bluuebunny/crossref_metadata_2025 huggingface dataset:
Artemisia iwayomogi plus Curcuma longa Synergistically Ameliorates Nonalcoholic Steatohepatitis in HepG2 Cells
Authors: Kim Hyeong-Geug , Lee Sung-Bae , Lee Jin-Seok , Kim Won-Young , Choi Seung-Hoon , Son Chang-Gue
Published: October 2017

The combination of Artemisia iwayomogi and Curcuma longa radix is frequently prescribed for liver diseases in TKM. However, the synergic effects of the two herbs on nonalcoholic steatohepatitis (NASH) have not yet been studied. Therefore, we investigated the anti‐NASH effects of the water extract of A. iwayomogi (AI), C. longa radix (CL), and combination of the two herbs (ACE). Hepatic steatosis and NASH were induced in HepG2 cells by treatment with palmitic acid (PA, for 6 h) with/without pretreatment of ACE (25 or 50 μg/mL), AI (50 or 100 μg/mL), CL (50 or 100 μg/mL), curcumin (5 μg/mL), or scopoletin (5 μg/mL). The PA treatment (200 μM) drastically altered intracellular triglyceride levels, total cholesterol, and expression levels of genes related to lipid metabolism (CD36, SREBP1c, PPAR‐γ, and PPAR‐α), whereas pretreatment with ACE significantly attenuated these alterations. ACE also protected HepG2 cells from PA‐ (300 μM‐) induced endoplasmic reticulum (ER) stress and apoptosis and attenuated the related key molecules including GRP78, eIF2, and CHOP, respectively. In conclusion, we found synergic effects of A. iwayomogi and C. longa on NASH, supporting the clinical potential for fatty liver disorders. In addition, modulation of ER stress‐relative molecules would be involved in its underlying mechanism.
Exploiting Awareness for the Development of Collaborative Rehabilitation Systems
Authors: Teruel Miguel A. , Navarro Elena , González Pascual
Published: October 2017

Physical and cognitive rehabilitation is usually a challenging activity as people with any kind of deficit have to carry out tasks that are difficult due to their damaged abilities. Moreover, such difficulties become even harder while they have to work at home in an isolated manner. Therefore, the development of collaborative rehabilitation systems emerges as one of the best alternatives to mitigate such isolation and turn a difficult task into a challenging and stimulating one. As any other collaborative system, the need of being aware of other participants (their actions, locations, status, etc.) is paramount to achieve a proper collaborative experience. This awareness should be provided by using those feedback stimuli more appropriately according to the physical and cognitive abilities of the patients. This has led us to define an awareness interpretation for collaborative cognitive and physical systems. This has been defined by extending an existing proposal that has been already applied to the collaborative games field. Furthermore, in order to put this interpretation into practice, a case study based on an association image-writing rehabilitation pattern is presented illustrating how this cognitive rehabilitation task has been extended with collaborative features and enriched with awareness information.
Suppressed Programmed Death 1 Expression on CD4+ and CD8+ T Cells in Psoriatic Patients
Authors: Bartosińska Joanna , Zakrzewska Ewelina , Raczkiewicz Dorota , Purkot Joanna , Michalak-Stoma Anna , Kowal Małgorzata , Krasowska Dorota , Chodorowska Grażyna , Giannopoulos Krzysztof
Published: October 2017

Psoriasis is a chronic inflammatory disease mediated by T cell immunity. Programmed death 1 (PD-1), a coinhibitory receptor, plays an important role in immune regulation and maintaining peripheral tolerance. The aim of the study was to compare the expression of PD-1 on the peripheral T cells between psoriatic patients and healthy controls. The study included 75 psoriatic patients and 52 healthy volunteers. The percentages and absolute numbers of CD3+, CD4+, CD8+, CD4+PD-1+, and CD8+PD-1+ T cells were analyzed using flow cytometry. The absolute numbers and percentages of CD4+PD-1+ and CD8+PD-1+ T cells were significantly decreased in the psoriatic patients in comparison with the control group. No significant correlations were found between the absolute numbers and percentages of CD4+PD-1+ or CD8+PD-1+ T cells and clinical characteristics of psoriasis. Decreased PD-1 expression on the T cells may be responsible for impaired negative regulation of immune response in psoriasis pathogenesis.
Conducting Prolonged General Anesthesia without Intravenous Access in a Child with Hypoplastic Left Heart Syndrome
Authors: Dang Phat T. , Sriratana Binjon
Published: October 2017

Children with chronic medical conditions often need multiple intravenous (IV) access instances during their hospitalizations, both peripheral and central. Obtaining a working IV in this patient population undergoing general anesthesia can be challenging. In our case report, we describe a method of administering general anesthesia in an infant with partially repaired hypoplastic left heart syndrome without IV access.
MRI-Based Estimation of Scalar Cochlear-Implant Electrode Position
Authors: Stratmann A. , Mittmann P. , Rademacher G. , Grupe G. , Hoffmann S. , Mutze S. , Ernst A. , Todt I.
Published: October 2017

The position of the cochlear-implant electrode is important to audiological outcomes after cochlear implantation. The common technique to evaluate the intracochlear electrode’s position involves the use of ionized radiation in MSCT, DVT, or flat-panel tomography (FPT). Recent advances in knowledge regarding the handling of MRI artifacts in cochlear implantees indicate that estimating the intracochlear electrode’s position with an MRI could be possible. This study’s aim was to evaluate the ipsilaterally position of electrodes using MRI at 1.5 T. In a retrospective study of 10 implantees with postoperative need for MRI scanning, we evaluated the intrascalar electrode’s position using a T2-weighted sequence at 1.5 T. We compared the resulting estimate of the intracochlear position with the estimates from the postoperative FPT scan and the intraoperative NRT ratio. For each ear, the MRI-estimated scalar position corresponded with the estimated positions from the FPT and NRT ratio. For eight ears, a scala tympani’s position was observed in the MRI. In one case, an electrode scalar translocation was found. In one case, the scala vestibuli’s position was observed. Thus, MRI-based estimation of the scalar position of a cochlear-implant electrode is possible. Limitations to this method include implant-specific magnet and fixation configurations, which can cause complications.
Mycoplasma Pneumonia: An Unrecognized Cause of Fever of Unknown Origin in an Adult
Authors: Ali-Ahmed Fatima , Halalau Alexandra
Published: October 2017

A 26-year-old female was admitted for fever of unknown origin (FUO), headaches, left ankle edema, and a lower extremity rash consistent with erythema nodosum. She had no respiratory symptoms or family history of autoimmune diseases. A chest X-ray was negative for pneumonia or hilar adenopathy. Extensive autoimmune workup was negative. A chest, abdomen, and pelvis computed tomography scan was unremarkable and laboratory studies revealed no source of infection. On hospital day 5, the patient developed a mild productive cough. Her Mycoplasma pneumonia (MP) IgM was high, confirming the diagnosis of MP induced FUO. She was started on azithromycin 500 mg daily and within 24 hours her fevers and headaches resolved. Her left ankle edema and EN gradually improved over a course of a few weeks. This case report highlights the need for MP testing in the evaluation of fever of unknown origin, even in the absence of pulmonary manifestations.
Investigation into Hypoglycemic, Antihyperlipidemic, and Renoprotective Potentials ofDennettia tripetala(Pepper Fruit) Seed in a Rat Model of Diabetes
Authors: Anioke Innocent , Okwuosa Chukwugozie , Uchendu Ikenna , Chijioke Olive , Dozie-Nwakile Ogechukwu , Ikegwuonu Ifeoma , Kalu Peculiar , Okafor Maryann
Published: October 2017

This study investigated the hypoglycemic, antihyperlipidemic, and renoprotective potentials ofDennettia tripetala(DT) in a rat model of diabetes. The hypoglycemic activity in crude methanol seed extract of DT (CMEDT) and methanol seed fraction of DT (MFDT) measured by glucose oxidase method was increased by 47.37% and 28.72%, respectively, after 8 hours of administration. After 10 days of treatment, CMEDT and MFDT gave a good glycemic control with the highest percentage reduction of 75.82% and 71.34% in glucose level, respectively, which is closely compared with 79.91% in glibenclamide. Using the enzymatic assay and Friedewald’s equation, there was a significant reduction in serum level of total cholesterol (TC), triglyceride (TG), very-low-density lipoprotein (VLDL), and low-density lipoprotein (LDL) and a significant increase in high-density lipoprotein (HDL) (p<0.05) following treatment with CMEDT and MFDT, when compared with the untreated group, although results varied in dosed groups, with high dose of MFDT showing a better lipid-lowering activity. High dose of MFDT improved lipid metabolism and increased percentage protection against atherogenesis by 44%. However, neither CMEDT nor MFDT ameliorated the renal biochemical alteration in urea and creatinine. Thus, the study demonstrates hypoglycemic and antihyperlipidemic potentials of DT seed in diabetes.
Effects of rhBMP-2 Loaded Titanium Reinforced Collagen Membranes on Horizontal Bone Augmentation in Dogs
Authors: Lee Ki-Sun , Jeon Yu-Sung , Shin Sang-Wan , Lee Jeong-Yol
Published: October 2017

The aim of this study was to evaluate the efficacy of growth factor loaded collagen membranes on new bone formation during horizontal bone augmentation. Mandibular defects (4 × 4 × 4 mm) were surgically prepared in six male beagle dogs, which were then protected with one of three types of membranes: (1) titanium mesh, (2) titanium reinforced collagen, or (3) rhBMP-2 loaded titanium reinforced collagen. Animals were euthanized 8 and 16 weeks after surgery, and nondecalcified specimens were prepared and histomorphologically investigated to determine the degree of osteogenesis. Data were analyzed with Friedman test. With respect to the degree of osteogenesis at earlier stage (8 weeks after surgery), there was significantly higher new bone ratio in rhBMP-2 loaded membrane group (p>0.05). However, with respect to the long-term results (16 weeks after surgery), there were no significant differences among the three membranes (p>0.05). Based on histomorphometric analysis, there were no significant differences in horizontal bone gaining ratio (p>0.05).
GosB Inhibits Triacylglycerol Synthesis and Promotes Cell Survival in Mouse Mammary Epithelial Cells
Authors: Xu Gaoxiao , Duan Saixing , Hou Jianye , Wei Zhongxin , Zhao Guangwei
Published: October 2017

It has been demonstrated that the activator protein related transcription factor Finkel-Biskis-Jinkins murine osteosarcoma B (GosB) is involved in preadipocyte differentiation and triacylglycerol synthesis. However, the role of GosB in regulating the synthesis of milk fatty acid in mouse mammary glands remains unclear. This research uncovered potentially new roles of GosB in suppressing milk fatty acid synthesis. Results revealed that GosB had the highest expression in lung tissue and showed a higher expression level during nonlactation than during lactation. GosB inhibited the expression of fatty acid synthase (FASN), stearoyl-CoA desaturase (SCD), fatty acid binding protein 4 (FABP4), diacylglycerol acyltransferase 1 (DGAT1), perilipin 2 (PLIN2), perilipin 3 (PLIN3), and C/EBPα in mouse mammary gland epithelial cells (MEC). In addition, GosB reduced cellular triglyceride content and the accumulation of lipid droplets; in particular, GosB enhanced saturated fatty acid concentration (C16:0 and C18:0). The PPARγ agonist, rosiglitazone (ROSI), promoted apoptosis and inhibited cell proliferation. GosB increased the expression of Bcl-2 and protected MEC from ROSI-induced apoptosis. Furthermore, MECs were protected from apoptosis through the GosB regulation of intracellular calcium concentrations. These findings suggest that GosB may regulate mammary epithelial cells milk fat synthesis and apoptosis via PPARγ in mouse mammary glands.
Tomographic Evaluation of the Lower Incisor’s Bone Limits in Mandibular Symphysis of Orthodontically Untreated Adults
Authors: Guerino Paula , Marquezan Mariana , Mezomo Maurício Barbieri , Antunes Kaline Thumé , Grehs Renésio Armindo , Ferrazzo Vilmar Antônio
Published: October 2017

The amount of available bone in the lower incisor region is critical for periodontal preservation when planning large anteroposterior dental movements. The aims of this study were to evaluate bone limits of the lower incisors in the mandibular symphysis and to verify whether they are influenced by facial growth patterns, lower incisor inclinations, skeletal anteroposterior relationships, or patient age. Tomographic images of 40 orthodontically untreated patients were evaluated and measurements of width and height of the mandibular symphysis, thickness on the lingual and labial sides of the alveolar bone, and thickness of the entire alveolar bone were performed in sagittal view. The following cephalometric measurements were also evaluated: growth pattern (FHI), lower incisor inclination (IMPA), and skeletal anteroposterior relationships (AO-BO). Pearson’s correlation test was used to assess associations among bone measurements, cephalometric measurements, and patients’ ages. Weak to moderate positive correlations between FHI and bone measurements on the labial side of the incisors and total alveolar width were found. The height of the symphysis had a moderate negative correlation with FHI. It was concluded that patient age, FHI, and IMPA influenced bone limits of the lower incisors in the mandibular symphysis, while AO-BO had no influence.
Tumor PDCD1LG2 (PD-L2) Expression and the Lymphocytic Reaction to Colorectal Cancer
Authors: Masugi Yohei , Nishihara Reiko , Hamada Tsuyoshi , Song Mingyang , da Silva Annacarolina , Kosumi Keisuke , Gu Mancang , Shi Yan , Li Wanwan , Liu Li , Nevo Daniel , Inamura Kentaro , Cao Yin , Liao Xiaoyun , Nosho Katsuhiko , Chan Andrew T. , Giannakis Marios , Bass Adam J. , Hodi F. Stephen , Freeman Gordon J. , Rodig Scott J. , Fuchs Charles S. , Qian Zhi Rong , Nowak Jonathan A. , Ogino Shuji
Published: October 2017

Expression of the immune checkpoint ligand CD274 (programmed cell death 1 ligand 1, PD-L1, from gene CD274) contributes to suppression of antitumor T cell–mediated immune response in various tumor types. However, the role of PDCD1LG2 (PD-L2, CD273, from gene PDCD1LG2) in the tumor microenvironment remains unclear. We hypothesized that tumor PDCD1LG2 expression might be inversely associated with lymphocytic reactions to colorectal cancer. We examined tumor PDCD1LG2 expression by IHC in 823 colon and rectal carcinoma cases within two U.S.-nationwide cohort studies and categorized tumors into quartiles according to the percentage of PDCD1LG2–expressing carcinoma cells. We conducted multivariable ordinal logistic regression analysis to assess the associations of tumor PDCD1LG2 expression with Crohn-like lymphoid reaction, peritumoral lymphocytic reaction, intratumoral periglandular reaction, or tumor-infiltrating lymphocytes, controlling for potential confounders, including microsatellite instability, CpG island methylator phenotype, long-interspersed nucleotide element-1 methylation, and KRAS, BRAF, and PIK3CA mutations. Tumor PDCD1LG2 expression was inversely associated with Crohn-like lymphoid reaction (Ptrend = 0.0003). For a unit increase in the three-tiered ordinal categories of Crohn-like lymphoid reaction, a multivariable OR in the highest (vs. lowest) quartile of the percentage of PDCD1LG2–expressing tumor cells was 0.38 (95% confidence interval, 0.22–0.67). Tumor PDCD1LG2 expression was not associated with peritumoral lymphocytic reaction, intratumoral periglandular reaction, tumor-infiltrating lymphocytes, or patient survival (Ptrend > 0.13). Thus, tumor PDCD1LG2 expression is inversely associated with Crohn-like lymphoid reaction to colorectal cancer, suggesting a possible role of PDCD1LG2-expressing tumor cells in inhibiting the development of tertiary lymphoid tissues during colorectal carcinogenesis. Cancer Immunol Res; 5(11); 1046–55. ©2017 AACR.
Subversion of NK-cell and TNFα Immune Surveillance Drives Tumor Recurrence
Authors: Kottke Tim , Evgin Laura , Shim Kevin G. , Rommelfanger Diana , Boisgerault Nicolas , Zaidi Shane , Diaz Rosa Maria , Thompson Jill , Ilett Elizabeth , Coffey Matt , Selby Peter , Pandha Hardev , Harrington Kevin , Melcher Alan , Vile Richard
Published: October 2017

Understanding how incompletely cleared primary tumors transition from minimal residual disease (MRD) into treatment-resistant, immune-invisible recurrences has major clinical significance. We show here that this transition is mediated through the subversion of two key elements of innate immunosurveillance. In the first, the role of TNFα changes from an antitumor effector against primary tumors into a growth promoter for MRD. Second, whereas primary tumors induced a natural killer (NK)–mediated cytokine response characterized by low IL6 and elevated IFNγ, PD-L1hi MRD cells promoted the secretion of IL6 but minimal IFNγ, inhibiting both NK-cell and T-cell surveillance. Tumor recurrence was promoted by trauma- or infection-like stimuli inducing VEGF and TNFα, which stimulated the growth of MRD tumors. Finally, therapies that blocked PD-1, TNFα, or NK cells delayed or prevented recurrence. These data show how innate immunosurveillance mechanisms, which control infection and growth of primary tumors, are exploited by recurrent, competent tumors and identify therapeutic targets in patients with MRD known to be at high risk of relapse. Cancer Immunol Res; 5(11); 1029–45. ©2017 AACR.
Hepatocarcinogenesis Is Associated with Serum Albumin Levels after Sustained Virological Responses with Interferon-Based Therapy in Patients with Hepatitis C
Authors: Umehara Yasuko , Hagiwara Satoru , Nishida Naoshi , Sakurai Toshiharu , Ida Hiroshi , Minami Yasunori , Takita Masahiro , Minami Tomohiro , Chishina Hirokazu , Ueshima Kazuomi , Komeda Yoriaki , Arizumi Tadaaki , Watanabe Tomohiro , Kudo Masatoshi
Published: October 2017

Objective: It is a generally accepted fact that eradication of hepatitis virus C inhibits the subsequent development of hepatocellular carcinoma (HCC). On the contrary, a significant population of patients developed HCC despite sustained virological responses (SVRs) to interferon (IFN) therapy. Methods: A total of 415 patients with chronic hepatitis C, who were treated at our hospital between 2004 and 2014, were enrolled for this study. We examined the risk factors for HCC development after IFN therapy. Results: After analyzing various clinical parameters, it was concluded that a serum albumin (ALB) level <4.0 g/dL and the presence or absence of SVR achievement were risk factors for the development of HCC. When analyzing pre- and posttreatment factors, only a serum ALB level <4.0 g/dL was considered a significant risk factor. The presence or absence of liver fibrosis progression was not identified as a risk factor. Conclusions: In patients with a serum ALB level <4.0 g/dL before IFN therapy, hepatic carcinogenesis after SVR achievement need to be considered. Furthermore, the serum ALB level may be more useful than the degree of fibrosis for the prediction of HCC after SVR in chronic hepatitis C.
Unique Characteristics Associated with Sustained Liver Damage in Chronic Hepatitis C Patients Treated with Direct Acting Antivirals
Authors: Kono Masashi , Nishida Naoshi , Hagiwara Satoru , Minami Tomohiro , Chishina Hirokazu , Arizumi Tadaaki , Minaga Kosuke , Kamata Ken , Komeda Yoriaki , Sakurai Toshiharu , Takenaka Mamoru , Takita Masahiro , Yada Norihisa , Ida Hiroshi , Minami Yasunori , Ueshima Kazuomi , Watanabe Tomohiro , Kudo Masatoshi
Published: October 2017

Background and Aims: Direct-acting antivirals (DAAs) dramatically improve the sustained virological response (SVR) of chronic hepatitis C (CHC) patients. However, continuous liver damage after SVR may be a risk of hepatocellular carcinoma (HCC). We clarified pretreatment characteristics related to sustained liver damage after SVR. Methods: A total of 286 CHC patients were treated with an interferon-free DAA regimen. Among them, 250 patients achieved SVR for 12 weeks after the end of treatment (SVR12); these individuals were classified based on α-fetoprotein (AFP) and alanine transaminase (ALT) levels posttreatment. Baseline characteristics significantly associated with AFP >5 ng/mL and ALT level ≥20 IU/L after SVR were clarified using multivariate analyses. Results: Among the pretreatment factors examined, serum AFP values and the presence of fatty liver (FL) were significantly associated with abnormal AFP (p < 0.0001) and ALT levels 12 weeks after SVR12 (SVR24; p = 0.0109). For 126 patients who showed an increase in baseline AFP level, FL, fibrosis-4 (FIB-4) index, and albumin levels before treatment were related to abnormal AFP at SVR24 (p = 0.0005, 0.0232, and 0.0400 for FL, FIB-4 index, and albumin, respectively). Similarly, for 150 patients with abnormal baseline ALT levels, FL was associated with an ALT level ≥ 30 IU/L after SVR (p = 0.0430). Conclusions: High FIB-4 index, low albumin level, and FL before DAA treatment were associated with a risk of sustained liver damage with AFP and ALT elevation after SVR; patients with these factors should be carefully monitored for emergence of HCC.
Hepatocellular Carcinoma after Achievement of Sustained Viral Response with Daclatasvir and Asunaprevir in Patients with Chronic Hepatitis C Virus Infection
Authors: Ida Hiroshi , Hagiwara Satoru , Kono Masashi , Minami Tomohiro , Chishina Hirokazu , Arizumi Tadaaki , Takita Masahiro , Yada Norihisa , Minami Yasunori , Ueshima Kazuomi , Nishida Naoshi , Kudo Masatoshi
Published: October 2017

Background: Interferon-based antiviral therapies against hepatitis C virus (HCV) infection have been shown to reduce the incidence of hepatocellular carcinoma (HCC) in patients with sustained viral response (SVR). Recently, direct-acting antivirals (DAAs) have been proven to be much more effective in achieving SVR than interferon-based therapies. However, whether DAAs can efficiently prevent the occurrence of HCC after SVR remains controversial. To clarify this issue, we analyzed the clinical features of patients in whom HCC developed after achievement of SVR with DAAs for chronic HCV infection. Summary: Among patients who achieved SVR with daclatasvir and asunaprevir (n = 100), HCC developed in 17 patients (HCC group; n = 17) and did not develop in 83 patients (non-HCC group; n = 83) during a mean observation period of 15 months. A multivariate Cox proportional hazards analysis identified past history of HCC and male sex as significant risk factors for the emergence of HCC after DAAs. Sixteen cases with HCC after DAAs were in the very early or early stage (16/17, 94.1%), and one case was in the advanced stage (1/17, 5.9%) with portal venous tumor thrombus. Radiofrequency ablation and/or transarterial chemoembolization were performed in most cases as curative therapy (16/17, 94.1%). Key Messages: SVR by DAAs did not completely prevent the occurrence of HCC. However, even if HCC did develop after SVR, curative anticancer therapy was applicable in most cases.
Non-Hypervascular Hypointense Hepatic Nodules during the Hepatobiliary Phase of Gadolinium-Ethoxybenzyl-Diethylenetriamine Pentaacetic Acid-Enhanced MRI as a Risk Factor of Intrahepatic Distant Recurrence after Radiofrequency Ablation of Hepatocellular Carcinoma
Authors: Iwamoto Takayuki , Imai Yasuharu , Igura Takumi , Kogita Sachiyo , Sawai Yoshiyuki , Fukuda Kazuto , Yamaguchi Yoshitaka , Matsumoto Yasushi , Nakahara Masanori , Morimoto Osakuni , Ohashi Hiroshi , Fujita Norihiko , Kudo Masatoshi , Takehara Tetsuo
Published: October 2017

Background: Non-hypervascular hypointense hepatic nodules during the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI have been reported to be associated with intrahepatic distant recurrence (IDR) after hepatectomy or radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). IDR is categorized into hypervascular transformation of non-hypervascular hypointense hepatic nodules and new intrahepatic recurrence. The aim of this study was to evaluate the relationship between non-hypervascular hypointense hepatic nodules on Gd-EOB-DTPA-enhanced MRI and IDR after RFA, focusing on new intrahepatic recurrence. Methods: Ninety-one consecutive patients with 115 HCCs undergoing pretreatment Gd-EOB-DTPA-enhanced MRI and RFA for treatment of HCC were enrolled. Results: Of the 91 patients who underwent RFA for HCC, 24 had non-hypervascular hypointense hepatic nodules on pretreatment Gd-EOB-DTPA-enhanced MRI. Recurrences were observed in 15 and 19 patients with and without non-hypervascular hypointense hepatic nodules, respectively. Of the 15 recurrences in patients with non-hypervascular hypointense hepatic nodules, 10 patients had new intrahepatic recurrences. The cumulative incidence of new intrahepatic recurrence was significantly higher in patients with non-hypervascular hypointense hepatic nodules than in those without non-hypervascular hypointense hepatic nodules (p < 0.0001). Multivariate analysis revealed that the presence of non-hypervascular hypointense hepatic nodules and Child-Pugh score were independent risk factors for new intrahepatic recurrence. Conclusions: Non-hypervascular hypointense hepatic nodules during the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI were a useful predictive factor for IDR, particularly for new intrahepatic recurrence, after RFA.
Hemodynamic Changes on Cone-Beam Computed Tomography during Balloon-Occluded Transcatheter Arterial Chemoembolization Using Miriplatin for Hepatocellular Carcinoma: A Preliminary Study
Authors: Ishikawa Toru , Imai Michitaka , Owaki Takashi , Sato Hiroki , Nozawa Yujiro , Sano Tomoe , Iwanaga Akito , Seki Keiichi , Honma Terasu , Yoshida Toshiaki , Kudo Masatoshi
Published: October 2017

Background/Aim: Balloon-occluded transcatheter arterial chemoembolization (B-TACE) using miriplatin (MPT) is anticipated as a new strategy for hepatocellular carcinoma (HCC). This study was aimed at evaluating the hemodynamic changes with/without balloon occlusion of the hepatic artery, correlation of cone-beam CT (CBCT) pixels, and CT value after B-TACE for HCC. Methods: A total of 52 patients with HCC, who underwent B-TACE using MPT in addition to the balloon-occluded CBCT hepatic arteriography, were studied. Results: After balloon occlusion, CBCT pixel values increased in 37 lesions, whereas it decreased in 15 lesions. Intratumoral CT values after B-TACE were lower with decreased CBCT pixel values than with increased CBCT pixel values. Conclusion: Hemodynamic changes on CBCT during balloon occlusion can be used to predict the efficacy of B-TACE using MPT.
Hepatic Function during Repeated TACE Procedures and Prognosis after Introducing Sorafenib in Patients with Unresectable Hepatocellular Carcinoma: Multicenter Analysis
Authors: Hiraoka Atsushi , Kumada Takashi , Kudo Masatoshi , Hirooka Masashi , Koizumi Yohei , Hiasa Yoichi , Tajiri Kazuto , Toyoda Hidenori , Tada Toshifumi , Ochi Hironori , Joko Koji , Shimada Noritomo , Deguchi Akihiro , Ishikawa Toru , Imai Michitaka , Tsuji Kunihiko , Michitaka Kojiro ,   On behalf of the Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics)
Published: October 2017

Background/Aim: We evaluated the relationship of hepatic function with repeated transarterial catheter chemoembolization (TACE) and prognosis after sorafenib treatment in various patient cohorts. Methods: Study 1 comprised of 212 Barcelona clinic liver cancer stage-B (BCLC-B) HCC patients classified as Child-Pugh A (CP-A) and who had received repeated TACE treatments (r-TACE) (naïve:recurrence = 66:146). Study 2 comprised of 435 patients with unresectable HCC classified as CP-A in who sorafenib was introduced (naïve:recurrence = 37:398; CP score 5:6 = 282:153; macro-vessel invasion [MVI]+: extrahepatic metastasis [EHM]+ both negative = 124:226:143). Changes in hepatic function along with CP and albumin-bilirubin (ALBI) score/grade during r-TACE in Study 1, and prognosis after introducing sorafenib in Study 2 were evaluated. Results: Hepatic function worsened to CP-B in 9-14% with each TACE procedure, while 18-21% had a change of classification from ALBI-1 to ALBI-2. When the prognosis of patients with the best CP score of 5 was analyzed, those with ALBI-1 (n = 154) had a better outcome than those with ALBI-2 (n = 128) (MST 17.5 vs. 9.9 months; p = 0.01), while ALBI-1 (n = 43) patients also showed a better outcome than ALBI-2 (n = 34) patients with a CP score of 5 without MVI/EHM (MST: 17.5 vs. 10.0 months; p = 0.029). The Akaike's Information criterion for ALBI-grade (MST: grade 1 vs. 2 = 16.9 vs. 10.4 months; p = 0.001) was also better than that for CP (MST: score 5 vs. 6 = 14.4 vs. 10.5 months; p = 0.003) (3195.6 vs. 3197.5) in all 435 patients. Conclusion: The rate of patients with downgraded hepatic function during r-TACE, especially with regard to ALBI-grade, was not low. ALBI-grade was shown to be a better hepatic function assessment tool than CP in patients receiving sorafenib treatment. Strict judgment of TACE-refractory status in patients with unresectable HCC is needed to improve prognosis before downgrading the hepatic function.
Sorafenib-Regorafenib Sequential Therapy in Advanced Hepatocellular Carcinoma: A Single-Institute Experience
Authors: Ueshima Kazuomi , Nishida Naoshi , Kudo Masatoshi
Published: October 2017

Objectives: Previously, no therapeutic agent has been known to improve the overall survival compared with placebo in patients with hepatocellular carcinoma (HCC), who have progressed after sorafenib. In this patient population, regorafenib was first demonstrated to confer a survival benefit in the RESORCE trial, and subsequently it was approved as a second-line treatment for patients with advanced HCC. An open-label expanded access program (EAP) of regorafenib was implemented for compassionate use. We investigated the efficacy and safety of regorafenib based on our experience of the RESORCE trial and the EAP. Methods: Data from 5 patients from the RESORCE trial and 6 from the EAP were analyzed retrospectively. All patients had tolerated prior sorafenib and were progressing during sorafenib treatment. Results: The median progression-free survival was 9.2 months (95% CI 2.3-16.1). One patient achieved a partial response and 7 achieved stable disease. The objective response rate was 9.1%, and the disease control rate was 72.7%. No treatment-associated mortalities were observed. Grade 3 hypophosphatemia was observed in 2 patients, grade 2 anorexia was observed in 5 patients, and grade 3 neutropenia was observed in 2 patients. Grade 2 and grade 3 thrombocytopenia were observed in 2 and 3 patients, respectively. All treatment-related adverse events were improved by reduction or interruption of regorafenib. Five patients showed decreased serum albumin levels. Conclusion: Sorafenib and regorafenib sequential therapy presents a safe and effective treatment option for patients with advanced HCC.
Cardiogenic Shock during First Infusion of Anthracycline Chemotherapy in a Patient with Hodgkin Lymphoma: An Unusual Event
Authors: Binaghi Giulio , Congia Damiana , Cossa Stefano , Massidda Stefania , Pasqualucci Daniele , Pilo Federica , Serra Emanuela , Angelucci Emanuele , Porcu Maurizio
Published: October 2017

Introduction: Hodgkin lymphoma (HL) is one of the most common types of cancers of the lymphatic system. The currently available therapies enable a cure in approximately 80-85% of treated patients. However, the cardiotoxicity of HL treatment has become a major cause of morbidity and mortality in survivors mainly related to the use of anthracycline. Case Report: An HL, staged IIIB, was diagnosed in a 60-year-old man with no cardiovascular disease. During the first cycle of ABVD chemotherapy (Adriamycin; bleomycin; vinblastine; dacarbazine), near the end of the dacarbazine infusion, the patient presented a sudden cardiogenic shock characterized by a severe left ventricular systolic dysfunction. Laboratory and instrumental examinations performed did not suggest any specific etiology. After 15 days of medical support, the patient presented a complete cardiac function and clinical recovery. Subsequently bendamustine chemotherapy was started because of its limited extrahematological toxicity, but after 4 cycles the patient had progressive disease and died of septic shock. We concluded that a very rare hyperacute anthracycline cardiotoxicity was the most likely reason for this critical scenario. Conclusions: This rare event stresses our inability to correctly predict the risk of a patient developing cardiotoxicity and also highlights the need to improve the knowledge of underlying pathophysiological mechanisms; in fact, it suggests a possible genetic predisposition to develop cardiotoxicity due to a relatively limited dosage.
An Intergroup Randomized Phase II Study of Bevacizumab or Cetuximab in Combination with Gemcitabine and in Combination with Chemoradiation in Patients with Resected Pancreatic Carcinoma: A Trial of the ECOG-ACRIN Cancer Research Group (E2204)
Authors: Berlin Jordan D. , Feng Yang , Catalano Paul , Abbruzzese James L. , Philip Philip A. , McWilliams Robert R. , Lowy Andrew M. , Benson III Al B. , Blackstock A. William
Published: October 2017

Objectives: Evaluate toxicity of two treatment arms, A (cetuximab) and B (bevacizumab), when combined with gemcitabine, and chemoradiation in patients with completely resected pancreatic carcinoma. Secondary objectives included overall survival (OS) and disease-free survival (DFS). Methods: Patients with R0/R1 resection were randomized 1:1 to cetuximab or bevacizumab administered in combination with gemcitabine for two treatment cycles. Next three cycles included concurrent cetuximab/bevacizumab plus chemoradiation, followed by one cycle of cetuximab/bevacizumab. Cycles 7-12 included cetuximab/bevacizumab with gemcitabine. Cycles were 2 weeks. Frequency of specific toxicities was summarized for each treatment arm at two times during the study, after chemotherapy but prior to chemoradiation and after all therapy. Results: A total of 127 patients were randomized (A, n = 65; B, n = 62). Prior to chemoradiation, the overall rate for toxicities of interest was 10% for arm A and 2% for arm B. After all therapy, the overall rates for toxicities of interest were 30 and 25% for arms A and B, respectively. Overall median OS and DFS were 17 and 11 months, respectively, which is not a significant improvement over expected survival rates for historical controls. Conclusions: Both treatments were tolerable with manageable toxicities, and were safe enough for a phase III trial had this been indicated.
Characteristics and Outcomes of Vertebrobasilar Artery Dissection with Accompanied Atherosclerosis
Authors: Chien Chun , Chang Feng-Chi , Huang Hui-Chi , Tsai Jui-Yao , Chung Chih-Ping
Published: October 2017

Background: With the popularity of MRI use, vertebrobasilar artery dissection (VBD) has been found more frequently in patients with posterior circulation ischemic stroke (PCS). The relationship between VBD and atherosclerosis is unknown. The present study aimed to prove the hypothesis that PCS with pure VBD (p-VBD) and with VBD and accompanied cervical or cerebral artery atherosclerosis (a-VBD) have distinct manifestations. Methods: Patients with VBD-related PCS who were prospectively enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and August 31, 2014 were recruited for the present study. Patients who had (1) atherosclerotic plaques with or without stenotic flow in cervical arteries on Duplex ultrasonography or (2) focal >30% stenosis in cerebral arteries other than the dissecting region (usually in arterial bifurcations which are prone to atheroma formation) on brain MRA were defined as a-VBD. Results: There were 91 patients (67 [73.6%] males, mean age 65.5 years [SD = 15.2, range, 21–91]) with VBD-related PCS recruited for the present study; 31 were a-VBD and 60 were p-VBD. The results showed that there were significant differences in onset age, frequency of cigarette smoking, dissecting vascular involvement, and infarct locations between the 2 groups. In addition, compared with p-VBD, the a-VBD group had poorer functional recovery at 3 months and 1 year, respectively, which was independent of age, sex, vascular risk factors, stroke severity at admission, and treatment options. Conclusion: VBD-related PCS with and without accompanied atherosclerosis had different manifestations and should be regarded as distinct arterial diseases.
FCGR2A and FCGR3A Genotypes Correlate with Farletuzumab Response in Patients with First-Relapsed Ovarian Cancer Exhibiting Low CA125
Authors: Wang Wenquan , Somers Elizabeth B. , Ross Erin N. , Kline J. Bradford , O'Shannessy Daniel J. , Schweizer Charles , Weil Susan , Grasso Luigi , Nicolaides Nicholas C.
Published: October 2017

Farletuzumab is a humanized monoclonal antibody that binds to folate receptor alpha and elicits an anti-tumor response via immune effector activity. Recent studies from a global phase 3 trial in ovarian cancer patients treated with carboplatin/taxane plus farletuzumab found that the tumor-produced CA125 protein can suppress farletuzumab function via perturbing its engagement to the activating Fc-γ receptors CD32a (FCGR2A) and CD16a (FCGR3A). Previous reports have indicated that naturally occurring polymorphisms in both of these receptors may play a role in their ability to engage therapeutic antibodies and elicit an optimal immune response via antibody-dependent cellular cytotoxicity (ADCC). In light of the importance of farletuzumab ADCC function for optimal tumor cell killing, we evaluated the frequency of FCGR2A-131H/R and FCGR3A-158V/F polymorphisms in 461 consenting patients from this global clinical study and their association with clinical outcome to placebo versus farletuzumab treatment. Here, we show that farletuzumab has enhanced binding to FCGR3A-158V high-affinity receptor and has an enhanced clinical outcome in patients with low baseline CA125 levels and at least 1 high-affinity allele of FCGR2A or FCGR3A.
A Solitary Intestinal Myofibroma: A Rare Cause of Neonatal Anemia
Authors: Ottenhoff Janna S.E. , Nikkels Peter G.J. , Terwisscha van Scheltinga C.E.J. , Naeije L.
Published: October 2017

Solitary infantile myofibroma with visceral involvement is very rare. We present an unusual case of a solitary myofibroma with abdominal localization in a 1-day-old female neonate who presented with severe anemia and rectal bleeding. A bleeding myofibroma was found, located in the wall of the jejunum, and totally resected. In case of a solitary lesion, treatment is relatively easy and effective, with excellent prognosis after total resection. The multiple form (myofibromatosis) has a poor prognosis with low survival rates. We therefore recommend total body MRI for all patients diagnosed with myofibroma to rule out other lesions.
Recurrent Masses after Testicular Cancer: Growing Teratoma Syndrome. A Case Report and Review of the Literature
Authors: Priod Fanny , Lorge Francis , Di Gregorio Marcelo , Dupont Michaël V. , Nollevaux Marie-Cécile , Faugeras Laurence , Lawson Georges , Eucher Philippe , D’Hondt Lionel
Published: October 2017

Background: Growing teratoma syndrome is a rare syndrome that affects patients with nonseminomatous germ-cell tumors (NSGCTs). It is characterized by recurrent growing masses that appear during or after chemotherapy in the presence of normal levels of tumor markers. Histological examination is the only way to confirm the diagnosis. Case Presentation: We present the case of a 36-year-old man who developed recurrent masses after curative treatment for NSGCT of the testicle. His tumor markers were normal. The patient was cured after multiple surgical procedures. Conclusions: Close follow-up after treatment for NSGCT is very important for early detection of this syndrome, which can occur even many years after tumor onset. Normal blood makers can be misleading, and surgery remains the only curative treatment.
Use of Random Dot Patterns in Achieving X-Ray Vision for Near-Field Applications of Stereoscopic Video-Based Augmented Reality Displays
Authors: Ghasemi Sanaz , Otsuki Mai , Milgram Paul , Chellali Ryad
Published: October 2017

This article addresses some of the challenges involved with creating a stereoscopic video augmented reality “X-ray vision” display for near-field applications, which enables presentation of computer-generated objects as if they lie behind a real object surface, while maintaining the ability to effectively perceive information that might be present on that surface. To achieve this, we propose a method in which patterns consisting of randomly distributed dots are overlaid onto the real surface prior to the rendering of a virtual object behind the real surface using stereoscopic disparity. It was hypothesized that, even though the virtual object is occluding the real object’s surface, the addition of the random dot patterns should increase the strength of the binocular disparity cue, resulting in improved performance in localizing the virtual object behind the surface. In Phase I of the experiment reported here, the feasibility of the display principle was confirmed, and concurrently the effects of relative dot size and dot density on the presence and sensitivity of any perceptual bias in localizing the virtual object within the vicinity of a flat, real surface with a periodic texture were assessed. In Phase II, the effect of relative dot size and dot density on perceiving the impression of transparency of the same real surface while preserving detection of surface information was investigated. Results revealed an advantage of the proposed method in comparison with the “No Pattern” condition for the transparency ratings. Surface information preservation was also shown to decrease with increasing dot density and relative dot size.
‘A Tourist In The Country Of Men’: Sexuality, Self, And Multiple Modernities In Anya Ulinich’s Graphic Novel Lena Finkle’s Magic Barrel
Authors: Carr Jessica
Published: October 2017

This article analyzes how Anya Ulinich’s graphic novel Lena Finkle’s Magic Barrel (2014) engages in and expands upon Jewish writing practices. I argue that through her use of the graphic novel as a medium, Ulinich both draws on and subverts masculine writing practices and images of women that have dominated Jewish literature and culture. Through her cross-discursive, intertextual, multi-directional writing, Ulinich depicts her protagonist Lena as gaining a sense of self, but one that is fragmentary and constantly experienced and re-pictured through memory and in relationship to others. Ulinich also raises the question, without providing a stable answer, as to the place of Soviet Jewish memory in Jewish-American life, experience, and literature. She places Russian, Jewish, and American writing and gender norms in conversation with each other, suggesting the difficulty of reconciling these different visions for women and modernity.
New genera and new species of Acrometopini (Orthoptera: Tettigonioidea Phaneropterinae) from East Africa and a review of all known stridulatory organs, songs and karyotypes of the tribe
Authors: Hemp Claudia , Heller Klaus-Gerhard , Warchałowska-Śliwa Elżbieta , Grzywacz Beata , Hemp Andreas
Published: October 2017

Two new genera of East African Acrometopini are erected: the monotypicPeronurellan. gen. withP. centralisn. sp. from Miombo woodlands in central Tanzania, andTenerasphagan. gen. for a morphological uniform group of species formerly included inHoratosphaga,T. chyuluensisn. sp.,T. mbulun. sp.T. nanyuki,T. nudan. comb,T. meruensisn. comb,T. teneran. comb andT. bazeletaen. comb. Additional species are described in the generaAltihoratosphaga,LamecosomaandPeronura. Keys to African genera of Acrometopini and species of the genusTenerasphagaare provided. We review the male calling songs and the morphology of the acoustical apparatus and discuss how the morphology of the stridulatory files explains the complicated song patterns and elements. All Acrometopini species showed a plesiomorphic karyotype with a diploid chromosome number of 2n = 31 and a X0 sex chromosome system in males.
Between East and West
Authors: Taroutina Maria
Published: October 2017

Taking cue from Dmitry Sarabyanov’s seminal publications on the Stil Modern and turn-of-the-century Russian visual culture, the present article resituates Mikhail Vrubel’s œuvre “between East and West” by demonstrating that the artist moved beyond the narrowly circumscribed nationalist agenda typically attributed to the work he produced at the Abramtsevo and Talashkino artistic colonies. In addition to indigenous sources, Vrubel also assimilated a number of external artistic influences such as Jugendstil, medieval Gothic and Renaissance ceramics, Japanese and Chinese porcelain, and Egyptian and Assyrian art. Through a close analysis of Vrubel’s orientalist paintings, as well as his cycle of folkloric works such as Mikula Selyaninovich and the Volga (1896), I demonstrate that his aesthetic program crossed multiple boundaries: geographical, temporal, material, and institutional. Through a complex renegotiation of the global and the local, the past and the present, and the traditional and contemporary, Vrubel arrived at a strikingly modernist visual syntax, which paved the way for an entire generation of avant-garde artists such as Mikhail Larionov, Natalia Goncharova, Kazimir Malevich, Aleksandr Rodchenko, Liubov Popova, Vladimir Tatlin, and Naum Gabo, among others. Using Vrubel as a case study, this article thus proposes to rethink the opposing binary categories of avant-gardism and revivalism, historicism and innovation, Orientalism and Occidentalism, regionalism and cosmopolitanism, as they have been applied to the trajectory of modern Russian art—a set of ostensibly fixed dichotomies that Dmitry Sarabyanov had repeatedly and successfully challenged in his own work.
An Unexpected Role Reversal
Authors: Blakesley Rosalind P.
Published: October 2017

In 1862, the collector Pavel Tretyakov made his second visit to Britain, and lent three paintings to the International Exhibition held in London that year. Then aged just thirty, he had bought his first Russian paintings just six years previously, yet his collection was already of sufficient calibre for the Imperial Academy of Arts in St. Petersburg to desire works from it for the Russian submission to the London event. Moreover, the genre paintings which Tretyakov lent added spice to what was otherwise a rather routine academic display. In this respect, Tretyakov’s contribution to the 1862 exhibition could be seen to foretell his later patronage of the Peredvizhniki, who similarly unsettled the academic status quo.

Yet one small but telling fact disrupts this narrative of a collector who championed the innovative and the marginalized. Tretyakov had in fact suggested lending to the exhibition paintings by Vladimir Borovikovsky, Fedor Bruni, Karl Briullov and Vasily Khudiakov, all of whom were established members of the academic firmament. But his proposal was overruled and replaced by the alternative selection of genre paintings put forward by Fedor Iordan, a stalwart of the Academy. Far from confirming an image of Tretyakov as a nonconformist whose pioneering vision shook up the practices of the establishment, the case of the 1862 exhibition thus sees the binary which has often been drawn between this ground-breaking collector and the hidebound conservatism of the Academy significantly reversed.