Vibrio cholerae is mainly known to cause gastrointestinal infection after seawater exposure or raw seafood intake. It is rarely reported to cause cellulitis or sepsis, but threre has been no known case after acupuncture. Herein, We report a 56-year-old cirrhotic patient of non-O1, non-O139 Vibrio cholerae septicemia caused by cellulitis of both lower extremities after acupuncture.

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  Tae-Hun Kim, Myeong Soo Lee, Stephen Birch, Terje Alræk, Arne Johan Norheim, Jung Won Kang
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Hepatocellular carcinoma(HCC), a highly malignant tumor with a poor prognosis, is one of the common cancers in Korea like other Asian and African countries. Despite of recent advances in diagnostic and surgical techniques, early diagnosis of HCC is difficult and chance of surgical resection is still very low due to the multiplicity of tumor and associated liver cirrhosis. Transcatheter arterial chemoembolization(TAE) is a proven effective method of treating HCC regardless of operability.

The current study was undertaken on 111 cases to evaluate the survival period of the pat-ients with HCC and to find their prognostic factors.

The results were as follows:

1) The mean age of the patients was 54.8 years, with a range from 33 to 79 years. The highest incidence of age was in the 6th decade and the male to female ratio was 4.6:1.

2) The survival period of the patients was significantly related to serum albumin, SGOT, bilirubin and treatment(TAE).

3) The survival period was not significantly related to size and type of tumor.

4) The revised staging systems by Primack and Okuda were not significantly related to the survival period. But Child's classification was significantly related to the survival period.

5) The median survival period of TAE group was 11 months while non-TAE group was 0.5 month(p=0.0023).

6) Multivariate Cox regression analysis showed that the treatment modality(TAE or non-TAE group) was the factor with the greatest relative risk and an independent prognostic value.

Accordingly, it is suggested that TAE is an effective method for treating unresectable HCC, and the prospective investigations on TAE are needed.

To investigate the prevalence of antibody against hepatitis C virus(HCV), anti-HCV wasdetected by enzyme immunoassay in 170 patients with liver cirrhosis, 77 patients with hepatocellular carcinoma, and 100 healthy controls.

The results were as follows :

1) Prevalence of anti-HCV was 15.3% in liver cirhosis and 9.1% in hepatocellular carcinomabut no significant difference was found between two groups. Anti-HCV was not detected inhealthy control group. prevalence of hepatitis B surface antigen(HBsAg) was 3% in healthycontrol, 52.9% in liver cirrhosis, and 72.7% in hepatocelltular carcinoma.

2) Prevalence of anti HCV in HBsAg positive patients with liver cirrhosis was 2.2% and30.0% in HBsAg negative patients. In HBs Ag negaive patients with liver cirrhosis, the prevalenceof anti-HCV was 40.9% in patients with antibodies to hepatitis B core antigen (anti-HBc)only, 21.1% in patients with anti-HBc and antibody to hepatitis B surface antigen(anti-HBs),and 35.0% in patients with no HBV markers.

3) Anti-HCV was not detected in HBsAg positive patients with hepatocellular carcinoma,but the prevalence of anti-HCV was 33.3% in HBsAg negative patients. In HBsAg negativepatients with hepatoccllular carcinoma, the prevalence of anti-HCV was 12.5% in patients withanti-HBc only, 45.5% in patients with anti-HBc and anti-HBs, and 50.0% in patients withno HBV markers.

4) In studying the relation of anti-HBc and anti-HCV in HBsAg negative patients withliver cirrhosis and hepatocellular carcinoma, prevalence of isolated anti-HCV, positive for bothanti-HBc and anti-HCV, negative for both anti-HBc and anti-HCV showed no significant difference between two groups. Prevalence of isolated anti-HBc showed significant difference betweentwo groups(p<0.01).

According, it is suggested that the most important factor in the pathogenesis of liver cirrhosisand hepatocellular carcinoma in Korea is HBV but in HBsAg negative patients, HCV is suggested to play an important etiologic role. In endemic areas of HBV such as Korea, whetherHCV acts in the process of development of hepatocellular carcinoma from liver cirrhosis andwhether HCV superinfection modifies the natural course of chronic HBV infection need furtherinvestigation.