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Contrast-enhanced ultrasonography for the diagnosis of spontaneous necrosis of hepatocellular carcinoma: A report of 2 cases. Radiol Case Rep 2023; 18:173-181. [DOI: 10.1016/j.radcr.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022] Open
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2
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Spontaneous Regression of Hepatocellular Carcinoma and Review of Reports in the Published English Literature. Case Rep Med 2019; 2019:9756758. [PMID: 31049068 PMCID: PMC6462316 DOI: 10.1155/2019/9756758] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/21/2019] [Indexed: 12/12/2022] Open
Abstract
Background Spontaneous regression of hepatocellular carcinoma (HCC) is a rare event, although it has been described by numerous groups. The long-term fate of individuals experiencing an SR is not well described, and the underlying mechanism(s) of SR are unknown. Case Presentation: A 79-year-old Asian female with metastatic HCC taking only valsartan for hypertension had a marked reduction in tumor dimension in the primary tumor and the pulmonary metastases. Serum alpha-fetoprotein (AFP) decreased from 17,833 μg/L to 26 μg/L. Her disease progressed after 71 months, and she died shortly after. In a review of 66 patients with SR reported in the English literature, median survival was 83 months. Median survival in 37 cases that underwent resection after SR was 108 months. Conclusions The case and a review of the literature illustrate that SR is often durable and associated with an excellent prognosis. Understanding the underlying mechanism of SR may point to novel therapeutic strategies.
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Luo SC, Wu CC, Jheng SB, Huang ZY. Spontaneous remission of hepatocellular carcinoma without any treatment. JOURNAL OF CANCER RESEARCH AND PRACTICE 2016. [DOI: 10.1016/j.jcrpr.2016.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Lee SB, Kim HG, Kim HS, Lee JS, Im HJ, Kim WY, Son CG. Ethyl Acetate Fraction of Amomum xanthioides Exerts Antihepatofibrotic Actions via the Regulation of Fibrogenic Cytokines in a Dimethylnitrosamine-Induced Rat Model. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:6014380. [PMID: 27594891 PMCID: PMC4995331 DOI: 10.1155/2016/6014380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/08/2016] [Accepted: 07/16/2016] [Indexed: 01/18/2023]
Abstract
Amomum xanthioides has been traditionally used to treat diverse digestive system disorders in the Asian countries. We investigated antihepatofibrotic effects of ethyl acetate fraction of Amomum xanthioides (EFAX). Liver fibrosis is induced by dimethylnitrosamine (DMN) injection (intraperitoneally, 10 mg/kg of DMN for 4 weeks to Sprague-Dawley rats). EFAX (25 or 50 mg/kg), silymarin (50 mg/kg), or distilled water was orally administered every day. The DMN injection drastically altered body and organ mass, serum biochemistry, and platelet count, while EFAX treatment significantly attenuated this alteration. Severe liver fibrosis is determined by trichrome staining and measurement of hydroxyproline contents. EFAX treatment significantly attenuated these symptoms as well as the increase in oxidative by-products of lipid and protein metabolism in liver tissues. DMN induced a dramatic activation of hepatic stellate cells and increases in the levels of protein and gene expression of transforming growth factor-beta (TGF-β), platelet derived growth factor-beta (PDGF-β), and connective tissue growth factor (CTGF). Immunohistochemical analyses revealed increases in the levels of protein and gene expression of α-smooth muscle actin. These alterations were significantly normalized by EFAX treatment. Our findings demonstrate the potent antihepatofibrotic properties of EFAX via modulation of fibrogenic cytokines, especially TGF-β in the liver fibrosis rat model.
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Affiliation(s)
- Sung-Bae Lee
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 176-9 Daeheung-ro, Jung-gu, Daejeon 301-724, Republic of Korea
| | - Hyeong-Geug Kim
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 176-9 Daeheung-ro, Jung-gu, Daejeon 301-724, Republic of Korea
| | - Hyo-Seon Kim
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 176-9 Daeheung-ro, Jung-gu, Daejeon 301-724, Republic of Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 176-9 Daeheung-ro, Jung-gu, Daejeon 301-724, Republic of Korea
| | - Hwi-Jin Im
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 176-9 Daeheung-ro, Jung-gu, Daejeon 301-724, Republic of Korea
| | - Won-Yong Kim
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 176-9 Daeheung-ro, Jung-gu, Daejeon 301-724, Republic of Korea
| | - Chang-Gue Son
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 176-9 Daeheung-ro, Jung-gu, Daejeon 301-724, Republic of Korea
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Takeda Y, Wakui N, Asai Y, Dan N, Yamauchi Y, Ueki N, Otsuka T, Oba N, Nishinakagawa S, Minagawa M, Takeda Y, Shiono S, Kojima T. Spontaneous complete necrosis of hepatocellular carcinoma: A case report and review of the literature. Oncol Lett 2015; 9:1520-1526. [PMID: 25788993 PMCID: PMC4356411 DOI: 10.3892/ol.2015.2937] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 12/12/2014] [Indexed: 01/26/2023] Open
Abstract
The present study reports the case of a 68-year-old male patient who presented to Tokyo Rosai Hospital for the treatment of alcoholic liver disease. A high density was observed in liver segment S2, while a tumor, 30 mm in size, exhibiting a low density was observed in the delayed phase upon contrast-enhanced computed tomography (CT), which was performed prior to admission. The tumor appeared slightly poorly defined upon abdominal ultrasound and was observed as a 30 mm low-echoic nodule that was internally heterogeneous. A 5-mm thick contrast enhancement effect was observed in the tumor border in the vascular phase on Sonazoid contrast-enhanced ultrasonography, while a defect in the entire tumor was observed in the post-vascular phase. Dysphagia had commenced three months prior to presentation and a weight loss of ~3 kg was observed. Therefore, the patient was admitted to Tokyo Rosai Hospital due to the presence of a hepatic tumor, and to undergo a close inspection of the cause of the tumor. Upon close inspection, it was determined that the weight loss and aphagia were caused by progressive bulbar paralysis. A contrast-enhanced CT was performed on post-admission day 29 as a follow-up regarding the hepatic tumor. As a result, although no change in the tumor size was observed, the contrast enhancement in the tumor borderline had disappeared. Necrosis of the tumor was considered. However, as viable persistence of the malignant tumor could not be excluded, a hepatic left lobe excision was performed. The patient was diagnosed with hepatocellular carcinoma (HCC) based on the morphology of the cellular necrosis. In addition, occlusion due to thrombus was observed within the blood vessels passing inside the fibrous capsule. It was hypothesized that the formation of a thick fibrous capsule and occlusion due to thrombus in the feeding vessel were possibly involved as the cause of complete spontaneous necrosis. Written informed consent was obtained from the patient.
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Affiliation(s)
- Yuki Takeda
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Noritaka Wakui
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Yasutsugu Asai
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Nobuhiro Dan
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Yoshiya Yamauchi
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Nobuo Ueki
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Takafumi Otsuka
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Nobuyuki Oba
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Shuta Nishinakagawa
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Masami Minagawa
- Department of Surgery, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Yasushi Takeda
- Department of Surgery, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Saori Shiono
- Department of Pathology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
| | - Tatsuya Kojima
- Department of Internal Gastroenterology and Hepatology, Tokyo Rosai Hospital, Tokyo 143-0013, Japan
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Saito T, Naito M, Matsumura Y, Kita H, Kanno T, Nakada Y, Hamano M, Chiba M, Maeda K, Michida T, Ito T. Spontaneous regression of a large hepatocellular carcinoma with multiple lung metastases. Gut Liver 2014; 8:569-74. [PMID: 25228980 PMCID: PMC4164250 DOI: 10.5009/gnl13358] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 10/02/2013] [Accepted: 10/02/2013] [Indexed: 01/11/2023] Open
Abstract
A 75-year-old Japanese man with chronic hepatitis C was found to have a large liver tumor and multiple nodules in the bilateral lungs. We diagnosed the tumor as hepatocellular carcinoma (HCC) with multiple lung metastases based on imaging studies and high titers of HCC tumor markers. Remarkably, without any anticancer treatment or medication, including herbal preparations, the liver tumor decreased in size, and the tumor makers diminished. Moreover, after 1 year, the multiple nodules in the bilateral lungs had disappeared. Fifteen months after the first medical examination, transcatheter arterial chemoembolization (TACE) was performed for the residual HCC. Because local relapse was observed on follow-up computed tomography, a second TACE was performed 13 months after the first one. At 4 years after the second TACE (7 years after the initial medical examination), there was no recurrence of primary or metastatic lesions. Spontaneous regression of HCC is very rare, and its mechanism remains unclear. Understanding the underlying mechanism of this rare phenomenon may offer some hope of finding new therapies, even in advanced metastatic cases.
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Affiliation(s)
- Tamiko Saito
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Masafumi Naito
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Yuki Matsumura
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Hisaaki Kita
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Tomoyo Kanno
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Yuki Nakada
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Mina Hamano
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Miho Chiba
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Kosaku Maeda
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Tomoki Michida
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
| | - Toshifumi Ito
- Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan
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Yan B, Meng X, Wang X, Wei P, Qin Z. Complete regression of advanced prostate cancer for ten years: A case report and review of the literature. Oncol Lett 2013; 6:590-594. [PMID: 24137376 PMCID: PMC3789058 DOI: 10.3892/ol.2013.1377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 05/30/2013] [Indexed: 11/16/2022] Open
Abstract
Long-term complete regression of prostate cancer (PCa) is a rare phenomenon. The current report presents the case of an advanced PCa patient with rare clinical features. Following the generation of a definitive diagnosis, the patient was administered with flutamide treatment (0.25 g flutamide) 3 times a day, for 5 consecutive years, prior to surgical castration. Following surgery, 3.75 mg enantone was injected (i.h.) once per month for 3 months, without suspending the flutamide treatment. In addition, traditional Chinese herbal medicine was administrated immediately following surgery. Strontium-89 radiotherapy was performed for multiple bone metastases, and the multiple metastatic lesions (lung and bone) of the individual disappeared in <7 months. The patient has currently survived for >10 years with no development of castration resistance or signs of recurrence. Nadir prostate-specific antigen (PSA) levels had remained at <0.1 ng/ml following the initial treatment, and the erythrocyte sedimentation rate (ESR) value was high and had been observed to fluctuate during the treatment. The present case report considers the role of the androgen-receptor in PCa and indicates that careful interpretation of nadir PSA and ESR levels may aid in the prediction of patient prognosis.
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Affiliation(s)
- Bing Yan
- Department of Traditional Chinese Medicine, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
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Huz JI, Melis M, Sarpel U. Spontaneous regression of hepatocellular carcinoma is most often associated with tumour hypoxia or a systemic inflammatory response. HPB (Oxford) 2012; 14:500-5. [PMID: 22762397 PMCID: PMC3406346 DOI: 10.1111/j.1477-2574.2012.00478.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Spontaneous regression of hepatocellular carcinoma (HCC) is well documented, although the aetiology of this phenomenon remains unknown. METHODS A review of the English literature was performed for reports of spontaneous regression of HCC. Reports were classified by mechanism based on the available information. RESULTS Spontaneous regression of HCC has been identified in 75 patients. The most common mechanisms of regression identified were tumour hypoxia (n= 21, 28.0%), a systemic inflammatory response (n= 25, 33.3%) and unknown (n= 29, 38.7%). In patients where tumour hypoxia was described as the aetiology, mechanisms included spontaneous hepatic artery thrombosis and sustained systemic hypotension. In patients where a systemic inflammatory response was the aetiology, mechanisms included cholangitis, trauma and elevated cytokine levels. DISCUSSION Spontaneous regression of HCC is most commonly associated with tumour hypoxia or a systemic inflammatory response. Determining the aetiology of spontaneous regression may identify potential therapeutic pathways. Tumour hypoxia is already the basis of treatment modalities such as hepatic artery embolization and the anti-angiogenic agent sorafenib. However, treatment modalities for HCC do not currently include immune-directed therapies; this may prove to be a worthy target for future research.
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Affiliation(s)
- Jonathan I Huz
- Department of Surgery, New York University School of Medicine, NY 10029, USA
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Huang TM, Luo GR. Mechanisms underlying spontaneous regression of hepatocellular carcinoma. Shijie Huaren Xiaohua Zazhi 2012; 20:1939-1948. [DOI: 10.11569/wcjd.v20.i21.1939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We searched MEDLINE and identified 85 cases of spontaneous regression of hepatocellular carcinoma (HCC). Analysis of these cases found that immunity is the most likely cause of spontaneous regression of HCC, and the elimination of immunosuppressive microenvironment may play a key role in this process. Ischemia, ethanol abstinence, and blood transfusion might lead to regression of HCC through the elimination of immunosuppression and activation of antitumor immunity.
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Yamamoto S, Tokuhara T, Nishikawa M, Nishizawa S, Nishioka T, Nozawa A, Takahashi A, Watanabe Y, Wada R, Wakasa K, Kubo S. Spontaneous regression of hepatocellular carcinoma after improving diabetes mellitus: possibly responsible for immune system. ACTA ACUST UNITED AC 2012. [DOI: 10.2957/kanzo.53.164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Olaku O, White JD. Herbal therapy use by cancer patients: a literature review on case reports. Eur J Cancer 2010; 47:508-14. [PMID: 21185719 DOI: 10.1016/j.ejca.2010.11.018] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 11/10/2010] [Accepted: 11/23/2010] [Indexed: 02/06/2023]
Abstract
Complementary and alternative medicine use is common amongst cancer patients. In many surveys, herbal medicines are amongst the most commonly used group of treatments. Herbal remedies are believed by the general public to be safe, cause less side-effects and less likely to cause dependency. The authors performed a literature review to assess which herbal approaches have had associated cancer case reports and determine which of these have been studied in prospective research. Eighteen case reports of patients having apparent antitumour effects from herbal therapy and 21 case reports of toxic effects of herbs used by cancer patients were identified. Clinicaltrials.gov and MEDLINE (via PubMed) were searched for each of the herbal products identified in these reports. Clinical trials in cancer populations were identified for green tea extracts or compounds (n=34), phytoestrogens (n=27), mistletoe (n=8), Ganoderma lucidum (n=1), noni (n=1) and Silymarin (n=1). Daikenchuto, PC-SPES, Nyoshinsan/TJ and Saw palmetto have also been studied prospectively. In conclusion, some of the herbs with promising case report findings have undergone prospective clinical investigations but many others have either not yet been explored or the results have not been reported in English. Unconventional therapies, such as herbs and minerals, used in ancient medical traditions have led to the identification of active anticancer agents. Mechanisms to support prospective research with such approaches are discussed.
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Cho WC, Chen HY. Transcatheter arterial chemoembolization combined with or without Chinese herbal therapy for hepatocellular carcinoma: meta-analysis. Expert Opin Investig Drugs 2010; 18:617-35. [PMID: 19388879 DOI: 10.1517/13543780902855308] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Chinese herbal therapy is sometimes used in conjunction with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) in Asian countries. This study aims to systemically review the efficacy of Chinese herbal therapy in HCC patients receiving TACE. METHODS Meta-analysis was performed for clinical trials comparing Chinese herbal therapy versus no Chinese herbal therapy given to HCC patients receiving TACE. Publications in 10 electronic databases were extensively searched. RESULTS/CONCLUSION Chinese herbal therapy was associated with a significant rise in the number of patients with survival > 1-year, 2-year and 3-year, as well as a significant rise in the number of patients who reported complete or partial response and non-deterioration performance status. Chinese herbal therapy also showed significant efficacies in the increase of T cells and natural killer cells, whereas a significant lower blood alpha-fetoprotein concentration was reported. There were a significant increase in white blood cell count, a significant lower risk in patients with nausea and vomiting, and a significant rise in patients with increased body weight when Chinese herbal therapy was given. The evidence from this review supports the use of Chinese herbal therapy to enhance the efficacy of TACE in HCC patients. However, owing to limited data and heterogeneity of the included studies, further trials are required.
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Affiliation(s)
- William Cs Cho
- Queen Elizabeth Hospital, Department of Clinical Oncology, Room 1305, 13/F, Block R, 30 Gascoigne Road, Kowloon, Hong Kong.
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Oquiñena S, Iñarrairaegui M, Vila JJ, Alegre F, Zozaya JM, Sangro B. Spontaneous regression of hepatocellular carcinoma: three case reports and a categorized review of the literature. Dig Dis Sci 2009; 54:1147-53. [PMID: 18716866 DOI: 10.1007/s10620-008-0447-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Accepted: 07/02/2008] [Indexed: 12/21/2022]
Affiliation(s)
- Susana Oquiñena
- Department of Gastroenterology, Hospital Virgen del Camino, Pamplona, Spain
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