Biomedical subjects

C Y Kim

Publications and source records attributed to C Y Kim.

At least 91 records · Page 5Linked to original sources

PubMed1998

The E6 and E7 genes of human papilloma virus-type 16 protect primary astrocyte cultures from injury.

Many oncogenes are implicated in the regulation of apoptosis as well as in control of the cell cycle, and several have been shown to protect cells from injury. We tested whether the expression of human papillomavirus type 16 genes E6 and E7 could protect primary astrocytes from injury. Retroviral vectors were used to express E6, E7, or E6E7 in primary murine astrocyte cultures. Astrocytes expressing E6E7 suffered less than half the injury seen in controls after exposure to 400 microM H2O2. When we compared astrocytes expressing only E6 or E7, cells expressing E7 alone were protected to a greater extent and from more severe injury than those expressing E6. E6E7, E6 and E7 all provided protection from 30 h glucose deprivation, but again E7 provided the best protection, reducing injury to less than a third of that seen in controls. Expression of E7 alone decreases vulnerability to both hydrogen peroxide and glucose deprivation injury while E6 alone primarily decreases glucose deprivation injury. These results demonstrate that expression of human papillomavirus oncogenes can reduce the vulnerability of astrocytes to oxidative stress and nutrient deprivation.

Animals↗

PubMed1998

Cloning of the 52-kDa chitinase gene from Serratia marcescens KCTC2172 and its proteolytic cleavage into an active 35-kDa enzyme.

A chitinase gene (pCHI52) encoding the 52-kDa chitinase was isolated from a Serratia marcescens KCTC2172 cosmid library. This chitinase gene consists of 2526 bp with an open reading frame that encodes 485 amino acids. Escherichia coli harboring the pCHI52 gene secreted not only a 52-kDa but also a 35-kDa chitinase into the culture supernatant. We purified both 52-kDa and 35-kDa chitinases using a chitin affinity column and Sephacryl-S-300 gel filtration chromatography. We determined that the 17 N-terminal amino acid sequences of the 52-kDa and the 35-kDa chitinase are identical. Furthermore, a protease obtained from S. marcescens KCTC2172 cleaved the 52-kDa chitinase into the 35-kDa protein with chitinase activity. These results suggest that the 35-kDa chitinase derives from the 52-kDa chitinase by post-translational proteolytic modification. The optimal reaction temperature of 45 degrees C and the optimal pH of 5.5 were identical for both enzymes. The specific activities of the 52-kDa and 35-kDa chitinases on natural swollen chitin were 67 mumol min-1 mg-1 and 60 mumol min-1 mg-1, respectively.

Amino Acid Sequence↗

PubMed1998

Synergy between Entamoeba histolytica and Escherichia coli in the induction of cytokine gene expression in human colon epithelial cells.

Entamoeba histolytica induces the expression and secretion of interleukin 8 (IL-8) by cultured colon epithelial cells. We assessed the array of cytokine genes expressed by human colon epithelial cells in response to co-culture with E. histolytica trophozoites and tested the hypothesis that enteric bacteria may alter the E. histolytica-induced expression of such genes. HT-29 colon epithelial cells were co-cultured with E. histolytica trophozoites in the presence or absence of Escherichia coli. Cytokine gene expression was assessed by quantitative reverse-transcription polymerase chain reaction (RT-PCR). IL-8 mRNA in colon epithelial cells was up-regulated following exposure to E. histolytica and this was paralleled by increased IL-8 secretion. Granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-1alpha/beta mRNAs were also up-regulated in these cells. When HT-29 cells were co-cultured with E. coli DH5alpha and E. histolytica there was a synergistic increase in the expression of IL-8, IL-1alpha, and GM-CSF. These results suggest that enteric bacteria may significantly affect early proinflammatory signals produced in host tissues in response to E. histolytica infection.

Animals↗

PubMed1998

Whole-body [18F]FDG PET in the management of metastatic brain tumours.

BACKGROUND: To determine its roles in the diagnosis and the systemic evaluation of metastatic brain tumours, whole-body positron emission tomography (PET) using [18F]FDG was performed in 20 consecutive patients. METHODS: All patients were thought to be suffering or needing to be differentiated from metastatic brain tumours. Nine patients had multiple brain lesions; six were older and showed a rim-enhancing lesion with surrounding oedema; seven had homogeneously enhancing periventricular lesion(s) on computed tomography (CT) and/or magnetic resonance (MR) imaging, thought to be central nervous system lymphomas. Two patients had skull mass(es) and two patients had a solid mass suspected to be, respectively, a haemorrhagic metastasis and a metastatic malignant melanoma. All of them received whole-body [18F]FDG PET and conventional systemic work-up for metastasis in order to compare the results of the two methods. RESULTS: Metastatic brain tumours were diagnosed on whole-body [18F]FDG PET in eleven patients who had extracranial and intracranial hypermetabolic lesions. In nine of these, a conventional work-up also detected primary lesions which on whole-body [18F]FDG PET were seen to be hypermetabolic foci. Systemic lymph node metastases were detected by whole-body [18F]FDG PET only in two patients and histological diagnosis was possible by biopsy of lymph nodes rather than of brain lesions. In the remaining nine patients who had only intracranial hypermetabolic foci, histological diagnosis was made by craniotomy or stereotactic biopsy. It was confirmed that seven of nine patients were suffering from a primary brain tumour and two from metastatic carcinoma. None of the nine showed evidence of systemic cancer on conventional work-up. Histological diagnoses of the primary brain tumours were four cases of primary central nervous system lymphoma and one each of multifocal glioblastoma, Ewing's sarcoma, and cavernous angioma. Patients felt no discomfort during the whole-body [18F]FDG PET procedure and there were no complications. The false negative rate in [18F]FDG PET and in conventional work-up was 15.4% and 30.7% respectively. There were no false positives on either [18F]FDG PET or conventional work-up. CONCLUSION: It is suggested that whole-body [18F]FDG PET is a safe, reliable, and convenient method for the diagnosis and systemic evaluation of patients thought to be suffering or needing to be differentiated from a metastatic brain tumour.

Adult↗

PubMed1998

Leukotriene D4-induced contraction of cat esophageal and lower esophageal sphincter circular smooth muscle.

BACKGROUND & AIMS: In esophageal circular muscle, acetylcholine activates phosphatidylcholine-specific phospholipases C and D and phospholipase A2, producing diacylglycerol and arachidonic acid, which cause contraction by interacting synergistically to activate protein kinase C. In a model of acute esophagitis, leukotriene D4 (LTD4) contributes to acetylcholine-induced contraction. We examined intracellular signaling in LTD4-induced contraction. METHODS: Esophageal and lower esophageal sphincter (LES) cells, isolated by enzymatic digestion, were contracted by LTD4 in the absence or presence of inhibitors. Permeabilization by saponin allowed use of G-protein antibodies and heparin. RESULTS: Esophageal contraction was inhibited by pertussis toxin, Gi3 antibodies, D609 (phosphatidylcholine-specific phospholipase C inhibitor), propranolol (phospholipase D pathway inhibitor), and chelerythrine (protein kinase C antagonist) but not W7 (calmodulin antagonist). LES contraction was unaffected by pertussis toxin. It was inhibited by Gq antibodies, U-73122 (phosphatidylinositol-specific phospholipase C inhibitor), heparin (inositol 1,4,5-trisphosphate inhibitor), and W7 and reduced by D609. CONCLUSIONS: In the esophagus, LTD4 activates a protein kinase C-dependent pathway through pertussis toxin-sensitive Gi3 proteins and phosphatidylcholine-specific phospholipase. In the LES, LTD4 activates a calmodulin-dependent pathway through pertussis toxin-insensitive Gq proteins and phosphatidylinositol-specific phospholipase C. The intracellular pathways activated by LTD4 in the esophagus and the LES are similar to those activated by acetylcholine and other agonists.

Animals↗

PubMed1998

A new class II rice chitinase, Rcht2, whose induction by fungal elicitor is abolished by protein phosphatase 1 and 2A inhibitor.

Among the four classes of chitinase, a class II chitinase had not yet been reported for rice. We have isolated and characterized a class II acidic chitinase, Rcht2, from rice (Oryza sativa L. cv. Cheongcheongbyeo). The protein consists of a single polypeptide chain of 261 amino acid residues and includes a putative signal sequence of 29 amino acids at its N-terminus. It has a calculated molecular mass of 27,642 Da and an isoelectric point of 5.56. The Rcht2 chitinase lacks the cysteine-rich and hinge domains in the N-terminal region of the protein, which is the criterion for its classification as a class II chitinase. Comparison of the genomic and the cDNA sequence revealed that the coding region of Rcht2 consist of three exons of 301, 112, and 370 bp separated by two introns of 89 and 984 bp. In suspension-cultured rice cells, the transcript level of Rcht2 was dramatically increased by treatment with both glycol chitin and fungal elicitor. The application of protein phosphatase 1 and 2A inhibitors, calyculin A and okadaic acid, effectively abolished the induction of Rcht2 in response to fungal elicitor. In contrast, the activation of Rcht2 transcript was not inhibited by both cycloheximide and protein kinase inhibitors. These results demonstrate that protein dephosphorylation events play a crucial role in the elicitor-mediated induction of Rcht2 in rice cells, while de novo protein synthesis is not required for induction.

Amino Acid Sequence↗

PubMed1998

Interleukin-8 expression by human neutrophils activated by Helicobacter pylori soluble proteins.

BACKGROUND: Helicobacter pylori soluble proteins may serve as chemoattractants for neutrophils. Once extravasated and attracted to the gastric mucosa, neutrophils themselves may be a source of interleukin-8 (IL-8), further amplifying the inflammatory response. We evaluated IL-8 expression and the activation of human neutrophils by H. pylori products. METHODS: After neutrophils had been stimulated with H. pylori culture supernatant, IL-8 mRNA expression was assessed by quantitative reverse transcription polymerase chain reaction, using synthetic standard RNA at 0, 1, 2, 4, and 9 h. The amount of IL-8 protein was measured by enzyme-linked immunosorbent assay (ELISA). Lymphocyte function-associated antigen-1beta (LFA-1beta) (CD18) expression was determined with flow cytometry, and myeloperoxidase secretion was analyzed with ELISA. After acetohydroxamic acid (AHA) and/or N-tert-butoxycarbonyl-methionyl-leucyl-phenylalanine (BOC-MLP) was added to H. pylori culture supernatant, IL-8 ELISA was analyzed for 9 h. RESULTS: IL-8 mRNA expression by stimulated neutrophils was 16 to 67 times greater than by controls, peaking at 2 h after stimulation. The amount of IL-8 protein was markedly increased at 4 h after stimulation. H. pylori culture supernatant enhanced LFA-1beta expression and myeloperoxidase secretion by neutrophils. AHA and/or BOC-MLP decreased IL-8 production at 2-4 h after stimulation. CONCLUSIONS: H. pylori-induced neutrophil recruitment may be mediated via IL-8 expressed by neutrophils activated by H. pylori soluble proteins. This may explain the gastric mucosal inflammatory response to the non-invasive organism.

CD18 Antigens↗

PubMed1998

Hepatitis B vaccination and reduced risk of primary liver cancer among male adults: a cohort study in Korea.

BACKGROUND: Primary liver cancer is an important health problem in Korea, where hepatitis B virus (HBV) infection is prevalent. The authors conducted a prospective cohort study to evaluate the protective effect of HBV vaccination against liver cancer in adults. METHODS: A total of 370,285 males aged > or = 30 comprised the study population. They were clinically free of liver diseases, and had not been vaccinated against HBV at enrolment. The results of HBV surface antigen (HBsAg) and antibody to HBsAg (anti-HBs) marker positivity and those of the vaccination programme which took place during 1985 were used for the construction of the cohort. About 5% (n = 18,914) were HBsAg positive, 78,094 were anti-HBs positive, and 273,277 were negative for both. Among the candidates for HBV vaccination (n = 273,277), 35,934 (13.2%) people had been vaccinated against HBV during 1985. Cases of liver cancer were ascertained by record linkage and from medical records covering 1986-1989. A multivariate log-linear model was used to test statistical significance and to estimate relative risks (RR). RESULTS: The total follow-up period was 1,404,566 person-years, with an average of 3 years and 10 months. A total of 302 incident cases were ascertained. The overall incidence rate of liver cancer was 21.7 per 100,000 person-years. With reference to the incidence level among the unvaccinated and uninfected, the RR of primary liver cancer among the chronically infected and that of the unvaccinated and infected was 18.1 (95% CI: 14.2-22.9) and 0.34 (95% CI: 0.19-0.60), respectively. The RR among the vaccinated group was 0.58 (95% CI: 0.31-1.09). CONCLUSIONS: This study suggested that artificial immunization through HBV vaccination, even in adulthood, reduces the risk of liver cancer. It might also offer a practicable means of primary prevention, especially in areas with hyperendemicity of HBV infection.

Adult↗

PubMed1998

Helicobacter pylori reinfection rate and duodenal ulcer recurrence in Korea.

In the short term, the eradication of Helicobacter pylori in patients with duodenal ulcer (DU) is deemed to be clearly effective; the long-term effectiveness apparently depends on the H. pylori reinfection rate. We conducted the present study to investigate the rates of H. pylori reinfection and DU recurrence in 45 patients previously cured of DU in whom H. pylori had been eradicated. These patients underwent gastroscopy and tests for H. pylori at least 1 year after eradication. In a control group comprising 31 patients with DU who were not treated with H. pylori eradication regimen, the DU recurrence rate was checked annually for 4 years. Twenty of 45 patients (44.4%) in whom the mean follow-up period was 3.5 years were again found to be H. pylori positive, and the reinfection rate was 12.8% per year. DU recurred in 8 of these 20 (40%) but not in any nonreinfected patients. In the control group, the DU recurrence rate was 61% within 1 year, 81% within 2 years, 84% within 3 years, and 90% within 4 years. The respective recurrence rates in the 45 patients in whom the bacteria had been eradicated were 0%, 4%, 13%, and 18%. The H. pylori reinfection rate was as high as 12.8% per year in Korea, but in that the DU recurrence rate is significantly lower (p < 0.01; odds ratio, 129.5) in the H. pylori-eradicated group than in the control group, the eradication of H. pylori in DU patients is effective over the long term (at least 4 years).

Adolescent↗

PubMed1998

Prevalence estimation of dementia in a rural area of Korea.

OBJECTIVES: A cross-sectional survey was conducted to estimate prevalence of dementia and to determine factors related to dementia among residents in a rural area, Yonchon county, Korea, in 1993. PARTICIPANTS: Of the study population more than 65 years of age (n = 2171), 1674 persons participated in the cross-sectional survey using the Korean version of the Mini-Mental State Examination (MMSE-K). DESIGN: Subjects were defined as having dementia according to NINCDS-ADRDA criteria through direct interview by psychiatrists. A total of 436 subjects were selected randomly according to MMSE-K scores, and cases were confirmed as having either Alzheimer's or vascular dementia. RESULTS: The adjusted prevalence of dementia was estimated at 9.5%. The prevalence of total dementia was 8.8% for men and 9.9% for women. The prevalence of Alzheimer's disease was 3.2% for men and 5.3% for women and that of vascular dementia 3.1% and 2.1%, respectively. Age-standardized prevalence of Alzheimer's disease was 4.5%, whereas that of vascular dementia was 2.5%. Using DSM-III-R criteria to stratify dementia patients according to severity showed the prevalence of mild, moderate, and severe Alzheimer's disease was 3.4%, 0.7%, and 0.5%, respectively. CONCLUSION: These results showed that the prevalence of dementia in Korea was similar to its presence in Western countries but different from that previously reported in other Asian countries, e.g., China and Japan.

Aged↗

PubMed1998

Type A behavior and stroke: high tenseness dimension may be a risk factor for cerebral infarction.

Although type A behavior (TAB) has been shown to be related to coronary heart disease, the relationship between TAB and stroke was rarely investigated. We studied TAB in stroke patients with the use of the questionnaire developed by Eysenck and Fulker that has 4 subdimensions: Tenseness, Ambition, Activity, and Unrepressed. The questionnaire was administered to 224 patients with acute stroke and 100 controls. The patients were further classified as having cerebral infarction (large vessel infarction and small vessel infarction), and intracerebral hemorrhage. We found that, among the 4 subdimensions, only the Tenseness score was significantly higher in patients with cerebral infarction but not in those with intracerebral hemorrhage compared to the controls. On subgroup analysis, Tenseness score was higher in patients with large vessel infarction but not in those with small vessel infarction than in those with intracerebral hemorrhage or controls. The association of high Tenseness score with cerebral infarction (and large vessel infarction) remained significant after multiple logistic analysis adjusting various risk factors such as hypertension, diabetes mellitus, cigarette smoking and habitual alcohol drinking. Our data suggest that a high Tenseness dimension of TAB may be an independent risk factor for ischemic stroke, probably associated with atherogenesis.

Cerebral Infarction↗

PubMed1998

Effects of mild chronic heat exposure on the concentrations of thiobarbituric acid reactive substances, glutathione, and selenium, and glutathione peroxidase activity in the mouse liver.

To determine whether mild and chronic heat stress leads to oxidative stress and to differentiate such effects of different exposure periods, we kept male ICR-mice at an ambient temperature of either 35 degrees C or 25 degrees C for 6 hours, 3 days, or 7 days and measured the concentrations of thiobarbituric acid reactive substances (TBARS), glutathione (GSH), selenium (Se), and glutathione peroxidase (GSH-Px) activities in the liver. Since the food consumption of the heat-exposed group was only half that of the control, we prepared pair-fed groups, which were kept at 25 degrees C and whose food consumption were limited to those of the heat-exposed group for the 3-day and the 7-day exposure. TBARS concentrations of the liver was significantly higher in the heat group than the control after the 3-day exposure, while there was no significant difference among the groups after the 7-day exposure. There was no significant difference in GSH concentrations between the heat-exposed group and the control after the 7-day exposure, when the GSH concentration of the pair-fed group was significantly lower than that of the control. Hepatic cytosolic Se GSH-Px activity in the heat group was significantly less than that in the control group after the 6-hour exposure and it tended to be lower in the heat group than that of the control group after the 7-day exposure, while there was no difference in the total GSH-Px activity among the three groups. Our results showed that mild and chronic heat exposure may cause oxidative damage to organisms and that GSH-related anti-oxidative systems would play an important role to defensive reaction.

Animals↗

PubMed1998

Effect of melatonin on cadmium-induced hepatotoxicity in male Sprague-Dawley rats.

Effect of melatonin on toxicity of cadmium (Cd) was studied in male SD rats co-administered daily Cd (1 mg/kg b.w., s.c.) with melatonin (10 mg/kg b.w., i.p.) for 15 days. Cd alone injection decreased GSH concentrations in the liver and RBC by 35% and 43% compared with those in saline-treatment group, but not in the kidney and whole brain. The activity of GSSG-reductase was significantly decreased in the liver of Cd alone injected rats, while melatonin given in combination with Cd failed to prevent the Cd-induced decreased activity of hepatic GSSG-reductase. However, the hepatic GSH concentration decreased by Cd alone was restored by melatonin treatment, and the melatonin also ameliorated Cd-induced histopathological changes in the liver. Therefore, data indicate that melatonin restores the reduction of hepatic GSH level induced with Cd regardless of GSSG-reductase activity, and suggests that melatonin may ameliorate Cd-induced hepatotoxicity.

Animals↗

PubMed1998

Compression of color medical images in gastrointestinal endoscopy: a review.

This paper reviews the state of medical color digital imaging with respect to image compression. Only recently has the creation and storage of color medical images become technically and economically feasible. This has allowed medical images to become a part of an electronic medical record, to be used in telemedicine, or to be used for medical education. The Internet has become an important medium for the dissemination of medical images, whether through file transferring or through the World Wide Web. There is a growing need to evaluate the degree and types of image compression that are clinically acceptable (either for diagnostic or archival purposes) for different specialties. The focus will be on gastrointestinal endoscopic images, although work in other medical specialties will be mentioned.

Data Display↗

PubMed1997

Characterization of a putative helix-loop-helix motif in nucleotide excision repair endonuclease, XPG.

Complementation group G of xeroderma pigmentosum (XPG) is one of the most rare and pathophysiologically heterogeneous forms of this inherited disease. XPG patients exhibit varying phenotypes, from having a very mild defect in DNA repair to being severely affected, and a few cases are also associated with the neurological degeneracy and growth retardation of Cockayne's syndrome. The XPG gene encodes a 134-kDa nuclear protein that is essential for the incision steps of nucleotide excision repair. XPG protein contains a putative helix-loop-helix (HLH) motif in the region that is most conserved among the members of structure-specific endonuclease family. To establish the functional significance of the HLH motif, we used several approaches, including theoretical modeling, functional complementation assay, structure-specific endonuclease assay, and DNA binding assay. A secondary structure of the motif was predicted by energy minimization and the Monte Carlo simulation and empirically proven using the circular dichroism to contain a high content of alpha-helix. When an XPG mutant lacking the HLH was overexpressed in UV135 cells, which have defects in the hamster homolog of XPG, the mutant gene failed to confer to the hamster cells the resistance to UV light. A recombinant XPG protein lacking the HLH motif was purified from insect cells and tested for a structure-specific endonuclease activity. The mutant protein failed to cleave the flap strand. A recombinant peptide containing the HLH (amino acids 758-871) was expressed in and purified from bacteria, tested for DNA binding activity, and found to bind to a DNA substrate with the flap structure. These results suggest that the HLH motif is required for the catalytic and DNA binding activities of XPG.

Amino Acid Sequence↗

PubMed1997

Selection of human cervical epithelial cells that possess reduced apoptotic potential to low-oxygen conditions.

Since human papillomavirus (HPV) infection is strongly associated with cervical neoplasia and tumor hypoxia has prognostic significance in human cervical carcinomas, we examined the relationship between hypoxia and apoptosis in human cervical epithelial cells expressing high-risk HPV type 16 oncoproteins. In vitro, hypoxia stimulated both p53 induction and apoptosis in primary cervical epithelial cells infected with the HPV E6 and E7 genes but not in cervical fibroblasts infected with E6 and E7. Furthermore, cell lines derived from HPV-associated human cervical squamous cell carcinomas were substantially less sensitive to apoptosis induced by hypoxia, indicating that these cell lines have acquired additional genetic alterations that reduced their apoptotic sensitivity. Although the process of long-term cell culturing resulted in selection for subpopulations of HPV oncoprotein-expressing cervical epithelial cells with diminished apoptotic potential, the exposure of cells to hypoxia greatly accelerated the selection process. These results provide evidence for the role of hypoxia-mediated selection of cells with diminished apoptotic potential in the progression of human tumors and can in part explain why cervical tumors that possess low pO2 values are more aggressive.

Apoptosis↗

PubMed1997

Isolation and characterization of the 54-kDa and 22-kDa chitinase genes of Serratia marcescens KCTC2172.

A DNA fragment (pCHI5422) containing two genes encoding a 54-kD and a 22-kDa chitinase was isolated from a cosmid DNA library of Serratia marcescens KCTC2172. The complete nucleotide sequence of pCHI5422 consisting of 4581 bp was determined. The nucleotide sequence of the 22-kDa chitinase consists of 681 bp of open reading frame encoding 227 amino acids and is located 1422 bp downstream of the translation termination codon of the 54-kDa chitinase sequence. The 54-kDa chitinase gene consisted of 1497 bp in a single open reading frame encoding 499 amino acids. The genes encoding the 54-kDa and 22-kDa chitinase were separately subcloned in Escherichia coli and the individual chitinases were expressed and purified from the culture broth using chitin affinity chromatography. When chitohexaose was used as substrate, the major product of the enzymatic reaction of both the 54-kDa and 22-kDa chitinases was a (GlcNAc)2 dimer with a minor amount of monomer. The specific activity of the 54-kDa and 22-kDa chitinases were 300 microM (min)-1 mg-1 and 17 microM (min)-1 mg-1 on the natural swollen chitin, respectively.

Amino Acid Sequence↗

PubMed1997

The safety and efficacy of transcatheter arterial chemoembolization in the treatment of patients with hepatocellular carcinoma and main portal vein obstruction. A prospective controlled study.

BACKGROUND: Transcatheter arterial chemoembolization (TACE) has been contra-indicated for the treatment of patients with hepatocellular carcinoma (HCC) and main portal vein (MPV) obstruction because of the potential risk of hepatic insufficiency resulting from ischemia after TACE. The current controlled study was undertaken to assess the safety, efficacy, and predictive factors of favorable response to TACE in patients with HCC and MPV obstruction with good hepatic function and adequate collateral circulation around the MPV. METHODS: Of a total of 47 patients, 31 were treated with TACE, and 16 who declined the procedures were untreated controls. Thirty-six patients (77%) had diffuse-type HCC and 11 (23%) had nodular-type HCC. During the first week after TACE immediate postprocedural complications were evaluated, and the development of hepatic insufficiency as a late complication was assessed at the end of the fourth week. The cumulative survival rate was estimated by the Kaplan-Meier method, and predictors of better prognosis were obtained by univariate and multivariate analyses. RESULTS: Although no patients showed clinical evidence of hepatic insufficiency as an immediate complication, transient fever and abdominal pain were common. Progressive hepatic insufficiency developed at the fourth week; however, there was no difference between the treated and untreated groups. The survival time of treated patients was statistically no longer than that of untreated patients. In the univariate analysis, tumor type and size, the pattern of iodized oil uptake in the tumor, and the presence of iodized oil uptake in the tumor thrombi at the MPV significantly influenced the prognosis. Tumor type, whether treated or not, was the most important prognostic factor patients with nodular-type HCC had significantly longer survival time (median, 11 months) than those with diffuse-type HCC (median, 4 months). Regarding the efficacy of TACE, there was no statistical difference in survival between treated and untreated diffuse-type HCC patients. In comparison, with nodular-type HCC it seemed that survival time was longer for TACE-treated patients (median, 30 months) than for untreated patients (median, 7 months). CONCLUSIONS: TACE may be a safe modality for the treatment of patients with HCC and MPV obstruction, provided that the patients have good hepatic function and collateral circulation around the MPV. However, TACE was not efficacious in the treatment of diffuse-type HCC. The authors recommend TACE for treating nodular-type HCC because of the potential benefit of prolonged survival.

Adult↗