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

Hepatocellular carcinoma was treated with slow injection of an emulsion containing 40 to 60 mg of adriamycin and 3.5 to 12 ml of Lipiodol into the portal vein via a segmental hepatic artery. During and after the injection, the portal branches of the segment were demonstrated. Six patients with resectable hepatocellular carcinoma received this treatment, which in 3 of them was followed by embolization with Gelfoam of the segmental artery. In these 3, all main tumors and daughter nodules became completely necrotic, but some infarction developed in the non-tumorous area. Those without Gelfoam had complete necrosis of all daughter nodules, but incomplete response of the main tumor. This combined treatment may be recommended for patients with localized lesions which are nonresectable due to cirrhosis, or for other reasons.
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PMID:Treatment of hepatocellular carcinoma by segmental hepatic artery injection of adriamycin-in-oil emulsion with overflow to segmental portal veins. 216 28

The serial histological changes of the liver following the intrahepatic arterial injection of Lipiodol in the rat with cirrhosis were investigated. The hepatocytes showed acidophilic degeneration and focal necrosis after 12 hours and restoration of focal necrosis was seen after 72 hours. Necrosis and infarction were resolved after 120 hours. We concluded that the intrahepatic arterial injection of 0.1 ml Lipiodol in the rat with cirrhosis was safely performed.
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PMID:[Effect of intraarterially injected lipiodol on rat liver with cirrhosis]. 217 21

Plasma abnormal prothrombin (protein induced by vitamin K absence or antagonist-II: PIVKA-II) was evaluated as a serological marker for hepatocellular carcinoma (HCC). Its plasma levels were measured by enzyme immunoassay using an anti-PIVKA-II monoclonal antibody in 1010 patients with various diseases. Of 192 patients with HCC, 116 (60%) had abnormal PIVKA-II levels greater than 0.1 AU/ml. Elevation of PIVAK-II levels was observed rarely in chronic hepatitis, liver cirrhosis and other malignant tumors. Plasma PIVKA-II levels in HCC increased with tumor size. Normal levels were observed in patients with tumors measuring 2 cm or less in diameter. As a result, diagnostic application of plasma PIVKA-II levels to small liver tumors is limited. The sensitivity of PIVKA-II in the diagnosis and monitoring of HCC was increased by serial and simultaneous determinations of AFP, because high PIVKA-II levels were observed more often in low AFP-producing HCC patients. In some patients with HCC, plasma PIVKA-II levels decreased after surgical resection of the tumor or chemoembolization with cisplatin suspended in Lipiodol (LPS), but later rose again with recurrence of the disease. Elevated plasma PIVKA-II levels were not related to low vitamin K concentration in the serum. In fact, in many patients vitamin K administration resulted in only a moderate reduction of PIVKA-II levels. From these results, plasma PIVKA-II assay by the EIA method using a monoclonal antibody is a useful tool for the diagnosis and monitoring of HCC, particularly in HCC patients with low AFP levels.
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PMID:[Clinical usefulness of plasma PIVKA-II assay and its limitations in patients with hepatocellular carcinoma]. 247 53

Choice of treatment for HCC depends mainly on the size of tumor and patient's liver function because more than 80% of HCC patients are associated with liver cirrhosis. Percutaneous ethanol injection therapy (PEIT), transcatheter arterial embolization (TAE) and intraarterial infusion chemotherapy are, at present, commonly used treatments for HCC in Japan. PEIT is a safe and reliable treatment, in which absolute ethanol is injected to the tumor through a fine needle under US guide. PEIT is indicated for tumors of small size, which can not be removed surgically. The survival rate of PEIT for small liver cancer, less than 2 cm in diameter, is similar with the one of surgically removed cases. TAE is indicated for advanced HCC. Chemoembolization with Lipiodol is commonly used with good result. After TAE has been often performed, the survival rate of HCC patients was dramatically increased. In future, TAE combined with percutaneous transhepatic portal embolization or PEIT would be applied more often to obtain complete destruction of the lesion for advanced HCC. Intraarterial infusion chemotherapy is indicated for advanced HCC, in which TAE can not be performed. MMC, ADM and CDDP are commonly used anti-cancer drugs. Recently frequent infusion of these drugs has become possible by using implantable reservoir with good result. We have performed chemosensitivity test by SRCA for HCC specimens obtained by biopsy using a fine needle.
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PMID:[Non-surgical (medical) treatment of hepatocellular carcinoma (HCC)]. 253 69

Fifty patients with HCC associated with hepatic cirrhosis underwent intra-arterial injection of Lipiodol UltraFluid (LUF) during diagnostic DSA of liver parenchyma, 42 of them for a complete chemotherapeutic treatment, 8 for an isolated diagnostic control. LUF is known to be specifically captured by HCC neoplastic tissue, with long-term persistence in the lesion if injected in the arterial hepatic tree; this is not the case with other focal hepatic masses. Therefore LUF opacification can be used to demonstrate small daughter tumors not shown by CT or US in cases with evidence of HCC, or to diagnosis HCC in clinically positive patients with no evidence of tumor at non-invasive screening. In our series of patients, accumulation of LUF in the HCC was observed in 100% of the cases, with no false negatives. Two false positives (4%) were observed, due to CT being performed too early (it should be performed not sooner than 10 days after the injection). Overall DSA accuracy was 78%, with 22% false negatives. In 14% of the cases DSA was positive for HCC in patients with aspecific noninvasive screening. CT, performed 10 days after LUF injection, demonstrated HCC daughter tumors not depicted by US, conventional CT, and angiography, in 34% of the cases, and in 9% of the patients only CT/LUF was able to show HCC in clinically positive cases with no evidence of tumor on other imaging techniques. Specificity, sensitivity and over-all accuracy were thus 100% in our series; LUF was well tolerated by the patients, and no technical complications were observed. In our opinion, the diagnostic DSA and CT/LUF is justified only for the typification of suspected focal nodules unsuitable for biopsy: in other instances, especially in case of HCC with positive biopsy/clinical findings and focal nodular mass, the technique should be directly employed as a therapeutic approach, with the injection of lipiodolized agents to treat both primary and daughter nodules after surgery in operable patients, and to begin chemoembolization treatment in patients with intrahepatic polyfocal diffusion. DSA and LUF are therefore of primary importance in the diagnosis and therapeutic flow-chart of HCC associated with hepatic cirrhosis.
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PMID:[Lipiodol UltraFluid in the imaging diagnosis of hepatocarcinoma with cirrhosis]. 255 Sep 98

In 41 patients with 54 lesions which were resected ans studied histopathologically, there were 14 lesions of adenomatous hyperplasias (AH) in 9 patients, 28 AHs containing hepatocellular carcinoma foci (early HCC, e-HCC) in 22 and 12 borderline lesions which fell between these two lesions in 10. The detectability of these lesions on imagings was evaluated. Detection rates for all lesions and e-HCCs were as follows; intraoperative sonography, 70.0%, 87.5%; Portal-CT, 71.4%; sonography, 44.4%. 64.3%; Arterial-CT, 37.5%, 50.0%; CT, 32.7%, 57.7%; angiography, 17.0%, 30.8%; Lipiodol-CT, 9.1%. 25.0%. On angiography, tumor stain was recognized in only 8 patients with e-HCC. Arterial-CT showed a relatively low density mass compared to non-tumorous area in 2 patients with e-HCC and one with borderline lesion. The median size of 54 lesions was 1.2 +/- 0.4 cm in diameter and that of AHs was 0.8 +/- 0.3 cm, the latter being significantly smaller than the other two lesions (p less than 0.01). Liver cirrhosis coexisted in 35 of 41 patients (85.4%). No complete necrosis occurred in 13 e-HCC lesions following therapeutic embolization or infusion chemotherapy in the hepatic artery.
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PMID:[Imaging of adenomatous hyperplastic lesions containing and not containing hepatocellular carcinoma in the liver]. 255 97

Accurate detection of intrahepatic metastases, or daughter nodules, of primary hepatocellular carcinoma is of crucial importance. Due to the introduction of infusion hepatic angiography, computed tomography (CT) after Lipiodol (iodized oil) infusion, and intraoperative ultrasound (US), tumors less than 10 mm in diameter are now frequently found. We compared the diagnostic accuracy of these three modalities in the detection of nodules in 45 patients who had hepatocellular carcinoma (confirmed by biopsy). CT with Lipiodol was superior to hepatic angiography in demonstrating nodules when they were overlapped by the primary tumor or very small in size. Intraoperative US demonstrated nodules in four avascular or hypovascular hepatocellular carcinomas, which both hepatic angiography and CT failed to demonstrate. In cases associated with severe liver cirrhosis, differentiation of small nodules from regenerating cirrhotic nodules was sometimes difficult with intraoperative US. The combined use of these three modalities is indispensable for the accurate detection of small nodules of metastatic hepatocellular carcinoma.
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PMID:Metastatic nodules of hepatocellular carcinoma: detection with angiography, CT, and US. 281 41

We have investigated the effects of preoperative Lipiodol-Transcatheter arterial embolization (Lp-TAE) on both the nuclear DNA content of noncancerous liver cells by DNA-cytofluorometry (using NIKON SPM-RF1-D), and the histopathological findings of liver lesions. Lp-TAE through the hepatic artery was performed on ten primary hepatocellular carcinoma patients using Gelfoam in combination with adriamycin (40 mg) or mitomycin C (20 mg), emulsified in Lipiodol (10 ml) and 60% Urografin (2 ml). And hepatic resection was carried out after one or two months later in each case. Histologically, primary hepatocellular carcinoma lesions showed various patterns of necrosis, while the non-cancerous liver cells did not show hepatocellular infarction in the liver cirrhosis. The results of the nuclear DNA content showed an increase in the fractions of poliploid cells in the non-cancerous lesions treated with Lp-TAE compared with that in the normal age-matched controls. But we found no remarkable differences in the ploidy patterns between Lp-TAE treated patients and untreated patients with liver cirrhosis. In conclusion, preoperative Lp-TAE does not induce any remarkable histological hepatocellular damage of non-cancerous lesion and does not affect nuclear DNA content of non-cancerous liver cells.
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PMID:[Cytofluorometric and histopathological studies on non-cancerous liver lesions after lipiodol-transcatheter arterial embolization]. 284 9

A case of hepatoma with cirrhosis for whom hepatectomy was impossible because of a severe complication is reported. The case has been treated with various treatments, so long survival has been obtained. The patient is a 56-year-old female with hepatoma with cirrhosis. The initial symptom was bleeding from esophageal varices. Her condition was not suitable for hepatectomy because of hypersplenism and remarkable hepatic disorder. Consequently, she was given endoscopic sclerotherapy for esophageal varices, partial splenic embolization for hypersplenism, and transarterial embolization with ADM, Lipiodol and Spongel powder for hepatoma. Although abdominal pain, pleural effusion and bleeding from gastric ulcer appeared after embolization, esophageal varices and hypersplenism were significantly improved; reduction of 75% of hepatoma was observed and AFP decreased from 18.7 ng to 3 ng. At 12 months after the embolization, there is no sign of hepatoma growth, rupture of esophageal varices or hypersplenism.
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PMID:[Transarterial embolization in the treatment of hepatoma complicated with cirrhosis, esophageal varices and hypersplenism]. 284 16

Between April 1981 and October 1984, 189 embolisations of the hepatic artery were carried out in 82 patients with primary hepato-cellular carcinomas. Two types of embolisation were performed: 1) embolisation using only gel foam and 2) a combination of peripheral and proximal embolisation using Lipiodol and gel foam. Embolisation of the hepatic artery is indicated for inoperable carcinoma, provided less than 75% of the liver is involved or for localised carcinomas in patients whose general condition makes surgery impossible, often because of severe cirrhosis of the liver. Complications following embolisation include pain, fever and transient changes in liver function. Deaths, abscesses or rupture of the tumour did not occur.
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PMID:[Embolization of the hepatic artery in primary hepatocellular carcinoma]. 299 17


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