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  • 1
    Electronic Resource
    Electronic Resource
    Anatomic Dissociation between the Intrahepatic Bile Duct and Portal Vein: Risk Factors for Left Hepatectomy (1997)
    Springer
    World journal of surgery 21 (1997), S. 297-300 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The anatomic variations of the intrahepatic portal vein and bile duct were analyzed to evaluate the potential risk of left hepatectomy. A total of 210 cholangiograms and hepatic arterioportograms were performed in which the ramifications of the intrahepatic portal vein and bile duct were investigated. The orientation of the intrahepatic duct and portal vein were classified into five types. In 175 patients (83.33%), the intrahepatic portal vein and bile duct had the same anatomic classification. In 24 patients (11.43%), the right anterior or posterior intrahepatic duct drained into the left hepatic duct at the umbilical portion (type IV); there were only 15 patients (7.14%) whose portal veins fell into this category. All patients with type IV portal veins had type IV hepatic ducts, but there were 9/49 patients (18.36%) whose hepatic duct distribution belonged to type IV but their portal veins belonged to type II (6 cases) or III (3 cases). Without complete knowledge of the intrahepatic portal and biliary anatomy, insufficient portal perfusion and bile duct complications may result from the left hepatectomy operation. Preoperative portal vein evaluation or left portal vein clamping can provide significant information, but there are still 18.36% of patients where type IV biliary ducts were not detected in those with type II and III portal veins. Cholangiography is of paramount importance in these two groups of patients, as it can prevent inadvertent injury to the right intrahepatic ducts, which drain into the left intrahepatic duct. On the other hand, intraoperative ultrasonography is recommended to identify or exclude an aberrant portal vein if type VI biliary anatomy is detected during intraoperative cholangiography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900232
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Efficacy and Safety of Preoperative Lobar or Segmental Ablation via Transarterial Administration of Ethiodol and Ethanol Mixture for Treatment of Hepatocellular Carcinoma: Clinical Study (2000)
    Springer
    World journal of surgery 24 (2000), S. 844-850 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Transarterial embolization (TAE) using various thrombotic substances for unresectable hepatocellular carcinoma (HCC) performed on many patients has resulted in a better survival rate. We evaluated the efficacy and clinical safety of using an Ethiodol–ethanol mixture as the embolizer for treatment of HCC and the possibility of a surgical approach for inoperable tumors after TAE. Twenty patients with HCC who underwent TAE and tumor resection were included in the study. Initially, eight had increased retention rate of indocyanine green dye via intravenous injection (0.5 mg/kg) at 15 minutes (ICGR15), and six had an insufficient residual volume that precluded them from undergoing tumor resection. TAE was performed by slowly infusing the mixture of Ethiodol and ethanol into the artery supplying the tumor until dual hepatic artery and portal vein embolization was achieved. Serum levels of alanine aminotransferase increased after embolization, but all biochemistry studies reverted to normal within 2 weeks. A decreased tumor size (n= 15), improved ICG (n= 8), and increased volume of the nonembolized lobe (n= 10) were noted. The operations performed were right lobectomy (n= 11), extended right lobectomy (n= 3), left lobectomy (n= 2), extended left lobectomy (n= 2), and wedge resection (n= 2), which included patients who did not want to undergo major hepatectomy. Complete tumor necrosis was found in seven cases. All patients survived with no associated complications. The 1-year survival rate was 95%. Transarterial Ethiodol and ethanol administration creating dual hepatic artery and portal vein embolization was a safe and efficacious method for treating HCC. It effectively decreases tumor size, causes compensatory hepatic hypertrophy, and improves the ICGR15, which allows a wider range of patients to undergo liver surgery and achieve better survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002680010135
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  • 3
    Electronic Resource
    Electronic Resource
    Liver transplantation in Taiwan: the Chang Gung experience (1992)
    Springer
    Cancer chemotherapy and pharmacology 31 (1992), S. S162 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Between March 1984 and February 1991, six orthotopic liver transplantations were performed at the Chang Gung Memorial Hospital in Taiwan. The indications for transplantation were Wilson's disease (5 patients) and biliary atresia (1 patient). Donors and recipients were matched only for size and ABO blood group compatibility, and the recipient operations were performed without the use of a venovenous bypass. Arterial reconstruction was carried out by end-to-end hepatic artery anastomosis (4), thoracic aortic conduit (1), or interposition of an iliac artery graft (1), whereas biliary reconstruction was accomplished by a choledochocholedochostomy using a T-tube stent (4) or a choledochocholedochostomy using an external cholecystostomy without stenting (2). Biliary complications occurred in three patients, and all required additional surgery. The average duration of donor-liver cold ischemia, operating time, and blood loss during surgery were 7 h and 50 min (range, 4.5–9 h), 13.5 h (range, 11.8–17h), and 4,385 ml (range, 750–12,000 ml) respectively. The immunosuppressive regimens included a cyclosporinsteroid combination (n=2) and a triple-drug combination (n=4). All except one of the surviving patients experienced at least one rejection episode that was reversed by a methyl-prednisolone bolus and/or recycle. One patient developed a primary cytomegalovirus (CMV) infection that responded well to Ganciclovir treatment. Two of the patients died, one of injuries sustained in a traffic accident 3 years after transplantation, and the other of massive upper gastrointestinal bleeding. The overall survival value at 3 months was 83%, and the follow-up period ranged from 3 months to 7 years. All of the survivors have achieved complete rehabilitation and currently enjoy an excellent quality of life with normal liver function. Althought the present study involved a small number of cases, our results indicate that liver transplantation can be successfully achieved in a high proportion of patients with acceptable morbidity, mortality, and cost in an Asian setting. The extreme shortage of donor organs is currently the most important obstacle limiting the application of liver transplantation in Taiwan.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00687128
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  • 4
    Electronic Resource
    Electronic Resource
    Experience with major hepatic resections for hepatocellular carcinoma (1989)
    Springer
    Cancer chemotherapy and pharmacology 23 (1989), S. S101 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nine major hepatic resections for hepatocellular carcinoma were performed during a period of 2 years and 4 months. HBsAg was positive in six patients, preoperative serum α-fetoprotein was more than 20 ng/ml in 5 patients, and liver cirrhosis was present in four patients. Two patients presented with spontaneous rupture of hepatocellular carcinoma. The great value of ultrasonography is stressed as an emergency diagnostic tool in any patient with an acute abdomen without obvious cause. There was no operative mortality or morbidity among this series of patients. All but one patient with a ruptured hepatoma are alive without evidence of disease 3–31 months after liver resection. These encouraging operative results made the authors willing to adopt an aggressive policy toward the surgical treatment of hepatocellular carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00647251
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  • 5
    Electronic Resource
    Electronic Resource
    Why not choledochal cyst? (1988)
    Springer
    Pediatric surgery international 3 (1988), S. 331-337 
    Details
    ISSN: 1437-9813
    Keywords: Choledochal cyst ; Acute pancreatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract With excision as a standard procedure for treating choledochal cyst, early diagnosis becomes a central issue in reducing morbidity and mortality from that disorder. In a retrospective analysis of 35 patients treated over a 10-year period, we found the diagnosis was delayed for an average of 11.9 months from the beginning of presenting symptoms. Three factors were responsible: (1) a random combination of non specific presenting symptoms such as pain and vomiting or jaundice and hepatomegaly frequently led to a diagnosis such as acute pancreatitis or hepatitis, in which conservative treatment was considered most appropriate; (2) the three parameters commonly used to diagnose acute pancreatitis (serum amylase, lipase, and Cam/Ccr) may all be elevated in patients with a choledochal cyst; and (3) a combination of several noninvasive examinations such as radionuclide cholescintigraphy, ultrasonography, and upper gastrointestinal X-rays may fail to diagnose some difficult cases of choledochal cyst. To obviate such problems, we recommend a routine ultrasound examination of biliary tract in children with recurrent or progressive obstructive jaundice or unexplained acute pancreatitis. When these noninvasive examinations fail to solve the problem, endoscopic retrograde cholangiopancreatography should be considered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00189171
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  • 6
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    The effect of exogenous histone H1 on rat adipose-derived stem cell proliferation, migration, and osteogenic differentiation in vitro (2012)
    Wiley-Blackwell
    Details
    Publication Date: 2012-04-16
    Description: Adipose-derived stem cells (ASCs) are of great interest for the development of novel cell therapies due to their ease of isolation and expansion, immunosuppressive activity and multilineage differentiation potential. However, the mechanisms underlying the therapeutic potential of ASCs remain to be elucidated. Others and we have shown that nuclear proteins such as histone H1 and high mobility group box 1 (HMGB1) play important roles in the maturation of dendritic cells (DCs). Furthermore, we previously demonstrated translocation of histone H1 from the nucleus to the cytoplasm and activation of mitogen-activated protein kinases (MAPKs) in DCs. In the present study, we confirmed that histone H1 does not alter the immunophenotype and immunosuppression potential of ASCs, but that histone H1 enhanced wound healing and increased interleukin (IL)-6 expression. Moreover, histone H1 treated-ASCs showed up-regulation of mitogen-activated protein kinases (MAPKs) extracellular-regulated kinase 1/2 (ERK1/2) and sequential NF-κB translocation. Finally, we found that culture in differentiation media supplemented with histone H1 enhanced ASC osteogenesis. In contrast, inhibition of histone H1 by small interfering RNA (siRNA) reduced osteogenic differentiation markers including ALP. These results suggest that histone H1 may be useful for induction of mesenchymal stem cells in tissue engineering and future potential ASC therapies. J. Cell. Physiol. © 2011 Wiley Periodicals, Inc.
    Electronic ISSN: 1097-4652
    Topics: Biology , Medicine
    Published by Wiley-Blackwell
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