Intraoperative blood loss is a risk factor for complications in donors after living donor hepatectomy.

Complications in a donor are a distressing but inevitable occurrence, since graft procurement is a major undertaking. Although the technique for procurement has some similarities to hepatic resection, a donor is very unlike a patient with malignancy. The risk factors identified in these patients cannot be extrapolated to donors.

Image in reproductive medicine. Cesarean scar ectopic pregnancy.

Bilateral hypogastric artery ligation followed by dilatation and evacuation under laparoscopic guidance was successful in the treatment of an advanced cesarean scar ectopic pregnancy. This case presents images of ultrasound, magnetic resonance imaging, and gross anatomy unique to cesarean scar pregnancy.

Improving hepatic and portal venous flows using tissue expander and Foley catheter in liver transplantation.

Background And Objective: Vascular reconstruction is important in liver transplantation because its obstruction causes graft failure and eventual loss. Vascular outflow obstruction may be due to graft malposition. We describe our experience with liver allograft repositioning using tissue expander and Foley catheter to improve hepatic and portal venous outflows.

Imaging factors related to rotator cuff tear in patients with deltoid contracture.

Background: Bony deformity and muscular malfunction around the shoulder induced by deltoid contracture may influence rotator cuff function and lead to subsequent tearing. The purpose of this study was to investigate the imaging and clinical factors related to rotator cuff tear in patients with deltoid contracture.

Methods: We retrospectively reviewed 48 shoulders in 44 patients with magnetic resonance imaging diagnosis of deltoid contracture and surgically-proven rotator cuff tear.

Donor graft outflow venoplasty in living donor liver transplantation.

Hepatic venous outflow reconstruction is a key to successful living donor liver transplantation (LDLT) because its obstruction leads to graft dysfunction and eventual loss. Inclusion or reconstruction of most draining veins is ideal to ensure graft venous drainage and avoids acute congestion in the donor graft. We developed donor graft hepatic venoplasty techniques for multiple hepatic veins that can be used in either right- or left-lobe liver transplantation.

Characterization of liver enzymes on living related liver transplantation patients with acute rejection.

Background/aims: To determine the biochemical data that reliably predict allograft injury from acute rejection (AR) in patients with living related liver transplantation (LRLT), liver function test and histopathological characteristics of AR were compared and analyzed retrospectively.

Methodology: From Aug. 1994 to Nov.

Liver regeneration and splenic enlargement in donors after living-donor liver transplantation.

Liver regeneration after donor hepactectomy offers a unique insight into the process of liver regeneration in normal livers. As the liver restores itself, concurrent splenic enlargement occurs. There are many theories about why this phenomenon takes place: some investigators have proposed a relative portal hypertension that leads to splenic congestion or, perhaps, the presence of a common growth factor that induces both the liver and spleen to enlarge.

Emergency splenic arterial embolization for massive variceal bleeding in liver recipient with left-sided portal hypertension.

Splenic vein thrombosis with gastric variceal bleeding is difficult to manage, and splenectomy may be necessary to stop variceal bleeding. The authors report the case of a post-orthotopic liver transplant patient with bleeding gastric varices secondary to splenic vein thrombosis treated by partial splenic artery embolization. Successful embolization was performed via transcatheter approach depositing Gianturco coils into the intrasplenic artery resulting in immediate cessation of variceal bleeding.

Contracture of the deltoid muscle: sonographic evaluation with MRI correlation.

Objective: This article evaluates the sonographic features of deltoid contracture (DC) with MRI correlation.

Material And Methods: Two reviewers evaluated the imaging features in 22 painful shoulders of 20 patients with a sonographic diagnosis of DC and a subsequent confirming MRI study. The sonographic and MRI findings with regard to the lesion extent (assessed by a 3-point scale: 1 = less than or equal to one third of the longitudinal deltoid length involved, 2 = greater than one third and less than or equal to two thirds involved, and 3 = greater than two thirds involved), transverse lesion morphologic appearance, and maximal transverse diameter measured were compared with kappa statistics and Wilcoxon's signed rank test, respectively.

Effect of autologous blood donation on the central venous pressure, blood loss and blood transfusion during living donor left hepatectomy.

Aim: Autologous blood donation (ABD) is mainly used to reduce the use of banked blood. In fact, ABD can be regarded as acute blood loss. Would ABD 2-3 d before operation affect the CVP level and subsequently result in less blood loss during liver resection was to be determined.

Modified extended distal pancreatectomy for carcinoma of body and tail of pancreas.

The prognosis of carcinoma in the body and tail of the pancreas is disappointing due to the low rate of resectability, since it is usually presented at an advanced stage with local invasion of adjacent major vessels. However, the postoperative survival, if resectable, is similar to carcinoma of the pancreatic head. Aggressive approach, by applying extended distal pancreatectomy with the resection of the celiac axis, may increase the resectability but promote the potential risk of hepatic dysfunction and biliary necrosis after the sudden interruption of the common hepatic artery.

Deceased-donor liver transplantation: 10 years' experience at Change Gung Memorial Hospital-Kaohsiung Medical Center.

Background: The purpose of this study was to summarize the outcomes we achieved using deceased-donor liver transplantation (DDLT) in the past 10 years at Chang Gung Memorial Hospital-Kaohsiung Medical Center (CGMH-KMC).

Methods: Between March 1993 and March 2003, 53 DDLTs were performed at CGMH-KMC. Patients were divided into 2 stages: stage 1 (n = 22) from March 1993 to February 1998, and stage 2 (n = 31) from March 1998 to March 2003.

Is there any difference in anesthetic management of biliary atresia and glycogen storage disease patients undergoing liver transplantation?

Background: The purpose of the study was to compare the intraoperative blood glucose changes and the dosage of glucose infused between biliary atresia and glycogen storage disease (GSD) patients undergoing living donor liver transplantation (LDLT).

Patients And Methods: The anesthesia records of biliary atresia and GSD patients undergoing LDLT were reviewed retrospectively. The levels of intraoperative blood glucose before operation, after induction of anesthesia, in the dissection, anhepatic, 10 min after reperfusion, and at the end of operation, as well as the dosage glucose infused, were compared between groups.

Survival outcome of lobar or segmental transcatheter arterial embolization with ethanol-lipiodol mixture in treating hepatocellular carcinoma.

Aim: To evaluate the clinical outcome and cost-effectiveness of transcatheter arterial ethanol-lipiodol embolotherapy on hepatocellular carcinoma (HCC).

Methods: One hundred patients with HCC who were treated only by lobar or segmental transarterial embolization (TAE) with ethanol-lipiodol mixture were enrolled in this study. The 1st- and 2nd-year survival rates were analyzed to evaluate the feasibility of its method.

Dextrose in the banked blood products does not seem to affect the blood glucose levels in patients undergoing liver transplantation.

Aim: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT.

Methods: A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out.

The effects of anti-histone H1 antibody on immune cells responsible for rejection reaction.

We previously demonstrated the immunosuppressive activity of anti-histone H1 autoreactive antibodies (Ab) transiently induced in serum of a rat tolerogenic orthotopic liver transplantation (OLT) model. In the present study, we investigated the effects of anti-histone H1 Ab on dendritic cells (DCs), T-cells, lymphokine-activated killer (LAK) cells, and human natural killer (NK) cells. The effects of anti-histone H1 Ab on Concanavalin A (ConA) blast, on rat DC cytokine profiles and phenotypes, and on T-cells, LAK cells, and human NK cells were examined by flow cytometry and RT-PCR.

Adenoid cystic carcinoma of the breast: truly uncommon or easily overlooked?

Background: Adenoid cystic carcinoma of the breast is an uncommon histologic form of breast cancer, comprising in most series less than 1% of all mammary cancers. Due to the rarity, little information about its presentation on image studies has been noted in the literature. Here we report two additional cases with emphasis on the intriguing image presentations.

Maintenance of normothermia at operation room temperature of 24 degrees C in adult and pediatric patients undergoing liver transplantation.

Hypothermia is common during surgery in regular operating room (OR) temperature. The effect of increasing the OR temperature to 24 degrees C coupled with simple warming measures to maintain normothermia in both pediatric and adult patients during living donor liver transplantation (LDLT) was evaluated. One hundred patients undergoing LDLT were separated into pediatric (GI) and adult (GII) groups.

Impact of pre-operative transarterial embolization on the treatment of hepatocellular carcinoma with liver transplantation.

Aim: To determine the effectiveness of pre-liver transplant (LT) transarterial embolization (TAE) in treating hepatocellular carcinoma (HCC) and the patient categories, which are likely to have a good outcome after LT.

Methods: Twenty-nine patients with hepatitis-related cirrhosis and unresectable HCC after LT were studied over a 7-year period. The patients were divided into two groups: group A patients (19/29) received pre-LT TAE, whereas group B (10/29) underwent LT without prior TAE.

Diarrhea in medical care workers with severe acute respiratory syndrome.

Background And Goal: Several known coronavirus species cause a variety of diseases, including respiratory or enteric diseases. The purpose of this study was to investigate the interesting enteric symptoms of the medical care workers who were evidently infected with SARS by means of respiratory transmission.

Study: Between May 1 and June 16, 2003, we enrolled 16 medical care workers who fulfilled the definition of probable SARS.

Severe acute respiratory syndrome: prognostic implications of chest radiographic findings in 52 patients.

Purpose: To retrospectively assess prognostic implications of radiographic findings in severe acute respiratory syndrome (SARS).

Materials And Methods: Radiographic findings were reviewed by two radiologists for 52 patients with SARS. On each radiograph, each lung was separated into upper, middle, and lower zones.

Liver abscess complicating transcatheter arterial embolization: a rare but serious complication. A retrospective study after 3878 procedures.

Objectives: Liver abscess is one of the complications of transcatheter arterial embolization (TAE) for hepatocellular carcinoma. We studied the clinical features and analysed the incidence, risk factors, helpful clinical clues, culture profiles and predictive factors of post-TAE liver abscess. The influence of abscess development on the evolution of the tumour process was also studied.

Perioperative normovolemic anemia is safe in pediatric living-donor liver transplantation.

Background: Perioperative normovolemic anemia was applied in pediatric living-donor liver transplant (LDLT) recipients with the aim of reducing the use of blood products and decreasing transfusion-related risk.

Methods: The anemic state was allowed to occur by replacing intraoperative blood and transudate loss with colloid solutions and a discriminate use of packed red blood cells. When blood transfusion was required, the amount of blood replacement was calculated to target a hemoglobin level not higher than 8 to 9 g/dL.

Quantified short-term outcome of uterine artery embolization with gelatin sponge particles and lipiodol for symptomatic myoma.

Objective: To investigate and quantify clinical outcomes and spectral Doppler analyses of uterine arteries in patients with myoma undergoing uterine artery embolization (UAE) with gelatin sponge particles and lipiodol.

Design: Prospective observational study.

Setting: Tertiary medical center.