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  • 1
    Online Resource
    Online Resource
    Partial Splenic Embolization with Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma Accompanied by Thrombocytopenia
    Hindawi Limited ; 2014
    In:  BioMed Research International Vol. 2014 ( 2014), p. 1-6
    Details
    In: BioMed Research International, Hindawi Limited, Vol. 2014 ( 2014), p. 1-6
    Abstract: Background . Thrombocytopenia often makes the introduction of systemic treatment difficult in patients with cirrhosis and hepatocellular carcinoma (HCC). We retrospectively evaluated the long-term effects of partial splenic embolization (PSE) with transarterial chemoembolization (TACE) in patients with HCC patients accompanied by thrombocytopenia. Patients and Methods . Twenty-one patients with HCC complicated by severe thrombocytopenia (platelet count, 〈 5.0 × 10 4 /mm 3 ) were treated with PSE and TACE. Both the safety and platelet-increasing effect was evaluated in these patients. Results . Seventeen of 21 patients (81.0%) showed increased platelet counts to ≥5.0 × 10 4 /mm 3 . Subsequently, 13 patients (61.9%) successfully received systemic chemotherapy. Platelet counts and serum levels of total bilirubin, as well as neutrophil counts, improved significantly one month after treatment. However, serum levels of albumin and hemoglobin decreased significantly one month after treatment. Severe adverse events, including acute liver failure and portal vein thrombus, were observed in two patients. Conclusion . PSE with selective TACE made it possible for patients with HCC and severe thrombocytopenia to receive systemic chemotherapy. Although PSE with TACE was safe and tolerable for most patients, the extent of PSE with TACE in a wide area of the liver may increase the risk for fatal liver failure.
    Type of Medium: Online Resource
    ISSN: 2314-6133 , 2314-6141
    URL: Article
    DOI: 10.1155/2014/960628
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2014
    detail.hit.zdb_id: 2698540-8
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  • 2
    Online Resource
    Online Resource
    Changes in Plasma Ghrelin and Serum Leptin Levels after Cisplatin-Based Transcatheter Arterial Infusion Chemotherapy for Hepatocellular Carcinoma
    Hindawi Limited ; 2013
    In:  ISRN Gastroenterology Vol. 2013 ( 2013-03-07), p. 1-6
    Details
    In: ISRN Gastroenterology, Hindawi Limited, Vol. 2013 ( 2013-03-07), p. 1-6
    Abstract: Background and Objective. Cisplatin-based chemotherapy is widely recognized to cause severe gastrointestinal disorders like nausea, vomiting, and appetite loss. The aim of this study was to assess whether cisplatin-based transcatheter arterial infusion (TAI) chemotherapy reduces plasma ghrelin levels and food intake in hepatocellular carcinoma (HCC) patients. Methods. Seventeen patients with HCC who underwent cisplatin-based TAI chemotherapy (80–100 mg/body) were enrolled in this study. Changes in peptide hormones, including ghrelin and leptin, as well as cytokines, were measured before and after chemotherapy. Appetite was evaluated by visual analog scale (VAS) and food intake was scored by eleven stages (0–10). Results. Appetite and food intake were significantly decreased after chemotherapy ( P 〈 0.05 ). Plasma acylated ghrelin levels before therapy and at day 1, day 7, and day 14 after chemotherapy were 10.4 ± 7.2, 4.7 ± 4.7, 11.7 ± 8.9, and 9.3 ± 6.6 fmol/mL, respectively. The level on day 1 was decreased significantly ( P 〈 0.05 ). In contrast, the levels of leptin, granulocyte colony-stimulating factor (G-CSF), and monocyte chemotactic protein-1 (MCP-1) on day 1 were increased significantly ( P 〈 0.05 ). Conclusions. TAI for HCC reduced plasma acylated ghrelin levels, appetite, and food intake significantly. In addition, it increased serum leptin levels.
    Type of Medium: Online Resource
    ISSN: 2090-4401
    URL: Article
    DOI: 10.1155/2013/415450
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2013
    detail.hit.zdb_id: 2589532-1
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  • 3
    Online Resource
    Online Resource
    Comparison of Liver Biopsy and Transient Elastography based on Clinical Relevance
    Hindawi Limited ; 2008
    In:  Canadian Journal of Gastroenterology Vol. 22, No. 9 ( 2008), p. 753-757
    Details
    In: Canadian Journal of Gastroenterology, Hindawi Limited, Vol. 22, No. 9 ( 2008), p. 753-757
    Abstract: BACKGROUND: Liver stiffness measurement (LSM) by transient elastography has recently been validated for the evaluation of liver fibrosis in chronic liver diseases. The present study focused on cases in which liver biopsy and LSM were discordant. METHODS: Three hundred eighty-six patients with chronic hepatitis C who underwent a liver biopsy between December 2004 and April 2007 were studied. First, the optimal cut-off value of LSM was selected for the determination of cirrhosis based on the receiver operating characteristic curve. Then, the cases in which liver histology and evaluation by LSM were discordant were selected. Laboratory test results such as serum total bilirubin concentration, prothrombin activity, albumin concentration, platelet count and the aspartate aminotransferase to platelet ratio index, together with the presence of esophageal varices, were analyzed. RESULTS: The optimal cut-off value was chosen to be 15.9 kPa for cirrhosis (fibrosis stage [F] 4) determination to maximize the sum of sensitivity (78.9%) and specificity (81.0%). There were 78 discordant cases: 51 patients showed an LSM of 15.9 kPa or higher and a fibrosis stage of F1 to F3 (high LSM group), and 27 patients had an LSM lower than 15.9 kPa and a fibrosis stage of F4 (low LSM group). Esophageal varices were seen in 11 patients in the high LSM group (n=51) and in no patients in the low LSM group (n=27) (P=0.0012). The aspartate aminotransferase to platelet ratio index was significantly higher in the high LSM group (1.49 versus 0.89, P=0.019). Other parameters did not differ significantly. However, platelet count, prothrombin activity and albumin concentration tended to be lower in the high LSM group. CONCLUSIONS: Patients with a high LSM need proper attention for cirrhosis, even if liver biopsy does not reveal cirrhosis.
    Type of Medium: Online Resource
    ISSN: 0835-7900
    URL: Article
    DOI: 10.1155/2008/306726
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2008
    detail.hit.zdb_id: 2762184-4
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