No abstract available.
Plasminogen Activators* ; Plasminogen* ; Pulmonary Embolism*

No abstract available.
Hypophysectomy*

No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Pleural Effusion*

No abstract available.
Diagnosis* ; Tuberculosis*

No abstract available.
Animals ; Guinea Pigs* ; Guinea* ; Perilymph*

BACKGROUND: The prognosis for a hepatocellular carcinoma (HCC) is very poor because of delayed diagnosis caused by the absence of specific clinical manifestations in the early stage, the limitation of the extent of resection, the high postoperative complication rate due to associated liver cirrhosis, and the high recurrence rate due to multifocal tumorigenesis. Among the various kinds of treatment modalities for HCC, surgical resection is still recognized as the first treatment method. However, it is true that surgical resection has many problems, such as a high operative risk and a high postoperative recurrence rate. Therefore, an evaluation of the factors associated with the overall survival rate and with the recurrence rate is very important for improving the results of operative therapy for HCC. METHODS: We retrospectively analyzed the clinical and the pathological results of 44 curative hepatic resections for HCC performed at Chonnam University Hospital from 1991 to 1997. We evaluated 19 clinical and pathological factors by univariate and multivariate analysis, and we calculated the survival rate by using the Kaplan-Meier method. RESULTS: The cumulative 1-, 3-, and 5-year survival rates were 81%, 66%, and 28%, respectively. In 25 of the 44 cases, recurrences developed, and the 1-, 3-, and 5-year recurrence rates were 38%, 60%, and 65%, respectively. Factors with an independent effect on the overall survival rates were multiplicity of tumors, HBs Ag status, and Child classification. However, liver cirrhosis, ascites, prothrombin time, AFP level, and portal vein invasion were not statistically significant. CONCLUSIONS: The significant prognostic factors detected by multivariate analysis were multiplicity of tumors, HBs Ag status and Child classification. A preoperative evaluation for these factors should be done. If early diagnosis and multidisciplinary therapies are done through frequent postoperative follow-up surveys in these high risk groups, we can anticipate better long-term survival rates after a hepatectomy.
Ascites ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Child ; Classification ; Delayed Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Hepatectomy ; Humans ; Jeollanam-do ; Liver Cirrhosis ; Multivariate Analysis ; Portal Vein ; Postoperative Complications ; Prognosis ; Prothrombin Time ; Recurrence ; Retrospective Studies ; Survival Rate*

No abstract available.
Tuberous Sclerosis*

Xanthogranulomatous cholecystitis (XGC) is an uncommon, focal or diffuse destructive inflammatory process of the gallbladder that is assumed to be a variant of chronic cholecystitis. XGC is characterized grossly by irregular thickening of the gallbladder wall with the formation of a yellow mass (xanthogranuloma). Histologically the xanthogranuloma appears as yellow nodules or streaks in a thickened gallbladder wall and is composed of predominantly lipid-laden macrophages, inflammatory cells, and fibroblasts. These xanthogranulomatous foci may extend into adjacent structures, adhesions or ulcerations are often present, and fistula formation may occur. Although the pathogenesis of XGC is unclear, recurrent inflammation in the presence of calculi and biliary stasis are thought to be the main etiological factors because of the histologic evidence of chronic inflammation and the presence of gallstones in a majority of cases. XGC may lead to associated complications such as perforation, abscess, and fistula, and sometimes closely mimics a gallbladder carcinoma. During an operation for XGC, careful surgical technique is required to dissect the gallbladder and to excise the adjacent xanthogranulomatous tissue. Also a careful investigation to find the coincident gallbladder carcinoma is necessary. We report a case with XGC in a hemophilia A patient and a review of the clinical literatures.
Abscess ; Calculi ; Cholecystectomy ; Cholecystitis* ; Cholestasis ; Fibroblasts ; Fistula ; Gallbladder ; Gallstones ; Hemophilia A* ; Humans ; Inflammation ; Macrophages ; Ulcer

Agenesis of the right lobe of the liver is such a rare congenital anomaly that only about 40 cases have been reported in the literature. This anomaly is considered to be caused by a developmental failure of the right portal vein or by an error of mutual induction between the primitive diaphragm and the endodermal diverticulum representing the primitive liver. When the absence or hypoplasia of the right lobe is found by radiological examinations, several condition, such as liver cirrhosis, a cholangiocarcinoma, and a previous hepatic resection, must be taken into a consideration for a differential diagnosis besides agenesis. Agenesis of the right lobe could be complicated by various biliary tract diseases, including cholelithiasis, a carcinoma of the gallbladder and Mirizzi syndrome, portal hypertension, and rarely volvulus of the stomach, and these complications usually draw clinical attention. We experienced a 58-year-old female who complained of intermittent fever, chills, and jaundice and who was diagnosed with agenesis of the right lobe of the liver with multiple intrahepatic stones by using abdominal CT and MRI. Percutaneous transhepatic biliary drainage was done to relieve the obstructive jaundice, and a percutaneous transhepatic cholangiogram revealed agenesis of the right lobe and abnormal course of the biliary tract. In operative findings, there was no right lobe, and the left lateral segment was markedly enlarged with compensatory hypertrophy. However, the medial segment of the left lobe and caudate lobe was relatively normal in size. The gallbladder was located on the right side of the liver retrohepatically. A cholecystectomy and a choledocholithotomy through a choledochotomy and a retrograde approach after a subsegmentectomy of segments II and III were done.
Bile Ducts, Intrahepatic* ; Biliary Tract ; Biliary Tract Diseases ; Chills ; Cholangiocarcinoma ; Cholecystectomy ; Cholelithiasis ; Diagnosis, Differential ; Diaphragm ; Diverticulum ; Drainage ; Endoderm ; Female ; Fever ; Gallbladder ; Humans ; Hypertension, Portal ; Hypertrophy ; Intestinal Volvulus ; Jaundice ; Jaundice, Obstructive ; Liver Cirrhosis ; Liver* ; Magnetic Resonance Imaging ; Middle Aged ; Mirizzi Syndrome ; Portal Vein ; Stomach ; Tomography, X-Ray Computed

BACKGROUNDING/AIMS: Although several papers provided evidence of a survival advantage for preoperative transcatheter arterial chemoembolization(TAE), recent studies have revealed that patients with resectable tumors have not been benefited from this adjuvant therapy. This study has been done for investigating the effect of the preoperative TAE with resectable hepatocellular carcinoma(HCC) which were diagnosed and treated by surgery and surgery with TAE by analysis and comparison with patient's survival rate between two different methods of treatment. METHODS: We retrospectively reviewed the medical records of 39 patients who underwent the hepatic resection for hepatocellular carcinoma at Chonnam National University Hospital between 1986 and 1997. Median follow-up period was 28 months. Survival rates were estimated by Kaplan-Meier method and difference was detected by Log-rank test using SPSS program.. RESULTS: Male patients were 28 and female were 11 and their mean age was 54.4 years. The patients treated by operation alone were 17 and by preoperative TAE with operation were 22. A reduction of tumor size was achived in 13 of the 22 patients(59.1%) who underwent preoperative TAE. The cumulative survival rate of 1 year, 2 year, 3 year were 90%, 84%, 70% in patients treated by operation alone, 86%, 75%, 52% in patients treated by preoperative TAE and operation respectively. And the relative risk of death for TAE with operation and operation alone was 0.974. The postoperative mean liver function test of the patients who underwent preoperative TAE was higher than those who did not. CONCLUSIONS: The advantage of preoperative TAE with resectable HCC still remains disputable. However, preoperative TAE has the advantage of reducing tumor size and make it easy to operate and decrease the resection field. But the liver function after TAE may deteriorate in some of the patients with liver dysfunction. In conclusion, preoperative TAE must not be performed for resectable HCC as a routine procedure because the overall survival rate was similar between the two groups.
Carcinoma, Hepatocellular* ; Female ; Follow-Up Studies ; Humans ; Jeollanam-do ; Liver ; Liver Diseases ; Liver Function Tests ; Male ; Medical Records ; Prognosis* ; Retrospective Studies ; Survival Rate