An assessment was made on the therapeutic effects of arterial chemotherapy and transcatheter arterial embolization (TAE) therapy on 378 cases with non-resectable hepatocellular carcinoma (HCC). For the 191 cases who had undergone arterial chemotherapy, 22% had a 1-year survival rate, 8.9% survived for 2 years, and 4.0% for 3 years. Of these, for the 128 cases who were compatible with our criteria for patient selection, the three survival rates were 31.4%, 12.2% and 5.9% respectively. However, for the other 63 cases, who were incompatible with our criteria, the 1-year survival rate was 1.6% and it was worse for the cases who had received supportive care alone. For the cases who had undergone arterial chemotherapy, the highest survival rates were obtained by the alternate administration of different anticancer agents, and the three survival rates were 39.0%, 13.1% and 4.9% respectively. For the 187 cases who had undergone TAE therapy, the 1-year survival rate was 66.2%, the 2-year survival rate 36.5%, and the 3-year survival rate 21.9%. For the 124 cases with a tumor progression rate of less than 20% in the liver (E1), the survival rates were 77.8%, 50.1% and 30.8% respectively. The peripheral venous drug concentrations of mitomycin C and adriamycin were lower, but were maintained for a longer period in TAE therapy than in arterial chemotherapy. These results suggest that consideration of the criteria for patient selection and the alternate administration of anticancer agents are necessary in arterial chemotherapy, and that the best therapeutic effects can be obtained by TAE therapy combined with chemotherapy for cases of non-resectable HCC because of the chemotherapeutic and ischemic effects on the tumors.
LIVER ISSN 0106-9543Clinical and hstological features of cytomegalovirus hepatitis in previously healthy adults Kanno A, Abe M, Yamada M, Murakami K. Clinical and histological features of cytomegalovirus hepatitis in previously healthy adults.Abstract: It is well known that cytomegalovirus infection is often accompanied by hepatitis, but there have been few comparative studies with respect to clinical features of cytomegalovirus-associated hepatitis and other acute viral hepatitides. In the present study, clinical and pathological features of 1 1 acute sporadic cytomegalovirus hepatitis infections in previously healthy adults were compared with those of 45 acute sporadic viral hepatitis, including type A, type B and type C. As a result, the characteristics of cytomegalovirus hepatitis were a long-lasting fever, splenomegaly, atypical lymphocytosis, a mild transaminasemia, a low ratio of alanine aminotransferase level to lactate dehvdrogenase level, and mild hepatic histopathological changes.
It is well known that mood disorder such as depression occasionally develops during interferon (IFN) therapy for chronic viral hepatitis. So far, however, IFN-induced manic disorder has been rarely reported. We present a case of manic psychosis which developed during IFN treatment for chronic hepatitis C. A 35-year-old man with chronic hepatitis positive for hepatitis C virus RNA in serum was treated with natural IFN alpha with a daily dosage of 5 million units. Six weeks later he complained of insomnia, and then became exhilarated, talkative, restless and aggressive. Since the mental state was compatible with manic disorder, IFN therapy was immediately ceased. Simultaneously, psychotropic drugs were administered. One week later, the psychiatric disturbances disappeared. He has been keeping his usual social interactions without the psychotropic drugs after that. It is suggested that manic psychosis happened secondary to IFN alpha treatment.
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