Background/aims The purpose of this study was to investigate factors that may predict the development of the right inferior phrenic artery (RIPA) as a feeding artery in hepatocellular carcinoma (HCC) at the initial (first session) chemoembolization. Methodology From January 1997 to June 2002, 538 patients with HCC were treated with a first session of transcatheter arterial chemoembolization (TACE). Twenty-six of these patients underwent TACE via both the Hepatic artery (HA) and RIPA at the initial TACE. We retrospectively analyzed the Child-Pugh's classification, macroscopic tumor type, location and size of the tumor, past history of intervention, complications and outcome in these 26 patients with HCC fed by the RIPA. Results The incidence of HCC fed by both the HA and RIPA at the initial TACE was 4.8% (26/538 patients). No hepatic arterial occlusion or attenuation was found in any of these 26 patients. All of the tumors abutted the diaphragm and were located at the surface of the liver. All of the tumors that were larger than 5 cm in diameter protruded from the surface of the liver. Seven of the 9 patients with HCC smaller than 5 cm in diameter had a defect in the liver capsule induced by previous intervention for the treatment of a different tumor, such as hepatic resection or percutaneous ablation therapy. There were no serious complications after TACE. Conclusion The RIPA can be an extrahepatic feeding artery for HCC even at the initial TACE. A high incidence of HCC fed by the RIPA was recognized in cases in which a large tumor protruded from the surface of the liver, and when the liver capsule was damaged due to previous intervention such as hepatic resection or in ruptured HCC even at the initial TACE.
We hypothesized that patterns of CTNNB1 (β-catenin) mutations would affect the outcome of conservative therapy in patients with desmoid tumors. This study aimed to determine the significance of CTNNB1 (β-catenin) mutations in predicting the treatment outcome in patients with desmoid tumors treated with meloxicam, a cyclooxygenase-2 (COX-2) selective inhibitor. Between 2003 and 2012, consecutive thirty-three patients with extra-peritoneal sporadic desmoid tumors were prospectively treated with meloxicam as the initial systemic medical therapy. The efficacy of meloxicam was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). DNA was isolated from frozen tissue or formalin-fixed materials. CTNNB1 mutation analysis was performed by direct sequencing. Positivity of nuclear β-catenin staining by immunohistochemistry was compared with the status of CTNNB1 mutations. The correlation between the efficacy of meloxicam treatment and status of CTNNB1 mutations was analyzed. Of the 33 patients with meloxicam treatment, one showed complete remission (CR), 7 partial remission (PR), 12 stable disease (SD), and 13 progressive disease (PD). The following 3 point mutations were identified in 21 of the 33 cases (64%): T41A (16 cases), S45F (4 cases) and S45P (one case). The nuclear expression of β-catenin correlated significantly with CTNNB1 mutation status (p = 0.035); all four cases with S45F mutation exhibited strong nuclear expression of β-catenin. S45F mutation was significantly associated with a poor response (all cases; PD) (p = 0.017), whereas the other mutations had no impact on efficacy. The CTNNB1 mutation status was of significant prognostic value for meloxicam treatment in patients with sporadic desmoid tumors.
A 52-year-old woman with abdominal distension underwent computed tomography (CT) that demonstrated extensive paraaortic lymphadenopathy and a right renal mass. Compared to the renal cortex, the lesions exhibited low signal intensity on T(1)- and T(2)-weighted images and high intensity on diffusion-weighted magnetic resonance (MR) images. We suspected malignant lymphoma and performed excisional biopsy, which revealed metastatic papillary renal cell carcinoma. Retrospectively, significantly reduced signal on in-phase chemical shift MR images compared to out-of-phase images suggested the presence of intratumoral hemosiderin, a characteristic finding of this entity.
Purpose: To evaluate the influence of balloon ― occluded retrograde obliteration (BRTO) of portosystemic shunts on the liver function as evaluated by Child ― Pugh scores (CPS). Materials and Methods: Between 1996 and 2005, 44 patients underwent BRTO for gastrointestinal varices or hepatic encephalopathy. Of these, 21 were compromised with hepatocellular carcinoma synchronously or metachronously. The clinical symptoms, CPS, serum ammonia level, and other clinical laboratory data were compared before and after BRTO (one month through two years). Angiographically, the diameter of the portal vein was compared before and immediately after BRTO. Results: The CPS and serum ammonia level significantly improved from before to one month (n=29) after BRTO (Mann-Whitney U-test, p<0.05). The CPS was still improved at three months (n=16), and 6 months (n=13) after BRTO, but returned to the pre ― procedural level at one year after the procedure. The improvement in CPS was ascribed to improvement in the albumin level and resolution of encephaolopathy. A significant increase in the diameter of the portal vein was observed immediately after BRTO in all cases. Conclusion: BRTO immediately increases the volume of hepatopetal portal flow, and thus improves the liver function, and such an improvement may last at least 6 months.
Abstract Two series of inorganic/organic hybrid gels were prepared by the sol‐gel reaction of triethoxysilyl‐terminated poly(tetramethylene oxide) and tetraethoxysilane. The structure of hybrid gels was observed by small‐angle X‐ray scattering, and the scattered profiles were analysed by assuming a priori the density correlation functions. The results suggest that the hybrid gel is composed of organic‐rich, inorganic‐rich and organic/inorganic mixed regions. The size and structure of respective regions were discussed in terms of the correlation lengths evaluated from the scattering profiles.
Hair colouring was carried out by using catechinone prepared from (+)-catechin by enzymatic or chemical oxidation reaction. The difference of dyeability between the catechinone produced by enzymatic reaction (EC) and that produced by chemical reaction (CC) was studied changing the dyeing condition such as dye concentration, dyeing temperature, pH or the sort and concentration of salts. The colour of the hair dyed by EC or CC at 30°C is yellowish or reddish brown, respectively. The colour of the hair dyed by EC and CC is deeper at a higher dye concentration and at a higher temperature. Hair is dyed deepest by EC or CC at the solution pH = 6.04 or 5.45, respectively. The dyeability is increased by adding NaCl (≤4 M) or CaCl2 (≤1 M), while it is decreased by adding AlCl3. The colour fastness of the dyed hair to washing or ultraviolet light is high enough for practical use. Furthermore, it was found that colourants are obtained from tea extracts which contain catechin derivatives. Hair is dyed reddish brown by the colourants.
Hyaluronan (HA) has been shown to play important roles in the growth, invasion and metastasis of malignant tumors. Our previous study showing that high HA expression in malignant peripheral nerve sheath tumors (MPNST) is predictive of poor patient prognosis, prompted us to speculate that inhibition of HA synthesis in MPNST might suppress the tumorigenicity. The aim of our study was to investigate the antitumor effects of 4-methylumbelliferone (MU), an HA synthesis inhibitor, on human MPNST cells and tissues. The effects of MU on HA accumulation and tumorigenicity in MPNST cells were analyzed in the presence or absence of MU in an in vitro as well as in vivo xenograft model using human MPNST cell lines, sNF96.2 (primary recurrent) and sNF02.2 (metastatic). MU significantly inhibited cell proliferation, migration and invasion in both MPNST cell lines. HA binding protein (HABP) staining, particle exclusion assay and quantification of HA revealed that MU significantly decreased HA accumulation in the cytoplasms and pericellular matrices in both MPNST cell lines. The expression levels of HA synthase2 (HAS2) and HA synthase3 (HAS3) mRNA were downregulated after treatment with MU. MU induced apoptosis of sNF96.2 cells, but not sNF02.2 cells. MU administration significantly inhibited the tumor growth of sNF96.2 cells in the mouse xenograft model. To the best of our knowledge, our study demonstrates for the first time the antitumor effects of MU on human MPNST mediated by inhibition of HA synthesis. Our results suggest that MU may be a promising agent with novel antitumor mechanisms for MPNST.
Background There has been no consensus as to which system, either the Cancer of the Liver Italian Program (CLIP) or the Japan Integrated Staging (JIS) system, is suitable to predict the prognosis of hepatocellular carcinoma (HCC) patients who underwent transcatheter arterial chemoembolization (TACE) as initial therapy. Purpose To retrospectively compare the usefulness of CLIP and JIS in predicting and stratifying the prognosis of HCC patients treated by TACE. Material and Methods Between 1995 and 2005, consecutive 728 patients with untreated HCC who underwent TACE in our institute were selected for this study. The survival rate and its prognostic factors were assessed by multivariate analysis. Patients were stratified according to the two systems, and their survival rates between the scores were compared. Results The mean follow-up period was 1689 days. The 1-year, 3-year, 5-year, and 10-year survival rates were 83.1%, 55.1%, 34.7%, and 12.8%, respectively. Both systems stratified the prognosis of patients well, but was slightly better in CLIP as compared to in JIS. As for multivariate factor analysis, less severe Child-Pugh classification ( P < 0.001), simple tumor morphology ( P < 0.001), absence of portal vein invasion ( P < 0.001), and lower alpha-fetoprotein (AFP) level ( P < 0.001) were suggested to be independent indicators for favorable survival rate. All of these independent factors were included in CLIP, whereas JIS lacked AFP level. Furthermore, the likelihood χ 2 -test value was higher, and the Akaike information criterion value was lower for CLIP than for JIS. Conclusion CLIP is more suitable than JIS for predicting prognosis of patients with HCC who would undergo TACE in a Japanese population.
