Fatal acute portal vein thrombosis associated with hepatic cysts in a patient with autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) often involves polycystic liver disease (PLD). In severe cases, PLD can develop various complications. However, fatal acute portal vein thrombosis (APVT) associated with PLD has not been reported. A 64-year-old male reported mild consciousness disorder. He had been under maintenance hemodialysis for end-stage renal disease due to ADPKD with PLD. Because of recurring hepatic cyst infections, he had sustained high levels of C-reactive protein. Regarding the mild consciousness disorder, a diagnosis of hepatic encephalopathy was made based on an elevation of serum ammonia without any other abnormal liver function tests. Several days after his admission, hepatobiliary enzymes elevated, and acute liver failure progressed. Enhanced abdominal computed tomography suggested the possibility of complete occlusion of the portal vein by a thrombus. Based on an absence of obvious portosystemic collaterals, a diagnosis of APVT was made. The patient died 19 days after admission. Patients with PLD with repeated cystic infections have been seen to develop liver failure, and APVT formation may be one cause of the rapid progression of fatal liver failure. In conclusion, this is the first paper to report on the involvement of APVT in patients with PLD.

Size-tunable synthesis of iron oxide nanocrystals by continuous seed-mediated growth: role of alkylamine species in the stepwise thermal decomposition of iron(II) oxalate.

The properties of inorganic nanoparticles (NPs) are governed by their size. Therefore, tuning the size of NPs is a fundamental technique in nanoscience. However, the size-tunable synthesis of inorganic NPs is generally carried out in a dilute solution, which produces large quantities of waste. Herein, we report the predictable size-tunable synthesis of Fe3O4 NPs by the stepwise thermal decomposition of iron(II) oxalate (Fe(ox)). Monodisperse Fe3O4 seed crystals were synthesized by the thermal decomposition of oleylamine-coordinated iron oxalate (Fe(ox)-OAm) in a small amount of oleylamine, followed by continuous seed-mediated growth of Fe3O4 NPs. The thermal decomposition behavior of Fe(ox) in oleylamine with and without N,N-diethyl-1,3-diaminopropane (dedap) revealed the important role of dedap in the stepwise thermal decomposition of Fe(ox). The size of the Fe3O4 NPs was easily tuned via the stepwise thermal decomposition of Fe(ox) by controlling the amount of decomposed Fe(ox) in a small amount of an alkylamine mixture. The particle diameter was predicted from the size of the Fe3O4 seed crystals and the amount of decomposed Fe(ox). Finally, the size dependency of magnetic properties of the synthesized Fe3O4 NPs was studied. This continuous seed-mediated growth method based on the stepwise thermal decomposition of metal oxalate can be applied to control the size of a variety of metal and metal oxide NPs.

Long-term survival of 11 years with multidisciplinary therapy for hepatocellular carcinoma metastasis to the ovary and peritoneum: a case report.

We herein report a rare case of HCC metastases to the ovary and peritoneum in a 61-year-old female patient who has achieved 11-year survival with multidisciplinary therapy. The patient was diagnosed with HCC during balloon angioplasty performed for Budd-Chiari syndrome in 1994 and underwent partial hepatectomy twice. Five years after the second hepatectomy, allochronic recurrence of a single nodule detected in S8 was treated by radiofrequency ablation, followed by percutaneous ethanol injection therapy and stereotactic body radiotherapy. However, her α-fetoprotein level rose to 1862 ng/mL within one year and computed tomography revealed a large pelvic tumor suggesting HCC metastasis to the ovary. The subsequent laparotomy revealed one 11-cm left ovarian tumor, one small right ovarian nodule, and numerous peritoneal nodules. Bilateral salpingo-oophorectomy and peritoneal resection of as many nodules as possible were performed. Combination therapy with intravenous 5-fluorouracil plus cisplatin and ramucirumab monotherapy effectively suppressed tumor progression with maintenance of hepatic functional reserve, and she has achieved long-term survival of 11 years, illustrating that multidisciplinary therapy with favorable hepatic functional reserve maintenance can contribute to long-term survival in HCC with extrahepatic spread.