[Effective transcatheter arterial embolization for hepatic metastasis in a case of AFP producing gastric cancer].

We experienced a case of effective transcatheter arterial embolization (TAE) for hepatic metastasis in a AFP producing gastric cancer. A 51-year-old man with 2 type gastric cancer (H0) underwent subtotal gastrectomy (D2). The serum AFP level was 134.3 ng/ml, and AFP positive tumor cells were detected by PAP method. After the operation, the serum AFP level initially decreased but re-increased on the 7th postoperative month, and metastatic lesions of the liver were detected by CT scan. After the patient was treated 4 times by TAE, the serum AFP level returned within normal range and the metastatic tumors of the liver decreased markedly. Therefore liver resection was performed at the 28th month after the first operation. Total necrosis of metastatic liver lesions was confirmed. This patient has been well without recurrence signs for 10 years since operation. It is concluded that TAE should be used to treat hepatic metastasis in the case of an AFP producing gastric cancer.

Predicting the viability of grafted livers in rats through a rapid and sensitive metabolic indicator assessed by 31P-NMR spectroscopy.

The present study was undertaken to clarify whether a correlation exists between the hepatic ratio of the beta-phosphorus moiety of ATP (beta-ATP) to inorganic phosphate (Pi), measured by 31P nuclear magnetic resonance spectroscopy 1 h after the reestablishment of portal blood flow, and the survival rate of rats following liver transplantation. This ratio was compared with the arterial ketone body ratio [AKBR (acetoacetate/3-hydroxybutyrate)], which is accepted as a reliable indicator of liver viability. After the transplantation of fresh livers, the 1-week survival rate was 92% and the beta-ATP/Pi ratio was 64% of the normal level. When the liver grafts were subjected to warm ischemia for 25 min or 45 min prior to harvesting, the 1-week survival rate decreased to 43% and 0%, respectively, and the beta-ATP/Pi ratio dropped to 31% and 18% of the normal level, respectively. On the other hand, the AKBR was about 25% of the normal level after transplantation of fresh livers, while it was 37% and 48% after transplantation with 25 min and 45 min of warm ischemia, respectively. However, 4 h after the reestablishment of portal blood flow, the AKBR correlated with the beta-ATP/Pi ratio in both the fresh graft group and the 45-min warm ischemic damage group. These results show that the beta-ATP/Pi ratio provides an accurate evaluation of a graft viability even at an extremely early stage following liver transplantation, and should prove useful for the early diagnosis of primary graft nonfunction after liver transplantation.

Radiotherapy-centered multimodal treatment of unresectable pancreatic carcinoma.

Multimodal treatment procedures, including intraoperative and external beam radiotherapy, chemotherapy and hyperthermotherapy, used for treatment of unresectable pancreatic carcinoma for the past two years have been described. Among the ten progressive cases where multimodal treatment was applied, marked reduction in tumor mass was observed in three cases. The cases receiving such treatment reported prolonged survival, the median survival period being 250 days as compared with 85.4 days in the non-multimodal group. The conclusion is that optimal palliative effects can be achieved by sustained application of both intraoperative and postoperative radiotherapy, hyperthermia and other techniques of multimodal therapy in cases of unresectable pancreatic carcinoma.

Lymphangioma of the transverse colon treated by transendoscopic polypectomy: report of a case and review of literature.

This report concerns a 73-year-old man complaining of intermittent, dull, umbilical pain on one month's duration. Barium-enema examination and endoscopy revealed a hemispheric cystic tumor at the midportion of the transverse colon, and the presumptive diagnosis was cystic submucosal tumor of the colon. Transendoscopic polypectomy was performed and the bulk of the lesion was locally excised from the colonic mucosa. Histologic examination revealed cavernous lymphangioma originating from the submucosa.

A case of granuloma of the ascending colon due to penetration of Trichuris trichiura.

A 33 year-old woman was admitted with chief complaint of abdominal pain and high fever. A barium-enema showed serration and a tumor was seen in the proximal ascending colon. At laparotomy, a localized tumor about 5 cm in diameter was located in the proximal portion of the ascending colon. The operation was made according to the ileoceal resection. On the macroscopic examination of the resected specimen, a small hole penetrating into the subserosa of the ascending colon was noticed and a tumor measuring approximately 3 x 1.2 x 1 cm was located under the hole. A female worm, Trichuris trichiura, was found to be harbored in the adjacent site of the lesion. Histopathologic examination revealed granulomatous tissue reaction due to penetrating of Trichuris trichiura. The patient is in good health now 20 months after operation.