Between 1990 and 1997, 227 patients with hepatocellular carcinoma were treated by intrahepatic arterial injection of a Lipiodol-Epirubicin-Mitomycin C emulsion followed by intermittent hepatic artery infusion of Epirubicin, Mitomycin C and 5-FU, employing an implantable subcutaneous infusion port. A catheter was inserted percutaneously into the hepatic artery using the Seldinger technique. Objective remission was induced in 80% of the evaluable patients as evidenced by a decrease in their AFP and PIVKA II levels. These remissions were also confirmed by liver sonogram and CT scan showing decreased tumor volume. Transcatheter oily chemoembolization combined with intermittent hepatic artery infusion chemotherapy seems to be an effective treatment for unresectable hepatocellular carcinoma both for palliation of symptoms as well as prolongation of survival with good quality of life.
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Minerva Anestesiol
January 2025
Transplant Anesthesia and Critical Care, Pisa NHS and University Hospitals, Pisa, Italy -
Intraoperative hemodynamic monitoring is crucial for managing patients with end-stage liver disease (ESLD) undergoing orthotopic liver transplantation (OLT) due to their complex cardiovascular and pulmonary abnormalities. Traditionally, pulmonary artery catheterization (PAC) has been the standard for hemodynamic monitoring during OLT. However, the use of transesophageal echocardiography (TEE) has increased due to its real-time visualization of cardiac and vascular structures, which aids in managing hemodynamic instability during the three surgical phases of OLT: pre-anhepatic, anhepatic, and neo-hepatic.
View Article and Find Full Text PDFAm J Case Rep
January 2025
Division of Transplant Surgery, Department of Surgery, University of Virginia School of Medicine, UVA Health, Charlottesville, VA, USA.
BACKGROUND Post-transplant lymphoproliferative disorder (PTLD) encompasses a group of disorders ranging from hyperplastic to malignant lymphoid proliferations in the post-transplant period owing to immunosuppression, often in the setting of EBV transformation. PTLD is a rare complication of immunosuppression that, like lymphomas, can have a variable presentation based on disease localization. We report a case of PTLD mass effect at the porta hepatis for the first time in the literature, resulting in hepatic artery stenosis (HAS) and common hepatic duct obstruction.
View Article and Find Full Text PDFQuant Imaging Med Surg
January 2025
Organ Transplant Center, Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan City People's Hospital, Zhongshan, China.
Background: The presence of hepatic steatosis (HS) is a crucial histological parameter for evaluating the suitability of liver transplantation. However, to date, no studies have used contrast-enhanced ultrasonography (CEUS) to diagnose and grade HS in brain-dead donors. This study aimed to detect and quantify hepatic microcirculatory perfusion in brain-dead donors using CEUS and to assess the utility of CEUS in the diagnosis and grading of HS.
View Article and Find Full Text PDFQuant Imaging Med Surg
January 2025
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: The scanning trigger threshold affects image quality. The aim of this study was to investigate the effect of different scanning trigger thresholds on brain computed tomography angiography (CTA) image quality.
Methods: In this prospective study, 80 patients undergoing brain CTA examinations with dual-layer CT (DLCT) were randomly divided into group A and group B, with 40 patients in each group.
Clin Rheumatol
January 2025
Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
Microscopic polyangiitis (MPA) affects small and medium vessel, which sometimes leads to arterial aneurysms. In English database, only 15 reports refer to ruptured aneurysms in MPA. We experienced a fatal case with MPA who developed multiple visceral aneurysms, resulting in rupture of the hepatic aneurysm.
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