Intra-arterial versus systemic chemotherapy for non-operable hepatocellular carcinoma.

BACKGROUND/AIMS: To compare intra-arterial (regional) hepatic chemotherapy with doxorubicin, to the systemic (intravenous) one in patients with non-resectable (Stage IVA) hepatocellular carcinoma. METHODOLOGY: Seventy-two patients with inoperable hepatocellular carcinoma were randomized to receive doxorubicin 50 mg/m2 as a bolus infusion either via an implantable intra-arterial catheter (Group A) or as systemic chemotherapy (Group B) every 21-28 days. RESULTS: Patients of Group A had a higher rate of objective and subjective remissions and Karnofsky performance status improvement in comparison to Group B. The mean survival was 7 months (range: 2-16) for Group A and 6.5 months (range: 1-13) for Group B, but this difference was not statistically significant. The quality of life remained at an acceptable level until death in both groups. CONCLUSIONS: A slight but not statistically significant superiority of intra-arterial chemotherapy against the systemic one is concluded.

Herniography with methylene blue for the detection of recurrent inguinal hernia.

OBJECTIVE: To validate a new technique for the confirmation of the diagnosis of recurrent inguinal hernia. DESIGN: Open study. SETTING: University hospital. SUBJECTS: 14 Patients with gorin pain who had previously had hernias repaired. INTERVENTIONS: Herniography in all 14, which showed recurrent hernias in 6. The 6 then had 20 ml methylene blue infused intraperitoneally, and 12-18 hours later 4 of the 6 were operated on. RESULTS: At operation 3 of the 4 hernial sacs were stained with methylene blue. There was no histological evidence of acute inflammatory reaction, but only of chronic inflammation which was probably caused by the hernia itself. CONCLUSION: Methylene blue injected into the peritoneal cavity makes it easier to repair recurrent inguinal hernias safely.