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  • 1
    ISSN: 1436-2813
    Keywords: liver ischemia ; cyto-protection ; nifedipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was undertaken in order to determine whether the administration of nifedipine, a calcium channel blocker, could protect the liver from ischemic damage and to investigate its effect on the hepatic cellular energy status and cardio-vascular system after 60 minutes of hepatic ischemia in dogs. The ischemia was induced by temporarily clamping the portal vein and hepatic artery. One group of animals (n=17) received nifedipine (5 μg/kg body weight) intravenously 15 minutes before the induction of liver ischemia, which was continued at a dose of 0.2 μg/kg body weight/min throughout the ischemic period, and for an additional 30 minutes afterwards. Control dogs (n=16) were not given nifedipine and survival was observed over seven days. The survival rate was 83 per cent in the nifedipine treated animals and 0 per cent in the control animals. Serum glutamic oxaloacetic transaminase levels were greatly increased following ischemia, and they were significantly lowered with the nifedipine treatment. The hepatic energy charge decreased remarkably during the hepatic ischemia, however it increased gradually after declamping but did not returned to its preoperative value in either group until one hour later and then it was higher in the nifedipine treated animals than in the control animals. Cardiac index and portal venous blood flow ratio remained higher in the nifedipine treated animals than in the control animals, after the ischemic period. These results suggest that nifedipine may have a powerful cytoprotective effect and that the period of warm hepatic ischemia could be prolonged with its use.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1436-2813
    Keywords: hepatic cyst ; nonparasitic cyst ; cyst fluid ; tumor marker
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fifteen patients with nonparasitic hepatic cysts underwent surgery to relieve abdominal complaints, at the First Surgical Department, Tokyo University Hospital between 1966 and 1989. Total removal of the cyst was carried out in 14 of the patients, while puncture and aspiration only were performed in the other patient in whom a cyst had ruptured spontaneously, after which hemoperitoneum was observed at emergency laparotomy. The size of the cysts varied from 7–19 cm with a mean of 12.4 cm. Histological study revealed a congenital cyst in 14 patients and a cystadenoma in one. The epithelium lining of the internal surface of the congenital cysts was highly atrophic and desolated and often disappeared. Examination of the cyst fluid revealed the same concentration of electrolytes as in the serum. Hepatic enzyme levels were usually lower than in the serum, but lactic dehydrogenase and aminotransferase levels were elevated in a few cases. Tumor marker levels of the cyst fluid were higher than those in the serum in four of five patients examined.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1436-2813
    Keywords: minute hepatocellular carcinoma ; hepatic resection ; liver cirrhosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twenty-three patients with minute hepatocellular carcinoma, defined as a solitary lesion ≦2 cm, underwent hepatectomy at our institute during the 10 years between January, 1979 and December, 1988. Hepatitis B surface antigen was positive in 4 patients and the preoperative serum alpha-fetoprotein level was within the normal range in 7 patients and slightly elevated (20–200 ng/mL) in 14 patients. Liver cirrhosis was present in 16 patients and chronic hepatitis in 6 patients. The diagnosis was first suspected from the results of periodic examinations, including echography and the measurement of alpha-fetoprotein, in all except one patient. Minor hepatic resection was performed in 22 patients, and lobectomy in one patient in whom the tumor was located centrally in the liver. Three patients died of hepatic failure in hospital following surgery, and the survival rates of the other 20 patients at 1, 3, and 5 years were 90, 79, and 61 per cent, respectively. The prognostic factors that influenced long-term survival were investigated by comparing the survival curves. The only factor associated with a significant difference in survival was the severity of concomitant liver disease. Thus, severe cirrhosis is the main obstacle against the long-term survival of patients with minute hepatocellular carcinoma.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1436-2813
    Keywords: hepatocellular carcinoma ; spontaneous rupture ; delayed hepatectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cirrhotic patients with ruptured hepatocellular carcinoma (HCC), presenting with hemoperitoneum, were successfully treated by elective hepatectomy. Both of these patients, a 67-year-old female and a 76-year-old male, had first been taken to other primary hospitals by ambulance due to hypovolemic shock. They were then found to have a mass of approximately 5 cm in the cirrhotic liver. In the initial management, however, neither any direct hemostasis by surgery nor indirect measures such as transcatheter hepatic arterial embolization were performed in either case. Instead, conservative treatment consisting mainly of fresh blood and plasma transfusions were continued for more than a month until the liver function stabilized. In both hepatectomies, the use of a microwave tissue coagulator resulted in minimal intra-operative blood loss and an appreciably excellent post-operative course. These cases point to the effectiveness of a “wait and see” policy for selected patients with ruptured HCC.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1436-2813
    Keywords: hepatoblastoma ; adult ; resection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hepatoblastoma (HB) rarely occurs in adults, and very few cases of successful resection have been documented. We report herein the unusual case of a 22-year-old, otherwise healthy woman with no history of liver disease who presented with upper abdominal pain and hepatomegaly. Tests for hepatitis B virus (HBV) and hepatitis C virus (HCV) were negative, but the AFP was mildly elevated at 77 ng/ml, the normal being 〈20. There was no evidence of liver cirrhosis on either the laboratory or histologic examinations. A well-demarcated solid mass of 14cm in diameter, which was lobulated and partly necrotic, was detected in the liver by computed tomography (CT). The lesion was echogenic on ultrasound, slightly hypodense on CT, and mildly hyper-vascular on arteriogram. The entire tumor was resected by extensive hepatectomy preserving only the lateral segment and part of the posterior segment of the liver. Histologically, the neoplasm was diagnosed as a pure epithelial HB of the fetal type. Following the operation, the patient has been well and free of recurrence for 38 months, maintaining low alpha-fetoprotein (AFP) levels at around 5 ng/ml. To our knowledge, this is the longest reported survival of an adult following surgical resection of an epithelial HB.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1436-2813
    Keywords: ICAM-1 ; LFA-1 ; liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of the anti-cell adhesion molecule anti-bodies, anti-ICAM-1 (1A29) and anti-LFA-1 (WT1), on rat liver transplantation was investigated. Livers from ACI rats were transplanted into Lewis rats by Kamada's method and during the recipient operation 1A29 1 mg/kg, and WT1 1 mg/kg were administered intravenously to one group of rats (treated group). The survival time of the treated group was significantly longer than that of the untreated group, but permanent unresponsiveness could not be induced. Postmortem examination revealed little histological evidence of acute rejection in the treated rats, in which the main cause of death was thought to be chronic rejection.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 25 (1995), S. 802-805 
    ISSN: 1436-2813
    Keywords: biofragmentable anastomosis ring ; esophageal transection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since the first publication on the new anastomosis technique using a biofragmentable anastomosis ring (BAR) by Hardy in 1985, various studies have been performed to investigate the superiority of this type of anastomosis, and it has since been reported that the BAR was safely used not only in large and small bowel anastomosis, but in cholecystojejunal and gastrojejunal anastomosis as well. In this study, the feasibility of the BAR for esophageal transection was investigated. Seven dogs were operated on, and one died of intraabdominal bleeding on the operative day while another died of leakage at the site of gastrotomy on the 3rd postoperative day. These deaths were all considered to be due to simple technical errors not directly related to the use of the BAR. The postoperative recovery of the other five dogs was uneventful, and the ring eventually disintegrated into several small fragments that passed out of the body in the faces between the 14th and 21st postoperative days. The dogs were killed on the 28th postoperative day, and both gross and histological examinations, revealed that the transection had been successful. Neither leakage nor significant stenosis at the site of transection was found. Our results suggested that the BAR could be used for esophageal transection and is thus recommended as an easy-to-learn, time-saving, and safe technique for esophageal operations.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1436-2813
    Keywords: Bactobolamine ; tacrolimus ; mizoribine ; combination index ; rat liver allotransplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to examine the immunosuppressive effect of bactobolamine (BBL) alone and in combination with tacrolimus (FK) using in vitro proliferation assays on human peripheral blood lymphocytes (PBLs) and in vivo liver allografts in rats. In the latter setting, the immunosuppressive activity of BBL alone and in combination with FK was compared to that of mizoribine (MIZ). The interactions between BBL and FK and between MIZ and FK were assessed by the combination index (CI) proposed by Chou and Kahan. In the in vitro study, the combination of BBL and FK displayed stronger inhibitory effects on T-cell proliferation than when each drug was applied alone. The mean CI values for the BBL/FK combination were below 1.0, rangin from 0.19 to 0.86, indicating synergism between BBL and FK. In the in vivo study, 50–200 mg/kg/day BBL monotherapy significantly prolonged survival compared with a control group, and the effect was dose-dependent. Conversely, the efficacy of MIZ monotherapy at 2.5–10 mg/kg/day did not increase dose-dependently. The CIs for MIZ at doses of 2.5 and 5.0 mg/kg/day with FK 0.08 mg/kg/day were 0.48 and 0.42, respectively, indicating therapeutic synergism between MIZ and FK. The CI for BBL 100mg/kg/day with FK was 0.26, which indicated further synergism between BBL and FK.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1436-2813
    Keywords: superoxide dismutase ; liver transplantation ; oxygen free radicals
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We performed orthotopic liver transplantation in male Wistar rats and investigated the effect of superoxide dismutase (SOD) on the liver graft. Animals were divided into the four following experimental groups. Group I was an untreated control group, group II received oxygen, group III received SOD and group IV received both oxygen and SOD. The dose of SOD was 3 mg/kg which was injected intravenously into both donors and recipients during the operation. Oxygen was given through an oxygen inhaler to both donors and recipients during the operation. The preservation time of the liver graft ranged from 4 hours and 41 minutes to 5 hours and 40 minutes. The survival after liver transplantation was compared among groups I, II, III and IV. Group IV showed a significantly higher survival rate than groups I and II by two weeks after liver grafting, but there was no statistical difference in the survival rates between groups III and IV. These results indicate the beneficial effect of SOD on the rat liver graft and may implicate oxygen free radicals in the pathogenesis of ischemia/reperfusion injury in liver grafts.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1436-2813
    Keywords: nonspecific colonic ulcer ; liver dysfunction ; hepatectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We herein report the case of a 53-year-old man with a nonspecific acute colonic ulcer whose liver function deteriorated after he had undergone hepatectomy. He was referred to our hospital for a hepatoma caused by hepatitis B virus and a right hemihepatectomy was performed. His liver function was poor after the operation, and minor complications such as pleural effusion and biliary fistula developed. A large amount of melena was seen 29 days after the hepatectomy and he developed hemorrhagic shock. Superior mesenteric arteriography revealed pooling of blood in both the hepatic flexure of the ascending colon and the cecum. An emergency right hemicolectomy was performed. There was a 5 x 1-mm ulcer 18 cm distal to the ileocecal valve. Numerous erosions were observed to be scattered throughout the colonic mucosa. The patient recovered slowly and was discharged 6 months after the hepatectomy. This is the first report of an acute colonic ulcer that could have been caused by liver dysfunction.
    Type of Medium: Electronic Resource
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