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(1) Background: Respiratory virus infections, including Coronavirus disease 2019 (COVID-19), seasonal influenza (FLU), and respiratory syncytial virus (RSV) as prominent examples, can severely affect both children and adults. This study aimed to investigate the clinical characteristics of respiratory viral infections in pediatric and adult populations and to identify determinants influencing patient hospitalization. (2) Methods: This retrospective study analyzed the electronic medical records of patients admitted to a regional hospital's emergency department from 1 January 2015 to 31 December 2022, to investigate the clinical characteristics and hospitalization risk factors associated with these three viruses. (3) Results: Infants aged 1 to 11 months were most affected by COVID-19 and RSV, whereas FLU more commonly infected children aged 3 to 5 years. Key factors influencing hospitalization included age and abnormal chest X-ray findings, with higher risks observed in younger children and adults over 65. Notably, the presence of abnormal chest x-ray findings significantly increased the hospitalization risk by 1.9 times [1.5–2.4] in children and 21.4 times [2.4–189.0] in adults. (4) Conclusions: This analysis underscores the impact of COVID-19, FLU, and RSV on hospitalization risk, offering insights for managing these respiratory viral infections (RVIs). Age-related risk differences highlight the necessity for tailored strategies, improving understanding of and treatment development for RVIs. [ABSTRACT FROM AUTHOR]

In this paper, a design method is proposed for a 20 (kW) audio amplifier power supply that can be used for both single-phase and three-phase applications. The proposed circuit is a boost converter + LLC resonant converter structure with additional rectifier diodes added to the single-phase PFC converter. It has the advantages of a high power density and a high output power. A power factor of 0.9 or more can be satisfied without control. In addition, an unregulated LLC converter is adopted for the isolated DC/DC stage to improve power density and efficiency since LLC converters have excellent dynamic characteristics. For the design of the proposed circuit, an appropriate design method is presented that considers the audio load. The performance of the proposed circuit has been verified on a 20 (kW) [input voltage 220/380 (Vac), output voltage 450 (V)] prototype designed with the design method. [ABSTRACT FROM AUTHOR]

Laparoscopic surgery has been traditionally contraindicated for gallbladder cancer, but there have been few reports demonstrating the oncologic outcomes of this treatment. This study aimed to compare the technical feasibility and the long-term outcomes after laparoscopic versus open extended cholecystectomy for gallbladder cancer. Between January 2011 and December 2018, 44 patients with gallbladder cancer who underwent extended cholecystectomy were included in this study, with 20 patients in the laparoscopic group and 24 patients in the open group. Perioperative outcomes, overall survival (OS), and recurrence-free survival (RFS) were retrospectively analyzed. There were no significant differences (p > 0.05) between the two groups in terms of perioperative outcomes, including blood loss, postoperative complications, R0 resection, and the number of lymph nodes retrieved. Patients in the laparoscopic group showed similar OS compared to the open group (5 year tumor-specific OS rate: 84.7% vs. 62.5%; p = 0.125). On subgroup analysis of patients with stage T2 and N0 disease, the laparoscopic group showed better OS (T2: 90.9% vs. 75.0%, p = 0.256; N0: 100.0% vs. 76.5%, p = 0.028). There was no difference in terms of RFS (3 year RFS: 74.4% vs. 64%; p = 0.571) and locoregional recurrence (10.0% vs. 16.9%, p = 0.895) between the two groups. There was no port-site recurrence in the laparoscopic group. This study suggests that laparoscopic extended cholecystectomy might be not inferior to open surgery in terms of oncologic safety or early and long-term outcomes in patients with early gallbladder cancer. [ABSTRACT FROM AUTHOR]

Background: Surgical and oncological outcomes in ruptured hepatocellular carcinoma (HCC) are not well known. The objective of this study was to review and compare survival outcomes and recurrence rates between ruptured and unruptured HCC. Methods: Data of patients with ruptured HCC who underwent curative surgical resection between January 2000 and December 2016 were retrospectively reviewed. To compare survival outcomes between ruptured and unruptured HCC, 1:2 individual matching was conducted. Results: The 1-, 3-, and 5-year overall survival (OS) rates were 88.8%, 67.0%, and 51.9%, respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 51.7%, 32.8%, and 25.0%, respectively. OS and DFS rates were significantly lower in the ruptured HCC group than the matched unruptured HCC group. HCC recurred in 63 patients (70.8%), 33 (52.4%) of whom presented with both intrahepatic and extrahepatic recurrences. Mean recurrence interval was 12.6 ± 13.8 months. The 1-, 3-, and 5-year survival rates after recurrence were 61.6%, 40.2%, and 33.6%, respectively. Mean survival time after recurrence was 26.4 ± 29.5 months. Incidence of peritoneal seeding (PS) was 18.0%, and eight of them demonstrated solitary lesion. Mean recurrence interval was 5.9 ± 8.2 months. The 1-, 3-, and 5-year OS rates after recurrence were significantly lower in patients with PS (49.7%, 18.7%, and 9.3%, respectively) than in patients without PS. Conclusions: Hepatectomy in ruptured HCC did show worse survival outcome compared with unruptured HCC and bear a high risk of PS. However, surgical resection combined with transcatheter arterial chemoembolization could help in achieving acceptable oncological outcomes. [ABSTRACT FROM AUTHOR]

Maintenance of adequate portal inflow is crucial for graft regeneration in adult living donor liver transplantation (ALDLT) to allow the recipients to meet their early metabolic demands. A persistent large spontaneous portosystemic shunt can divert portal flow away from the liver graft, leading to impaired or delayed graft regeneration and subsequent graft failure. The importance of obliterating huge portosystemic shunt during liver transplantation is obvious for successful ALDLT. However, in partial liver graft with a relatively small graft-to-recipient weight ratio (GRWR) (compared with deceased donor whole graft liver transplantation), even the persisting small portosystemic shunt may result in repeated portal flow steal when a liver graft faces increased intrahepatic vascular resistance caused by rejection or graft congestion with hepatic venous outflow stenosis. We present 2 complicated cases of reappearing portal flow steal that were derived from the remaining small portosystemic shunt under the increased vascular resistance of the liver graft, even after interruption of a large portosystemic shunt during ALDLT. Because ALDLT is always a partial liver graft, even when GRWR is over 1%, it is much more vulnerable to hemodynamic changes in portal flow by rejection or graft congestion by hepatic venous outflow obstruction. Therefore, a comprehensive understanding of complex portosystemic shunt and complete reinterruption of reappearing portosystemic shunt, even though small and insignificant, during ALDLT is important for graft salvage procedures before irreversible liver graft damage. [ABSTRACT FROM AUTHOR]

Liver cancer exhibits the fourth most common cause of cancer-associated mortality worldwide. Due to the rapid growth, solid tumors undergo severe hypoxia and produce high levels of extracellular adenosine to maintain homeostasis. A previous study indicated that the hypoxic condition in liver cancer increased hepatic adenosine, which is known to facilitate cancer survival and proliferation. Extracellular adenosine has been revealed to regulate pathological and physiological processes in cells and tissues. However, its pathophysiological role in liver cancer remains undetermined. Emerging evidence has indicated that the adenosine A2B receptor promotes the progression of liver cancer. Therefore, it was hypothesized that HIF-1α is a transcriptional regulator of A2B in human liver cancer. The current study determined A2B expression of a number of liver cancer cell lines and performed functional studies of HIF-1α as a master transcriptional regulator of hepatic A2B signaling during hypoxic conditions. The current study aimed to identify the promoter region of A2B, which has a hypoxia response element, by performing luciferase assays. The present study demonstrated that reduced HIF-1α expression is associated with low expression of A2B, and HIF-1α overexpression is associated with A2B induction. Furthermore, the siRNA-mediated downregulation of A2B inhibited the growth and proliferation of HepG2, which is a liver cancer cell line. The relationship between HIF-1α and A2B expression was also identified in human liver cancer specimens. In conclusion, the current study indicated that A2B is induced by the HIF-1α transcriptional regulator during hypoxia, and it may be a potential pharmacologic and therapeutic target for the treatment of patients with liver cancer. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) universally recurs after liver transplantation (LT). Although the introduction of direct-acting antiviral agents (DAAs) has revolutionized the treatment of HCV infection, no optimal treatment for HCV recurrence after LT has been developed.Methods: This study retrospectively evaluated the efficacy of DAAs as a pre-emptive treatment for recurrent HCV infection after living donor liver transplantation (LDLT). From January 2010 to December 2016, 70 patients received pegylated interferon (PegIFN) and 35 patients were treated with DAA-based regimens to treat recurrent HCV after LDLT. All antiviral treatments were pre-emptive.Results: Genotype 1b was the most common HCV type (61.9%). Twenty-two recipients in the DAA group were treated with ledipasvir/sofosbuvir, nine received daclatasvir plus asunaprevir, three received sofosbuvir, and one received sofosbuvir plus daclatasvir. All 35 patients (100%) in the DAA group achieved a sustained virologic response (SVR), a percentage significantly higher than that (71.4%) in the PegIFN group (p < 0.001). In the PegIFN group, the 1-, 3-, and 5-year graft survival rates were 85.7, 73.9, and 70.7%, respectively, whereas those in the DAA group were 100, 100, and 100%, respectively (p = 0.008).Conclusion: DAA-based regimens are an effective treatment for HCV recurrence after LDLT, resulting in an improved SVR and better graft survival than PegIFN. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of superselective trans-catheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA) for patients with acute non-variceal upper and lower gastrointestinal (GI) bleeding.Methods: TAE using NBCA was performed in 21 patients (13 males, 8 females, mean age 60.9 years) with acute non-variceal upper (n = 15) and lower (n = 6) GI bleeding. TAE using other embolic agents was performed in 25 patients (13 males, 12 females, mean age 69.1 years) with acute non-variceal upper (n = 16) and lower (n = 9) GI bleeding. Technical success, clinical success, clinical failure, major and minor complications, bleeding-related 30-day mortality, and overall in-hospital mortality were analyzed.Results: In 21 patients who underwent TAE with NBCA, the overall technical success was 100% (21/21) and overall clinical success was 72.2% (13/18). Uncontrolled bleeding, recurrent bleeding, and clinical failure were seen in 11.1% (2/18), 16.7% (3/18), and 27.8% (5/18) of cases, respectively. The minor complication rate was 16.7% (4/21) and no major complications occurred. Three patients showed ischemic damage in the treated lesion and one patient showed epigastric pain. The bleeding-related 30-day mortality and overall in-hospital mortality rates were 16.7% (3/18) and 28.6% (6/21), respectively. Two patients died of septic shock and one died of myocardial infarction within 30 days after TAE. In 25 patients who underwent TAE with other agents, the overall technical success was 100% (25/25), and the overall clinical success was 68.2% (15/22). The rates of uncontrolled bleeding, recurrent bleeding, clinical failure, bleeding-related 30-day mortality, and overall in-hospital mortality were 0.5% (1/22), 22.7% (5/22), 31.8% (7/22), 22.7% (5/22), and 32.0% (8/25), respectively.Conclusions: TAE with NBCA for acute non-variceal upper and lower GI bleeding proved to be a technically feasible, safe, and effective treatment modality. Thus, NBCA could be used as a primary embolic agent for controlling GI bleeding. [ABSTRACT FROM AUTHOR]

Background The accurate estimation of liver volume and right/left ratio in donor candidates is critical, but there is no method using portal vein (PV) flow. Methods Of 125 donor candidates, right/left liver volume ratio was estimated using ultrasound (US)-PV area ratio and Doppler US-PV flow ratio, and the results were compared with CT volumetry. We analyzed these results in 76 donors who underwent hemihepatectomy. We evaluated diagnostic values of Doppler US-PV flow for <30% remnant liver volume high-risk donors, and compared liver volume by Doppler US-PV flow with actual graft weight. Results In 125 donor candidates, 96.8% showed <10% difference between liver volume ratio by Doppler US-PV flow ratio and CT volumetry. Compared with CT volumetry, the mean percentage difference of liver volume ratio by Doppler US-PV flow ratio was significantly smaller than that by US-PV area ratio (±0.7% vs ±6.3%, P<.001). In 76 donors who underwent hemihepatctomy, results were similar, showing smaller mean percentage difference of liver volume ratio by Doppler US-PV flow ratio than that by US-PV area ratio (±1.0% vs ±6.0%, P<.001). Sensitivity and specificity for <30% remnant liver volume donors were 76.9% and 76.8%. Blood-free liver volume by Doppler US-PV flow was linearly correlated with graft weight ( R2=0.770, P<.001), although significantly different, with 8.5% error ratio (669.3±173.2 vs 633.7±187.1, P=.001). Conclusion Doppler US-PV flow can effectively estimate right/left liver volume ratio in initial donor investigation. However, Doppler US-PV flow is not accurate in assessing donors with <30% remnant liver volume and in estimating actual graft weight. [ABSTRACT FROM AUTHOR]

Purpose. We report the clinical outcomes of patients with spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated conservatively. Materials and Methods. A retrospective review was performed in 14 patients from 2006 to 2016 with SIDSMA. Their clinical features and computed tomographic angiography (CTA) characteristics, treatment methods, and clinical outcomes were analyzed. The mean age was 53.6 (range, 41–73) years, and the mean follow-up duration was 20.6 (range, 1–54) months. Conservative management was the primary treatment if no bowel ischemia or arterial rupture was noted. Results. The mean initial abdominal visual analog pain score was 7 (range, 5–9) in seven patients. The mean total duration of abdominal pain was 10.2 days (range, 2–42 days) in 10 patients. The mean percentage stenosis of the dissected SMA at the initial presentation was 78.8% in 14 patients. Complete obstruction of the SMA at the initial presentation was evident in 4 of the 14 patients (28.6%). Conservative management was successful in all 14 patients. None of the 14 patients developed bowel ischemia or an infarction. Abdominal pain did not recur in any patient during follow-up (mean, 20.6 months; range, 1–54 months). Conclusion. Conservative management was successful for all SIDSMA patients, even those with severe compression of the true lumen or complete obstruction of the dissected SMA. [ABSTRACT FROM AUTHOR]

Background/Aims: This study aimed to investigate the incidence and risk factors for acute kidney injury (AKI) and chronic kidney disease (CKD) in patients with renal infarction. Methods: A single-center retrospective study was conducted from January 2005 to December 2013. Baseline and clinical characteristics of the enrolled patients with renal infarction were evaluated and analyzed according to the presence of AKI and CKD. In particular, predictors for AKI and CKD were determined using logistic regression analysis. Results: Of the 105 patients included in present study, 41 (39.0%) patients had AKI. A total of 80 patients were followed up for 2 years after hospital discharge. Among these patients, 27 (33.8%) patients had CKD. In the multivariate analysis, the predictors were mean blood pressure (odds ratio [OR] 1.062, 95% confidence interval [CI] 1.015-1.112, p = 0.009) and bilateral involvement (OR 4.396, 95% CI 1.096-17.632, p = 0.037) for AKI, and AKI (OR 14.799, 95% CI 4.173-52.490, p < 0.001) and old age (OR 1.065, 95% CI 1.016-1.116, p = 0.009) for CKD. Conclusions: Physicians should pay attention to the development of AKI and CKD after renal infarction and follow patients over a long term. [ABSTRACT FROM AUTHOR]

Background: The relative benefit of anatomical resection (AR) versus non-anatomical resection (NAR) in hepatocellular carcinoma (HCC) remains controversial. This study compared the survival outcomes and recurrence rates of HCCs analysed according to tumour size and the extent of resection. Methods: Consecutive patients with HCC who underwent curative resection at Asan Medical Center between January 1999 and December 2009 were included in this study. We performed propensity score matching (PSM) according to tumour size to compare the survival outcomes between AR and NAR. A total of 986 patients were analysed; 812 and 174 patients underwent AR and NAR, respectively. Results: Before PSM, regardless of tumour size, the AR group demonstrated significantly better 5-year overall survival (OS) and recurrence-free survival (RFS) than the NAR group (p < 0.001). After PSM, the AR group demonstrated better OS and RFS rates than the NAR group when tumour size was less than 5 cm, but there was no significant difference in the OS and RFS rates between the two groups when tumour size was equal to or greater than 5 cm. In tumours less than 5 cm in size, AR was the most significant factor associated with OS and RFS. However, this prognostic effect of AR was not demonstrated in tumours with sizes equal to or greater than 5 cm. Conclusion: In patients with HCCs smaller than 5 cm, AR reduced the risk of tumour recurrence and improved OS. In HCCs larger than 5 cm, AR and NAR showed comparable survival outcomes. [ABSTRACT FROM AUTHOR]

The modulation of propagating spin wave amplitude in Ni81Fe19 (Py) films, resulting from constructive and destructive interference of spin wave, has been demonstrated. Spin waves were excited and detected inductively using pulse-inductive time domain measurements. Two electrical impulses were used for launching two interfering Gaussian spin wave packets in Py films. The applied bias magnetic field or the separation between two pulses was used for tuning the amplitude of the resulting spin wave packets. This may thus be useful for spin wave based low-power information transfer and processing. [ABSTRACT FROM AUTHOR]

Background: We determined serum endogenous secretory receptor of advanced glycation end products (esRAGE) and soluble RAGE (sRAGE) concentrations and the esRAGE/sRAGE ratio in normal pregnancy and preeclampsia because esRAGE and sRAGE have been negatively linked to components of metabolic syndromes and pathologic pregnancy including preeclampsia. Method: Eighty-seven normal pregnant women and 28 with preeclampsia were recruited. Serum sRAGE and esRAGE levels were measured by enzyme-linked immunosorbent assay. Results: There were significant differences in esRAGE concentration and esRAGE/sRAGE ratio between 1st and 3rd trimester in normal pregnancy (P =0.007 and P=0.003). Serum esRAGE concentrations and esRAGE/sRAGE ratio in patients with preeclampsia significantly increased compared to controls (P =0.005 and P<0.001). Conclusions: Maternal serum esRAGE concentration and esRAGE/sRAGE ratio (1) gradually decrease with gestational age in normal pregnancy; and (2) are higher in patients with preeclampsia than healthy pregnant controls, significantly. Serum esRAGE and esRAGE/sRAGE ratio might be associated with preeclampsia. [ABSTRACT FROM AUTHOR]

In the diffusive regime, the accumulated spins diffuse out symmetrically in both directions of the InAs channel and the spin signal exponentially decays with the distance. However, considering spin drift induced by the applied electrical current, the spin diffusion occurs in an asymmetric manner. Nonlocal measurements of a lateral spin-valve structure show that the amount of spin polarized electron depends on the direction of the electric field. The magnitude of the nonlocal signal difference due to the bias-current-induced drift effect diminishes from 5.6 mΩ at T = 20 K to close to zero at T = 300 K. [ABSTRACT FROM AUTHOR]

Abstract: The spin transport signals from NiFe and Co into two-dimensional electron gas layers are measured for various thicknesses of transmission barriers. A stable and reproducible electrical detection of spin transport was obtained only when the barrier thickness is less than 10nm. The typical interface resistance to observe spin signals in this experiment is about 0.5–250Ω, which is a neither transparent nor a severe tunneling limit. The optimal interface resistance depends on the ferromagnetic materials, but severe tunneling barrier is not proper for fully electrical spin transport. Device size is also a critical factor to decide the proper range of interface resistance. [Copyright &y& Elsevier]

Abstract: On-line control of polymer dosage in waterworks sludge conditioning was studied on a pilot-scale basis. As an on-line parameter, the streaming potential (SP), which arises in an electrophoretic field in sludge filtrate, was investigated in terms of the amount of polymer dosage savings and the feasibility regarding dewatering performance. Results show that the polymer dosage determined by the streaming potential corresponded to the range of 0.1–0.3%/TS, which means that it was very similar to the amount of the dosage studied in the basic results of this study. Also, there was a SP set-point showing good dewatering ability in view of time-to-filter (TTF), at which the charge condition was identical with the charge neutralization determined by the zeta potential. Furthermore, the proper mixing (this study, mixing gradient (G) 7.5s−1) leading to sludge floc agglomeration should be accompanied, because the TTF was changed by the flocculation mixing condition even though the polymer was optimally dosed by the streaming potential. This indicates that optimum polymer dosage in case of the control at the rapid mixing step should be taken in a broad range of conditions, including optimum flocculation mixing, for a better dewatering performance. [Copyright &y& Elsevier]

B Introduction: b Carbonyl reductase 1 (CBR1) protects cells against lipid peroxidation. B Method: b As living-donor liver transplantation creates low oxygen conditions that induce oxidative stress, we investigated whether CBR1 transcription is upregulated under ischemic conditions via Nrf2 and attenuates hepatic ischemia-reperfusion injury. Western blot analysis showed that the expression levels of oxidative stress markers and lipid peroxidation products were significantly lower in cells overexpressing CBR1. [Extracted from the article]

Here we present our techniques for doing a pure Laparoscopic live donor (LLS) with a variant anatomy. The donor had a variant anatomy which is a type III portal vein, the left hepatic artery coming from the left gastric artery and the middle hepatic artery coming from the common hepatic artery). [Extracted from the article]

Blood vessels are subjected in vivo to mechanical forces in a form of radial distention, encompassing cyclic mechanical strain due to the pulsatile nature of blood flow. Vascular smooth muscle (VSM) tissues engineered in vitro with a conventional tissue engineering technique may not be functional, because vascular smooth muscle cells (VSMCs) cultured in vitro typically revert from a contractile phenotype to a synthetic phenotype. In this study, we hypothesized that pulsatile strain and shear stress stimulate VSM tissue development and induce VSMCs to retain the differentiated phenotype in VSM engineering in vitro. To test the hypothesis, rabbit aortic smooth muscle cells (SMCs) were seeded onto rubber-like elastic, three-dimensional PLCL [poly(lactide-co-caprolactone), 50:50] scaffolds and subjected to pulsatile strain and shear stress by culturing them in pulsatile perfusion bioreactors for up to 8 weeks. As control experiments, VSMCs were cultured on PLCL scaffolds statically. The pulsatile strain and shear stress enhanced the VSMCs proliferation and collagen production. In addition, a significant cell alignment in a direction radial to the distending direction was observed in VSM tissues exposed to radial distention, which is similar to that of native VSM tissues in vivo, whereas VSMs in VSM tissues engineered in the static condition randomly aligned. Importantly, the expression of SM α-actin, a differentiated phenotype of SMCs, was upregulated by 2.5-fold in VSM tissues engineered under the mechano-active condition, compared to VSM tissues engineered in the static condition. This study demonstrates that tissue engineering of VSM tissues in vitro by using pulsatile perfusion bioreactors and elastic PLCL scaffolds leads to the enhancement of tissue development and the retention of differentiated cell phenotype. [Copyright &y& Elsevier]

Reproducible current hysteresis is observed in graphene with a back gate structure in a two-terminal configuration. An opposite sequence of switching with different charge carriers, holes, and electrons is found. The charging and discharging effect is proposed to explain this ambipolar bistable hysteretic switching. To confirm this hypothesis, one-level transport model simulations including charging effect are performed and the results are consistent with our experimental data. Methods of improving the on/off ratio of graphene resistive switching are suggested. [ABSTRACT FROM AUTHOR]

The spin splitting energy obtained from the Shubnikov–de Haas oscillation increases with decreasing channel width (w) of the InAs-based heterostructure. Since the surface charge concentration depends only weakly on w, the channel width dependence of the spin splitting energy is attributed to variations in the spin-orbit interaction strength. The spin-orbit interaction parameter was found to be inversely proportional to w in the range of w=2–64 μm. Our findings indicate that a strong spin-orbit interaction is induced in a narrow channel due to suppression of the spin precession length for a thin quantum well layer system. [ABSTRACT FROM AUTHOR]

B Method: b Between January 2000 and December 2016, patients with ruptured HCC who underwent curative surgical resection were retrospectively reviewed. Recurrences of HCC were occurred in a total of 63 patients (70.8%), 52.4% (33 patients) of whom presented with both intra- and extra-hepatic recurrences. B Conclusion: b Hepatectomy in ruptured HCC did show worse survival outcome when compared to un-ruptured one and bear high risk of peritoneal seeding. [Extracted from the article]

B Introduction: b Cryopreserved iliac vein, Polytetrafluoroethylene (PTFE) grafts, and cryopreserved aorta without endarterectomy have been used as middle hepatic vein (MHV) conduits for right liver graft in living donor liver transplantation, but each has advantages and disadvantages. Aorta after endarterectomy showed 3-month patency rate of 91.6% and 1-year patency rate of 63.5%. [Extracted from the article]

Causes of patient death in nine patients were recurrent HCC in four patients, biliary sepsis in two patients, graft failure (not associated with AMR) in one patient, post-operative bleeding after re-LT in one patient, and pneumonia in one patient. Among the other fifteen patients who are alive, five patients got re-LT, three patients presented mild graft dysfunction with well-functioning PTBD, three patients showed resolution of DIHBS and removed biliary drainage, and four patients demonstrate normal graft function with well-maintained biliary drainage. In patients who demonstrated DIHBS, over half of the patient progress to graft failure and need re-LT. [Extracted from the article]

B Introduction: b Liver transplantation (LT) is the optimal treatment for hepatocellular carcinoma (HCC) in select patients with cirrhosis. [Ed1] In patients with initial Organ Procurement and Transplantation Network (OPTN) stages T1 and T2[Ed2], the 5-year RFS and OS did not significantly differ between LT groups with or without bridging (all P >=.05). The 5-year RFS and OS of OPTN stage T3 patients with successful downstaging were not significantly different from those with OPTN stage T2 with primary LT (P =.070 and P =.185), but were significantly lower than in patients with OPTN stage T3 with downstaging failure and OPTN stages T1 or T2 with progression (all P <.001). [Extracted from the article]

After craniectomy, autologous bone flaps may be stored using wet or dry cryopreservation. After brain edema subsides, they are replaced during an operation termed cranioplasty. Cranioplasty is associated with 15% infection incidence. We conducted a retrospective comparison of infection outcomes between wet and dry cryopreservation of cranioplasty bone flaps. Historically, bone flaps were stored utilizing wet cryopreservation—bone flap storage in 1 L of lactated Ringer's solution containing 80 mg gentamicin and 2 g nafcillin in a sterile plastic container secured in an unsterile plastic bag. Our newer dry cryopreservation protocol involved storage in gauze soaked in 80 mg gentamicin and 2 g nafcillin within a 3-layer sterile bag system. A total of 119 autologous bone flaps were included, with median follow-up of 3.9 months from cranioplasty. Overall, 10.9% became infected, requiring subsequent surgery; 18.4% of 49 bone flaps stored using wet cryopreservation became infected compared with only 5.7% of 70 dry cryopreservation bone flaps (P = 0.038; relative risk [RR] 0.311; absolute risk reduction 12.7%). Tobacco use (P = 0.076; RR 3.17) was not associated with increased infection risk. Infection incidence was similar for traumatic craniectomy indications compared to the other indications (12.0% trauma vs. 10.1% other; P = 0.750). On average, infected cranioplasty patients spent 8.5 more days hospitalized and faced increased risk of additional complications. Dry cryopreservation significantly decreases infection after cranioplasty when compared with wet cryopreservation, and this mitigates additional morbidity, mortality, and costs attributable to cranioplasty infection. Other nonmodifiable risk factors for cranioplasty infection were identified. [ABSTRACT FROM AUTHOR]

Functional, tumor-specific CD8+ cytotoxic T lymphocytes drive the adaptive immune response to cancer. Thus, induction of their activity is the ultimate aim of all immunotherapies. Success of anti-tumor immunotherapy is precluded by marked immunosuppression in the tumor microenvironment (TME) leading to CD8+ effector T cell dysfunction. Among the many facets of CD8+ T cell dysfunction that have been recognized—tolerance, anergy, exhaustion, and senescence—CD8+ T cell senescence is incompletely understood. Naïve CD8+ T cells require three essential signals for activation, differentiation, and survival through T-cell receptor, costimulatory receptors, and cytokine receptors. Downregulation of costimulatory molecule CD28 is a hallmark of senescent T cells and increased CD8+CD28− senescent populations with heterogeneous roles have been observed in multiple solid and hematogenous tumors. T cell senescence can be induced by several factors including aging, telomere damage, tumor-associated stress, and regulatory T (Treg) cells. Tumor-induced T cell senescence is yet another mechanism that enables tumor cell resistance to immunotherapy. In this paper, we provide a comprehensive overview of CD8+CD28− senescent T cell population, their origin, their function in immunology and pathologic conditions, including TME and their implication for immunotherapy. Further characterization and investigation into this subset of CD8+ T cells could improve the efficacy of future anti-tumor immunotherapy. [ABSTRACT FROM AUTHOR]

Deterministic magnetization switching using spin-orbit torque (SOT) has recently emerged as an efficient means to electrically control the magnetic state of ultrathin magnets. The SOT switching still lacks in oscillatory switching characteristics over time, therefore, it is limited to bipolar operation where a change in polarity of the applied current or field is required for bistable switching. The coherent rotation based oscillatory switching schemes cannot be applied to SOT, because the SOT switching occurs through expansion of magnetic domains. Here we experimentally achieve oscillatory switching in incoherent SOT process by controlling domain wall dynamics. We find that a large field-like component can dynamically influence the domain wall chirality which determines the direction of SOT switching. Consequently, under nanosecond current pulses, the magnetization switches alternatively between the two stable states. By utilizing this oscillatory switching behavior, we demonstrate a unipolar deterministic SOT switching scheme by controlling the current pulse duration. Magnetism plays a key role in data storage devices. This paper reports on the experimental observation of spin-orbit torque-driven oscillatory switching due to field-like torque and finds that the magnetization can be switched back through using appropriate pulse duration. [ABSTRACT FROM AUTHOR]

This paper proposes a 2-kW plasma power supply with a small frequency fluctuation. In existing plasma power supplies, when the input voltage is fixed, the frequency fluctuation is large according to the load impedance and output voltage of the plasma discharger, which constitutes a problem. The proposed plasma power supply addresses this problem by generating an output voltage with a small frequency fluctuation according to the load impedance and output voltage change by applying a variable input voltage and a compensation capacitor. The proposed circuit has a two-stage structure comprising a single-phase power factor correction (PFC) boost converter and a high-frequency inverter with a parallel resonant circuit. Accordingly, a prototype plasma power supply with an output voltage of 3–5 kVpk and 2-kW was designed, and its validity was verified using experimental results obtained from the proposed circuit. [ABSTRACT FROM AUTHOR]

Abstract: Magnetostatic surface spin waves (MSSW) excited from a coplanar waveguide antenna travel in different directions with different amplitudes. This effect, called nonreciprocity of MSSW, has been investigated by micromagnetic simulations. The ratio of amplitude of two counter propagating spin waves, the nonreciprocity parameter κ, is obtained for different ferromagnetic materials, such as NiFe (Py), CoFeAl, yttrium iron garnet (YIG), and GaMnAs. A device schematic has been proposed in which κ can be tuned to a large value by varying simple geometrical parameters of the device. [Copyright &y& Elsevier]

Objective: This study was undertaken primarily to investigate the possible prognostic values of several cell-cycle regulators for the prediction of functioning pituitary adenoma (FPA) recurrence after surgical resection by immunohistochemically analyzing tumor samples obtained by surgical resection. Methods: The medical records of the patients with FPA diagnosed from January 2000 to December 2009 at the Department of Neurosurgery at Samsung Changwon Hospital and Dong-A University Medical Center were selected. Immunohistochemical staining was performed on archived paraffin-embedded tissues obtained by surgical resection for adenohypophysial cells, cell-cycle regulatory proteins (p16, p15, p21, cyclin-dependent kinase [CDK] 4 and 6, phosphorylated retinoblastoma [pRB] protein, and cyclin D1), MIB-1 antigen, and p53. Results: Of the 174 FPAs, 62 (35.6%) recurred during follow-up period (mean duration 62.4 months, range 24.2–118.9 months). Immunohistochemically, overstaining for p16 in 89 samples (51.1%), p15 in 27 samples (15.5%), p21 in 20 samples (11.5%), CDK4 in 54 samples (31.0%), CDK6 in 18 samples (10.3%), pRB protein in 69 samples (39.7%), and cyclin D1 in 87 samples (50.0%). Multivariate analysis using the Cox proportional hazard regression model showed that invasion into cavernous sinus (hazard ratio [HR] of 4.02; P < 0.001), immunohistochemical normostaining for p16 (HR of 3.16; P < 0.001), immunohistochemical overstaining for pRB protein (HR of 2.45; P = 0.008), cyclin D1 (HR of 2.13; P = 0.029), MIB-1 antigen (HR of 2.74; P = 0.002), and p53 (HR of 2.21; P = 0.002), predicted the recurrence of FPA after surgical resection. Conclusions: Our findings indicate that p16, pRB protein, and cyclin D1 are associated with recurrence FPA after surgical resection. [Copyright &y& Elsevier]

Abstract: Cerebral paragonimiasis causes various neurological disorders including seizures, visual impairment and hemiplegia. The excretory–secretory product (ESP) released by Paragonimus westermani has a cysteine protease activity and plays important roles in its migration in the host tissue and modulation of host immune responses. To gain more insight into the pathogenesis of ESP in the brain, we investigated the inflammatory reaction and cerebral injury following microinjection of ESP into rat striatum. The size of injury was maximally observed 3 days after microinjection of ESP and then declined to control levels as astrocytes have repopulated the injury. ED1-positive monocytes and microglia were confluently found inside the injury. The mRNA expression of inducible nitric oxide synthase (iNOS) occurred as early as 9h after ESP injection and then declined to control levels within 1 day. The iNOS inhibitor aminoguanidine largely decreased the expression of iNOS but did not reduce the size of lesion caused by ESP. Interestingly, however, heat inactivation of ESP caused a decrease of injury formation with no altered expression of iNOS. The data indicate that ESP produces brain tissue injury by recruiting activated monocytes/microglia via heat-labile protease activity. [Copyright &y& Elsevier]

The long-term outcomes after living donor liver transplantation (LDLT) vs deceased donor liver transplantation (DDLT) for hepatocellular carcinoma (HCC) remain controversial. We compared the long-term outcomes between LDLT and DDLT in patients with HCCs within or beyond the Milan criteria. This retrospective study included 896 patients who underwent liver transplantation (829 LDLTs and 67 DDLTs) for HCC from June 2005 to May 2015. Recurrence-free survival (RFS) and overall survival (OS) were estimated using the Kaplan–Meier method with log-rank test. RFS at 1, 3, 5, and 10 years after LDLT was 89.6%, 84.6%, 82.4%, and 79.6%, respectively, and, after DDLT, was 92.4%, 86.2%, 82.4%, and 82.4%, respectively, and OS at 1, 3, 5, and 10 years after LDLT was 96.1%, 88.1%, 85.6%, and 82.7%, respectively, and, after DDLT, was 97.0%, 83.6%, 82.1%, and 77.3%, respectively, with no significant differences in RFS (P =. 838) or OS (P =. 293) between groups. No statistically significant differences after LDLT or DDLT were identified in RFS (89.8% vs 98.1%, respectively, at 5 years; P =. 053) or OS (90.4% vs 90.6% , respectively, at 5 years; P =. 583) for HCCs meeting the Milan criteria as well as for those beyond the Milan criteria (RFS, 37.8% vs 28.6%, respectively, at 5 years; P =. 560 and OS, 57.3% vs 50.0%, respectively, at 5 years; P =. 743). Patients who underwent LDLT for HCCs showed comparable long-term outcomes to patients who underwent DDLT. Patients with HCCs within the Milan criteria demonstrated acceptable long-term outcomes after both LDLT and DDLT. • No statistically significant differences were identified in recurrence-free survival (RFS) or overall survival (OS) rates after living donor liver transplantation (LDLT) or deceased donor liver transplantation (DDLT) in patients with hepatocellular carcinomas (HCCs) within the Milan criteria. • For patients with HCCs beyond the Milan criteria, LDLT and DDLT also demonstrated similar RFS and OS rates. • Patients with HCCs that met pretransplant Milan criteria showed acceptable long-term outcomes after both LDLT and DDLT. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic treatment for hepatocellular carcinoma (HCC) has increased. We retrospectively compared the perioperative and long-term oncological outcomes of laparoscopic liver resection (LLR) with those of open liver resection (OLR) for hepatocellular carcinoma (HCC) in well-matched patient groups using propensity score matching (PSM).Methods: We reviewed medical records of patients with HCC who underwent liver resection between July 2007 and April 2016 at our center. In total, 2335 patients were included in this study and divided into LLR (n = 264) and OLR (n = 2071) groups. For group comparisons, 1:2 PSM was used with covariates of baseline characteristics, including tumor characteristics and surgical liver resection procedures.Results: After PSM, there were 217 and 434 patients in the LLR and OLR groups, respectively. The LLR group had shorter hospital stays (8.9 vs. 14.8 days; P < 0.001) and lower postoperative morbidity (6.5% vs. 12.0%; P = 0.022). The 1-, 3-, and 5-year overall survival rates were 98.1%, 87.0%, and 78.6%, respectively, for the LLR group, and 98.3%, 90.8%, and 84.3%, respectively, for the OLR group (P = 0.570). The 1-, 3-, and 5-year disease-free survival rates were 81.0%, 62.0%, and 49.1%, respectively, for the LLR group, and 85.3%, 64.7%, and 56.2%, respectively, for the OLR group (P = 0.563).Conclusions: Long-term oncological outcomes were comparable between LLR and OLR for selected patients. LLR was associated with multiple benefits, even for selected patients with cirrhosis who underwent major hepatectomy. LLR for HCC performed by an experienced surgeon could be considered a safe and feasible alternative to OLR for selected patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the role of multiphase computed tomography (CT) in patients with acute postoperative bleeding after liver transplantation(LT). Methods: We retrospectively analyzed multiphase CT images in 270 post-LT bleeding patients between November 2013 and December 2017, with special attention to contrast extravasation (type I, focal or stipple; type II, jet). Patients were classified into conservative management trial and primary therapeutic intervention groups by initial treatment strategy, and then conservative management trial group was subdivided into successful conservative management and conservative management failure groups. On multiphase CT, we evaluated contrast extravasation volume, rate, and patterns (focal or stipple vs. jet). The concordances of the bleeding source determined by multiphase CT to the actual bleeding source were analyzed. Results: Of 270 patients, 134 contrast extravasation sites were identified in 116 (43.0%) patients. Most (94.8%, 146/154) of patients without contrast extravasation was successfully managed by conservative management. The mean volume and rate of contrast extravasation significantly increased in order of successful conservative management, conservative management failure, and primary therapeutic intervention groups (all p < 0.01). In subgroup analysis, jet pattern contrast extravasation was more commonly observed with conservative management failure group (p = 0.01). In addition, the change in pattern of contrast extravasation from type I to II was significantly related to the conservative management failure (OR 10.3; 95% CI 1.8–60.4; p = 0.01). There was substantial agreement in localization of bleeding source between multiphase CT and surgery or angiography (Cohen Kappa = 0.78). Conclusion: Multiphase CT is helpful in the assessment for need of therapeutic intervention and to determine the treatment of choice in recipient with post-LT bleeding. [ABSTRACT FROM AUTHOR]

Objectives: To determine the incremental value of hepatobiliary-phase-MRC (HBP-MRC) added to T2-magnetic resonance cholangiography (T2-MRC) for evaluating biliary anatomy in living donor liver transplantation (LDLT) and to correlate T2+HBP-MRC findings with surgical results.Methods: A total of 276 donors who underwent T2 and gadoxetic acid-enhanced MRI before right hemihepatectomy for LDLT between January and December 2016 were retrospectively enrolled. Two reviewers evaluated biliary anatomy classification using T2-MRC in the first session and T2+HBP-MRC in the second session. The sensitivity, specificity, and confidence level (5-point scale) of T2-MRC and T2+HBP-MRC for variant biliary anatomy were evaluated. The agreement rates between MRC and operative cholangiography for each biliary anatomy classification and the underestimation rates for multiple bile duct openings (BDOs) for both MRC techniques were evaluated.Results: Of the 276 donors, variant biliary anatomy was observed in 36.2% (100/276). T2+HBP-MRC showed a significantly higher sensitivity for diagnosing variant biliary anatomy than T2-MRC alone (99.0% [99/100] vs. 89.0% [89/100], p = 0.006), with better observer confidence level (4.9 ± 0.3 vs. 4.6 ± 0.7, p < 0.001) and inter-observer agreement (kappa, 0.902 vs. 0.730). Compared with T2-MRC alone, T2+HBP-MRC provided significantly higher agreement with operative cholangiography in biliary anatomy classification (98.6% [272/276] vs. 89.9% [248/276], p < 0.001), and significantly lower underestimation rate for multiple BDOs (5.8% [16/276] vs. 9.4% [26/276], p = 0.002).Conclusion: T2+HBP-MRC might be considered than T2-MRC alone, as a better depiction of biliary anatomic variations, correlated with surgical findings.Key Points: •T2+HBP-MRC predicted variant biliary anatomy more accurately than T2-MRC alone. •T2+HBP-MRC might have clinical usefulness by reducing the underestimation rate of multiple bile duct openings, which requires more complicated biliary anastomoses. [ABSTRACT FROM AUTHOR]

We aimed to determine the visibility of bile ducts of the caudate lobe (B1s) and right/left (R/L) dissociation on contrast-enhanced T1-magentic resonance cholangiography after gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid administration (CE-T1-MRC) in live liver donors. In 300 live liver donors who underwent CE-T1-MRC, the visibility and R/L dissociation of B1 were evaluated. Confidence level of B1 visibility and depiction of the presence of R/L dissociation on axial and coronal reconstruction images were compared. Strength of agreement between R/L dissociation on MRC and that on intraoperative cholangiography was evaluated. At least 1 B1 was visible on CE-T1-MRC in 142 of 300 subjects (47.3%; a total of 195 B1s; 0.64 [SD, 0.80], 0-4 branches per person). Of 195 subjects with visible B1, 55 ducts showed R/L dissociation (28.2%; right-to-left crossover, n = 28; left-to-right crossover, n = 27). The confidence level of B1 visibility on axial images of MRC was significantly higher than that on coronal images of MRC (P <.001). Of 55 B1s with R/L dissociation, axial images were superior to coronal images in depicting B1 crossover in 31 and vice versa in 2 (equal between axial and coronal images in 22). The agreement for R/L dissociation between CE-T1-MRC and intraoperative cholangiography was excellent (κ = 0.819; 95% CI, 0.722-0.917). Bile ducts of the caudate lobe with R/L dissociation can be occasionally identified on CE-T1-MRC. Axial reconstruction is superior to coronal counterpart. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted in order to investigate computed tomography (CT) findings associated with acute cellular rejection (ACR) following liver transplantation (LT) and their relevance to clinical outcomes. Materials and methods: We analyzed 120 patients with newly diagnosed ACR following LT for various liver diseases and 119 controls matched for age, sex, type of liver graft, and date of CT exam following LT. Two radiologists analyzed the images for morphological characteristics of the graft, morphological change in the major draining vein, graft enhancement in the portal venous phase, graft attenuation on noncontrast CT, and periportal halo. Univariate analysis was used to determine the association between radiological findings and ACR. Clinical outcomes, including treatment response and graft survival, were compared between patients with and without associated radiological findings. Results: Morphological characteristics of the graft (i.e., globular swelling), morphological change in the major draining vein (i.e., nonanastomotic luminal narrowing), and heterogeneous enhancement were significantly associated with ACR (all p < 0.001). On univariate analysis, the severity of morphological characteristics of the grafts (mild/severe: odds ratio [OR], 19.98/32.24) and morphological change in the major draining vein (without/with prestenotic dilatation: OR, 4.17/22.5) were significantly associated with the increased possibility of an ACR diagnosis. Clinical outcomes for treatment response and graft survival were not significantly different between patients with and without associated radiological findings. Conclusions: Globular swelling, nonanastomotic stenosis with or without prestenotic dilatation of the major draining vein, and heterogeneous enhancement of the graft on portal venous-phase CT were significantly associated with ACR. Key Points: • Globular swelling of the graft, nonanastomotic narrowing in the major vein, and heterogeneous graft enhancement on CT were significantly associated with acute cellular rejection (ACR). • Associated CT findings were highly specific but not sensitive for differentiating ACRs from matched controls. [ABSTRACT FROM AUTHOR]

Summary: Simultaneous splenectomy (SSPX) in adult living donor liver transplantation (ALDLT) has definitely beneficial roles such as portal flow modulation in small‐for‐size graft and correction of hypersplenism‐related pancytopenia, and so on, but disastrous complications after SSPX often occur. For the first time, we devised unique and innovative splenic devascularization (SDV) procedure to alleviated untoward effects of SSPX but to maintain its benefits for the indicated patients. From April 2013 to December 2014, 520 recipients underwent ALDLT, and the SSPX and SDV were simultaneously performed in 62 (11.9%) and 61 (11.7%) patients, respectively. The most common indication was hypersplenism‐related pancytopenia (n = 101), small‐for‐size graft (n = 14), hepatitis C virus (HCV) (n = 7), and splenic artery aneurysm (n = 1). Postoperative small‐for‐size graft syndrome (SFSS) was absent in both SSPX and SDV, and preoperative pancytopenia was improved in both groups since postoperative 1 week, although SSPX was more substantial than SDV. Preoperative splenic volume (706.2 ± 282.9 ml) after SDV significantly decreased to 425.5 ± 204.4 ml on 1 month, respectively. In contrast to SDV, SSPX resulted in longer operation time and higher incidence of postoperative complications including mortality. In conclusion, SDV can replace SSPX during ALDLT without hampering its beneficial roles seriously, but get rid of splenectomy‐related lethal complication. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate CT findings of biliary strictures in ABO-incompatible living donor liver transplantation (LDLT) recipients, with emphasis on associated 1-month post-transplantation CT findings, and evaluate clinical outcomes.Methods: Of 351 ABO-incompatible recipients, we retrospectively evaluated CT scans in 65 recipients with biliary stricture. The biliary strictures on CT scans were classified as type A (perihilar) and type B (diffuse). Precedent CT abnormality patterns and the presence of a periportal halo sign at 1-month post-transplantation were evaluated. For each patient, clinical outcomes were evaluated.Results: Of 65 ABO-incompatible recipients with biliary strictures, 36.9% had type B strictures. Compared with biliary strictures at diagnosis, similar CT abnormality patterns were observed for 84.4% in type A and 86.4% in type B strictures at 1-month post-transplantation. Complex periportal halo signs on the 1-month post-transplantation CT were more frequently noted for type B than type A strictures (86.4% vs. 3.1%, P < 0.001). Progressive clinical outcomes were more frequently observed for type B than type A strictures (79.2% vs. 26.8%, P < 0.001), with a significantly shorter graft survival time (46.4 months vs. 90.8 months, P < 0.001).Conclusion: CT abnormality patterns and complex periportal halo signs on 1-month post-transplantation CT may be clinically useful for managing biliary strictures in ABO-incompatible LDLT recipients. Key Points • Of ABO-incompatible LDLT recipients, type B biliary stricture incidence was 6.8%. • Of type B strictures, 86.4% exhibited similar CT abnormality patterns at 1-month post-transplantation. • Complex periportal halo at 1 month was significantly associated with type B strictures. • Progressive clinical outcomes were more frequently observed in type B strictures. [ABSTRACT FROM AUTHOR]

Background & Aims Living-donor liver transplantation (LDLT) can simultaneously cure hepatocellular carcinoma (HCC) and underlying liver cirrhosis, improving long-term results in patients with HCC. ABO-incompatible LDLT could expand the living-donor pool, reduce waiting times for deceased-donor liver transplantation, and improve long-term survival for some patients with HCC. Methods We retrospectively reviewed the medical records of patients undergoing LDLT for HCC from November 2008 to December 2015 at a single institution in Korea. In total, 165 patients underwent ABO-incompatible and 753 patients underwent ABO-compatible LDLT for HCC. ABO-incompatible recipients underwent desensitization to overcome the ABO blood group barrier, including pretransplant plasma exchange and rituximab administration (300–375 mg/m 2 /body surface area). Results We performed 1:1 propensity score matching and included 165 patients in each group. 82.4% of ABO-incompatible and 83.0% of -compatible LDLT groups had HCC within conventional Milan criteria, respectively, and 92.1% and 92.7% of patients in each group had a Child-Pugh score of A or B. ABO-incompatible and -compatible LDLT groups were followed up for 48.0 and 48.7 months, respectively, with both groups showing comparable recurrence-free survival rates (hazard ratio [HR] 1.14; 95% CI 0.68–1.90; p  = 0.630) and overall patient-survival outcomes (HR 1.10; 95% CI 0.60–2.00; p  = 0.763). Conclusions These findings suggested that ABO-incompatible liver transplantation is a feasible option for patients with HCC, especially for those with compensated cirrhosis with HCC within conventional Milan criteria. Lay summary Despite hypothetical immunological concerns that the desensitization protocol for breaking through the ABO blood group barrier might have a negative impact on the recurrence of hepatocellular carcinoma, our experience demonstrated no significant differences in the long-term overall survival and recurrence-free survival rates between patients receiving ABO-compatible or ABO-incompatible liver transplantation. In conclusion, results from our institution indicated that ABO-incompatible living-donor liver transplantation constitutes a potentially feasible option for patients with hepatocellular carcinoma, especially those with compensated cirrhosis with hepatocellular carcinoma within conventional Milan criteria. [ABSTRACT FROM AUTHOR]

Background An N-butyl-2 cyanoacrylate (NBCA) embolus in the graft portal vein was frequently observed after an intraoperative embolization of portosystemic collaterals performed to prevent portal steal in liver transplant (LT) recipients. The radiological and clinical features of NBCA emboli have not yet been described. Purpose To describe radiological and clinical features of NBCA embolus in graft portal vein after portosystemic collateral embolization in LT recipients. Material and Methods A total of 165 consecutive LT recipients who had undergone intraoperative NBCA embolization of varix were found in single institution's computerized databases of a clinical cohort of LT. Patients were evaluated for NBCA emboli (categorized into major and minor emboli according to location) on first postoperative computed tomography (CT). All electronic medical records and radiologic studies including follow-up was evaluated to determine any radiological and clinical abnormality associated with NBCA embolus. Results NBCA emboli were found in 24% (39/165) of recipients. Although most patients had minor emboli (77%, 30/39) without remarkable ultrasonography (US) abnormalities, seven (78%) of nine recipients with major emboli showed intraluminal echogenic lesions in graft portal vein on grayscale US, and five of them (71%) showed partial portal flow obstruction, although none exhibited any abnormality on contrast-enhanced US. Recipients with NBCA portal emboli showed no significant clinical abnormalities and were discharged safely. NBCA embolus eventually disappeared mostly within six months (82%, 32/39). Conclusion NBCA emboli are frequently observed after portosystemic collateral embolization in LT recipients and are not associated with poor clinical outcome. They may mimic ordinary thromboemboli on US. [ABSTRACT FROM AUTHOR]

To determine the feasibility of using UltraFast Doppler in post-operative evaluation of the hepatic artery (HA) after liver transplantation (LT), we evaluated 283 simultaneous conventional and UltraFast Doppler sessions in 126 recipients over a 2-mo period after LT, using an Aixplorer scanner The Doppler indexes of the HA (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistive index [RI] and systolic acceleration time [SAT]) by retrospective analysis of retrieved waves from UltraFast Doppler clips were compared with those obtained by conventional spectral Doppler. Correlation, performance in diagnosing the pathologic wave, examination time and reproducibility were evaluated. The PSV, EDV, RI and SAT of spectral and UltraFast Doppler measurements exhibited excellent correlation with favorable diagnostic performance. During the bedside examination, the mean time spent for UltraFast clip storing was significantly shorter than that for conventional Doppler US measurements. Both conventional and UltraFast Doppler exhibited good to excellent inter-analysis consistency. In conclusion, compared with conventional spectral Doppler, UltraFast Doppler values correlated excellently and yielded acceptable pathologic wave diagnostic performance with reduced examination time at the bedside and excellent reproducibility. [ABSTRACT FROM AUTHOR]

The spin Hall angle in Pt is evaluated in Pt/NiFe bilayers by spin torque ferromagnetic resonance measurements and is found to increase with increasing the NiFe thickness. To extract the intrinsic spin Hall angle in Pt by estimating the total spin current injected into NiFe from Pt, the NiFe thickness dependent measurements are performed and the spin diffusion in the NiFe layer is taken into account. The intrinsic spin Hall angle of Pt is determined to be 0.068 at room temperature and is found to be almost constant in the temperature range of 13-300 K. [ABSTRACT FROM AUTHOR]

Prompt antimicrobial therapy, together with subsequent biliary drainage, is crucial to prevent the rapidly deteriorating course of severe acute cholangitis. Therefore, updates in bacteriological epidemiology and resistance profile are important for management of this critical disease. Also, because the routine addition of metronidazole to the first-line regimen is controversial, we intended this prospective study with historical controls. Patients with severe acute cholangitis who fulfilled the definition of severity by the Tokyo Guidelines and underwent biliary drainage within 24 h from presentation were enrolled prospectively from January 2010 to December 2011. During that period, metronidazole was not added to third-generation cephalosporins, which were used as the initial antimicrobials except for patients who were allergic to penicillin and received ciprofloxacin instead (no metronidazole group). Outcomes were compared with a historical cohort from March 2007 to December 2009 when metronidazole was added routinely (metronidazole group). A unified strategy was maintained throughout the whole period excepting the use of metronidazole. Outcomes between the metronidazole group ( n = 338) and the no metronidazole group ( n = 338) did not differ in terms of the rate of successful biliary drainage by interventional procedures (93.2 % vs. 94.7 %, p = 0.88), time elapsed for cholangitis to be controlled (10.4 ± 0.6 vs. 8.9 ± 1.2 days, p = 0.38), and mortality (1.2 % vs. 0.6 % with p = 0.34 for all causes and 0.9 % vs. 0 % with p = 0.15 for cholangitis-related, respectively). As the routine addition of metronidazole did not improve outcomes, it can be excluded from the first-line regimen if emergent biliary drainage can be performed efficiently. [ABSTRACT FROM AUTHOR]

Abstract: In the present study, we report that activated human astroglioma cells can injure T-lymphocytes by producing tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL). Treatment with lipopolysaccharides (LPS), a well-known immune stimulator, increased the expression levels of TRAIL mRNA and protein in human astroglioma cells. The increase of TRAIL mRNA expression by LPS was preceded by phosphorylation of the c-Jun N-terminal kinase (JNK) and consequently abrogated in the presence of the specific JNK inhibitor SP600125. The up-regulation of TRAIL expression was well co-related with AP-1 activation. Activated human astroglioma cells markedly induced the apoptotic death of T-lymphocytes. Pre-treatment with the TRAIL antagonistic protein TRAIL-R2:Fc prevented the death of T-lymphocytes caused by activated human astroglioma cells. The present results suggest that astroglioma cells may down-regulate T-lymphocytes via up-regulation of TRAIL. [Copyright &y& Elsevier]

Doppler Ultrasound is clinically important for evaluation of various hepatic vascular disease as well as hepatic vessel evaluation after liver transplantation. However, there are some limitations in conventional Doppler methods as follows: 1) time consuming and labor intensive and 2) limited slow flow sensitivity. There are two recently advanced Doppler signal-processing methods (i.e., UltraFast and superb microvascular imaging), which overcome those limitations. UltraFast Doppler ultrasound, which emerged with the advent of massive parallel computing (or processing) capabilities, transmits several tilted plane waves into the medium and coherently sums the backscattered echoes to reconstruct US images, leading to a marked increase in the frame rate, while conventional ultrasound imaging involves sequential medium insonification via focused beams and successive image reconstruction. A stored UltraFast Doppler clip contains information on both spectral analysis and color-coded flow imaging and could be retrospectively evaluated quantitative analysis, because UltraFast ultrasound has high spatio-temporal resolution. Superb microvascular imaging (SMI, Cannon Medical Systems Corporation, Tochigi, Japan) uses a different kind of adaptive wall filter, which could minimize the flash artifact and increased sensitivity to slow flow and improve the signal detection of flow from small vessels. Therefore, in clinical practice, UltraFast Doppler can be performed by anyone. If the exam protocol such as acquisition of clip by less experienced sonographer and evaluation by retrospective wave reconstruction by specialist can be established, efficient work force management can be possible. Superb Microvascular imaging can distinguish very slow portal flow by portal hyper tension and so forth from thrombus. Thrombus can be evaluated with almost the same resolution as CT. The weak flow of a small hepatic artery hiding by vigorous flow of portal vein after liver transplantation can be also distinguished. In conclusion, smart application of recent advanced Doppler technique will help comprehensive assessment of hepatic vascular abnormalities. [ABSTRACT FROM AUTHOR]

Tubular scaffolds were fabricated from very elastic poly(l-lactide-co-#x03B5;-caprolactone) (PLCL, 50:50). The scaffolds were seeded with smooth muscle cells (SMCs) and implanted in nude mice to investigate the tissue compatibility and in vivo degradation behavior. Histological examination of all the implants with haematoxylin and eosin staining, masson trichrome staining, SM α-actin antibody, and CM-DiI labeling confirmed that the regular morphology and biofunction of the SMCs seeded and the expression of the vascular smooth muscle matrices in PLCL scaffolds. The implanted PLCL scaffolds displayed a slow degradation on time, where caprolactone units were faster degraded than lactide did. This could be explained by the fact that amorphous regions composed of mainly CL moieties degraded earlier than hard domains where most of the LA units were located. From these results, the scaffolds applied in this study were found to exhibit excellent tissue compatibility to SMCs and might be very useful for vascular tissue engineering. [Copyright &y& Elsevier]

Negative differential conductance and tunneling characteristics of two-terminal graphene devices are observed before and after electric breakdown, respectively. The former is caused by the strong scattering under a high E-field, and the latter is due to the appearance of a tunneling barrier in graphene channel induced by a structural transformation from crystalline graphene to disordered graphene because of the breakdown. Using Raman spectroscopy and imaging, the presence of nonuniform disordered graphene is confirmed. A memory switching effect of 100 000% ON/OFF ratio is demonstrated in the tunneling regime, which can be employed in various applications. [ABSTRACT FROM AUTHOR]