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During oxidative stress neurons release lipids that are internalized by glia. Defects in this coordinated process play an important role in several neurodegenerative diseases. Yet, the mechanisms of lipid release and its consequences on neuronal health are unclear. Here, we demonstrate that lipid-protein particle release by autolysosome exocytosis protects neurons from ferroptosis, a form of cell death driven by lipid peroxidation. We show that during oxidative stress, peroxidated lipids and iron are released from neurons by autolysosomal exocytosis which requires the exocytic machinery; VAMP7 and syntaxin 4. We observe membrane-bound lipid-protein particles by TEM and demonstrate that these particles are released from neurons using cryoEM. Failure to release these lipid-protein particles causes lipid hydroperoxide and iron accumulation and sensitizes neurons to ferroptosis. Our results reveal how neurons protect themselves from peroxidated lipids. Given the number of brain pathologies that involve ferroptosis, defects in this pathway likely play a key role in the pathophysiology of neurodegenerative disease.SUMMARYRelease of lipid-protein particles by autolysosomal exocytosis protects neurons from ferroptosis.

Study question Is there any association between clinical outcomes of women undergoing in vitro fertilization (IVF) and the polymorphic variants of matrix metalloproteinases (MMPs) or tissue inhibitors of metalloproteinases (TIMPs)? Summary answer Our findings suggested that clinical outcomes of women undergoing IVF were associated with rs2277698 SNPs in TIMP2. What is known already The extracellular matrix proteolytic machinery is one of the most important mechanisms for regulating trophoblast invasion. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), which are involved in the extracellular matrix proteolysis process, have the ability to regulate the degradation of the extracellular matrix and play a critical role in trophoblast invasion. Study design, size, duration A prospective study was composed of 1014 women undergoing their first fresh IVF cycle with non-donor from January 2014 to December 2015. Participants/materials, setting, methods The present study was carried out in Lee Women’s Hospital, Taiwan. DNA was extracted from the peripheral blood of all participants, and the SNPs were genotyped by real-time polymerase chain reaction. The effects of the following three single nucleotide polymorphisms (SNPs) on IVF outcomes were explored: TIMP1 (rs4898 C/T), TIMP2 (rs2277698 C/T) and MMP2 (rs243865 C/T). The SNP genotype, correlation with clinical pregnancy, embryo implantation, abortion and live birth rates of IVF were analyzed. Main results and the role of chance In the analysis of 1014 patients attempting their first cycle of IVF, the genotypes frequencies of the study population showed a statistically significant association between TIMP2 (rs2277698 C/T) and clinical outcome. For TIMP2 polymorphisms, women with wild genotype (CC) hadhigher clinical pregnancy rate (34.8% v.s 28.0%; p = 0.032), embryo implantation rate (19.4% v.s 15.4%; p = 0.009), live birth rate (29.8% v.s 22.1%; p = 0.006), and lower abortion rate (7.0% v.s 17.1%; p = 0.005) compared women with CT/TT genotype. On the other hand, the clinical outcomes in different TIMP1 or MMP2 gene polymorphisms groups were no statistically significant difference. Limitations, reasons for caution The size number of the study samples. Wider implications of the findings This study showed that the TIMP2 SNP polymorphisms CT/TT was associated with low trend of clinical outcomes. The mechanism of TIMP2 gene T allele affected the outcomes of IVF remains to be determined. Further studies should focus on the mechanism of these associations in a larger, more heterogeneous cohort. Trial registration number CS13194

A 23-year-old Korean woman with a residence history in Kenya and Malawi for about 2 years presented with gross hematuria for 1 month. Blood tests were within normal range except eosinophilia. Asymmetrically diffuse wall thickening and calcification were observed at the urinary bladder on CT. Multiple erythematous nodular lesions were observed in the cystoscopy and transurethral resection was done. Numerous eggs of Schistosoma haematobium with granulomatous inflammation were observed in the submucosal layer of the bladder. The patient was diagnosed with schistosomiasis-related cystitis and treated with praziquantel (40 mg/kg/day) twice before and after transurethral resection. This case suggests that S. haematobium infection should be considered as a cause of hematuria in Korea when the patient had a history of traveling endemic areas of schistosomiasis.

Background Recurrence of pancreatic cancer after primary pancreatectomy occurs in the vast majority of patients. The role of surgical treatment for recurrent pancreatic cancer is not well established. Methods Patients who underwent primary pancreatectomy with curative intent from 2000 to 2014 at a single large-volume centre were evaluated retrospectively. CT or PET was used to select patients with an isolated recurrence. The clinicopathological features and survival outcomes were compared according to treatment modalities. Results Of the 1610 patients with pancreatic cancer who underwent resection, 1346 (83·6 per cent) were diagnosed with recurrent pancreatic cancer. Recurrence was locoregional in 366 patients (27·2 per cent), distant multifocal in 251 (18·6 per cent), distant isolated in 188 (14·0 per cent), locoregional plus distant in 153 (11·4 per cent) and peritoneal seeding in 388 (28·8 per cent). Of the 1346 patients with recurrence, 197 (14·6 per cent) had isolated recurrence; of these, 48 (24·4 per cent of all isolated recurrences; 3·6 per cent of all recurrences) underwent resection. Median survival of the 197 patients after diagnosis of isolated recurrence was 14·7 months; it was longer in patients who underwent surgical resection than among those treated non-surgically (23·5 versus 12·0 months; P = 0·014). Multivariable analysis showed that chemotherapy and resection for recurrence were associated with better prognosis. Median survival after recurrence was longest in the 23 patients with isolated pulmonary recurrence (33·3 months). Survival after recurrence was better in patients who underwent resection of isolated recurrence in the remnant pancreas (median 28·0 versus 12·0 months, P = 0·010) and lung (median 36·5 versus 9·5 months; P = 0·010) than in those who did not undergo resection. Conclusion Surgical resection may be considered an option for treatment of patients with isolated recurrent pancreatic cancer.

Research supports that maxillomandibular advancement (MMA) surgery is an effective treatment modality for severe obstructive sleep apnea (OSA). In a systematic review, Ankichetty, et al, found that the use of alpha 2 agonists in OSA patients reduces the requirement of perioperative analgesics, but no randomized clinical trials with the use of dexmedetomidine (DEX) in OSA patients exist.1 Furthermore, while there are several studies evaluating peri-operative parameters in patients who have undergone Stanford Protocol's Phase I OSA surgeries, published studies regarding the usage of intra-operative DEX and anesthetic outcomes following MMA surgery are difficult to find. The authors seek to elucidate the effects that DEX, an alpha 2 agonist with analgesic, amnesic, and supposed anesthesia-sparing properties, has on patients immediately following MMA surgery.2 A search through the sponsoring institution's electronic medical record system was conducted from January 1, 2017, through December 31, 2020, using Current Procedural Terminology codes for bilateral sagittal split ramus osteotomy (BSSRO), Le Fort I osteotomy with or without bone grafts (LFI), genioplasty, genioglossus advancement, and/or genial bone graft (GG). Two independent investigators (ADC and YJL) reviewed the resultant charts and selected adult patients aged 18 years and older with a diagnosis of OSA. Patients who remained intubated at the conclusion of MMA surgery and whose procedures included solely revision osteotomies were excluded from this study. The remaining 58 patient records underwent a detailed retrospective chart review. Postoperative opioid requirement was calculated as milligrams (mg) of morphine equivalent dosages (MEDs). Univariate analysis was conducted with Pearson's Chi-square to determine the presence of a statistically significant association between cumulative doses of intraoperative DEX and the opioid requirement within the first 8- and 24-hours postoperatively, as well as the time from "Surgery End to Extubation" (EXT). Multiple linear regression and multinomial logistic regression were utilized to evaluate relationships among different doses of medications received and to calculate odds ratios, respectively. Significance was defined as P There were 58 patients included in this study: 47 (81%) males and 11 (19%) females; 27 (46.6%) had received intraoperative DEX and 31 (53.4%) had not. While all patients underwent at least 2 osteotomies, 49 (84.5%) of patients underwent 4 (i.e., LF1, BSSRO, and GG osteotomies). There was no significant difference detected between cumulative dosage of intraoperative DEX and first 8-hour postoperative narcotic requirement (P = .30). However, a statistically significant association was detected between cumulative dosage of intraoperative DEX and first 24-hour postoperative narcotic requirement (P = .02). Furthermore, patients who received a cumulative DEX dose between 100.1 and 200 micrograms (mcg) received less opioids within the first 24-hour postoperative period than those patients who received > 200mcg of DEX. EXT in patients who received between 100.1 and 200mcg of DEX, as compared to those who did not receive and those who did receive lower amounts of intraoperative DEX, was statistically significantly higher (P = .01 and .02, respectively). In contrary to the conclusions of Ankichetty, et al, and Bamgbade, et al, less intraoperative DEX was found to be significantly associated with lower 24-hour postoperative opioid requirements. This study also suggests that EXT may decrease with lower doses of DEX administered intraoperatively. Well-designed prospective, randomized studies involving larger numbers of patients with OSA undergoing MMA surgery and receiving DEX are warranted.

Background/Aims: Yes-associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) activation has been implicated in hepatocarcinogenesis and hepatic progenitor cell differentiation, and hypoxia has been shown to induce nuclear translocation of YAP in cancer cells. Here, we aimed to investigate the relationship between hypoxia, YAP and TAZ expression and stemness-related marker expression in human hepatocellular carcinomas (HCCs) and its clinical implications.Methods: Immunohistochemical stains were performed on tissue microarrays from 305 surgically resected HCCs, and the expression status of YAP and TAZ were correlated with CAIX, stemness markers (K19, EpCAM) and epithelial-mesenchymal transition (EMT)-related markers (uPAR, ezrin). The clinicopathological significance of YAP/TAZ expression was analyzed with relation to CAIX expression status.Results: YAP and TAZ expression were seen in 13.4 and 4.3% of HCCs, respectively. YAP/TAZ-positive HCCs frequently demonstrated higher serum AFP levels, microvascular invasion, advanced tumor stage, increased proliferative activity and expression of stemness- and EMT-related markers, CAIX, p53 and Smad2/3 (p < 0.05, all). Interestingly, YAP/TAZ-positivity was associated with microvascular invasion, higher serum AFP levels, stemness and EMT-related marker expression only in tumors expressing CAIX (p < 0.05, all), while these associations were not seen in CAIX-negative HCCs.Conclusions: YAP/TAZ expression is associated with vascular invasion, stemness and EMT in HCCs with hypoxia marker expression. The effect of Hippo signaling pathway deregulation in HCC may depend on the presence or absence of a hypoxic microenvironment, and hypoxia marker expression status should be taken into account when considering the use of YAP/TAZ as markers of aggressive biologic behavior in HCC.

The effect of Si addition on the initial deformation mechanism of Fe–30Mn–9Al–0.9C–0.5Mo cast lightweight steel has been investigated. Atomic-scale analysis by three-dimensional atom-probe tomography confirmed that Si addition accelerates the formation kinetics of the κ-carbide, and increases remarkably the partitioning coefficient of carbon by more than 2 times. Promotion of C partitioning into κ-carbides by Si addition leads to deformation localization in an aged state. This is attributed not only to the increase of the κ-carbide size associated with higher coherency strain, but also to higher frequency of Al-C bonding formation. First-principles calculations indicated that the energy required for a/2 shearing of κ-carbide in the aged 1%-Si steel is higher (561 mJ/m2) than that in the aged Si-free steel (494 mJ/m2). Therefore, Si addition leads to a significant energy difference for shearing and results in different shear bands formation. The operative deformation mechanism can be calculated for this alloy system as a function of precipitates volume fraction and size. It was determined that deformation proceeds primarily by κ-carbide shearing as long as the radius of κ-carbides is smaller than 13.4 nm.

In April 2020, manufacturing of the ITER vacuum vessel (VV) first sector has been completed by the Korean domestic agency, manufacturing having started in February 2012. The ITER VV sector is the largest fusion VV structure in the world. Each step of the manufacturing was a challenge as a first-of-a-kind, and a French nuclear pressure vessel. The paper provides an overview of the major challenges which were overcome over the last 10 years.

Aim A lectin Concanavalin A (ConA) derived from Canavalia ensiformis (jack bean) exhibits high-binding affinity to carbohydrates on bacterial cell surfaces. The objective of this study was to inhibit the biofilm formation of the foodborne pathogens enterohemorrhagic Escherichia coli and Listeria monocytogenes using ConA prepared by a membrane-based extraction method. Methods and results ConA was extracted using a simple and inexpensive membrane method instead of a chromatography approach. The extracted ConA was effective in inhibiting biofilms of E. coli by 30-fold and L. monocytogenes by 140-fold. In addition, ConA decreased the swimming motility of enterohemorrhagic E. coli EDL933 (EHEC) by 37%, resulting in low biofilm formation, as ConA binding to the bacterial cell surfaces might cause a reduced capability to adhere due to low cellular motility. We confirmed that the extracted ConA contains active components at less than 10 kDa as well as ConA multimers (>30 kDa) that repress EHEC biofilms. Additionally, noncell-based mannose reduced the activity of ConA in inhibiting biofilms. Conclusions ConA extracted using the membrane-based method is active in inhibiting the biofilm formation by E. coli and L. monocytogenes via the mannose-binding affinity of ConA. Significance and impact of the study ConA can be used as a promising anti-adherent and antibiofilm agent in inhibiting biofilm formation by enterohemorrhagic E. coli and L. monocytogenes. The membrane-based extraction approach may be applied for the economic production of biologically active lectins.

Color changes controlled by electronic energies have been studied for many years in order to fabricate energy-efficient smart windows. Reduction and oxidization of nickel oxide under the appropriate voltage can change the color of a window. For a superior nickel oxide (NiO) electrochromic device (ECD), it is important to control the chemical and physical characteristics of the surface. In this study, we applied polystyrene bead templates to nickel oxide films to fabricate a honeycomb-structured electrochromic (EC) layer. We synthesized uniform polystyrene beads using the chemical wet method and placed them on substrates to create honeycomb-structured NiO films. Then, the EC characteristics of the nickel oxide films with a honeycomb structure were evaluated with UV-Visible and cyclic voltammetry. FE-SEM and AFM were used to measure the morphologies of the nanostructures and the efficiencies of the redox reactions related to the specific surface area.

Background We aimed to determine the clinicopathological significance of the gross classification of hepatocellular carcinoma (HCC) according to the Korean Liver Cancer Association (KLCA) guidelines. Methods A retrospective analysis was performed on 242 cases of consecutively resected solitary primary HCC between 2003 and 2012 at Seoul National University Bundang Hospital. The gross classification (vaguely nodular [VN], expanding nodular [EN], multinodular confluent [MC], nodular with perinodular extension [NP], and infiltrative [INF]) was reviewed for all cases, and were correlated with various clinicopathological features and the expression status of “stemness”-related (cytokeratin 19 [CK19], epithelial cell adhesion molecule [EpCAM]), and epithelial-mesenchymal transition (EMT)–related (urokinase plasminogen activator receptor [uPAR] and Ezrin) markers. Results Significant differences were seen in overall survival (p=.015) and disease-free survival (p = .034) according to the gross classification; INF type showed the worst prognosis while VN and EN types were more favorable. When the gross types were simplified into two groups, type 2 HCCs (MC/NP/INF) were more frequently larger and poorly differentiated, and showed more frequent microvascular and portal venous invasion, intratumoral fibrous stroma and higher pT stages compared to type 1 HCCs (EN/VN) (p

KSTAR project has required the new helium distribution box named upgraded distribution box (DBU) for the operation of the cryogenic components such as in-vessel cryo-pump (CPI), super-sonic molecular beam injector (SMBI), and deuterium pellet injection system (PIS). Two CPIs are inserted into the tokamak vacuum vessel and these components shall be operated at 90 K for the liquid nitrogen thermal shields and 4.5 K for the hydrogen cryo-panel. One hydrogen PIS was newly mounted on the tokamak for the 2016 KSTAR campaign. Liquid nitrogen shall be supplied to the one SMBI. For the operation of above mentioned 3 kinds of cryogenic components, a helium refrigerator, which had been used for the R&D in the KSTAR facility construction phase (2002–2013), was moved and inserted into the KSTAR 9 kW helium facility room. The cooling capacity of the refrigerator at 4.5 K is 1 kW and it was manufactured from the Linde Kryotechnik before 2002. After some maintenances in warm compressor, electrical power supply, oil-filter, and so on, commissioning of the refrigerator up to 4.5 K was accomplished successfully. From the beginning of 2015, design and fabrication of the DBU was started. It shall control the liquid nitrogen for the SMBI and CPI thermal shields whereas liquid helium for the CPI cryo-panel and PIS. To minimize the temperature of the liquid nitrogen to be supplied to SMBI and CPI, a thermal damper tank was inserted into the distribution box. Nitrogen return gases are to be warmed up to room temperature at the heater in the distribution box. A 1000 l of liquid helium vessel is located nearby the PIS to supply cold gas helium (∼5 K). Because the CPI cryo-panel requires regeneration up to 90 K, complex regeneration and re-cool down scenario was developed and applied to the DBU. Including operational results, details of the DBU progresses will be reported in this paper.

To reduce solar heat and glare from visible light, the color of window panes need to be controlled by electronic energy. Metal oxides deposited on these “smart” windows such as WO 3 , Nb 2 O 5 , and NiO can change the color of the glass by absorbing visible rays. It is important to control the chemical and physical characteristics of the surface of films and to apply a uniformly thin film to obtain a superior product. In this study, we generated templates as nanostructured WO 3 monolayers in nanorods with 400 nm-sized polystyrene (PS) beads. Honeycomb structures were prepared from the well-ordered monolayer template with PS beads that were synthesized by wet chemistry. We investigated the enhanced electrochromic (EC) properties of a honeycomb structured WO 3 thin films which were composed of WO 3 nanostructures. Nanoarchitectural properties like morphology of films, crystalline phases and the structures of WO 3 nanoparticles were examined by Field Emission Scanning Electron Microscopy, X-ray diffraction and Transmission Electron Microscopy. And EC standards such as the variation of transmittance, reaction time and efficiency of redox reactions called by “coloration efficiency” were measured by UV–Vis spectrophotometer, and cyclic voltammetry. The electrochromic reaction rate of honeycomb structured WO 3 thin films was fast (coloration time: 5.86 s and bleaching time: 6.65 s) but, the variation of light transmission (Δ85.04% at 700 nm wavelength) was comparable to that of flat WO 3 film with the similar thickness of about 300 nm. These results suggested that the surface area enlarged by the honeycomb structure induced by PS templating caused the simultaneous redox reaction in the entire WO 3 film.

Increased copy number of chromosome enumeration probe (CEP) targeting centromere 17 is frequently encountered during HER2 in situ hybridization (ISH) in breast cancer. The aim of this study was to clarify the clinicopathologic significance of CEP17 copy number gain in a relatively large series of breast cancer patients. We analyzed 945 cases of invasive breast cancers whose HER2 fluorescence ISH reports were available from 2004 to 2011 at a single institution and evaluated the association of CEP17 copy number gain with clinicopathologic features of tumors and patient survival. We detected 186 (19.7%) cases of CEP17 copy number gain (CEP17≥3.0) among 945 invasive breast cancers. In survival analysis, CEP17 copy number gain was not associated with disease-free survival of the patients in the whole group. Nonetheless, it was found to be an independent adverse prognostic factor in the HER2-negative group but not in the HER2-positive group. In further subgroup analyses, CEP17 copy number gain was revealed as an independent poor prognostic factor in HER2-negative and hormone receptor-positive breast cancers, and it was associated with aggressive histologic variables including high T stage, high histologic grade, lymphovascular invasion, p53 overexpression, and high Ki-67 proliferative index. In conclusion, we found that elevated CEP17 count can serve as a prognostic marker in luminal/HER2-negative subtype of invasive breast cancer. We advocate the use of the dual-colored fluorescence ISH using CEP17 rather than the single-colored one because it gives additional valuable information on CEP17 copy number alterations.

Background:Based on the benefit of chemoprophylaxis among patients receiving biologics [1], Health Insurance Review and Assessment (HIRA) service of Korea requires patients to undergo latent tuberculosis (LT) screening before initiation of any biologics and to receive chemoprophylaxis for positive LT.Objectives:To assess the effect of chemoprophylaxis on tuberculosis infection (TI) risk among patients with rheumatoid arthritis (RA) receiving biologics in KoreaMethods:Using 2002-2016 Korea National Health Insurance database, we conducted a cohort study on RA patients initiating biologic drugs (TNF inhibitors, abatacept, tocilizumab) to compare TI risk between those who started isoniazid and/or rifampin within 1 year before biologics initiation (prophylaxis group) versus those who did not (non-prophylaxis group). TI was defined by ICD10 codes plus anti-tuberculosis medications as previously described [2]. Patients were followed-up from biologics initiation to censoring events (TI occurrence, death, biologics discontinuation, initiation of anti-tuberculosis drug due to non-TI cause, and end of database). To control >50 baseline confounders, we used propensity score (PS)-based fine stratification and weighting. A weighted Cox proportional hazards model estimated hazard ratios (HRs) and 95% confidence intervals (CIs).Results:Before PS stratification (PSS) and weighting, we identified 2,250 and 7,259 RA patients for prophylaxis and non-prophylaxis group, respectively. Mean age was 57.6 years and 81.3% female. Three-fourths of patients in the prophylaxis group completed >70% of recommended treatment periods [3]. The incidence rate of TI per 100 person-years was 0.33 for prophylaxis group versus 0.57 for non-prophylaxis group. 28% of all TI cases (n=34) were extra-pulmonary with gastrointestinal (n=11) and miliary TI (n=9) being most common. The PSS-weighted HR (95% CI) of TI comparing prophylaxis versus non-prophylaxis group was 0.52 (0.32-0.86) (Table 1, Figure 1). Sensitivity analyses showed that the chemoprophylaxis was particularly effective for those with younger age (Table 1.Comparative risk of tuberculosis infection between prophylaxis versus non-prophylaxis groupCrudePSS-weightedNEventsPYIR per100 person-yearsHR (95% CI)Primary as-treated analysis1TotalP2,250185,5320.330.52 (0.32-0.86)NP7,25910017,5030.64ITT analyses11 year ITTP2,250102,1150.470.33 (0.17-0.64)NP7,259976,8331.422 year ITTP2,250213,9070.540.49 (0.31-0.78)NP7,25914012,6981.104 year ITTP2,250316,3050.490.56 (0.38-0.82)NP7,25918121,2780.88Sensitivity AnalysesAge P1,75194,5880.200.39 (0.19-0.78)NP5,3457213,6340.52MaleP54621,3190.150.12 (0.03-0.50)NP1,235282,6241.33Comorbidity score ≥3P82461,9080.310.34 (0.15-0.79)NP2,668526,1290.941As-treated analysis censored patients when they discontinued biologics use, while ITT analysis did not.IR=incidence rate; ITT=intention-to-treat; HR=hazard ratio; PSS=propensity-score stratification; CI=confidence interval; PY=person-years; P=prophylaxis group; NP=non-prophylaxis groupConclusion:We found 48% risk reduction of TI by chemo-prophylaxis among RA patients receiving biologics. Due to HIRA requirements, a majority of non-prophylaxis group were considered negative for LT by screening at biologics initiation [4]. These findings indicate that the risk of TI during bDMARD treatment is still high among RA patients who were negative for LT at baseline but did not undergo chemoprophylaxis, which is double the risk among RA patients who had LT and underwent chemoprophylaxis.References:[1]Carmona L et al. Arthritis Rheum. 2005;52:1766-72.[2]Lee J et al. Ann Am Thorac Soc. 2017;14:690-697.[3]https://www.cdc.gov/tb/topic/treatment/ltbi.htm[4]Kim ES et al. World J Gastroenterol. 2015;21:3308-16.Disclosure of Interests:None declared

Background Hepatic resection has been the main treatment option for patients with hepatocellular carcinoma (HCC). Several previous studies attempted to establish reliable criteria to predict mortality or post-hepatectomy liver failure (PHLF) after liver resection Methods A total of 1,481 consecutive patients underwent hepatic resection between January 2016 and December 2017. Laboratory tests were assessed before, and 1,2,3,5,7, and 10 days after surgery. Post-hepatectomy hepatic dysfunction was defined as an increase in the total bilirubin ≥2.9 mg/dL (50 μmol/L) or an increase INR on or after postoperative day 5, compared with the values of the previous day. PHLF includes post-hepatectomy hepatic dysfunction, ICU stay, development of ascites requiring diuretics or drainage procedure, and mortality from any cause. Patients were randomly divided into train set (n=1,111) and validation set (n=370). Results Of 1,565 patients with available data, the mean age was 58.3 years and male comprised 80.6% of patients. 403 (32.1%) patients underwent major hepatic resection and 481(38.3%) revealed cirrhosis at pathologic specimens. The mortality at 30 and 90 days were 0.3% and 0.9%, respectively. PHLF developed in 117(9.3%) patients: posthepatectomy hepatic dysfunction in 62 (4.9%) patients, ICU stay in 18(1.4%) patients, ascites in 42(3.3%) patients, and death 11 (0.9%) patients. In multivariable logistic regression, age over 70 years (adjusted odds ratio [AOR]: 2.89, 95% confidence interval [95% CI]: 1.65–4.97), cirrhosis (AOR:2.60, 95% CI:1.67–4.08), albumin less than 3.5 (AOR:2.17, 95% CI:1.56–3.01), major hepatic resection compared with minor resection (AOR:2.26, 95% CI:1.41–3.62), and high indocyanine green (ICG) index at 15 minutes over 20% (AOR:2.53, 95% CI:1.21–5.46) were significantly associated with a high risk of PHLF. Integer values were assigned to each factor to develop a model that predicted PHLF, which presented an area under the curve of 0.780. Conclusions Cirrhosis, age over 70 years, major resection, lower albumin and high ICG level were associated independently with PHLF. A composite integer-based risk scoring model could accurately predict PHLF in patients undergoing hepatic resection for HCC