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  • 1
    Online Resource
    Online Resource
    Liver Transplantation for Hepatocellular Carcinoma in Patients Who Do Not Meet the Milan Criteria
    S. Karger AG ; 2007
    In:  Digestive Diseases Vol. 25, No. 4 ( 2007), p. 329-333
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 25, No. 4 ( 2007), p. 329-333
    Abstract: 〈 i 〉 Background: 〈 /i 〉 To expand the Milan criteria, prognostic factors other than size and number of tumor may be necessary. We analyzed outcome and prognostic factors in patients with hepatocellular carcinoma (HCC) exceeding Milan criteria to select favorable group of patients. 〈 i 〉 Methods: 〈 /i 〉 Between November 1997 and December 2005, 104 cases of liver transplantation for patients with HCC were performed at our center. Twenty-four patients did not meet the Milan criteria preoperatively. Among these 24 patients, 19 had no major vascular invasion at the time of surgery. We analyzed the survival and prognostic factors of these 19 patients. The mean follow-up period was 33 months (range 6–89). 〈 i 〉 Results: 〈 /i 〉 Three-year survival rate in 19 patients was 67.4%. Three-year survival rates were significantly higher when preoperative alpha-fetoprotein was less than 400 ng/ml (86.2 vs. 0%, p 〈 0.001) when Edmonson-Steiner’s histological grade 1 or 2 (100 vs. 40%, p = 0.036) and when microvascular invasion was absent (78.6 vs. 30%, p = 0.039). 〈 i 〉 Conclusion: 〈 /i 〉 If vascular invasion is absent in preoperative radiological studies, and the preoperative alpha-fetoprotein is less than 400 ng/ml, our findings suggest a good prognosis after liver transplantation for HCC patients who do not meet the Milan criteria.
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000106913
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1482221-0
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  • 2
    Online Resource
    Online Resource
    Current Role of Surgery in Treatment of Early Stage Hepatocellular Carcinoma: Resection versus Liver Transplantation
    S. Karger AG ; 2008
    In:  Oncology Vol. 75, No. Suppl. 1 ( 2008), p. 124-128
    Details
    In: Oncology, S. Karger AG, Vol. 75, No. Suppl. 1 ( 2008), p. 124-128
    Abstract: Hepatocellular carcinoma (HCC) is the most common malignancy of the liver and is most commonly associated with hepatitis B infection in Korea. Although liver resection is regarded as a potentially curative treatment option, it is only feasible in less than 20% of patients. The reason for this is that HCC arises in cirrhotic livers and is often multicentric. Liver transplantation (LT) which could be used in the treatment both of the tumor and background liver seems to be a rational approach for early stage patients with decompensated liver cirrhosis. Current good selection criteria of LT for HCC are the Milan criteria: 1 HCC nodule ≤5 cm in diameter or 3 nodules ≤3 cm. By restricting LT to patients within the Milan criteria, the 4-year disease-free survival rate was more than 80%, which is comparable to that of a transplant candidate without HCC. However, there are serious limitations for the wider application of LT for HCC: (1) organ shortage, (2) risk to a live donor, (3) high cost, and (4) lifelong immunosuppression. For this reason, for a patient with early stage HCC and with Child A cirrhosis in whom partial hepatectomy is possible, the choice of primary treatment with curative intent is still under debate.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000173434
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 3
    Online Resource
    Online Resource
    Laparoscopic Liver Resection versus Percutaneous Radiofrequency Ablation for Small Single Nodular Hepatocellular Carcinoma: Comparison of Treatment Outcomes
    S. Karger AG ; 2021
    In:  Liver Cancer Vol. 10, No. 1 ( 2021), p. 25-37
    Details
    In: Liver Cancer, S. Karger AG, Vol. 10, No. 1 ( 2021), p. 25-37
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Treatment outcomes of laparoscopic liver resection (LLR) and percutaneous radiofrequency ablation (p-RFA) for small single hepatocellular carcinomas (HCCs) have not yet been fully compared. The aim of this study was to compare LLR and p-RFA as first-line treatment options in patients with single nodular HCCs ≤3 cm. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From January 2014 to December 2016, a total of 566 patients with single nodular HCC ≤3 cm treated by either LLR ( 〈 i 〉 n 〈 /i 〉 = 251) or p-RFA ( 〈 i 〉 n 〈 /i 〉 = 315) were included. The recurrence-free survival (RFS) and cumulative incidence of local tumor progression (LTP) were estimated using Kaplan-Meier methods and compared using the log-rank test. Treatment outcome of 2 treatment modalities was compared in the subgroup of patients according to the tumor location. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There were no significant differences in overall survival between LLR and p-RFA ( 〈 i 〉 p 〈 /i 〉 = 0.160); however, 3-year RFS was demonstrated to be significantly higher after LLR (74.4%) than after p-RFA (66.0%) ( 〈 i 〉 p 〈 /i 〉 = 0.013), owing to its significantly lower cumulative incidence of LTP (2.1% at 3 years after LLR vs. 10.0% after p-RFA, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). The complication rate of p-RFA was significantly lower than that of LLR (5.1 vs. 10.0%, 〈 i 〉 p 〈 /i 〉 = 0.026). LLR also provided significantly better local tumor control than p-RFA for subscapular tumors (3-year LTP rates: 1.9 vs. 8.8%, 〈 i 〉 p 〈 /i 〉 = 0.012), perivascular tumors (3-year LTP rates: 0.0 vs. 17.2%, 〈 i 〉 p 〈 /i 〉 = 0.007), and tumors located in anteroinfero-lateral liver portions (3-year LTP rates: 0.0 vs. 10.7%, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). However, there were no significant differences in LTP rates between LLR and p-RFA for non-subcapsular and non-perivascular tumors ( 〈 i 〉 p 〈 /i 〉 = 0.482) and for tumors in postero-superior liver portions ( 〈 i 〉 p 〈 /i 〉 = 0.380). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 LLR can provide significantly better local tumor control than p-RFA for small single HCCs in subcapsular, perivascular, and anteroinferolateral liver portions and thus may be the preferred treatment option for these tumors.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000510909
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2666925-0
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  • 4
    Online Resource
    Online Resource
    Expert Panel Statement on Laparoscopic Living Donor Hepatectomy
    S. Karger AG ; 2018
    In:  Digestive Surgery Vol. 35, No. 4 ( 2018), p. 284-288
    Details
    In: Digestive Surgery, S. Karger AG, Vol. 35, No. 4 ( 2018), p. 284-288
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 With improvements in living donor liver transplantation (LDLT) techniques and the increased experience of surgeons in laparoscopic major liver resection, laparoscopic donor hepatectomy is performed increasingly. Therefore, expert opinion on this procedure is required. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 The study aimed to report the current status and summarize the expert opinion on laparoscopic donor hepatectomy. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 An expert consensus meeting was held on September 8, 2016, in Seoul, Korea. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Laparoscopic donor left lateral sectionectomy could be considered the standard practice in pediatric LDLT. In adult LDLT, laparoscopy-assisted donor hepatectomy or left hepatectomy is potentially the next need, requiring more evidence for becoming standard practice. Laparoscopic donor right hepatectomy is still in the developmental stage, and more supporting evidence is required. Waving the cost consideration, the robotic approach could be a valid alternative for the suitable approaches of laparoscopy. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Laparoscopic donor hepatectomy is increasing its role in both pediatric and adult LDLT. However, for major donor hepatectomy, more evidence is needed.
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    URL: Article
    DOI: 10.1159/000479242
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1468560-7
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  • 5
    Online Resource
    Online Resource
    Survey Results of the Expert Meeting on Laparoscopic Living Donor Hepatectomy and Literature Review
    S. Karger AG ; 2018
    In:  Digestive Surgery Vol. 35, No. 4 ( 2018), p. 289-293
    Details
    In: Digestive Surgery, S. Karger AG, Vol. 35, No. 4 ( 2018), p. 289-293
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Because laparoscopic donor surgery has been successful in pediatric living donor liver transplantation, its application is expanding to right hepatectomy. However, there is no consensus on the indications for laparoscopic donor hepatectomy or on the details of the surgical technique. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To evaluate the current status of laparoscopic donor hepatectomy and to summarize the expert opinion on it. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Before the expert meeting on September 8, 2016, in Seoul, Korea, a survey was undertaken from expert liver surgeons from around the world. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Fifteen of 17 (88.2%) surgeons responded to the survey. The selection criteria for laparoscopic donor surgery are stricter than for open surgery in terms of the anatomy, remnant liver volume, and recipient's condition. There is no consensus on the instruments or equipment used. A literature review of laparoscopic donor hepatectomy showed that the use of this method is increasing and the short-term outcomes are similar to those of open surgery. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 This survey and literature review show that laparoscopic donor hepatectomy is performed by experienced surgeons in selected cases, and that its incidence is increasing worldwide.
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    URL: Article
    DOI: 10.1159/000479243
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1468560-7
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  • 6
    Online Resource
    Online Resource
    Clinical Features of Hereditary Angioedema in Korean Patients: A Nationwide Multicenter Study
    S. Karger AG ; 2018
    In:  International Archives of Allergy and Immunology Vol. 176, No. 3-4 ( 2018), p. 272-279
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 176, No. 3-4 ( 2018), p. 272-279
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Hereditary angioedema (HAE) is a genetically heterogeneous autosomal dominant disorder characterized by recurrent episodes of nonpruritic, nonpitting edema increasing after puberty. It can be fatal due to laryngeal or gastrointestinal (GI) involvement with varied and changing frequency of mortality according to studies published from the Western countries. Epidemiological and clinical data of HAE in Asian countries are sparse. We sought to examine the clinical characteristics of HAE patients in Korea. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Patients diagnosed with HAE at 15 tertiary hospitals across the country until 2016 were retrospectively reviewed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 65 patients diagnosed with HAE by 2016 were identified. The prevalence of HAE was estimated at 1.3/1,000,000 in Korea. Of the 65 patients, 21 (32.3%) were males. A total of 90.8% patients had type I HAE, while the remaining 9.2% patients had type II HAE. The first symptom developed after 20 years in 73.8% of patients, with a mean age 28.4 ± 14.1 years. The age at diagnosis was 36.5 ± 15.8 years, with a mean time delay of 7.8 ± 10.5 years. While the face (82.3%) and extremities (upper 71.0%, lower 62.9%) were the most frequently involved, the GI tract was affected in 40.5% of Korean HAE patients. Prophylaxis was maintained in 62.5% of patients. There was no reported case of death from HAE so far. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The clinical manifestation and severity of HAE may vary according to ethnicity. HAE is more infrequent and GI involvement is less likely in Korea compared with Western countries.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    URL: Article
    DOI: 10.1159/000488350
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482722-0
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  • 7
    Online Resource
    Online Resource
    Chromosomal Constitution of Embryos Derived from Tripronuclear Zygotes Studied by Fluorescence in situ Hybridization Using Probes for Chromosomes 4, 13, 18, 21, X, and Y
    S. Karger AG ; 2005
    In:  Gynecologic and Obstetric Investigation Vol. 59, No. 1 ( 2005), p. 14-18
    Details
    In: Gynecologic and Obstetric Investigation, S. Karger AG, Vol. 59, No. 1 ( 2005), p. 14-18
    Abstract: This study was designed to assess the chromosomal constitution and segregation patterns of cleaving embryos derived from tripronuclear zygotes. Thirty-two embryos obtained from 19 conventional IVF patients were analyzed by fluorescence in situ hybridization (FISH) using probes for chromosomes 4, 13, 18, 21, X, and Y. Sixteen embryos (50.0%) exhibited uniform, non-mosaic patterns. These embryos showed pure triploid (n = 7), pure diploid (n = 7), or pure haploid (n = 2). The remaining 16 embryos showed mosaic patterns; 1 was triploid-diploid mosaics, 9 were diploid-haploid, and 4 were haploid only. Autosomal aneuploidy occurred in 2 embryos showing a triploid complement. The sex chromosomal constituent XXX:XXY:XYY was 3:4:2 in embryos showing a pure triploid complement (including 2 embryos with aneuploidy). This ratio was not significantly different from the expected 1:2:1 (p = 0.96). Pure triploid was found in 41.7% of 2-cell embryos, but no triploid complement was found in 3-cell embryos. The present study also supports the diandric origin of tripronuclear zygotes in the conventional IVF, and, to our knowledge, is the first study to use simultaneous six-color FISH for chromosomes 4, 13, 18, 21, X, and Y in human embryos. However, no additive information was obtained about chromosome 4.
    Type of Medium: Online Resource
    ISSN: 0378-7346 , 1423-002X
    URL: Article
    DOI: 10.1159/000080522
    RVK:
    XA 45603
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1482695-1
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