Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is no definition for early liver cancers. However, solitary liver cancers smaller than 2 cm in diameter are defined as small liver cancers and this term is often used as the meaning of early cancers. Small liver cancers are diagnosed by US, US-guided biopsies, computed tomography (CT), magnetic resonance imaging (MRI), and angiography. They are successfully treated by percutaneous ethanol injection (PEI), subsegmental transcatheter arterial embolization (TAE), operations and percutaneous microwave coagulation therapy (PMCT), 3-years survival rates being more than 70%. The choice of treatments depends on the techniques available in each institute and liver function, since most cases are complicated with liver cirrhosis.
 ...
PMID:[Early liver cancer]. 896 70

The treatment outcomes were analysed in 37 patients with intrahepatic arterioportal fistulas (IAPF) of various etiology. In 21 patients with fistulas in the presence of hepatoma, surgical resection (n = 4), hepatic arterial embolization with a hemostatic sponge and metallic spirals (n = 7) and conservative therapy (n = 10) were used. In 4 large iatrogenic IAPF, embolization was conducted just after making a diagnosis; in other 7 cases, a follow-up was accompanied by control arteriography. Embolization was done in all 5 patients with large spontaneous IAPF in the intact and cirrhosis- or hemangioma-related liver. One fatal outcome was observed after embolization in the presence of severe hepatic failure. No other complications were registered. Symptoms of elevated pressures in the portal vein regressed in most patients. It is concluded that despite the cause of occurrence, long-term IAPF results in hyperkinetic portal hypertension, followed by bleeding from the esophageal and gastric varicosity. Arterial embolization of IAPF in the hepatoma reduces the risk for fatal hemorrhage. Small iatrogenic IAPF should be followed up by making control arteriography. Arterial occlusion is the treatment of choice for spontaneous and persistent iatrogenic IAPF. Severe chronic hepatic failure is a contraindication for embolization.
 ...
PMID:[Role of transcatheter embolization in intrahepatic arterioportal fistulas]. 902 73

During the period between April 1981 and March 1988, 232 consecutive patients underwent transcatheter arterial embolization (TAE) for hepatocellular carcinoma at the Department of Radiology, Wakayama Medical College. A > or = 5-year course calculated from the time of the initial TAE was able to be confirmed in 216 patients, who became the subjects of this study. Five-year survival rates were calculated by the direct method, while the clinical features existing at the time of the initial therapy and the clinical course of patients surviving > or = 5 years were studied. The 5-year survival rate was 6.0%. Comparison of the patients dying within 1 year and the patients surviving for > or = 5 years revealed differences in the severity of liver cirrhosis and the tumor type. The long-term survivors tended to have low serum alpha-fetoprotein values. The clinical picture of the patients surviving > or = 5 years after TAE was characterized by relatively mild liver cirrhosis (Child's class A or B), a serum alpha-fetoprotein value of < or = 1,500 ng/dL, relatively small nodular-type tumors with a maximum main tumor diameter of < or = 5.5 cm, a tumor-occupying rate of less than 20%, and absence of portal vein involvement by the tumor. There were patients in whom a relatively small number of TAE sessions was effective in controlling the tumor for a prolonged period, with the patients then dying of causes unrelated to the tumor, as well as patients in whom proliferation of the tumor was controlled by numerous applications of transcatheter therapy, resulting in > or = 5-year survival but with eventual death due to the tumor. Transcatheter arterial embolization makes a major contribution to achieving long-term survival of > or = 5 years in patients with hepatocellular carcinoma.
 ...
PMID:Factors associated with survival exceeding 5 years after transcatheter arterial embolization for hepatocellular carcinoma. 915 14

A rare case of malignant lymphoma of the stomach after treatment for hepatocellular carcinoma (HCC) is reported. A 72-year old man presented with a large mass on the right hypochondrium, which was diagnosed as HCC associated with chronic hepatitis C with cirrhosis. The inoperable tumor was treated conservatively with cisplatin, etoposide, carboplatin, and Lipiodol infused into the hepatic artery, together with transcatheter arterial embolization. The patient presented 38 months later with features suggestive of gastric ulceration. Endoscopy and histological examination of biopsy material confirmed the presence of malignant lymphoma of the stomach. He ultimately died as a result of hepatic failure. The clinical presentation suggests that gastric lymphoma was possibly related to the lymphotropic effect of hepatitis C virus (HCV) and exacerbated by intraarterial injection of the cytotoxic drugs.
 ...
PMID:Malignant lymphoma of the stomach after chemotherapy for hepatocellular carcinoma. 925 Sep 3

A 66-year-old female with liver cirrhosis was treated by transcatheter arterial embolization (TAE) for a small hepatocellular carcinoma. She developed steatonecrosis with tenderness which occurred in the upper abdomen after TAE. The hepatic falciform artery from the middle hepatic artery was detected by arteriography. Necrosis in the upper abdomen was considered to be due to ischaemic changes caused by micromaterials for embolization of this artery, injuries of hepatic arterial endothelia slowly caused by carcinostatics, and chemotoxicity. It was considered that such complication as observed in this patient should be taken into consideration when performing TAE.
 ...
PMID:Case report: Steatonecrosis in the upper abdomen following transcatheter arterial embolization for hepatocellular carcinoma. 964 42

The present status of hepatic resection for hepatocellular carcinoma (HCC) is reviewed with special reference to the vascular aspects. Hepatic resection combined with portal tumor thrombectomy has been attempted in Japan. This procedure may be effective in the prevention of rupture of esophageal varices and making transcatheter arterial embolization possible. According to the report of Yamaoka and his associates, the 1- and 3-year survival rates of 29 patients treated with this combined procedure were 53% and 12%, respectively. This surgical strategy may thus yield survival benefits. In patients with a tumor near the confluence of the major hepatic vein and inferior vena cava, resection of segments 4b, 7, and 8 combined with hepatic vein reconstruction has been performed, which allows functional preservation of the residual liver. The historical development of hepatic vascular exclusion (HVE) is also reviewed. HVE can be performed safely using a centrifugal active pump, even in patients with cirrhosis. Hepatic resection combined with removal of tumor thrombus in the right atrium has been carried out using extracorporeal circulation. There are reports that at least two patients undergoing this operation survived more than 2 years after surgery. The hepatic warm ischemic time should be less than 60 min. Vascular surgery techniques are being increasingly applied in Japan for the treatment of HCC. Such surgery can be performed safely even in patients with cirrhosis. Improvement of long-term survival in patients undergoing such procedures remains an unresolved problem, however.
 ...
PMID:[Treatment of hepatocellular carcinoma: application of vascular surgery]. 964 88

In most of the cases, hepatocellular carcinoma (HCC) develops in the setting of cirrhosis associated with hepatitis B or C infection. Thus, cirrhotic patients constitute the population at risk for HCC. This has prompted the screening of cirrhotic patients for HCC and this policy has facilitated the detection of HCC at an early and/or asymptomatic phase when potentially effective treatments are available. However, it must be stressed that the prognosis of the patients with HCC is determined not only by the stage of the HCC, but also by the functional status of the underlying liver. In such a situation in Japan, systematic subsegmentectomy using intraoperative ultrasound, trancathether arterial embolization (TAE), and percutaneous ethanol injection (PEI) were developed to treat HCC patients with cirrhosis. On the other hand in the West, liver transplantation is the therapeutic modality for small HCC with cirrhosis while small HCCs are treated mainly by PEI. However, the lack of controlled trials for the most therapeutic options in our country precludes knowing if their antitumoral effect is associated with an improved survival. In summary, the treatment of patients with HCC remains a clinical challenge with several areas to be investigated through carefully designed prospective randomized controlled trials. Ideally, this clinical research will provide us with solid therapeutic options that unequivocally improve the survival of the patients with HCC. Application of living-related liver transplantation for carefully selected adult patients with small HCC will be necessary in Japan.
 ...
PMID:[Different strategies for treatment of hepatocellular carcinoma in the west and in the east]. 967 75

Hepatocellular carcinoma occurs almost exclusively in patients with cirrhosis, at least in the West. In most of these patients, potential curative treatments, such as resection or percutaneous alcohol injection, are usually contra-indicated. Transarterial chemoembolization may induce tumor necrosis. In order to avoid massive necrosis of the non tumoral liver, two major contra-indications have been identified: inadequate portal flow and liver failure. The influence of chemoembolization on survival was thought to be high on the basis of non randomized trials. However, no beneficial effects on survival were observed in three randomized trials. In these trials, the beneficial effect on tumor necrosis was counterbalanced by frequent deleterious effects on liver function. Moreover, progressive liver atrophy may follow repeated procedures. As there is no alternative treatment for most of these patients and chemoembolization can still be beneficial in selected cases, efforts have been made to improve patient selection and method to improve the results. Good liver function, a normal portal flow, and a well limited hypervascularized tumor are necessary conditions for treatment, which may even be curative when used in association with percutaneous alcohol injection. Moreover, arterial embolization can be performed without chemotherapy, and the procedure should not be repeated in the short term.
 ...
PMID:Intra-arterial chemoembolization in patients with hepatocellular carcinoma. 973 Mar 82

gamma delta T lymphocytes, which are CD3+ lymphocytes that express gamma delta chains of the T-cell antigen receptor (TCR) on their surface, are functionally distinct from alpha beta T lymphocytes, which express alpha beta chains of the TCR. gamma delta T lymphocytes are thought to differentiate in mouse hepatic sinusoids, to play a role in antitumor action, and to act as natural killer cells. The purpose of this study was to examine whether gamma delta T lymphocytes in the peripheral blood are suppressed when hepatic sinusoids are damaged during transcatheter arterial embolization (TAE). The numbers of alpha beta T lymphocytes and gamma delta T lymphocytes in the peripheral blood were examined with monoclonal antibodies and flow cytometry before and after TAE in 32 patients (from 46 to 78 years of age) with liver cirrhosis and hepatocellular carcinoma. The number of alpha beta T lymphocytes before and after TAE was unchanged. However, the number of gamma delta T lymphocytes and the ratio of gamma delta T lymphocytes to CD3+ lymphocytes were significantly decreased for 3 weeks after TAE treatment. This decrease suggests that TAE suppresses the supply of gamma delta T lymphocytes to the peripheral blood. In addition, TAE may weaken a patient's antitumor immunity, because gamma delta T lymphocytes that have antitumor activity decrease after TAE.
 ...
PMID:[Diminution of the number of gamma delta T lymphocytes in hepatocellular carcinoma patients treated with transcatheter arterial embolization]. 975 13

The N-linked sugar chain structures of human hepatic, intestinal, and placental alkaline phosphatases (ALPs) were studied comparatively by chromatography on various lectin columns in combination with digestion by several kinds of exoglycosidases. The sugar chain structures were organ specific. On the basis of these organ-specific structures, we investigated serum ALP using a Neu5Ac(alpha)2-->6Gal(beta)1-->4 GlcNAc-specific Trichosanthes japonica agglutinin-I (TJA-I)-Sepharose column to clarify whether the level of TJA-I-binding serum ALP activity can be used as an indicator to discriminate one form of chronic liver disease from another. Levels of TJA-I-binding ALP in serum were higher in cases of liver cirrhosis and hepatocellular carcinoma than in chronic hepatitis (P < 0.01). The levels of TJA-I-binding ALP in serum did not change significantly after transcatheter arterial embolization, and the amounts of TJA-I-binding ALP activity in noncancerous cirrhotic liver tissues were higher than those in cancerous liver tissues derived from hepatocellular carcinoma patients, indicating that the TJA-I-binding ALP is mainly derived from cirrhotic liver tissues rather than cancerous liver tissues. These results indicate that analysis of the levels of TJA-I-binding ALP in serum is clinically useful for differentiating liver cirrhosis from chronic hepatitis and that altered sugar chain expression in ALP occurs mainly in liver cirrhosis.
 ...
PMID:Elevated serum levels of Trichosanthes japonica agglutinin-I binding alkaline phosphatase in relation to high-risk groups for hepatocellular carcinomas. 982 41


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>