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  • Liver transplantation  (2)
  • Diagnostik.  (1)
  • Immunohistochemistry  (1)
  • 1
    ISSN: 1432-2277
    Keywords: Key words Hepatocellular carcinoma ; Liver transplantation ; Recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recurrence-free survival (RFS) in patients with small hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT) was analyzed. From 1988 until 1996, 725 OLTs were performed in 669 patients. In 52 adults, HCC was confirmed histologically. OLT was limited to patients with small (〈 5 cm) HCC with a maximum number of three nodules. Actuarial survival for these 52 patients at 1 and 5 years is 88 % and 71 %. RFS was defined as time until death without recurrence, time until follow up with a diagnosis of recurrence, or, in patients without recurrence, time of last follow up. Overall, the 5-year RFS was 60 %. Five-year RFS was less for bilobar compared to unilobar tumors (36 % vs 70 %), less for stage IVa tumors (UICC) compared to stage I–III tumors (17 % vs 71 %), and less for multiple compared to solitary tumors (54 % vs 67 %). In conclusion, potential cure may be achieved in more than 50 % of all transplanted patients.
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  • 2
    ISSN: 1433-0385
    Keywords: Key words: Schwannoma ; Soft tissue tumors ; Surgical therapy ; Diagnosis. ; Schlüsselwörter: Schwannom ; Weichteiltumoren ; chirurgische Therapie ; Diagnostik.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Wir berichten exemplarisch über drei Patienten, die im Zeitraum von Februar 1991 bis Oktober 1994 in unserer Klinik wegen intraabdomineller Schwannome operiert wurden. Im Fall 1 wurde ein benignes Schwannom des Magens durch Billroth-II-Resektion behandelt, Leitsymptom war eine gastrointestinale Blutung. In Fall 2 wurde ein malignes Schwannom des Duodenums mit Lebermetastase durch weite En-bloc-Tumorresektion mit retroperitonealer Lymphadenektomie und anatomischer Rechtsresektion der Leber behandelt. Eine nach 7 Monaten aufgetretene metachrone Lebermetastase wurde durch intraparenchymatöse Lasercoagulation kontrolliert, ein nach 19 Monaten aufgetretenes Lokalrezidiv erforderte eine weitere Tumorresektion. Primäres Leitsymptom war eine palpable Tumormasse. In Fall 3 wurde ein malignes Schwannom der Bauchwand auswärts in Fragmenten reseziert. Trotz postoperativer Radiatio kam es nach 6 Monaten zum Lokalrezidiv mit Leberinfiltration, welches en bloc reseziert wurde. Zu diesem Zeitpunkt bestand bereits eine beginnende Peritonealsarkomatose. Unter postoperativer Chemotherapie kam es zum raschen Tumorprogreß. Der Patient verstarb 18 Monate nach Erstoperation. Anhand der dargestellten Fälle werden Symptomatik, differentialdiagnostische Probleme und operatives Vorgehen bei benignen und malignen Schwannomen des Bauchraums erörtert.
    Notes: Summary. We report three patients who were operated on because of an intraabdominal schwannoma between February 1991 and October 1994 in our department. In the first case, a benign gastric schwannoma was treated by a distal gastric resection (Billroth II); the main symptom was gastric bleeding. In the second case, a malignant duodenal schwannoma with liver metastasis was treated by wide en-bloc resection of the tumor including retroperitoneal lymphadenectomy and an anatomical resection of the right lobe of the liver. A metachronous metastasis of the liver, appearing 7 months postoperatively, was treated by intraparenchymatous laser coagulation; a local recurrence, appearing 19 months postoperatively, led to another tumor resection. The main symptom was a palpable intraabdominal mass in this case. In the third case, a malignant schwannoma of the abdominal wall was resected in fragments in another clinic. Six months later a local recurrence with infiltration of the liver appeared in spite of postoperative radiation and was resected en bloc. Early peritoneal sarcomatosis was apparent at that time. Postoperative chemotherapy did not prevent quick progression of the tumor. The patient died 18 months after the first operation. The clinical presentation, differential diagnosis and operative strategy for benign and malignant intraabdominal schwannomas are discussed.
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  • 3
    ISSN: 1432-2277
    Keywords: Key words Extracellular matrix ; Liver transplantation ; Acute rejection ; Early chronic rejection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have previously observed changes at the extracellular matrix (ECM) which significantly correlated with the extent of preservation and reperfusion injury. In the present study, we attempted to investigate whether the ECM may be also involved in the pathophysiological sequelae of acute and chronic rejection. Of 81 patients monitored for the ECM parameters laminin, hyaluronic acid, fibronectin receptor, and transforming growth factor (TGF)-β , 28 patients developed acute rejection (〈 1 month), in 14 patients (17.4 %) acute rejection was steroid resistant, 4 patients (4.5 %) developed early chronic rejection following acute steroid-resistant rejection. Acute and chronic rejection were confirmed by established clinical and histological criteria. Laminin levels were significantly increased in patients experiencing acute steroid-resistant rejection (4204 ± 133 ng/ml; P K 0.01) compared with patients with steroid-sensitive rejection (1059 ± 27.3 ng/ml) and with an uneventful postoperative course (1214 ± 17.4 ng/ml). No increase in laminin was observed in those four patients who developed early chronic rejection (1099 ± 58.7 ng/ml). Hyaluronic acid, fibronectin receptor, and TGF-β levels also increased in patients with acute steroid-resistant rejection; hyaluronic acid: 290 ± 10.8 μg/l vs 154 ± 13.6 μg/l and 131 ± 11.7 μg/l in patients with steroid-sensitive and no rejection, respectively; fibronectin receptor: 1003 ± 23.5 ng/ml vs 573 ± 24.8 ng/ml and 428 ± 13.6 ng/ml in patients with steroid-sensitive and no rejection, respectively; and TGF-β : 393 ± 14.9 pg/ml versus 315 ± 10.7 pg/ml and 233 ± 8.9 pg/ml in patients with steroid-sensitive and no rejection, respectively. A further increase in hyaluronic acid levels was observed in patients who developed early chronic rejection, while fibronectin receptor and TGF-β levels remained low, similarly to laminin levels. The increase in laminin, hyaluronic acid, fibronectin receptor, and TGF-β during acute steroid-resistant rejection may be stimulated by the rejection-related release of cytokines and adhesion molecules which paralleled the increase in ECM parameters. The lack of increase in laminin and fibronectin receptor levels in those patients who developed early chronic rejection may reflect an inability to recover from acute rejection.
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  • 4
    ISSN: 1434-0879
    Keywords: Immunohistochemistry ; Bladder carcinoma ; Keratin ; Cytokeratin ; Carcinoembryonic antigen ; Cal ; Prostate-specific antigen ; Prostate acid phosphatase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Keratin was identified with the aid of polyclonal antisera in the cytoplasm in over 90% of the transitional cell carcinomas investigated. The intensity of staining increased with the degree of dedifferentiation. Detection of cytokeratin with monoclonal antibodies was successful in over 80% of samples. All squamous cell carcinomas of the bladder were strongly positive for keratin and cytokeratin. CEA was found in 20% of the G1 and 40% of the G2 and G3 carcinomas of the bladder. Both the prostatic epithelium markers PSA and PAP and the monoclonal antibody Ca1 were negative in all cases.
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