Progressive liver fibrosis is a similar feature of all chronic liver diseases and eventually develops liver cirrhosis. The prognosis and treatment plans of chronic liver diseases depend strongly on the degree of liver fibrosis. These facts raise clinical interests in quantifying liver fibrosis. Although liver biopsy has been the gold standard for assessment of liver fibrosis, it has some technical limitations and risks. Accordingly, an increasing need for alternative non-invasive method to quantify liver fibrosis has been a major challenge that has stimulated search for new non-invasive methods. Such methods for diagnosing liver fibrosis have progressed significantly over the last few years notably with the appearance of several serological markers which have been reported to predict the presence of significant fibrosis or cirrhosis in patients with chronic liver disease with considerable accuracy. However, complicated calculation, cost problems, and influences of extrahepatic conditions make it less accessible to clinicians. Recently, liver stiffness measurement using FibroScan(R) is emerging as a new diagnostic method for liver fibrosis. It is totally non-invasive and reproducible and gives an immediate result without intra- and inter-observer variability. Its clinical use in comparison with liver biopsy and several available serologic markers is now intensively being investigated. Here, we review the currently available data on FibroScan(R).
Biopsy ; Fibrosis ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Observer Variation ; Prognosis

Telbivudine is an L-nucleoside analogue with potent antiviral activity against hepatitis B virus (HBV). Clinical trials have shown that telbivudine has a more potent and sustained antiviral activity with a lower frequency of viral resistance than lamivudine. Although there are several reports concerning the safety profile of telbivudine, most adverse events are described as mild and transient in nature. Here we report two cases of telbivudine-induced myopathy in patients with chronic hepatitis B who were siblings.
Adult ; Antiviral Agents/adverse effects/*therapeutic use ; Creatine Kinase/blood ; Electromyography ; Hepatitis B, Chronic/*drug therapy/metabolism/pathology ; Humans ; Male ; Muscle, Skeletal/pathology ; Muscular Diseases/etiology ; Siblings ; Thymidine/adverse effects/*analogs & derivatives/therapeutic use

Background: This study examined possible risk factors for myringosclerosis formation after ventilation tube insertion (VTI). Methods: A retrospective study was performed in a single tertiary referral center. A total of 582 patients who underwent VTI were enrolled in this study. Patients were divided into two groups based on the presence or absence of myringosclerosis: MS+ and MS−. Characteristics of patients were collected through medical chart review; these included age, gender, nature and duration of effusion, type of ventilation tube (VT), duration and frequency of VTI, incidence of post-VTI infection, incidence of intraoperative bleeding, and presence of postoperative perforation. Incidences of risk factors for myringosclerosis and the severity of myringosclerosis in association with possible risk factors were analyzed. Results: Myringosclerosis developed in 168 of 582 patients (28.9%) after VTI. Patients in the MS+ group had an older mean age than those in the MS− group. The rates of myringosclerosis were higher in patients with older age, serous otitis media, type 2 VT, post-VTI perforation, and frequent VTI. However, there were no differences in occurrence of myringosclerosis based on gender, duration of effusion, duration of VT placement, incidence of post-VTI infection, or incidence of intraoperative bleeding. The severity of myringosclerosis was associated with the duration of effusion and frequency of VTI. Conclusion Older age, serous effusion, type 2 VT, presence of post-VTI perforation, and frequent VTI may be risk factors for myringosclerosis after VTI; the severity of myringosclerosis may vary based on the duration of effusion and frequency of VTI.

Laparoscopic retroperitoneal lymph node dissection, especially when performed with the da Vinci Surgical System (Intuitive Surgical), has shown excellent cosmetic results with similar oncologic outcomes to those of open surgery. In this study, we present a case of robot-assisted retroperitoneal lymph node dissection performed in an 18-year-old man who was diagnosed with a stage IIIb mixed germ cell tumor and who was initially treated with radical orchiectomy, followed by chemotherapy. This case shows that robot-assisted retroperitoneal lymph node dissection is technically feasible, safe, and cosmetically favorable, even when performed on patients with high-stage disease or after chemotherapy.
Adolescent ; Chemotherapy, Adjuvant ; Humans ; Laparoscopy/methods ; Lymph Node Excision/*methods ; Lymphatic Metastasis ; Male ; Neoplasm Staging ; Neoplasms, Germ Cell and Embryonal/pathology/radiography/*secondary/therapy ; Orchiectomy ; Robotic Surgical Procedures/*methods ; Testicular Neoplasms/pathology/radiography/*secondary/therapy ; Tomography, X-Ray Computed

Silver-Russel syndrome (SRS) is a disorder present at birth that involves poor growth, low birth weight, differences in the size of the two sides of the body, and genital anomalies. The diagnosis is based on distinct prenatal growth restriction and the presence of typical dysmorphic features, including short stature and limb asymmetry. We report a case of bilateral cryptorchidism with no other genital anomalies in SRS. This report provides an overview of the genital anomalies of SRS and describes, for the first time, a laparoscopic orchiopexy in SRS.
Cryptorchidism ; Dwarfism ; Extremities ; Fetal Growth Retardation ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Laparoscopy ; Male ; Orchiopexy ; Parturition

OBJECTIVE: Central nervous system has unique inflammatory responses to the exposure to the endotoxin and immature brain may have a different response with that of the mature. The authors conduct this experiment to elucidate the characteristics of inflammatory response in immature brain. METHODS: Lipopolysaccharide(LPS) was injected in the right caudate nucleus in 7-day-old and adult Sprague-Dawley rats. The doses were 1 microliter of 0.1, 0.5, and 2.0mg/ml of LPS and the same amount of saline for controls. The rats were sacrificed 24hours after injections. Light microscopic examination was performed to evaluate the leukocyte recruitment, and reverse transcriptase-polymerase chain reaction(RT-PCR) to measure the expression of interleukin-1beta(IL-1beta) and tumor necrosis factor-alpha(TNF-alpha) mRNA. RESULTS: Light microscopic examination revealed more pronounced leukocyte infiltration in neonatal brain than in adult, even though lower than in peripheral tissue. RT-PCR revealed dose dependent expression of IL-1beta and TNF-alpha mRNA in both neonatal and adult brain as in peripheral tissue. CONCLUSION: These results support that the immature brain is more vulnerable to the LPS induced inflammation in terms of leukocyte infiltration and possibly resultant brain damage. However, the mechanism of inflammatory response in immature brain should be studied further in association with the research of the activity of microglia, astrocyte, blood brain barrier, chemokine, and adhesion molecule in immature brain.
Adult ; Animals ; Astrocytes ; Blood-Brain Barrier ; Brain* ; Caudate Nucleus ; Central Nervous System ; Humans ; Inflammation ; Interleukin-1beta ; Leukocytes ; Microglia ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Tumor Necrosis Factor-alpha

BACKGROUND: Telomerase, an enzyme synthesizing telomere, plays an important role in cell immortalization and carcinogenesis. Telomerase activity is detected in large number of malignant tumors and also in precancerous lesions, such as intestinal metaplasia. It suggests that telomerase activation may be an early event in carcinogenesis. Helicobacter pylori (H. pylori) infection is the major carcinogen in gastric cancer. The aim of this study was to evaluate the relationship between telomerase activation and H. pylori infection in gastric cancer. METHODS: We measured telomerase activity and H. pylori infection using the tissues obtained by gastroduodenoscopy in 50 patients of gastric cancer. Telomerase activity was detected with a Telomerase PCR ELISA(R) kit and H. pylori infection was examined with a CLO(R) kit. RESULTS: Telomerase activity was detected in 32% of intestinal metaplasia and 72% of gastric cancer. The histological type, degree of differentiation, stage and ECOG performance status were found to be unrelated to telomerase activity. H. pylori infection was significantly higher in telomerase-positive patients of gastric cancer (p=0.016). Telomerase activity measured by photometric absorbance was significantly higher in intestinal metaplasia and cancers with H. pylori infection than in those without infection (p<0.05). CONCLUSION: This study suggested that H. pylori infection may induce telomerase activation in intestinal metaplasia and gastric cancer.
Carcinogenesis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metaplasia ; Polymerase Chain Reaction ; Stomach Neoplasms* ; Telomerase* ; Telomere

PURPOSE: We evaluated the biochemical recurrence (BCR) of prostate cancer patients treated by radical prostatectomy (RP) or radiotherapy (RT). MATERIALS AND METHODS: Patients who underwent RP or RT as primary definitive treatment from 2007 were enrolled for this study. They were divided into two groups; the low-intermediate risk group and the high risk group according to the National Comprehensive Cancer Network guidelines. We compared differences such as age, prostate specific antigen, Gleason score, follow-up duration, clinical T staging, and BCR. Their BCR-free survival rates were analyzed. RESULTS: A total of 165 patients were enrolled. There were 115 patients in the low-intermediate risk. Among them, 88 received RP and 27 underwent RT. BCR occurred in 9 of the RP patients (10.2%) and 3 of the RT patients (11.1%). For the high risk group, 50 patients were included. RP was performed in 25 patients and RT in 25 patients. BCR was observed in 4 of the RP patients (16%) and 12 of the RT patients (48%). There were no differences in BCR-free survival for the low-intermediate group (p=0.765). For the high risk group, the RP group had a higher BCR free survival rate (p=0.032). CONCLUSIONS: No difference of BCR and BCR-free survival was seen in the low-intermediate risk group but lower BCR and better BCR-free survival were observed for patients that received RP in the high risk group. RP should be a more strongly considered option when deciding the treatment method for selected high risk patients.
Aged ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prostate-Specific Antigen/blood ; Prostatectomy/*methods ; Prostatic Neoplasms/blood/pathology/*radiotherapy/*surgery ; Retrospective Studies

PURPOSE: To compare clinical and radiologic results after total knee arthroplasty (TKA) with posterior cruciate sacrificing (PCS) and posterior cruciate substitution (PS). MATERIALS AND METHODS: Of 66 knees in 53 patients with degenerative arthritis, we completed both practical and radiological evaluations for 27 patients with PCS TKA (30 knees) and 31 patients with PS TKA (36 knees). RESULTS: The knee score improved from 33 to 81.9 for PCS TKA and from 35 to 86.6 for PS TKA. Preoperative flexion was 104.5degrees in the PCS TKA group and 104.7degrees in the PS TKA group.These scores significantly improved to 113.9degrees and 104.7degrees respectively (p<0.05 for each). However, there was no significant difference between the two groups when comparing postoperative results and improvements (p>0.05). On radiological evaluation, the alpha angle was found to be 98.9degrees, the beta angle 89.9degrees , the gamma angle 5.0degrees, and the delta angle 39.2degrees for PCS TKA. Also, the alpha angle was 95.6degrees, beta angle 89.0degrees, gamma angle 9.0degrees, and delta angle 88.4degrees for PS TKA (p>0.05). Loosening was not encountered in either type. Postoperative complications were few; there was 1 knee (1.5%) with a polyethylene insert spin-out for the PCS TKA group and 1 knee (1.5%) with a periprosthetic fracture for the PS TKA group. CONCLUSION: On both clinical and radiological evaluations, PCS TKA and PS TKA demonstrated satisfactory results out to 4.5 years of follow up, which also indicated a lack of any significant difference between these two types.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Osteoarthritis ; Periprosthetic Fractures ; Polyethylene ; Postoperative Complications

PURPOSE: Health-related quality of life (HRQOL) information related to radical prostatectomy (RP) is valuable for prostate cancer (PC) patients needing to make treatment decisions. We aimed to investigate HRQOL change in PC patients who underwent three types of RP (open, laparoscopic, or robotic) and compared their HRQOL with that of general population. MATERIALS AND METHODS: Patients were prospectively recruited between October 2014 and December 2015. European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) and PC-specific module (PR25) were administered before surgery (baseline) and at postoperative 3 and 12 months. At each time point, HRQOL was compared, and a difference of 10 out of 0-100 scale was considered clinically significant. RESULTS: Among 258 screened patients, 209 (41 open, 63 laparoscopic, and 105 robotic surgeries) were included. Compared to baseline, physical, emotional, and cognitive functioning improved at 12 months. Role functioning worsened at 3 months, but recovered to baseline at 12 months. Pain, insomnia, diarrhea, and financial difficulties also significantly improved at 12 months. Most PR25 scales excluding bowel symptoms deteriorated at 3 months. Urinary symptoms and incontinence aid recovered at 12 months, whereas sexual activity and sexual function remained poor at 12 months. Clinically meaningful differences in HRQOL were not observed according to RP modalities. Compared to the general population, physical and role functioning were significantly lower at 3 months, but recovered by 12 months. Social functioning did not recover. CONCLUSION: Most HRQOL domains showed recovery within 12 months after RP, excluding sexual functioning and social functioning. Our findings may guide patients considering surgical treatment for PC.
Cohort Studies ; Diarrhea ; Humans ; Prospective Studies ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Quality of Life ; Sexual Behavior ; Sleep Initiation and Maintenance Disorders ; Weights and Measures