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Minimally invasive surgery using endoscopic vision is widely employed for the treatment of thyroid diseases. We have performed endoscopic thyroidectomy by the axillary approach (axillary approach) and video-assisted thyroidectomy via a 3 cm cervical incision (video-assisted approach). In this study, we evaluated the efficacy of these two procedures. Each procedure was performed in 20 consecutive consenting patients. The degree of invasiveness after surgery was compared using postoperative results. The amount of pain and satisfaction with surgery was evaluated by grade (1-5) using a patient questionnaire. All thyroidectomies were completed successfully. No recurrent laryngeal nerve palsies occurred. Operating time for the video-assisted approach was significantly shorter than that for the axillary approach (p < 0.01). The amount of pain for the axillary approach on 1, 3, and 5 days after operation, respectively, was graded 3.2+/-0.7, 2.1+/-0.6, and 1.6+/-0.7 compared to 2.7+/-1.1, 1.7+/-0.7, and 1.1+/-0.2 for the video-assisted approach. The postoperative course was significantly less painful in patients undergoing the video-assisted approach on postoperative days 3 and 5 (p < 0.01). The degrees of satisfaction for the axillary approach and the video-assisted procedure were 1.2+/-0.4 and 2.4+/-1.0, respectively (p < 0.01). The video-assisted approach is less "invasive" than the axillary approach, but the axillary approach may be indicated for patients who are anxious about the visible cosmetic results.

AIM:To elucidate risk factors contributing to the development of hepatocellular carcinoma (HCC) among patients with sustained viral response (SVR) after interferon (IFN) treatment and to examine whether HCV-RNA still remained in the liver of SVR patients who developed HCC. METHODS:Two-hundred and sixty-six patients, who achieved SVR, were enrolled in this study. We retrospectively reviewed clinical, viral and histological features of the patients, and examined whether the development of HCC depends on several clinical variables using Kaplan-Meier Method. RT-PCR was used to seek HCV-RNA in 3 out of 7 patients in whom liver tissue was available for molecular analysis. RESULTS:Among the enrolled 266 patients with SVR, HCC developed in 7 patients (7/266; 2.6%). We failed to detect HCV-RNA both in cancer and non-cancerous liver tissue in all three patients. The cumulative incidence for HCC was significantly different depending on hepatic fibrosis (F3-4) (P = 0.0028), hepatic steatosis (Grade 2-3) (P = 0.0002) and age (≥ 55) (P = 0.021) at the pre-interferon treatment. CONCLUSION:The current study demonstrated that age, hepatic fibrosis, and hepatic steatosis at preinterferon treatment might be risk factors for developing HCC after SVR.

The purpose of this study is to estimate the effectiveness of psychological intervention on personality change, enhancing perceived emotional support, and, ultimately, assisting in the adaptive coping and psychological well-being of Japanese primary breast cancer patients. The intervention consists of 3 sessions that include providing medical and psychological information and counseling using the structured association technique. The participants were 28 primary breast cancer patients (14 for the experimental group and 14 for the control group). Participants were assessed at 3 to 4 days after surgery (preintervention) and 3 months (postintervention) and 6 months (follow-up) after discharge using 5 scales: the self-repression scale, the Japanese version of the self-esteem scale, the emotional support scale, the Japanese version of the Mental Adjustment to Cancer Scale, and the Japanese version of the Hospital Anxiety and Depression Scale. The intervention seemed to have enhanced the short-term personality change, adaptive coping, and psychological well-being of primary breast cancer patients. However, further trials will be needed with larger samples to corroborate the findings.