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The length of tumour-vein contact between the portal-superior mesenteric vein (PV/SMV) and pancreatic head cancer, and its relationship to prognosis in patients undergoing pancreatic surgery, remains controversial.Patients diagnosed with pancreatic head cancer who were eligible for pancreatoduodenectomy between October 2002 and December 2016 were analysed. The PV/SMV contact was assessed retrospectively on CT. Using the minimum P value approach based on overall survival after surgery, the optimal cut-off value for tumour-vein contact length was identified.Among 491 patients included, 462 underwent pancreatoduodenectomy for pancreatic head cancer. PV/SMV contact with the tumour was detected on preoperative CT in 248 patients (53·7 per cent). Overall survival of patients with PV/SMV contact exceeding 20 mm was significantly worse than that of patients with a contact length of 20 mm or less (median survival time (MST) 23·3 versus 39·3 months; P = 0·012). Multivariable analysis identified PV/SMV contact longer than 20 mm as an independent predictor of poor survival, whereas PV/SMV contact greater than 180° was not a predictive factor. Among patients with a PV/SMV contact length exceeding 20 mm on pretreatment CT, those receiving neoadjuvant therapy had significantly better overall survival than patients who had upfront surgery (MST not reached versus 21·6 months; P = 0·002).The length of PV/SMV contact predicts survival, and may be used to suggest a role for neoadjuvant therapy to improve prognosis.El valor pronóstico de la longitud del contacto del tumor de la cabeza pancreática con las venas porta y mesentérica superior (portal-superior mesenteric vein, PV/SMV) en los pacientes sometidos a cirugía pancreática sigue siendo un tema controvertido. MÉTODOS: Se analizaron los pacientes diagnosticados de un cáncer de la cabeza pancreática a los que se realizó una duodenopancreatectomía cefálica entre octubre de 2002 y diciembre de 2016. El contacto tumoral con la PV/SMV se evaluó de forma retrospectiva mediante tomografía computarizada (TC). Se identificó el valor de corte óptimo para la longitud del contacto tumoral con la PV/SMV, utilizando el valor mínimo de la P basado en la supervivencia global (overall survival, OS) después de la cirugía.De 491 pacientes incluidos, en 462 pacientes se realizó una duodenopancreatectomía cefálica por cáncer de la cabeza de páncreas. En la TC preoperatoria, se detectó contacto tumoral con la PV/SMV en 248 (53,7%) pacientes. La OS de los pacientes en los que el contacto del tumor con la PV/SMV fue 20 mm fue significativamente peor que en aquellos cuyo contacto fue ≤ 20 mm (mediana de supervivencia (median survival time, MST) 23,3 versus 39,3 meses; P = 0,012). En un análisis multivariado se identificó el contacto tumoral-PV/SMV 20 mm como un factor independiente predictor de mala supervivencia, pero el contacto tumor-PV/SMV 180° no fue un factor pronóstico. En los pacientes en los que el contacto tumor-PV/SMV fue 20 mm en el TC preoperatorio, la OS en aquellos que recibieron tratamiento neoadyuvante fue significativamente mejor en comparación con los pacientes tratados directamente con cirugía (MST, no alcanzada versus 21,6 meses, P = 0,002). Conclusión La longitud del contacto tumoral con la PV/SMV predice la supervivencia, por lo cual dicha longitud podría jugar un papel en la indicación de tratamiento neoadyuvante para mejorar el pronóstico.

We have investigated a prototype triggerless data acquisition (DAQ) system for charmed-baryon spectroscopy at J-PARC. A special time-to-digital converter (TDC) dedicated to continuous timing measurement without any external trigger was developed. A high dynamic range of the order of 1010 for the timing measurement was realized by introducing the heartbeat method, which periodically generates a delimiter datum. DAQ software receiving and filtering the data stream from the TDCs was also developed based on a message-queue application programming interface (API), FairMQ. We tested the prototype DAQ system with detectors using electrons and positrons converted from a bremsstrahlung photon beam with a rate condition of up to 1.9 MHz/1-mm detector segment. The DAQ received a 5.4 Gbps data stream from six TDCs and merged them to a complete data set. After sorting a certain portion of the data, the software searched for a set of corresponding data fragments in response to the penetration of a positron or electron using time separation between detector hits in the time axis and removed unnecessary hits. Around 25 GB RAM and 25 CPU threads were required for the online computing power under the test conditions. No silent data drop in the DAQ software was observed.

Background Hepatectomy with vascular resection (VR) for perihilar cholangiocarcinoma (PHCC) is a challenging procedure. However, only a few reports on this procedure have been published and its clinical significance has not been fully evaluated. Methods Patients undergoing surgical resection for PHCC from 2002–2017 were studied. The surgical outcomes of VR and non-VR groups were compared. Results Some 238 patients were included. VR was performed in 85 patients. The resected vessels were hepatic artery alone (31 patients), portal vein alone (37 patients) or both (17 patients). The morbidity rates were almost the same in the VR (49.4 per cent) and non-VR (43.8 per cent) groups (P = 0.404). The mortality rates of VR (3.5 per cent) and non-VR (3.3 per cent) were also comparable (P > 0.999). The median survival time (MST) was 45 months in the non-VR group and 36 months in VR group (P = 0.124). Among patients in whom tumour involvement was suspected on preoperative imaging and whose carbohydrate antigen 19-9 (CA19-9) value was 37 U/ml or less, MST in the VR group was significantly longer than that in the non-VR group (50 versus 34 months, P = 0.017). In contrast, when the CA19-9 value was greater than 37 U/ml, MST of the VR and non-VR groups was comparable (28 versus 29 months, P = 0.520). Conclusion Hepatectomy with VR for PHCC can be performed in a highly specialized hepatobiliary centre with equivalent short- and long-term outcomes to hepatectomy without VR., Major hepatectomy with vascular (hepatic artery and/or portal vein) resection and reconstruction was performed in 85 consecutive patients with advanced perihilar cholangiocarcinoma. This surgery is technically demanding but can be performed with equivalent short- and long-term outcomes in a highly specialized hepatobiliary centre.

Background Non-anatomical liver resection (NAR) and radiofrequency ablation (RFA) are treatment options for early-stage hepatocellular carcinoma (HCC). The aim was to compare the outcomes of NAR and RFA for HCC in patients with three or fewer tumour nodules, each measuring not more than 3 cm in maximum diameter. Methods Eligible patients undergoing NAR or RFA with curative intent between September 2002 and December 2014 were identified. A propensity score-matching analysis was performed to reduce bias, and outcomes in these patients were analysed. Results From a total of 199 patients, 1:1 propensity score matching identified 70 matched pairs. Patients having NAR had a longer hospital stay (median 10 days versus 4 days for those who had RFA; P < 0·001) and a higher morbidity rate (24 versus 10 per cent respectively; P = 0·042). Patients who had NAR had slightly better recurrence-free survival but this failed to reach statistical significance in univariable analysis (P = 0·064). There was no significant difference in overall survival between the two groups (P = 0·475). RFA was identified as an independent risk factor for recurrence-free survival (hazard ratio (HR) 1·57; P = 0·041) in multivariable analysis. Local recurrence was significantly more common in patients receiving RFA (23 versus 1 per cent; P < 0·001). Conclusion RFA was an independent risk factor for shorter recurrence-free survival, with a significantly higher local recurrence rate than NAR. Despite these differences, overall survival was not affected.

International audience; Although more detailed analysis for deriving the cross section of \(\Sigma p\) scattering is necessary to derive the cross section of \(\Sigma p\) scattering, we have confirmed that CFT has enough angular resolution of tracking and energy resolution in order for the identification of the scattering events and particles.

We report two patients with mediastinal abscess developing after surgery for oesophageal cancer who were treated by percutaneous drainage using a unified CT and angiography system, which allows both CT and fluoroscopy to be conducted with the patient on the same bed. Fine needle puncture is performed under CT guidance and this needle is used as a tandem for insertion of the drainage needle under fluoroscopic guidance, making safe puncture possible whilst confirming the position of the needle tip. Moreover, contrast medium can be injected from the drainage tube, allowing the extent of the abscess cavity to be determined by fluoroscopy and CT, thereby making accurate drainage possible.

We report two cases in which hepatic arterial occlusion developed soon after percutaneous catheter placement for hepatic arterial infusion chemotherapy in malignant hepatic neoplasms. A replaced hepatic artery and a proper hepatic artery, respectively, became occluded in these cases. In both, because the tip of a side-holed catheter for arterial infusion was fixed in place, we performed recanalization without removing the indwelling catheter. Despite the presence of the catheter, a stent could be inserted into the occluded portion of the hepatic artery. Recanalization of the hepatic artery was achieved with stent placement, and continuation of hepatic arterial infusion became possible.

Background: Preoperative portal vein embolization (PVE) is performed to enhance the future remnant liver function (FRLF) and volume (FRLV). However, the volume of the nonembolized liver does not increase enough in some patients, which results in an insufficient FRLF. The aim of this study was to evaluate the predictors of insufficient FRLF after PVE for extended hepatectomy. Methods: This retrospective study included 172 patients (107 patients with cholangiocarcinoma, 40 patients with metastatic liver cancer and 25 patients with hepatocellular carcinoma) who underwent PVE before extended hepatectomy. The total liver function was evaluated by measuring the indocyanine green plasma clearance rate (KICG). Computed tomography volumetry was conducted to evaluate the total liver volume and FRLV. The KICG of the future remnant liver (remK) was calculated using the following formula: KICG × FRLV/total liver volume. The safety margin for hepatectomy was set at remK after PVE (post-PVE remK) ≥0.05. Results: One hundred and twenty-three patients with a post-PVE remK level of >0.05 underwent hepatectomy without postoperative liver failure [sufficient liver regeneration (SLR) group], and 9 patients with a post-PVE remK level of Conclusions: The patients in the ILR group did not achieve SLR after PVE due to a significant decrease in the KICG and an insufficient increase in %FRLV. A pre-PVE remK value of

This paper describes a high speed and area effective multiplier-accumulator for an embedded RISC processor. The point of architecture is to utilize a full adder array and the Booth's encoder twice in a cycle. The multiplier-accumulator executes one multiply-add operation (32 b multiplication followed by 64 b addition) per cycle at 56.5 MHz. The area is 2.35 mm/sup 2/ with 0.4 /spl mu/m CMOS technology.

During attempted oesophageal stent placement in a patient with cervical oesophageal cancer in whom swallowing of even saliva was impossible, transoral access to the cervical oesophagus was unsuccessful. Under ultrasound and fluoroscopy guidance, percutaneous gastric puncture was performed, and using an angiographic catheter and guidewire, access to the oesophagus by a retrograde transgastric route was successfully achieved. The obstructed segment of the oesophagus was traversed. It was then possible to pull the guidewire through the mouth and place an oesophageal stent via an antegrade approach.

The effect of blood volume contraction induced by a 4-week regimen of spironolactone (100 mg/day) or furosemide (40 mg/day) on the hepatic venous pressure gradient (HVPG), an indicator of portal hypertension, was evaluated in patients with cirrhosis and no ascites. In the spironolactone group (n = 15), HVPG decreased significantly from 16.5 +/- 0.9 mmHg (mean +/- S.E.M.) to 12.9 +/- 1.0 mmHg (P0.005) and total blood volume contracted significantly from 4338 +/- 231 ml to 4006 +/- 203 ml (n = 14, P0.01). Although the HVPG changes did not correlate significantly with changes in measured total blood volume or in simultaneously determined systemic haemodynamics, a significant inverse correlation (r = -0.74, P0.01, n = 12) was found between the HVPG change and posttreatment plasma aldosterone levels, attesting to the effectiveness of spironolactone therapy in lowering HVPG. In the furosemide group (n = 10), neither HVPG (13.7 +/- 0.3 mmHg vs. 13.6 +/- 0.9 mmHg) nor total blood volume (4961 +/- 153 ml vs. 4964 +/- 162 ml) declined significantly. These results show that long-term administration of spironolactone to patients with cirrhosis and no ascites produced a significant reduction in HVPG that may have been due to gradual, sustained volume contraction. Thus, spironolactone may prove to be an effective treatment for portal hypertension in cirrhosis without ascites.

Two-dimensional radiation by a relativistic sheet electron beam propagating parallel to a reflection grating composed of a sinusoidally corrugated conducting surface is studied rigorously using the mode-matching method. Accurate dispersion curves for the eigenmodes that govern the Smith-Purcell radiation and the instability of the electromagnetic surface wave are presented. The imaginary parts of the eigenwavenumber and eigenfrequency give the leakage coefficient of space-charge waves and the growth rate of electromagnetic surface waves. Their dependences on the dimensions of the radiating structure are discussed. Optimum parameters for achieving the maximum leakage coefficient and the growth rate are determined. The method is general and can be applied to any two-dimensional system of electron beam coupled to an open periodic structure of arbitrary profile. >

The Geographical Survey Institute of Japan has installed a network of about 1000 dual-frequency GPS receivers in Japan with their mutual distance of about 25 km. Phases and pseudo ranges of dual-frequency GPS signals are recorded every 30 s. The dense distribution of the GPS receivers allows us to reveal two-dimensional structures of the ionospheric plasma density irregularities with scale sizes of the order of several kilometers. We analyzed TEC data obtained from the GPS network of Japan in 2000. It was found that the irregularity characteristics over Japan depended on latitude. The results are as follows: (1) at the northern part, the irregularities appeared only during geomagnetic storms. (2) At the middle part, they had the most frequent occurrence in summer nighttime and were usually accompanied by Medium-Scale Traveling Ionospheric Disturbances (MSTID). (3) At the southern part, they were associated with the equatorial plasma bubbles and their occurrences were highest in the equinoctial nighttime.

Background: The role of positron emission tomography with the glucose analogue [18F] fluoro-2-deoxy-D-glucose (FDG-PET) in the initial staging of disease in patients with primary colorectal cancer (CRC) has not been adequately assessed. Aims: To evaluate the additional value of FDG-PET as a staging modality, complementary to routine multidetector row computed tomography (MDCT) in patients with CRC. Methods: Forty four patients with CRC underwent preoperative MDCT and FDG-PET. The accuracy of intraoperative macroscopic staging was also investigated compared with histopathological diagnosis. All FDG-PET images were evaluated with respect to detectability of the primary tumour, lymph node involvement, and distant metastases. Both MDCT and FDG-PET diagnoses and treatment plan were compared with surgical and histopathological results. Results: Thirty seven patients underwent surgery. Tumour detection rate was 95% (42/44) for MDCT, 100% (44/44) for FDG-PET, and 100% (37/37) for intraoperative macroscopic diagnosis. Pathological diagnosis of T factor was T1 in five, T2 in four, T3 in 24, and T4 in four cases. Concordance rate with pathological findings of T factor was 57% (21/37) for MDCT and 62% (23/37) for macroscopic diagnosis. Lymph node involvement was pathologically positive in 19 cases. Regarding N factor, overall accuracy was 62% (23/37) for MDCT, 59% (22/37) for FDG-PET, and 70% (26/37) for macroscopic diagnosis. For all 44 patients, FDG-PET findings resulted in treatment changes in only one (2%) patient. Conclusion: FDG-PET is not superior to routine MDCT in the initial staging of primary CRC.

The rapid growth of the Internet impacts ATM networks to be furnished with IP handling capability. This paper discusses networking issues for IP and ATM integration. First, it considers function allocation at the boundary of an ATM backbone network and the Internet. As a result, the paper explains the necessity of built-in IP handling capability in an ATM switching system, and summarizes functional requirements for the system architecture. According to the discussion, the authors propose a system architecture for IP/ATM integration in the ATM switching system. The implementation of the proposed architecture is evaluated, and the wire-speed IP handling capability in the ATM switch is confirmed.

The authors investigate Smith-Purcell radiation due to a relativistic sheet-electron beam propagating parallel to a reflection grating composed of sinusoidally corrugated conducting surface. A self-consistent analysis of the method and instability is developed using the mode-matching method. The precise numerical results for the dispersion relation of eigenmodes supported by the two-dimensional system are presented over the frequency range from the spontaneous emission regime to the stimulated emission regime. >

The authors propose a parallel ATOM (asynchronous transfer mode output modular) switch architecture, capable of handling multi-gigabit per second lines. It is composed of distributors, a number of switch planes, and resequencers. A simple resequencing method is also proposed to keep sequence integrity for cells sent out from different switch planes. It is shown that the memory access speed requirement can be reduced dramatically, as the number of switch planes increases. With this architecture, for example, a 9.6 Gb/s per line 32 by 32 ATM switch can be achieved using 70 Mb/s BiCMOS technologies. Performance evaluations by computer simulation show that additional delay and buffer memories for resequencing are much smaller than for conventional methods, and that they pose no practical problem. >

In this paper, an access network controller for ADSL (asymmetric digital subscriber line) is described. It consists of a VR4120 MPU core, a system controller, an Ethernet controller, an ATM (asynchronous transfer mode) cell processor, a USB (universal serial bus interface) controller, and other blocks. This controller, along with ADSL PHY devices, can provide a total solution for ADSL modem and ADSL router.

Background Methotrexate (MTX) is the cornerstone of the treatment for rheumatoid arthritis (RA) as an “anchor” drug, and it is often used concomitantly with biologics. There are many reports of the concomitant use of MTX with a biologics resulting in increased efficacy, particularly with TNF inhibitors. It has been shown in clinical trials that, in bio-naive RA patients treated with TCZ, whether or not MTX is used concomitantly makes no difference in the outcome. However, there have so far been few reports that have directly compared the patients treated with and without the combination in clinical practice. Objectives The aim of this study was to compare a group of bio-naive RA patients receiving TCZ with concomitant MTX to a group being treated without concomitant MTX in the clinical setting. Methods The study was conducted in 39 bio-naive RA patients being treated with TCZ; 22 of these patients were not receiving concomitant MTX (the monotherapy group: M group) and 17 were receiving concomitant MTX (the combination therapy group: C group). At baseline, and after six and 12 months, the following parameters were investigated: CRP, ESR, swollen joints count (SJC), tender joints count (TJC), MMP-3, DAS28-ESR, DAS28-CRP and adverse events. Results In the baseline comparison, the non-MTX group had significantly higher DAS28-ESR scores (M group mean: 5.4 [3.4-8.3]; C group mean: 5.0 [3.1-6.2]). After six months, the mean number of swollen joints was 3.0 (0-8) in the M group and 1.2 (0-7) in the C group, the mean number of tender joints was 2.2 (0-7) in the M group and 0.7 (0-4) in the C group, the mean DAS28-ESR was 3.2 (1.4-5.2) in the M group and 2.4 (0.7-3.5) in the C group, and the mean DAS28-CRP was 2.4 (1.5-3.8) in the M group and 1.7 (1.2-2.9) in the C group. Therefore, each of these scores improved significantly more in subjects receiving concomitant MTX than in subjects not receiving concomitant MTX. After 12 months of treatment, the mean number of tender joints was 1.5 (0-1) in the M group and 0.4 (0-1) in the C group and the mean DAS28-CRP was 2.2 (1.2-3.6) and 1.6 (1.2-2.5) in the M and C groups, respectively. Therefore, after 12 months, the C group exhibited significantly better improvement than the M group, but only in these two parameters. No differences were found between the groups in terms of adverse events. Conclusions In this study, the C group showed significantly inhibited disease activity at both six and 12 months, suggesting that MTX should be used concomitantly with TCZ whenever possible. The improvement was demonstrated as early as six months, thus suggesting that patients who concomitantly receive MTX can achieve an improvement in the disease activity sooner than patients who do not concomitantly receive MTX. References Dougados M, Kissel K, Sheeran T, et al. Adding tocilizumab or switching to tocilizumab monotherapy in methotrexate inadequate responders: 24-week symptomatic and structural results of a 2-year randomised controlled strategy trial in rheumatoid arthritis (ACT-RAY). Ann Rheum Dis. 2013 Jan;72(1):43-50 Disclosure of Interest None Declared

Background A single-arm expanded treatment efficacy and safety study of TACE in Japan and Korea was conducted to confirm the reproducibility of the results in the phase III study carried out by Llovet et al., which showed a significant survival advantage of TACE, compared with conservative treatment, for unresectable HCC. Methods Patients with unresectable HCC who had no indications for curative treatment and who had not received prior therapy for HCC were enrolled. The patients underwent TACE using an emulsion of epirubicin HCl or doxorubicin HCl and Lipiodol, followed by the injection of gelatin sponge particles. The treatment was repeated on an as-needed basis. The primary end point was the 2-year survival rate, and the secondary end points were the incidence and grade of adverse events and the response rate. Results The study accrued 102 patients enrolled at 27 institutions in both countries between January 2008 and January 2009, but three patients withdrew their informed consent. The 2-year survival rate of the 99 evaluable patients was 75.0% (95% CI, 65.2–82.8%). The median time-to-progression and the median overall survival period were 7.6 months and 3.1 years, respectively. Among the 99 evaluable patients, 42 (42%) achieved a complete response and 31 (31%) had a partial response, and the response rate was 73% (95% CI: 63–82%) using the modified response evaluation criteria for solid tumors. The major grade 3–4 toxic effects were an increased AST level (35%) and an increased ALT level (36%), thrombocytopenia (12%), and abdominal pain (4%); all other toxic effects were generally transient. Conclusion In Japan and Korea, TACE exerted a marked favorable efficacy in patients with unresectable HCC who were not suitable for curative treatment, and this treatment modality may be regarded as a standard therapy for unresectable HCC.

Background We previously found that GADD45b, which is associated with cellular stress response and apoptosis regulation, contributes to sorafenib resistance in HCC cells. The present study explored the role of GADD45γ, another GADD45 family protein, in HCC treatment. Methods HCC cell lines tested included Huh-7, HepG2, Hep3B, Huh-7R, HepG2R, the latter two sorafenib-resistant cell lines established by continuously exposure of Huh-7 and HepG2 cells to sorafenib. GADD45γ expression was examined by quantitative real-time PCR (qRT-PCR) and western blotting. Control of GADD45γ transcription was examined by luciferase reporter assay using a series of reporter plasmids with deletions or site-directed mutants of the 5′-flanking region of GADD45γ promoter. Apoptosis was analyzed by flow cytometry and western blotting. Expression of GADD45γ in human HCC tumor tissues was measured by qRT-PCR and immunohistochemistry. Results GADD45γ mRNA and protein levels were increased after sorafenib independent of cellular MEK/ERK activity. GADD45γ induction was more prominent in sorafenib-sensitive HCC cells (Huh-7 and HepG2, IC50 6-7 µM) than in sorafenib-resistant HCC cells (Hep3B, Huh-7R and HepG2R, IC50 12-15 µM). Knockdown of GADD45γ expression partially abrogated the pro-apoptotic effects of sorafenib in sorafenib-sensitive cells but not sorafenib-resistant cells. The region -449/ - 82 in the 5′-flanking region of GADD45γ promoter was found crucial for GADD45 gamma induction by sorafenib. Decreased GADD45γ expression in HCC tumor tissue was associated with worse overall survival in patients who underwent surgery for HCC. Conclusions Induction of GADD45γ expression contributes to sorafenib-induced apoptosis in HCC cells. The role of GADD45γ as a predictive biomarker for sorafenib sensitivity in HCC warrants further exploration. (Supported by grants NSC-100-2325-B-002 -042, NSC 100-2314-B-002 -058-MY3, DOH100-TD-B-111-001, and NHRI-EX101-9911BC.)

Purpose TSU-68 is an antitumor drug that acts by inhibiting angiogenesis. We evaluated the efficacy and safety of TSU-68 in combination with transcatheter arterial chemoembolization (TACE) in patients with intermediate-stage hepatocellular carcinoma (HCC). Methods In this multicenter, open-label phase II study, we randomly assigned patients with HCC who had been treated by TACE to receive either 200 mg TSU-68 twice daily or no medication. TACE was performed according to the standard technique using anticancer drugs, lipiodol, and gelatin sponge. TACE was completed for all patients within the 2 weeks prior to randomization. The primary endpoint was progression-free survival (PFS) and the secondary endpoints were safety and biomarker assessments. Results In total, 103 patients were enrolled. Median PFS was 5.2 months in the TSU-68 group and 4.0 months in the control group (HR in the TSU-68 group, 0.699; p = 0.054, log-rank test with a 2.5% one-sided significance level). Fatigue, elevated aspartate aminotransferase (AST), elevated alkaline phosphatase, edema, and anorexia were more frequent in the TSU-68 group than in the control group. The most frequent grade 3/4 adverse events were AST elevation (46% of patients in the TSU-68 group and 12% of controls) and alanine aminotransferase elevation (26% of patients in the TSU-68 group and 8% of controls). Subgroup analyses suggested that treatment with TSU-68 may extend PFS for patients with Child–Pugh A liver function and those with hepatitis C. Among patients with baseline t-PA concentrations below the median value, the PFS of the TSU-68 group was longer than that of the control group. TSU-68 treatment may also improve PFS among patients with VCAM-1, ELAM-1, IL-8, or PDGF-BB levels above the median values. Conclusion TSU-68 was well tolerated, and may provide longer PFS after TACE than was observed for controls. This result suggests that TSU-68 combined with sequential and repeated TACE sessions may provide additional clinical benefits to patients, including prolongation of overall survival. A randomized placebo-controlled phase III global study was initiated in 2010 to evaluate the survival benefit of TSU-68 in combination with repeated TACE. Disclosure All authors have declared no conflicts of interest.

Background TH-302 is a hypoxia targeted prodrug with a hypoxia-triggered 2-nitroimidazole component designed to release the DNA alkylator, bromo-isophosphoramide mustard (Br-IPM), when reduced in severe hypoxia. A randomized Phase 2B study (NCT01144455) was conducted to assess the benefit of G + T to standard dose G as first-line therapy of PAC. Materials and methods An open-label multi-center study of two dose levels of TH-302 (240 mg/m2 or 340 mg/m2) in combination with G versus G alone (randomized 1:1:1). G (1000 mg/m2) and T were administered IV over 30-60 minutes on Days 1, 8 and 15 of a 28-day cycle. Patients on the G could crossover after progression and be randomized to a G + T arm. The primary efficacy endpoint was a comparison of progression-free survival (PFS) between the combination arms and G alone (80% power to detect 50% improvement in PFS with one-sided alpha of 10%). Summary PFS outcome has previously been reported; more detailed PFS as well as the initial overall survival (OS) data are presented. Results 214 pts were treated; 164 (77%) Stage IV and 50 (23%) Stage IIIB. Median age 65 (range 29-86); 126 M/88 F; 40% ECOG 0/60% ECOG 1. Receiving 6 or more cycles: 32% G; 45% G + T240; 55% G + T340. Median PFS was 3.6 mo in G vs 5.5 mo in G + T240 (p = 0.031) and 6.0 mo in G + T340 (p = 0.008). Poorer prognostic factors (older age, poorer performance status, reduced albumin) were associated with larger treatment effect. Median OS was 7.0 mo in G vs 9.0 in G + T240 and 9.5 mo in G + T340. RECIST best response was 12% in G vs 17% in G + T240 and 27% in G + T340. CA19-9 decreases were significantly greater G + T340. A >50% CA19-9 decrease was 52% with G vs 50% with G + T240 and 70% with G + T340. AEs leading to discontinuation were: 16% G, 15% G + T240 and 11% G + T340. Rash (45% in G + T340) and stomatitis (36% in G + T340) were greater in combination, 4 pts Grade 3 rash. Grd 3/4 thrombocytopenia were 11% G, 39% G + T240 and 59% G + T340 and Grd 3/4 neutropenia were 28% G, 56% G + T240 and 59% G + T340. Conclusions The combination of G plus TH-302 improved the efficacy of G. A TH-302 dose of 340 mg2 was identified for future studies. Skin and mucosal toxicity and myelosuppression were the most common TH-302 related AEs with no increase in treatment discontinuation. Disclosure All authors have declared no conflicts of interest.

Publisher Summary In a coke oven chamber, the coking of coal charge is conducted batchwise. This chapter discusses a study in which a tracer technique using He and Ar was employed to investigate the paths of travel of gases produced in a test coke oven especially in the coal layer because the coal layer is thought to be mostly surrounded by the impermeable plastic zone. The variation in temperature distribution in the charge with elapse of time was monitored. The position of the plastic layer was predicted by assuming that it exists between the positions at 385°C of Soft T and 465°C of Solid T. A small amount of argon was detected from the center and helium was slightly found from the wall side as well, which suggests the small amount of cross flow through the plastic zone. In the middle of the stage, helium mostly flowed toward the door of coke side. After the plastic zone reached the center of the charge and disappeared, the maldistribution of tracer gases was hardly found, suggesting that the produced gas passed through the coke layer uniformly.

The authors present a model of a receptive field neural network as a discriminator for Kanji character recognition. Double emphases on local features of character images are performed in learning: first, generating receptive fields to capture distinctive structures of the characters, and then emphasizing strong differences of the features in the receptive fields which each detects precise positions of the features by shift tolerant LVQ (learning vector quantization) learning. The model is evaluated on printed Kanji characters with high similarity in each of 893 small categories with an average of 2.8 characters per category. It improves the discrimination accuracy from 98.87% without it to 99.55%, a 60% reduction in errors on a test data set of more than 13 fonts. A large scale neural network of three-stage hierarchical structure for Kanji character recognition is presented whose third stage is constructed by this model. It shows 99.0% accuracy on recognition of the multi-font printed 3303 Kanji characters including alphanumeric and symbol on 12000 randomly selected characters from the test data set. >