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  • 1
    ISSN: 1534-4681
    Keywords: Liver transplantation ; Epithelioid hemangioendothelioma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Hepatic epithelioid hemangioendothelioma (PHEHE) is a multifocal, low-grade malignant neoplasia characterized by its epithelial-like appearance and vascular endothelial histogenesis. The outcome of 16 patients treated with orthotopic liver transplantation (OLT) is the subject of this report. Methods: A retrospective study of 16 patients with HEHE (7 men, 9 women) with ages ranging from 24 to 58 years (mean 37 ± 10.6 years). Follow-up intervals ranged from 1 to 15 years (median of 4.5 years). Results: Actual patient survival at 1, 3, and 5 years was 100, 87.5, and 71.3%, respectively. Disease-free survival at 1, 3, and 5 years was 81.3, 68.8, and 60.2%, respectively. The 90-day operative mortality was 0. Involvement of the hilar lymph nodes or vascular invasion did not affect survival. The 5-year survival of HEHE compares favorably with that of hepatocellular carcinoma at the same stage (stage 4A): 71.3 versus 9.8% (p=0.001) Conclusions: The long-term survival obtained in this series justifies OLT for these tumors even in the presence of limited extrahepatic disease.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-9813
    Keywords: Ovarian cyst ; Prenatal diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fetal ovarian cysts are an increasingly common finding during routine prenatal ultrasonography (US). These lesions were occasionally diagnosed in the past, but only on the basis of a palpable abdominal mass or, rarely, because a twisted ovarian cyst caused an acute abdomen. Surgery is currently recommended for neonates after prenatal diagnosis, even in asymptomatic cases, when the cyst has a diameter larger than 5 cm or echographic findings suggest torsion or intracystic hemorrhage. In our 12 cases of suspected fetal ovarian cysts, wide variations in diameter were seen in 6 during pre- and postnatal follow-up. Two of these were not confirmed at birth; 7 were treated conservatively and excluding 1 perinatal death from multiple associated anomalies and 1 case lost to follow-up, the remaining cases showed uneventful, spontaneous regression of the cyst. Postnatal US signs suggesting necrosis secondary to torsion in a previously uncomplicated cyst and requiring surgery were seen in only 3 cases. Conservative treatment must be recommended in most prenatally diagnosed cysts; indications for surgery cannot be based only on dimensions. The incidence of complications has been overemphasized and the risk of associated malignancy is negligible in newborns, while possible size reduction and resorption can be expected in most cases. Nonoperative management may also be recommended when signs of torsion are seen before birth and spontaneous asymptomatic involution of the cystic ovary is documented in early postnatal life. Accurate clinical and US follow-up is mandatory in all cases. Surgery must be reserved for symptomatic cases or when an alteration of the cystic structure is documented by US in a previously uncomplicated cyst.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Archives of environmental contamination and toxicology 10 (1981), S. 271-280 
    ISSN: 1432-0703
    Source: Springer Online Journal Archives 1860-2000
    Topics: Energy, Environment Protection, Nuclear Power Engineering , Medicine
    Notes: Abstract Groups of six male Sprague-Dawley rats were administered single oral doses of mono-2-ethylhexyl phthalate (MEHP) at 50, 100 or 200 mg/kg or di-2-ethylhexyl phthalate (DEHP) at 2,000 mg/kg in 2% gum acacia and were observed clinically for seven days. Body weight and food consumption were not affected by treatment. The liver weight increased in the groups receiving 100 mg or 200 mg mono-2-ethylhexyl phthalate and 2,000 mg diethylhexyl phthalate. Hepatic microsomal aniline hydroxylase activity was not altered by treatment. In a subsequent 28-day experiment, groups of ten weanling Sprague Dawley rats were fed diets containing 0, 25, 100, 400, 1,600 or 6,400 ppm of mono-2-ethylhexyl phthalate. Decreased growth rate occurred in the group receiving the highest dose level. Increased heart and liver weights were observed in animals from the 1,600 and 6,400 ppm groups. Minor alterations in serum biochemical values included decreased SDH and calcium levels, and elevated alkaline phosphatase activity in some treated groups. A mild reduction in red cells saturation and hematocrit was noted in some groups. In 3-month and 6-month feeding studies, groups of ten male and female weanling Sprague-Dawley rats were fed diets containing 1, 5, 25, 125 or 625 ppm of mono-2-ethylhexyl phthalate. Growth rate and food consumption were not affected at any dose level or time interval. Relative organ weights of rats of both sexes were not altered in the 3-month period, but the liver weights of female rats in the 6-month experiment were increased. Changes in clinical chemistry and hematological values were mild. These included lower LDH, SGOT, hemoglobin, and hematocrit values in male rats at the 3-month period and reduced potassium content at the 6-month period. Histological changes were mild in both male and female rats at both time intervals. Treatment-related lesions were found in the liver, heart, and adrenals. Alteration in the liver consisted of midzonal and periportal eosinophilic cytoplasmic inclusions and vacuolations with isolated binucleated and necrotic hepatocytes. There was a mild enlargement of myocardial nuclei and segmental deregistration of myocardial striations in test animals. The adrenal glands exhibited vacuolation of the zona fasciculata which was less severe in the 6-month period than the 3-month counterpart. In conclusion, mono-2-ethylhexyl phthalate is similar to its parent compound diethylhexyl phthalate in that it possesses a low order of oral toxicity in rats.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Major bacterial infections and the predictors of early (within 100 days of transplantation) versus late onset (after 100 days post-transplant) bacterial infections were prospectively assessed in 130 consecutive liver transplant recipients receiving tacrolimus (FK506) as primary immunosuppression. The median follow-up period was 38 months. Overall, 35% (45/130) of the patients developed 67 episodes of major bacterial infections (0.52 episodes/patient). Sixty-three percent of the major bacterial infections occurred early, and 37% occurred in the late post-transplant period. Eighty-four percent of the abdominal infections occurred early, whereas 38% of the cases of pneumonia, 60% of the cases of primary bacteremia, and 50% of the biliary infections occurred late. By logistic regression analysis, portal vein thrombosis was the most significant independent risk factor for early-onset major bacterial infection (odds ratio 4.1;95% Cl 1.4–12.2), and recurrent hepatitis C was the most significant independent predictor of late-onset major bacterial infections (odds ratio 6.21;95% Cl 1.9–20.2). Thus, sources and risk factors differ for early versus late-onset bacterial infections after liver transplantation. Knowledge of the differences in the potential sources, the pathogens, and the predictors of early versus late-onset bacterial infections can be valuable in the evaluation and empiric treatment of liver transplant recipients with bacterial infections.
    Type of Medium: Electronic Resource
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