Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis
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- Annals of Hepato-Biliary-Pancreatic Surgery
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- v.28 no.2
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- pp.134-143
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- 2024
Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.
This study investigates the perceptions, Stages of Concern (SoC), and Levels of Use (LoU) regarding process-based assessment among Home Economics (HE) teachers to determine the necessary support for its implementation in schools. Data were gathered from a survey administered to HE teachers. The results are as follows. First, HE teachers viewed process-based assessment favorably, valuing its multifaceted evaluation approach over result-based assessment. The feedback from process-based assessments was seen as an opportunity for reflection for both educators and students. While some teachers expressed uncertainty about the optimal timing of implementation, they generally demonstrated a sound understanding of the feedback concept within the assessment process. HE teachers were predominantly concerned with their own professional expertise and the learning outcomes of their students. The majority of HE teachers have utilized process-based assessments for at least one semester. None deemed it irrelevant to their practice or showed disinterest in its adoption. Those who had yet to implement it were either in the first(introduction) or the second(preparation) stages.
Internet commerce has been growing at a rapid pace for the last decade. Many firms try to reach wider consumer markets by adding the Internet channel to the existing traditional channels. Despite the various benefits of the Internet channel, a significant number of firms failed in managing the new type of channel. Previous studies could not cleary explain these conflicting results associated with the Internet channel. One of the major reasons is most of the previous studies conducted analyses under a specific market condition and claimed that as the impact of Internet channel introduction. Therefore, their results are strongly influenced by the specific market settings. However, firms face various market conditions in the real worlddensity and disutility of using the Internet. The purpose of this study is to investigate the impact of various market environments on a firm's optimal channel strategy by employing a flexible game theory model. We capture various market conditions with consumer density and disutility of using the Internet.
This study aimed to investigate responses of photosynthesis, plant growth, and phytochemical contents to different artificial light sources for 'Seneca RZ' and 'Gaugin RZ' two butterhead lettuce (Lactuca sativa L.). In this study, fluorescent lamps (FL), three colors LEDs (red, blue and white, 5 : 4 : 1; RBW) and metalhalide lamps (MH) were used as artificial lighting sources. Photoperiod, air temperature, relative humidity, EC, and pH in a cultivation system were maintained at 16/8 h,
Purpose: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. Results: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Conclusion: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.
Purpose : Acute poststreptococcal glomerulonephritis(APSGN) follows infection of group A
Purpose: This study was conducted to assess the nutritional status of female marriage immigrants attending Korean language class in Gwangju, Korea by analyzing daily food and nutrient intake. Methods: Eighty-three female immigrants completed a survey. Anthropometric measurements were obtained, and dietary food intake was assessed using a 1-day 24 hour recall method. Results: The average length of residence in Korea was 5.3 years, and mean age of subjects was 31.0 years old. The home countries of subjects were Vietnam (50.6%), China (24.1%), Philippines (13.3%), and others (12%). Due to the length of residence, there were significant differences in body weight (p < 0.05), BMI (p < 0.05), percent body fat (p < 0.05), and diastolic blood pressure (p < 0.05). The subjects who were 30~49 years old consumed more vegetables and less seaweed than the subjects who were 20~29 years old. The other kinds of consumed foods were similar among groups in different age groups or lengths of residence in Korea. Average energy intake of subjects was 1,641.0 Kcal. The group with less than 5 years of residence showed higher cholesterol intake than the group with 5 or more years of residence in Korea (p < 0.05). There was no significant difference in nutrient intake between the groups of different age or length of residence. There was a positive association among dietary cholesterol intake and consumption of eggs, milk. and dairy products, and blood pressure. Conclusion: The study shows that length of residence affects rate of obesity and nutritional status. Further extensive research is needed to understand the effect of dietary changes and nutritional status of female marriage immigrants as well as for their successful adaptation to develop a more active and long-term nutrition education program.
Background: Superoxide anion which was produced by macrophage and neutrophil has a defensive role to kill invasive microorganisms and also an injurious role to produce self lung damage. Production of oxygen free radicals including superoxide is a main mechanism of acute lung injury caused by bacterial endotoxin. Endotoxin is known to activate alveolar macrophage to produce increased oxygen free radicals after the stimulation with various biological materials (priming effect). Calcium is a very important intracellular messenger in that cellular process of superoxide production. Method: This experiment was performed to elucidate the effects of endotoxin and calcium on superoxide production by phorbol myristate acetate-stimulated alveolar macrophage and the effect of verapamil on priming effect of endotoxin. Results: 1) Preincubation of macrophages with endotoxin (E. coli 055-B5) primed the cells to respond with increased superoxide production after the stimulation with PMA. Priming with endotoxin (
Numerous studies have suggested that dietary flavonoids contribute to prevent cardiovascular disease. Onion contains many functional phytochemicals such as quercetin. The aim of this study was to examine whether onion peel extracts supplementation affect blood lipid profiles and blood coagulation in animal model. Total 48 Sprague-Dawley male rats at 5 weeks old were divided into 6 groups with different diets(C: control, HF: high fat diet, HFOE 0.01%: high fat+onion peel extract 0.01% diet, HFOE 0.02%, HFOE 0.05%, HFOE 0.1%) for 8 weeks. Onion peel extract supplementation significantly decreased serum levels of LDL-cholesterol and increased HDL-cholesterol, while total cholesterol and triglyceride levels were not affected. Hematological parameters(hematocrit, white blood cell, red blood cell, and platelet count) and blood coagulation parameters(prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen) were not significantly different among 6 groups. However, activated partial thromboplastin time of HFOE 0.05% group was significantly longer than that of HF group. These results indicate that onion peel extract supplementation displays hypocholestrolemic effects but does not seem to have anti-coagulation effects in high fat fed SD rats.
Chemical and microbial characteristics of bacterial populations were investigated in a quercus and pine humus forest soil. Soil pH was shows the channel structures analyzed in this study. Before the Internet channel is introduced, a monopoly manufacturer sells its products through an independent physical store. From this structure, the manufacturer could introduce its own Internet channel (MI). The independent physical store could also introduce its own Internet channel and coordinate it with the existing physical store (RI). An independent Internet retailer such as Amazon could enter this market (II). In this case, two types of independent retailers compete with each other. In this model, consumers are uniformly distributed on the two dimensional space. Consumer heterogeneity is captured by a consumer's geographical location (ci) and his disutility of using the Internet channel ( shows various market conditions captured by the two consumer heterogeneities. (a) illustrates a market with symmetric consumer distributions. The model captures explicitly the asymmetric distributions of consumer disutility in a market as well. In a market like that is represented in (c), the average consumer disutility of using an Internet store is relatively smaller than that of using a physical store. For example, this case represents the market in which 1) the product is suitable for Internet transactions (e.g., books) or 2) the level of E-Commerce readiness is high such as in Denmark or Finland. On the other hand, the average consumer disutility when using an Internet store is relatively greater than that of using a physical store in a market like summarizes the various scenarios of consumer distributions analyzed in this study. The range for disutility of using the Internet (
summarizes the analysis results. As the average travel cost in a market decreases while the average disutility of Internet use remains the same, average retail price, total quantity sold, physical store profit, monopoly manufacturer profit, and thus, total channel profit increase. On the other hand, the quantity sold through the Internet and the profit of the Internet store decrease with a decreasing average travel cost relative to the average disutility of Internet use. We find that a channel that has an advantage over the other kind of channel serves a larger portion of the market. In a market with a high average travel cost, in which the Internet store has a relative advantage over the physical store, for example, the Internet store becomes a mass-retailer serving a larger portion of the market. This result implies that the Internet becomes a more significant distribution channel in those markets characterized by greater geographical dispersion of buyers, or as consumers become more proficient in Internet usage. The results indicate that the degree of price discrimination also varies depending on the distribution of consumer disutility in a market. The manufacturer in a market in which the average travel cost is higher than the average disutility of using the Internet has a stronger incentive for price discrimination than the manufacturer in a market where the average travel cost is relatively lower. We also find that the manufacturer has a stronger incentive to maintain a high price level when the average travel cost in a market is relatively low. Additionally, the retail competition effect due to Internet channel introduction strengthens as average travel cost in a market decreases. This result indicates that a manufacturer's channel power relative to that of the independent physical retailer becomes stronger with a decreasing average travel cost. This implication is counter-intuitive, because it is widely believed that the negative impact of Internet channel introduction on a competing physical retailer is more significant in a market like Russia, where consumers are more geographically dispersed, than in a market like Hong Kong, that has a condensed geographic distribution of consumers.
Effects of Artificial Light Sources on the Photosynthesis, Growth and Phytochemical Contents of Butterhead Lettuce (Lactuca sativa L.) in the Plant Factory
(식물공장에서 인공광원의 종류가 반결구상추의 광합성, 생육 및 기능성물질 함량에 미치는 영향)
Usefulness of
Prognosis of Acute Poststreptococcal Glomerulonephritis (APSGN) in Children
(소아 연구균 감염 후 급성 사구체 신염의 예후)
Food intake and nutritional status of female marriage immigrants residing in Gwangju, Korea
(광주지역 결혼이주여성의 식품 및 영양소 섭취 실태)
Effects of Endotoxin and Verapamil on Superoxide Production by Rat Alveolar Macrophage
(백서폐포대식세포에서의 Superoxide 생산에 미치는 내독소 및 Verapamil의 영향)
Effect of Onion Peel Extracts on Blood Lipid Profile and Blood Coagulation in High Fat Fed SD Rats
(고지방 섭취 흰쥐에서 양파 껍질 추출물의 보충 섭취가 혈중 지질농도와 혈행 개선에 미치는 효과)
Comparison of Phylogenetic Characteristics of Bacterial Populations in a Quercus and Pine Humus Forest Soil
(활엽수림과 침엽수림 부식토 내 세균군집의 계통학적 특성 비교)
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