To validate the utility of hepatic resection combined with complementary radiofrequency ablation (RFA) compared with resection alone for patients with multiple hepatocellular carcinoma (HCC), and to ...compare these results with those of a previous report.
A total of 78 HCC patients with multiple (≤5) tumours who were initially treated with hepatic resection only (Resection group) or with combined hepatic resection and RFA (Combination group) were included. Overall and disease-free survival were analysed.
There were 21 women and 57 men with a median age of 72.5 (64.3–76.8) years. Fifty-three patients were treated with resection alone and 25 received combination therapy. The 3-, 5-, and 7-year cumulative overall survival rates were 81.2%, 68.2%, and 57.1%, respectively, in the Resection group, and 81.3%, 59.6%, and 42.4%%, respectively, in the Combination group (hazard ratio HR, 1.462; 95% confidence interval CI, 0.682–3.136; p=0.329). The 1-, 3-, and 5-year cumulative disease-free survival rates were 61.4%, 45.7%, and 39.8%, respectively, in the Resection group, and 53.1%, 18.6%, and 0%, respectively, in the Combination group (HR, 2.080; 95% CI, 1.157–3.737; p=0.014). The overall survival rate was not significantly different between the Resection and Combination groups in patients within the up-to-seven HCC criteria (n=56; HR, 2.101; 95% CI, 0.805–5.486; p=0.130) or those beyond these criteria (n=22; HR, 0.804; 95% CI, 0.197–3.286; p=0.761).
The combination of hepatic resection and RFA therapy may be an effective strategy for HCC patients with multiple tumours.
•To validate the utility of hepatic resection combined with RFA for multiple HCC.•The overall survival was not different between the resection and combination therapy.•The combination of resection and RFA may be an effective strategy for multiple HCC.
Summary
Background
Whether direct‐acting anti‐viral therapy can reduce liver fibrosis and steatosis in patients with chronic hepatitis C virus (HCV) infection is unclear.
Aims
To evaluate changes in ...liver stiffness and steatosis in patients with HCV who received direct‐acting anti‐viral therapy and achieved sustained virological response (SVR).
Methods
A total of 198 patients infected with HCV genotype 1 or 2 who achieved SVR after direct‐acting anti‐viral therapy were analysed. Liver stiffness as evaluated by magnetic resonance elastography, steatosis as evaluated by magnetic resonance imaging‐determined proton density fat fraction (PDFF), insulin resistance, and laboratory data were assessed before treatment (baseline) and at 24 weeks after the end of treatment (SVR24).
Results
Alanine aminotransferase and homeostatic model assessment‐insulin resistance levels decreased significantly from baseline to SVR24. Conversely, platelet count, which is inversely associated with liver fibrosis, increased significantly from baseline to SVR24. In patients with high triglyceride levels (≥150 mg/dL), triglyceride levels significantly decreased from baseline to SVR24 (P = 0.004). The median (interquartile range) liver stiffness values at baseline and SVR24 were 3.10 (2.70‐4.18) kPa and 2.80 (2.40‐3.77) kPa respectively (P < 0.001). The PDFF values at baseline and SVR 24 were 2.4 (1.7‐3.4)% and 1.9 (1.3‐2.8)% respectively (P < 0.001). In addition, 68% (19/28) of patients with fatty liver at baseline (PDFF ≥5.2%; n = 28) no longer had fatty liver (PDFF <5.2%) at SVR24.
Conclusion
Viral eradication reduces both liver stiffness and steatosis in patients with chronic HCV who received direct‐acting anti‐viral therapy (UMIN000017020).
The total direct count (TDC) microbial enumeration method is rapid and suitable for analysing environmental samples containing numerous un‐culturable micro‐organisms. Conventional TDC methods require ...the addition of a fluorescent stain and are thus unsuitable for automatic monitoring. We unexpectedly found that heated micro‐organisms emit strong autofluorescence. This study was conducted to determine how heating enhances the autofluorescence of bacteria and fungi and to evaluate whether the phenomenon could be exploited to develop a new TDC method. Bacterial autofluorescence was augmented by heating cells at 200°C. ELISA results indicated that levels of advanced glycation end products (AGEs) increased in heated microbes. Catechin, an inhibitor of the Maillard reaction, disrupted the intensification of autofluorescence. These results suggest that the enhanced autofluorescence is associated with the formation of AGEs and that the reaction could be utilized as alternative probe in TDC methods.
Significance and Impact of the Study
Autofluorescence of bacteria and fungi was prominently intensified by heat treatment at 200°C. This phenomenon was associated with advanced glycation end products formed in micro‐organisms via the Maillard reaction. The fluorescence signal was strong enough to be utilized as an alternative probe for fluorescent dye in the total direct count method. This phenomenon could be incorporated in an automatic apparatus for microbial enumeration, as it does not require staining.
Significance and Impact of the Study: Autofluorescence of bacteria and fungi was prominently intensified by heat treatment at 200°C. This phenomenon was associated with advanced glycation end products formed in micro‐organisms via the Maillard reaction. The fluorescence signal was strong enough to be utilized as an alternative probe for fluorescent dye in the total direct count method. This phenomenon could be incorporated in an automatic apparatus for microbial enumeration, as it does not require staining.
-A GPS array with about 1,000 permanent stations is under operation in Japan. The GPS array revealed coseismic deformations associated with large earthquakes and ongoing secular deformation in the ...Japanese islands. Based on daily coordinate data of the GPS stations, strain rate distribution is estimated. Most regions with a large strain rate are related to plate boundaries and active volcanoes. In addition, the Niigata-Kobe Tectonic Zone (NKTZ) is recognized as a region of large strain rate along the Japan Sea coast and in the northern Chubu and Kinki districts. This newly found tectonic zone may be related to a hypothetical boundary between the Eurasian (or Amurian) and the Okhotsk (or North America) plates. Precise observation of crustal deformation provides important boundary conditions on numerical modeling of earthquakes and other crustal activities. Appropriate computation methods of continuous deformation field are directly applicable to data assimilation for such numerical simulations.
The interhemispheric competition model proposes that the functional recovery of motor deficits in patients after stroke can be achieved by increasing the excitability of the affected hemisphere or ...decreasing the excitability of the unaffected hemisphere. We investigated whether bilateral repetitive transcranial magnetic stimulation might improve the paretic hand in patients after stroke.
A double-blind study.
Thirty patients with chronic subcortical stroke.
The patients were randomly assigned to receive 1 Hz repetitive transcranial magnetic stimulation over the unaffected hemisphere, 10 Hz repetitive transcranial magnetic stimulation over the affected hemisphere, or bilateral repetitive transcranial magnetic stimulation comprising both the 1 Hz and 10 Hz repetitive transcranial magnetic stimulation. All patients underwent motor training following repetitive transcranial magnetic stimulation.
Bilateral repetitive transcranial magnetic stimulation and 1 Hz repetitive transcranial magnetic stimulation immediately improved acceleration in the paretic hand. Compared with 1 Hz repetitive transcranial magnetic stimulation, bilateral repetitive transcranial magnetic stimulation decreased the inhibitory function of the affected motor cortex and enhanced the effect of motor training on pinch force. Moreover, this effect of motor training lasted for one week. On the other hand, 10 Hz repetitive transcranial magnetic stimulation had no effect on the motor function.
Bilateral repetitive transcranial magnetic stimulation improved the motor training effect on the paretic hand of patients after stroke more than unilateral stimulation in pinch force; this might indicate a new neurorehabilitative strategy for stroke.
Rubber friction: Comparison of theory with experiment Lorenz, B.; Persson, B. N. J.; Dieluweit, S. ...
The European physical journal. E, Soft matter and biological physics,
12/2011, Letnik:
34, Številka:
12
Journal Article
Recenzirano
We have measured the friction force acting on a rubber block slid on a concrete surface. We used both unfilled and filled (with carbon black) styrene butadiene (SB) rubber and have varied the ...temperature from −10 °C to 100 °C and the sliding velocity from 1
μ
m/s to 1000
μ
m/s. We find that the experimental data at different temperatures can be shifted into a smooth master-curve, using the temperature-frequency shifting factors obtained from measurements of the bulk viscoelastic modulus. The experimental data has been analyzed using a theory which takes into account the contributions to the friction from both the substrate asperity-induced viscoelastic deformations of the rubber, and from shearing the area of real contact. For filled SB rubber the frictional shear stress σ
f
in the area of real contact results mainly from the energy dissipation at the opening crack on the exit side of the rubber-asperity contact regions. For unfilled rubber we instead attribute σ
f
to shearing of a thin rubber smear film, which is deposited on the concrete surface during run in. We observe very different rubber wear processes for filled and unfilled SB rubber, which is consistent with the different frictional processes. Thus, the wear of filled SB rubber results in micrometer-sized rubber particles which accumulate as dry dust, which is easily removed by blowing air on the concrete surface. This wear process seams to occur at a steady rate. For unfilled rubber a smear film forms on the concrete surface, which cannot be removed even using a high-pressure air stream. In this case the wear rate appears to slow down after some run in time period.
Sitagliptin has been suggested as a treatment option for older adults with type 2 diabetes (T2D). However, no randomized controlled trial has been performed to evaluate the efficacy and safety of ...sitagliptin treatment in older Japanese patients with T2D. The STREAM study was a multicenter, open-label, randomized controlled trial. T2D outpatients aged 65-80 years with moderately controlled glycemic levels (HbA1c 7.4-10.4%) under lifestyle interventions without or with oral anti-diabetic drugs excluding DPP4 inhibitors or GLP-1 receptor agonists were recruited (n = 176). The participants were randomized into sitagliptin group (n = 88) who received sitagliptin as an initial or an additive anti-diabetic drug and control group (n = 88) who did not. The treatment goal was HbA1c level < 7.4%. Efficacy and safety during 12-month treatment period were investigated. The mean (± SD) ages were 70.6 ± 3.9 and 71.9 ± 4.4 years old in sitagliptin and control groups, respectively. According to a mixed-effects model analysis, average changes from baseline over the treatment period in fasting plasma glucose (FPG), HbA1c, and glycated albumin (GA) were - 27.2 mg/dL, - 0.61%, and - 2.39%, respectively, in sitagliptin group, and 0.50 mg/dL, - 0.29%, and - 0.93%, respectively, in control group. The reductions in FPG, HbA1c, and GA were significantly greater in sitagliptin group (P < 0.0001, P < 0.01, and P < 0.0001, respectively). There were no differences in the incidence of adverse effects, except for cystatin C elevation and platelet count reduction in sitagliptin group. Sitagliptin treatment effectively improved the glycemic profile without any serious adverse effects in older T2D patients.Trial registration number: UMIN000010376.
Summary
We compared the background characteristics of patients with chronic hepatitis C who achieved eradication of hepatitis C virus (HCV), that is sustained virologic response (SVR), with ...interferon (IFN)‐based versus IFN‐free antiviral therapy in Japan. In addition, we used a previously reported risk assessment model to compare the incidence of hepatocellular carcinoma (HCC) after SVR by treatment type. Pretreatment characteristics of 1533 patients who achieved SVR with IFN‐based therapy and 1086 patients with IFN‐free therapy from five institutions across Japan were compared. The risk of HCC after SVR was assessed based on pretreatment characteristics, and the incidence of HCC after SVR was estimated in both groups. Age and serum alpha‐fetoprotein levels were higher, platelet count was lower, and liver fibrosis was more advanced in patients who achieved SVR with IFN‐free therapy compared with IFN‐based therapy. The incidence of HCC after SVR in the IFN‐free group was estimated to be more than twofold higher than in the IFN‐based therapy group (7.29% vs. 3.09%, and 6.23% vs. 3.01% when excluding patients who have underwent curative treatment for HCC). There are large differences in pretreatment characteristics between patients who achieved SVR with IFN‐based and IFN‐free therapies in Japan, which are associated with differential risk of HCC after SVR. These differences can influence the incidence of HCC after SVR and should be taken into consideration when comparing IFN‐based and IFN‐free therapies in terms of hepatocarcinogenesis suppression with HCV eradication.
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