Results of Hepatectomy for Hepatocellular Carcinoma at the National Cancer Center Hospital

The number of hepatectomies has increased greatly in recent years. Surgery for hepatocellular carcinoma (HCC) in the normal liver has not increased. However, the increase in numbers of hepatectomies for HCC associated with liver cirrhosis is remarkable. More than 80% of our hepatectomy cases were cirrhotic and about 80% of these cirrhotic cases had HCCs 5cm or less in diameter. The operative mortality rate has improved in the latter half of this series, from 10.1% (9/89) to 1.5% (5/338), in spite of an increase in cases with poor liver function. This corresponds to a decrease in the mean value of the annual operative blood loss. The survival rates after hepatectomy for all cases (n = 378) were 40.6% ± 6.6 (% ± SE) for 5 year and 22.7% ± 5.3 for 10 year at the end of 1988. A difference of the 5-year survival rate between the patients operated on before 1981 (n = 78, 25.6% ± 4.9) and after 1982 (n = 300, 46.1% ± 4.8) was observed (p<0.05). Because the cancer-free survival rates of the patients operated on in the two periods, before 1981 and after 1982, were almost the same, the recent improvement of the survival rates seems to be due to a prolongation of survival time after recurrence

The Neural Basis of Recursion and Complex Syntactic Hierarchy

Language is a faculty specific to humans. It is characterized by hierarchical, recursive structures. The processing of hierarchically complex sentences is known to recruit Broca’s area. Comparisons across brain imaging studies investigating similar hierarchical structures in different domains revealed that complex hierarchical structures that mimic those of natural languages mainly activate Broca’s area, that is, left Brodmann area (BA) 44/45, whereas hierarchically structured mathematical formulae, moreover, strongly recruit more anteriorly located region BA 47. The present results call for a model of the prefrontal cortex assuming two systems of processing complex hierarchy: one system determined by cognitive control for which the posterior-to-anterior gradient applies active in the case of processing hierarchically structured mathematical formulae, and one system which is confined to the posterior parts of the prefrontal cortex processing complex syntactic hierarchies in language efficiently

Technical progress in living donor liver transplantation for adults

These manoeuvres should improve graft function and survival

A deficit of spatial remapping in constructional apraxia after right-hemisphere stroke

This Article is provided by the Brunel Open Access Publising Fund - Copyright @ 2010 Oxford University PressConstructional apraxia refers to the inability of patients to copy accurately drawings or three-dimensional constructions. It is a common disorder after right parietal stroke, often persisting after initial problems such as visuospatial neglect have resolved. However, there has been very little experimental investigation regarding mechanisms that might contribute to the syndrome. Here, we examined whether a key deficit might be failure to integrate visual information correctly from one fixation to the next. Specifically, we tested whether this deficit might concern remapping of spatial locations across saccades. Right-hemisphere stroke patients with constructional apraxia were compared to patients without constructional problems and neurologically healthy controls. Participants judged whether a pattern shifted position (spatial task) or changed in pattern (non-spatial task) across two saccades, compared to a control condition with an equivalent delay but without intervening eye movements. Patients with constructional apraxia were found to be significantly impaired in position judgements with intervening saccades, particularly when the first saccade of the sequence was to the right. The importance of these remapping deficits in constructional apraxia was confirmed through a highly significant correlation between saccade task performance and constructional impairment on standard neuropsychological tasks. A second study revealed that even single saccades to the right can impair constructional apraxia patients’ perception of location shifts. These data are consistent with the view that rightward eye movements result in loss of remembered spatial information from previous fixations, presumably due to constructional apraxia patients’ damage to the right-hemisphere regions involved in remapping locations across saccades. These findings provide the first evidence for a deficit in remapping visual information across saccades underlying right-hemisphere constructional apraxia.European Commission Marie Curie Intra-European Fellowship (011457 to C.R.) and a Wellcome Trust Senior Fellowship (to M.H.)