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31.
32.
Ho-Seong Han Jai Young Cho Yoo-Seok Yoon 《Journal of hepato-biliary-pancreatic sciences》2009,16(4):427-432
Many studies have recently reported on laparoscopic liver resection, although its development has been slow compared to laparoscopy in other fields. The indications for the location of laparoscopic liver resection have previously been limited to easily accessible lesions. Performing laparoscopic liver resection in the posterior and superior parts of the liver has been considered difficult due to inadequate exposure, the poor operative field and the difficulty with parenchymal dissection. Flexible endoscopy, high definition imaging and various kinds of equipment for parenchymal transection have been introduced for clinical use. In addition, much experience with this procedure has been accumulated at many centers. Accordingly, there are an increasing number of reports on laparoscopic liver resection in difficult locations. At our institution, the location of the tumor is no longer a limitation to laparoscopic liver resection. However, for safer laparoscopic liver resection, the patient positioning and trocar placement should be individualized according to the tumor location. The type of resection also may depend on the remaining liver’s functional capacity. We describe here the technical considerations for performing laparoscopic liver resection, including the technical considerations for performing laparoscopic liver resection for lesions located in the postero-superior segments of the liver. 相似文献
33.
G Gaitanis K Nomikos E Vava EC Alexopoulos ID Bassukas 《Journal of the European Academy of Dermatology and Venereology》2009,23(12):1427-1431
Background/aim Theoretical considerations support the combination of cryosurgery and topical imiquimod to treat basal cell carcinomas (BCC). The aim of the present study was to test the feasibility and efficacy of 'cryosurgery during continued imiquimod application' ('immunocryosurgery') to treat 'high-risk-for-recurrence' BCCs.
Methods Thirteen patients with 21 biopsy-proven tumours (4 of 21 relapses after prior surgery) were included. After 2–5 weeks (median, 3) of daily 5% imiquimod cream application, the tumours were treated by liquid N2 cryosurgery (spray, two cycles, 10–20 s) and imiquimod was continued for additional 2–12 weeks (median, 4). The outcome after at least 18 months of follow-up (18–24 months) is currently reported.
Results Nineteen of 21 tumours responded promptly to immunocryosurgery; two tumours required additional treatment cycles to clear. Thus, the clinical clearance rate was 100%. Only 1 of 21(5%) tumour relapsed after at least 18 months of follow-up (cumulative efficacy: 95%).
Conclusions 'Immunocryosurgery' is a promising non-surgical combination modality to treat 'high-risk-for-recurrence BCCs'. Initial evidence is suggestive of an at least additive effect of the two combined modalities. Further studies comparing immunocryosurgery directly with cryosurgery and imiquimod monotherapies will confirm the reported results. 相似文献
Methods Thirteen patients with 21 biopsy-proven tumours (4 of 21 relapses after prior surgery) were included. After 2–5 weeks (median, 3) of daily 5% imiquimod cream application, the tumours were treated by liquid N
Results Nineteen of 21 tumours responded promptly to immunocryosurgery; two tumours required additional treatment cycles to clear. Thus, the clinical clearance rate was 100%. Only 1 of 21(5%) tumour relapsed after at least 18 months of follow-up (cumulative efficacy: 95%).
Conclusions 'Immunocryosurgery' is a promising non-surgical combination modality to treat 'high-risk-for-recurrence BCCs'. Initial evidence is suggestive of an at least additive effect of the two combined modalities. Further studies comparing immunocryosurgery directly with cryosurgery and imiquimod monotherapies will confirm the reported results. 相似文献
34.
H. Kurokawa M. Zhang S. Matsumoto Y. Yamashita T. Tomoyose T. Tanaka H. Fukuyama T. Takahashi 《Journal of oral pathology & medicine》2005,34(6):329-333
BACKGROUND: Although many histopathologic factors in squamous cell carcinoma of the tongue predict the prognosis, the major predictive factors have not been identified clearly. This study analyzed the prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma. METHODS: The clinicopathologic features of 124 consecutive patients seen between January 1985 and December 1999 with previously untreated squamous cell carcinoma of the tongue were reviewed. Their mean age was 58.5 years (range: 23-90) and the male-female ratio was 1.8: 1 (79 men and 45 women). There were 41, 40, 30, and 13 cases at stage I to stage IV, respectively. The clinicopathologic factors, especially the histologic grade at the deep invasive front (invasive front grade, IFG), were analyzed to determine factors predicting prognosis. RESULTS: The 5-year disease-free survival rate of the patients treated with curative aim only was 66.7%. Clinicopathologic factors significantly associated with the prognosis were T classification, tumor size, stage classification, tumor depth, macroscopic appearance, cervical lymph node metastasis (nodal metastasis), microvascular invasion, and IFG. In a multivariate analysis, patients with tumor depth >/=4 mm, IFG >/=8 points, and nodal metastasis had a reduced disease-free survival and IFG >/=11 points had a predictive value for nodal metastasis (odds ratio: 7.34; P = 0.0019). CONCLUSION: This study found that a high IFG malignancy score had a high prognostic value for squamous cell carcinoma of the tongue. 相似文献
35.
F. Ide K. Obara K. Enatsu K. Mishima I. Saito 《Journal of oral pathology & medicine》2005,34(3):187-189
Sclerosing mucoepidermoid carcinoma (SMEC) with eosinophilia is a rare but distinctive tumor usually affecting the thyroid. SMEC involvement of salivary gland is exceptional, with only six cases in the literature. We present here the first case of an intermediate-grade SMEC, arising from the intraoral minor salivary glands. A particularly interesting finding is the cytoplasmic accumulation of eosinophilic hyaline granules in carcinoma cells, similar to aberrant zymogen-like granules previously described in salivary sclerosing polycystic adenosis. 相似文献
36.
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38.
鼻咽癌CT灌注成像及其生物学相关性研究 总被引:1,自引:0,他引:1
目的研究鼻咽癌CT灌注值与肿瘤微血管密度(MVD)、肿瘤分期的关系,探讨多层螺旋CT灌注成像对鼻咽癌的临床应用价值。方法49例鼻咽部CT灌注检查中,鼻咽癌组30例,鼻咽癌放疗后组14例,正常鼻咽部5例,测量鼻咽癌和鼻咽黏膜位置的血流量(BF)、最大强化指数(PEI)、峰值到达时间(TTP)及血容量(BV)作为灌注指标,其中16例鼻咽癌活检组织行免疫组织化学CD34单抗染色后,Weidner方法计数MVD。各组灌注值比较行方差分析,CT灌注值、肿瘤分期与MVD之间行Spearman等级相关分析。结果49例中1例鼻咽癌灌注检查失败。鼻咽癌组(29例)肿瘤CT灌注值BF为(48.6±16.9)ml·100g^-1·min^-1,PEI为(32.3±7.9)HU,TTP为(17.5±4.9)s,BV为(12.8±4.4)ml·100g^-1;正常对照组(5例)BF、PEI、TTP、BV值分别为(15.9±5.9)ml·100g^-1·min^-1、(12.6±1.3)HU、(22.6±6.9)s、(3.5±0.5)ml·100g^-1;鼻咽癌放疗后组(14例)BF、PEI、TTP、BV值分别为(25.2±7.0)ml·100g^-1·min^-1、(19.8±5.9)HU、(22.6±4.3)s、(6.1±2.4)ml·100g^-1,三组各灌注值差异有统计学意义(P值均〈0.01);相关分析显示,鼻咽癌组(29例)中TNM分期(其中Ⅰ期3例,Ⅱ期9例,Ⅲ期10例,Ⅳ期7例)与PEI和BV存在相关性(r值分别为0.48和0.50),与BF和TTP无明显相关性(r值分别为0.23和0.22);16例鼻咽癌MVD为(30.8±12.6)个/高倍镜视野,与其BF(51.4±17.0)ml·100g^-1·min^-1、PEI(33.2±9.6)HU和TTP(16.3±4.1)8存在相关性(r值分别为0.85、0.60和0.78),与BV(13.2±5.6)ml·100g^-1弱相关(r=0.48)。结论鼻咽癌有着特征的CT灌注表现,多层螺旋CT灌注成像的灌注值可以反映鼻咽癌微血管密度特征,PEI和BV值与鼻咽癌的TNM分期存在一定的相关性。 相似文献
39.
Burkhard H. A. von Rahden Brigitte Stigler Wolfgang Weiß Hubert J. Stein 《Journal of gastrointestinal surgery》2007,11(7):945-947
Management of upper gastrointestinal bleeding because of erosion of vessels by esophageal cancer may be challenging. We present
herein the angiographic images of a 49-year-old patient who was admitted with massive bleeding from a tumor-eroded inferior
thyroid artery. Attempts to control the bleeding by means of flexible endoscopy and insertion of a Sengstaken–Blakemore tube
had failed. The diagnosis was impressively demonstrated by multislice computed tomography with intravenous contrast in the
arterial phase and multiplanar reconstructions (computed tomography angiography) and by digital subtraction angiography. The
bleeding was successfully treated with superselective catheterization and coiling of the eroded vessel. 相似文献
40.
Z. Levi R. Hazazi I. Kedar-Barnes E. Hodak E. Gal E. Mor Y. Niv J. Winkler 《American journal of transplantation》2007,7(2):476-479
Little is known about the effects of immunosuppression on patients with hereditary nonpolyposis colorectal cancer (HNPCC). We describe a kidney transplant recipient with unrecognized Muir-Torre syndrome in whom the administration of a tacrolimus-based regimen led to the eruption of multiple sebaceous tumors. The patient was later found to harbor an MSH2 mutation. Switching to a sirolimus-based regimen resulted in arrest of the disease. When the patient was switched back to tacrolimus, new facial lesions rapidly appeared. Switching again to sirolimus resulted again in halting the appearance of new lesions. This finding is in line with the known antiangiogenic activity of sirolimus and reports on the regression of cutaneous Kaposi's sarcoma in kidney transplant recipients switched from another immunosuppressive regimen to sirolimus. Further studies on the potential use of sirolimus for the treatment of de novo tumors in immunosuppressed kidney transplant recipients with HNPCC are warranted. 相似文献