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Background Autoantibodies (AAbs) against immunoglobulin E (IgE) antibodies (Abs) and their high-affinity receptor alpha subunits (FceRIα) are key factors in the elicitation of type IIb autoimmune chronic spontaneous urticaria (type IIb aiCSU). In this study, we aimed to develop a new method to detect functional anti-FceRIα and anti-IgE AAbs, which can crosslink the plural FceRІα molecules and IgE Abs on the surface of mast cells and basophils, in sera from aiCSU patients using the amplified luminescence proximity homogeneous assay (Alpha). Methods Sera were obtained from 14 aiCSU patients, as diagnosed by recurrent chronic spontaneous urticaria episodes and positive results for the autologous serum skin test and/or histamine release test (HRT). The AAbs to FceRIα and IgE Abs were determined in sera from aiCSU patients using enzyme-linked immunosorbent assay (ELISA) and Alpha by cross-linking (AlphaCL) of IgE Abs and/or FceRІα. Results Serum anti-FceRIα and anti-IgE AAb levels were not significantly different between aiCSU patients and healthy subjects in ELISA. Anti-FceRIα AAbs were detected in 10 of 14 aiCSU patients who displayed positive (5/5) and negative (5/9) results in the HRT for anti-FceRIα AAbs by AlphaCL, whereas no signals were observed in healthy subjects. Additionally, anti-IgE AAbs were detected in two of four aiCSU patients who displayed positive results in the HRT for anti-IgE AAbs. Conclusions A new assay method using AlphaCL can detect anti-FceRIα and anti-IgE AAbs with FceRIα- and IgE-crosslinking abilities in sera from aiCSU patients. This simple and practical assay method may be available as a diagnostic tool for urticaria patients.

Summary The potato tuber or potato rot nematode, Ditylenchus destructor, causes severe damage to garlic (Allium sativum) produced in Japan. Although consumption of a nematode-infected garlic bulb is not harmful to human health, it causes consumer dissatisfaction because the infected bulb deteriorates quickly. In addition, nematode-contaminated garlic cloves are inadvertently used as seed garlic for next season, which then leads to nematode-infested fields and increases yield loss. However, infected garlic bulbs look the same as healthy ones, and hence have been unknowingly distributed and sold. A method is needed to discriminate infected garlic bulbs from non-infected garlic bulbs before distribution in the market, but to date no suitable technique has been developed. The objective of this study was to identify specific odour-active compounds associated with nematode-infected garlic through the use of analytical chemistry. Garlic cloves were infected with cultured nematodes under controlled conditions, and the volatile odour-active compounds were analysed by an ‘odour identification system’ which included gas chromatography-olfactometry (GC-O), GC-fractionation (GC-F), GC-mass spectrometry (GC-MS), and odour/aroma-specific database. Two specific odour-active compounds associated with nematode-infected garlic cloves were identified as allyl methyl disulfide and eugenol, and two others were tentatively identified as (E)-1-allyl-2-(prop-1-en-1-yl)disulfane and allyl methyl trisulfide. These specific odour-active compounds may be useful as indicators to detect nematode-infected garlic bulbs in a non-destructive manner.

Background/aims Application of polyglycolic acid (PGA) sheets using fibrin glue in post-endoscopic submucosal dissection (ESD) ulcers to prevent bleeding has been reported to be difficult with the conventional delivery method because of gravity. This study assessed the usefulness of the envelope-based delivery system with and against gravity in living pigs. Methods PGA sheets were applied on post-ESD ulcers with and against gravity six times each using the conventional and envelope methods, respectively. The PGA sheet delivery time and the endoscopic and histological findings of the treated ulcer floors were compared. Results With gravity, the median PGA sheet application time was 1.00 (0.68-1.30) min/cm2 and 0.32 (0.18-0.52) min/cm2 with the conventional and envelope techniques (p=0.002), respectively, and against gravity, it was 1.20 (1.13-1.63) min/cm2 and 0.50 (0.39-0.58) min/cm2 (p=0.002), respectively. Against gravity, the endoscopic and histological findings revealed that the conventional group had insufficient fixation of the PGA sheets, but the envelope groups had sufficient fixation. The results with gravity were similar between the groups. Conclusions The envelope method makes it possible to deliver PGA sheets to the stomach quickly and cover ulcers appropriately both with and against gravity in living pigs.

The formation of tetra-n-butylammonium bromide (TBAB) hydrate from a TBAB aqueous solution tends to show a supercooling phenomenon, which is non-ideal for the practical use of TBAB hydrate. However, as reported in the literature, the products obtained from the use of metal electrodes for the application of an electric field can accelerate the nucleation of the hydrate. Herein, we investigated the role of metal particles (Ag, AgBr, Zn, and ZnO) and their mixed forms (Ag–AgBr and Zn–ZnO) on promoting the nucleation of TBAB semiclathrate hydrate. The nucleation-promoting effect was most significant for the mixed metal particles when prepared by simultaneous grinding of the metal particle components. The changes in the physicochemical properties of the mixed metal particles as a result of grinding were believed to accelerate the nucleation of TBAB hydrate.

A 39-year-old man with no medical history complained of right flank pain that developed 1 day prior. He reported no history of sexual activity or of travelling abroad for the past 6 months. His temperature was 38.0°C, his BP was 144/87 mm Hg and his pulse was 119 per minute. Physical examination revealed tenderness in the right flank, with no rebound tenderness. Laboratory evaluation revealed elevated white blood cell count of 12.9×109/L (neutrophils: 67.8%). A right upper quadrant ultrasound …

The potato-rot nematode Ditylenchus destructor (Tylenchida: Anguinidae) causes severe damage to garlic production in Japan. Nematode-contaminated garlic seed cloves are often used for planting, because nematode-infested cloves are difficult to discriminate from healthy ones. To be able to find nematode-infested garlic in a nondestructive way, here this study introduced a novel analytical system of GC–O and GC–MS with heart-cut enrichment technique. The objective of this research was to find an analytical approach to identify the existence of subjectively perceptible odors which derive from the garlic infested with the nematode and to evaluate the effectiveness of those novel analytical systems. Ten odor activities associated with nematode-infested garlic were detected by the system, and “allyl methyl sulfide” and “2-methyl-1-butanol” were identified as major odor compounds (1-propanethiol was candidate). This result suggests that the novel analytical technique introduced in this study delivered sufficient data to identify the odor compounds from infested garlics. Two distinctive odor compounds might be used as indicators to detect nematode-infested garlic cloves with nondestructive way.

Magnesium (Mg) alloy has been actively investigated as a bioresorbable scaffold (BRS) for use as a next-generation stent because of its appropriate mechanical properties and biocompatibility. However, Mg alloy quickly degrades in the physiological environment. Hydrofluoric acid (HF) treatment and surface coating with biodegradable polymer are approaches for enhancing the corrosion resistance of Mg alloy. However, there are no studies that focus on the corrosion behavior of the Mg alloy stent after balloon catheter expansion, which results in mechanical stress and is required for stent placement. In this study, the corrosion behavior of a Mg alloy stent after expansion by a balloon catheter was investigated. Compared with the bare Mg alloy stent, the HF-treated Mg alloy stent showed excellent corrosion resistance without expansion. However, balloon catheter expansion caused small fragments and cracks to appear on the surface of the HF-treated Mg alloy stent and accelerated its corrosion rate. The HF-treated Mg alloy stent was therefore further coated with poly(d,l-lactic acid) (PDLLA). As a result, the high corrosion resistance of the coated stent was maintained after its expansion along with higher biocompatibility for endothelial cell adhesion than the stent without the polymer coating. The HF-treated and PDLLA-coated platform is expected to be a BRS candidate for clinical applications.

Production of tritium using a high-temperature gas-cooled reactor (HTGR) has been studied for a prior engineering test with tritium handling and for the startup operation of a demonstration fusion reactor. For this purpose, the hydrogen absorption speed of Zr in a Li-loading rod for the reactor operation is experimentally measured, and an analysis model is presented to evaluate the tritium outflow from the Li rod in a high-temperature engineering test reactor (HTTR). On the basis of the presented model, the structure of the Li-loading rod for the demonstration test using the HTTR is proposed.

BACKGROUND AND AIM Clinical significance of endoscopic response (ER) after neoadjuvant chemotherapy (NAC) for esophageal cancer has not been fully understood. Thus, the present study aimed to investigate the association between ER to NAC and its clinicopathological outcomes in patients with esophageal squamous cell carcinoma (ESCC). METHODS In total, 141 patients who underwent NAC and subsequent esophagectomy for ESCC were included. ER to NAC was retrospectively evaluated based on macroscopic findings of the primary tumor, which was classified into three categories: endoscopic no response (eNR), endoscopic partial response (ePR), and endoscopic good response (eGR). An endoscopic responder was defined as patients with eGR/ePR. RESULTS Approximately 89.4% of patients had cStage II-III disease, and 7.1% had pathological complete response. Upon ER evaluation, eNR, ePR, and eGR were observed in 46 (32.6%), 54 (38.3%), and 41 (29.1%) patients, respectively. Pathological responders significantly increased as the ER grade became better. Among preoperative clinical factors, only ER significantly correlated with pathological response in univariate and multivariate analysis. Endoscopic responders showed a significantly better prognosis than did eNR patients (P

Large quantities of tritium are required to start up fusion reactors and conducts engineering tests using tritium for a fusion blanket system. However, tritium is very rare and kg orders of tritium must be produced artificially. Tritium production, by 6Li(n,α)T reaction using a high temperature gas-cooled reactor (HTGR) has been proposed. This method considers the loading of Li rods into burnable poison holes in the HTGR. In this paper, the Li rod suited for use in the High Temperature engineering Test Reactor (HTTR) was designed, and tritium production and leakage from Li-rod capsules were evaluated by adjusting the thicknesses of LiAlO2, alumina, and Zr layers. An irradiation test scenario to be conducted in the HTTR for demonstration of the Li rod’s tritium production and containment performance was presented.

The environmental monitoring survey using this organisms was called “Caddisfly Watch” and this activity has involved both scientists and local people for collecting them. A simple method is needed for the continuous monitoring of radiocesium (137Cs) contamination in riverine environments after the 2011 accident at the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) in Japan. In a program called “Caddisfly Watch”, we used larvae of the caddisfly Stenopsyche marmorata (Trichoptera: Stenopsychidae) to monitor the spatial distribution and estimate effective half-life (Teff) of 137Cs pollution in riverine environments. Caddisfly larvae showed that the highest concentration of 137Cs among several aquatic organisms and no apparent variation between growth stage. In addition, caddisfly larvae reflected 137Cs concentrations in suspended particulate matter in their gut, and that showed no seasonal variation, better reproducibility, and significant correlation with those in sediment. Results indicate that caddisfly larvae can be used as a biological sampler of suspended particulate matters. The Teff values of 137Cs concentrations in caddisfly larvae estimated by single component decay function model showed significant fit. The Teff values in Kuma, Maeda, downstream Niida, upstream Niida, Ohkawa, and Ukedo river showed 2.8, 5.7, 3.1, 6.7, 0.6, and 4.8 years (34, 68, 38, 80, 6.9, and 58 months), respectively. The results of declining trend in this study were similar to those in previous reported in Fukushima. Further continuous observations using this simple approach of “Caddisfly Watch” make it possible to predict the future of the contamination with radioactive Cs in the river environment.

Background In neurosurgery, it is important to use local hemostatic agents. We have explored a more powerful method of hemostasis by the combination of commercially available hemostatic agents with fibrin glue in the hopes of synergistic effects. Method A bleeding model was constructed by puncturing the rabbit posterior vena cava with a needle. After applying the sample to the bleeding point, compression was performed for 10 s. If temporary hemostasis was achieved after pressure release, a 30 s wash was performed to confirm that ultimate hemostasis was achieved. Up to three hemostasis attempts were performed on the same bleeding point until hemostasis was achieved, and the number of attempts required for hemostasis was counted. If hemostasis was not achieved after three attempts, it was counted as four times. Four groups were evaluated: (1) gelatin sponge alone, (2) gelatin sponge + fibrin glue, (3) oxidized cellulose alone, and (4) oxidized cellulose + fibrin glue; each group was tested 16 times. Results The median value (range minimum value–maximum value) of the number of hemostatic attempts in Group 1 to Group 4 was 3 (1–4), 1 (1–1), 4 (4–4), and 4 (2–4). In Group 2, there were two test exclusions owing to deviations of the test procedure. Conclusions The compatibility of gelatin sponge and fibrin glue was very good, with a very strong and rapid hemostatic effect compared to other methods, showed its usefulness. This combination method may be effective for a variety of venous hemorrhages in neurosurgery.

In recent years, concern about the release of anthropogenic organic micropollutants referred to as contaminants of emerging concern (CECs) has been growing. The objective of this study was to find potential CECs by means of an analytical screening method referred to as comprehensive target analysis with an automated identification and quantification system (CTA-AIQS), which uses gas and liquid chromatography combined with mass spectrometry (GC-MS and LC-QTOF-MS). We used CTA-AIQS to analyze samples from a sediment core collected in Beppu Bay, Japan. With this method, we detected 80 compounds in the samples and CTA-AIQA could work to useful tool to find CECs in environmental media. Among the detected chemicals, three PAHs (anthracene, chrysene, and fluoranthene) and tris(isopropylphenyl)phosphate (TIPPP) isomers were found to increase in concentration with decreasing sediment depth. We quantified TIPPP isomers in the samples by means of targeted analysis using LC-MS/MS for confirmation. The concentration profiles, combined with previous reports indicating persistent, bioaccumulative, and toxic properties, suggest that these chemicals can be categorized as potential CECs in marine environments.

Tritium is required for research and development activities for the deuterium–tritium (DT) fusion reactor and fueling the DEMOnstration Power Station (DEMO). However, tritium is a very rare nuclide and must be produced artificially. Tritium production by loading Li compounds (Li rods) into burnable poison holes of a high-temperature gas-cooled reactor (HTGR) has been proposed (H. Matsuura, et al., Nucl. Eng. Des. 243 (2012) 95–101.). Al2O3 and Zr are used to prevent tritium leaks. Nuclear reaction heat caused by the nuclear reaction (e.g., 6Li(n,α)T reaction) can cause a spatial temperature profile in the Li rods and may change its tritium containment performance, because Al2O3 and Zr performance strongly depend on these temperatures. The effect of nuclear reaction heat by the 6Li(n,α)T reaction on the tritium containment performance of the Li rods was evaluated by simulation. The temperatures of the Li rods for the high-temperature engineering test reactor (HTTR) and gas turbine high-temperature reactor 300 (GTHTR300) increased by 36 K and 46 K, and the leaked tritium decreased by 32% and 37% via nuclear reaction heat, respectively.

This study investigated the predictors associated with early recurrence (i.e. within 12 months) after curative gastrectomy for gastric cancer (GC). We evaluated the clinicopathological factors in 429 patients who underwent curative gastrectomy for GC without preoperative chemotherapy and analyzed these factors’ associations with early recurrence. Of 429 patients, 57 experienced recurrences, which were associated with gender, diameter, depth of invasion, lymph node (LN) metastasis, the LN ratio (LNr; LNs with metastasis/dissected LNs), lymphatic invasion, vascular invasion, carbohydrate antigen 19-9 (CA19-9) levels, C-reactive protein levels and the neutrophil/lymphocyte ratio. Twenty-one patients (36.8%) recurred within 12 months. Early recurrence was associated with a high LNr (P = 0.0020) and high CA19-9 levels (P = 0.0415). The other factors were not significantly associated with early recurrence. The 12-month recurrence rate was 33.9% in patients with a high LNr and 1.9% in those with a low LNr and 20.3% in patients with high CA19-9 levels and 3.5% in those with low CA19-9 levels. The 12-month recurrence rate was 62.5% in patients with a high LNr and high CA19-9 levels, 18.4% in those with a high LNr or high-CA19-9 levels, and 1.4% in those with a low LNr and low CA19-9 levels. LNr ≥ 0.15 and CA19-9 ≥ 37 U/ml were effective surrogate markers for predicting early recurrence.

Peritoneal dissemination is the most common metastatic pattern in advanced gastric cancer (GC) and has a very poor prognosis. However, its molecular mechanism has not been elucidated. Our study investigated genes associated with peritoneal dissemination of GC. We performed combined expression analysis of metastatic GC cell lines and identified Procollagen-lysine, 2-oxoglutarate 5-dioxygenase2 (PLOD2) as a potential regulator of peritoneal dissemination. PLOD2 is regulated by hypoxia-inducible factor-1 (HIF-1) and mediates extracellular matrix remodeling, alignment, and mechanical properties. We analyzed PLOD2 expression immunohistochemically in 179 clinical samples, and found high PLOD2 expression to be significantly associated with peritoneal dissemination, leading to poor prognosis. In an in vivo-collected metastatic cell line, downregulation of PLOD2 by siRNA reduced invasiveness and migration. Hypoxia upregulated PLOD2 mediated by HIF-1, and promoted invasiveness and migration. After exposure to hypoxia, a cell line transfected with siPLOD2 exhibited significantly suppressed invasiveness and migration, despite high HIF-1 expression. These findings indicate that PLOD2 is a regulator of, and candidate therapeutic target for peritoneal dissemination of GC. Although peritoneal dissemination of GC has a very poor prognosis, its molecular mechanism has not been elucidated. We identified PLOD2 regulated by HIF-1 as a potential regulator of peritoneal dissemination of GC. Finally, we showed that PLOD2 promotes cell invasiveness and migration in GC under hypoxia and lead to peritoneal dissemination of GC.

Patients with gastric cancer (GC) are affected by changes in iron status. Before surgery, GC patients are likely to have iron-deficiency anemia; and after gastrectomy, patients suffer from low nutritional status and low iron. This study investigated preoperative iron status associated with prognosis after curative gastrectomy for gastric cancer. We evaluated preoperative serum hemoglobin (Hgb), Fe and total iron-binding capacity (TIBC) in 298 patients who underwent curative gastrectomy for GC without preoperative chemotherapy, and analyzed these factors’ associations with prognosis after surgery. Of the 298 patients, 129 (43.2%) had low Hgb levels, and 33 (11.1%) had low TIBC (

We have succeeded in utilizing In–Ga–Zn–O (IGZO) thin-film devices as synapse elements in a neural network. The electrical conductance is regarded as the connection strength, and the continuous change by flowing electrical current is employed as the connection plasticity based on the modified Hebbian learning as a learning rule. We developed a cellular neural network using the IGZO thin-film devices and confirmed that the neural network can learn simple logic functions. These results suggest a possibility to realize 3-D layered structure for brain-type integrated systems.

Programmed death ligand 1 (PD-L1) expression as a predictive biomarker for programmed cell death 1 (PD-1) inhibitor efficacy in gastric cancer (GC) remains controversial. We hypothesised that the conflicting results may be due to the inaccurate assessment of PD-L1 expression using biopsy samples. A total of 191 patients with GC who received radical resection were enrolled. PD-L1 expressions in biopsy and paired resected samples by immunohistochemistry staining were compared according to the number of biopsies. The numbers of PD-L1-positive patients determined by biopsy and resected samples were 89 (46.6%) and 135 (70.1%), respectively. The accordance rate was 64.4% (κ = 0.31). Single biopsy showed a lower accordance rate compared with multiple biopsies. Our study revealed that single biopsy cannot fully reflect PD-L1 expression in the whole tumour in GC. Multiple biopsies are recommended for accurate diagnosis of PD-L1 expression in GC.

The production of tritium (T) using high-temperature gas-cooled reactors (HTGRs) has been studied for a prior engineering research with T handling and initial T possession in demonstration fusion reactors. Stable containment of T in Li-loading rods during HTGR operation is a critical issue. This study investigates this for an irradiation test to examine T-containment performance in Li-loading rods and develops an analytical model of evaluating the amount of T outflow to a He coolant. The hydrogen absorption characteristics, including the deterioration of the hydrogen absorption speed after Zr has sufficiently absorbed the hydrogen, is experimentally measured assuming an HTGR setting. We present an analytical model of evaluating the T outflow from a Li rod and, on the basis of this model, estimate the total T outflow, assuming the presence of a gas-turbine high-temperature reactor of 300 MWe with a nominal capacity and a high-temperature engineering test reactor. It is demonstrated that, by loading a sufficient amount of Zr into the Li rod, the T outflow can be suppressed to less than a small percent of the total T produced during 360 days of reactor operation.

Few reliable prognostic markers have been established despite elucidation of the molecular mechanisms of gastrointestinal stromal tumor (GIST) development. We evaluated F-box and WD repeat domain-containing 7 (FBXW7), a cell-cycle-regulating and tumor suppressor, in GISTs. We aimed to determine the clinical relevance of FBXW7 in GISTs and characterize the molecular mechanism of FBXW7 in a GIST cell line. We measured FBXW7 expression in 182 GIST cases, correlated the expression levels with clinicopathological features, and characterized the molecular mechanism underlying suppressed FBXW7 expression in GIST cells in vitro. Of the 182 GISTs, 98 (53.8%) and 84 (46.2%) were categorized in the high and low FBXW7 expression groups, respectively. Compared with the high FBXW7 expression group, the low expression group showed a significantly poorer prognosis in terms of recurrence-free (P = 0.01) and overall (P = 0.03) survival. FBXW7 expression was a significant independent factor affecting the 10-year recurrence-free survival rate (P = 0.04). In vitro, FBXW7-specific siRNAs enhanced c-myc and Notch 1 protein expression and upregulated cell proliferation, invasion, and migration. FBXW7 is a potential predictive marker of recurrence after curative resection of GISTs. FBXW7 expression may help identify patients benefitting from adjuvant therapy more precisely compared with a conventional risk stratification model.

Resistive random access memories (ReRAMs) have attracted much attention as a next-generation non-volatile memory. We focused on a NiO-based ReRAM in this study because it contains the magnetic element Ni. As-fabricated devices exhibit ideal memristive operation. When bias was swept in one polarity, the resistance decreased by repeating the bias sweeping. Conversely, by changing the polarity of the sweeping bias, the resistance gradually increased by repeating the bias sweeping. A steep increase in current was observed when continuing bias sweeping in the polarity that decreased the resistance. The resistance after that was lower than 12.9 kΩ, which suggests the formation of a Ni atom chain. Conductance quantization, with a unit of 2e 2/h, also suggested the said formation. When a magnetic field was applied, the unit of conductance quantization appeared to change from 2e 2/h to e 2/h.

Double tract reconstruction (DT) after proximal gastrectomy (PG) is considered beneficial for postoperative nutrition status by preserving the physiological passage of food. We conducted this study to assess postoperative nutrition status based on food passage after this operation. The subjects of this retrospective study were 63 patients who underwent PG with DT. The patients were divided into two groups according to whether they had postoperative malnutrition (PM) 1 year postoperatively (PM group) or not (non-PM group). PM was defined by both weight loss > 10% and a low body mass index of

A simple and cost-effective cholinesterase assay is presented. Thiocholine (TCh), which is generated from substrates by the action of cholinesterase, promotes the electron transfer between [Fe(CN)6]3–/4– and Au electrodes. The electric current increases with the TCh concentration; therefore, the current decreases when cholinesterase is inhibited by neurotoxic chemicals, such as organophosphorus and carbamate compounds. First, we monitored the responses of acetylcholinesterase to cholinesterase inhibitors. The substrate acetylthiocholine was digested with acetylcholinesterase in Tris−HCl buffer, then the reaction mixture was combined with acetonitrile. A polished Au electrode was immersed in the mixed solution for 30 s to immobilize the enzymatic hydrolysis product, TCh, on the electrode surface. The electrode was then subjected to differential pulse voltammetry in 0.5 mM [Fe(CN)6]3– in the presence of KCl as a supporting electrolyte, with a concentration as low as 1 mM. The optimum conditions for the enzymatic treatment were for 10 min at 30 °C with 1.25 mU/mL acetylcholinesterase and 100 μM acetylthiocholine as final concentrations. The inhibition of acetylcholinesterase activities from DDVP (organophosphorus) and methomyl (carbamates) could be monitored. This system was applied to human serum samples containing butyrylcholinesterase. The inhibition of butyrylcholinesterase by DDVP and methomyl were successfully monitored even in human serum. Finally, real human blood donated by 10 volunteers were subjected to a cholinesterase assay using this system. The results from the present method showed good correlation with those obtained from the conventional method using 5,5′-dithiobis-(2-nitrobenzoicacid). The present method was considered valid as a novel ChE assay for human blood.

Background/aim Poorly differentiated hepatocellular carcinoma (HCC) is a malignant phenotype following radiofrequency ablation, but not liver resection. This study aimed to identify prognostic parameters that could predict poorly differentiated HCC. Patients and methods Between 2007-2014, 158 HCC patients undergoing liver resection were enrolled that not the Milan criteria. Laboratory data were measured including three tumor markers and inflammatory factors (neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, and monocyte/lymphocyte ratio. Preoperative parameters to predict poorly differentiated HCC were assessed by multivariate logistic regression analysis. Results Poorly differentiated HCC was observed in 28 (17.7%) patients. In multivariate analysis, two or three positive tumor markers and high NLR (≥2.33) were independent predictors of poorly differentiated HCC. Recurrence-free and overall survival were comparable despite these significant predictors. Conclusion The preoperative status of two or three positive tumor markers and high NLR facilitated selecting HCC patients with poorly differentiated disease, which will assist making therapeutic decisions for HCC patients.

Background/aim To investigate the utility of adjuvant hepatic arterial infusion chemotherapy (HAIC) following hepatectomy for patients with hepatocellular carcinoma (HCC) with intrahepatic dissemination (IHD) after local ablation therapy. Patients and methods Twelve patients with HCC with IHD were divided into two groups: HAIC group (n=6) underwent hepatectomy followed by HAIC; and the non-HAIC group (n=6) underwent hepatectomy alone. HAIC with cisplatin and 5-fluorouracil was started within a month and was continued for a month: Results: At the first local ablation, tumors close to the major portal vein and insufficient ablation were recognized in eight (67.7%) and six (58.3%) of the patients, respectively. In the HAIC group, the 1-, 3-, and 5-year disease-free and overall survival rates were 50.0%, 16.7%, and 16.7%, and 83.3%, 83.3% and 62.5%, respectively. Three patients in the HAIC group remain alive after 10 years of follow-up. Conclusion Hepatic resection with short-term postoperative HAIC may provide excellent outcomes in patients with HCC and IHD.

Peritoneal dissemination is the most common metastatic pattern in advanced gastric cancer (GC) and has a very poor prognosis. However, its molecular mechanism has not been elucidated. Our study investigated genes associated with peritoneal dissemination of GC. We performed combined expression analysis of metastatic GC cell lines and identified Procollagen-lysine, 2-oxoglutarate 5-dioxygenase2 (PLOD2) as a potential regulator of peritoneal dissemination. PLOD2 is regulated by hypoxia-inducible factor-1 (HIF-1) and mediates extracellular matrix remodeling, alignment, and mechanical properties. We analyzed PLOD2 expression immunohistochemically in 179 clinical samples, and found high PLOD2 expression to be significantly associated with peritoneal dissemination, leading to poor prognosis. In an in vivo-collected metastatic cell line, downregulation of PLOD2 by siRNA reduced invasiveness and migration. Hypoxia upregulated PLOD2 mediated by HIF-1, and promoted invasiveness and migration. After exposure to hypoxia, a cell line transfected with siPLOD2 exhibited significantly suppressed invasiveness and migration, despite high HIF-1 expression. These findings indicate that PLOD2 is a regulator of, and candidate therapeutic target for peritoneal dissemination of GC. Although peritoneal dissemination of GC has a very poor prognosis, its molecular mechanism has not been elucidated. We identified PLOD2 regulated by HIF-1 as a potential regulator of peritoneal dissemination of GC. Finally, we showed that PLOD2 promotes cell invasiveness and migration in GC under hypoxia and lead to peritoneal dissemination of GC.

Background Macroscopic diffuse-type hepatocellular carcinoma with concomitant major portal vein tumor thrombus (PVTT) and peritoneal dissemination indicates poor prognosis. Additionally, triple-positive tumor marker status is a predictor of poor outcome even after hepatectomy. Sorafenib is recommended in such patients, but it has limited therapeutic effectiveness. Case presentation A 54-year-old man was diagnosed with a liver abscess that was treated by puncture and drainage at a regional hospital. However, the diagnosis was subsequently changed to hepatocellular carcinoma with macroscopic portal vein tumor thrombus, based on the results obtained for the triple-positive tumor markers (alpha-fetoprotein, 45,928 ng/ml; protein induced by vitamin K absence or antagonist-II, 125,350 mAU/ml; and alpha-fetoprotein-L3, 38.3%). As the patient’s liver functional reserve was not adequate for curative resection, chemoembolization was performed with a hepatic arterial infusion of cisplatin (50 mg) and 5-FU (1000 mg), followed by mild embolization with cisplatin (50 mg) suspended in lipiodol (5 ml) and starch microspheres (300 mg) containing mitomycin C (4 mg). As the thrombus had progressed to the bifurcation of the right and left portal veins, the right vein was surgically ligated. Three peritoneal nodules could be identified and were removed. Three additional rounds of hepatic arterial chemotherapy/chemoembolization were performed after the initial surgery. At the 2-year evaluation, all tumor markers were observed to have normalized and diagnostic imaging showed complete remission. Conclusions Complete remission of hepatocellular carcinoma with macroscopic portal vein tumor thrombus and peritoneal dissemination was obtained with a treatment regimen that involved four rounds of hepatic arterial infusion chemotherapy and transient chemoembolization, portal vein ligation, and the removal of peritoneal dissemination. This regimen can be recommended for patients with advanced hemiliver lesions who cannot undergo curative resection.