RESUMEN
BACKGROUND: Radiofrequency ablation (RFA), currently used extensively for liver tumors, also has been applied successfully to hepatic cavernous hemangioma (HCH) percutaneously. The aim of this study was to assess the feasibility, safety, and efficacy of laparoscopic RFA for patients with HCHs. METHODS: Between March 2001 and March 2004, 27 patients with symptomatic and rapid-growth lesions were treated by laparoscopic RFA using the RF-2000 generator system. The treatment-related complications were observed. All the patients were followed up with helical computed tomography scans and ultrasonography at regular intervals to assess the therapeutic efficacy of laparoscopic RFA. RESULTS: This study assessed 9 men and 18 women with a mean age of 41.6 +/- 8.3 years. Three additional intrahepatic lesions missed preoperatively were found in three patients on intraoperative ultrasound. A total of 27 patients with 50 liver lesions were treated successfully with laparoscopic RFA. The mean maximum tumor diameter was 5.5 +/- 2.0 cm. The mean length of time for RFA per lesion was 20.7 +/- 11.9 min, and the mean blood loss was 134.4 +/- 88.9 ml. Laparoscopic cholecystectomy was performed simultaneously for gallstones in 13 patients and for abutting of gallbladder from hemangioma in 2 patients. In addition, 3 patients also had a laparoscopic deroofing of simple hepatic cysts. Although postoperative low-grade fever and transient elevation of serum transaminase levels were observed in 13 patients, there were no complications related to laparoscopic RFA. During a median follow-up period of 21 months (range, 12-42 months), complete lesion necrosis was achieved for all the patients. CONCLUSIONS: Laparoscopic RFA therapy is a safe, feasible, and effective treatment option for patients with symptomatic and rapid-growth HCHs located on the surface of the liver or adjacent to the gallbladder. Intraoperative ultrasonography is a useful adjunct for detecting additional liver lesions and offering more accurate targeting for RFA.
Asunto(s)
Ablación por Catéter , Hemangioma Cavernoso/cirugía , Laparoscopía , Neoplasias Hepáticas/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos , Adulto , Ablación por Catéter/efectos adversos , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Laparoscopía/efectos adversos , Hígado/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Tomografía Computarizada Espiral , Resultado del Tratamiento , UltrasonografíaRESUMEN
A styryllactone namely cardiobutanolide was isolated from the stem bark of Goniothalamus cardiopetalus together with four known styryllactones goniothalamin, goniodiol, goniofufurone, goniofupyrone and known acetogenins squamocin and an epimeric mixture of goniodonin and 34-epi-goniodonin. The structure of the new compound was elucidated on the basis of 1D and 2D NMR experiments and mass spectroscopic techniques.
Asunto(s)
4-Butirolactona/aislamiento & purificación , Annonaceae/química , Glicerol/aislamiento & purificación , Lactonas/aislamiento & purificación , 4-Butirolactona/análogos & derivados , 4-Butirolactona/química , Glicerol/análogos & derivados , Glicerol/química , India , Lactonas/química , Espectroscopía de Resonancia Magnética , Modelos Moleculares , Estructura Molecular , Corteza de la Planta/química , EstereoisomerismoRESUMEN
As is well known, carbohydrate is the most appropriate organic material for hydrogen fermentation, and its hydrogen yield is significantly larger than that of protein. The fermentation of protein began with hydrogen production followed by hydrogen consumption, which helps overall hydrogen recovery. Both carbohydrate and protein are basic components of organic material, and yet carbohydrate is known to be a better substrate than protein in terms of hydrogen yield during hydrogen fermentation. This study used multiple substrates containing different ratios of glucose and peptone as multiple substrates to investigate the roles played by carbohydrate and protein in hydrogen fermentation. The experimental results demonstrated that suitable ratios of glucose and peptone improved the growth of hydrogen producing bacteria. Additionally, a maximum hydrogen yield of 6.4 mmole-H2/g-COD was obtained from the multiple substrate containing 40% peptone and 60% glucose. Most of the produced hydrogen came from fermentation of glucose, not peptone. During hydrogen fermentation, the pH dropped by 1.0 and 1.9 units in 80% and 20% of peptone content in the substrate. Ammonia produced due to peptone degradation neutralized the acids produced from hydrogen fermentation.