Repair of the diaphragm with an external oblique muscle flap.

The technique for repair of large defects in the diaphragm by the use of an ipsilateral or contralateral flap from the external oblique abdominal muscle was successfully used during five hepatic resections and has been described herein.

[Hepatocellular carcinoma with intraductal tumor thrombus diagnosed by ultrasonography; report of two resected cases].

The authors report two resected cases of hepatocellular carcinoma with intraductal tumor thrombus which showed transient jaundice and were diagnosed by ultrasonography. Ultrasonography is very useful in revealing intraductal tumor thrombus and it is necessary when patients with hepatocellular carcinoma are accompanied by jaundice.

[Quantitative evaluation for murine oocyte toxicity following intraperitoneal treatment with chemotherapeutic agents].

The ovarian toxicity induced with 12 oncostatics was evaluated using syngeneic mice, 6-week-old C57BL/6. Each drug diluted with saline to 0.2ml was intraperitoneally infused twice at 6 and 7 weeks old.

Establishment of a human leukaemic cell line (CMK) with megakaryocytic characteristics from a Down's syndrome patient with acute megakaryoblastic leukaemia.

A new megakaryoblastic cell line (CMK), which also exhibits erythroid and myeloid markers, was established from a Down's syndrome patient suffering from acute megakaryoblastic leukaemia. The CMK cells were found to be positive in reactions with anti-platelet antibodies (anti-glycoproteins IIb/IIIa and Ib, and Plt-1). Platelet peroxidase (PPO) reactivity was found to be associated with the nuclear envelope and the endoplasmic reticulum but not with the Golgi apparatus.

[Primary cytoreductive surgery of advanced ovarian cancer with special reference to the significance of bowel resection].

The importance of cf cytoreductive surgery is discussed with special reference to the bowel resection for advanced epithelial ovarian cancer. In the 10.5-year period from January 1978 to June 1988, 134 patients with epithelial ovarian cancer were seen at Toranomon Hospital.

Human chorionic gonadotropin in gastric carcinoma. A useful marker for bone metastasis.

Twenty patients with bone metastases from gastric carcinoma resected during the 13 years from 1974 through 1987 were investigated in relation to the serum and tissue carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG). The incidence of bone metastases was 2.1% (20/933).

[Arterial-portal shunting in hepatic cavernous hemangioma; a case report].

A 60-year-old woman had a small hepatic tumor in the right lobe detected by CT scan. Angiography showed a hypervascular lesion with shunting of dense contrast material into portal vein radicles. Resected specimen revealed a cavernous hemangioma.

Multimodal treatment of hepatocellular carcinoma.

Our multimodal treatment of hepatocellular carcinoma (HCC) has brought about a significant improvement of the survival rate. It consists of a combination of hepatectomy and transcatheter arterial embolization using lipiodol (L-TAE). In order to facilitate L-TAE, we have developed a special catheter with notches.

[Advantages and disadvantages of L-TAE in diagnosis and treatment of hepatocellular carcinoma].

Transcatheter arterial embolization using lipiodol ultra-fluid (L-TAE) is frequently used for hepatocellular carcinoma (HCC). Its advantages are: (1) Excellent therapeutic and diagnostic ability in our pathological study of 153 resected tumors. (2) Preoperatively, we can localize HCC and prevent spreading of cancer cells by manipulation at hepatectomy.

Combined peripheral and central chemoembolization of liver tumors. Experience with lipiodol-doxorubicin and gelatin sponge (L-TAE).

Patients with primary and a few with secondary liver tumors were embolized through the hepatic artery. Lipiodol and doxorubicin occluded peripherally, which was immediately followed by central embolization with gelatin sponge cubes. Preoperative embolizations were made for diagnostic and possible surgical adjuvant purposes.

Liver injury with perivenular fibrosis and alcoholic hyalin after pancreatoduodenectomy for pancreatic carcinoma.

We describe a patient who developed progressive hepatic failure one year after pancreatoduodenectomy for pancreatic carcinoma and died of gastrointestinal bleeding. He suffered from progressive weight loss after surgery, even though obstruction or stenosis of the gastrointestinal tract was excluded. At autopsy, the liver showed extensive perivenular fibrosis associated with variable loss of hepatocytes, perisinusoidal fibrosis, alcoholic hyalin and a lack of parenchymal regenerative activity, all of which closely resembled severe alcoholic liver disease.

Hepatocellular carcinoma: treatment with intraarterial iodized oil with and without chemotherapeutic agents.

Thirty-one patients with hepatocellular carcinoma (HCC) were given either an intraarterial injection of iodized poppyseed oil (Lipiodol) alone (group A, n = 6), an emulsion of iodized oil and doxorubicin hydrochloride (Adriamycin) (group B, n = 15), or chemoembolization with the same emulsion followed by gelatin sponge (Gelfoam) particles (group C, n = 10). Hepatic resection was subsequently performed. The frequencies of complete necrosis of tumor in the main lesion, daughter tumors, tumor thrombus, and foci of intracapsular invasion were evaluated in the cut surface of the resected specimen.

Imaging characteristics of large lipoma and angiomyolipoma of the liver. Case reports.

A large lipoma and a large angiomyolipoma of the liver, one case each, are described. In the first case, a 24 X 14-cm homogeneous mass demonstrated a fatty density (-96H) on computed tomography (CT), echogenicity on sonography, and fine neovascular vessels on angiography in the right lobe of the liver. Histopathologic diagnosis of the resected specimen was lipoma.

[Multiple rectal carcinoids--with special reference to the histogenesis of these lesions].

A 61 year-old man was diagnosed prior to surgery as having multiple carcinoids of the rectum. Postoperative histological examination revealed 52 carcinoids, 1-6 mm in diameter, invading the submucosal layer, and innumerable endocrine cell micronests, less than 0.1 mm in diameter, were present in the rectum.

Computed tomography findings of hepatic lesions in human fascioliasis: report of two cases.

Two patients with hepatic fascioliasis are presented. Computed tomography demonstrated multiple low density areas located in the center and periphery of the liver. In one patient a spontaneous decrease in the size of the low-density areas occurred but the abdominal symptoms were persistent before bithionol treatment.

[HCG-producing intrahepatic cholangiocarcinoma].

The serum level of human chorionic gonadotropin (hCG) in a 60-year-old man with intrahepatic cholangiocarcinoma was found to be abnormal (44.6 mIU/ml) at the diagnosis. The patient underwent right hemihepatectomy, and the high serum hCG returned to normal 28 days postoperatively.

Selective portal branch occlusion by balloon catheter during liver resection.

An intraoperative ultrasonographically guided introduction of a balloon catheter into labor or smaller branches of the portal vein within the liver parenchyma made it possible to temporarily occlude them and perform regional staining during resection for tumors. The technique minimized blood loss without hilar dissection for vascular control, and the presence of the catheter facilitated intraparenchymal dissection of the portal stalk to the part of the liver to be resected.

[A study of malignancy in gastro-intestinal carcinoids with special reference to the association of the prognosis and peptide hormone or oncofetal protein producing pattern].

It is difficult to differentiate malignant carcinoid tumors from benign ones early in the course of the illness. We investigated retrospectively a series of thirty-nine gastro-intestinal carcinoids not only for primary tumor anatomic site, macroscopic type, tumor size, histological depth, vessel invasion and mitosis, but also for peptide, ectopic hormone and oncofetal proteins by immunohistochemistry. Carcinoids primary in the appendix or rectum rarely metastasize, but those primary in the stomach or colon grow rapidly.

Necrosis of hepatocellular carcinoma as a result of subintimal injury incurred by hepatic angiography: report of two cases.

This report described two patients with hepatocellular carcinoma in whom angiographic procedure caused an inadvertent subintimal injury of the hepatic artery, resulting in tumor necrosis. In the first case of a 38-year-old male, complete obstruction of the common hepatic artery occurred on the initial angiography. It was followed by marked reduction of the tumor vessels on repeat angiography, and necrosis of about half of the tumor as confirmed by computed tomography.

Clinical and radiologic features of hepatocellular carcinoma originating in the caudate lobe.

Five patients with hepatocellular carcinoma in the caudate lobe were evaluated. Computed tomography (CT) scan and/or angiography clearly demonstrated multiple intrahepatic metastases in four (80%), and tumor thrombi in the portal vein in two (40%), and in the inferior vena cava in one. Even though there was no recognizable lung metastasis, metastases were found in the orbita in one patient, and in the ribs and thoracic vertebrae in two patients.