Complete Remission with Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma Who Showed Early Recurrence following Surgical Resection

Although surgical resection is a curative treatment option for solitary hepatocellular carcinoma, high recurrence rate contributes to dismal long-term prognosis after curative resection. Early recurrence within 2 years after surgery is associated with intrahepatic metastasis of primary tumor. Liver regeneration after hepatic resection can accelerate tumorigenesis in remnant liver. Treatment strategies for intrahepatic recurrence after curative resection include salvage transplantation, repeated resection, local ablation, and transarterial chemoembolization (TACE). Here, we report a 51-year-old male who was presented with a single large tumor located at segment 4. The patient was initially treated with surgical resection, but intrahepatic recurrence occurred only 4 months after surgery. He achieved complete remission with repeated TACE and has survived without recurrence for 4 years so far.

Relation Dietary and Urinary Na, K, and Ca Level to Blood Pressure in Elderly People in Rural Area

It has been considered that high Na intake, and low Ca/K intake are related to the incidence of hypertension. In this preliminary study, dietary Na, K, and Ca intake and their urinary excretion in rural area in Kyungpook province were measured to recognize the relationship between those blood pressure-related minerals and blood pressure regulation in elderly people in rural area of South Korea. Sixty eight subjects (male 39, female 29) aged over 60 were randomly selected in rural area in South Korea. Blood pressure and soup saltness were measured, and dietary intake using 24 hours recall and urinary excretion of Na, K and Ca were measured. Depending on the blood pressure level, the data were analyzed using non-parametric ANOVA of Kruskal Wallis analysis on the basis of categorizing of one of four blood pressure groups, such as normal, high normal, hypertension I and hypertension II. Mean systolic (124.2+/-15.1 mmHg) and diastolic (79.0+/-10.2 mmHg) blood pressures were within the normal range. Soup saltiness and systolic pressure was positively correlated (p<0.05). Even without statistical significance, dietary Na intake was higher in the upper systolic blood pressure groups then in the lower ones, which suggested higher Na intake caused the increase of blood pressure. No consistency was shown between the urinary concentration of Na, K, Ca level and blood pressure level, respectively. From the results of this study, it is assumed that high Na intake might be related to the incidence of hypertension. Further study with large sample size is needed to supplement the limitation of this preliminary study.

Macronutrient, Mineral and Vitamin Intakes in Elderly People in Rural Area of North Kyungpook Province in South Korea

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly, even it is worse in rural areas. In the present study, we conducted the anthropometric measurement and the dietary intakes including macronutrients, minerals and vitamins to assess the nutrient intakes and nutritional risk in elderly people in rural kyungpook province in South Korea. Subjects (n = 168, mean age, 67.3 yrs) were interviewed using d general questionnaire and 3 days of 24-hours recall for dietary intake. Nutrient intakes were analyzed using CAN-pro soft program and compared to Korean RDA and nutrition reference values (NRV). The anthropometric measurement showed that the weight and the height of the subjects in the rural area were below the average of the same age of Korean elderly people. The energy and protein intakes were 85% and 90% of Korean RDA, respectively. The intakes of lipid, cholesterol and dietary fiber were 62%, 40% and 22% of NRV for Korean adults. Main sources for protein and lipid intakes came from the vegetable sources and this pattern was more prominent in female elderly people. Ca intake was half of Korean RDA (56%), while P intake was 132% of Korean RDA. For the antioxidant trace mineral (Fe, Cu, Mn, Zn, and Se) intakes, Fe and Zn intakes were 78% and > 103% of Korean RDA. Cu, Mn and Se intakes were > 113%, > 275%, and > 185% of Korean NRV. Thiamin, niacin and vitamin C intakes were above Korean RDA, but the intakes of vitamin A and riboflavin were 88% and 63% of Korean RDA, respectively. On summarizing the results of the present study, the elderly people in rural area consume less lipid, cholesterol, Ca, and dietary fiber. Ca intake is lower, while P intake is higher, and this would be the potential risk for bone health. Also, Na intake was high, which can be the potential risk for the cardiovascular disease prevailance. Vitamin intakes were fairly good status, excepting riboflavin. Antioxidant mineral intakes were much higher than Korean NRV, unexpectedly. The results suggest that the elderly people in rural area have inadequate intakes of protein, lipid, dietary fiber and Ca, which mainly should be supplied from animal products. Recommendations to increase diet variety would be emphasized for this nutritionally poor-conditioned subjects, specially including animal food products and high dietary fiber food.