A 8-yrs-old boy was admitted because of convulsion and coma. The diagnosis of Cushing's syndrome(key word) associated with hypertensive encephalopathy(key word) due to right adrenocortical carcinoma(key word) was made by clinical features, biochemical studies, radiological studies and pathological examination. The tumor was successfully resected by right adrenalectomy. But 22 months later after operation, he died of dyspnea and heart failure. A brief review of literature was presented.
Adrenalectomy ; Coma ; Cushing Syndrome* ; Diagnosis ; Dyspnea ; Heart Failure ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Male ; Seizures

A 8-yrs-old boy was admitted because of convulsion and coma. The diagnosis of Cushing's syndrome(key word) associated with hypertensive encephalopathy(key word) due to right adrenocortical carcinoma(key word) was made by clinical features, biochemical studies, radiological studies and pathological examination. The tumor was successfully resected by right adrenalectomy. But 22 months later after operation, he died of dyspnea and heart failure. A brief review of literature was presented.
Adrenalectomy ; Coma ; Cushing Syndrome* ; Diagnosis ; Dyspnea ; Heart Failure ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Male ; Seizures

PURPOSE: Improvements in the prevention or control of rejection of kidneys and livers have been largely interchangeable and then applicable. However, the mechanism by which antirejection treatment permits any of these grafts to be accepted has been an immunological enigma. Recently, the exchange of migratory leukocytes between the transplant and the recipient, with consequent long-term cellular chimerism in both has been the basis for acceptance of all whole-organ allografts and xenografts. METHODS: The donors of liver transplants were male Lewis rats weighing 100-150 g in all experiments groups. Male Brown Norway rats were the experimental group and female Lewis were the control group. Heterotopic partial liver transplantation was performed by Lee's method without arterial reconstruction. All procedures were performed under ether anesthesia. Bone marrow was taken from the tibias and femurs and was processed in RPMI 1640. The cell counts of suspensions were 2.5x10(8) per experiment. Genomic DNA prepared from peripheral blood and various tissues. Male Lewis Sry-specific oligonulceotide primers were used. RESULTS: In allogenic liver transplantation with bone marrow transplants (LEW-BN), donor cells were detected in the liver, and the spleen by day 7. However, in rejection cases, donor cell were not detected in any tissues. In isografted transplants (LEW-LEW), after bone marrow transplantation, donor cells were found in lymph nodes, the liver, and peripheral blood. In isografted transplants (LEW-LEW), after liver transplantation donor, cells were only found in the grafts. CONCLUSION: In allogenic liver transplantation with bone marrow transplantation, chimerism induction was augmentedwith bone marrow-derived stem cells. Therefore, it is necessary to have many samples to investigate more precisely chimerism and rejection after liver transplantation with bone marrow transplantation.
Allografts ; Anesthesia ; Animals ; Bone Marrow Transplantation* ; Bone Marrow* ; Cell Count ; Chimerism* ; DNA ; Ether ; Female ; Femur ; Heterografts ; Humans ; Isografts ; Kidney ; Leukocytes ; Liver Transplantation* ; Liver* ; Lymph Nodes ; Male ; Norway ; Rats* ; Spleen ; Stem Cells ; Suspensions ; Tibia ; Tissue Donors* ; Transplants

One case of hepatocellular carcinoma with sarcomatous changes is presented. Histologically, the tumor was composed of hepatocellular-carcinomatous and sarcomatous components, including trabecular, pseudoglandular, and spindle-shaped varieties. There was a transitional cell form between the carcinoma and sarcomatous cells. Immunohistochemical examination for alpha-feto protein reveals positive staining in hepatocellular carcinoma component, and vimentin had positive result in most spindle-shaped sarcomatous cells and some epithelial tumor cells, whereas cytokeratin and EMA(epithelial membrane antigen) revealed negative staining in tumor cells, On the basis of this findings, the possibility of sarcomatous transformation of hepatocellular carcinoma was discussed.
Carcinoma, Hepatocellular* ; Immunohistochemistry ; Keratins ; Liver* ; Membranes ; Negative Staining ; Vimentin

BACKGROUND: Surgical resection is generally accepted as the first choice of treatment for primary hepatic malignancy. But liver resection of primary hepatic malignancy is associated with a high incidence of recurrence, that has a poor prognosis. The goal of this research was to assess the rationale and result of treatment of recurrence following resection of primary hepatic malignancy. PATIENTS & METHODS: This was a retrospective study of 258 patients who had done hepatic resection with primary hepatic malignancy from 1990. Jan to 1999. Dec. And retrospective analysis of 72 patients with recurrent intrahepatic malignancy after hepatic resection. We exclude extrahepatic recurrence. The treatment methods of intrahepatic recurrence are variable. They include repeated hepatic resection, transcatheter arterial chemoembolization, percutaneous injection therapy of alcohol or hot saline, holmium-166 injection therapy, systemic chemotherapy and combined therapy. RESULTS: The cases of hepatic re-resection are 8, the cases of transcatheter arterial chemoembolization are 19, the cases of percutaneous injection therapy of alcohol or hot saline are 7, the cases of holmium- 166 injection therapy are 6, the cases of systemic chemotherapy are 13 and the cases of combined therapy are 13. In the poor general condition, 6 patients, only conservative therapy was applied. The survival rate of 72 patients with recurrent intrahepatic malignancy after hepatic resection is 61.6%, 46.6%, 33.5%, 26.9%, 15.5%, 2.7% at 3 month, 6 month, 9month, 1year, 2year, 3year. The survival rate of the cases of hepatic re-resection is 100%, 85.7%, 71.4%, 71.4%, 47.6%. The survival rate of transcatheter arterial chemoembolization is 89.5%, 73.0%, 61.8%, 61.8%, 44.1%. 11.0%. The survival rate of percutaneous injection therapy of alcohol or hot saline is 100%, 71.4%, 42.9%, 42.9%, 14.3%, 0%. The survival rate of holmium-166 injection therapy is 66.7%, 66.7%, 66.7%, 33.3%, 33.3%. The survival rate of systemic chemotherapy is 53.9%, 38.5%, 30.8%, 15.4%, 15.4%, 0%. The survival rate of combined therapy is 100%, 84.6%, 69.2%, 69.2%, 41.5%, 0%. And the survival rate of conservative therapy is 54.1%, 39.8%, 19.9%, 14.2%, 7.6%, 3.8%. CONCLUSION: We got results that the hepatic resection, holmium-166 injection therapy, and transcatheter arterial chemoembolization combined therapy were better than systemic chemotherapy and percutaneous injection therapy of alcohol or hot saline in longterm survival rate.
Drug Therapy ; Humans ; Incidence ; Liver ; Prognosis ; Recurrence* ; Retrospective Studies ; Survival Rate

BACKGROUND/AIMS: Transcatheter arterial chemoembolization (TACE) is the one of effective methods which treat hepatocellular carcinoma (HCC) in patients who have unresectable tumors or poor liver function. The aim of this study is to evaluate the histologic necrosis rate of hepatocellular carcinoma (HCC) treated with TACE. METHODS: From 1997 to 2001, 77 patients diagnosed as a HCC with percutaneous needle biposy underwent hepatic resection, who had been treated with properative TACE. Complete necrosis rate of tumor was studied by histologic examination of resected specimens. RESULTS: A complete necrosis rate was demonstrated in 31.2% (24/77). A mean size of completely necrotized tumors was 2.8 cm, incompletely necrotized tumor size was 4.8 cm. Lymph node metastasis of 77 hepatocellular carcinoma cases was shown in 5.2% (4/77). Of 24 cases with a complete necrotized tumor, lymph node metastasis was found in one case. CONCLUSION: This study indicates the effectiveness of TACE on the destruction of HCC. However, the presence of viable residual tumors strongly argues for the necessity of surgical resection whenever it is possible.
Carcinoma, Hepatocellular* ; Humans ; Liver ; Lymph Nodes ; Necrosis* ; Needles ; Neoplasm Metastasis ; Neoplasm, Residual

PURPOSE: Although the liver is an important source of IL-6 and the primary site for its clearance, the role of IL-6 in liver disease remains unclear. Warm ischemia/reperfusion (WI/Rp) injury to the liver occurs in numerous clinical situations including liver transplantation and surgery, trauma, hemorrhagic and endotoxic shocks, and thermal injury. A better understanding of the pathogenesis of WI/Rp injury of the liver and the availability of an agent that could alleviate Rp injury would have important clinical implications. The aim of this study was to evaluate the role of IL-6 in WI/Rp injury of the liver. METHODS: Thirteen patients who had undergone hepatectomy were evaluated with regard to postoperative changes in serum IL-6. The measurements were performed before surgery, within 30 minutes after WI/Rp injury, and at postoperative 24 hr, 48 hr, 1 wk, 2 wk, and 4 wk. Seven of 13 patients had the complication of cirrhosis. RESULTS: The mean value of IL-6 was 8.13 pg/ml preoperatively, and peaked at 20.51 pg/ml on the first postoperative day. Serum IL-6 levels within 30 minutes following WI/Rp injury and at postoeprative 1 day were higher in patients with cirrhosis than non-cirrhotic patients, although statistically insignificant. In the case of the cirrhotic patients, IL-6 values on the first postoperative day peaked at 40.81 pg/ml, compared to 35.27 pg/ml in non-cirrhotic patients. SGOT and SGPT were consistently increased with IL-6 on the first postoperative day, and gradually decreased thereafter. CONCLUSION: This study shows that IL-6 may be an indicatorin WI/Rp injury of the liver. Procedures undertaken to reduce the excessive production of this cytokine may be useful of improving postoperative liver function with or without cirrhosis.