No abstract available.
Child* ; Cyclosporine* ; Humans ; Nephrosis, Lipoid*

BACKGROUNDS/AIMS: Although recent advances in surgical techniques and alternative treatment, the long-term survival >5 years after liver resection for hepatocellular carcinoma (HCC) is still unsatisfactory due to the high recurrence rate compared with other solid organ cancers. This study was conducted to analyze long-term survival after HCC resection and to develop an optimal strategy to achieve long-term survival. METHODS: A retrospective review was performed for HCC patients who underwent liver resection between 1996 and 2006. The survival rates and prognostic factors were assessed. The clinical and pathological factors of patients who survived more than 5 years were compared with those of patients whose survival was less than 5 years. The clinicopathological features characterizing long-term survivors were also reviewed. RESULTS: The overall and disease-free 5-year survival rates of 87 cases were 38.5% and 29.4%, respectively. Twenty-seven of 87 patients survived longer than 5 years after liver resection. The univariate analysis revealed that hepatitis C, the serum aspartate sminotransferase (AST) level, liver cirrhosis, Edmondson-Steiner grade, AJCC stage, and vascular invasion were significant factors for overall survival, and serum AST level, liver cirrhosis, Edmondson-Steiner grade, AJCC stage, and vascular invasion were the affecting factors for disease-free survival. In multivariate analysis, serum AST level, hepatitis C and vascular invasion were related with the overall survival, liver cirrhosis and vascular invasion which were associated with disease-free survival. Vascular invasion, AJCC stage, and the Edmondson-Steiner grade were significant factors in long-term survivors. CONCLUSIONS: Patients without liver cirrhosis, vascular invasion and normal liver function, good differentiation and an early stage may be expected to have a long-term survival.
Aspartic Acid ; Carcinoma, Hepatocellular ; Disease-Free Survival ; Hepatitis C ; Humans ; Liver ; Liver Cirrhosis ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate ; Survivors

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

No abstract available.

Marchiafava-Bignami disease(MBD), characterized by the primary degeneration of the corpus callosum, is a rare complication of chronic alcoholism. Recently, a few cases of MBD with reversible neuro-imaging abnormalities were reported. A 58-year-old, chronic alcoholic man was admitted with mental change, dysarthria, and a seizure attack. A T2-weighted Brain magnetic resonance imaging demonstrated high signal intensities in the body and splenium of the corpus callosum, multiple white matter, and cortical gray matter. Treatment with a multiple vitamin complex resulted in a near complete recovery of neurological manifestation. A brain MRI obtained four weeks after admission revealed a dramatic resolution of previous imaging abnormalities. We report a case of Marchiafava-Bignami disease with reversible neuro-imaging abnormalities.
Alcoholics ; Alcoholism ; Brain* ; Corpus Callosum ; Dysarthria ; Humans ; Magnetic Resonance Imaging* ; Marchiafava-Bignami Disease* ; Middle Aged ; Neurologic Manifestations ; Seizures ; Vitamins

A 39 years old healthy male patient with intracranial brain stem tuberculoma manifested hydrocephalic symptoms due to obstruction of aqueduct of sylvius is presented. Surgical excision was undertaken for obtaining histologic diagnosis and resolving hydrocephalus, which made postoperative neurologic deficits. CT and Magnetic resonance(MR) imaging of intracranial tubercuroma were studied for approaching nonsurgical diagnosis of tuberculoma. MR imaging of tuberculoma shows low intensity on T2-weighted imaging with Magnevistring enhancement. The MR imaging feature of the tuberculoma were found to be distinct from those abscess, metastasis and glioma. Antituberculous chemotherapy is thought to be better than surgical approach in managing brain stem tuberculoma if radiologic diagnosis was obtained.
Abscess ; Adult* ; Brain Stem* ; Brain* ; Cerebral Aqueduct ; Diagnosis ; Drug Therapy ; Glioma ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Neurologic Manifestations ; Tuberculoma

The authors report a case of growing fracture of the skull, also called as leptomeningeal cyst, in a young boy who presented with symptoms of skull defect, headache, and pulsating mass on right posterior parietal area. Successful duroplasty and cranioplasty with autogenous bone were performed resulting in disappearance of all symptoms. The most significant factor contributing to the growing fracture is an underlying dura tear. A brief review of the relevant literature is also presented.
Arachnoid Cysts ; Headache ; Humans ; Male ; Rabeprazole ; Skull*

The authors report a case of growing fracture of the skull, also called as leptomeningeal cyst, in a young boy who presented with symptoms of skull defect, headache, and pulsating mass on right posterior parietal area. Successful duroplasty and cranioplasty with autogenous bone were performed resulting in disappearance of all symptoms. The most significant factor contributing to the growing fracture is an underlying dura tear. A brief review of the relevant literature is also presented.
Arachnoid Cysts ; Headache ; Humans ; Male ; Rabeprazole ; Skull*

PURPOSE: For bile duct carcinomas, local treatment including surgical resection plays an important role. In the case of hilar bile duct carcinoma, the rate of resection is low and local recurrences are frequent, even after radical resection. Radiotherapy, one of the local remedies, may influence the treatment result. The aims of this study were to determine the effect of radiotherapy after surgical resection on the length of survival, as well as the radiation toxicity, in patients with hilar bile duct carcinoma. METHODS: Seventy patients with hilar bile duct carcinoma were included in this study; 46 underwent surgical resection only while 24 additionally received external beam radiotherapy after resection. The authors compared the survival rate between the two groups and investigated the complications following radiotherapy. RESULTS: The overall 5-year survival rate after surgical resection was 28.3%; 20.1% and 31.3% in patients with and without radiotherapy, respectively. The difference was not significant (P> 0.10). In patients with positive surgical margin, the 5-year survival rate for the radiation group was superior to that of the non-radiation group (21.8% vs. 10.1%), but aqain the difference was not statistically significant (P> 0.10). In patients with lymph node metastasis the survival rates for radiation and non-radiation groups showed no significant difference(median survival, 7 vs. 13 months) (P> 0.10). Leukopenia (n=2) and digestive complications including gastroduodenal ulcers (n=2) occurred after radiotherapy. CONCLUSION: External beam radiotherapy after radical resection had no significant effect on the length of survival in patients with resectable hilar bile duct carcinomas.
Bile Ducts* ; Bile* ; Humans ; Leukopenia ; Lymph Nodes ; Neoplasm Metastasis ; Peptic Ulcer ; Radiotherapy* ; Recurrence ; Survival Rate

PURPOSE: Hepatic resection and liver transplantation are considered a curative treatment for hepatocellular carcinoma (HCC) within the Milan criteria. In this study, we examine the outcome of hepatic resection for HCC within the Milan criteria, and determine the effectiveness of hepatic resection as the primary treatment for HCC within the Milan criteria in Child-Pugh class A. METHODS: 110 patients underwent curative surgical resection for HCC in Child-Pugh class A between August 1991 and June 2008. Fifty-six patients met Milan criteria (Group M) and the remaining 54 did not (Group N). RESULTS: Overall survival rates at 1, 3, and 5 years were 92.6%, 72.5% and 54.6% versus 70.4%, 43.1%, and 28.7% in Group M and Group N, respectively (P=0.0043). The corresponding disease-free survival rates were 81.5%, 69.7%, and 38.2% versus 46.0%, 32.9%, and 26.9% in Group M and Group N (P=0.0012). HCC recurred in 25 patients in Group M (44.6%) and 35 patients in Group N (64.8%)(P=0.034). Outcomes of hepatic resection in Group M were significantly better compared to Group N. CONCLUSION: Hepatic resection can achieve a comparable 5-year overall survival & disease-free survival to that reported for liver transplantation. Hepatic resection should be considered as the standard therapy for HCC within the Milan criteria in Child-Pugh class A patients.
Carcinoma, Hepatocellular ; Disease-Free Survival ; Humans ; Liver Transplantation ; Survival Rate