Postoperative recurrence pattern and prognosis of patients with hepatocellular carcinoma, with particular reference to the hepatitis viral infection status.

BACKGROUND & AIMS: Various modalities have been employed effectively according to the tumour recurrence status in patients with hepatocellular carcinoma (HCC) undergoing hepatectomy. Therefore, their overall prognosis depends largely on the pattern of recurrence/treatment. We investigated the patterns of recurrence and prognosis in HCC patients, especially in relation to the hepatitis virus infection status. METHODS: The study population comprised 244 patients with HCC undergoing hepatectomy. Curative treatments, including repeated hepatectomies, were performed for recurrences, whenever possible. Detailed information on recurrences was collected until the recurrences exceeded Milan criteria. RESULTS: The 5-year disease-free survival, survival within the Milan criteria and overall survival were 38.4%, 56.3% and 74.5% respectively. In the comparison between patients with hepatitis C and B virus-related HCC (HC-HCC: n = 122; and HB-HCC: n = 45 respectively), the former showed lower disease-free (30.2% vs. 40.7% at 5 years, P = 0.061) and overall (65.7% vs. 89.7% at 5 years, P = 0.011) survivals; they also showed a higher incidence of multinodular (≥4) intrahepatic recurrences (19.4% vs. 5.3% at 3 years, P = 0.010). However, the incidences of recurrences exceeding the Milan criteria because of other components were comparable. Patients with HC-HCC showed a higher incidence of intrahepatic recurrences characterized by multiple lesions and the difference became increasingly more pronounced with time. CONCLUSIONS: Patients with HC-HCC were associated with a higher carcinogenesis in the background liver than those with HB-HCC, and this difference was aggravated with time after hepatic resection.

Sexual dimorphism in shape and distribution of GABA-like immuno-reactive neurons in cricket terminal abdominal ganglion.

We studied age-related sexual dimorphism of the terminal abdominal ganglion in the cricket, Gryllus bimaculatus using osmium/ethyl-gallate staining and GABA immunohistochemistry. We determinedthat the volume of the terminal abdominal ganglion increases with increasing body size. The growth ratio between longitude and width in the terminal abdominal ganglion is the same in all nymph stages and sexes. However, the longitudinal growth of the male terminal abdominal ganglion ceases in the 8th instar and the adult stage. Therefore, in the adult stage, sexual dimorphism is observed in ganglion morphology. Additionally, sexual dimorphism is also observed in numbers of neuronal somata and GABA-like immunoreactive neurons in the terminal abdominal ganglion. At the beginning of the 8th instar, the number of somata is greater in female crickets than in males. GABA-like immunoreactive neurons, which were classified into eight clusters, increased between the 8th instar and adult in both sexes, but their numbers were sexually dimorphic in the 7th and 8th instars, and in the adult. Females had a greater number of GABA-like immunoreactive neurons than males. These differences occurred mainly in the 8th neuromere cluster, as well as the anterior region of the 9-11th neuromeres.