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

Preoperative chemoembolization was performed in 10 patients with hepatocellular carcinoma. The therapeutic regimen included Adriamycin (ADM) solved in nonionic contrast media, Iopamiron and Lipiodol (LP). Two to four ml of the solution, containing 20-40 mg of ADM, was mixed with 5-10 ml of LP by "pumping" method. This emulsion was infused superselectively into the hepatic artery by the balloon-occluded method. The regimen contained no permanent embolic material (e.g., Gelfoam or Ivaron). Dense deposition of LP in the tumor was seen on the CT scan 3-4 weeks after TAI. Surgical specimens, resected 3-12 weeks after TAI, revealed total necrosis of the tumor in 4 cases, subtotal necrosis (more than 80% on the cut surface) in 3 cases, and partial necrosis (less than 80%) in 3 cases. Tumor invasion in the fibrous capsules was necrosed in 4/7 of the cases. Tumor thrombi in the portal vein were also necrosed in 2/4. Our new method is more effective than the previous ones of LP and ADM without Iopamiron, and is equally effective as the regimen using LP, anticancer drugs, and permanent embolic materials.
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PMID:[Preoperative chemoembolization of iopamiron-solved adriamycin and lipiodol on hepatocellular carcinoma--clinicopathological study of ten surgical cases]. 284 22

We have performed fluoroscopic contrast medium percutaneous ethanol injection therapy (FCM-PEIT) total 266 times to 82 hepatocellular carcinoma (HCC) nodules in 44 HCC cases: FCM-PEIT is the newly developed method that HCC nodules are punctured by a needle and injected with ethanol mixed with water-soluble contrast medium (Iopamidol containing 370 mg/ml iodine) (vol/vol: 7/3) under the fluoroscopic observation as well as ultrasonic diagnostic equipment (US). Autopsy analyses have demonstrated nearly complete tumor necrosis by FCM-PEIT. We analyzed the detectable rate (%) of the contrast medium-mixed ethanol (CME) leakage out of HCC nodules by US-alone, fluoroscope-alone, and US-fluoroscope observation. The detectable rate of the leakage was 63% by US-fluoroscope, while was only 32% by US-alone. Particularly, all leakages into intra hepatic bile duct were missed by US-alone. The maximal CME-amount for injection without any leakage was not uniform and not related to the size of HCC nodules. The present results suggest that FCM-PEIT is clinically more useful method for the treatment of HCC compared to general PEIT that HCC nodules are injected with ethanol under the US-alone observation, since it is easy to confirm whether ethanol can be sufficiently injected into HCC nodules without any leakage.
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PMID:[Fluoroscopic contrast medium percutaneous ethanol injection therapy (FCM-PEIT): newly developed clinical useful method for injecting ethanol into nodules of hepatocellular carcinoma]. 811 22

Prior injection of an anticancer agent and Lipiodol mixture is a key point for the treatment of hepatocellular carcinoma (HCC). We therefore prepared a new, improved emulsion of Lipiodol containing a high dose of cis-diamminedichloroplatinum (CDDP) and epirubicin by replacing the ionic contrast medium (Urografin 67) with a nonionic contrast medium (Iopamidol; Iopamiron 300) and adding phosphatidyl choline. This CDDP-epirubicin-Lipiodol emulsion (CELE) was examined pharmacologically and chemically with the following results. The size of these particles is less than 10 microns (diameter) for up to 24 h; the release of 28%-34% of the CDDP and 80%-90% of the epirubicin was estimated in the dissolution test, and 85% of the CDDP and 35% of the epirubicin was retained in the organs in the moment calculation. CELE was injected into 58 HCC patients via a celiac angiographic catheter. In 36 of these patients, the CELE injection was followed by transcatheter arterial embolization (TAE) therapy. Following the administration of CELE as one-shot injection therapy for stage IV HCC, the 1-year survival rate was 59% and the 2-year survival rate was 27%. Moreover, in patients (stage II, 12; stage III, 8; stage IV, 16) who received CELE and subsequently underwent TAE therapy, the 1-year survival rate was 90% and the 2-year survival rate was 67%. The nonionic contrast medium with Lipiodol forms finer emulsified particles, and these particles are more capable of penetrating into the tumor. In addition, the greater pharmacological stability of these particles provides a slow-release effect and prolonged stability of their shape. Finally, theoretically, the use of two major anticancer agents such as CDDP and epirubicin showed a greater clinical effect in the treatment of HCC than either our earlier suspension or a single anticancer agent.
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PMID:Therapeutic effect of a CDDP-epirubicin-Lipiodol emulsion on advanced hepatocellular carcinoma. 813 88

Of the alternative methods of treatment to surgery in the treatment of liver cancer, chemoembolization with Lipiodol appears to have obtained encouraging results. After a preoperative study to confirm the diagnosis and staging of the tumour, lipiodolisation is performed: a mix of Adriamycin, Iopamidol and Lipiodol is injected using selective catheterism of the hepatic artery; gelfoam is then added. Lipiodol selectively localises in the hepatocarcinoma and has a distal embolising effect on the vessels of the tumour, thus necrotising it, acting as a carrier for chemotherapy. Since july 1990 a total of 15 hepatocarcinoma have been observed: 6 in healthy livers and 9 in cirrhotic livers; 3 patients recovered after radical surgery, 1 patient underwent associated surgery and chemoembolization, whereas in 11 the only therapy was chemoembolization, at six monthly intervals. Lipiodolisation enabled a better diagnosis to be made and was found to be a valuable therapeutic aid both when used alone in Inoperable patients and in association with non-radical surgery.
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PMID:[Lipiodol chemoembolization in the treatment of hepatic carcinoma. Our experience]. 829 Jan 23

To assess the optimal scanning protocol for three-phase dynamic helical CT, 20 patients were examined according to the following 4 methods (5 cases each) : (1) 100 ml Iopamidol (300 mgI/ml), at a rate of 2 ml/sec ; (2) 120 ml,3 ml/sec, (3) 150 ml, 3 ml/sec ; (4) biphasic method, initial 100 ml, 3.3 ml/sec ; remaining 50 ml, 1.6 ml/sec. Assessment of the time-density curve of the aorta, and the liver parenchyma, indicated that protocol (4) was superior to the others. Using protocol (4), 32 patients (62 nodules) with hepatocellular carcinoma underwent three-phase scanning, consisting of early, late, and delayed phases. Out of 61 nodules, 43 nodules were detected as high density areas in the early phase, 7 nodules as low density areas only in the late phase, and 3 nodules as low density areas only in the delayed phase. Compared with MRI, three-phase dynamic helical CT demonstrated numerous nodules, especially those less than 10 mm in diameter, and, therefore, was useful for the detection of hepatocellular carcinoma.
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PMID:[Three-phase dynamic helical CT for hepatocellular carcinoma: optimal scanning protocol]. 883 Dec 16

Ultra rapid injection of isotonic sodium chloride after the injection of contrast medium may make it possible to clearly distinguish between the arterial phase and the portal phase. This method could improve the detectability of hepatocellular carcinoma on double phase dynamic spiral CT. A time-density analysis of the aorta and the portal vein was carried out according to the following 2 protocols (5 cases each). In protocol 1, 95 ml of Iopamidol (300 mgI/ml) was injected at a rate of 3 ml/second, while the protocol 2, 40 ml of isotonic sodium chloride was injected at a rate of 10 ml/second after the injection of 60 ml of Iopamidol (300 mgI/ ml) at a rate of 10 ml/second. The duration of the arterial phase (aortic enhancement unit (EU) > or = 200) in protocol 2 was 11 seconds, which was shorter than that in protocol 1. In protocol 2, the duration of the clearly portal dominant phase (reversal phase; aortic EU < portal EU) was about 11 seconds.
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PMID:[Experiment in ultra-rapid injection of isotonic sodium chloride after injection of contrast medium: time-density analysis of the aorta and portal vein]. 926 43