The presence of MVI was the most important risk factor affecting recurrence and survival in HCC patients after curative resection. Furthermore, this study showed that gross classification of HCC can be very helpful in predicting the presence of MVI.

We examined the validity of 'Transtheoretical Model of Behavior Change' six stages in exercise domain. A paper-pencil survey was completed by 457 workers. Self-efficacy tended to increase from Precontemplation to Action, did not change from Action to Maintenance, and then increase from Maintenance to Termination. Pros tended to increase and cons decrease only from Precontemplation to Action. A follow-up survey was completed by 331 workers. More preparers (25.4%) moved to Action compared to precontemplator (3.8%) and contemplators (6.5%). Relapse rates were lower among those in Termination (17.0%) than those in Action (43.8%) and Maintenance (38.1%). These results partially supported the validity.

Abstract. Sessile serrated adenoma (SSA) is a proposed precursor of colorectal carcinogenesis. This study aimed to analyze the potential of endoscopy to discriminate SSA from other serrated lesions, specifically traditional serrated adenoma (TSA) and hyperplastic polyp (HP). Of 145 serrated lesions, 111 sessile serrated lesions including 32 TSAs, 25 SSAs and 54 HPs were analyzed for size, color, location and morphologic features using conventional endoscopy and magnifying chromoendoscopy. SSA was preferentially located in the right colon, whereas TSA and HP were located in the left colon. The sizes of SSA and TSA were larger than those of HP. The lesion color was indistinguishable among TSA, SSA and HP. Macroscopically, a pinecone-like or twotier raised appearance were found more frequently in TSA than in SAA and HP. Under magnified chromoendoscopic observation, the stellar III L pit pattern and fern-like appearance were observed more frequently in TSA than in SAA and HP. In conclusion, endoscopic discrimination between SSA and other sessile serrated lesions based on morphological features was difficult. However, size and location of the lesions facilitated diagnosis. IntroductionSerrated polyps of the colorectum have been the focus of critical reappraisal and intense study in recent years. Previously, the majority of serrated, non-adenomatous polyps were diagnosed as hyperplastic polyps (HPs) and treated as innocuous, benign lesions (1). Subsequently, HP was implicated in the development of colorectal cancer through a putative HP-serrated adenoma-colorectal cancer sequence. At present, the serrated polyps are regarded as heterogeneous lesions with several histological subtypes, including HP, traditional serrated adenoma (TSA) and sessile serrated adenoma (SSA) (2,3).Mounting evidence shows that SSA may be the precursor lesion through the previously described 'serrated pathway' of colorectal carcinogenesis (4), and some investigators recommend that SSA should be clinically managed in a similar manner to conventional adenomas (5). A greater frequency of microsatellite instability has been shown in SSA versus HP or TSA (6). SSA shows a higher frequency of CpG island methylation than conventional HP (7), while showing a higher frequency of BRAF gene mutations and a lower frequency of K-ras gene mutations versus conventional adenoma (8,9). Thus, reliable identification of SSA and its differentiation from other serrated lesions, such as HP and TSA, has important clinical implications and may condition therapeutic attitudes and endoscopic follow-up.Colonoscopy is the only technique currently available that offers the potential to detect and remove colorectal lesions throughout the large intestine. Some authors previously reported the endoscopic features of TSA and HP (10-13). However, the endoscopic features of SSA have yet to be established. This study aimed to compare the endoscopic features of the three sessile serrated lesions, TSA, SSA and HP, and to determine whether SSA can be distinguished from other serrated ...

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Minor complications were frequently observed. However, all GTCs underwent en bloc resection with ESD without any serious complications. ESD is considered a useful treatment for GTC.