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  • 1
    Electronic Resource
    Electronic Resource
    One shot administration of antineoplastic agents in massive doses via the celiac artery for inoperable cancer of the liver (1972)
    Springer
    Surgery today 2 (1972), S. 122-130 
    Details
    ISSN: 1436-2813
    Keywords: One shot administration ; antineoplastic agents ; celiac artery ; liver cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As a chemotherapeutic maneuver for inoperable cancer of the liver, massive administration of antineoplastic agents was performed into the celiac axis through the femoral artery by Seldinger's method. Out of 46 cases subjected to this method, 0.5–0.8 mg/kg of Mitomycin C or 10–15 mg/kg of 5-fluorouracil was given in one-shot in 33, and for the remainders of 13 the same dosis of antineoplastic agents was continuously perfused for 2 to 3 days through the same route. Subjective symptom improved in 67 per cent and objective symptom in 46 per cent with continuous infusion, while the former improved in 76 per cent and the latter in 52 per cent in cases of one-shot administration. Average survival time of 53 cases in control study was 3.0 months in contrast to 4.9 months with the massive dose administration. Noteworthy is the fact that 50 per cent survival time of 7 cases received repeated one-shot administration was 7.5. months. Cancer of the liver was classified into 4 types according to angiographic findings and correleted to the effect of one-shot administration. In type I and II, improvement of subjective symptom was observed in 76 per cent and that of objective symptom in 65 per cent, average survival time being 7.0 months. Therefore this mode of administrations seems to be most effective in tumors of type I and II.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02470399
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  • 2
    Electronic Resource
    Electronic Resource
    Hepatic resection for primary liver malignancy (1984)
    Springer
    Surgery today 14 (1984), S. 486-493 
    Details
    ISSN: 1436-2813
    Keywords: primary liver malignancy ; hepatocellular carcinoma ; liver cirrhosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of hepatic resection for patients with primary liver malignancy seen at our clinic during the past 21 years are reported. Of 92 patients, 57 had cirrhosis in addition to hepatocellular carcinoma, and 49 (53 percent) underwent hepatic resection of various degrees from partial resection to trisegmentectomy. Resectability rates of the liver were 52 percent in 77 patients with hepatocellular carcinoma, including 19 in whom the tumor was less than 5 cm in diameter, and 60 percent in 15 patients with other malignant tumors; operative mortality rates were 15 percent in the former and 0 percent in the latter. Cumulative survival rates of all patients who underwent hepatic resection, excluding death within one month, were 55 percent at one year, 29 at 3 and 5 years. In patients with hepatocellularcarcinoma, survival rates of 15 those who had a curative resection of the tumor were 87 percent at one year and 47 percent at 3 or 5 years, there was a significant difference in survival curves between those with tumors less than 5 cm and more than 5 cm (p〈0.05). On the other hand, survival rates of all patients with other malignant tumors were 78 percent at one year and 37 percent at 5 years. These results indicate the importance of performing hepatic resection for patients with small hepatocellular carcinoma associated with cirrhosis and those with other malignant tumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02469791
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  • 3
    Electronic Resource
    Electronic Resource
    Multifocal intraductal papillary adenocarcinoma of the pancreas: Report of a case (1993)
    Springer
    Surgery today 23 (1993), S. 471-475 
    Details
    ISSN: 1436-2813
    Keywords: mucin-producing tumor ; pancreatic ductal tumor ; mucin-producing carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper descibes a case of a mucin-producing tumor of the pancreas, histologically diagnosed as multifocal intraductal papillary adenocarcinoma. The patient had a markedly dilated main pancreatic duct, detected by ultrasound (US) and computed tomography (CT), and endoscopy showed a papillary tumor projecting from the patulous orifice of the enlarged papilla of Vater. Several biopsies taken from the tumor indicated a diagnosis of papillary adenocarcinoma. Total pancreatectomy was thus performed, revealing a multifocal papillary tumor growing along the main duct in the head, body, and tail of the pancreas. Microscopically, these multiple tumors were found to be mucin-producing papillary adenocarcinoma of the main and subsidiary pancreatic ducts with nodular and microfocal periductal invasion. The surgical treatment of multifocal tumors, may therefore necessitate total pancreatectomy to achieve curative resection, in some cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00309511
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  • 4
    Electronic Resource
    Electronic Resource
    Prevention of the pancreatic complications after surgical procedures of the pancreas (1978)
    Springer
    World journal of surgery 2 (1978), S. 881-889 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé A la recherche d'une méthode de prévention des complications postopératoires qui sont peut-être dues aux enzymes pancréatiques, nous avons étudié les effets sur le pancréas d'inhibiteurs des synthèses protéiniques: 5-fluorouracil (5-FU), daunomycine (DAU), actinomycine D (ACD), vincristine (VCR), et méthotrexate (MTX). Ces effets ont été testés sur le pancréas exocrine de rats Donryu et chez 12 malades opérés pour affection pancréatique. Dans les expériences de contrôle, des études de fixation d'acides aminés marqués et des autoradiographies ont montré que les synthèses enzymatiques dans le pancréas exocrine sont temporairement réduites après l'opération, mais reviennent rapidement à la normale. Toutes les drogues testées diminuent la fixation de 75 Se-sélénométhionine dans le pancréas. Chez les rats traités au 5-FU ou à la VCR, la fixation de 3 H-leucine sur la fraction protéinique, la radioactivité et le nombre de grains de zymogène sont réduits. Sur la base de ces résultats expérimentaux, nous avons choisi le 5-FU comme drogue la plus efficace. Douze malades ont été traités. L'un a présenté une petite fistule pancréatique de courte durée; au autre a fait, après duodénopancréatectomie, un lâchage de la pancréaticojéjunostomie. Les autres malades n'ont pas eu de complication, même dans les opérations faites en cas de pancréatite. Chez plusieurs patients, le 5-FU a réduit la quantité de protéines et l'activité amylasique du suc pancréatique recueilli en postopératoire par un cathéter drainant le canal pancréatique.
    Notes: Abstract In order to find a way to prevent postoperative complications believed to be caused by pancreatic enzymes, we studied the effects on the pancreas of 5-fluorouracil (5-FU), daunomycin (DAU), actinomycin D (ACD), vincristine (VCR), and methotrexate (MTX), all of which have an inhibitory effect on protein synthesis. The effects of these drugs were tested on the exocrine cells of Donryu rats and in 12 patients who had had surgical procedures for pancreatic diseases. In control experiments, the uptake of labeled amino acid and autoradiographic studies showed that enzyme synthesis by pancreatic exocrine cells was diminished transiently after surgery but recovered in a short time. All of the drugs produced a decrease of75Se-selenomethionine uptake in the pancreas.3H-leucine uptake in the pancreatic protein fraction and autoradiographic studies showed a significant reduction of radioactivity and a decrease of grain counts on zymogen granules in rats treated with 5-FU and VCR. On the basis of these experimental results, 5-FU was selected as the most favorable drug. Of 12 patients treated with 5-FU, one developed a small pancreatic fistula for a short period of time and another had leakage from a pancreaticojejunostomy after pancreaticoduodenectomy. The others had no postoperative complications even when operations were performed in the presence of pancreatitis. 5-FU produced a decrease in the amount of protein and the activity of amylase in pancreatic juice obtained postoperatively from a catheter in the pancreatic duct of several patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01556548
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  • 5
    Electronic Resource
    Electronic Resource
    Function of pancreatic endocrine cells in experimental acute pancreatitis (1982)
    Springer
    World journal of surgery 6 (1982), S. 471-477 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Une étude expérimentale a été conduite pour étudier les modifications des fonctions endocriniennes du pancréas au cours de la pancréatite aigue. Pour ce faire des rats mâles (de race Donryu) ont été divisés en deux groupes: le premier constitué de rats chez qui fut provoquée une pancréatite aigue selon la méthode de Block, le second formé de rats chez qui fut pratiqué une simple laparotomie. L'examen histologique du pancréas des rats du premier groupe met en évidence une pancréatite aigue oedémateuse interstitielle, sans qu'il y ait d'altérations importantes des cellules endocrines en dépit des modifications inflammatoires des cellules exocrines. Le taux de l'insuline et du glucagon au niveau du tissu pancréatique des rats du premier groupe a été trouvé significativement abaissé par rapport aux rats du second groupe. Les études autoradiographiques employant un corps marqué (3H leucine) ont montré une baisse significative du nombre des granules endocriniens chez les rats atteints de pancréatite aigue oedémateuse. La libération de l'insuline à partir des ilôts de Langerhans isolés ne fut réduite que 72 heures après le développement de la pancréatite aigue cependant que ce phénomène de réduction s'observait dès la 6ème heure pour le glucagon. Ces faits indiquent que la pancréatite aigue s'accompagne d'une réduction de la synthèse et de la secrétion des hormones pancréatiques et suggèrent que l'atteinte des cellules A est plus précoce que celle des cellules B.
    Notes: Abstract This experimental study was carried out to clarify changes in pancreatic endocrine function in acute pancreatitis. Male Donryu rats were divided into 2 groups, consisting of a group with acute pancreatitis induced by Block's method, and another group with simple laparotomy as control. Histological examination in the former group revealed an interstitial edematous pancreatitis, but there was no marked alteration of endocrine cells in spite of inflammatory changes in the exocrine region. Insulin and glucagon levels in the pancreatic tissue of rats with acute pancreatitis were significantly lower than those of control rats. Autoradiographic studies using3H-leucine showed a significant decrease of grain counts for endocrine granules in rats with acute pancreatitis. The release of insulin from isolated islets of Langerhans was not reduced until 72 hours after the development of acute pancreatitis, while the release of glucagon from isolated islets was reduced 6 hours after the development of acute pancreatitis. These findings indicate that there is a reduction of synthesis and secretion function in endocrine cells of the pancreas in acute pancreatitis, and suggest that the damage to A cells occurs more rapidly than damage to B cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01657685
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  • 6
    Electronic Resource
    Electronic Resource
    Operative results of extrahepatic bile duct carcinoma (1982)
    Springer
    Surgery today 12 (1982), S. 171-177 
    Details
    ISSN: 1436-2813
    Keywords: extrahepatic bile duct ; hepatic resection ; hepatojejunostomy ; pancreaticodenectomy ; carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine the benefits of surgical treatment for patients with carcinoma of the extrahepatic bile duct, data on 100 patients with this disease who had been surgically treated in our clinic during the past 18 years were evaluated. These patients were grouped into three, i.e., upper, middle and lower bile duct groups. Patients with periampullary tumor were excluded from this study. Surgical procedures consisted of resection of the tumor, including hepatic resection and dissection of the regional lymph nodes, and a bypass operation of the extra- or intrahepatic bile duct. Resectability rates of the tumor were 21.6% in upper, 82.4% in middle, and 50% in lower bile duct groups. Average survival times of patients who had a resection of the tumor were 30.3 months in the upper bile duct group, 35.9 months in middle (the longest, 13 years and 3 months) and 22.5 months in lower bile duct group. Survival rates of overall patients with resection of tumors were 64.5% at one year, 29.0% at 3 years, and 12.9% at 5 years after surgery, respectively. The middle bile duct group showed the most favorable operative results of all the groups, an extended resection of the tumor should be carried out to obtain for a longer survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02469583
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  • 7
    Electronic Resource
    Electronic Resource
    Hepatic resection for hepatocellular carcinoma associated with liver cirrhosis (1986)
    Springer
    World journal of surgery 10 (1986), S. 294-300 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Au cours des 21 dernières années les auteurs ont soumis 63 malades atteints d'un cancer hépatocellulaire sur cirrhose à différentes thérapeutiques. Parmi eux 35 ont subi une résection hépatique. Ils ont été divisé en 2 groupes: selon que le diamètre de la tumeur était supérieur ou inférieur à 5 cm. Les résultats obtenus ont été comparé en fonction de la taille de la tumeur. Il a été constaté une différence significative entre l'âge des deux groupes mais aucune différence en ce qui concerne la durée de la maladie et les données biologiques. Le taux de résection a été de 89% quand le diamètre de la tumeur était inférieur à 5 cm (17 malades) et de 41% quand il était supérieur (18 malades). La mortalité globale a été de 14%. Dès que la diamètre de la tumeur était supérieur à 3 cm les caractères histologiques étaient identiques. Le taux de survie à 3 ans a été de 0% lorsque la tumeur était importante et de 53% quand elle était peu développée. Ces résultats permettent d'affirmer que la résection hépatique est efficace lorsque les malades atteints de cirrhose sont porteurs d'une tumeur de petite taille.
    Abstract: Resumen En el Asia se presenta un elevado nÚmero de pacientes con cirrosis y carcinoma hepatocelular asociado. Un informe del grupo de Estudio de Cancer del Hígado del Japón expedido en 1982 reveló que el 85.6% de los pacientes con carcinoma hepatocelular presentaba cirrosis o fibrosis asociada. La mayoría de los pacientes que poseen ambas enfermedades exhibe no sólo una baja tasa de resección hepática en comparación con la de los pacientes no cirróticos, sino también un pronóstico pobre después de la cirugía. Sesenta y tres pacientes con carcinoma hepatocelular asociado con cirrosis recibieron diferentes formas de tratamiento en nuestra institución en el curso de los Últimos 21 años. De éstos, 35 pacientes sometidos a resección hepática fueron divididos entre un grupo con tumores grandes (tumores de más de 5 cm de diámetro) y un grupo de tumores pequeños (tumores de menos de 5 cm de diámetro) y los resultados del tratamiento operatorio fueron evaluados en ambos grupos. Apareció una diferencia en la edad promedio entre los dos grupos (p〈0.05), pero no se observó diferencia en cuanto a la duración de la enfermedad o los resultados de las determinaciones de laboratorio. La tasa de resección hepática en 17 pacientes con tumores pequeños fue de 89% y significativamente mayor que la de 41% en 18 pacientes con tumores grandes (p〈0.005). La tasa global de mortalidad operatoria fue de 14% para ambos grupos. Los pacientes con tumores de más de 3 cm ya exhiben los hallazgos histológicos que se presentan en el cáncer avanzado. Las tasas de supervivencia acumulada a 3 años de los grupos con tumores grandes y pequeños fue de 0% y de 53% respectivamente, y se encontró una diferencia significativa en cuanto a las curvas de supervivencia entre los dos grupos (p〈 0.005). Los anteriores resultados sugieren que la resección hepática en pacientes con tumores pequeños es efectiva como tratamiento del hepatoma asociado con cirrosis.
    Notes: Abstract Sixty-three patients with hepatocellular carcinoma associated with cirrhosis received various kinds of treatment at our clinic during the past 21 years. Of these, 35 patients who underwent hepatic resection were divided into a large tumor group (tumors more than 5 cm in diameter) and a small tumor group (tumors less than 5 cm in diameter), and the operative results of both groups were studied. There was a difference in the average ages between the 2 groups ( p 〈0.05), but there was no difference in the duration of illness or laboratory data. The resectability rate of the liver in 17 patients with small tumors was 89% and was significantly higher than that of 41% in 18 patients with large tumors ( p〈0.005). The overall operative mortality rate was 14% for both groups. Patients with tumors over 3 cm already exhibited the histological findings seen in advanced cancer. Cumulative 3-year survival rates of the large and small tumor groups were 0% and 53%, respectively, and there was a significant difference in survival curves between the 2 groups ( p〈0.005). The above results suggest that hepatic resection for patients with small tumors is effective as a treatment for hepatoma associated with cirrhosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01658148
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