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and leiomyosarcoma (LMS) of the duodenum are relatively rare, and precise, differential diagnosis is not necessarily easy in either case. We report one case each of LM and LMS, and review the 165 cases of LM (1935-1985) and 126 cases of LMS (1975-1985), including our cases, in the Japanese literature. 1) The main symptom of LM is melena; that of LMS, abdominal mass. 2) If an upper gastrointestinal series reveals displacement of the stomach and duodenum, widening of the duodenal sweep, fistula, cavity and others, LMS is highly likely. 3) LMS is disclosed as variegated findings on US and CT. 4) If angiography reveals encasement, LMS is highly likely. 5) LM is usually 2-5cm in size, and LMS 10-15cm. 6) LMS is often associated with liver metastases. From these findings we think that, in addition to histological findings, the size and nature of the tumor, especially biological malignancy, should be referred to in determining the treatment for LM and LMS.

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Hepatic circulation after hepatectomy was investigated in conscious dogs under fasting and feeding conditions. After a 40% hepatectomy, both the hepatic arterial and portal blood flow were measured simultaneously using ultrasonic transit time flowmeters. During fasting, the total hepatic blood flow (i.e., the sum of arterial and portal blood flow) changed in a biphasic pattern after hepatectomy. The first peak (517.9 +/- 42.7 ml/min; 130.1% of preoperative flow) was seen on the 1st postoperative day (POD) and the second peak (444.8 +/- 25.6 ml/min; 112.7% of preoperative flow) occurred on the 7th POD. The portal flow demonstrated the same biphasic changes as the total hepatic flow, although the hepatic arterial flow showed only the first peak. A heart rate analysis suggested that the first peak was probably due to hyperdynamic circulatory conditions, as has been previously reported. In addition, the existence of the second peak was established by the present study. The postprandial hepatic blood flow decreased during the first 2 weeks postoperatively, but exceeded the presurgical levels on PODs 21 and 28.

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