Biomedical subjects

J T Chen

Publications and source records attributed to J T Chen.

At least 55 records · Page 3Linked to original sources

PubMed2000

Frequent down-regulation and lack of mutation of the KAI1 metastasis suppressor gene in epithelial ovarian carcinoma.

OBJECTIVE: KAI1 is a recently identified metastasis suppressor gene on human chromosome 11p11.2. It belongs to a structurally distinct family of cell surface glycoproteins. Decreased KAI1 expression seems to be involved in the progression of human prostate, lung, pancreatic, and possibly breast cancer, and recently a reduced KAI1 protein expression has been demonstrated in several ovarian carcinoma cell lines. The aim of this study is to determine whether the KAI1 gene is altered in human epithelial ovarian carcinomas. In addition, its prognostic significance in this tumor is also evaluated. METHODS: To detect KAI1 expression, 102 tumor samples from benign, borderline, primary invasive, metastatic, and recurrent epithelial ovarian tumors were prepared for immunohistochemical study with C-16, an anti-KAI1 polyclonal antibody. In addition, cellular RNA from 24 primary invasive and 7 recurrent tumors was also analyzed for KAI1 expression by using a reverse transcriptase PCR (RT-PCR) technique. The PCR single-strand conformation polymorphism method and direct DNA sequencing were used to detect KAI1 mutation in the 44 primary invasive and 8 recurrent ovarian carcinomas. RESULTS: In immunohistochemical study, decrease of KAI1 protein expression was associated with the progression of ovarian tumor. However, it had no relation to the stage of primary invasive cancers because of its frequent occurrence in early stage tumors. KAI1 expression was also frequently down-regulated in primary invasive and recurrent tumors in RT-PCR analysis. Except for a missense change at codon 241 (ATC to GTC), which causes the substitution of a valine for an isoleucine in the amino acid sequence and occurs in both normal and tumor tissues, no mutation of the KAI1 gene was found in any of the 52 carcinomas. Although there was a trend for deteriorating survival from patients with KAI1-preserved tumors to those with KAI1-decreased and -negative tumors, statistically it was not significant (P = 0.079). CONCLUSION: KAI1 may play a role in the malignant progression of epithelial ovarian carcinoma through the down-regulation of expression rather than gene mutation. Since the decreased expression presented frequently in early stage tumors, it may be an early event in the progression of this tumor and its prognostic significance needs further investigation with a larger number of cases.

Adolescent↗

PubMed2000

Effects of chronic lead exposure on short-term and long-term depression in area CA1 of the rat hippocampus in vivo.

Chronic developmental lead (Pb) exposure to the rat has been reported to impair the long-term potentiation (LTP) in area CA1 and DG of the hippocampus. The present study was performed to investigate the effects of chronic Pb exposure on homosynaptic short-term depression (STD) and long-term depression (LTD) of population spikes (PS) in area CA1 of the rat hippocampus in vivo. Neonatal Wistar rats were exposed to Pb from parturition to weaning via the milk of dams fed with 0.2% lead acetate solution. The input/output (I/O) function, paired-pulse reaction (PPR), the PS were measured in the area CA1 in response to low frequency stimulation (LFS). The results showed that the homo-STD amplitude of PS depotentiation in Pb-exposed rats (87.48 +/- 7.44%, n = 14) was less significant than that in control rats (72.34 +/- 6.05%, n = 18, P<0.05), and the homo-LTD amplitude of PS depotentiation in Pb-exposed rats (72.80 +/- 5.86%, n = 14) was even less significant than that in control rats (47.80 +/- 5.03%, n = 18, P<0.01). The results suggest that chronic Pb exposure in neonatal rats caused impairments in the STD and LTD of area CA1 of hippocampus.

Animals↗

PubMed2000

Modulation of symptomatic palatal tremor by magnetic stimulation of the motor cortex.

OBJECTIVES: Magnetic stimulation of the motor cortex can be used to determine the involvement of the cortex in rhythmic movement disorders. Symptomatic palatal tremor (SPT) is thought to come from a pacemaker that is relatively resistant to internal and external stimulation. In this study, we investigated the effect of magnetic stimulation of motor cortex on SPT. METHODS: Five male patients, aged 67-79 years, with SPT after brain stem infarction or hemorrhage, all had a synchronous mouth angle twitch with the palatal movement. Electromyographic activity was recorded with a monopolar needle electrode from orbicularis oris. In experiment 1, transcranial magnetic stimulation (TMS) was delivered at 200% motor threshold (MT) to reset SPT. In experiment 2, the effect of TMS intensities was studied at 80-240% MT in two SPT patients. To determine the influence of the TMS, we used the resetting index (RI). RESULTS: TMS reset the tremor in all 5 SPT patients at 200% MT with RIs of 0.86-0.96. The latency of the tremor reappearance after TMS was longer than the pre-stimulus tremor interval, and the intervals between the subsequent tremor bursts were also prolonged. The degree of tremor resetting was closely correlated with the magnetic stimulus intensity and the latency of the tremor reappearance after TMS. CONCLUSIONS: Stimulation of the motor cortex may modulate the generator of SPT.

Aged↗

PubMed2000

Chromosomal changes and clonality relationship between primary and recurrent hepatocellular carcinoma.

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) is highly malignant and prone to recur after surgical treatment. Differentiation between a true relapse of HCC and a second primary tumor is of clinical importance. However, no convenient method is currently available. METHODS: Comparative genomic hybridization (CGH) was used to analyze 31 pairs of initial and recurrent HCC samples obtained from patients undergoing 2 consecutive surgeries. The resulting chromosomal aberration profiles were used as genomic fingerprints to determine tumor clonalities and their relationships. RESULTS: Eleven recurrent tumors with high clonal relationship (CR) values (>0.95) were found to be relapsed HCCs, and 11 tumors with CR values close to 0 were found to be second primary HCCs. The other 9 paired samples had inconclusive CR values between 0.95 and 0.4. Two were confirmed by hepatitis B virus integration and X chromosome inactivation analysis to be de novo cancers (CR values, 0.35 and 0. 23, respectively). Initial HCCs that subsequently relapsed accumulated more chromosomal aberration events than those that developed de novo HCC (mean, 16.1 +/- 4.5 vs. 5.4 +/- 4.8 events; P < 0.01). Also, they more frequently showed gains on chromosome arms 3q, 6p, 8q, and 17q and losses on 4q and 16p. CONCLUSIONS: CGH is useful for chromosomal aberration study and tumor clonality analysis. More and characteristic genomic changes in the initial HCC suggest that subsequent tumor recurrence is a true relapse.

Adult↗

PubMed2000

The short-term effect of pentoxifylline on rabbit choroidal blood flow.

This study evaluates the effect of different doses ofpentoxifylline on rabbit choroidal blood flow (CBF). Sixteen albino rabbits of both sexes, weighing 2.0-3.0 kg, were randomly separated into four groups. The first group of rabbits received 2 ml normal saline injection through the ear vein. They served as the control group (group n). Three different doses of pentoxifylline, 1 mg/kg, 5 mg/kg, and 10 mg/kg, were injected intravenously to groups p1, p5 and p10, respectively. By means of a laser Doppler flowmeter, the blood cell flux (PF), velocity, and the concentration of moving blood cells (CMBC) were recorded simultaneously. The laser probe was advanced through the pars plana and positioned near the retinal surface. The mean arterial pressure was recorded at the same time. There was a significant increase in PF at 1, 5 and 10 min in group p10 rabbits compared with the control group (p=0.0005, 0.0416, and 0.0087, respectively). The velocity increased at 5 min in group p5 rabbits (p=0.0082) and at 1, 5 and 10 min in group p10 rabbits (p=0.0188, 0.0080, and 0.0207, respectively) as compared with the controls. The CMBC decreased after injection of pentoxifylline and reached statistical significance at 5 and 10 min in group p5 rabbits (p=0.0019 and 0.0046, respectively) and at 5 min in group p10 rabbits (p=0.0447). These results show that larger doses of pentoxifylline (10 mg/kg) increased the CBF of rabbits. This effect was achieved primarily by an increase in blood cell velocity.

Animals↗

PubMed2000

Bilateral superior cervical ganglionectomy increases choroidal blood flow in the rabbit.

In this study, we evaluate the effect of bilateral superior cervical ganglionectomy on albino rabbit choroidal blood flow (CBF) in changes of perfusion pressure (PP). Twenty albino rabbits of either sex weighing between 2.0 and 3.0 kg were randomly divided into two groups. The experimental group (group S) included 10 rabbits (20 eyes) that received bilateral superior cervical ganglionectomy one week prior to the study. The other 10 rabbits (20 eyes) served as a control (group N): each received the same procedure as group S except that the superior cervical ganglion was preserved. By means of a laser Doppler flowmeter (Perimed PF4001), blood cell flux (PF), velocity (V), and concentration of moving blood cells (CMBC) were recorded simultaneously while intraocular pressure was increased linearly by a syringe pump. Blood pressure and intraocular pressure were continuously monitored. The laser beam focused on the posterior pole away from major retinal vessels. When PP decreased from 75 to 0 mm Hg, in group N, PF, V and CMBC decreased from 100% to 6.94+/-0.91%, 8.41+/-0.87%, and 19.38+/-1.11%; in group S, it was 17.75+/-2.58%, 16.78+/-1.48%, and 34.58+/-4.42%, respectively. Group S poses higher PF, V, and CMBC than group N while PP decreased gradually. These results indicate that the superior cervical ganglion plays a role in CBF regulation. Bilateral sympathectomy led to a higher PF in the group S rabbits, indicating increased CBF. PF, V, and CMBC remained constant until PP <55 mm Hg demonstrated the existence of CBF autoregulation within a limited perfusion range in both groups. This autoregulation did not change after sympathectomy.

Animals↗

PubMed2000

Interferences with semen detection by an immunoassay for a seminal vesicle-specific antigen.

A commercial enzyme-linked immunosorbent assay (ELISA), the SEMA assay, for a seminal vesicle-specific antigen (SVSA) provides highly sensitive detection of semen. Here we show marked interference of proteins such as albumin, serum proteins, or mucin with the assay. This would substantially decrease the sensitivity for detecting semen mixed with other biological fluids such as blood or vaginal secretions.

Enzyme-Linked Immunosorbent Assay↗

PubMed2000

Clinicopathologic analysis of renal and extrarenal angiomyolipomas: report of 44 cases.

BACKGROUND: Angiomyolipoma (AML) is a rare soft tissue tumor involving the kidneys, liver and other visceral organs. It is composed of smooth muscle cells, adipocytes and small- to medium-sized hyalinized vessels. The purpose of this study was to investigate the characteristic clinicopathologic manifestations of AML in different tissues. METHODS: We collected 37 renal, four hepatic, one lymph node, one subcutaneous and one uterine cervical AML to analyze the clinical, histologic, histochemical and immunohistochemical variations of AML in different tissues. RESULTS: Clinically, renal and hepatic AML were associated with tuberous sclerosis complex and predominate in women. There were several prominent pathologic differences between renal and extrarenal AML. First, none of the tumors were encapsulated except for the subcutaneous AML, which had a pseudocapsule. Secondly, the smooth muscle cells were usually epithelioid shaped in hepatic AML and occasionally in renal AML, but not in subcutaneous or uterine AML. Furthermore, hepatic AML characteristically showed extramedullary hematopoiesis and eosinophilic hyaline granules. Finally, only the tumor cells of renal, lymph node and hepatic AML had periodic acid-Schiff (PAS), PAS-D (after diastase digestion) positive granules and monoclonal mouse anti-human melanosome clone (HMB-45) immunoreactivity. CONCLUSIONS: By combining the clinical, histologic, histochemical and immunohistochemical features, some discrepancies between the renal and extrarenal AML were observed, such as female predominance, association with tuberous sclerosis complex, morphology of the smooth muscle cells, presence of PAS, PAS-D positive granules and HMB-45 immunoreactivity in tumor cells. Extramedullary hematopoiesis and hyaline globules are unique to hepatic AMLs. These specific pathologic manifestations not only implicate the histogenesis of AML from different organs, but also assist in making a correct diagnosis.

Adult↗

PubMed2000

Lymph node revealing solution and traditional 10% buffered formaldehyde for detecting lymph nodes in colorectal carcinoma.

BACKGROUND: Cancer stage has been the most important factor in evaluating the prognosis and treatment of colorectal carcinoma, and the presence of lymph node metastasis in the resected specimen plays a key role in serial staging. We evaluated a newly proposed "lymph node revealing solution" (LNRS) that proponents claim is inexpensive, easy, rapid, and innocuous, and that could help to establish the stage of disease more accurately than buffered formaldehyde (formalin). Our study compared traditional 10% formalin and LNRS as second search solutions to determine whether LNRS is a more useful and practical solution than formalin. METHODS: Thirty randomly selected colorectal carcinomas from low anterior resection (LAR) were studied. The specimens were handled routinely on the first day. Then, the entire fat of odd-numbered cases was immersed in three times its volume of LNRS, and the entire fat of even-numbered cases was immersed in 10 times its volume of formalin overnight. The chi-squared test was used to evaluate the results. RESULTS: Of 145 cassettes in the second search by LNRS, seven had no lymph nodes. Of 107 cassettes in the second search by formalin, 18 had no lymph nodes. Totally, 792 lymph nodes were found with an average number of 26.4 per case and 1.53/cm (per centimeter of specimen) in all 30 cases. By the LNRS method, 138 lymph nodes were found in the 15 odd-numbered cases, and by the formalin method, 89 lymph nodes were found in the 15 even-numbered cases. We were able to adjust the stage upward in two cases by LNRS-fixation method. There were no changes in staging in the formalin-fixation method cases. CONCLUSIONS: LNRS showed no statistically significant difference from formalin in the numbers of total lymph nodes, positive lymph nodes, or minute (less than 1 mm) lymph nodes found. Nonetheless, we do believe that LNRS is a potential replacement solution for formalin due to its fast fixation, ease of searching, high identification rate and time-saving procedure.

Colorectal Neoplasms↗

PubMed2000

Correlation of genetic instability with mismatch repair protein expression and p53 mutations in non-small cell lung cancer.

To examine the etiological association of genetic instability in lung tumorigenesis, we investigated the frequency of microsatellite instability (MI) of eight dinucleotide repeat markers in 68 patients with non-small cell lung cancer. Twenty-eight patients (41.2%) evidenced instability in multiple tested microsatellite markers ranging from 3-7 and were defined as MI-positive patients. MI occurred more frequently in patients suffering from squamous cell lung carcinoma (P = 0.004). We examined the association between MI and expression of hMLH1 mismatch repair protein by immunohistochemical analysis of hMLH1 protein in paraffin-embedded tumors from 64 patients. Twenty MI-positive patients (76.9%) had no expression of hMLH1 protein. The data showed that MI was associated with altered hMLH1 expression (P = 0.03). To examine the role of genetic instability in the previous identified small intragenic deletion of the p53 gene, we explored the association between MI and p53 gene mutations. All patients, except one, containing small intragenic deletion in p53 gene showed MI (P = 0.018). In addition, we found that MI was not associated with the prognosis. Our data suggest that MI plays a significant role in non-small cell lung cancer tumorigenesis in Taiwan and that MI is associated with the altered expression of hMLH1 mismatch repair protein. In addition, MI may be involved in frequent small intragenic deletions of p53 gene.

Adaptor Proteins, Signal Transducing↗

PubMed2000

Benign metastasizing leiomyoma of the lung: a case report.

Benign metastasizing leiomyoma (BML) refers to benign pulmonary neoplasm associated with a previous or coincident history of uterine leiomyomata. We report the case of a 56-year-old postmenopausal woman with a 4-year history of multiple benign leiomyomatous lesions in bilateral lungs and the uterus. The tumor cells from the lungs and uterus were focally immunoreactive for HMB-45 antibody and progesterone receptor. Immunoreactivity to HMB-45 is well known in smooth muscle cells of hamartomatous neoplasms, such as angiomyolipoma and lymphangioleiomyomatosis, but has not been reported in BML previously. These features suggest a multifocal hamartomatous histogenesis rather than metastasis in the present case.

Antigens, Neoplasm↗

PubMed2000

[Research on improving rice resistance to the pest by B.t. and SBTi genes].

B.t. gene alone or and SBTi gene together were introduced into two elite indica rice varieties grown in South China by bombardment. And 21 independent transgenic lines containing B.t. gene and 4 independent transgenic lines containing B.t. gene and SBTi gene were obtained. Molecular and genetics analysis for R1 plants showed integration of multiple transgenes occurred at one genetic locus. Northern blot result proved B.t. gene expressed in R2 transgenic plants stably. Bioassays using R2 transgenic plants with leaf-folder (Cnaphalocrosis medinalis), indicated that transgenic rice plants are more resistant to the pest than untransformed control plants. And those transgenic plants containing B.t. and SBTi genes showed more resistance compared with those plants containing B.t. gene.

Bacillus thuringiensis Toxins↗

PubMed2000

[Cloning of cancer-related genes of Rat6 fibroblasts by using an improved differential display method].

The p53 gene is the most frequently mutated gene identified so far in human cancers. When a mutant p53(135)-val gene was allowed to be over-expressed in Rat6(R6) cells, a high incidence of spontaneous transformation was observed in long-term culture of this cell line(R6 # 13-8). To identify genes involved in cell transformation, parental p53 over-expressing cell, R6 # 13-8, and its spontaneous transformant T2, were analyzed by an improved mRNA differential display technique, which was reproducible, simpler, and was able to clone cDNA longer than 500 bp, and was with less false positives. When 33 10-mer or 12-mer single primers with arbitrary but defined sequence were used for PCR, over 90 discrete cDNAs were obtained from R6 # 13-8 and T2 cells. Three differentially expressed cDNAs were identified, one of them is highly expressed in T2 cells, while the other two, 0.8 kb and 0.9 kb long, are highly expressed in R6 # 13-8 cells. The latter were cloned and confirmed by Northern hybridization. Both cloned fragment were not homologous with any published sequence. Our results suggest that the activation and inactivation of genes are involved in the process of the spontaneous transformation from R6 # 13-8 to T2.

Animals↗

PubMed1999

Galectin-3 expression is induced in cirrhotic liver and hepatocellular carcinoma.

Galectins are a family of beta-galactoside-binding animal lectins. In particular, a widely studied member galectin-3, previously designated as epsilonBP, CBP35, Mac-2, L-29 and L-34, has been associated with assorted processes such as cell growth, tumor transformation and metastasis. Galectin-3 is expressed in various tissues and organs but is significantly absent in normal hepatocytes. However, evaluation of patient liver biopsies for galectin-3 expression resulted in the finding that hepatocellular carcinoma (HCC) frequently expressed significant levels of this lectin (76% immunohistochemically positive). Further investigation revealed that galectin-3 expression in HCC is independent of whether the patient had prior hepatitis B virus infection: 14 of 18 HCC cases from HBV- patients, and 5 of 7 cases from HBV patients demonstrated positive galectin-3 immunohistochemistry. However, co-transfection studies using a galectin-3 promoter construct and an HBV-X protein (HBV-X) expression vector demonstrated that galectin-3 expression can occur through transactivation of the lectin promoter by HBV-X. Based on presently known properties of this lectin, it is possible that deregulated expression of galectin-3 can result in tumor transformation and invasiveness, or confer propensity for tumor cell survival. In addition, galectin-3 was abundantly expressed in cirrhotic liver in peripheral distribution within regenerating nodules. Such galectin-3 expression in rapidly proliferating hepatocytes in cirrhotic liver may be a result of the high mitotic index. Alternatively, it is possible that proliferating cells expressing galectin-3 are in the process of being transformed, thus indicating an early neoplastic event.

Animals↗

PubMed1999

The effects of chronic lead exposure on long-term depression in area CA1 and dentate gyrus of rat hippocampus in vitro.

Long-term potentiation (LTP) and long-term depression (LTD), two forms of synaptic plasticity, are believed to underlie the mechanisms of learning and memory. Previous studies have demonstrated that low-level lead exposure can impair the induction and maintenance of LTP in vivo and in vitro. The present study was carried out to investigate whether the low-level lead exposure affected the induction and maintenance of LTD. Neonatal Wistar rats were exposed to lead from parturition to weaning via milk of dams drinking 0.2% lead acetate solution. Field excitatory postsynaptic potentials (EPSPs) were recorded in hippocampal slices in adult rats (50-65 days) to study the alterations of LTD in area CA1 and dentate gyrus (DG) of hippocampus following chronic lead exposure. The input-output (I/O) curves before conditioning in both areas showed no evident alterations in basic synaptic transmission between the control and lead exposure groups. In area CA1, the mean amplitude of EPSP slope in control rats (61+/-11%, n=15) decreased significantly greater than that in lead-exposed rats (78+/-8%, n=8, P<0.05) following low frequency stimulation (LFS, 1 Hz, 15 min), which lasted at least 45 min. In area DG, with application of the same LFS, the LTD was induced in control rats (72+/-22%, n=8), while the LFS failed to induce LTD in lead-exposed rats (100+/-26%, n=8). These results showed that chronic lead exposure affected the induction of LTD in both area CA1 and DG. The effect of lead on synaptic plasticity in area CA1 was also investigated. The alteration of the amplitude of LTP in hippocampal slices caused by lead was reexamined in order to compare with that on LTD (control: 189+/-23, n=5; lead-exposed: 122+/-12, n=10). The result demonstrated that low-level lead exposure could reduce the range of synaptic plasticity, which might underlie the dysfunction of learning and memory caused by chronic lead exposure.

Animals↗

PubMed1999

Fitting cytosolic ADP recovery after exercise with a step response function.

Phosphorus magnetic resonance (MR) spectroscopy was used to measure the recovery kinetics of calculated cytoplasmic metabolically active adenosine diphosphate (ADP) after exercise in normal subjects and patients with mitochondrial myopathies. These kinetics have previously been fitted with a single exponential function, despite a complex time-dependent undershoot in many subjects. By considering the transition from ischemic-exercise to perfused-recovery as a step function input, a second-order linear system was developed yielding a step response function to fit the ADP recovery. Using this method, an average improvement in fit of 23% resulted in a significant improvement in the characterization of ADP recovery for all normal subjects with substantial undershoot. The patient group had a comparable improvement in fit of 11%. Fitting the ADP recovery with a second-order step response function can provide significantly better characterization of muscle oxidative metabolism in vivo.

Adenosine Diphosphate↗

PubMed1999

Clinicopathologic analysis of malignant melanoma in Taiwan.

BACKGROUND: Malignant melanoma is the leading cause of death among skin cancers in western countries. However, the incidence, histologic subtypes, and tumor behaviors are quite different in Asians and people of color. OBJECTIVE: Our purpose was to define the tumor behaviors and possible prognostic predictors of melanomas based on a Taiwanese patient population. METHODS: From the 65 patients diagnosed with melanoma at Veterans General Hospital, Taichung, we analyzed mean age at onset, gender, histologic subtypes, tumor thickness, level of invasion, primary tumor locations, and metastatic sites. Univariate analysis and multivariate analyses for survival, according to clinical and histologic tumor behaviors, were performed by means of Cox proportional hazard model. Survival curves were plotted by Kaplan-Meier method. RESULTS: Fifty-one cutaneous melanomas were identified and analyzed by both clinical behaviors and histology. Acral lentiginous melanoma was the most common type (54.9%), followed by nodular melanoma (29.4%), superficial spreading melanoma, and lentigo maligna melanoma. Univariate analysis for overall survival of melanoma revealed that age at onset older than 55 years, male gender, ulceration of tumor, and thicker tumor have the tendency to poorer prognosis, but without significant differences. The advanced stages (III and IV) and histologic subtypes other than acral lentiginous melanoma predicted a poorer survival with significant differences. Multivariate analysis demonstrated advanced stages, and histologic subtypes were the independent risk factors for poor prognosis. CONCLUSION: We proposed that histologic subtypes other than acral lentiginous melanoma and advanced stages have a poorer prognosis with significant differences.

Aged↗

PubMed1999

Mesohepatectomy for centrally located hepatocellular carcinoma: an appraisal of a rare procedure.

BACKGROUND: For centrally located hepatocellular carcinoma (HCC), extended major hepatectomy is usually recommended, but the risk of postoperative liver failure is high when liver function is not sound. Mesohepatectomy (en bloc resection of Goldsmith and Woodburne's left medial and right anterior segments or Couinaud's segments IV, V, and VIII) is a rare procedure, so its role in treating HCC is unclear. STUDY DESIGN: We retrospectively reviewed 364 patients who underwent a curative resection for HCC. Among them, 15 patients were treated by mesohepatectomy. Their nontumorous liver revealed cirrhosis in 11 and chronic hepatitis in 4. The mean tumor diameter was 12.8 cm. In 10 of the 15 patients, HCC also invaded adjacent organs. The operative results of another 25 patients with different disease extent who underwent extended major hepatectomy were compared. RESULTS: The hepatic inflow occlusion time for mesohepatectomy was longer than for extended hepatectomy (p = 0.01). The mean operative blood loss, amount of blood transfusion, operating time, and postoperative hospital stay in the mesohepatectomy group were 2,450 mL, 1,100 mL, 7.9 hours, and 14.9 days, respectively. In the extended-hepatectomy group, the values were 1,863mL, 768mL, 5.8 hours, and 16.8 days, respectively (all p>0.05 compared with mesohepatectomy). No patient died after mesohepatectomy, but after extended hepatectomy there was one death from liver failure. The Union Internationale contre le cancer (UICC) TNM stages of patients who underwent mesohepatectomy were as follows: stage II in 1, stage III in 4, and stage IVA in 10. All patients who underwent extended hepatectomy presented with stage IVA disease. The 6-year disease-free and actuarial survival rates after mesohepatectomy were 21% and 30%, respectively. The 6-year disease-free survival rate after extended hepatectomy was 9% (p = 0.11 compared with mesohepatectomy). CONCLUSION: Although mesohepatectomy is time-consuming, it is justified for selected patients with centrally located large HCC in a diseased liver.

Adult↗