These results indicate that subfascial endoscopic perforator surgery is an alternative to improve the long-lasting disease severity and/or clinical outcome.

Requirements to be met by an artificial liver support system are the abilities to perform the function of the liver, i.e., to support the functions of protein synthesis, detoxification, and phagocytosis. At present there are no artificial liver support that can satisfy all these conditions other than the detoxification and protein synthesis by removal and supply in plasma exchange. This mode of treatment poses various problems, including the disadvantage of requiring a great amount of plasma (1). Noting the adsorption performance of powdered charcoal, we have developed a new type of adsorbent for clinical application (UPC, BESPORE, Japan Medical Supply Co. Ltd., Hiroshima, Japan) that consists of powdered charcoal immobilized and encapsulated on a blood-biocompatible sheet. UPC is capable of purifying middle to large molecular weight and protein-bound substances, which have been relatively difficult to achieve with conventional blood purification (Fig.1).

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