4 research outputs found
Evaluation of Liver Function Tests to Predict Operative Risk in Liver Surgery
Despite numerous studies in the past it is not possible yet to predict postoperative liver failure
and safe limits for hepatectomy. In this study the following liver function tests ICG-ER
(indocyaninegreen elimination rate), GEC (galactose elimination capacity) and MEGX-F
(monoethylglycinexylidid formation) are examined with regard to loss of liver tissue and
prediction of operative risk. Liver function tests were assessed in 20 patients prior to liver
resection and on the 10th. postoperative day. Liver and tumor volume were measured by
ultrasound and pathologic specimen and the parenchymal resection rate was calculated. In
patients without cirrhosis (n = 10) ICG-ER and MEGX-F remained unchanged after
resection, GEC was reduced but did not correspond to the resection rate. Patients with
cirrhosis (n = 10) had a significantly lower ICG-ER and GEC before resection than patients
without cirrhosis. After resection these tests were unchanged. Patients with liver related
complications and cirrhosis (n = 5) had lower ICG-ER and GEC than patients with cirrhosis
and no complications. In the postoperative course all liver function tests in these patients were
significantly lower compared to preoperative results. Comparing liver function tests ICG
serves best to indicate postoperative liver failure. Liver function tests do not correspond with
loss of liver tissue
Unusual Features of Multiple Endocrine Neoplasia
In addition to the common presentations of the multiple endocrine neoplasia (MEN) syndromes, unusual organ involvement as rare manifestations of a single disease may occur. Among our patients we have identified four cases in which unusual features of MEN were present. In the first patient, bilateral adrenal cortical adenoma, parathyroid adenoma, multiple pancreatic tumors, and follicular thyroid carcinoma were observed. The second patient suffered from thymic carcinoid, parathyroid hyperplasia, gastrinoma, and pituitary adenoma. Additionally, one family was discovered in which medullary thyroid carcinoma (MTC), Hirschsprung\u27s disease, and pheochromocytoma occurred and another family had MTC and ovarian cancer. Based on these observations, we stress the importance of screening for MEN syndromes in all patients with pathologic findings in any endocrine organ