Subsegmentectomy or segmentectomy in hepatocellular carcinoma

BACKGROUND/AIMS: We determined the optimal therapeutic strategy for improving survival in patients with hepatocellular carcinoma (HCC), based on an analysis of our surgical results. METHODOLOGY: Between January 1990 and December 1996, 205 patients underwent initial curative hepatectomy. The liver volume to be resected was decided according to the plasma retention of indocyanine green 15 minutes after injection. The appropriate subsegmental and segmental areas were disclosed by staining under ultrasonographic guidance. Limited resection or tumor enucleation was performed in 119 patients, subsegmentectomy or segmentectomy in 71, and lobectomy or extended lobectomy in 15. RESULTS: Intrahepatic recurrence was documented in 115 patients, 46 of whom died from cancer recurrence. Disease free survival was 65% after 1 year, 35.1% after 3 years and 25.3% after 5 years. The type of hepatectomy (limited vs. subsegmental or segmental resection) significantly affected the cumulative survival (p = 0.047) and disease free survival rates (p < 0.01). Among the 115 patients with recurrence, 22 patients underwent repeated hepatectomy combined with TAE (transcatheter arterial embolization) and the remainder underwent TAE alone. Patients who underwent repeated hepatectomy combined with TAE survived significantly longer after recurrence than those who underwent TAE alone (p = 0.0197). CONCLUSION: Initial subsegmentectomy or segmentectomy prolongs disease free survival, and patients eligible for repeated hepatectomy combined with TAE after recurrence have a good chance of long-term survival. Subsegementectomy or segmentectomy should be performed in a lot more HCC patients in order to improve survival.     

Mutation analysis of the WT1 gene in myelodysplastic syndromes

Infectious mononucleosis due to Epstein-Barr virus (EBV) is almost always a self-limited disease, most commonly seen in young adults. Hepatitis is a well-recognized complication of EBV infection that usually resolves spontaneously. Jaundice occasionally results from the unusual complication of autoimmune haemolytic anaemia rather than hepatitis. We report a 60-year-old man with severe cholestatic jaundice whose history, liver histology and laboratory findings suggested EBV infection. He also developed significant jaundice related to his hepatitis, but not to autoimmune haemolysis, a situation that led to diagnostic delay. Costly diagnostic laboratory tests and invasive procedures were performed to rule out a malignant extrahepatic biliary obstruction. Physicians need to be aware of this complication and EBV infection should be included in the differential diagnosis of cholestatic jaundice in the elderly.     

A real-time intelligent gas sensor system using a nonlinear dynamic response

We developed an intelligent gas sensor system for discrimination and quantification of gases by a single semiconductor gas sensor in real-time. This system is based on the information embedded in a nonlinear dynamic response. By applying a sinusoidal voltage to a heater attached to a sensing material, a characteristic time-dependent trace of the sensor resistance is obtained as a response to environmental gases. In order to evaluate the characteristic response in a quantitative manner, fast Fourier transformation (FFT) was performed for the dynamic response. Higher harmonics, obtained by performing FFT, were processed by using a discrimination method and a multiple regression. It is possible for the system to respond in the time order of several seconds. The physico-chemical meaning of the response was also discussed.     

Multi-agent consensus under a communication–broadcast mixed environment

This paper addresses multi-agent control under an environment where both agent-to-agent communication and one-to-all broadcast are available. The problem studied here is a consensus problem for a pre-specified location, i.e. collecting the agents at a desired location in an n-dimensional space, with a limited communication range and an unlimited broadcast range, which is a nice example to be solved under the mixed environment. For solving this, we first introduce a concept of the connected agent group. Using this notion, the problem is reduced to a consensus problem for the group-to-group relation and that for the agent-to-agent relation in the groups, from which we derive a controller achieving the consensus with probability 1. Finally, the performance of the proposed controller is demonstrated by numerical simulation.     

Shorter-wavelength lithography utilizing MRS-type negative resists

New negative photoresists, called MRS-type resists, are successfully applied to deep-UV 1:1 projection printing and 365 nm 10:1 reduction projection printing. The MRS-type resists are characterized by intense absorption of exposure light and absence of swelling in aqueous developer solutions. They resolve steep profile submicron images in a 1.0 μ thick film. They are not adversely affected by reflected light from water surfaces. In order to use MRS-type resists with broader development latitude, optimizing the extent of light absorption is important because the resist profiles strongly depend on development conditions due to increasing solubility towards the resist bottom.     

A study on a porous residential building model in hot and humid regions: Part 1—the natural ventilation performance and the cooling load reduction effect of the building model

This study targets environmental load reduction in hot and humid regions. It reveals the effects that porous residential buildings have on the natural ventilation performance and, consequently, the cooling load reduction. Two residential building models, namely a model with a void ratio of 0% and a model with a void ratio of 50%, are evaluated using computational fluid dynamics (CFD) analysis and thermal and airflow network analysis. The analysis on components of the heat load indicates that improvements in the natural ventilation performance would significantly reduce the cooling load.     

Simultaneous Perturbation Stochastic Approximation with Norm‐Limited Update Vector

This paper addresses the convergence of simultaneous perturbation stochastic approximation (SPSA) with a norm‐limited update vector. We first illustrate an unstable solution of the standard SPSA algorithm which motivates the consideration of a modified version, where the norm of the update vector is limited to a certain value. Next, a result on the almost‐sure convergence is presented by reducing the modified algorithm into the standard SPSA algorithm and restricting the probability distribution for the perturbation to a Bernoulli distribution. Finally, we apply the modified algorithm to a system identification problem to demonstrate its performance.     

Simultaneous determination of five antioxidants in food by HPLC with fluorescence detection

An HPLC method with fluorescence detection was developed for the determination of propyl gallate, nordihydroguaiaretic acid, butylated hydroxyanisole (2- and 3-tert-butyl-4-hydroxyanisole), tert-butylhydroquinone and octyl gallate in edible oils and foods. The antioxidants in edible oil were isolated directly with acetonitrile saturated with n-hexane. The antioxidants in food were extracted with ethyl acetate and the extract was concentrated under vacuum. They were isolated from the residue with acetonitrile saturated with n-hexane. The acetonitrile layer was centrifuged at 5,000 rpm for 10 min. The HPLC separation was performed on a Symmetry C18 column (3.5 microns, 4.6 mm i.d. x 150 mm) using a mixture of 5% acetic acid-acetonitrile-methanol (4:3:3, v/v/v) as the mobile phase and monitored by using a fluorescence detector with time programming. Sample peaks were identified by comparison of the fluorescence spectra with those of antioxidant standards. Average recoveries of fortified antioxidants at 100 micrograms/g were 72.1-99.6%. Coefficients of variation were 0.7-7.2%.     

Investigation on the polymer particle growth in ethylene polymerization with PS beads supported rac-Ph2Si(Ind)2ZrCl2 catalyst

The mechanism of polyethylene particle growth was investigated using poly(styrene-co-divinylbenzene) (PS beads) supported rac-Ph₂Si(Ind)₂ZrCl₂ catalyst. From the analysis of the resulting polyethylene particles by SEM (scanning electron microscopy) and EPMA (electron probe microanalysis), it was found that the active species are located on the surface layer of catalyst particles and that the catalytic species are uniformly distributed throughout the polymer particles, whereas the cores of PS beads, which lack a potential active species, were not disintegrated during polymerization. These results suggest that the PS beads supported catalyst also follows the fragmentation and replication process as frequently observed with the MgCl₂ supported Ziegler–Natta catalysts.