Prognostic factors after curative resection hepatocellular carcinoma and the surgeon's role

PURPOSE: Patient, surgical, and tumor factors affect the outcome after surgical resection for hepatocellular carcinoma (HCC). The surgical factors are only modifiable by the surgeon. We reviewed our experience with curative resection for HCC in terms of surgical factors. METHODS: After analyses of the prospectively collected clinical data of 256 consecutive patients undergoing surgical resection for HCC, prognostic factors for disease-free survival (DFS) and overall survival (OS) were identified; all patients were stratified by tumor diameters > or 5 cm. CONCLUSION: Tumor recurrence after liver resection for HCC depends on tumor status, bleeding, and transfusions, which subsequently lead to poor patient survival. Surgeons can help improve the prognosis of patients by minimizing blood loss and transfusion, particularly in patients with larger tumors.

Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation

PURPOSE: The purpose of this study was to analyze the risk factors for delayed graft function (DGF) and determine its impact on the outcomes of deceased donor (DD) kidney transplantation (KT). METHODS: Between January 2000 and December 2011, we performed 195 DD renal transplants. After the exclusion of primary nonfunctional grafts (n = 4), the study recipients were divided into two groups-group I, DGF (n = 31, 16.2%); group II, non-DGF (n = 160, 83.8%). The following variables were compared: donor and recipient characteristics, patient and graft survival, postoperative renal function, acute rejection (AR) episodes, and the rates of surgical and infectious complications. RESULTS: Donor-related variables that showed significant differences included hypertension (P = 0.042), diabetes (P = 0.025), and prerecovery serum creatinine levels (P 20%, P = 0.008). On multivariate analysis, only the prerecovery serum creatinine level (P < 0.001; hazard ratio [HR], 1.814) was an independent risk factor for the development of DGF. A Cox multivariate analysis of risk factors for graft survival identified these independent risk factors for graft survival: nephron mass (donor kidney weight to recipient body weight ratio) index (P = 0.026; HR, 2.328), CMV infection (P = 0.038; HR, 0.114), and AR episode (P = 0.038; HR, 0.166). CONCLUSION: In DD KT, an independent risk factor for DGF was the prerecovery serum creatinine level. Although there was a significant difference in graft survival between the DGF and non-DGF groups, DGF was not an independent risk factor for graft failure in this study.

Expression of alpha3beta1 Integrin in ECV304 Endothelial Cells and Angiogenesis / 대한해부학회지

Angiogenesis is a fundamental biological process including endothelial cell adhesion, migration, invasion and tube formation. Integrin receptors of endothelial cells play important roles in angiogenesis. They mediate cell-cell contact and cell adhesion to extracellular matrix. Roles of integrins have been described for a number of cell types. ECV304 endothelial cells were known to overexpress alpha3beta1 integrin and to form tube like structure in 3-D Matrigel culture. However the function of alpha3beta1 integrin in endothelial cells remains to be determined. Therefore, we have investigated morphological characteristics of ECV304 cells and roles of alpha3beta1 integrin in angiogenesis. To elucidate several characteristics, ECV304 endothelial cells were compared with HUVEC in the aspect of morphology, localization of integrins, angiogenesis pattern. In addition, role of alpha3beta1 integrin were analyzed in the aspect of endothelial cell binding, migration, invasion and tube formation on Matrigel. The result showed that alpha3beta1 integrin overexpressed ECV304 endothelial cells showed strong adhesiveness to extracellular matrix proteins, and high migration and invasion activities. Furthermore, expression of alpha3beta1 integrin was increased according to time course during in vitro culture and was continuously strong in ECV304 cells on 3-D Matrigel culture. These results indicate that alpha3beta1 integrin is able to be a critical component in control of angiogenesis by regulation of cell adhesion, migration, invasion and tube formation of ECV304 endothelial cells.

A STUDY ON TMJ DISC POSITION BY MAPPING METHOD

According to the autopsy study for the temporomandibular joint disc position, rotation and sideway displacements as well as anterior displacement of TMJ discs are important aspect of internal derangement. There were some trials to suspect anterior and sideway disc displacements through MR images. But the sagittal and the coronal views of MRI could only show the image of cutted slices, these images were not sufficient for showing the entire correlations amomg glenoid fossa, condylar head and articular disc. In this study we combined the images of the each slice of sagittal views like drawing a map, then we could see the interrelations among these three major components of TMJ smore precisely. Applying this method to both asymtomatic volunteers and TMD patients, we classified the interrelationships between condylar head and articular disc of TMJ as twelve types. The distributions are as follows: 1. In asymptomatic volunteers cases, normal relations were 65.0%, sideways or rotational displacements without anterior displacement were 20.0%, only anterior displacements were 15.0%, and anterior displacements combined with rotational displacements were 5.0%. 2. In unaffected sides of TMD patients, normal relations were 42.1%, rotational displacements were 11.8% and anterior displacements were 47.0%. 3. In affected sides of TMD patients, normal relations were 10.6%, sideways or rotational displacements were 13.6%, anterior displacements were 75.8%. 4. In asymptomatic volunteers or unaffected sides of TMD patients, pure anterior displacement was more prominent than combined with sideways or rotational displacement, but in affected sides of TMD patients pure anterior displacement was less prominent.