Hepato Gastroenterol
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Hepato Gastroenterol · Jul 2008
Clinical TrialHepatic arterial infusion combined with oral UFT/UZEL systemic chemotherapy for unresectable liver metastasis of colorectal cancer.
Hepatic arterial infusion (HAI) chemotherapy has a number of limitations, including a low rate of complete response and frequent extrahepatic recurrence, in colorectal cancer (CRC) patients with unresectable hepatic metastases. A clinical trial was planned to assess the safety and efficacy of combination chemotherapy of HAI and oral administration of UFT and leucovorin (UZEL) in CRC patients with unresectable liver metastases. ⋯ This novel locoregional HAI with an oral UFT/UZEL systemic chemotherapeutic regimen is feasible in an outpatient setting and should be considered as first-line chemotherapy for CRC patients with unresectable liver metastases.
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Hepato Gastroenterol · Jul 2008
The evaluation of hemodynamics in post thoracic esophagectomy patients.
Thoracic esophagectomy is one of the most invasive operations, and it is necessary to have a precise understanding of postoperative hemodynamics in order to maintain normal circulation. PiCCO (pulse contour cardiac output, Pulsion Medical Systems; Munich, Germany), a new technique based on an arterial thermodilution technique, allows the measurement of intra-thoracic blood volume index (ITBVI), which has been reported to be a useful parameter for cardiac preload. In this study, changes of ITBVI were analyzed after thoracic esophagectomy using the PiCCO system. Simultaneously, the patient's circulating blood volume (cBV) and cardiac index (CI) were measured using dye densitometry and the relation between the CI and ITBVI was evaluated. ⋯ Following thoracic esophagectomy, ITBVI was maintained within the normal range, in spite of a decrease in cBV. There was a correlation between ITBVI and CI, indicating that ITBVI might be a useful parameter for cardiac preload.
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Hepato Gastroenterol · Jul 2008
Living donor liver transplantation for hepatitis B associated liver diseases: a 10-year experience in a single center.
Hepatic failure associated with hepatitis B virus (HBV) is one of the main indications for living donor liver transplantation (LDLT). ⋯ The basic strategy using a combination of HBIG and antiviral agents gave acceptable long-term outcomes for LDLT for HBV associated liver diseases. The close monitoring of HBV viral status after transplantation is still crucial in managing these patients.
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Hepato Gastroenterol · Jul 2008
Preoperative pulmonary evaluation (PPE) as a prognostic factor in patients undergoing upper abdominal surgery.
Upper abdominal operations are relatively high risk for postoperative pulmonary complications. The influences of general anesthesia and an operative procedure are well known to negatively impact pulmonary gas exchange. For this reason, the preoperative pulmonary evaluation (PPE) should emphasize risk factors for pulmonary complications. The prediction of these complications is still an under-investigated field. The aim of this study is to identify risk indicators for pulmonary complications after elective upper abdominal operations. ⋯ Pulmonary complications have enormous implications for the patient and the health care system. The first step in reducing postoperative complications is to identify which patients are at increased risk. PPE is the better way to select clinical and laboratory factors that allow risk stratification for postoperative pulmonary complications after upper abdominal surgery.
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Hepato Gastroenterol · May 2008
COMT gene val158met polymorphism in patients with dyspeptic symptoms.
The role of genetics in the susceptibility to functional dyspepsia (FD) is unclear. Catechol-O-methyltransferase (COMT) has been an important enzyme in brain gut axis and pain sensitivity. Polymorphism in codon 158 of the COMT gene influences its activity. This study aimed to clarify the association between COMT polymorphism and dyspepsia in a Japanese population. ⋯ The data suggest that the COMT genotype seems to influence the susceptibility of dyspepsia when it interacts with gender and age. The role of genetics in the development of dyspepsia needs to further evaluation.