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  • 1
    ISSN: 1436-2813
    Schlagwort(e): splenic artery aneurysm ; idiopathic portal hypertension ; recurrence
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report herein the case of a 47-year-old man who developed a huge splenic artery aneurysm (SAA) with splenomegaly, for which ligation of the splenic artery and partial aneurysmectomy was performed. A celiac arteriogram taken 2 months postoperatively revealed that two small aneurysms had developed in the collateral vessels, indicating that increased blood flow through the collateral circulation could be responsible for the formation of secondary aneurysms. This postoperative change suggests that the etiology is related to the SAA and thus, the possibility that aneurysms may develop in the collateral vessels following spleen-preserving procedures for SAA must be borne in mind and careful follow-up performed at regular intervals.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1432-2307
    Schlagwort(e): Key words Myosin heavy chain isoforms ; Smooth muscle actin ; Capsule ; Hepatocellular carcinoma ; Liver cirrhosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  We examined the expression of smooth muscle cytoskeleton in spindle-shaped cells in the capsule of hepatocellular carcinoma (HCC) and the septa of liver cirrhosis (LC). Serial sections of livers resected from 11 patients were stained with monoclonal antibodies against vimentin, desmin, smooth muscle actin (1A4, HHF35, CGA7) and smooth muscle myosin heavy chain isoforms (SM1, SM2). Capsular spindle-shaped cells exhibited a cytoskeletal feature indicative of intermediately differentiated smooth muscle cells. Computer-assisted morphometry revealed that the proportions of 1A4-, HHF35-, CGA7- and SM1- positive areas to vimentin-positive area were 88.0±11.0%, 50.8±17.4%, 25.3±16.4% and 19.4±12.4% (n=11) in main tumours and 86.6±9.4%, 50.9±18.7%, 21.1±12.3% and 17.6±9.7% (n=12) in daughter tumours, indicating that spindle-shaped cells are heterogeneous in cytoskeletal expression. Septal spindle-shaped cells in LC lacked the cytoskeletal proteins specific to differentiated smooth muscle cells (CGA7, SM1, SM2 and desmin). Electron microscopically, capsular spindle-shaped cells contained more microfilaments and less rough endoplasmic reticulum than do septal cells. Intermediately differentiated smooth muscle cells are induced in the capsule of HCC but not in the septa of LC, suggesting a role for stromal interaction by tumour cells in the induction of smooth muscle cells.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1436-0691
    Schlagwort(e): carcinoma of the pancreatic head ; complete situs inversus ; polycystic liver
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A case of carcinoma of the pancreatic head associated with situs inversus (SI) and polycystic liver (PCL) is presented. The patient was a 71-year-old male with complaints of jaundice and general fatigue. Percutaneous transhepatic biliary drainage (PTBD) revealed complete obstruction of the lower end of the common bile duct (CBD). Endoscopic retrograde cholangiopancreatography (ERCP) revealed stenosis of the main pancreatic duct (MPD) in the head of the pancreas. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated multiple cysts in the liver as well as SI. Pylorus-preserving-pancreatoduodenectomy (PPPD) was performed by an operator who took his usual position on the patient's right side. We had no particular difficulty during surgery, although we had to charge several procedures. We consider it reliable to take the usual positions during surgery, even in cases of SI.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    ISSN: 1436-0691
    Schlagwort(e): Key words: early bile duct carcinoma ; mucosal carcinoma ; percutaneous transhepatic cholangioscopy (PTCS) ; superficial spreading carcinoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract: We describe a case of mucosal bile duct carcinoma with superficial spread in a 69-year-old man with gallstone pancreatitis. The patient was seen at the hospital because of abdominal pain, fever, and jaundice. Endoscopic retrograde cholangiography (ERC) demonstrated a protruding lesion in the lower third of the common bile duct (CBD) showing wall irregularity suggestive of malignancy. Percutaneous transhepatic cholangioscopy (PTCS) disclosed a papillary tumor with granular mucosa extending continuously to the middle third of the CBD. Cholangioscopic biopsy specimens taken from both the papillary tumor and surrounding granular mucosa revealed papillary adenocarcinoma. After this assessment of extent of cancer by PTCS, we performed pancreatoduodenectomy with extrahepatic bile duct resection and regional lymph node dissection. Pathology examination revealed papillary adenocarcinoma limited to the mucosal layer. The resected margin of the bile duct was free of tumor. We also reviewed 25 cases of early mucosal bile duct carcinoma described in detail in the Japanese literature, and we discuss the diagnostic advantages of PTCS.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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