ABSTRACT
The tumor seeding after percutaneous ethanol injection (PEI) therapy has been considered to be a rare complication in hepatocellular carcinoma. We report a case of needle tract implantation of hepatocellular carcinoma following PEI manifested as subcutaneous nodule. A 57-years old male patient had been treated with PEI for hepatocellular carcinoma. Thirteen months after completion of the PEI session, a subcutaneous nodule was palpated at the site of the needle puncture. A CT scan showed that the subcutaneous nodule was 1.7 cm in size and enhanced in the early phase. The nodule was surgically removed. Microscopic examination showed hepatocellular carcinoma.
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Ethanol , Needles , Punctures , Tomography, X-Ray ComputedABSTRACT
BACKGROUND/AIMS: The aim of this study was to evaluate the efficacy of lamivudine in patients with HBeAg-negative and HBV DNA-positive chronic liver disease. METHODS: Twenty-four chronic liver disease patients were enrolled whose serology had common characteristics of HBeAg (-), and anti-HBe (+) but HBV DNA (+). All had elevated alanine aminotransferase (ALT) levels. 150mg of lamivudine was given orally once daily for more than 6 months. The goal of this treatment was the elimination of HBV DNA in serum and normalization of ALT level. Once HBV DNA disappearance and ALT normalization were observed, lamivudine was continued for two additional months. HBeAg, anti-HBe, HBV DNA and ALT were followed up every 1-2 month during, and after, treatment. RESULTS: Median duration of treatment was seven months. HBV DNA became undetectable after a median one month of treatment and ALT activity was normalized in all 24 patients within six months. Among the sixteen patients who were followed for more than 12 months after cessation of treatment, six relapsed. The cumulative relapse rate at 12 months was 37.5%. CONCLUSION: Lamivudine suppresses HBV replication effectively and normalizes serum ALT in patients with HBeAg-negative and HBV DNA-positive chronic liver disease. The relapse rate after cessation of treatment seems to be relatively low.
Subject(s)
Humans , Alanine Transaminase , DNA , Hepatitis B e Antigens , Hepatitis B virus , Lamivudine , Liver Diseases , Liver , Recurrence , Withholding TreatmentABSTRACT
BACKGROUND/AIMS: Several endoscopie studies found an association between periampuilary diverticula and biliary calculi, however, the results of the reports are inconsistent when considering the anatomical location of the stones. The aims of our study are to evaluate the association between periampullary diverticula and gallstones according to their location iand to clarify the origin of the common bile duct stones by analyzing the composition of the stones. METHODS: During a period of 10 months, 611 of 632 consecutive cases of endoscopic retrograde cholangiopancreatography(ERCP) were prospectively enrolled. The data of periampullary diverticula and gallstones were analyzed according to the location of the stones. The stones available were initially grouped on the basis of their grass marphology and cross-sectional appearance, and finally analyzed by quantitative infrared spectroscopy. RESULTS: Diverticula were found in 165 of 611 cases(27.0%) and there was a positive relationship between age and duodenal diverticula(p<0.01). Considering the location of the gallstones, this significance was found only in patients with common bile duct stones not associated with gallbladder or intrahepatic duct stones(p<0.001). Of these 40 cases with gallstones only in common bile duct, 32 had a history of cholecystectomy with more than a two year asymptomatic period following their surgery, and on analysis, most of the stones(30/36, 83%) were classified as brown pigment stones. Therefore, these stones were presumed to be primary common bile duct stones. On the contrary, the common bile duct stones with associated gallbladder or intrahepatic stones were identical with their paired gallbladder or intrahepatic stones in gross and cross-sectional appearance and chemical composition. They were assumed to be secondary common bile duct stones and the difference in prevalence of calculi according to the presence of diverticula was not significant. CONCLUSION: The prevalence of gallstones was significantly higher in periampullary diverticula, and considering the location and the origin of the gallstones the association between diverticula and gallstones is significant in patients with primary common bile duct stones but not with the secondary ones.