In spite of the nice screening program using the state-of-the-art imaging modalities, most patients with hepatocellular carcinoma (HCC) are not eligible for curative resection due to poor hepatic functional reserve and multiplicity of the tumors. Therefore they greatly rely on percutaneous interventional procedures. Among these, transcatheter arterial chemoembolization and local ablation therapies including ethanol injection therapy or radiofrequency (RF) thermal ablation have gained wider acceptance for the local treatment of unresectable HCC with growing evidence of survival gain. Although we need more prospective randomized trials to determine the definite role of these interventional therapies, the current consensus is that they are safe and effective for the local control of small HCC and have a potential to replace definitive surgical options. In this review, the basic principles and published clinical results including long-term survival rates and complications are reviewed. The benefits and limitations of each therapy are also discussed.
Carcinoma, Hepatocellular/radiography/*therapy ; Combined Modality Therapy ; English Abstract ; Humans ; Liver Neoplasms/radiography/*therapy ; *Radiography, Interventional

This study describes an evaluation of the sonographic, cholangiographic, pathological, and immunological findings, and the protective effect shown by rats reinfected with Clonorchis sinensis. Eight experimental rat groups were, namely, a normal control, a primary infection control, a reinfection I (reinfection 7 week after treatment following 3-week infection), a reinfection II (reinfection 2 week after treatment following 8-week infection), a reinfection III (exploration of the intrahepatic bile ducts 1 week after reinfection 4 week after treatment following 4-week infection), a superinfection, a secondary infection control, and an infection following immunization group. Sonographic and cholangiographic findings showed moderate or marked dilatation of the bile duct confluence in the primary infection control, reinfection II, and secondary infection control groups. Juvenile worms survived in the intrahepatic bile ducts 1 week after reinfection following treatment in the reinfection III group. It was concluded that reinfecting juvenile worms found during the first week following reinfection failed to survive or grow further. Anatomical, pathophysiological, or immunological changes may induce protection from reinfection in rats.
Animals ; Anthelmintics/administration & dosage/therapeutic use ; Antibodies, Helminth/blood ; Antigens, Helminth/administration & dosage/immunology ; Bile Duct Diseases/parasitology/*pathology/ultrasonography ; Bile Ducts, Intrahepatic/parasitology/*pathology/ultrasonography ; Cholangiography ; Clonorchiasis/parasitology/*pathology/ultrasonography ; Clonorchis sinensis/*pathogenicity ; Immunization ; Praziquantel/administration & dosage/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Sound Spectrography ; Support, Non-U.S. Gov't

Among several diagnostic tools for clonorchiasis (Clonorchis sinensis infection), radiologic examinations are commonly used in clinical practices. During the 2 past decades, many reports regarding imaging findings of clonorchiasis were introduced. The basic imaging finding of clonorchiasis is diffuse dilatation of the peripheral intrahepatic bile ducts, without dilation of the large intrahepatic or extrahepatic bile ducts. By this finding, however, active clonorchiasis cannot be differentiated from cured infection. Some recent radiologic studies suggested specific findings of active clonorchiasis. Besides direct demonstration of worms, increased periductal echogenicity on sonography and periductal enhancement on dynamic contrast-enhanced CT or MR imaging possibly represent active clonorchiasis. Those images of the liver clonorchiasis are known to be correlated with worm burdens (EPG counts) in their frequency and also severity. The images of cholangiocarcinoma associated with clonorchiasis show both the tumor with obstruction images and diffuse dilatation of the peripheral intrahepatic bile ducts. Radiological images can be a good practical alternative diagnostic method of clonorchiasis.
Bile Ducts/parasitology/pathology ; *Cholangiography ; Clonorchiasis/*diagnosis/ultrasonography ; Humans

PURPOSE: Overproduction of lipid peroxidation byproducts and disturbances in the antioxidant defense system have been implicated in the pathogenesis of several diseases, including prostate cancer. Although several studies have investigated the level of lipid peroxidation and antioxidants in prostate cancer, there are no reports on alpha-lipoic acid (ALA) in prostate cancer. Here we assessed the effects of ALA on the antioxidant system in prostate cancer cells. MATERIALS AND METHODS: PC-3, LNCaP, and RWPE-2 cell lines were used in this study. Redox factor (Ref)-1 protein was measured by Western blot analysis after treatment with ALA. Real-time polymerase chain reaction (RT-PCR) was performed to detect superoxide dismutase (SOD)-1 and -2, catalase, and glutathione peroxidase (GSH-Px) mRNA expression. RESULTS: Ref-1 was expressed in the PC-3, LNCaP, and RWPE-2 cell lines. The expression of Ref-1 protein was increased after treatment with 125, 250, and 500 microM ALA in the PC-3 (p<0.05) and LNCaP (p>0.05) cells compared with the RWPE-2 cells at 48 hours. In PC-3 cells, the mRNA expression of SOD-1, SOD-2, catalase, and GSH-Px decreased at 24 and 48 hours dose-dependently compared with that in RWPE-2 cells (p<0.05). The mRNA expression of SOD-2, catalase, and GSH-Px in LNCaP cell decreased at 48 hours dose-dependently (p<0.05). CONCLUSIONS: The expression of Ref-1 protein and antioxidant enzymes changed after ALA exposure in prostate cancer cells. Our findings suggest that ALA affects the antioxidant system in prostate cancer cells and may be related to compensatory changes in the antioxidant defense system of the cells.
Antioxidants ; Blotting, Western ; Catalase ; Cell Line ; Glutathione Peroxidase ; Lipid Peroxidation ; Oxidation-Reduction ; Prostate ; Prostatic Neoplasms ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Superoxide Dismutase ; Thioctic Acid

Congenital short pancreas due to agenesis of its body and tail of the pancreas results from defectivedevelopment of part of the dorsal primordium. We describe the ERCP and CT features of this rare condition, whichis associated with acute pancreatitis.
Cholangiopancreatography, Endoscopic Retrograde ; Pancreas* ; Pancreatitis*

We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) was observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Ducts, Intrahepatic/parasitology/ultrasonography ; Child ; China/epidemiology ; Clonorchiasis/complications/*drug therapy/epidemiology/*ultrasonography ; *Endemic Diseases ; Female ; Gallbladder/parasitology/ultrasonography ; Humans ; Male ; Middle Aged ; Praziquantel/*therapeutic use ; Treatment Outcome ; Young Adult

No abstract availble.
Angiomyolipoma/*diagnosis/pathology/surgery ; Antigens, Neoplasm/immunology ; Carcinoma, Hepatocellular/diagnosis/pathology/surgery ; Diagnosis, Differential ; Humans ; Liver Neoplasms/*diagnosis/pathology/surgery ; Male ; Middle Aged ; Neoplasm Proteins/immunology ; Tomography, X-Ray Computed

PURPOSE: Small uterine cervical tumors are often undetected on MRI, and undetectable tumors are usually regarded as being in their early stages. The purpose of this study was to evaluate morphological factors determining MRI detectability of uterine cervical tumors by comparing detected and undetected tumors using high resolution MRI units. MATERIALS AND METHODS: Sixty-six surgically-proven uterine cervical cancer patients were included in this study. Using a GE Signa 1.5T magnet (GE, U.S.A.) axial T1-weighted MR images and axial, sagittal, and coronal T2-weighted fast spin echo MR images were obtained with a 5 mm thickness/2 mm gap and a 512x256 matrix size. The patients were divided into two groups, tumor-detected and tumor-undetected. Maximal tumor dimension, depth of stromal invasion, and horizontal tumor spread, measured during histopathological examinations, as well as pathological stages, were compared between the two groups. RESULTS: In the tumor-detected group, the pathological stages were IB1 in 25, IB2 in 3, IIA in 10, and IIB in 5 patients; in the tumor-undetected group, the stages were IA1 in 8, IA2 in 2, and IB1 in 13 patients. Maximal tumor dimension, depth of stromal invasion and horizontal tumor spread for tumor-detected and -undetected groups were 27.4 (10-60) mm vs. 10.4 (3-40) mm (p=0.077), 11.1 (3-20) mm vs. 2.3 (0-5) mm (p<0.001), and 26.6 (8-60) mm vs. 10.4 (3-40) mm (p=0.057), respectively. CONCLUSION: Of the criteria studied, depth of stromal invasion is the most important factor in determining tumor detectability on MRI. All tumors in which this depth was more than 5 mm were thus detected; which are undetected on high resolution MRI can be regarded as early-stage tumors (stage IB1).
Humans ; Magnetic Resonance Imaging* ; Uterine Cervical Neoplasms

OBJECTIVE: The aim of this study is to investigate the effects of cooperative training on the pretreatment assessment of the feasibility to perform Ultrasonography (US) guided percutaneous radiofrequency ablation for patients afflicted with hepatocellular carcinoma. MATERIALS AND METHODS: In our prospective study, 146 patients with 200 hepatocellular carcinomas were referred for radiofrequency ablation after triage by hepatologists. Three radiologists with different levels of experience performed the planning US before (group I) and after (group II) cooperative training, to evaluate whether radiofrequency ablation was feasible. The feasibility rates considered eligible according to our criteria were evaluated. In addition, we analyzed the reasons for the lack of feasibility were analyzed. The interobserver agreement for the assessment of feasibility before and after training was also calculated. RESULTS: The overall feasibility rates for both groups was 73%. No significant difference in the feasibility rates was observed. The feasibility rates of each observer for group I were 71% (observer 1), 77% (observer 2) and 70% (observer 3) and those for group II were 73%, 76% and 69%, respectively. In the tumors (n = 164) considered ineligible, the two most common causes for refraining from performing radiofrequency ablation included non-visualization of the tumor (62%) and the absence of a safe route for the percutaneous approach (38%). We found moderate interobserver agreement for all observers before cooperative training and a good agreement after training. CONCLUSION: Although the cooperative training did not affect the feasibility rate of each observer, it improved the interobserver agreement for assessing the feasibility of performing US guided radiofrequency ablation, which may reduce unnecessary admission or delayed treatment.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/*surgery/ultrasonography ; *Catheter Ablation ; Clinical Competence ; Feasibility Studies ; Humans ; Inservice Training ; Liver Neoplasms/*surgery/ultrasonography ; Male ; Middle Aged ; Prospective Studies ; Reproducibility of Results ; *Ultrasonography, Interventional

OBJECTIVE: To evaluate the effect of the heat-sink phenomenon induced by artificial ascites on the size of the ablation zone during percutaneous radiofrequency (RF) ablation of the hepatic subcapsular area in an in vivo rabbit model. MATERIALS AND METHODS: A total of 21 percutaneous rabbit liver RF ablations were performed with and without artificial ascites (5% dextrose aqueous solution). The rabbits were divided into three groups: a) control group (C, n = 7); b) room temperature ascites group (R, n = 7); and c) warmed ascites group (W, n = 7). The tip of a 1 cm, internally cooled electrode was placed on the subcapsular region of the hepatic dome via ultrasound guidance, and ablation was continued for 6 min. Changes in temperature of the ascites were monitored during the ablation. The size of the ablation zones of the excised livers and immediate complications rates were compared statistically between the groups (Mann-Whitney U test, Kruskal-Wallis test, linear-by-linear association, p = 0.05). RESULTS: One rabbit from the "W" group expired during the procedure. In all groups, the ascites temperatures approached their respective body temperatures as the ablations continued; however, a significant difference in ascites temperature was found between groups "W" and "R" throughout the procedures (39.2 +/- 0.4 degrees C in group W and 33.4 +/- 4.3 degrees C in group R at 6 min, p = 0.003). No significant difference was found between the size of the ablation zones (782.4 +/- 237.3 mL in group C, 1,172.0 +/- 468.9 mL in group R, and 1,030.6 +/- 665.1 mL in group W, p = 0.170) for the excised liver specimens. Diaphragmatic injury was identified in three of seven cases (42.9%) upon visual inspection of group "C" rabbits (p = 0.030). CONCLUSION: Artificial ascites are not likely to cause a significant heat-sink phenomenon in the percutaneous RF ablation of the hepatic subcapsular region.
Animals ; *Ascites ; *Body Temperature ; Burns/etiology/prevention & control ; *Catheter Ablation/adverse effects/methods ; Diaphragm/injuries ; Glucose/administration & dosage ; Liver/pathology/*surgery ; Rabbits ; Solutions