ABSTRACT
A study was conducted to estimate the functional reserve of the liver of patients with severe hepatitis by computed tomography (CT), in particular employing the integrated CT number of the whole liver (ICTN). ICTN was calculated by integrating the product of "area" times "mean CT number" of the liver in each CT slice for the entire height of the liver. The following results were obtained: 1) In patients with fulminant hepatitis (FH) as well as those with subacute hepatitis (SAH), ICTN was found to be significantly lower as compared to that of patients with acute hepatitis (AH) or non-hepatic diseases. In addition, in FH and SAH patients, ICTN showed a larger degree of decrease when compared with such conventional parameters as either estimated liver volume or mean hepatic CT number. Thus, ICTN seems to more sensitively reflect the changes in functional reserve of the liver. 2) ICTN showed significant positive correlations with prothrombin time and plasma BCAA/AAA ratio, and a significant negative correlation with plasma methionine level. 3) Time course of changes in ICTN correlated well with the clinical features of severe hepatitis. In particular, patients with initial ICTN values above 20 l.HU/m2 of body surface area showed significantly higher survival rate than those with initial ICTN below 20. In conclusion, ICTN well indicates the functional reserve of the liver, and is further suggested to be valuable as a parameter to predict the prognosis of patients with severe hepatitis.
Subject(s)
Hepatitis/diagnostic imaging , Liver/diagnostic imaging , Tomography, X-Ray Computed , Acute Disease , Adult , Aged , Female , Hepatic Encephalopathy/diagnostic imaging , Hepatic Encephalopathy/mortality , Hepatitis/mortality , Humans , Male , Middle AgedABSTRACT
In September, 1980, a 57-year-old male, was admitted to hospital for precise examinations to determine if he had Recklinghausen's disease, pneumoconiosis, and a duodenal ulcer. Endoscopy revealed a redness and a shallow depression of the posterior wall of the antrum, and a biopsy of a specimen led to the diagnosis of early gastric cancer, Stage II c. After the examination, the patient did not return to our department again. In May, 1987, however, the man was readmitted to our hospital, suffering from pains in the right back. X-ray and endoscopic findings revealed a gastric cancer with a center depression and a peripheral elevation (II a + II c). Histological findings showed the gastric cancer to be a moderately differentiated tubular adenocarcinoma, with a submucosal invasion that was also seen. This case, uncovered 80 months earlier, represents a rare instance in which an early gastric cancer, accompanied by Recklinghausen's disease, expanded slowly.
Subject(s)
Adenocarcinoma/complications , Neurofibromatosis 1/complications , Stomach Neoplasms/complications , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Humans , Male , Middle Aged , Neurofibromatosis 1/pathology , Pneumoconiosis/complications , Stomach Neoplasms/pathology , Stomach Neoplasms/surgeryABSTRACT
Presented is a case of a 76-year-old male who had a double cancer, in the stomach and the gall bladder. The gastric tumor was found to be a IIc early cancer that showed invasion into the submucosa, and was, histologically, tubular adenocarcinoma. The carcinoma of the gall bladder was limited to the mucosal layer, and was, histologically a papillary adenocarcinoma. Partial gastrectomy and cholecystectomy were performed. In a review of the literature in Japan, synchronous double cancer, an early gastric cancer and an early carcinoma of the gall bladder, is very rare and 3 only cases have been summarized, including this case.