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Toru Ishikawa,1 Iori Hasegawa,2 Hiroshi Hirosawa,2 Tsubasa Honmou,2 Nobuyuki Sakai,2 Takanori Igarashi,1 Shun Yamazaki,1 Takamasa Kobayashi,1 Toshifumi Sato,1 Akito Iwanaga,1 Tomoe Sano,1 Junji Yokoyama,1 Terasu Honma1 1Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan; 2Department of Clinical Engineering, Saiseikai Niigata Hospital, Niigata, JapanCorrespondence: Toru Ishikawa, Department of Gastroenterology, Saiseikai Niigata Hospital, Teraji 280-7, Niigata, Japan, Tel +81-25-233-6161, Fax +81-25-233-8880, Email toruishi@ngt.saiseikai.or.jpBackground: Microwave ablation (MWA) is a standard percutaneous local therapy for hepatocellular carcinoma (HCC). Next-generation MWA is reported to create a more spherical ablation zone than radiofrequency ablation (RFA). We compared the ablation zone and aspect ratio of two 2.45 GHz MWA ablation probes; Emprint® (13G) and Mimapro® (17G). We compared the ablation zone to the applied energy after MWA in patients with hepatocellular carcinoma (HCC). Furthermore, we investigated local recurrence.Materials and Methods: We included 20 patients with HCC, with an average tumour diameter of 33.2 ± 12.2 mm, who underwent MWA using Emprint®, and 9 patients who underwent MWA using Mimapro® with an average tumour diameter of 31.1 ± 10.5 mm. Both groups underwent the same ablation protocol using the same power settings. The images obtained after MWA showed the treatment ablation zone and aspect ratio, which were measured and compared using three-dimensional image analysis software.Results: The aspect ratios in the Emprint® and Mimapro® groups were 0.786 ± 0.105 and 0.808 ± 0.122, respectively, with no significant difference (p = 0.604). The ablation time was significantly shorter in the Mimapro® group than in the Emprint® group, and there was no significant difference in the frequency of popping or the ablation volume. There were no significant differences in local recurrence between the two groups.Conclusion: There was no significant difference in the aspect ratios of the ablation diameter, and the ablation zone was almost spherical in both cases. Mimapro® at 17G was less invasive than Emprint® at 13G.Keywords: hepatocellular carcinoma, microwave ablation, ablation zone

Shunsuke Nojiri,1 Atsunori Kusakabe,1 Kei Fujiwara,1 Noboru Shinkai,1 Kentaro Matsuura,1 Etsuko Iio,1 Tomokatsu Miyaki,1 Tomoyuki Nomura,2 Satoshi Sobue,3 Hitoshi Sano,4 Izumi Hasegawa,5 Tomoyoshi Ohno,5 Yoshitsugu Takahashi,6 Etsuro Orito,7 Takashi Joh11Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, 2Inabe General Hospital, Inabe, 3Kasugai Municipal Hospital, Kasugai, 4Tajimi Prefectural Hospital, Tajimi, 5Social Chukyo Insurance Hospital, Nagoya, 6Chita Kousei Hospital, Aichi-ken, 7Nagoya Daini Red Cross Hospital, Showa-ku, JapanBackground: Sorafenib has been approved in the indication of unresectable hepatocellular carcinoma, but there are many cases in which administration of the drug is discontinued due to severe side effects. In this study, we compared the characteristics of patients who continued and discontinued sorafenib.Methods: Ninety-six patients (75 men and 21 women) were initiated on sorafenib from July 2009 through September 2011. The patient characteristics of interest included gender, age, etiology, Child-Pugh classification, treatment history and frequency, and levels of α-fetoprotein, des-gamma-carboxy prothrombin, aspartate amino acid transferase, and alanine aminotransferase. Duration of administration of sorafenib and reasons for its discontinuation were compared.Results: Median overall survival was 11.8 months. Discontinuation of sorafenib within 90 days was identified as an independent prognostic factor for overall survival on multivariate analysis (P < 0.0001). Transarterial chemoembolization performed six times or more (P = 0.013) was also identified as an independent factor contributing to discontinuation of sorafenib within 90 days in multivariate analysis. Patients who received sorafenib for ≥90 days had significantly longer overall survival than those who discontinued it (P < 0.0001).Conclusion: Prolonged treatment with sorafenib is an important factor in achieving extended overall survival. We recommend starting sorafenib before latent liver damage has occurred as a result of too many transarterial chemoembolization procedures.Keywords: sorafenib, hepatocellular continuation, discontinuation, efficacy

In this study, a new pretreatment for using wet food biomass waste as a high calorific and reactive feedstock for gasification is presented. The method involves the addition of calcium hydroxide, hot water treatment, and dewatering in vegetable oil. Hot water treatment at 230°C reduced the oxygen/carbon atomic ratio of coffee grounds waste to improve the calorific value, but this treatment also formed an inactive cross-linked structure caused by dehydration reactions. By mixing the coffee grounds waste with calcium hydroxide powder before the hot water treatment, cross-linking was suppressed and the gasification rate of the char significantly increased because of the catalytic effect. With or without hot water treatment, the time required to complete gasification for the chars of the grounds mixed with calcium hydroxide was reduced to about one-third of that for the char of the untreated grounds. After heating in vegetable oil at 150°C, moisture was completely removed from the coffee grounds and they became impregnated with a large amount of the oil. As dewatering in oil did not affect the gasification rate of the chars, a combination of these three treatments was found to efficiently convert wet food biomass waste into a gasification feedstock.