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  • 1
    Electronic Resource
    Electronic Resource
    Indication of liver transplantation for hepatocellular carcinoma in Japan (1992)
    Springer
    Surgery today 22 (1992), S. 395-400 
    Details
    ISSN: 1436-2813
    Keywords: liver transplantation ; hepatocellular carcinoma ; treatments of hepatocellular carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Approximately 20,000 patients die of hepatocellular carcinoma (HCC) annually in Japan and most of them are hepatitis B virus (HBV) or hepatitis C virus (HCV) carriers. Recently, small HCC, less than 3 cm in diameter, have frequently been found by ultrasonography in the follow-up of patients with chronic liver diseases. Such cases are mainly treated by either surgical resection or percutaneous ethanol injection therapy (PEIT) with a satisfactory 5 year survival rate of 50%. In addition, the survival rate of advanced cases has gradually improved thanks to transcatheter arterial chemo-embolization combined with PEIT, radiation, hyperthermia, or immune therapy. On the other hand, our autopsy study has indicated a high frequency of extrahepatic metastasis in advanced cases. From these results, liver transplantation for HCC does not seem to be the treatment of first choice, at present, in Japan. In the future, the means to control the underlying infection of HBV or HCV as well as making an accurate imaging diagnosis for the detection of extrahepatic metastasis will become inevitably more important for successful liver transplantation in HCC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00308786
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  • 2
    Electronic Resource
    Electronic Resource
    Mechanism of thrombocytopenia in liver cirrhosis: kinetics of indium-111 tropolone labelled platelets (1993)
    Springer
    European journal of nuclear medicine 20 (1993), S. 123-129 
    Details
    ISSN: 1619-7089
    Keywords: Platelet kinetics ; Liver cirrhosis ; Indium-111 tropolone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Using indium-111 tropolone-labelled platelets, a study of platelet kinetics was performed on the basis of the relationship between platelet count, platelet survival time, platelet dynamics, platelet-associated immunoglobulin G (PA-IgG) and splenic volume in 31 patients with liver cirrhosis and a platelet count of less than 100 × 109/l. The mean platelet count was 46.6±25.3 × 109/l, and the mean platelet survival time was 6.50±1.33 days. The mean uptake into the spleen was 43.2%±14.8% on the 1st day, and 53.7%±14.3% on the 7th day. The mean PA-IgG level was 107.6±66.0 ng/107 platelets in five patients with chronic active hepatitis who were studied as controls, the mean platelet count was 197±30 × 109/l, the mean platelet survival time 9.33±0.78 days, and the mean PA-IgG 21.2±2.9 ng/107 platelets. The former two parameters were significantly higher (P〈0.05), and the latter significantly lower (P〈0.05). In liver cirrhosis, the platelet count showed a positive correlation with the platelet survival time and a negative correlation with PA-IgG and the splenic volume. These results suggest that the increases in both the splenic platelet pool and platelet destruction in the spleen through immunological mechanisms may influence thrombocytopenia in liver cirrhosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00168872
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  • 3
    Electronic Resource
    Electronic Resource
    Chronic lymphocytic leukemia with esophageal varices (1993)
    Springer
    Digestive diseases and sciences 38 (1993), S. 2142-2143 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01297096
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  • 4
    Electronic Resource
    Electronic Resource
    Wedged hepatic venous pressure reflects portal venous pressure during vasoactive drug administration in nonalcoholic cirrhosis (1994)
    Springer
    Digestive diseases and sciences 39 (1994), S. 2439-2444 
    Details
    ISSN: 1573-2568
    Keywords: intraclass correlation coefficient ; portal venous pressure ; wedged hepatic venous pressure ; portal hypertension ; vasoactive agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hepatic venous catheterization is widely used to assess portal pressure. However, it remains unclear whether wedged hepatic venous pressure is a close indicator of portal venous pressure during vasoactive drug administration in nonalcoholic cirrhosis. To address this issue, we analyzed the data from our previous published studies. Forty patients with nonalcoholic cirrhosis (HBV infection in five, HCV infection in 28, and cryptogenic in seven) were available in this analysis. A vasoconstrictor (N=14), vasodilator (N=10), or combination (N=16) was administered. The agreement of the changes between portal and wedged hepatic venous pressures during pharmacological manipulation was assessed by an intraclass correlation coefficient. The intraclass correlation coefficient in each subgroup was more than 0.60 (0.62 in vasoconstrictor group, 0.87 in vasodilator group, and 0.73 in combination group). When the analysis was performed according to the cause of liver disease, the values were 0.67 in HBV infection, 0.73 in HCV infection, and 0.74 in cryptogenic cirrhosis. These results suggest that wedged hepatic venous pressure reflects portal venous pressure during vasoactive drug administration in patients with nonalcoholic cirrhosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02087663
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  • 5
    Electronic Resource
    Electronic Resource
    Reduced portosystemic hemodynamic responsiveness after orthostasis in patients with cirrhosis (1993)
    Springer
    Digestive diseases and sciences 38 (1993), S. 1251-1258 
    Details
    ISSN: 1573-2568
    Keywords: portal blood flow ; orthostasis ; liver cirrhosis ; noradrenaline ; Doppler flowmetry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied portosystemic hemodynamic responsiveness after 1 min orthostasis in nine patients with cirrhosis and nine age-matched normal subjects. Orthostasis increased diastolic arterial pressure, which is a close indicator of arterial tone, in normal subjects (+17%,P〈0.01). In contrast, no significant change in diastolic arterial pressure was observed in patients with cirrhosis (−3%, NS). The increase in heart rate was less in patients with cirrhosis than in normal subjects (+15% vs +28%,P〈0.05). Orthostasis also decreased portal blood flow, which was assessed by an echo-Doppler flowmetry, in normal subjects (−27%,P〈0.01), but in patients with cirrhosis it was not modified (−3%, NS). Plasma noradrenaline concentration showed similar increase in both groups (normal vs cirrhosis; +61% vs +55%, NS). Although the change in plasma noradrenaline concentration was related with that in diastolic arterial pressure (r=0.71,P〈0.05) and inversely with that in portal blood flow (r=−0.69,P〈0.05) in normal subjects, no such significant correlation was found in patients with cirrhosis. We conclude that (1) a reduced hemodynamic responsiveness to sympathetic stimulation exists on both systemic and portohepatic vascular beds and (2) such a blunted baroreflex function is probably located at the receptor or effector level in patients with cirrhosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01296074
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  • 6
    Electronic Resource
    Electronic Resource
    Effects of propranolol on gastric mucosal perfusion and serum gastrin level in cirrhotic patients with portal hypertensive gastropathy (1994)
    Springer
    Digestive diseases and sciences 39 (1994), S. 2433-2438 
    Details
    ISSN: 1573-2568
    Keywords: portal hypertensive gastropathy ; laser Doppler flowmetry ; propranolol ; gastrin ; pepsinogen I
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastric mucosal hyperemia associated with elevated serum gastrin level has been suggested in cirrhotic patients with portal hypertensive gastropathy (PHG). Clinical evidence has shown that these patients may benefit from propranolol administration. The aim of this study was to investigate effect of propranolol on gastric mucosal perfusion and serum gastrin level in cirrhotic patients with portal hypertensive gastropathy. Gastric mucosal perfusion was assessed by laser Doppler flowmetry. Measurements were performed under basal conditions and after observer-blind administration of propranolol (30–60 mg/day,N=9) or placebo (N=9) for seven days. Placebo had no effect on either gastric mucosal perfusion or serum gastrin level. In contrast, propranolol administration significantly decreased both antrum gastric mucosal perfusion (from 0.88±0.28 to 0.73±0.26 V,P〈0.05) and corpus gastric mucosal perfusion (from 0.94±0.35 to 0.78±0.25 V,P〈0.05). However, this drug had no effect on serum gastrin level. We conclude that chronic propranolol administration in cirrhotic patients with portal hypertensive gastropathy may reduce gastric mucosal perfusion without changing serum gastrin level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02087662
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  • 7
    Electronic Resource
    Electronic Resource
    Influence of nitroglycerin on portal pressure and gastric mucosal hemodynamics in patients with cirrhosis (1994)
    Springer
    Journal of gastroenterology 29 (1994), S. 180-188 
    Details
    ISSN: 1435-5922
    Keywords: portal hypertension ; nitroglycerin ; portal hypertensive gastropathy ; gastric mucosal hemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied 30 patients with cirrhosis to determine the effect of nitroglycerin on portal and gastric mucosal hemodynamics. Systemic hemodynamics, portal venous pressure (PVP), the hemoglobin index (IHB), and the oxygen saturation index (ISO2) of the gastric mucosa were measured before and after a continuous infusion of nitroglycerin. The patients were divided into two groups according to the presence or absence of major portal-systemic collateral routes on portograms. Nitroglycerin caused a reduction in PVP in all patients. Although there was no significant difference in systemic hemodynamic changes between the two groups, the reduction in PVP in patients with major portal-systemic collaterals was significantly higher than in those without major collaterals. A nitroglycerin infusion, at a dose of 1.0μg/kg per min for 10 min, produced a reduction in both IHB (−16%,P〈0.001) and ISO2 (−13%,P〈0.001) in the gastric mucosa, indicating gastric mucosal ischemia secondary to splanchnic vasoconstriction. These findings suggest that the continuous infusion of nitroglycerin reduces PVP in cirrhotic patients, particularly in those with major portal-systemic collaterals, and reduces the congestion of the gastric mucosa in patients with portal hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02358680
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  • 8
    Electronic Resource
    Electronic Resource
    Small hepatocellular carcinoma with intravascular tumor growth into the right atrium (1994)
    Springer
    Journal of gastroenterology 29 (1994), S. 41-46 
    Details
    ISSN: 1435-5922
    Keywords: small hepatocellular carcinoma ; intraatrial tumor growth ; Budd-Chiari syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 66-year-old man with ascites and marked edema in the lower extremities was suspected of having secondary Budd-Chiari syndrome due to primary liver cancer, based on imaging diagnosis, i.e., ultrasonography, computed tomography, and inferior venacavogram. At autopsy, an encapsulated small liver cancer was found to have extended into the inferior vena cava and right atrium. There have been few reports of small hepatocellular carcinoma with intravascular tumor growth into the right atrium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01229072
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  • 9
    Electronic Resource
    Electronic Resource
    Ultrastructural observation on hepatocellular carcinoma (1993)
    Springer
    Medical molecular morphology 26 (1993), S. 19-28 
    Details
    ISSN: 1860-1499
    Keywords: Hepatocellular carcinoma ; Tumor grade ; Ultrastructure ; Morphometry ; Cell organelles
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 31 cases of hepatocellular carcinoma, electron microscopic observation and morphometry on the cell organelles were carried out to evaluate the usefulness of electron microscopy for the diagnosis of well differentiated hepatocellular carcinoma. The cell organelles in well differentiated tumor cells were very similar to those in normal hepatocytes or hepatocytes with liver cirrhosis (LC). We found that in poorly differentiated tumor cells, the nuclear area, N/C ratio, nucleolar area, the amount of dispersed chromatin, and the number of free ribosomes had increased, but the cellular area, degree of nuclear roundness, and mitochondrial area had decreased. These results seem to indicate that electron microscopy is not as useful as light microscopy in the diagnosis of well differentiated hepatocellular carcinoma, but is useful in the study of poorly differentiated tumor cells, which indicated that the cell proliferation through mitoses was activated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02348832
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