Systemic amyloidosis manifesting as a rare cause of hepatic failure.

In 1854, the term "amyloid" was first used in the description of a liver specimen at autopsy by Virchow. The kidneys and heart are the most commonly involved organs in amyloidosis; liver and gastrointestinal tract involvement is less common, and the symptoms are usually mild. Here, we report the case of a 57-year-old male patient who presented with oral hemorrhagic bullae, thrombocytopenia and jaundice.

Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of Model for End-Stage Liver Disease score.

Background: The Model for End-Stage Liver Disease (MELD) score is currently used as a disease severity index of cirrhotic patients awaiting liver transplantation. This study evaluated the usefulness of the MELD score in predicting mortality and morbidity of patients with hepatocellular carcinoma (HCC) undergoing hepatic resection.

Methods: The study cohort consisted of 1,017 patients who underwent hepatic resection for HCC between 1991 and 2005.

An uncommon cause of abdominal pain and diarrhea-gastrinoma in an adolescent.

Gastrinoma is a hormone-secreting tumor associated with the Zollinger-Ellison syndrome. It is quite rare among children, and it is also uncommon in locations other than the pancreas and the duodenum in the pediatric group. Here, we describe an adolescent male, presenting with recurrent secretory diarrhea and abdominal cramping pain, who had a solitary gastrinoma in the lesser sac, close to the stomach.

Predictive value of aspartate aminotransferase to alanine aminotransferase ratio for hepatic fibrosis and clinical adverse outcomes in patients with primary biliary cirrhosis.

Background: The aspartate aminotransferase to alanine aminotransferase ratio (AAR) was seldom applied for fibrosis assessment in primary biliary cirrhosis (PBC) patients.

Goals: To validate the AAR for evaluating hepatic fibrosis, disease severity, and prognosis in patients with PBC.

Study: Ninety-two consecutive PBC patients were retrospectively evaluated to validate the AAR for assessing the severity of liver function, the degrees of hepatic fibrosis, and predicting outcomes.

Coexistence of large cell neuroendocrine carcinoma and adenocarcinoma of the ampulla of vater.

We report a case of coexisting poorly differentiated endocrine carcinoma and conventional adenocarcinoma in the ampulla of Vater. A 70-year-old female had a recent history of symptoms and signs related to obstructive jaundice. An initial endoscopic biopsy of the ampulla of Vater showed a poorly differentiated endocrine carcinoma in the lamina propria of duodenal mucosa.

Successful radiofrequency ablation therapy for hepatocellular carcinoma in a male patient with early stage primary biliary cirrhosis and positive serum hepatitis B core antibody.

Hepatocellular carcinoma (HCC) occurring in a 66-year-old male patient with early stage primary biliary cirrhosis (PBC) was successfully treated by radiofrequency ablation (RFA) therapy. He was diagnosed with PBC based on the findings of pruritus, elevated serum alkaline phosphate level and positive serum antimitochondrial antibody in 2005. The serologic tests for hepatitis B surface antigen, hepatitis B surface antibody and hepatitis C virus antibody were all negative.

A 35-year retrospective study of carcinoid tumors in Taiwan: differences in distribution with a high probability of associated second primary malignancies.

Background: A comprehensive study of carcinoid tumors from United States-based databases indicated that the small intestine, colon, rectum, and bronchopulmonary system are common locations for carcinoid tumors. In addition, certain carcinoid tumors, such as rectal carcinoids, appeared to be overrepresented in nonwhite populations in the United States. High frequencies of associated noncarcinoid malignancies were reported in some articles.

Lacrimal gland extranodal marginal zone B-cell lymphoma of MALT-type.

Purpose: To evaluate the clinical features and outcome of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma) in the lacrimal gland.

Design: Retrospective, noncomparative, observational case series in an academic referral setting.

Methods: A consecutive series of 13 histologically verified MALT lymphoma in the lacrimal gland at presentation was studied.

Clinical significance of p16INK4a and p53 overexpression in endocrine tumors of the gastrointestinal tract.

This study was designed to determine the expression of p16, p53, and CD117 in gastrointestinal tract endocrine tumors. Immunohistochemical studies of p16, p53, and CD117 were performed in 57 gastrointestinal tract endocrine tumors, including 22 poorly differentiated endocrine carcinomas (PDECs) and 35 well-differentiated endocrine tumors (WDETs). Overexpression of p16 and p53 was observed in 16 (73%) and 10 (45%) of the PDECs, respectively, whereas only 1 WDET showed overexpression of p53 and none showed overexpression of p16.

Prognostic value and clinical relevance of the 6th Edition 2002 American Joint Committee on Cancer staging system in patients with resectable hepatocellular carcinoma.

Background: A simplified American Joint Committee on Cancer (AJCC) TNM staging system for hepatocellular carcinoma (HCC) (the 6th edition) was proposed in 2002. In this study, we validated the prognostic value of the staging system in a patient cohort undergoing hepatic resection with longterm followup.

Study Design: From a prospective database, the study cohort consisted of 440 patients who underwent curative hepatic resection for HCC between July 1991 and January 1999.

Postresectional adjuvant intraportal chemotherapy in patients with hepatocellular carcinoma: a case-control study.

Background: The postresectional tumor recurrence rate is high in patients with hepatocellular carcinoma (HCC). Tumor portal venous invasion is the most important factor related to recurrence. Adjuvant intraportal infusion chemotherapy (IPIC) was used in HCC patients to improve the outcomes.

Nonalcoholic fatty liver disease manifesting esophageal variceal bleeding.

Nonalcoholic fatty liver disease (NAFLD) is a fatty liver disease occurring in patients without alcohol consumption. It includes a broad spectrum of liver disease, from fatty infiltration, inflammation and fibrosis, to cirrhosis, usually having obesity, hyperlipidemia, and diabetes mellitus as its etiology. NAFLD-related cirrhosis has rarely been reported in Taiwan.

Acute hepatitis induced by Chinese hepatoprotective herb, xiao-chai-hu-tang.

Xiao-chai-hu-tang (syo-saiko-to in Japanese) is a herbal remedy that has been widely used in China for treatment of respiratory, hepatobiliary, and gastrointestinal diseases, particularly among patients with chronic liver disease. However, its safety has recently been challenged. We, herein, report a Chinese patient with acute hepatitis induced by this herb.

Effects of gabexate mesilate on serum inflammatory cytokines in rats with acute necrotizing pancreatitis.

Gabexate mesilate is a synthetic protease inhibitor. The effectiveness of gabexate mesilate in patients with acute pancreatitis is controversial. Proinflammatory cytokines are associated with systemic inflammatory response syndrome (SIRS) in acute pancreatitis.

Urothelial carcinoma with rhabdoid features: report of 6 cases.

Extrarenal rhabdoid tumors have been described in a variety of primary sites with only rare case reports of urothelial carcinomas with rhabdoid features in the literature. In this report, we describe the clinicopathologic characteristics, including clinical follow-up on 6 cases of urothelial carcinoma with prominent rhabdoid features. Four cases were retrieved from the consultation files of one of the authors and 2 were retrieved from the surgical pathology files at our institution.

Differential immunoprofiles of hepatocellular carcinoma, renal cell carcinoma, and adrenocortical carcinoma: a systemic immunohistochemical survey using tissue array technique.

The differential diagnoses of hepatocellular carcinoma (HCC), renal cell carcinoma (RCC), and adrenocortical carcinoma (ACC) are sometimes difficult due to their overlapping histologic features. Immunohistochemistry is a helpful adjunct in supporting the histologic diagnosis. In this study, the authors used the tissue array technique to systemically analyze the efficacy of different immunohistochemical panels in discerning these neoplasms.

Risk factors associated with bile leakage after hepatic resection for hepatocellular carcinoma.

Background/aims: Bile leakage after hepatic resection can cause septic complications and mortality. This study evaluated the risk factors associated with postoperative bile leakage in hepatocellular carcinoma patients.

Methodology: Between July 1991 and December 2000, 605 consecutive hepatocellular carcinoma patients who underwent hepatic resection were enrolled.

Hepatocellular carcinoma confined to Couinaud segment VIII: experience with extensive or limited resection.

Background/aims: Surgical treatment of hepatocellular carcinoma (HCC) confined to Couinaud segment VIII has been regarded as difficult. This study evaluates surgical and oncological results after extensive or limited resection of the tumor(s).

Methodology: Of the 399 HCC patients that underwent hepatic resection, 36 patients had the tumor(s) confined to segment VIII.

Epithelioid hemangioendothelioma of the nasal cavity.

Epithelioid hemangioendothelioma (EH) is an unusual vascular neoplasm characterized by proliferation of endothelial cells with epithelioid morphology. It has an indolent course, with the potential for recurrence, but rarely metastasizes. The common locations include soft tissue, skin, viscera and bone.

Donor lymphocyte infusion induced acute hepatitis.

Hepatic graft-versus-host disease (GVHD) post allogeneic hematopoietic stem cell transplantation generally presents as cholestatic jaundice and increased serum alkaline phosphatase (ALK-P). Currently accepted standards for evaluating the clinical severity of hepatic GVHD are not based on serum aminotransferase levels but on the serum bilirubin levels. We describe a 25-year-old female who initially had no liver damage at all after an allogeneic peripheral blood stem cell transplantation (allo-PBSCT) from her HLA-indentical sister.

Splenic hamartoma: presentation on contrast-enhanced sonography.

Splenic hamartoma is a rare benign tumor of the spleen. It is usually found incidentally at autopsy or splenectomy. We report a case of splenic hamartoma that was discovered during medical workup for vague upper abdominal pain.

Fenofibrate-induced acute cholestatic hepatitis.

Fenofibrate-induced acute or chronic hepatitis is rare, and only 11 reports from French, Italian or Spanish literature have been published up to date. We report a case of fenofibrate-induced acute cholestatic hepatitis. To the best of our knowledge, this is the first one reported in Taiwan.

Malignant fibrous histiocytoma of the maxillary sinus presenting as toothache.

Malignant fibrous histiocytoma (MFH) is a high-grade and aggressive sarcoma. It is relatively rare in the head and neck region. Its diagnosis is based on immunohistochemical stains.