Patients with chronic hepatitis C infection show a gradual progression of fibrosis to liver cirrhosis and hepatocellular carcinoma (HCC). We studied whether the progression of liver fibrosis differed among Japanese subjects who were infected with different hepatitis C virus (HCV) genotypes. In 527 patients we examined whether there was a relationship between gender, age, history of blood transfusion, interval between date of blood transfusion and date of liver biopsy or date of diagnosis of HCC, serum alanine aminotransferase level, platelet count or HCV genotype, with the extent of liver fibrosis, classified into four stages (F1-F4). Moreover, we compared the mean rate of liver fibrosis progression per year in patients with each HCV genotype. Patients who had a higher fibrosis score tended to be older, have a lower platelet count and a longer interval since blood transfusion than those who had a lower fibrosis score. The mean rate of liver fibrosis progression was 0.12 +/- 0.15 stages per year after the blood transfusion. However, the progression rate of liver fibrosis in patients who had received a blood transfusion when they were > or = 30 years of age was 0.19 +/- 0.22, while the progression rate of liver fibrosis in the patients who had received a blood transfusion when they were < 30 years was 0.09 +/- 0.09. In conclusion, chronic hepatitis C is a progressive disease, and patients with genotype 1b, 2a and 2b have a similar rate of progression of liver fibrosis. Particular attention should be paid to patients who are infected with HCV when > or = 30 years of age, because intrahepatic fibrosis rapidly progresses in these patients.

This study examined properties of four composite veneering materials polymerized with two different photo-curing units for the purpose of evaluating curing performance of the combination of composite material and curing unit. Two microfilled (Dentacolor and Thermoresin LC II) and two hybrid (Cesead II and Solidex) composite materials designed for prosthetic veneer were selected. The respective light sources of the units were a xenon (Dentacolor XS) and a metal halide (Hyper L II) lamp. The composite materials were exposed with the photo-curing unit for 60 s on each side (i.e. from top and bottom). Knoop hardness, compressive strength, flexural strength, flexural modulus, water absorption and water solubility were determined according to standardized testing methods. The specimens exposed with the metal halide unit generally exhibited greater Knoop hardness number, and compressive strength and lower solubility than those exposed with the xenon unit. A microfilled material (Thermoresin LC II) cured with the metal halide unit exhibited significantly improved results for all tests as compared with the same material cured with the xenon unit.

Properties of laboratory-cured composite materials are affected by the type of activation system as well as by the photo-curing unit light source. This study examined curing depth of a composite veneering material polymerized by means of various photo-curing units with the aim of evaluating the curing performance of the light sources. A microfilled composite material designed for prosthetic veneer was cured with seven photo-curing units. The light sources of the units were halogen/fluorescent, xenon, metal halide, fluorescent, halogen, halogen and mercury lamps. Exposure periods were 20, 30, 60 and 90 s. The curing depth of the material was determined using the method described by the International Organization for Standardization (ISO 4049). Two-factor analysis of variance revealed that the depth of cure was influenced both by the type of curing unit and by the exposure period (P = 0.0001). Among the seven photo-curing units, a metal halide curing unit consistently exhibited the greatest depth of cure. For all units, longer exposure increased the depth of cure.

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This report describes a rare case of metastatic hepatocellular carcinoma (HCC) presenting a huge mass in the left external auditory canal (EAC). The patient was a 55-year-old man with hepatitis B virus-related HCC. He presented to our department with a three-month history of increasing left otalgia, and hearing loss with recent fresh aural bleeding. Histopathologic examination indicated that the tumor was secondary to HCC. Although external irradiation was not effective, the tumor was treated with surgical debulking and high dose rate 192 Ir remote afterloading system (RALS) for postoperative intracavitary irradiation. A review of the literature revealed only five other cases of HCC metastasis to the temporal bone, all of which mainly metastasized in the internal acoustic meatus. The present case is the first report of HCC metastasis to the EAC.