AIM： To determine the feasibility of performing computed tomography （CT）-guided transpulmonary radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） located in the hepatic dome. METHODS： A total of ...AIM： To determine the feasibility of performing computed tomography （CT）-guided transpulmonary radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） located in the hepatic dome. METHODS： A total of seven patients with HCC comprising seven nodules located in the hepatic dome were treated from April 2004 to December 2004. CTguided transpulmonary RFA was performed using a cool-tip type electrode （Radionics Company） based on a standardized energy protocol. All tumors located in the hepatic dome were not detectable by the usual ultrasound （US） methods. The lesion diameters ranged from 15 to 27 mm. RESULTS： RFA was technically feasible in all the patients. The puncture procedure was performed twice or less and the total average performance time was 40.6 min. Local tumor control was achieved in all the patients. The necrosis diameter ranged from 25 to 35 mm. The mean follow-up period was 9.6 （7-14 mo） mo. There was no local recurrenceat the follow-up points. Pneumothorax requiring pleural drainage was the main complication, which was observed in two of the seven patients （28.6%）. However, it improved with chest drainage tube, and the tube could be removed within 2-3 d. No other major complications were observed.CONCLUSION： CT-guided puncture is useful for the treatment of tumors located in the hepatic dome which are hardly detectable by US, even though pneumothorax sometimes may occur as a complication. In the cases with adhesion in the pleura for which artificial pleural effusion methods are not appropriate, CT-guided RFA is thus considered to be an alternative treatment for HCC located in the hepatic dome.展开更多
AIM： The beneficial effect of zinc supplementation on the efficacy of interferon as a treatment for chronic hepatitis C had been demonstrated in hepatitis virus genotype lb of high viral load. This study focused on p...AIM： The beneficial effect of zinc supplementation on the efficacy of interferon as a treatment for chronic hepatitis C had been demonstrated in hepatitis virus genotype lb of high viral load. This study focused on patients with genotype 2, which is more sensitive to interferon than genotype lb, and used consensus interferon （CIFN） with or without zinc. METHODS： We randomized 83 patients with chronic hepatitis C to CIFN at 18 MIU six times/wk for 4 wk, followed by CIFN at 18 MIU six times/wk for another 20 wk, in combination with polaprezinc 300 mg （regimen A, n = 41） or as monotherapy （regimen B, n = 42）. Thirtyone patients in regimen A and 33 patients in regimen B completed the clinical trial; the remaining patients withdrew because of side effects or a transfer to another hospital. RESULTS： Sustained biochemical response, defined as a normal aminotransferase level at the end of the 6-too post-treatment observation, was 68% and 69%, and sustained virological response, defined as undetectable HCV-RNA at the end of the 6-too post-treatment observation, was 54% and 67% for regimens A and B, respectively. CONCLUSION： CIFN treatment combined with zinc did not enhance the effect of CIFN as shown by biochemical, virological criteria. No side effects related to polaprezinc were noted.展开更多
基金Supported by the grant of Center of E-xcellence,Biomedical Research Using Accelerator Technology
文摘AIM： To determine the feasibility of performing computed tomography （CT）-guided transpulmonary radiofrequency ablation （RFA） for hepatocellular carcinoma （HCC） located in the hepatic dome. METHODS： A total of seven patients with HCC comprising seven nodules located in the hepatic dome were treated from April 2004 to December 2004. CTguided transpulmonary RFA was performed using a cool-tip type electrode （Radionics Company） based on a standardized energy protocol. All tumors located in the hepatic dome were not detectable by the usual ultrasound （US） methods. The lesion diameters ranged from 15 to 27 mm. RESULTS： RFA was technically feasible in all the patients. The puncture procedure was performed twice or less and the total average performance time was 40.6 min. Local tumor control was achieved in all the patients. The necrosis diameter ranged from 25 to 35 mm. The mean follow-up period was 9.6 （7-14 mo） mo. There was no local recurrenceat the follow-up points. Pneumothorax requiring pleural drainage was the main complication, which was observed in two of the seven patients （28.6%）. However, it improved with chest drainage tube, and the tube could be removed within 2-3 d. No other major complications were observed.CONCLUSION： CT-guided puncture is useful for the treatment of tumors located in the hepatic dome which are hardly detectable by US, even though pneumothorax sometimes may occur as a complication. In the cases with adhesion in the pleura for which artificial pleural effusion methods are not appropriate, CT-guided RFA is thus considered to be an alternative treatment for HCC located in the hepatic dome.
基金Supported by the grant center of Excellence,Biomedical research using accelerator technology,Gunma,Japan
文摘AIM： The beneficial effect of zinc supplementation on the efficacy of interferon as a treatment for chronic hepatitis C had been demonstrated in hepatitis virus genotype lb of high viral load. This study focused on patients with genotype 2, which is more sensitive to interferon than genotype lb, and used consensus interferon （CIFN） with or without zinc. METHODS： We randomized 83 patients with chronic hepatitis C to CIFN at 18 MIU six times/wk for 4 wk, followed by CIFN at 18 MIU six times/wk for another 20 wk, in combination with polaprezinc 300 mg （regimen A, n = 41） or as monotherapy （regimen B, n = 42）. Thirtyone patients in regimen A and 33 patients in regimen B completed the clinical trial; the remaining patients withdrew because of side effects or a transfer to another hospital. RESULTS： Sustained biochemical response, defined as a normal aminotransferase level at the end of the 6-too post-treatment observation, was 68% and 69%, and sustained virological response, defined as undetectable HCV-RNA at the end of the 6-too post-treatment observation, was 54% and 67% for regimens A and B, respectively. CONCLUSION： CIFN treatment combined with zinc did not enhance the effect of CIFN as shown by biochemical, virological criteria. No side effects related to polaprezinc were noted.
