Antibody-mediated rejection after adult ABO-incompatible liver transplantation remedied by gamma-globulin bolus infusion combined with plasmapheresis.

Adult ABO-incompatible liver transplantation has been known to be associated with markedly desperate outcomes. Antibody-mediated rejection (AMR) has been recognized as one of the primary causes of these desperate outcomes, but its clinical features and significance have not been well understood. Recently, some clinicians have succeeded in improving the outcome of adult ABO-incompatible liver transplantation.

Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastases.

Background: Consensus has not been reached concerning the timing of hepatectomy in patients with synchronous colorectal liver metastases, specifically with respect to patient selection criteria for simultaneous resection of the colorectal primary and the liver metastasis.

Methods: Retrospectively obtained clinicopathologic data for 39 consecutive patients with synchronous colorectal cancer metastases to the liver, who underwent curative simultaneous "1-stage" hepatectomy and resection of the colorectal primary at 1 institution, were subjected to univariate and multivariate analysis concerning the safety and success of the combined procedure.

Results: Only the volume of the resected liver was selected as a risk factor for postoperative complications (350 g mean resected liver volume in patients with postoperative complications vs 150 g in those without complications; P <.

Remaining caudate lobe in the right lobe graft in living donor liver transplantation: a blind spot?

The right margin of the caudate lobe is obscure. Therefore, a part of the caudate lobe (a part of the right side of the paracaval portion) seems almost always to remain with the right lobe graft during the standard harvesting procedure. We reviewed the intraoperative findings and the postoperative courses of donors and recipients of 11 consecutive living donor liver transplantations using right lobe grafts.

Protein tyrosine phosphatases in T cell physiology.

The molecular mechanisms of signal transduction have been the focus of intense research during the last decade. In T cells, much of the work has centered on protein tyrosine kinase-mediated signaling from the TCR and cytokine receptors, while the study of protein tyrosine phosphatases has lagged behind. Nevertheless, it has now become clear that many protein tyrosine phosphatases play equally important roles in T cell physiology and that no kinase-regulated system would work without the counterbalancing participation of phosphatases.

Value of 18F-FDG PET in the detection of peritoneal carcinomatosis.

Purpose: Peritoneal carcinomatosis can be difficult to diagnose using computed tomography (CT). The purpose of this study was to evaluate the role of 2-(fluorine 18) fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the detection of peritoneal carcinomatosis.

Methods: We reviewed the CT and FDG PET radiological reports and clinical charts of 18 patients with peritoneal carcinomatosis and 17 cancer patients without peritoneal carcinomatosis.

Gene expression profile analysis of regenerating liver after portal vein ligation in rats by a cDNA microarray system.

Aims: We assessed changes in gene expression of hypertrophied liver after portal vein ligation (PL) in a test group of rats compared to a control group, which had the same size liver but no PL.

Methods: The portal veins of the left and median lobes in the test group were ligated in an initial operation. Four days after the PL, the liver volume of the posterior caudate lobe (5%) increased two-fold and comprised 10% of the liver.

Microscopic liver metastasis: prognostic factor for patients with pT2 gallbladder carcinoma.

Hepatic metastasis is the most frequent mode of recurrence of advanced gallbladder cancer after radical resection. The aims of this study were to clarify the clinical significance of microscopic liver metastasis from pT2 gallbladder cancer and to clarify whether partial hepatectomy can prevent hepatic recurrence in patients with microscopic liver metastasis. The subjects included 20 patients with pT2 tumors who underwent radical surgery and partial hepatectomy with lymph node dissection.

Mechanism of liver regeneration after partial hepatectomy using mouse cDNA microarray.

Background/aims: The liver has the capacity to regenerate after partial hepatectomy. In order to clarify the mechanism of liver regeneration, we observed the initial stage, especially the mechanism of gene expression during progress from G0 to S phase (0-24 h), and attempted to identify new genes controlling progress to the S phase.

Methods: We applied large-scale gene expression analysis with complementary DNA microarrays in mouse hepatectomy models to clarify the mechanism of liver regeneration after partial hepatectomy.

Surgical strategy for the management of biliary injury in laparoscopic cholecystectomy.

Background/aims: The incidence of biliary injury during laparoscopic cholecystectomy remains high and several complications resulting from injuries have recently been reported. The aim of this study is to elucidate the surgical strategy for the management of biliary injury during laparoscopic cholecystectomy.

Methodology: Ten patients with biliary injury during laparoscopic cholecystectomy are retrospectively reviewed.

Safe and permissible limits of hepatectomy in obstructive jaundice patients.

The safe and permissible limits of hepatectomy in obstructive jaundice patients and the usefulness of preoperative portal embolization (PE) for increasing the limit for safe hepatectomy were examined. We classified 416 patients with hepatectomy performed over 9 years under the following headings: normal liver function (n = 242); chronic hepatitis (n = 71); liver cirrhosis (n = 64); and liver after relief of obstructive jaundice (n = 39). Hepatectomy was done after the total bilirubin level was reduced below 3 mg/dl by preoperative biliary drainage.

Procedures of choice for resection of primary and recurrent liver metastases from colorectal cancer.

Although liver resection offers the only realistic chance of cure for patients with liver metastases from colorectal cancer, no consensus exists as to the procedure of choice for managing these tumors. Data from 193 patients who underwent hepatectomy for liver metastases from colorectal cancer and 26 of 193 patients who underwent repeat hepatectomy for recurrent metastases were collected. The suitability of resection was evaluated retrospectively based on known risk factors for recurrence and patterns of recurrence.

Adjuvant hepatic arterial infusion chemotherapy after curative resection for Dukes C colorectal cancer: a pilot study.

Background/aims: The aim of this study was to evaluate the effect and the toxicity of prophylactic adjuvant hepatic arterial infusion chemotherapy (HAIC) on liver metastases and on overall survival of Dukes C colorectal cancer patients.

Methodology: Ninety patients in whom Dukes C colorectal cancer was diagnosed and were treated with curative resection between 1993 and 1997 underwent HAIC. The HAIC regimen consisted of a 24-hour continuous infusion of 1500 mg of 5-fluorouracil, administered once a week for 8 weeks, utilizing a portable infusion drug delivery system to ambulatory patients.

[Hepatic arterial infusion therapy for pancreatic cancer].

Introduction: One of the most difficult factors in curing pancreatic carcinoma is hepatic metastases. Many patients who undergo curative resection have hepatic recurrence, and unresected patients with hepatic metastases have terribly poor prognosis.

Aim: In this study, we evaluated the efficacy of hepatic arterial infusion therapy for pancreatic carcinoma.

Metastatic tumor doubling time: most important prehepatectomy predictor of survival and nonrecurrence of hepatic colorectal cancer metastasis.

We determined the relative value of the metastatic colorectal cancer doubling time as a predictor of recurrence and survival after hepatectomy in comparison with other established predictors. Consecutive patients who underwent hepatic resection ( n = 144) for colorectal cancer liver metastases were studied retrospectively to identify factors that influence overall survival and recurrence in the remnant liver. Overall 5-year survival and nonrecurrence rates were 49.

Current progress in the prediction of chemosensitivity for breast cancer.

Advances in chemotherapy have improved the prognosis of patients with breast cancer significantly. Individualization is important for optimization of chemotherapy. The prediction of tumor sensitivity to anticancer agents has been intensively investigated for that purpose.

Results of surgical treatment for multiple (> or =5 nodules) bi-lobar hepatic metastases from colorectal cancer.

Background: The surgery for the treatment of multiple (> or =5) bi-lobar hepatic metastases from colorectal cancer is controversial. This retrospective study presents our experience in an attempt to develop reasonable treatment guidelines.

Method: One hundred sixty-one consecutive patients who underwent liver resection with curative intent were classified into three groups: H1 (unilateral), H2 (bilateral, < or =4 nodules), or H3 (bilateral, > or =5 nodules).

[Efficacy of circadian chronotherapy via hepatic arterial infusion].

For hepatectomy after neoadjuvant chemotherapy (NAC), we applied circadian chronotherapy via the hepatic artery for multiple bilobar liver metastases from colorectal cancer. Four patients underwent chronotherapy and 16 patients underwent flat infusion therapy (5 day q 2 weeks, 4 or more courses). We used 2 drugs, (5-fluorouracil (5-FU) and l-leucovorin (l-LV)), and partially added cisplatin (CDDP) in the flat infusion group.

Risk factors of posthepatectomy liver failure after portal vein embolization.

Background/purpose: Major hepatectomy has been successfully performed after portal vein embolization (PE). However, post-hepatectomy liver failure following hyperbilirubinemia (HB) sometimes occurs even after PE. Our objective was to determine what factors affected post-hepatectomy HB and liver failure.

Enhancement of the quantum-liquid phase by increased resistivity in thick a-MoxSi1-x films.

Effects of normal-state resistivity rho(n) on the vortex phase diagram at low temperature T have been studied based on dc and ac complex resistivities for thick amorphous MoxSi(1-x) films. It is commonly observed irrespective of rho(n) that, in the limit T=0, the vortex-glass-transition line B(g)(T) is independent of T and extrapolates to a field below the T=0 upper critical field B(c2)(0), indicative of the quantum-vortex-liquid (QVL) phase in the regime B(g)(0) View Article and Find Full Text PDF

Hepatic resection combined with portal vein or hepatic artery reconstruction for advanced carcinoma of the hilar bile duct and gallbladder.

Hepatectomy with vascular reconstruction for biliary malignancy remains controversial. This study aimed to clarify the indications for surgery. Patients with advanced hilar bile duct cancer (HBDC) (n = 26) and gallbladder cancer (GBC) involving the hepatoduodenal ligament (n = 13) who underwent hepatectomy were enrolled.

Real-time PCR (TaqMan PCR) quantification of carcinoembryonic antigen (CEA) mRNA in the peripheral blood of colorectal cancer patients.

Reverse transcriptase-polymerase chain reaction (RT-PCR) has been utilized to detect living micrometastases of cancer cells in the lymph node, ascites or circulation system. However, the method was so sensitive that false-positives happened frequently. Therefore we have developed a quantification of CEA mRNA using real-time PCR to detect living cancer cells in the circulating blood and examined its usefulness as a predictive marker for liver metastases of colon cancer.

Effects of portal vein embolization before major hepatectomy.

Background/aims: Major hepatectomy can now be successfully performed after portal vein embolization, but the effects of portal vein embolization have not been clearly delineated. Our objective is to examine whether portal vein embolization really contributes to the success of major hepatectomy.

Methodology: Thirty-eight patients underwent portal vein embolization and hepatectomy of two subsegments or more.