition. A method for the simultaneous detection of ubiquinol-10 and ubiquinone-10 in human plasma is described. Heparinized human plasma was mixed with 5 volumes of methanol and 10 volumes of hexane. After vigorous shaking and centrifugation, the hexane phase (5 microliters) was injected immediately and directly on to reverse-phase HPLC equipped with an on-line reduction column and an electrochemical detector in order to avoid the oxidation of ubiquinol to ubiquinone. It was found that the ratio of ubiquinol-10 to ubiquinone-10 was about 95/5 in human plasma from healthy donors. A significant increase in the oxidized form (ubiquinone-10) content was observed in plasmas of patients with hepatitis, cirrhosis, and hepatoma when compared with normal subjects, suggesting increased oxidative stress in these patients.
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PMID:Plasma ratio of ubiquinol and ubiquinone as a marker of oxidative stress. 926 9

The serum concentration of the inter-alpha trypsin inhibitor heavy chain 4 protein (ITIH4) increases (from 1.4-3 times) in male patients suffering of different acute-phase processes (myocardial infarction, unstable angina or programmed surgery). The concentration of C-reactive protein (CRP) in these samples ranged from 15 microg/ml to 133 microg/ml. Using the hepatocarcinoma HepG2 cell line we have observed up-regulation of ITIH4 mRNA expression upon dose-response treatments with interleukin-6 (IL-6). This effect correlates with the increase of radiolabeled ITIH4 in the cellular media of (35)S-labeled HepG2 cells treated with the cytokine. A similar effect was observed for haptoglobin mRNA, used as a control for acute-phase protein expression. IL-1beta, although up-regulating the expression of alpha(1)-acid glycoprotein in these cells, did not induce any effect in the expression of ITIH4. No changes were observed after TNF-alpha treatments. The results presented here indicate that ITIH4 is a type II acute-phase protein in humans.
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PMID:ITIH4 serum concentration increases during acute-phase processes in human patients and is up-regulated by interleukin-6 in hepatocarcinoma HepG2 cells. 1048 81


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