Curvilinear relations between age and hemostatic parameters in Chinese

The role of hemostatic factors in the pathogenesis of cardiovascular disease has gained much attention recently. Information about hemostatic factors, and their age patterns is sparse for orientals. With the data collected in the Cardiovascular Disease Risk Factor Two-township Study in Taiwan, this study shows that, in general, the older the age, the stronger the tendency toward thrombosis. With advancing age, prothrombin time, activated partial thromboplastin time, and antithrombin-III level decreased steadily; but mean values of fibrinogen, factor VIIc, and factor VIIIc increased. Gender differences in the age patterns of the above factors are carefully described. Curvilinear relations between hemostatic factors and age were demonstrated for adults aged 18 and above for all hemostatic factors studied. This curvilinearity should be taken into consideration when adjusting for the effect of age in data analysis to avoid residual confounding, particularly when the age range of the study subjects is wide.

Paraumbilical vein tumor thrombosis in hepatocellular carcinoma

To evaluate the incidence and role of paraumbilical vein tumor thrombosis (PUVT) in hepatocellular carcinoma, we studied 431 patients with hepatocellular carcinoma. Nine patients (2.1%), all male, presented with PUVT. Eight of those patients were positive for hepatitis B surface antigen, with the size of the main tumor being at least 9 cm. All nine patients had a combination of left lobe invasion and left portal vein thrombosis. The dilated paraumbilical vein was not present before the PUVT occurred. The survival time for these nine patients was from 3 to 180 days (median 25 days). The poor prognosis of patients with PUVT resulted from the advanced stage of hepatocellular carcinoma and already poor general physical condition of these patients, but was not a result of the PUVT itself. We present a possible sequence of formation of PUVT.

Alteration of neuronal calcium homeostasis and excitotoxic vulnerability by chronic depolarization

Free intracellular Ca2+ concentration ([Ca2+]i, Ca2+ currents, and excitatory amino acid (EAA) currents were studied in spinal neurons cultured in low (4.5 mM) and high (25 mM) extracellular potassium. When challenged with lethal concentrations of N-methyl-D-aspartate (NMDA) or kainate, neurons cultured in 25 mM K+ exhibited markedly attenuated Ca2+ currents and [Ca2+]i responses, and survived the EAA challenge more readily than controls. Surprisingly, NMDA and Kainate currents remained comparable between neurons grown in high- and low K+. The disparity between the observed [Ca2+]i increases and EAA currents suggests that chronic depolarization induces a fundamental alteration in intracellular Ca2+ handling. This phenomenon may provide clues for the development of neuroprotective strategies against excitotoxin excess.

Expression of functional metabotropic and ionotropic glutamate receptors in baculovirus-infected insect cells

An ionotropic glutamate receptor of the kainate subtype (GluR6) and a G-protein coupled metabotropic glutamate receptor (mGluR1 alpha) were expressed and studied in two insect cell lines: sf9 cells from Spodoptera frugiperda and MG1 cells from Trichoplusia ni. Application of kainate to GluR6-infected MG1 cells produced kainate-activated currents. Glutamate activation of mGluR1 alpha in MG1- and sf9-infected cells caused rapid, transient increases in intracellular calcium levels. This effect was more pronounced in MG1 cells compared to sf9 cells. These results indicate that functional glutamate receptors can be expressed in the baculovirus system, and that MG1 cells may have several advantages over the widely used sf9 cells for studying the functional properties of receptors and channels.

Regulation of NMDA receptors in cultured hippocampal neurons by protein phosphatases 1 and 2A

Phosphorylation of glutamate receptors is probably an important mechanism for modulating excitatory transmission. However, there is little direct evidence to indicate which protein phosphatases can dephosphorylate glutamate or other ligand-gated channels, although it is known that protein phosphatases 1 and 2A play a major part in modulating voltage and second-messenger-gated channels. Here we report that in cultured hippocampal neurons, the N-methyl-D-aspartate (NMDA) receptor can be regulated by endogenous and exogenous serine/threonine protein phosphatases. Phosphatase inhibitors enhanced NMDA currents recorded using the perforated patch technique or in cell-attached patches, whereas protein phosphatases 1 or 2A decreased the open probability of these channels in inside-out patches.

Sensitivity of AMPA receptors to pentobarbital

The inhibitory effects of pentobarbital on various AMPA receptors expressed (GluR1, GluR3, GluR1/3, GluR1/2, and GluR2/3) in Xenopus oocytes were examined. Combinations of AMPA receptor subunits that included GluR2 demonstrated a much higher sensitivity to blockade by this barbiturate and the apparent co-operativity of the interaction of pentobarbital with the receptor was reduced. This evidence demonstrates that the GluR2 subunit alters the structure of AMPA receptors in such a way as to facilitate any interaction with this barbiturate.

A transmembrane model for an ionotropic glutamate receptor predicted on the basis of the location of asparagine-linked oligosaccharides

Several different models have been proposed for the transmembrane structure of receptors for the neurotransmitter L-glutamate. In this study, the sites of N-linked oligosaccharides on GluR6, a member of the kainate class of ionotropic glutamate receptors, were examined. Site-directed mutagenesis was utilized to alter the consensus sequence at three potential sites for N-linked glycosylation in the carboxyl-terminal half of the molecule. The presence of a carbohydrate substitution was monitored by shifts in the relative molecular weight of the mutant receptors on immunoblots. Molecular weight shifts were observed for the mutants N515Q and N720Q and for two companion mutants, T517A and T722A, which also eliminate the consensus sequence for N-linked glycosylation. No shift in molecular weight was observed in the the mutant N574Q. These results indicate that asparagines 515 and 720 are glycosylated and thus are likely located extracellularly. In immunocytochemical analyses of GluR6 expressed in baculovirus-infected cells, permeabilization with detergents was required for immunostaining with a carboxyl-terminal antibody, indicating that the carboxyl terminus is located intracellularly. Electrophysiological recordings of the mutant receptors expressed in human embryonic kidney cells demonstrated that the amplitudes of the kainate-activated currents mediated by the N574Q, N720Q, and the T722A mutants were not significantly different from currents mediated by wild type GluR6 receptors, while the currents mediated by the N515Q and T517A mutants were significantly depressed. Based on these findings, we propose a model for the transmembrane topology of GluR6.

Seroprevalence and associated risk factors of Helicobacter pylori infection in Taiwan

In order to estimate the seroprevalence and explore multiple risk factors associated with Helicobacter pylori infection among residents in Taiwan, a total of 823 subjects randomly selected from one metropolitan precinct and three townships were studied. Serum samples were tested for IgG antibodies against H. pylori by enzyme-linked immunosorbent assay using commercial kits. The overall seropositive rate was 54.4% with no gender difference (53.7% for males and 55.2% for females). There was a significant geographical variation with the highest seropositive rate (63.4%) in rural area where aborigines live, and where the age-adjusted stomach cancer mortality is highest and the lowest (40.5%) in urban area where Hakkas live, and where the stomach cancer mortality is lowest. There was also an increasing seropositive rate with age from 27.1% for children younger than 10 years old to 72.3% for adults aged more than 40 years old. Age-specific seroprevalence in Taiwan is higher than that in United States, France, Finland and Australia, and lower than that in Algeria, Ivory Coast and India. No association with H. pylori seropositivity was observed for drinking water source, toilet type, family income and educational level after adjusting for age and area. A dose-response relation between H. pylori seropositivity and sibship size was found. Upon further analysis of seroprevalence for children aged 16 or younger, a positive association was observed for birth order and current number of children in family; there was also an inverse association for current number of adults in family. The early childhood transmission among siblings seems an important determinant of H. pylori seropositivity in Taiwan.

Alveolar permeability enhancement by oleic acid and related fatty acids: evidence for a calcium-dependent mechanism

Pulmonary exposure to oleic acid (OA) is associated with permeability alterations and cellular damage; however, the exact relationship between these two effects has not been clearly established. Using cultured alveolar epithelial monolayers, we demonstrated that OA and some other fatty acids (< or = 50 microM) can induce permeability changes without detectable cellular damage. At higher concentrations, however, OA caused severe membrane damage and leakage to solute flux. The permeability enhancing effect of OA was observed with both the paracellular marker 3H-mannitol and the lipophilic transcellular indicator 14C-progesterone. While the effect of OA on transcellular permeability may be attributed to its known effect on membrane fluidity, the paracellular promoting effect of OA and its mechanism are not well established. We postulated that OA may increase paracellular permeability through a Ca(2+)-dependent tight junction mechanism. Using dual-excitation fluorescence microscopy, we demonstrated that OA can increase intracellular calcium, [Ca2+]i, in a dose-dependent manner. This effect was transient at low OA concentrations (< or = 50 microM) but became more pronounced and sustained at higher concentrations. Free hydroxyl and unsaturated groups were required for this activation since esterified OA (oleic methyl ester) and stearic acid (a saturated fatty acid with equal chain length) had much reduced effects on both the [Ca2+]i and the permeability alterations. Degree of unsaturation was unimportant since linolenic acid (18:3), linoleic acid (18:2), and OA (18:1) had similar and comparable effects on the two parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

p53 gene mutations in brain tumors in Taiwan

Mutations of the p53 gene were investigated in 116 surgically removed primary brain tumor tissues by PCR-SSCP analysis. The mutations did not follow a random distribution among the various different subtypes, but occurred in 21.0% (13/62) of astrocytomas, 13.0% (3/23) of oligodendrogliomas and 35% (7/20) 35% (7/20) of PNETs. No mutation was found in the ependymomas. The majority of mutations identified in this study were G:C to A:T or C:G to T:A transitions (56.0%, 14 of 25) and occurred most frequently (56.0%, 14 of 25) at sites of CpG dinucleotides. Interestingly, codon 158 is a new hot spot which occurred with a frequency of 16.0% (4 of 25) in the samples analyzed.

Modulation of AMPA/kainate receptors in cultured murine hippocampal neurones by protein kinase C

1. The patch clamp technique, together with intracellular perfusion of the catalytic fragment of protein kinase C (PKCM), was employed to investigate the role of this enzyme in the intracellular regulation of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA)/kainate receptors in cultured hippocampal neurones. 2. The responses evoked by near-maximal concentrations of kainate (250 microM) and AMPA (100 microM) were potentiated by the introduction of PKCM, whilst co-application of the inhibitory peptide fragment PKCI(19-36) prevented this action. 3. Modulation of kainate responses by PKCM was dependent upon the concentration of agonist applied. Currents evoked by kainate were potentiated at concentrations above those which caused 50% of the maximal response (EC50) and depressed at lower concentrations. Furthermore, okadaic acid, a specific inhibitor of phosphatases 1 and 2A, had a similar effect upon concentration-response relationships when currents activated by kainate were recorded using the perforated patch technique. 4. In addition, the mean amplitude and/or time constant of decay of miniature excitatory synaptic currents (mediated by AMPA/kainate receptors) was increased by the intracellular injection of PKCM. 5. These observations suggest that the function of postsynaptic excitatory amino acid receptors can be modulated by the activity of PKC as well as by endogenous phosphatases. This regulation may contribute to some forms of synaptic plasticity within the central nervous system.

[Effects of puerarin on cat vascular smooth muscle in vitro]

Puerarin is an isoflavone compound isolated from Pueraria lobata (Wild). This study characterized the vascular action of puerarin in order to more clearly elucidate its pharmacological activities. Helically cut strips of cat femoral veins and renal arteries were suspended in an organ chamber filled with Krebs bicarbonate solution for measurement of isometric force development. In the cases of femoral veins and renal arteries isoproterenol (0.01 mumol.L-1 -0.1 mmol.L-1) caused relaxation of methoxamine-induced contraction (0.01 mmol.L-1) in a concentration-related manner. Puerarin (0.01-0.1 mmol.L-1) inhibited the relaxation response to isoproterenol in a concentration-response fashion. Propranolol (0.1-1 mumol.L-1) inhibited the isoproterenol-induced relaxation too. Puerarin (0.1mmol.L-1) did not alter the relaxation response to nitroglycerin (1 mumol.L-1). These results indicated that puerarin acted as a beta-adrenoreceptor antagonist in isolated arteries and veins.

Development of portal vein invasion and its outcome in hepatocellular carcinoma treated by transcatheter arterial chemo-embolization

Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world. One serious complication is the invasion of the portal vein. To investigate the new invasion of the portal vein in HCC following treatment by transcatheter arterial chemo-embolization (TACE), 124 patients with HCC were screened by ultrasound, computed tomography and angiography. Fifteen patients were diagnosed with portal vein invasion (PVI) during the initial examination and were excluded from the study. Of the remaining 109 patients, 18 developed PVI. Fourteen were male and four were female. None of these 18 patients completely responded to TACE treatment and all were in recurrence. The median time for appearance of PVI after the first TACE was 212 days. The median interval between PVI and the last negative ultrasound examination was 100 days. Both were correlated with the degree of PVI. The only significant factor affecting the time until the appearance of PVI was the TACE treatment. After the development of PVI, eight patients continued with the TACE treatment, and three of these patients were also treated with portal vein local chemotherapy. The regression of PVI was observed in two patients. The median survival time after the discovery of PVI was 129 days. Factors affecting the survival time were performance state, Pugh classification, sex, the area of tumour invasion and continued treatment.

Increased sister chromatid exchange frequency in peripheral lymphocytes of nasopharyngeal carcinoma and cervical cancer patients

The specific aim of this study was to compare the frequency of sister chromatid exchange (SCE) in peripheral lymphocytes using it as a biomarker of integral exposures to carcinogens in 14 untreated newly-diagnosed nasopharyngeal carcinoma (NPC) patients, 16 untreated newly-diagnosed cervical cancer patients, and 30 healthy controls matched with patients on age, sex, cigarette smoking and alcohol drinking. Peripheral lymphocytes were cultured in RPMI 1640 medium containing 20% fetal calf serum and 6 microM phytohemagglutinin. After culture for 24 hours, 20 microM 5-bromo-2-deoxyuridine was added into the medium. Colcemid solution was further added after 70 hours. Harvested cells were stained with Hoesch 33258, illuminated, and restained with Giemsa. The SCE frequency was scored by two readers independently and blindly. The results showed a significantly increased SCE frequency in lymphocytes for NPC patients (mean +/- standard error = 14.7 +/- 1.7 SCEs/cell) compared with their matched controls (10.1 +/- 0.7 SCEs/cell) and for cervical cancer patients (12.0 +/- 0.9 SCEs/cell) compared with their matched controls (9.2 +/- 0.7 SCEs/cell). These results suggest that NPC and cervical cancer patients have a higher integral exposures to both viral and chemical carcinogens than matched controls.

[Changes in blood visco-elasticity in normal pregnancy and pregnancy induced hypertension]

The study was designed on blood visco-elasticity of normal pregnant and pregnancy induced hypertension (PIH) women. Visco-component (eta'), elastic-component (eta") and storage modulus (G') decreased significantly during the 1st trimester of pregnancy, but rose slowly in the 3rd trimester. eta' was the most significant and it revealed an inverse correlation with neonate birth weight. There were no changes of eta', eta" and G' in women with mild PIH, but they rose markedly in groups with moderate and severe PIH. In conclusion, abnormal blood viscosity and elasticity, i.e. an increase of RBC aggregation and/or a decrease of RBC deformability, may be an important abnormal hemorheological changes in PIH.

Hepatitis C virus infection as a risk factor for non-alcoholic liver cirrhosis in Taiwan

To assess whether hepatitis C virus infection was a risk factor for the development of non-alcoholic liver cirrhosis, antibody to hepatitis C virus (anti-HCV; detected by a second generation HCV enzyme immunoassay), hepatitis B surface antigen (HBsAg; detected by radioimmunoassay) were tested in 150 cirrhotics and 150 sex-matched and age-matched healthy controls. The prevalence of anti-HCV and HBsAg in cirrhotics was higher than in controls (22.0%, 73.3% vs. 2%, 18.7%; P = 0.001). The prevalence of anti-HCV in HBsAg-negative cirrhotics (45.0%) was higher than that in HBsAg-positive patients (13.6%; P = 0.001). Both the anti-HCV and carriage of HBsAg were associated significantly with liver cirrhosis, showing odds ratio of 12.0 for HBsAg carriers and 13.8 for patients with anti-HCV. Compared with those without HBsAg and anti-HCV, there was a significantly positive linear trend for developing cirrhosis with the presence of HBsAg alone (odds ratio = 19.9), anti-HCV alone (odds ratio = 49.0), and those positive for HBsAg and anti-HCV (odds ratio = 81.8) (P = 0.00001). The population-attributable risk for developing liver cirrhosis was estimated as 10.8% for anti-HCV alone, 55.2% for HBsAg alone, and 9.4% for both anti-HCV and HBsAg in southern Taiwan. In conclusion, this study shows that hepatitis B and C virus infection act independently and synergistically in the development of non-alcoholic liver cirrhosis among Chinese in Taiwan.

[Relaxation of coronary arterial smooth muscle and depolarization of cell membrane potential by selenium]

Selenium (Se) is an important trace element to the human being. The effects of selenium on contraction and cell membrane potential of coronary arterial smooth muscle were studied in guinea pig by isometric force development of strips and intracellular recording method. It was showed that Se caused vascular smooth muscle relaxation and depolarization of the cells in a dose dependent manner. Inhibitory effect of Se on KCl- or ACh-induced contraction could be quantitatively assessed by a rightward shift of the concentration-response curve. Furthermore, Se increased KCl-induced depolarization and decreased ACh-induced hyperpolarization.

[Studies on chemical constituents from solvent extracts of Poria cocos (Schw.) Wolf]

Crystals I-N were isolated from the ethereal extracts of Poria cocos and identified respectively as O-acetyl-pachymic acid (I), 3 beta-hydroxy-lanosta-7,9(11),24-trien-21-oic acid (II), beta-amyrin acetate (III) and 3 beta-hydroxy-16 alpha-acetoxy-lanosta-7,9(11),24-trien-21-oic acid (N). Crystal III was obtained from P. cocos for the first time, and crystal N was newly discovered.

Anorectal anomaly: neuropathological changes in the sacral spinal cord

The study was carried out on the bodies of five full-term newborn babies and 10 newborn patients with anorectal anomalies (four of whom had the high deformity, one had the intermediate, and five had the low). Serial transverse sections of the sacral spinal cords at 30 microns were made and stained with Nissle's. It was found that in the medial column of the sacral spinal cord there were two groups of motoneurons: posteriomedian group (group A) and anteriomedian group (group B). The former was found mainly in S3 and S4 and the latter extended from caudal S4 to caudal S2. In six of the 10 deformitive cases the cross-sections of the S5 showed a large diamond-shaped central canal and a thin conus medulla which could be distinguished as the basal and alar laminae; in one case, the lower part of the central canal and the anterior median fissure appeared undeveloped; in one case, the lower part of the central canal was divided into two large canals by a sagittal septum; and in the other two cases, their central canals appeared widened and flattened. Additionally, the average numbers of motoneurons in the group B of the high or intermediate deformity and the low deformity were 13.4% and 61.1%, respectively, of the normal number, and the corresponding numbers of group A were 61.3% and 77.7%, respectively, of the normal number. The observations suggest that sacral myelodysplasia is one of the neuropathological features in anorectal anomaly and may be responsible for the pathological changes in its peripheral nerve system.

Serum SP1, HPL levels and urinary estrogen/creatinine ratio in the detection of low birth weight

Serum pregnancy specific beta 1 glycoprotein (SP1), human placental lactogen (HPL) and urinary estrogen/creatinine (E/C) ratio levels were determined to study their clinical significance in predicting low birth weight (LBW) in women with normal pregnancy and patients with LBW. The results showed that the sensitivity of urinary E/C ratio was better than that of serum SP1 and HPL, and was increased gradually with the reduction of fetal weight. The specificity in predicting LBW decreased gradually with the increase of serum SP1 and HPL levels and urinary E/C ratio. When serum SP1 level was less than 50 mg/L, HPL less than 2.0 mg/L, and E/C ratio less than 10, their specificity could increase over 90%. It is suggested that multi-indexes measurement would improve the accuracy for predicting LBW. We conclude that SP1, HPL and E/C ratio measurement could be an useful index for predicting LBW.

The role of hepatitis C virus in chronic hepatitis B virus infection

To investigate the influence of hepatitis C virus (HCV) infection on patients with chronic hepatitis B virus (HBV), the presence of antibody against C100-3 antigen of HCV (anti-HCV) was examined in 420 patients with chronic HBV infection and 275 healthy subjects. It was found that the prevalence of HCV infection increased in parallel with the severity of liver damage. The positive rates of anti-HCV were as follows: healthy subjects, 2.9% (8/275); asymptomatic carriers, 2.6% (5/193); chronic hepatitis, 5.2% (3/58); liver cirrhosis, 11.4% (8/70); hepatocellular carcinoma (HCC), 12.1% (12/99). To elucidate the interaction of these two viruses in hepatocellular carcinoma, 128 HCC patients and 384 age-matched and sex-matched subjects were further analyzed. Eighty-seven of 128 HCC patients (68.0%) were only positive for HBsAg, 13 patients (10.1%) were only anti-HCV positive, and 12 (9.4%) were positive for both markers. The presence of HBsAg and anti-HCV was associated strongly with HCC. Moreover, the risk of HCC was significantly higher when both HBsAg and anti-HCV were present simultaneously. These results suggested that concurrent HCV infection might accelerate the progression of chronic HBV infection and may contribute to the pathogenesis of HCC in patients with chronic HBV infection.

Phosphorylation and modulation of a kainate receptor (GluR6) by cAMP-dependent protein kinase

Ligand-gated ion channels gated by glutamate constitute the major excitatory neurotransmitter system in the mammalian brain. The functional modulation of GluR6, a kainate-activated glutamate receptor, by adenosine 3',5'-monophosphate-dependent protein kinase A (PKA) was examined with receptors expressed in human embryonic kidney cells. Kainate-evoked currents underwent a rapid desensitization that was blocked by lectins. Kainate currents were potentiated by intracellular perfusion of PKA, and this potentiation was blocked by co-application of an inhibitory peptide. Site-directed mutagenesis was used to identify the site or sites of phosphorylation on GluR6. Although mutagenesis of two serine residues, Ser684 and Ser666, was required for complete abolition of the PKA-induced potentiation, Ser684 may be the preferred site of phosphorylation in native GluR6 receptor complexes. These results indicate that glutamate receptor function can be directly modulated by protein phosphorylation and suggest that a dynamic regulation of excitatory receptors could be associated with some forms of learning and memory in the mammalian brain.

Secular trend and geographical variation in hepatitis A infection and hepatitis B carrier rate among adolescents in Taiwan: an island-wide survey

During the last two decades an economic boom has occurred in Taiwan, a region where the prevalence of both hepatitis A and B virus infection was formerly very high. To examine the impact of socioeconomic developments on the secular trend and geographical variation in hepatitis A and B virus infection, 875 adolescents selected randomly from 20 junior high schools were studied. Serum samples collected from the subjects were tested for hepatitis A antibody (anti-HAV) and hepatitis B surface antigen (HBsAg) by enzyme immunoassay using commercial reagents. The anti-HAV prevalence increased from northern through central to southern Taiwan; the prevalence was highest in aboriginal townships and lowest in metropolitan precincts. This striking variation in anti-HAV prevalence in different geographical locations and at different urbanization levels remained significant in multiple logistic regression analysis. The HBsAg prevalence was significantly higher in aboriginal townships than in rural and urban townships and metropolitan precincts. In addition, HBsAg prevalence was related inversely to the number of physicians per 1,000 population. The prevalence of both anti-HAV and HBsAg declined significantly during the last decade in Taipei City and County. The decrease in anti-HAV prevalence may be due to improvements in environmental hygiene, water supply, and food sanitation, while the decline in the HBsAg carrier rate may result from the use of disposable needles and syringes as well as screening for HBsAg in blood banks.

Alpha-fetoprotein in patients with hepatocellular carcinoma after transcatheter arterial embolization

To assess the usefulness of alpha-fetoprotein (AFP) in monitoring treatment effects of transcatheter arterial embolization (TAE) in hepatocellular carcinoma (HCC) patients, a total of 31 sets of AFP levels after TAE in 21 HCC patients were analysed by linear regression between logarithmic AFP levels and days. Eleven sets of AFP data with poor linear declination were accompanied with poor TAE results except in one patient who had chronic hepatitis with acute exacerbations. Twenty sets of data with good linear declination in the first month after TAE indicated good TAE results. Seven of them showed no evidence of tumour recurrence nor elevated AFP levels within a follow-up of 6 months. The mean, standard deviation and range of half-lives of AFP in the non-recurrent group were 5.0, 1.6 and 2.9-7.2 days, respectively. The others experienced late tumour recurrence that was detected by rebound of AFP levels except one who had another non-AFP-secreting HCC. Thus, the results might be used as a reference in monitoring the treatment effects of TAE and the timing selection of repeated TAE.