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  • Review

    Role of natural antioxidants in the therapeutic management of hepatocellular carcinoma

    Hanaa Ali Hassan , Nermin E. El-Gharib , Anmar F. Azhari
    Hepatocellular carcinoma (HCC) is a growing health problem in humans. HCC is considered the most common of internal malignancy which cause the death of human, but in the developed Western world, HCC is less common accompanied by increasing essentially in incidence, due to it occurs specially in chronic liver disease. HCC associated with various risk factors including hepatitis B virus infection; hepatitis C virus infection; prolonged aflatoxin exposure; and alcoholic cirrhosis. Overall, one-third of cirrhosis patients will develop HCC during their life time. Also, chemical carcinogens cause...
    Published on: 5 Aug 2016
    Views: 92095
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  • Review

    Hepatitis B virus molecular biology and pathogenesis

    R. Jason Lamontagne , Sumedha Bagga , Michael J. Bouchard
    As obligate intracellular parasites, viruses need a host cell to provide a milieu favorable to viral replication. Consequently, viruses often adopt mechanisms to subvert host cellular signaling processes. While beneficial for the viral replication cycle, virus-induced deregulation of host cellular signaling processes can be detrimental to host cell physiology and can lead to virus-associated pathogenesis, including, for oncogenic viruses, cell transformation and cancer progression. Included among these oncogenic viruses is the hepatitis B virus (HBV). Despite the availability of an HBV...
    Published on: 1 Jul 2016
    Views: 13931
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  • Review

    Diet and nutrition therapy in pre-liver transplant patients

    Neha Bakshi , Kalyani Singh
    Malnutrition is universally prevalent among pre-liver transplantation patients. Malnutrition among cirrhotic patients had been associated to increased morbidity and mortality rates. Also, severely malnourished patients before the transplant surgery have a higher rate of complications and a decreased overall survival rate after liver transplantation. In light of the high incidence of malnutrition and associated complications, it is essential to initiate treatment as early as it is assessed. This review addresses the aetiologies of malnutrition and appropriate treatment strategies to correct...
    Published on: 5 Aug 2016
    Views: 3375
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  • Review

    Percutaneous hepatic perfusion with melphalan for unresectable liver metastasis

    Humair S. Quadri , Eden C. Payabyab , David J. Chen , William Figg , Marybeth S. Hughes
    Percutaneous hepatic perfusion (PHP) is an investigative technique for treating patients with diffuse unresectable metastatic liver disease. The technique has been clinically evaluated and shows great treatment potential for regional therapy to the liver. The advantage of PHP lies in its minimally invasive approach and ability to be repeated when compared to isolated hepatic perfusion. In a literature search, 135 publications were screened and 16 of these publications, including clinical trials and reviews, contributed to this review of PHP with melphalan. Melphalan is an alkylating agent...
    Published on: 13 Jul 2016
    Views: 2420
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  • Minireview

    Updates on hepatorenal syndrome and strategies bridging to liver transplantation

    Chung Yeung Cheung , Kenneth S.H. Chok
    Hepatorenal syndrome is not an uncommon life-threatening complication arising from liver cirrhosis. The diagnostic criteria for this syndrome have been revised throughout the years, with recent revisions aimed at improving earlier diagnosis and treatment. Liver transplantation remains the only definitive treatment for hepatorenal syndrome. Due to the scarcity of liver grafts, many patients die waiting. This review focuses on the different strategies to bridge patients to liver transplantation and to improve the postoperative outcome.
    Published on: 12 Apr 2017
    Views: 2324
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  • Review

    Radiological diagnosis of hepatocellular carcinoma in non-cirrhotic patients

    Alba Castán , Ylenia Navarro , Luis Sarría , Raquel Larrosa , Mario Serradilla , Alejandro Serrablo
    Hepatocellular carcinoma (HCC) arising in non-cirrhotic livers is relatively rare. Compared with HCC arising in cirrhotic livers they have some quirks. HCC in healthy livers are large tumors at diagnosis, and are detected due to the onset of abdominal symptoms, outside of any scheduled monitoring program. In non-cirrhotic patients, HCC has the same appearance as the classic image of cirrhotic HCC substrate. The presence of capsule, extensive intratumoral necrosis and typical behavior in the dynamic study after administration of intravenous contrast are present in most of the non-cirrhotic...
    Published on: 12 Jan 2017
    Views: 2261
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  • Original Article

    Preoperative liver functional volumetry performed by 3D-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT: a preliminary study

    Hiroshi Yoshida , Hiroshi Makino , Tadashi Yokoyama , Hiroshi Maruyama , Atsushi Hirakata , Junji Ueda , Yasuhiro Mamada , Nobuhiko Taniai , Eiji Uchida
    Aim: The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) scintigraphy/vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and functional volumetry. Methods: The study group comprised 15 patients who underwent preoperative 3-dimensional (3D)-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy between July 2014 and August 2015. The diagnosis was...
    Published on: 1 Jul 2016
    Views: 2079
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  • Original Article

    Is transarterial embolization a valuable treatment option for spontaneous rupture of hepatocellular carcinoma: experience from a tertiary care hospital of South-Asia

    Amna Subhan Butt , Saeed Hamid , Nazish Butt , Fatima Sharif , Tanveer Ul Haq , Wasim Jafri
    Aim: Transarterial embolization (TAE) has been found beneficial in treatment of ruptured Hepatocellular carcinoma (HCC) in earlier studies. So far no data is available from Pakistan. The aim of this study was to evaluate clinicopathological characteristics, outcomes of patients presented with spontaneously ruptured, unresectable HCC treated with or without TAE and to evaluate the factors associated with 30-day mortality. Methods: This was a cross sectional study. Patients ≥ 18 years old, presented with spontaneous rupture of unresectable HCC, were evaluated. The outcome measures were...
    Published on: 21 Oct 2016
    Views: 1852
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Case report of the fourth laparoscopic liver resection and review of repeat laparoscopic resection for recurrent hepatocellular carcinoma in cirrhotic liver

    Zenichi Morise , Masashi Isetani , Norihiko Kawabe Norihiko Kawabe , Hirokazu Tomishige , Hidetoshi Nagata , Satoshi Arakawa , Masahiro Ikeda , Kenshiro Kamio
    A 73-year-old woman with liver cirrhosis caused by hepatitis C virus (HCV) underwent treatment of three hepatocellular carcinomas (HCCs) in liver segment 4, following three previous laparoscopic liver resections (LLRs) over 73 months. Contrast-enhanced computed tomography showed three 0.5-1.2 cm HCCs deep within the portal territories of subsegments 4a and 4b. The patient underwent laparoscopic resection of 4a and 4b, with the preservation of the portal branch to 4c, after minimal adhesiolysis around segment 4. The operation lasted 284 min, there was 50 mL of intra-operative bleeding and...
    Published on: 19 Sep 2016
    Views: 1634
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Indications and technique for laparoscopic liver resection in patients with hepatocellular carcinoma and liver cirrhosis

    Yuichiro Otsuka , Masaru Tsichiya , Toshio Katagiri , Yoshihisa Kubota , Jun Ishii , Tetsuya Maeda , Hironori Kaneko
    Liver resection is the preferred initial treatment option for solitary or limited multifocal hepatocellular carcinoma (HCC). However, because of the characteristics of HCC, including its high recurrence rate and the frequent presence of chronic hepatitis and cirrhosis, both curability and invasiveness must be considered when selecting a treatment for HCC. Laparoscopic liver resection (LLR) is minimally invasive and increasingly performed worldwide as a curative surgical option for treatment of liver tumors. The 2014 International Consensus Conference on LLR concluded that minor LLRs are now...
    Published on: 19 Sep 2016
    Views: 1626
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  • Review

    Novel predictive and prognostic strategies of hepatitis B virus related hepatocellular carcinoma

    Wen-Bin Liu , Fan Yang , Ding-Yi Shao , Guang-Wen Cao
    Hepatocellular carcinoma (HCC) is a common malignancy and an important cause of cancer death worldwide. Chronic hepatitis B virus (HBV) infection is the major cause of HCC. Recent studies of HBV-induced carcinogenesis not only discovered many new biomarkers but also developed a novel theory: Cancer Evolution-Development (Cancer Evo-Dev). Cancer Evo-Dev provides an evolutionary insight of developing more reasonable predictive and prognostic strategies. Characterizing chronic inflammatory microenvironment of cancer evolution, genetic polymorphisms of inflammatory factors, and HCC-related HBV...
    Published on: 23 Dec 2016
    Views: 1516
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  • Original Article

    Efficacy of sorafenib therapy in patients with advanced hepatocellular carcinoma in Indian population

    Alit Abraham , Charumathi Purushothaman , Dhanya Damien , Jackson James , Prudence Attilade Rodrigues , Gursharan Singh
    Aim: Hepatocellular carcinoma (HCC) is the fourth most common type of cancer and the third leading cause of cancer-related mortality. Sorafenib is an oral multikinase inhibitor that is used for unresectable advanced HCC. It is only approved systemic therapy for advanced HCC. Methods: A retrospective prospective study conducted in a multispeciality hospital with 50 patients who received sorafenib. The primary outcome of the study was to find out the survival rate of patients treated with sorafenib. The secondary outcome of the study was to explore the efficacy and safety of sorafenib in a...
    Published on: 5 Aug 2016
    Views: 1515
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  • Brief Communication

    Hepatic disorder in Zika virus infection

    Viroj Wiwanitkit
    Zika virus infection is the present global problem. This arbovirus infection can cause acute illness and affect fetus in utero. However, there can be other additional clinical manifestation including to the hepatic disorder. In this short commentary article, the author briefly discusses on the liver problem due to Zika virus infection.
    Published on: 13 Jul 2016
    Views: 1485
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  • Case Report

    Hemorrhagic cardiac tamponade after percutaneous laser ablation of a liver metastasis in segment II

    Paola Tombesi , Francesca Di Vece , Silvia Rinaldi , Matteo Bertini , Sergio Sartori
    Despite percutaneous laser thermal ablation (LTA) of liver tumors being regarded as a safe technique, major complications can occur. We report the first case of hemorrhagic cardiac tamponade after LTA of a colorectal metastasis in segment II of the liver. Unpredictable heat diffusion causing indirect thermal injury to the pericardium with resultant hemorrhagic reaction was hypothesized as the most likely cause of tamponade. A pericardial drain was emergently placed, 200 mL of bright red blood were drained, and the patient showed rapid hemodynamic improvement. For lesions located in segment...
    Published on: 1 Jul 2016
    Views: 1397
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  • Original Article

    Evaluating normalization approaches for the better identification of aberrant microRNAs associated with hepatocellular carcinoma

    Jing Shen , Qiao Wang , Irina Gurvich , Helen Remotti , Regina M. Santella
    Aim: Dysregulated microRNAs (miRNAs) have been identified in hepatocellular carcinoma (HCC), but only a small proportion have been confirmed. An appropriate normalizer is crucial to determining the accuracy and reliability of data from miRNA studies. Methods: Different normalization strategies were used to validate genome-wide miRNA profiles in HCC tumor and non-tumor tissues, and to determine the consistency and discrepancy of data on dysregulated miRNAs. Results: Two sets of stable miRNAs (miR-30c/miR-30b and miR-30c/miR-126) were identified in HCC tissues by geNorm and NormFinder tools,...
    Published on: 18 Nov 2016
    Views: 1373
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  • Original Article

    Detecting hepatic nodules and identifying feeding arteries of hepatocellular carcinoma: efficacy of cone-beam computed tomography in transcatheter arterial chemoembolization

    Yasuhiro Ushijima , Tsuyoshi Tajima , Akihiro Nishie , Yoshiki Asayama , Kousei Ishigami , Masakazu Hirakawa , Daisuke Kakihara , Daisuke Okamoto , Hiroshi Honda
    Aim: To evaluate the effectiveness of using cone-beam computed tomography (CBCT) in transcatheter arterial chemoembolization (TACE) to detect hapatocellular carcinoma (HCC) nodules and their feeding arteries. Methods: Twenty-four patients with HCCs who underwent TACE using CBCT in addition to conventional digital subtraction angiography (DSA) were enrolled. After both conventional DSA and CBCT through the hepatic artery were acquired, TACE were performed. The nodules were defined as an HCC when dense accumulation of iodized oil was found within the nodule on CT obtained 2 weeks after the...
    Published on: 25 Aug 2016
    Views: 1369
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  • Case Report

    An extra-adrenal pheochromocytoma mimicking a primary liver cancer

    Kenneth Siu Ho Chok , Florence Loong , Chung Mau Lo
    Despite doctors’ every effort to be vigilant when diagnosing, sometimes a preoperative diagnosis is disproved by postoperative pathological examination. A patient was diagnosed with hepatocellular carcinoma and received surgery as treatment. On operation, a solitary retroperitoneal mass rather than a liver lesion was seen. On histopathological examination, the retroperitoneal mass was found to be an extra-adrenal pheochromocytoma.
    Published on: 7 Nov 2016
    Views: 1361
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  • Case Report

    Epstein-Barr virus associated secondary hemophagocytic lymphohistiocytosis with an unusual presentation of abdominal compartment syndrome

    Li Lei , Camilla J. Cobb , Jeffrey Cao , Anwar S. Raza
    Hemophagocytic lymphohistiocytosis (HLH) is a cytokine storm syndrome caused by an overactive but ineffective immune reaction. Without prompt diagnosis and treatment, HLH is life-threatening. However, presenting symptoms are often nonspecific, with fatigue and fever being the most common. A high index of suspicion is therefore critical for early diagnosis and timely management. A previously healthy, 65-year-old female who initially presented with fever and abdominal pain developed abdominal compartment syndrome (ACS) requiring decompressive laparotomy on hospital day 6. Intraoperative...
    Published on: 21 Oct 2016
    Views: 1254
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  • Case Report

    Hepatocarcinoma with metastasis to the anterior mediastinum

    Rogério Camargo Pinheiro Alves , Lorena Sagrilo Auer , Lisa Rodrigues da Cunha Saud , Raquel Coris Arrelaro , Aline Carboni Casado , Bruno Gustavo Ferreira , Denis Szjenfeld , Paula Bechara Poletti
    Liver malignancies are the sixth leading cause of cancer worldwide, whereas hepatocellular carcinoma (HCC) is the most frequent histological type of liver cancer. Extrahepatic metastasis, which rarely involves the mediastinum, is associated with poor prognosis. An 80-year-old male presenting with mild diffuse abdominal pain for 4 months, associated with hyporexia, increased abdominal volume, dry cough, and loss of 4 kg in 1 month, sought medical assistance due to hemoptysis and chest pain. Tomographic study revealed HCC with mediastinal metastasis, after which sorafenib therapy was started....
    Published on: 21 Oct 2016
    Views: 1147
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Laparoscopic resection of hepatocellular carcinoma in patients with and without cirrhosis: the Brisbane experience

    Daniel J. Kilburn , Universe Leung , David J. Cavallucci , Cassandra Jeavons , Mehan Siriwardhane , Richard Bryant , Thomas R. O’Rourke , Shinn Yeung , Nicholas A. O’Rourke
    Aim: Laparoscopic liver resection for hepatocellular carcinoma (HCC) is increasingly common around the world. There may be significant advantages over open resections. However, due to technical difficulties, they are performed in few centers with expertise in liver and advanced laparoscopic surgery. In this study the authors summarize the experience to date. Methods: A retrospective analysis of consecutive patients undergoing laparoscopic liver resection for HCC in 2 tertiary academic hepatobiliary units in Brisbane, Australia, between 1999 and 2015 was performed. Operative characteristics,...
    Published on: 30 Sep 2016
    Views: 1094
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