Background: In this study, we aimed to compare the long-term therapeutic outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) with those of radiofrequency ablation (RFA) for the initial treatment of a single small (≤ 3 cm) hepatocellular carcinoma (HCC). Methods: From January 2010 to December 2021, 259 consecutive patients who underwent DEB-TACE (67 patients) or RFA (192 patients) as a first-line treatment for a single small HCC were enrolled in this retrospective study. The therapeutic outcomes, including cumulative intrahepatic local tumor progression (LTP), progression-free survival (PFS), and longterm overall survival (OS) rates, were compared between the two groups before and after propensity score (PS) matching. Multivariate Cox proportional hazard models were used to evaluate the prognostic factors and differences in OS and PFS between the two groups for all 92 patients after PS matching. Results: After PS matching, the 1-, 2-, 3-, and 5-year LTP rates were lower in the RFA group than those in the DEB-TACE group (P < 0.001), and the 1-, 2-, 3-, and 5-year PFS rates in the RFA group were higher than those in the DEB-TACE group (P = 0.007). However, the 1-, 2-, 3-, and 5-year OS rates were not significantly different between the RFA and DEB-TACE groups (P = 0.584).Moreover, the OS was not significantly different between the RFA and DEB-TACE groups in the univariate and multivariate analyses, with a hazard ratio (HR) of 0.81. The PFS was significantly higher in the RFA group than that in the DEB-TACE group in the univariate analyses, with a HR of 0.44 (P = 0.009). Multivariate Cox regression analysis showed that albumin (P = 0.019) was an independent prognostic factor for OS. Additionally, the major complication rates were not significantly different between the DEB-TACE and RFA groups (P = 1.000). Conclusion The LTP and PFS rates of RFA were superior to those of DEB-TACE in the initial treatment of single small HCC after PS matching. However, the OS rates were not significantly different between RFA and DEB-TACE. Therefore, DEB-TACE may be considered an efficient substitute for RFA in some patients with a single small HCC who are ineligible for RFA.

BACKGROUND: International consensus guidelines have recently been developed to improve the assessment and management of asthma. One of the major recommendations of these guidelines is that asthma severity should be assessed through the recognition of key symptoms, such as nocturnal waking, medication requirements, and objective measurements of lung function. Differential classification of asthma severity would lead to major differences in both long term pharmacological management and the treatment of severe exacerbation. METHODS: This study examined the relationship between the symptom score and measurements of FEV1 and PEF when expressed as a percentage of predicted values in asthmatics(n=107). RESULTS: The correlation of FEV1% with PEFR% was highly significant(r=0.83, p<0.01). However, there was agreement in terms of the classification of asthma severity in 76.6% of the paired measurements of FEV1% and PEFR%. Agreement in the classification of asthma severity was also found in 57.1% of the paired analysis of FEV1% and symptom score. 39% of the patients classified as having moderate asthma on the basis of FEV1% recording would be considered to have severe asthma if symptom score alone were used. Low baseline FEV1 and high bronchial responsiveness were associated with a low degree of perception of airway obstruction. CONCLUSION: The relationships between the symptom score, PEFR and FEV1 were generally poor. When assessing asthma severity, age, duration, PC20, and baseline FEV should be considered.
Airway Obstruction ; Asthma* ; Classification ; Consensus ; Humans ; Lung ; Peak Expiratory Flow Rate

BACKGROUND AND OBJECTIVE: T cells play a pivotal role in initiating and orchestrating bronchial inflammation in asthma. However, little is known about changes in T cell subset in the airways. Our objective was to study whether the proportion of CD4+ or CD8+ T cells in the bronchoa1veolar lavage fluid (BALF) of bronchial asthma is different from normal subjects, and whether it is associated with clinical characteristics. METHODS: We examined the percentage of CD4+ and CD8+ cells in the BALF of 37 patients with bronchial asthma and 14 normal controls by flow cytometry. Bronchial asthma was classified as mild, moderate and severe according to bronchial hyperresponsiveness. Skin prick test and pulmonary function tests were performed. RESULTS: The percentage of CD4+ cells in BALF did not differ between asthmatics and controls, however, the percentage of CD8+ cells was significantly higher in asthmatics than contro1s, In asthmatics, the percentage of CD4+ cells and CD8+ cells did not differ between atopic and nonatopic asthmatics. The percentage of CD8+ cells in addition to CD4+ cells was correlated with the percentage of eosinophils in BALF, and the percentage of CD8+ cells also showed negative correlation with FEV, and FEF25-75% CONCLUSION: These results suggest that CD8+ cells as well as CD4+ cells are associated with airway inflammation in bronchial asthma.
Asthma* ; Eosinophils ; Flow Cytometry ; Humans ; Inflammation ; Respiratory Function Tests ; Skin ; T-Lymphocytes ; Therapeutic Irrigation

BACKGROUND: In the previous literature, single oral levodopa challenge test has been reported as one of the methods differentiating multiple system atrophy (MSA) from idiopathic Parkinson's disease (IPD). However many of the patients included in these studies had been on levodopa treatment for a variable period when they were examined. We performed this study to determine the value of single oral levodopa challenge test in differential diagnosis between IPD and MSA. METHODS: After a single oral dose of SinemetR(25/250), we assessed the improvement of motor function in 54 de novo patients with parkinsonian symptoms (33 with IPD and 21 with probable MSA). We measured the time taken to finish 20 taps with unilateral hand on two marks separated 20 cm apart and to walk 10 meter from a sitting position and return. Such performances were assessed 5 times before the medication, every 15 min for first 2 hrs after the medication, and then every 30 min for the next 4 hrs. RESULTS: The mean of the age, mean of the duration of disease and mean of the Hoehn and Yahr scale score were not significantly different between the patients with IPD and those with MSA. The mean of the unified Parkinson's disease rating scale score between the patients with IPD and MSA was not significantly different. Baseline scores of the hand and the walking performance were not significantly different. The median of the time interval between the levodopa intake and maximum beneficial effects, mean of the objective improvement at the peak, and mean of the amount of maximum subjective improvement comparing to the baseline was not significantly different between the patients with IPD and MSA. Also there were no significant differences in all measurements between the patients with striatonigral and olivopontocerebellar type of MSA. CONCLUSIONS: These findings suggest that single oral levodopa challenge test is not so helpful for the differential diagnosis between de novo patients with IPD and MSA.
Diagnosis, Differential ; Hand ; Humans ; Levodopa* ; Multiple System Atrophy* ; Parkinson Disease* ; Walking

Spontaneous intracerebral hemorrhage is one of the most devastating forms of cerebrovascular disease in the field of neurosurgery, and is most frequently associated with the hypertension in the distribution of the penetrating vessels, or can be secondary to other factors, like aneurysm, arteriovenous malformation, glial tumor, metastasis, infarction, anticoagulation therapy, coagulation disorders such as leukemia or thrombocytopenia. Although many cases of recurrent hypertensive intracerebral hemorrhage have been reported, bilateral simultaneous hemorrhage has not been reported. The authors report a case of bilateral simultaneous hypertensive intracerebral hemorrhage in a 62-year-old male, which was treated by conservative management.
Arteriovenous Fistula ; Basal Ganglia* ; Cerebral Hemorrhage ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Intracranial Hemorrhage, Hypertensive* ; Leukemia ; Male ; Middle Aged ; Neoplasm Metastasis ; Neurosurgery ; Thrombocytopenia

Interrupted aortic arch with concomitant intracardiac defects is a rare congenital anomaly that has an unfavorable natural course. We report a successful staged operation of interrupted aortic arch with apical muscular ventricular septal defect associating esophageal atresia with tracheoesophageal fistula in a 3-day-old neonate weighing 2.6 kg. We repaired esophageal atresia through the right thoracotomy and subsequently performed extended end-to-end anastomosis of the aortic arch with pulmonary artery banding through the left thoracotomy at same operation. The apical muscular VSD was repaired 87 day after first operation. The patient required multiple additional interventions before closure of the apical muscular ventricular septal defect, such as pyloromyotomy for idiopathic hypertrophic pyloric stenosis, anterior aortopexy for airway obstruction, and balloon aortoplasty for residual coarctation. She is now doing well.
Airway Obstruction ; Aorta, Thoracic* ; Esophageal Atresia* ; Heart Septal Defects, Ventricular* ; Humans ; Infant, Newborn ; Pulmonary Artery ; Pyloric Stenosis, Hypertrophic ; Thoracotomy ; Tracheoesophageal Fistula*

BACKGROUND: Acute lung injury (ALI) is a commonly encountered respiratory disease and its prognosis is poor when the treatment is not provided promptly and properly. However no specific pharmacologic treatment is currently available for ALI, although recently several supportive drugs have been under scrutiny. We studied anti-inflammatory effects of pentoxifylline (PF), a methylated xanthine, and ONO-5046, a synthetic neutrophil elastase inhibitor on lipopolysaccharide (LPS)-induced ALI in vitro. METHODS: To establish an in vitro model of LPS-induced ALI, primary rat alveolar macrophages and peripheral neutrophils in various ratios (1:0, 5:1,1:1,1:5,0:1) were co-cultured with transformed rat alveolar epithelial cells (L2 cell line) or vascular endothelial cells (IP2-E4 cell line) under LPS stimulation. Each experiment was divided into five groups-control, LPS, LPS+PF, LPS+ONO, and LPS+PF+ONO. We compared LPS-induced superoxide anion productions from primary rat alveolar macrophages and peripheral neutrophils in various ratios, and the resultant cytotoxxicity on L2 cells or IP2-E4 cells between groups. In addition we also compared the productions of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, monocyte chemotactic protein(MCP)-1, IL-6, and IL-10 as will as mRNA expressions of TNF-α, inducible nitric oxide synthetase(iNOS), and MCP-1 from LPS-stimulated primary rat alveolar macrophages between groups. RESULTS: (1) PF and ONO-5046 in each or both showed a trend to suppress LPS-induced superoxide anion productions from primary rat alveolar macrophages and peripheral neutrophils regardless of their ratio, except for the LPS+PF+ONO group with the 1:5 ratio, although statistical significance was limited to a few selected experimental conditions. (2) PF and ONO-5046 in each or both showed a trend to prevent IP2-E4 cells from LPS-induced cytotoxicity by primary rat alveolar macrophages and peripheral neutrophils regardless their ratio, although statistical significance was limited to a few selected experimental conditions. The effects of PF and/or ONO-5046 on LPS-induced L2 cell cytotoxicity varied according to expaerimental conditions. (3) PF showed a trend to inhibit LPS-induced productions of TNF-α, MCP-1, and IL-10 from primary rat alveolar macrophages. ONO-5046 alone didnot affect the LPS-induced productions of proinflammatory cytokines from primary rat alveolar macrophages but the combination of PF and ONO-5046 showed a trend to suppress LPS-induced productions of TNF-αand IL-10 PF and ONO-5046 in each or both showed a trend to increase LPS-induced IL-β and IL-6 productions from primary rat alveolar macrophages. (4) PF and ONO-5046 in each or both showed atrend to attenuate LPS-induced mRNA expressions of TNF-α and MCP-1 from primary rat alveolar macrophages but at the same time showed a trend increase iNOS mRNA expression. CONCLUSION: These results suggest that PF and ONO-5046 may play a role in attenuating inflammation in LPS-induced ALI and that further study is needed to use these drugs as a new supportive therapeutic strategy for ALI.
Acute Lung Injury* ; Animals ; Cytokines ; Endothelial Cells ; Epithelial Cells ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Interleukins ; Leukocyte Elastase* ; Macrophages, Alveolar ; Monocytes ; Neutrophils* ; Nitric Oxide ; Pentoxifylline* ; Prognosis ; Rats ; RNA, Messenger ; Superoxides ; Tumor Necrosis Factor-alpha ; Xanthine

No abstract available.
Carcinoma, Basal Cell ; Keratosis, Seborrheic

BACKGROUND: Bronchial asthma is characterized by chronic eosinophilic inflammatory airway disease associated with bronchial hyperresponsiveness and reversible airway obstruction. Bronchial inflammation in asthma may depend in part on the activation of T helper lymphocytes that elaborate proinflammatory cytokines. T helper (Th) lymphocytes can be divided into two categories ; Th1 lymphocytes, which secrete IL-2, IL-12 and IFN-, and Th2 lymphocytes, which secrete IL-4, IL-5, IL-6 and IL-10. Th2 lymphocytes appear to induce allergic responses, whereas Th1 lymphocytes induce delayed-type hypersensitivity response. Some infections, such as tuberculosis, cultivate a Th1 immunological environment and inhibit Th2 lymphocytes function. The presence of such infections might inhibit Th2 immune responses and thus protect development of atopic diseases. METHOD: 15 patients with allergic bronchial asthma, 10 patients with intrinsic bronchial asthma, and 10 healthy volunteers were studied. The serum concentrations of IFN-, IL-12, IL-4, IL-5, and IL-10 were measured by ELISA method and tuberculin skin test was estimated in different groups. RESULTS: The positive response rates of tuberculin test were 46.7% in patients with allergic asthma , 100% in patients with intrinsic asthma and 60% in normal controls. The positive response rates were significantly lower in patients with allergic asthma than those of in patients with intrinsic asthma (p<0.05). Degree of responses to tuberculin test were 12.09.6mm in patients with allergic asthma, 18.44.5mm in patients with intrinsic asthma and 10.98.8mm in normal controls. The degree of responses were significantly reduced in patients with allergic asthma than those of patients with intrinsic asthma (p<0.05). The serum levels of IL-5 in patients with allergic asthma were significantly higher than in patients with intrinsic asthma and normal controls (p<0.05), although it was insignificant, the serum levels of IL-4 and IL-10 in patients with allergic asthma were higher than that of intrinsic asthma and normal controls. The serum levels of IL-12 and IFN- in patients with allergic asthma and intrinsic asthma were significantly lower than those in normal controls(P<0.05). The serum levels of total immunoglobulin E (IgE) and peripheral blood eosinophile counts in patients with allergic asthma were significantly higher than those in normal controls. Peripheral blood esinophil counts had a significant correlation with the serum levels of total IgE, IL-5 and IL-10 in patients with allergic asthma (p<0.05). CONCLUSION: These results have showed that Th1 lymphocyte functions were lowered and Th2 lymphocyte functions were elevated in patients with allergic asthma than those in normal controls. Suppression of Th1 lymphocyte functions by activation of Th2 lymphocyte might be one of the important aspects of pathogenesis in allergic bronchial asthma.
Airway Obstruction ; Asthma* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Healthy Volunteers ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Interleukin-10 ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Interleukin-6 ; Lymphocytes ; Skin Tests* ; Skin* ; Tuberculin Test ; Tuberculin* ; Tuberculosis