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

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

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.

The purpose of this study was to examine the effects of anti-sperm antibody (ASA) on the fertilization processes using conventional IVF and ICSI procedure in human and hamster oocytes. In human IVF, we have observed restricted fertilization with sperm testing positive for ASA. (23~90% IgA, 60-97 % IgG). However, if ICSI was perform in the next IVF cycle with the same patients, we could successfully fertilize the oocytes (37%; p<0.001), thus achieving pregnancy and delivery. When the sperm were cocultured in medium containing ASA, there were binding of ASA to sperm surface. In addition, the mean rate of the acrosomal reaction in an in vitro acrosome reaction test was lower for Ab-bound sperm (43.5%) than for Ab-free sperm group (51.3%, p<0.05). We used human sperm and hamster oocytes to confirm the negative effects of the ASA on fertilization. The sperm and/or oocytes have been expose to medium containing ASA before IVF and ICSI. In this experiment, the ASA was bound to the oocyte and sperm surface. The following results were obtain by using various combinations of ASA free or ASA bound sperm with ASA free or ASA bound oocytes for IVF. When ASA free sperm were inseminate with ASA free and ASA bound hamster oocytes, the fertilization rates are 89.6% and 74.3% respectively. However, when ASA bound human sperm were use the results were 62.5% and 55.6% respectively. These shows the fertilization rate was significantly decreased in both ASA bound and ASA free oocytes when using ASA bound sperm. No difference found when ASA are present on the oocyte surface. When the hamster oocytes was treated by ICSI with ASA free or ASA bound human spermatozoa, no significant difference was found. These results showed that ICSI is the most promising method for couples who fertilization was not possible by conventional IVF because of ASA.
Acrosome Reaction ; Animals ; Antibodies* ; Cricetinae ; Family Characteristics ; Fertilization ; Humans ; Immunoglobulin A ; Oocytes ; Pregnancy ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

Cerebral Vasospasm was produced experimentally by injecting normal cat's blood into the cisterna magna of the cat. Ultrastructural changes were observed sequentially from 24 hours to 15 days following subarachnoid hemorrhage(SAH). Twenty-four hours after SAH, endothelial cells in the intima were round shaped and their cellulrar surface was corrugated, these changes remained to 72 hours after SAH with intimal thickening and loss of tight intercellular junction. But since 7 days after SAH, the endothelial cells assumed a more normal spindle-shaped configuration with tight intercelluar junction and an increase in cytoplasmic filaments and vacuoles. The internal elastic laminae was thickened and somewhat more electron dense than normal. In the media, the smooth muscle cells were most consistently and severely affected showing degeneration of mitochondria, vacuoles containing fine particles and loss of complex internal structure, surrounded by increased amounts of intercellular collagen. These findings concluded that the ultrastructural changes in the cat's basilar arterisl wall observed after induction of subarachnoid hemorrhage with fresh autogenous blood occurred as a consequence of vasospasm.
Animals ; Cats ; Cisterna Magna ; Collagen ; Cytoskeleton ; Endothelial Cells ; Intercellular Junctions ; Mitochondria ; Myocytes, Smooth Muscle ; Subarachnoid Hemorrhage* ; Vacuoles ; Vasospasm, Intracranial

OBJECTIVES: The present study was designed to investigate the effect of ginseng saponin and its major active metabolite on the HPA axis under acute stress-i.c.v. injection stress, and immobilization stress, and to examine whether nitric oxide is involved in the mechanism of ginseng saponin on the HPA axis under acute stress. METHODS: In the experiment to study the effect of ginseng on HPA axis during stress, various dose of GTS were injected intracerebroventricularly(i.c.v.) or intraperitoneally(i.p.). Plasma corticosterone levels were measured 30 min after the i.c.v. injection stress. Immobilization stress was applied for 30 min and then blood was cellected for the assays of plasma corticosterone levels immediately after the completion of immobilization stress. To determine the active ginsenosides that can affect the stressinduced plasma corticosterone levels, various dose of each gisendosides(Rb1, Rb2, Rc, Re, Rf, Rg1, 20(S)-Rg3, and 20(R)-Rg3) were injected i.c.v. or i.p.. In the experiment to determine the involvement of the nitric oxide in the inhibitory effect of ginseng on the HPA, NG-Nitro-L-arginine methyl ester(L-NAME) and ginsenosides were coadministered i.c.v. or i.p., and plasma corticosterone levels were measured 30 min after stress was applied. RESULTS: First, the present study showed that ginseng total saponin, ginsenoside Rg3(S form), and ginsenoside Rc administered i.c.v. attenuated the intracerebroventricular injection stress-induced increase in plasma corticosterone levels, and these effects were removed by nitric oxide co-injection. Second, ginseng total saponin and ginsenoside Rc administered i.p. attenuated the immobilization stress-induced increase in plasma corticosterone levels, but ginsenoside Rg3(S form) did not attenuate the immobilization stress-induced increase in plasma corticosterone levels. The attenuative effects of ginseng total saponin and ginsenoside Rc in the immobilization stress-induced increase in plasma corticosterone levels were not affected by L-NAME co-injection. CONCLUSION: This study suggests that ginseng saponin attenuated stress-induced increase in plasma corticosterone levels and these effects were mediated by different mechanisms according to the components of ginseng saponin, and routes of administration.
Animals ; Axis, Cervical Vertebra ; Corticosterone* ; Ginsenosides ; Immobilization ; Mice* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitroarginine ; Panax* ; Plasma* ; Saponins*

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

Recently, techniques of magnetic resonance angiography(MRA) have been developed that permit a three dimensional display of vessel without infusion of a contrast agent. However, to be competitive with conventional angiography(CA). MRA should show not only morphology of vessel but should also provide functional inforrnation, as selective delineation of specific vascular territories. Selective presaturation of individual vessels causes signal loss within the territory supplied by the presaturated artery, without affecting vessels not crossing the presaturation slab. We applied the selective MRA to the study of blood flow dynamics in five patients wiih ischemic stroke, showing patent middle cerebral arteIy in spite of obstruction or severe stenosis of the ipsilateral internal carotid artery on MRA. Selective MRA was able to demonstrate the direction of blood flow and presence of collateral blood flow. Findings of selective MRA were correlated with those from CA. Selective MRA can be used as a noninvasive and useful means for imaging the blood supply of the major intracranial arteries.
Arteries ; Carotid Artery, Internal ; Constriction, Pathologic ; Humans ; Magnetic Resonance Angiography* ; Stroke*

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