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Purpose: To evaluate the risk factors of hepatocellular carcinoma (HCC) extension into the right atrium (RA) and determine poor prognostic factors for HCC extension to the heart. Materials and Methods: A total of 665 patients who were newly diagnosed with HCC were analyzed retrospectively from January 2004 to July 2012. The patients were divided into two groups: 33 patients with HCC extending into the RA and 632 HCC patients during the same period. The patients with HCC extending into the RA were subdivided into shorter survival group (<2 months) and longer survival group (≥2 months). Results: The prevalence of HCC extending to the RA was 4.96%. In multivariate analysis, a modified Union Internationale Contre le Cancer (UICC) stage higher than IVA, hepatic vein invasion, concomitant inferior vena cava and portal vein invasion, and multinodular tumor type were risk factors for HCC extending to the RA. In multivariate analysis, Cancer of the Liver Italian Program (CLIP) score >3 (p=0.016, OR: 13.89) and active treatment (p=0.024, OR: 0.054) were associated with prognostic factors in patients HCC extending into the RA. Active treatment such as radiation (n=1), transcatheter arterial chemoembolization (TACE) (n=11), Sorafenib (n=1), and combined modalities (n=2) were performed. Conclusion: Modified UICC stage higher than IVA, vascular invasion and multinodular tumor type are independent risk factors for HCC extending to the RA. Active treatment may prolong survival in patients HCC extending into the RA. [ABSTRACT FROM AUTHOR]

This study concerns the development of an integrated calculation methodology with which to continually and consistently analyze the progression of an accident from the design-basis accident phase via core uncovery to the severe accident phase. The depletion rate of reactor coolant inventory was experimentally investigated after the safety injection failure during a large-break loss-of-coolant accident utilizing the Seoul National University Integral Test Facility (SNUF), which is scaled down to 1/6.4 in length and 1/178 in area from the APR1400 [Advanced Power Reactor 1400 MW(electric)]. The experimental results showed that the core coolant inventory decreased five times faster before than after the extinction of sweepout in the reactor downcomer, which is induced by the incoming steam from the intact cold legs. The sweepout occurred on top of the spillover from the downcomer region and expedited depletion of the core coolant inventory. The test result was simulated with the MAAP4 severe accident analysis code. The calculation results of the original MAAP4 deviated from the test data in terms of coolant inventory distribution in the test vessel. After the calculation algorithm of coolant level distribution was improved by including the subroutine of pseudo pressure buildup, which accounts for the differential pressure between the core and downcomer in MAAP4, the core melt progression was delayed by hundreds of seconds, and the code prediction was in reasonable agreement with the overall behavior of the SNUF experiment. [ABSTRACT FROM AUTHOR]