1/93. Central line sepsis in a child due to a previously unidentified mycobacterium.A rapidly growing mycobacterium similar to strains in the present mycobacterium fortuitum complex (M. fortuitum, M. peregrinum, and M. fortuitum third biovariant complex [sorbitol positive and sorbitol negative]) was isolated from a surgically placed central venous catheter tip and three cultures of blood from a 2-year-old child diagnosed with metastatic hepatoblastoma. The organism's unique phenotypic profile and ribotype patterns differed from those of the type and reference strains of the M. fortuitum complex and indicate that this organism may represent a new pathogenic taxon.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/93. renal artery rupture secondary to pretransplantation Candida contamination of the graft in two different recipients.Infected graft transplantation is an unwelcome complication that may lead to serious consequences in the immunosuppressed host. It can be caused by infection of the donor or by contamination of the organ during harvest, preservation and handling, or at transplantation. With current donor evaluation protocols, the risk of transmitting infections by exogenous contaminated grafts seems to be more frequent than true donor-transmitted infections. Nevertheless, although rare and usually free of clinically significant sequelae, if contamination is by some virulent organisms such as staphylococcus aureus, gram-negative bacilli, or fungi, severe complications may occur. We report the clinical outcome of liver, heart, and kidney recipients from a single donor. Both renal allografts had to be removed because of renal artery rupture secondary to candida albicans infection. Careful donor evaluation before transplantation, unusually early presentation of mycosis leading to anastomotic renal artery disruption, the histopathologic findings of the grafts, and the absence of Candida infection in the liver and heart recipients make us believe that exogenous contamination of the grafts occurred during donor procedure, kidney processing, or at transplantation. In summary, because infected grafts can lead to serious complications, besides careful donor screening, it is important to achieve early recognition of contaminated organs by culturing the perfusate to start specific antibiotic or antifungal therapy after transplantation if necessary and avoid the rare but, in this case, fatal consequences of these infections.- - - - - - - - - - ranking = 1.5keywords = organ (Clic here for more details about this article) |
3/93. Liver, spleen and tumor volume measured by personal computer.BACKGROUND/AIMS: Computed tomography (CT) scans are common examinations for patients with chronic liver diseases. To quantitate the organ or tumor volume from the scans and to accomplish the task in an efficient way with the most economic equipment, we developed a system based on a personal computer. METHODOLOGY: We used color-markers and transparency to sketch the edges of liver, hepatoma, and spleen. Each organ or tumor of interest is marked out by fine-point markers on pieces of transparency. The sketch was scanned into a digitized image format on a personal computer (Pentium 133). The calculation involves edge detection, three-dimensional reconstruction, and voxel counting. By using summation-of-the-area and trapezoid approximation technique, the voxels of each structure are counted. In this study, we illustrate the potential application in the management of a hepatic cancer patient. RESULTS: After digitalization, the data size of CT images is about 1 to 1.5 megabytes. It takes less than 5 min to complete volume calculation. CONCLUSIONS: By this method, tumor load before and after chemotherapy can be estimated easily and accurately. This would be helpful in clinical practice.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
4/93. dna mismatch repair deficiency in curatively resected sextuple primary cancers in different organs: a molecular case report.A male patient synchronously or metachronously underwent six curative resections after diagnoses of cancers in the rectum, urinary bladder, stomach, colon, liver and lung. Five cancers, excluding early colon cancer, were analyzed for instability in seven microsatellite markers and in transforming growth factor beta type II receptor, insulin-like growth factor ii receptor and BAX. All analyzed cancers had replication errors and instability in at least one target gene. These results suggest that abnormal dna mismatch repair system plays a major role in the occurrence of multiple primary cancers in this case.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
5/93. Adrenal metastasis from hepatocellular carcinoma (HCC): report of 3 cases.Although autopsy reports show that the adrenal gland is the second most common organ of hematogeneous metastasis from hepatocellular carcinoma (HCC), paradoxically there is found to be a very scarce number of the adrenal metastasis in clinical practice. We have recently experienced rare patients with right adrenal metastasis from HCC. Case 1: A 51 year-old man with a 5-year history of chronic hepatitis was admitted with hematemesis to Nippon Medical School Hospital. CT revealed a main tumor associated with a few daughter tumors in the hepatic posterior segment and in addition another tumor located between the right hepatic lobe and right kidney. The diagnosis of HCC with a right adrenal gland metastasis was made, and hepatectomy and right adrenalectomy was performed. Twenty months after operation he was alive and free of disease. Case 2: A 78 year-old man underwent resection of the lateral segment of the left hepatic lobe for HCC. Twelve months later, recurrent foci in the residual liver were found and those were treated with transarterial embolization (TAE). Right adrenal metastasis was found on CT 26 months after hepatectomy. TAE was done for the hepatic recurrent tumors and adrenal metastasis. Twelve months after, he survived in good condition. Case 3: A 47 year-old man presented with liver cirrhosis with a long history. He was diagnosed as having HCC with multiple intrahepatic metastases and was treated with TAE 4 times. Follow-up CT revealed right adrenal metastasis. TAE was done for hepatic recurrent tumor and right adrenal metastasis. Three months later the patient died of liver failure.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
6/93. Various extrahepatic manifestations caused by hepatitis c virus infection.It has been reported that hepatitis c virus (HCV) causes not only liver disease but also disorders of other organs and tissues. Previously, many HCV-related extrahepatic manifestations have been reported. In this study, we report 2 patients in whom tongue cancer was detected during the treatment of HCV-related liver disease. In one patient, tongue cancer was detected during the treatment of HCV-related liver cirrhosis, and articular rheumatism developed thereafter. The duration of HCV-related liver disease was 10 years. In the other patient, tongue cancer was detected during the treatment of HCV-related hepatocellular carcinoma. This patient had a past history of thyroid disease. The duration of HCV-related liver disease was 6 years. In these patients, the possibility that several conditions incidentally and concurrently developed cannot be denied. However, the conditions described above may be regarded as HCV-related extra-hepatic manifestations. In patients with HCV infection, it is important to examine conditions in organs other than the liver. Careful follow-up is needed.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
7/93. Hepatoid carcinoma of the pancreas.BACKGROUND: The majority of primary extrahepatic neoplasms exhibiting features of hepatocellular carcinoma in terms of morphology, immunohistochemistry, and behavior have been described in the stomach. To the authors' knowledge only a few cases have involved other organ sites. They frequently are associated with other histologic type tumors such as adenocarcinoma, and portend an aggressive behavior. methods: Two examples of hepatoid carcinoma arising from the pancreas are reported in the current study. RESULTS: One case was a malignant islet cell tumor with a full-blown clinical syndrome of glucagon overproduction, histologic evidence of hepatocytic differentiation, bile production, and alpha-fetoprotein (AFP) positivity. The second tumor was a ductal carcinoma showing periodic acid-Schiff positive and diastase-resistant hyaline globules, AFP production, and ultrastructural resemblance to hepatocytic cells. CONCLUSIONS: The rare observation of cellular phenotypic transformation that corresponds with the process of hepatocytic transdifferentiation of pancreatic cells demonstrated in animal models and the common embryologic foregut derivation of the pancreas and liver also may explain the phenomenon of pancreatic hepatoid carcinoma.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
8/93. Spontaneous rupture of hepatocellular carcinoma of the caudate lobe.A rare case of ruptured hepatocellular carcinoma (HCC) of the caudate lobe is reported. A 67-year-old man came to the hospital with complaints of abdominal pain and distension. Computed tomography (CT) showed haemoperitoneum and a mass in the caudate lobe. angiography demonstrated a tumor stain. However, extravasation of the contrast medium was not clear. Although transcatheter arterial embolization (TAE) was performed, bleeding from the tumor could not be controlled. The caudate lobe, including the tumor, was resected. The patient died of multiple organ failure despite intensive care. This case suggests that TAE is not always effective and may not be safely or easily performed when treating ruptured HCC in the caudate lobe. This is attributed to the multiple feeding arteries of the tumor, derived from the proximal portion of the right and left hepatic arteries. If bleeding from the ruptured HCC in the caudate lobe is not controlled, immediate resection of the tumor is recommended.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
9/93. Differentiation of multicentric origin from intra-organ metastatic spread of hepatocellular carcinomas by comparative genomic hybridization.In hepatocellular carcinoma (HCC), multifocal growth may be due to intrahepatic metastatic spread or to the multicentric origin of clonal neoplasms. Although this issue is of potential clinical and prognostic importance, reliable differentiation cannot be achieved using clinical or morphological criteria alone. In this study, comparative genomic hybridization (CGH) was used to differentiate between metastatic spread and multicentric growth in two cases of HCC. In the first case, six carcinoma nodules were examined. The affected chromosomes and their pattern of aberrations were almost identical for all six nodules. In addition to aberrations of chromosomes 1, 4, 9, and 13, further aberrations were observed for chromosomes 2, 5, 7, and 17, which are less typical for HCC. These findings were seen as indicative of metastatic spread of the HCC. In the second case, 75% (3/4) of the nodules showed comparable aberration patterns involving chromosomes 1, 4, 8, 13, and 17, together with a number of further aberrations also not frequently seen in HCC including chromosomes 5, 7, 10, 12, 14, and 18. chromosomes 4, 5, 8, 10, and 12 were also altered in the fourth nodule examined for this case, but they exhibited a unique aberration pattern. Additionally, gain of chromosome 15q was seen in only this fourth nodule. In the two cases examined, metastatic spread and multicentric origin of HCC could be differentiated by different patterns of karyotypic change. The CGH results were confirmed by fluorescence in situ hybridization (FISH). In conclusion, CGH facilitates the differentiation of multicentric growth from metastatic spread in HCC and appears to be superior to techniques previously used to resolve this clinically important diagnostic problem.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
10/93. Ischemic cholangitis caused by transcatheter hepatic arterial chemoembolization 10 months after resection of the extrahepatic bile duct.We report a case of ischemic cholangitis that occurred after transcatheter hepatic arterial chemoembolization (TAE). Ten months prior to TAE the patient had undergone central bisegmentectomy for hepatocellular carcinoma with resection of the extrahepatic bile duct. Eleven days after TAE, he developed suppurative cholangitis and multiple organ failure. Prior surgical ligation of the peribiliary arteries around the extrahepatic bile duct followed by TAE was considered to have played a crucial role in the development of ischemic cholangitis. This case demonstrates the importance of blood flow from the peribiliary arteries for the survival of the biliary epithelium.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
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