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  • 1
    Electronic Resource
    Electronic Resource
    Multivariate analysis of liver regenerative capacity after hepatectomy in humans (1997)
    Springer
    Journal of hepato-biliary-pancreatic surgery 4 (1997), S. 78-82 
    Details
    ISSN: 1436-0691
    Keywords: liver regeneration ; hepatectomy ; liver fibrosis ; multiple regression equation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Many factors affect liver regeneration after partial hepatectomy; however, those factors that are essential for regulation of liver regeneration in humans are not known. Using multiple regression analysis we conducted a study to determine essential factors involved in the speed of liver regeneration after hepatectomy. The subjects were 59 patients who underwent hepatic resection between January 1980 and December 1991. A regression equation for predicting regeneration speed (Y; cm3/day) during the 1st postoperative month was obtained by stepwise forward multiple regression analysis, using 11 explanatory parameters (Xi). The regeneration speed and the resection ratio (%; indicating the magnitude of resection) were calculated based on a computed tomography (CT) scan volumetric study. The degree of liver fibrosis, expressed as the fibrotic index (%), was morphometrically determined in Azan-Mallory stained sections. Of the 11 explanatory parameters, the resection ratio and the fibrotic index had a significant simple correlation with Y. The following regression equation was obtained: Y (cm3/day)=−1.1+3.7 × resection ratio −5.4 × alkaline phosphatase −3.7 × fibrotic index +1.2× total bilirubin −2.6 × glutamic pyruvic transaminase (multiple correlation coefficient, 0.82). We found that the extent of resection and the degree of fibrosis, as well as alkaline phosphatase, total bilirubin, and glutamic pyruvic transaminase, contributed to the speed of regeneration after partial hepatectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01211346
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  • 2
    Electronic Resource
    Electronic Resource
    Idiopathic benign biliary stricture (1998)
    Springer
    Journal of hepato-biliary-pancreatic surgery 5 (1998), S. 463-466 
    Details
    ISSN: 1436-0691
    Keywords: Key words: benign biliary stricture ; localized primary sclerosing cholangitis ; extrahepatic bile duct
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: A rare case of idiopathic benign biliary stricture is reported. A 50-year-old man with liver dysfunction underwent ultrasonography, which revealed dilation of the intrahepatic bile ducts, and endoscopic retrograde cholangiopancreatography, which revealed a short, ring-like stenosis at the junction of the left and right hepatic ducts. Although a benign stricture was suspected, radiologic tests alone were insufficient to make a firm diagnosis. Therefore, a cholecystectomy and resection of the extrahepatic biliary tract were performed. Microscopic examination of the resected specimen demonstrated no evidence of malignancy. The final diagnosis was mild, localized, chronic cholangitis. The patient had not had previous biliary tract surgery, choledocholithiasis, nor did he have a congenital abnormality of the biliary tract, bile duct carcinoma, or pancreatic disease. Since there was no evidence of primary sclerosing cholangitis, the stricture was considered to be idiopathic.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005340050074
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  • 3
    Electronic Resource
    Electronic Resource
    Cellular DNA content and histopathological analysis in hepatocellular carcinoma with multiple nodules (1997)
    Springer
    Surgery today 27 (1997), S. 483-490 
    Details
    ISSN: 1436-2813
    Keywords: hepatocellular carcinoma ; DNA ploidy ; multiple nodules
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Multiple tumors within the liver are a characteristic feature of hepatocellular carcinoma (HCC). This study investigated alterations in the histologic type and DNA content of multiple nodules of HCC. Both a pathologic examination and flow cytometric DNA analysis were performed on 49 resected specimens of multinodular HCC. The results showed that 35 cases had multiple metastatic satellite nodules around the main tumor (group 1), while 14 had two solitary nodules in different segments without satellite nodules (group 2). In group 1, 28 out of 35 (80.0%) showed a single DNA index while 7 (20.0%) revealed two different DNA contents in the main tumor. The histological type, cytological grade, and DNA index were equivalent between the main and satellite tumors in 100%, 88.6%, and 97.1% of the cases, respectively. In group 2, all tumors showed a single histological type, cytological grade, and DNA index in each nodule. The histological type was identical in 85.7% of the pairs of nodules, but the cytological grade and DNA index were different in 42.9% and 85.7%, respectively. The patients in group 2 showed a significantly higher 5-year survival rate than that in group I (64.8%vs 27.2%,P〈0.05). This study thus indicates that the cytological grade and DNA content are useful in distinguishing multicentric occurrence from intrahepatic metastasis in HCC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02385799
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  • 4
    Electronic Resource
    Electronic Resource
    Microwave Coagulonecrotic Therapy for Hepatocellular Carcinoma (1996)
    Springer
    World journal of surgery 20 (1996), S. 1076-1081 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The present study reports on the usefulness of microwave coagulonecrotic therapy (MCT) as a treatment option for hepatocellular carcinoma (HCC) with poor hepatic reserve. From June 1992 to March 1995, MCT using a microwave electrode was employed on 8 patients using laparoscopic control and 19 with the open method, and wedge resection (Hx) was applied to the 23 patients. All patients had HCC with poor hepatic reserve. Radiation output was 100 watts with a mean radiation duration of about 30 minutes. The severity of liver dysfunction and the regional characteristics of the tumor (tumor size, multiplicity, portal invasion, tumor depth) were comparable between the MCT and Hx groups. The operative time was significantly shorter for the MCT group than the Hx group. The mean blood loss was 1570 ml in the Hx group but negligible in the MCT group. There was no operative mortality in the MCT group in contrast to 4.3% (1 of 23) in the Hx group. Complications were observed in 11.1% (3 of 27) and 34.8% (8 of 23), respectively, for the MCT and Hx groups. The postoperative total bilirubin had lower values and the start of diet was earlier in the MCT group than the Hx group. The 3-year crude and disease-free survival rates were 86% and 44%, respectively, for patients who underwent MCT, which were comparable to 75% and 14% for those with Hx. MCT can achieve long-term results equivalent to those obtained by wedge resections, but it is less invasive and technically easier. Therefore it can be an alternative option in place of limited resection for HCC with poor hepatic reserve.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900163
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  • 5
    Electronic Resource
    Electronic Resource
    Historical Evolution of Hypothermic Liver Surgery (1998)
    Springer
    Molecular medicine 22 (1998), S. 1104-1107 
    Details
    ISSN: 1076-1551
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The clinical application of hypothermia dates back to the surgical treatment of blue babies (1949) and the early days of open heart surgery (1952), when generalized cooling was employed. The induction of hepatic hypothermia began with whole-body cooling in experimental models in 1953 and clinically in 1961. It was designed to minimize the ischemia-reperfusion injury associated with hepatic inflow occlusion. Body surface cooling and cooling via an extracorporeal circuit, however, were not widely accepted for hepatic surgery because of the adverse effects on the extrahepatic organs. Consequently, with the introduction of improved venovenous bypass techniques, in situ cold hepatic perfusion has been used in selected patients since 1971. In situ hypothermic hemihepatic perfusion, introduced in 1995, prevents an ischemic insult to the contralateral hepatic lobe. Topical cooling using ice slush under total or hemihepatic inflow occlusion was reported in 1993. This technique does not require cumbersome hypothermic perfusion equipment. In attempts to minimize intraoperative bleeding by vascular occlusion, the liver surgeon must consider the benefits and technical demands of hepatic hypothermia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900525
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  • 6
    Electronic Resource
    Electronic Resource
    Increased plasma α (1 → 3)-l-fucosyltransferase activities in patients with hepatocellular carcinoma (1995)
    Springer
    Glycoconjugate journal 12 (1995), S. 627-631 
    Details
    ISSN: 1573-4986
    Keywords: α(1 → 3)-l-fucosyltransferase ; liver cirrhosis ; hepatocellular carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Alpha(1 → 3)-l-fucosyltransferase (α1,3FT) activity was determined in plasma of patients with chronic liver diseases, namely, chronic hepatitis (CH), liver cirrhosis (LC) and hepatocellular carcinoma (HCC). The plasma α1,3FT activity was significantly higher (p〈0.01) in chronic liver diseases than that in normal controls. The enzyme activity in plasma of patients with HCC was also significantly higher than that in LC (p〈0.05) or that in CH (p〈0.01). However, no significant difference was observed in the enzyme activity between LC and CH. Plasma α1,3FT activity in patients with HCC was not significantly changed before and after transcatheter arterial embolization. In addition, the enzyme activity in the homogenate of the cirrhotic liver tissue was higher than that in the preparation of the hepatoma tissue in the same patient. These results suggest that the increased plasma α1,3FT activity in patients with HCC reflects mainly the enzyme activity of cirrhotic liver tissue, not that of hepatoma tissue. The significance of the elevated levels of plasma α1,3FT and its decreased hepatoma tissue activity in patients with HCC, compared with that in LC, remains to be clarified.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00731257
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