Predictive factors of survival and intrahepatic recurrence of hepatocellular carcinoma in cirrhosis after percutaneous ethanol injection: analysis of 71 patients

BACKGROUND/AIMS: This study was undertaken to determine the factors predicting survival and intrahepatic recurrence in hepatocellular carcinoma patients treated with percutaneous ethanol injection. METHODS: Seventy-one patients with cirrhosis and hepatocellular carcinoma underwent percutaneous ethanol injection (54 males/17 females; median age 66 years; Child A 54/B 17). Fifty-two patients had a single nodule < or = 5 cm and 19 had multiple nodules, up to three, each one < or = 4 cm. Follow-up ranged from 2-63 months (median 26). RESULTS: Overall survival rates were 89%, 54% and 24% and new lesions recurrence rates 32%, 73% and 81% at 1, 3 and 5 years, respectively. At univariate analysis, monofocal tumor (p<0.05), absence of ascites (p<0.05), complete tumor necrosis at CT-scan or MRI (p<0.01), post-treatment alpha-fetoprotein < or = 10 ng/ml (p<0.05) and Child A class in patients with a single nodule (p<0.05) were associated with higher survival. Presence of tumor capsule at imaging (p<0.05), complete tumor necrosis at CT-scan or MRI (p<0.01) and post-treatment alpha-fetoprotein < or = 10 ng/ml (p<0.01) were associated with lower recurrence rates. At multivariate analysis, basal alpha-fetoprotein (p=0.040) and tumor number (p=0.032) significantly affected survival; stepwise analysis revealed basal alpha-fetoprotein, tumor number and serum albumin (p=0.0012) as the best combination predicting survival. No variable reliably predicted recurrence by multivariate analysis. CONCLUSIONS: In patients with cirrhosis and hepatocellular carcinoma, treated with percutaneous ethanol injection, survival depends on: the severity of the underlying liver disease, uni/multifocality of the tumor and basal alpha-fetoprotein. Presence of a tumor capsule is associated with lower recurrence rates. At post-treatment evaluation, both survival and recurrence rates are positively affected by complete tumor necrosis and alpha-fetoprotein < or = 10 ng/ml.     

Applied studies in solar photocatalytic detoxification: an overview

The technical feasibility and performance of photocatalytic degradation of four water-soluble pesticides (diuron, imidacloprid, formetanate and methomyl) have been studied at pilot scale in two well-defined systems which are of special interest because natural-solar UV light can be used for them: heterogeneous photocatalysis with titanium dioxide and homogeneous photocatalysis by photo-Fenton. The pilot plant is made up of compound parabolic collectors specially designed for solar photocatalytic applications. The initial concentration tested with imidacloprid, formetanate and methomyl was 50 and 30 mg/l with diuron, and the catalyst concentrations were 200 mg/l and 0.05 mM with TiO₂ and iron, respectively. Total disappearance of the parent compounds, 90% mineralisation and toxicity reduction below the threshold (EC₅₀) have been attained with all pesticides tested. All these results have contributed to an evaluation of photocatalytic treatment capacity and comments on the main parameters of TiO₂ and Fe separation from the treated water.     

Large diameter carbon fibres from mesophase pitch

Large diameter carbon fibres of 15-60 μm were produced from naphthalene-derived mesophase pitch. In the as-spun state, preferred orientation increases with fibre diameter, confirming a previous study. However, the sheath-core structure that develops during carbonisation of large diameter fibres results in a decrease in preferred orientation. As a consequence, the strength, modulus and electrical resistivity also decrease. The coarse optical texture of the partially relaxed core allows a higher degree of graphitisation. With extended stabilisation, the core can be eliminated and the mechanical properties improve whilst the electrical resistivity increases.     

Scale‐up of adsorptive styrene drying

This work is focused on the analysis of the scale‐up process of styrene drying by adsorption onto activated alumina as a necessary step in the manufacture of styrene–butadiene rubber. In a previous work, the mathematical model was developed and the design parameters were estimated from the fitting of the model to experimental results obtained in a laboratory set‐up. The obtained model and parameters have been used to simulate the behaviour of a pilot plant that contains up to 56 times more sorbent stating their validity after comparison with experimental results. Finally, the behaviour of an industrial plant presently at work, was also satisfactorily described. The ability of the model to simulate experimental results obtained on three different scales checks its adequacy for process design and optimization. © 2002 Society of Chemical Industry     

Stress dependence of bistability in a zero-magnetostrictive amorphous wire

New data on the bistability of (Co₉₅Fe₅)_72.5Si_12.5B₁₅ amorphous wire are discussed in the framework of a simple model of magnetic interaction between inner core and outer shell of a wire. Experimental results are reported on the tensile stress and annealing-time dependence of switching field and remanence magnetization, for longitudinal and circular hysteresis loops. Theoretical considerations allow various scenarios of the bistability effect to be distinguished, which are helpful in our understanding of the experimental data.     

Successful therapy with danazol in refractory autoimmune thrombocytopenia associated with rheumatic diseases

The objective was to assess the efficacy of therapy with danazol in refractory immune thrombocytopenia associated with different rheumatic diseases. Patients with severe immune thrombocytopenia (platelet counts < 40 x 10(9)/l) with a bone marrow biopsy showing megakaryocytes in normal or increased number and normal morphology were included if they fulfilled at least one of the following criteria: (a) thrombocytopenia refractory to prednisone (> or = 1 mg/kg/day during > or = 4 weeks); (b) patients requiring an unacceptably high dose of prednisone for > 2 months (prednisone dose > or = 20 mg/day); (c) no response to at least another drug besides corticosteroids. Other causes of thrombocytopenia were excluded. They were treated with danazol (100-200 mg q.i.d.) and followed for at least 12 months. Four patients diagnosed with systemic lupus erythematosus, two with rheumatoid arthritis and one with primary antiphospholipid syndrome met the inclusion criteria. All of them achieved acceptable platelet counts within the first 4 weeks of danazol therapy that allowed the prednisone dosage to be tapered. No important side-effects related to danazol therapy were observed. Danazol therapy seems to be a useful and well-tolerated treatment for refractory immune thrombocytopenia associated with different rheumatic diseases.     

Aspects of 2-acetyl-1,3-cyclopentanedione as a chromium(iii) chelating agent: nutritional implications

The chemistry of 2‐acetyl‐1,3‐cycloalkanediones has acquired increased applied importance because of the great number of applications in the agroalimentary industry. The keto‐enol ratios and equilibrium constants for proton reactions of 2‐acetyl‐1,3‐cyclopentanedione have been determined in solution using nuclear magnetic resonance and spectrophotometric methods. Chromium(iii ) is an essential nutrient and it seems that high chromium supplementation improves glucose tolerance. Chromium chelates have been shown to have a significant beneficial effect on metal status by increasing metal bioavailability in human diets. The composition and log β‐value of the complex formed in aqueous solution by chromium(iii ) with the ligand mentioned above have been determined. A detailed reaction scheme is proposed for the 1 : 1 chelation process. The kinetic data are consistent with a mechanism in which the mono‐enol tautomer of the ligand reacts with both metallic species, the fully hydrated metal ion and the Cr(OH)²⁺. The results are discussed in the light of previous work.