Background: Hepatocellular carcinoma (HCC) is one of the most common cancers in men and the third most common cancer in woman in Thailand. This retrospective study was designed to assess the prevalence, clinical manifestations, treatment outcomes and prognosis of HCC in the central region of Thailand. Materials and Methods: The authors retrospectively reviewed all HCC patients aged more than 15 years old in Thammasat university hospital (TUH) during the period from January 2007 to December 2012. Clinical information, biochemical tests and radiologic findings were collected from review of medical records. Results: There were 308 patients with HCC, which accounted for the prevalence of 5.19% of all cancers diagnosed in TUH during the study period. Of these, 125 (40.5%) had complete information retrievable from their medical records and met the inclusion criteria, 99 (79.2%) were males. The mean age was 57.4 years. A quarter of HCC patients in this study presented without any symptom before diagnosis. The common clinical presentations in the remaining patients were hepatomegaly 64/125 (51.2%), abdominal pain 56/125 (44.8%) and ascites 16/125 (20.8%). Cirrhosis was seen in almost all patients (92.8%). The most common causes of HCC in this study were chronic hepatitis B (49.6%) and C (19.2%). Based on Barcelona Clinic Liver Cancer staging, 75.4% presented at intermediate or late stage. Patients receiving curative therapy with either surgical treatment or radiofrequency ablation had significantly longer survival time after the HCC diagnosis than the palliative therapy group (11.0 months vs 4.0 months, p value= 0.004). The mean survival time after the HCC diagnosis was 10.5 months. Conclusions: The common causes of HCC in central region of Thailand were chronic hepatitis B and C. Surgical therapy or RFA seemed to provide better outcomes than other treatments but only in patients with early stage lesions. Most of the patients in this study presented with advanced diseases and had grave prognosis. Appropriate screening patients at risk for HCC might be an appropriate way to achieve early diagnosis and improve the treatment outcome.
Kim, Sang-Yong;Kim, Jin-Chul;Kim, Jeong-Ki;Kim, Hye-Jin;Lee, Hee-Min;Choi, Mi-Sun;Maeng, Pil-Jae;Ahn, Jeong-Keun
BMB Reports
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제41권2호
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pp.158-163
/
2008
Hepatitis B virus X protein (HBx) is essential for hepatitis B virus infection and exerts a pleiotropic effect on various cellular machineries. HBx has been also demonstrated as an indirect transcriptional transactivator of various different viral and cellular promoters. In addition, HBx is involved in the development of various liver diseases including hepatocellular carcinoma. However the mechanism of HBx in hepatocellular carcinogenesis remains largely unknown. In this study, to identify possible new cellular proteins interacting with HBx, we carried out yeast two-hybrid assay. We obtained several possible cellular partners including VBP1, a binding factor for VHL tumor suppressor protein. The direct physical interaction between HBx and VBP1 in vitro and in vivo was confirmed by immunoprecipitation assay. In addition, we found that VBP1 facilitates HBx-induced $NF{\kappa}B$ activation and cell proliferation. These results implicate the important role of HBx in the development of hepatocellular carcinoma through its interaction with VBP1.
Klinefelter's syndrome is the most common congenital abnormality that causes primary hypogonadism. It is associated with diseases that predominantly affect women, such as systemic lupus erythematosus (SLE), and it can sometimes cause veno-occlusive disease. We experienced a case of Budd-Chiari syndrome (BCS) in a 33-year-old man with Klinefelter's syndrome presented with hematemesis and edema in both lower extremities. The clinical and laboratory findings were compatible with SLE, antiphospholipid syndrome, and BCS. To the best of our knowledge, this is the first case report to describe a simultaneous presentation of these four clinical syndromes in a single patient.
In 1957, Schwarz and Foltz discovered that selenium (Se) was an essential trace mineral and nutritionists then started extensive studies to figure out the metabolic function of this element which has been called as toxic mineral. The discovery that glutathione peroxidase (GSH-Px) contained Se demonstrated a biochemical role for Se as an essential trace element. The major physiological function of Se containing GSH-Px is thought to maintain low levels of $H_2O_2$ and other hydroperoxides in the cell to prevent tissues from peroxidation damages. It is known that the GSH-Px activity is increased when animals were fed high dietary levels of Se. Chemical properties of Se have much in common with sulfur (S) therefore Se would follow the sulfur pathways in its metabolism in animal body. Two sources of Se are available for supplementation of Se in animal feed. Inorganic Se can also exist in selenide (-2), elemental (0), selenite (+4) and selenate (+6) oxidation state with other minerals. When sulfur in S containing amino acids is replaced by Se, organic Se can be made and named "eleno"prior to the name of S containing amino acid, i.e. selenomethionine. Selenium deficiency affects humans as well as animals and dysfunctions such as exudative diathesis, retained placenta, mastitis, liver necrosis, Keshan disease, numerous diseases and cancer. From several centuries ago, Se toxicity was recognized in various animal species and much of the current toxic Se levels has been established largely based upon the controlled toxicity studies used inorganic Se. Toxic effects of Se in animal result in reduced feed intake, growth retardation, ataxia, diarrhea, alopecia and sloughing of hooves. However, several experiments demonstrated that Se deficiencies or toxicities were varied by dietary Se levels and sources. Recent studies demonstrated that the incidence of colorectal and prostate cancer was reduced by approximately 50% when humans consumed 200 ${\mu}g$ of Se daily.
Background: Colorectal cancer (CRC) is an important cause of mortality and morbidity in many communities worldwide. This population based study was conducted to assess determinants of colorectal mortality in Iranian patients. Materials and Methods: A cohort of 1,127 cases of confirmed colorectal cancer registered in a population based registry covering 10 referral hospital in Tehran, Iran, were followed for five years. Information about tumor characteristics, smoking status and family history were collected at base line and survival status were followed every six months by contacting patient or next of kin (if patients died during the follow-up). The cause of death for each case was validated by verbal autopsy and referring to patient medical records at the time of death. The data were analyzed by Stata software using univariate and multivariate analysis (Cox regression). In building the model a p value of less than 5% was considered as significant. Results: The age at diagnosis was $53.5{\pm}14$ years. Sixty one percent were male. Colorectal mortality among the patients was 96.9 person-years among men and 83 person-years among women. Seventy five percent of patients lived for 2.72 years, 50% for 5.83, and 25% for 13 years after the diagnosis of colorectal cancer. The age at diagnosis was significantly different between men and women (p<0.03). Higher tumor grade predicted higher death rate; the adjusted hazard ratios were 1.79 (95%CI, 0.88-3.61), 2.16 (95%CI, 1.07-4.37), and 3.1 (95%CI, 1.51-6.34) for grades II, III, and IV respectively when they were compared with grade I as reference. Ethnicity, marital status, family history of cancer, and smoking were related to survival with different degrees of magnitude. Conclusions: Among many factors related to survival among the colorectal patients, tumor grade and smoking showed the highest magnitudes of association.
Objectives: Recent data show that the metabolic syndrome may play a role in several cancers, but the etiology for biliary tract cancer is incompletely defined. The present aim was to evaluate risk factors for biliary tract cancer in China. Methods: A case-control study in which cases were biliary tract cancer patients referred to Peking Union Medical College Hospital (PUMCH). Controls were randomly selected from an existing database of healthy individuals at the Health Screening Center of PUMCH. Data on the metabolic syndrome, liver diseases, family history, and history of diabetes and hypertension were collected by retrospective review of the patients' records and health examination reports or by interview. Results: A total of 281 patients (102 intrahepatic cholangiocarcinoma (ICC), 86 extrahepatic cholangiocarcinoma (ECC) and 93 gallbladder carcinoma (GC)) and 835 age- and sex-matched controls were enrolled. $HBsAg^+/anti-HBc^+$ (P=0.002), history of diabetes (P=0.000), cholelithiasis (P=0.000), TC (P=0.003), and HDL (P=0.000) were significantly related to ICC. Cholelithiasis (P=0.000), Tri (P=0.001), LDL (P=0.000), diabetes (P=0.000), Apo A (P=0.000) and Apo B (P=0.012) were significantly associated with ECC. Diabetes (P=0.017), cholelithiasis (P=0.000) and Apo A (P=0.000) were strongly inversely correlated with GC. Conclusion: Cholelithiasis, HBV infection and metabolic symptoms may be potential risk factors for the development of biliary tract cancer.
Chang, Hye Jin;Han, Kyoung Hee;Cho, Min Hyun;Park, Young Seo;Kang, Hee Gyung;Cheong, Hae Il;Ha, Il Soo
Clinical and Experimental Pediatrics
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제57권3호
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pp.135-139
/
2014
Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.
The purpose of this study was to investigate the relationship between body fat and risk factors of chronic diseases in obese children and eventually to contribute to the prevention and treatment of childhood obesity. Anthropometric parameters such as height, weight, skinfold thickness, circumferences, body fat content were measured in 55 obese subjects of age 5-20. Blood pressure, serum components, daily food intakes were also considered. The average age of the subjects was 12.5$\pm$3.3yrs and the mean obesity index was 64.7$\pm$21.3%. The average percentage of body fat was 35.6$\pm$5.4% and the mean weight of lean body mass was 45.3$\pm$13.9kg. Mean total muscle weight of the subjects was estimated to be 34.11$\pm$1.3kg. The mean systolic and diastolic blood pressures of the obese were 134.8$\pm$15.8mmHg and 69.6$\pm$11.6mgHg respectively. The concentrations fo serum triglyceride, total cholersterol, HDL-cholesterol, LDL-cholesterol were estimated to be 246.0$\pm$136.4mg/dl, 257.0$\pm$54.3mg/dl, 48.2$\pm$13.1mg/dl and 158.9$\pm$53.5mg/이 respectively. The concentrations of serum GOT and GPT were 34.6$\pm$17.1U/L and 24.7$\pm$15.3U/L. The mean content of uric acid is serum was 6.2$\pm$1.9mg/dl. Of these 55 children, 82% has hyperlipidemia, 26% was abnormal liver function and 24% was hyperuricemia. One patient was diabetic. Eighty seven% of them have developed more than one complications.
Background: Helicobacter pylori (H. pylori) is a well known major cause of gastric cancer and even when asymptomatic infected patients are at elevated risk. Functional dyspepsia (FD) is also one of the most common gastrointestinal diseases, which greatly impacts the quality of life. H. pylori infection and psychosocial stress are frequently associated with FD but limited studies have confirmed the relationships, especially in Southeast Asian countries. Here we aimed to investigate the prevalence and impact of H. pylori infection, anxiety and depression on Thai FD patients. Materials and Methods: This cross-sectional study was conducted in a tertiary care center in Thailand, during February 2013-January 2014. All FD patients were diagnosed and categorized by Rome III criteria into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) groups. The Hospital Anxiety and Depression Scale was used to evaluate psychological status. The presence of H. pylori was defined as positive with H. pylori culture, positive rapid urease test or positive histology. Results: Three hundred FD patients were included, 174 (58%) female. Overall mean age was 54.8+15.1 years. There were 192 (64%) patients with PDS and 108 (36%) with EPS. H. pylori infection was demonstrated in 70 (23.3%) patients. Anxiety and depression were documented in 69 (23%) and 22 (7.3%), respectively. H. pylori infection, anxiety and depression were significantly higher in PDS than EPS patients (27.1% vs 16.7%; p=0.04; OR=1.86; 95%CI=1.01-3.53 and 29.7% vs 11.1%; p=0.0002; OR=3.4; 95%CI=1.7-7.1 and 10.4% vs 1.9%; p=0.006; OR=6.2; 95%CI=1.4-38.9, respectively). Conclusions: H. pylori infection, anxiety and depression were commonly found in Thai FD patients and more prevalent in PDS than EPS. H. pylori eradication might be the key to success for the treatment of Thai FD patients and prevent the development of gastric cancer.
Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.
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