Surgical treatment for hepatocellular carcinoma in cirrhotic patients. Guide to the selection and decision-making process in a context of multimodal strategy

2009 ◽  
Vol 11 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Héctor Daniel González ◽  
Joan Figueras
Keyword(s):  
Hepatocellular Carcinoma ◽  
Decision Making ◽  
Surgical Treatment ◽  
Decision Making Process ◽  
Multimodal Strategy ◽  
Cirrhotic Patients

scholarly journals ASSOCIATION BETWEEN MURINE DOUBLE MINUTE 2 - T309G polymorphism and recurrence of hepatocellular carcinoma after surgical treatment

2015 ◽  
Vol 52 (4) ◽  
pp. 325-330
Author(s):  
Uirá Fernandes TEIXEIRA ◽  
Andréa Gomes Coelho IZAGUIRRE ◽  
Mayara Christ MACHRY ◽  
Carlos Thadeu CERSKI ◽  
Ajácio Bandeira de Mello BRANDÃO ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Treatment ◽  
Tumor Recurrence ◽  
Histological Grade ◽  
Recurrence Rates ◽  
Single Nucleotide ◽  
Surgical Specimen ◽  
Potential Association ◽  
Cirrhotic Patients ◽  
The City

Background - Discovery and incorporation of biomarker panels to cancer studies enabled the understanding of genetic variation and its interference in carcinogenesis at molecular level. The potential association between single nucleotide polymorphism (SNP) 309 and increased development of tumors, such as hepatocellular carcinoma, has been subject to several studies. This is the first study on this association conducted in Brazil. Methods - 62 cases of cirrhotic patients with hepatocellular carcinoma surgically treated by partial hepatectomy (HPT) or by liver transplantation (LTX) from 2000 to 2009 at Santa Casa Hospital Complex, in the city of Porto Alegre, were retrospectively analyzed. Tumor samples from surgical specimen were collected and prepared for study in paraffin blocks. Results - Overall survival was 26.7 months in the HPT group and 62.4 months in the LTX group (P <0.01). Overall tumor recurrence was 66.7% in the HPT group (10/15) and 17% in the LTX group (8/47) (X²=13.602, P <0.01). Alpha-fetoprotein levels >200ng/mL, microvascular invasion and histological grade were associated with tumor recurrence (P <0.01). Recurrence rates in each surgical group and analysis of factors associated with tumor recurrence, when stratified for each genotypic pattern, were both not statistically significant. Conclusion - G/G genotype was not associated with tumor recurrence after surgical treatment and it did not show any correlation with other prognostic factors.

Vocal Fold Atrophy and its Surgical Treatment

1996 ◽  
Vol 105 (3) ◽  
pp. 182-188 ◽  
Author(s):  
Nobuhiko Isshiki ◽  
Kazuhiko Shoji ◽  
Hisayoshi Kojima ◽  
Shigeru Hirano
Keyword(s):  
Decision Making ◽  
Surgical Treatment ◽  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Folds ◽  
Decision Making Process ◽  
Type I ◽  
Vocal Fold Atrophy ◽  
The Voice ◽  
Type I Thyroplasty

The effectiveness of surgical treatment for vocal fold atrophy of various causes was examined. Type I thyroplasty was performed on 31 patients with vocal fold atrophy, often bilaterally and occasionally combined with type III thyroplasty. Of these 31 patients, 3 patients underwent the operation twice, for a total of 34 operations. The surgery was found to be effective in improving the voice quality and the ease of phonation. When a scar or sulcus was present, the results were not as satisfactory. The intraoperative decision-making process as to which procedure to perform is extremely important for achieving an optimal voice, and should be based on the intraoperative voice quality, fiberoptic findings, and manual tests. In operations for vocal fold atrophy in which the vocal folds are mobile, a silicone shim should be firmly fixed to prevent migration. Overcorrection is generally recommended. No complications were encountered. It was often the increased ease of phonation rather than the improved voice quality that patients appreciated after surgery.

AAC Decision-Making and Mobile Technology: Points to Ponder

2014 ◽  
Vol 23 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Mary Ann Abbott ◽  
Debby McBride
Keyword(s):  
Decision Making ◽  
Mobile Technology ◽  
Communication System ◽  
Augmentative And Alternative Communication ◽  
Evaluation Process ◽  
Decision Making Process ◽  
Alternative Communication ◽  
Ipod Touch ◽  
Feature Match

The purpose of this article is to outline a decision-making process and highlight which portions of the augmentative and alternative communication (AAC) evaluation process deserve special attention when deciding which features are required for a communication system in order to provide optimal benefit for the user. The clinician then will be able to use a feature-match approach as part of the decision-making process to determine whether mobile technology or a dedicated device is the best choice for communication. The term mobile technology will be used to describe off-the-shelf, commercially available, tablet-style devices like an iPhone®, iPod Touch®, iPad®, and Android® or Windows® tablet.

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