RESUMEN
During the last seven years 118 patients with histologic diagnosis of malign tumor in the liver were examinated by selective angiography, amongst other diagnostic recourses: 14 patients had primitive tumors: 12 hepatoma, 1 cholangiocarcinoma and 1 hepatocholangiocarcinoma. In 12 patients resection was contraindicated preoperative by the angiographic demonstration of the extension of the tumor to both lobes. In 1 patient with cholangiocarcinoma, the tumor was resected with an outlive of 4 years. In 1 patient with hepatoma very vascular a hard league of the right hepatic artery was done. Two months later angiography demonstrated a rich revascularisation of the tumor with development of the colateral circulation. In our experience the hiper or hipovascularization is related with the degree of fibrosis which accompanies the tumor and no so much with the histologic type, the degrees of differentiation or the existence of intratumoral necrosis. Emphasis is been done to show the diagnostical difficulties of hipovascularized tumors and the importance of angiography in the preoperative evaluation of hepatic tumors.
Asunto(s)
Neoplasias Hepáticas/diagnóstico por imagen , Adulto , Angiografía/efectos adversos , Femenino , Humanos , Hígado/irrigación sanguínea , Circulación Hepática , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana EdadRESUMEN
We have investigated the presence of genomic and replicative RNA strands of hepatitis C virus in liver and serum. Eleven patients with proven chronic hepatitis C, received Interferon a2a 4,5 MU, three times a week during six months. RT-PCR was used with sense primer to detect the replicative strand and an antisense primer to identify genomic strand. Before treatment, genomic strands were present in liver and serum of all patients. Replicative strands were present in liver and serum in five and six cases, respectively. Seven out of eleven responded to treatment. In responders, genomic strands were absent in liver of 3 cases (43%) and replicative strands in liver of 4 (57%). In plasma genomic and replicative strands were absent in 5 (71%) and 7 (100%), respectively. In all non responders, genomic strands in liver and plasma remained present. Replicative strands in liver and plasma were present in 100% and 25%, respectively. Knodell score improved in 5 out of 7 responders and remained unchanged in 3 out of 4 non responders. In 2 out of 4 responders with genomic and replicative strands in liver, Knodell score remained unchanged or worse. In all non responders, genomic and replicative strands in liver were present and Knodell score remained unchanged or worse. Genomic and replicative strands in plasma tended to be negative after treatment in responders. Genomic strands in plasma remained present in non responders. Conversely, genomic and replicative strands in liver were present in all non responders. It seems to exist a relationship between genomic and replicative strands in liver and the same or worse Knodell score. After a follow up, it will be possible to determined whether responders who still present viral RNA in liver would be prone to a relapse.
Asunto(s)
Genoma Viral , Hepacivirus/genética , Hepatitis C/virología , ARN Viral/análisis , Adolescente , Adulto , Secuencia de Bases , Femenino , Hepacivirus/fisiología , Hepatitis C/sangre , Hepatitis C/terapia , Humanos , Interferones/uso terapéutico , Hígado/virología , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Replicación ViralAsunto(s)
Hígado/patología , Linfoma/patología , Adulto , Anciano , Autoanticuerpos/análisis , Médula Ósea/patología , Femenino , Glucosa-6-Fosfato Isomerasa/análisis , Antígenos de Superficie de la Hepatitis B/análisis , Humanos , L-Lactato Deshidrogenasa/análisis , Hígado/fisiopatología , Linfoma/enzimología , Linfoma/inmunología , Masculino , Persona de Mediana Edad , UltrasonografíaAsunto(s)
Trasplante de Hígado , Adulto , Niño , Humanos , Cirrosis Hepática Biliar/cirugía , Hepatopatías/cirugíaAsunto(s)
Hepatitis C/transmisión , Femenino , Hepatitis C/virología , Humanos , Recién Nacido , Masculino , Factores de RiesgoAsunto(s)
Venas Hepáticas/diagnóstico por imagen , Hipertensión Portal/diagnóstico , Cirrosis Hepática/fisiopatología , Hígado/fisiopatología , Presión Sanguínea , Humanos , Circulación Hepática , Cirrosis Hepática/diagnóstico , Cirrosis Hepática/diagnóstico por imagen , Manometría , Métodos , FlebografíaAsunto(s)
Hepatopatías/diagnóstico , Complicaciones del Embarazo/diagnóstico , Sulfobromoftaleína , Fosfatasa Alcalina/sangre , Bilirrubina/sangre , Transporte Biológico , Colestasis/enzimología , Colestasis/fisiopatología , Femenino , Humanos , Hepatopatías/enzimología , Hepatopatías/fisiopatología , Pruebas de Función Hepática , Embarazo , Complicaciones del Embarazo/enzimología , Complicaciones del Embarazo/fisiopatología , Prurito/etiología , Transaminasas/sangreAsunto(s)
Carcinoma , Neoplasias Hepáticas , Lesiones Precancerosas , Adenoma de los Conductos Biliares/enzimología , Adulto , Anciano , Carcinoma/enzimología , Carcinoma Hepatocelular/enzimología , Femenino , Humanos , Cirrosis Hepática/complicaciones , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/enzimología , Masculino , Persona de Mediana EdadAsunto(s)
Colestasis Intrahepática , Femenino , Humanos , Masculino , Embarazo , Complicaciones del EmbarazoRESUMEN
During the last seven years 118 patients with histologic diagnosis of malign tumor in the liver were examinated by selective angiography, amongst other diagnostic recourses: 14 patients had primitive tumors: 12 hepatoma, 1 cholangiocarcinoma and 1 hepatocholangiocarcinoma. In 12 patients resection was contraindicated preoperative by the angiographic demonstration of the extension of the tumor to both lobes. In 1 patient with cholangiocarcinoma, the tumor was resected with an outlive of 4 years. In 1 patient with hepatoma very vascular a hard league of the right hepatic artery was done. Two months later angiography demonstrated a rich revascularisation of the tumor with development of the colateral circulation. In our experience the hiper or hipovascularization is related with the degree of fibrosis which accompanies the tumor and no so much with the histologic type, the degrees of differentiation or the existence of intratumoral necrosis. Emphasis is been done to show the diagnostical difficulties of hipovascularized tumors and the importance of angiography in the preoperative evaluation of hepatic tumors.
RESUMEN
During the last seven years 118 patients with histologic diagnosis of malign tumor in the liver were examinated by selective angiography, amongst other diagnostic recourses: 14 patients had primitive tumors: 12 hepatoma, 1 cholangiocarcinoma and 1 hepatocholangiocarcinoma. In 12 patients resection was contraindicated preoperative by the angiographic demonstration of the extension of the tumor to both lobes. In 1 patient with cholangiocarcinoma, the tumor was resected with an outlive of 4 years. In 1 patient with hepatoma very vascular a hard league of the right hepatic artery was done. Two months later angiography demonstrated a rich revascularisation of the tumor with development of the colateral circulation. In our experience the hiper or hipovascularization is related with the degree of fibrosis which accompanies the tumor and no so much with the histologic type, the degrees of differentiation or the existence of intratumoral necrosis. Emphasis is been done to show the diagnostical difficulties of hipovascularized tumors and the importance of angiography in the preoperative evaluation of hepatic tumors.
RESUMEN
We have investigated the presence of genomic and replicative RNA strands of hepatitis C virus in liver and serum. Eleven patients with proven chronic hepatitis C, received Interferon a2a 4,5 MU, three times a week during six months. RT-PCR was used with sense primer to detect the replicative strand and an antisense primer to identify genomic strand. Before treatment, genomic strands were present in liver and serum of all patients. Replicative strands were present in liver and serum in five and six cases, respectively. Seven out of eleven responded to treatment. In responders, genomic strands were absent in liver of 3 cases (43
) and replicative strands in liver of 4 (57
). In plasma genomic and replicative strands were absent in 5 (71
) and 7 (100
), respectively. In all non responders, genomic strands in liver and plasma remained present. Replicative strands in liver and plasma were present in 100
and 25
, respectively. Knodell score improved in 5 out of 7 responders and remained unchanged in 3 out of 4 non responders. In 2 out of 4 responders with genomic and replicative strands in liver, Knodell score remained unchanged or worse. In all non responders, genomic and replicative strands in liver were present and Knodell score remained unchanged or worse. Genomic and replicative strands in plasma tended to be negative after treatment in responders. Genomic strands in plasma remained present in non responders. Conversely, genomic and replicative strands in liver were present in all non responders. It seems to exist a relationship between genomic and replicative strands in liver and the same or worse Knodell score. After a follow up, it will be possible to determined whether responders who still present viral RNA in liver would be prone to a relapse.
RESUMEN
Se estudiaron 22 pacientes con PCT, 17 de ellos con biopsia hepática, presentando todos los casos alteraciones histológicas. Predominó la hepatitis crónica persistente. La deficiencia de UPG-asa en hígado tuvo relación directa con el daño hepático