ABSTRACT
BACKGROUND: Hepatocellular carcinoma(HCC) is one of the important causes of cancer-related mortality and morbidity in East Asia, including Korea. Most of the hepatocellular carcinoma in Korea are associated with hepatitis B and C virus infection. The clinical characteristics and prognosis of the patients with HCC were evaluated in relation to the type of hepatitis virus. METHODS: A retrospective analysis of the clinical data and survival rate was done in 603 patients(M:F=4.9:1, mean age; 54.2 years) who were admitted to Yonsei medical center from April, 1991 through April, 1994. RESULTS: Among 603 patients, tests for HBsAg and anti-HCV was done simultaneously in 455 patients. Out of the 455 HCC patients, 303 patients (66.6%) were classified as Group B(HBsAg+ve, anti-HCV-ve), 102 patients (22.4%) were classified as Group C (HBsAg-ve, anti-HCV+ve), 45 patients (9.9%) were classified as Group non-BC (HBsAg-ve, anti-HCV-ve), and 5 patients (1.1%) were classified as Group BC (HBsAg+ve, anti-HCV+ve). The mean age of the patients in Group C was older than that of Group B (64.9 vs. 51.3 yr) (p400 ng/mL) was significantly higher in Group B than in Group C (70.0 vs. 52.0%)(p<0.05). According to the gross type, nodular type was more common in Group C than in Group B(72.0 vs. 38.1%) (p<0.01). The incidence of portal vein thrombosis was significantly lower in Group C compared with that in Group B (16.7 vs. 31.4%)(p<0.05). The number of the patients whose tumor size of less than 5 cm was significantly higher in Group C than in Group B (35.3 vs. 17.8%) (p<0.05). Using multivariant analysis, independent prognostic factors were found to be Child grading, FP level, size of the tumor, gross type, and the type of hepatitis virus. The cumulative survival rate of 1, 2, and 3 year in each Group was 31.5%, 17.5%, and 10.8%, respectively in Group B, and 55.7%, 30.2%, and 21.6%, respectively in Group C. The median duration of survival of Group B was significantly shorter than that of Group C(5.0 vs. 13 months)(p<0.05). CONCLUSION: About 90 % of HCC was associated with hepatitis B or C viral infection in Korea. Hepatitis B virus associated HCC had poorer prognosis compared with hepatitis C virus associated HCC in Korea.
Subject(s)
Child , Humans , Carcinoma, Hepatocellular , Asia, Eastern , Hepacivirus , Hepatitis B , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis Viruses , Hepatitis , Incidence , Korea , Liver Cirrhosis , Mortality , Prognosis , Retrospective Studies , Survival Rate , Venous ThrombosisABSTRACT
BACKGROUND/AIMS: Generally, candida esophagitis has a low incidence of occurrence, but the prevalence of candida esophagitis was found to be higher in cases involving patients with impaired immunity due to an underlying disease and thereby using immunosupressive drugs. This study was designed to evaluate the relation of symptoms, endoscopic findings, and pathologic findings of each patient. METHODS: Between January 1993 and August 1996, 14,090 upper digestive tract endoscopies were done in Inha hospital. Among those patients, 20 cases of candida esophagitis (0.14%) were confirmed by an endoscopic biopsy. During these same endoscopic sessions, retrospectively reviews were conducted.
Subject(s)
Humans , Biopsy , Candida , Esophagitis , Gastrointestinal Tract , Incidence , Prevalence , Retrospective StudiesABSTRACT
Angiodysplasia is probably responsible for 2.6-6.2% of cases involving of lower gastrointestinal bleeding and 1.2-8.0% of cases involving hemorrhages from the upper GI tract. Small bowel neoplasia is rare, accounting for about 5% of gastrointestinal tumors overall and 2-3% of all malignacies. The third most common malignany of the small bowel is the sarcoma, of which the leiomyosarcoma is the most frequent. A 54-year-old male patient was admitted with the chief complaints of dizziness and headache during 2 months. Laboratory findings revealed iron deficiency anemia. A superior mesenteric arteriography found an intensive vascular stained mass in the hepatic flexure. A celiac artery angiography discovered a irregulary vascular stained lesion in the Ll vertebral level. A colonoscopy located a 10 mm sized angiodysplasia in the right colon. According to these findings, we presumed that these lesions are a colonic angiodysplasia and a suspicious duodenal lesion. The operation was perfomed. The final diagnosis was a colonic angiodysplasia combined with leiomyosarcoma of the duodenum. The rarity of this case is emphasized and the literative reviewed.
Subject(s)
Humans , Male , Middle Aged , Anemia, Iron-Deficiency , Angiodysplasia , Angiography , Celiac Artery , Colon , Colonoscopy , Diagnosis , Dizziness , Duodenum , Headache , Hemorrhage , Leiomyosarcoma , Sarcoma , Upper Gastrointestinal TractABSTRACT
Peliosis hepatis is characterized by the presence in the liver of blood-filled cavities, which may or may not be lined with sinusoidal cells. The individual cysts or cavities usually do not exceed several centimeters in diameter. The cysts are typically continuous with adjacent, more normal sinusoids, and they sometimes can be seen in continuity with hepatic venous tributaries. The lesion is usually diagnosed by gross or microscopic examination. When suspected, it can be diagnosed by percutaneous liver biopsy. In the past, peliosis hepatis is primarily associated with wasting diseases, such as tuberculosis, malignancy, and chronic suppurative infection. However, recently peliosis hepatis is seen most commonly in association with the administration of anabolic steroids or HIV infection. We report a case of peliosis hepatis that is diagnosed by peritoneoscopic live biopsy and not associated with known disease.
Subject(s)
Biopsy , HIV Infections , Laparoscopy , Liver , Peliosis Hepatis , Steroids , Tuberculosis , Wasting SyndromeABSTRACT
The majority of cystic lesions of the pancreas are psudocysts and a small fraction neoplastic. Failure to recognize the true nature of neoplastic cyst will lead to an incorrct treatment strategy. Ultrasonography, computerized tomography and angiography were used to distingish these lesions, but diagnostic value of ERCP is in controversy. To evaluate the diagnostic value of ERCP in cystic lesions of the pancreas, we analysed 33 cases of pancreatic cystic lesions (pseudocyst 18 cases, retention cyst 3 cases and cystic, neoplasm l2 cases) between Apr. 1985 and June 1993. In 18 cases of pseudocysts, ERP findings were communication with cyst in 8 cases (44.4%), chronic pancreatitis in 8 cases (44.4%), obstruction in 4 cases (22.2%) and displscement of pancreatic duct in 2 cases (11.1%), and ERC findings, which were perfomed in 8 cases, showed cholangitis in 3 cases (37.5%), CBD stone in 2 cases (25%), mass effect in 1 case (12.5%) and normal in 2 cases (25%). There was no communication with the cyst and pancreatic duct, except two mucinous ductal ectasia, in 12 cases of cystic neoplasms, and the other findings were displacement of pancreatic duct in 4 cases (33.3%), obstruction in 2 cases (16.7%) and normal in 4 cases (33.3%). ERC findings of cystic neoplasm were almost normal (85.7%) except 1 case of cholangitis. In conclusion, ERCP findings of pseudocysts were communication with pancreatic duct, chronic pancreatitis and biliary tract abnormality. In contrast, ERCP findings of cystic neoplasms were displacement or obstruction of pancreatic duct without communication and chronic pancreatitis, and biliary tract abnormality were rare.
Subject(s)
Angiography , Biliary Tract , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis , Dilatation, Pathologic , Mucins , Pancreas , Pancreatic Cyst , Pancreatic Ducts , Pancreatitis, Chronic , UltrasonographyABSTRACT
There is growing evidence that oxygen-derived free radicals(OFR's) play a role in the pathogenesis of pancreatic diseases, especially of acute pancreatitis. Many types of experimental ex vivo and in vitro pancreatitis can be inhibited by superoxide dismutase and catalse. (continue...)