Observation of e+e- → π+π-π(0)(χbJ) and Search for X(b) → ωϒ(1S) at sqrt[s] = 10.867 GeV

The e(+)e(-) → π(+)π(-)π(0)χ(bJ) (J = 0,1,2) processes are studied using a 118 fb(-1) data sample acquired with the Belle detector at a center-of-mass energy of 10.867 GeV. Unambiguous π(+)π(-)π(0)χ(bJ) (J = 1,2), ωχ(b1) signals are observed, and indication for ωχ(b2) is seen, both for the first time, and the corresponding cross section measurements are presented. No significant π(+)π(-)π(0)χ(b0) or ωχ(b0) signals are observed, and 90% confidence level upper limits on the cross sections for these two processes are obtained. In the π(+)π(-)π(0) invariant mass spectrum, significant non-ω signals are also observed. We search for the X(3872)-like state (named X(b)) decaying into ωϒ(1S); no significant signal is observed with a mass between 10.55 and 10.65 GeV/c(2).

The pharmacokinetics, pharmacodynamics and safety of oral doses of ilaprazole 10, 20 and 40 mg and esomeprazole 40 mg in healthy subjects: a randomised, open-label crossover study

BACKGROUND

Ilaprazole, a proton pump inhibitor (PPI) currently in clinical use, may provide improved acid suppression vs. other PPIs.

AIM

To compare the pharmacodynamic and pharmacokinetic profiles of ilaprazole and esomeprazole.

METHODS

A phase 1, randomised, open-label, single-centre, 4-period crossover study was conducted in 40 healthy volunteers. Ilaprazole 10, 20 or 40 mg or esomeprazole 40 mg was administered once daily for 5 days with ≥5-day washout intervals. Pharmacokinetic blood samples and intragastric pH measurements were collected at scheduled timepoints for 24 h after dosing on Days 1 and 5.

RESULTS

Esomeprazole 40 mg provided significantly better pH control during the initial hours (0-4 h) after a single dose, but ilaprazole (particularly 20 and 40 mg) provided significantly better pH control for the entire 24-h period and during evening and overnight hours after single and multiple doses. Increasing ilaprazole doses resulted in dose-proportional increases in peak plasma concentration and area under the plasma concentration vs. time curve following single and multiple doses. Ilaprazole was safe and generally well tolerated; an unexpectedly high incidence of allergic eye and skin reactions were observed but were not specific to any dosing regimen. Plasma gastrin concentrations did not increase proportionately with increasing ilaprazole dose.

CONCLUSIONS

Ilaprazole provided significantly better pH control over 24 h and during evening and overnight hours compared with esomeprazole in healthy volunteers, which may translate to greater relief of night-time heartburn in the clinical setting for patients with gastric acid-related disorders.

Measurement of the branching fraction B(Λc+ → pK-π+)

We present the first model-independent measurement of the absolute branching fraction of the Λ(c)(+) → pK(-)π(+) decay using a data sample of 978 fb(-1) collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. The number of Λ(c)(+) baryons is determined by reconstructing the recoiling D((*)-) pπ(+) system in events of the type e(+)e(-) → D((*)-) pπ(+)Λ(c)(+). The branching fraction is measured to be B(Λ(c)(+) → pK(-)π(+)) = (6.84 ± 0.24(-0.27)(+0.21))%, where the first and second uncertainties are statistical and systematic, respectively.

The highest prognostic impact of LDH among International Prognostic Indices (IPIs): an explorative study of five IPI factors among patients with DLBCL in the era of rituximab

Although the International Prognostic Index (IPI) is considered as the current standard prognostication system for diffuse large B-cell lymphoma (DLBCL), prognostic heterogeneity is suggested to exist among the patients within the same IPI risk group. Hence, we investigated the pattern of distribution and prognostic impact of five IPI factors within the same IPI score. We retrospectively reviewed the medical records of 387 patients newly diagnosed as pathologically proven DLBCL between February 2002 and February 2010. We classified patients to IPI risk scores and categorized them according to the combinations of IPI. Then, we explored the frequency of five IPI factors and analyzed the correlation between these subgroups and efficacy outcomes: complete response (CR), event-free survival (EFS), and overall survival (OS). Survival estimates by IPI score in this cohort corresponded to the classic IPI. Elevated serum level of lactate dehydrogenase (LDH) was the most prevalently distributed factor throughout the scores, and patients with elevated serum level of LDH tended to have lower CR, inferior EFS, and/or OS irrespective of IPI scores. Particularly, among the subgroups of IPI score of 2, elevated serum level of LDH was significantly associated with inferior CR (73.1 vs 95.2 %), 3-year EFS (57 vs 87 %), and 3-year OS (58 vs 82 %). In addition, the higher serum level of LDH, particularly above 2,000 IU/L, was significantly correlated with the inferior survival outcomes (3-year EFS 78.0 vs 58.5 vs 45.5 vs 20.0 %, 3-year OS 86.0 vs 66.2 vs 58.2 vs 40.0 %). In conclusion, among five factors of IPI, elevated serum level of LDH seems to be the most frequently distributed and, more importantly, the most relevant IPI factor with the highest prognostic impact. These findings still warrant further validation in larger cohorts.

Prognostic value of model for end-stage liver disease scores in patients with fulminant hepatic failure

BACKGROUND

This study was undertaken to investigate risk factors of mortality in patients with fulminant hepatic failure (FHF).

METHODS

Fifty-three patients with FHF treated from January 2006 to April 2011 were allocated to a spontaneous survival group (group 1), a death without liver transplantation (LT) group (group 2), and an LT group (group 3). To analyze risk factors associated with mortality in FHF, we excluded group 3 patients. Clinical features, Model for End-Stage Liver Disease (MELD) scores, and King's College Hospital criteria at the time of hepatic encephalopathy in group 2 were compared with those of group 1.

RESULTS

The causes of FHF were acute viral infection (n = 29, hepatitis A:B, 28:1), drugs (n = 18; including 4 acetaminophen and 14 herbal medication), autoimmune (n = 4), and miscellaneous (n = 2). Of the 53 patients, 19 were allocated to group 1, 18 to group 2, and 16 to group 3. According to univariate analysis, risk factors for mortality in group 2 were acute renal failure requiring renal replacement therapy and a MELD score ≥30 at the time of hepatic encephalopathy. However, by multivariate analysis, a MELD score ≥30 was the only independent risk factor for mortality in group 2 (P = .042; hazard ratio, 4.500).

CONCLUSIONS

A MELD score ≥30 was found to be the only independent risk factor of mortality in FHF patients without LT. Therefore, the findings of this study suggest that these patients may need emergent LT for survival.

Clinical significance of an increased cochlear 3D fluid-attenuated inversion recovery signal intensity on an MR imaging examination in patients with acoustic neuroma

BACKGROUND AND PURPOSE

The increased cochlear signal on FLAIR images in patients with acoustic neuroma is explained by an increased concentration of protein in the perilymphatic space. However, there is still debate whether there is a correlation between the increased cochlear FLAIR signal and the degree of hearing disturbance in patients with acoustic neuroma. Our aim was to investigate the clinical significance of an increased cochlear 3D FLAIR signal in patients with acoustic neuroma according to acoustic neuroma extent in a large patient cohort.

MATERIALS AND METHODS

This retrospective study enrolled 102 patients with acoustic neuroma, who were divided into 2 groups based on tumor location; 22 tumors were confined to the internal auditory canal and 80 extended to the cerebellopontine angle cistern. Pure tone audiometry results and hearing symptoms were obtained from medical records. The relative signal intensity of the entire cochlea to the corresponding brain stem was calculated by placing regions of interest on 3D FLAIR images. Statistical analysis was performed to compare the cochlear relative signal intensity between the internal auditory canal acoustic neuroma and the cerebellopontine angle acoustic neuroma. The correlation between the cochlear relative signal intensity and the presence of hearing symptoms or the pure tone audiometry results was investigated.

RESULTS

The internal auditory canal acoustic neuroma cochlea had a significantly lower relative signal intensity than the cerebellopontine angle acoustic neuroma cochlea (0.42±0.15 versus 0.60±0.17, P<.001). The relative signal intensity correlated with the audiometric findings in patients with internal auditory canal acoustic neuroma (r=0.471, P=.027) but not in patients with cerebellopontine angle acoustic neuroma (P=.427). Neither internal auditory canal acoustic neuroma nor cerebellopontine angle acoustic neuroma showed significant relative signal intensity differences, regardless of the presence of hearing symptoms (P>.5).

CONCLUSIONS

The cochlear signal on FLAIR images may be an additional parameter to use when monitoring the degree of functional impairment during follow-up of patients with small acoustic neuromas confined to the internal auditory canals.

Vertical growth of core-shell III-V nanowires for solar cells application

High density (In)GaAs/GaAs/AIGaAs nanowires (NWs) consisting of n-type core and p-type shell have been vertically grown on (111) GaAs substrate using metal organic chemical vapor deposition (MOCVD) and fabricated into solar cells. Au colloidal nanoparticles (NPs) are employed as a catalyst. High density nanowires were obtained by uniform distribution of Au NPs. Fe-SEM, TEM and HRTEM images show that the morphology of shell is sensitive to p-doping concentration. Increase in the density of p-doping precursor results in "kinking" of NPs and rough shell surface. The origin of kinking has been explained by the GaAs twin phases due to Zn segregation on the surface of shell. It has been observed that the morphology of NPs can be controlled through optimizing various source purge technique of DEZn and deposition temperature. Electrical properties of core-shell doped NWs are carried out using I-V characterization. The core-shell NWs show characteristics of p-n junction as revealed by I-V studies.

Observation of D0-D0 mixing in e+e- collisions

We observe D(0)-D(0) mixing in the decay D(0) → K+π- using a data sample of integrated luminosity 976 fb(-1) collected with the Belle detector at the KEKB e+e- asymmetric-energy collider. We measure the mixing parameters x'(2) = (0.09 ± 0.22) × 10(-3) and y'=(4.6 ± 3.4) × 10(-3) and the ratio of doubly Cabibbo-suppressed to Cabibbo-favored decay rates R(D) = (3.53 ± 0.13) × 10(-3), where the uncertainties are statistical and systematic combined. Our measurement excludes the no-mixing hypothesis at the 5.1 standard deviation level.

A randomised, prospective double-blind, propiverine-controlled trial of imidafenacin in patients with overactive bladder

AIM

To assess the efficacy and safety of imidafenacin compared with propiverine for treatment of overactive bladder (OAB) in Korean patients.

MATERIALS AND METHODS

Patients with OAB symptoms were randomised to double-blind treatment with 0.1 mg of imidafenacin twice daily (group A) or propiverine 20 mg once daily (group B) for 12-week regimen, and assessed for efficacy and safety. The primary efficacy outcome was per cent change of weekly urgency urinary incontinence (UUI) episodes at week 12. The secondary efficacy outcomes were changes in the micturitions per day, urine volume voided per micturition, urgency episodes per day, complete disappearance of incontinence episodes and severity of urgency from baseline to week 12. Quality of life and safety profiles were also compared.

RESULTS

Of 162 patients randomised, 140 completed the study protocol. The per cent change of weekly UUI episodes at week 12 was -69.1% in group A and -70.4% in group B (both p < 0.0001). The lower limit of 95% one-sided confidence interval of the difference between the groups was above the non-inferiority margin (-19.42%). Other voiding parameters and quality of life significantly improved at week 12 in both the groups. The discontinuation rates caused by adverse events were low in both the groups. While dry mouth was the most common adverse event (group A: 28.4% vs. B: 30.4%, p = 0.783), the severity of dry mouth was significantly less in the group A than B (p = 0.042) There were no significant differences in other safety profiles.

CONCLUSIONS

After the 12-week treatment of imidafenacin 0.1 mg twice daily, all OAB symptoms and quality of life improved. Imidafenacin was not inferior to propiverine for the reduction of UUI episodes, and was better tolerated than propiverine in the safety profile. Our results indicate that imidafenacin is a safe and effective drug in Korean patients with OAB.

Measurement of the τ-lepton lifetime at Belle

The lifetime of the τ lepton is measured using the process e+ e- → τ+ τ- , where both τ leptons decay to 3πν(τ). The result for the mean lifetime, based on 711  fb(-1) of data collected with the Belle detector at the ϒ(4S) resonance and 60  MeV below, is τ=(290.17±0.53(stat)±0.33(syst))×10(-15)  s. The first measurement of the lifetime difference between τ+ and τ- is performed. The upper limit on the relative lifetime difference between positive and negative τ leptons is |Δτ|/τ<7.0×10(-3) at 90% C.L.

Search for bottomonium states in exclusive radiative Υ(2S) decays

We search for bottomonium states in Υ(2S) → (bb)γ decays with an integrated luminosity of 24.7  fb(-1) recorded at the Υ(2S) resonance with the Belle detector at KEK, containing (157.8±3.6)×10(6) Υ(2S) events. The (bb) system is reconstructed in 26 exclusive hadronic final states composed of charged pions, kaons, protons, and K(S)(0) mesons. We find no evidence for the state recently observed around 9975 MeV (X(bb)) in an analysis based on a data sample of 9.3×10(6) Υ(2S) events collected with the CLEO III detector. We set a 90% confidence level upper limit on the branching fraction B[Υ(2S) → X(bb)γ] × ∑(i)B[X(bb) → h(i)] < 4.9×10(-6), summed over the exclusive hadronic final states employed in our analysis. This result is an order of magnitude smaller than the measurement reported with CLEO data. We also set an upper limit for the ηb(1S) state of B[Υ(2S) → ηb(1S)γ] × ∑(i)B[ηb(1S) → h(i)] < 3.7×10(-6).

Clinical validity of tissue carcinoembryonic antigen expression as ancillary to serum carcinoembryonic antigen concentration in patients curatively resected for colorectal cancer

AIM

Although serum carcinoembryonic antigen (CEA) level is prognostic in colorectal cancer, the prognostic role of tumour CEA expression is unclear. The aim of this study is to identify the prognostic and surveillance roles of tissue CEA expression along with serum CEA concentration in patients curatively resected for colorectal cancer.

METHOD

Between January and December 2003, 294 patients who underwent curative resection for colorectal cancer were included in the study. Correlation of tissue CEA expression with overall survival (OS), disease-free survival (DFS) and elevated serum CEA concentration at tumour recurrence were analysed.

RESULTS

Tissue CEA expression was positive in 215 patients (73.1%). CEA expression was an independent prognostic factor for OS [hazard ratio (HR) = 2.537, 95% confidence interval (CI) = 1.065-6.042, P = 0.035] and DFS (HR = 3.090, 95% CI = 1.405-6.795, P = 0.005). Elevation of serum CEA at tumour recurrence was significantly lower in patients without than with tissue CEA expression (14.3 vs 57.6%, P = 0.045). Moreover, when patients were grouped according to a combination of serum CEA elevation and tissue CEA expression, those with tissue CEA expression and elevated serum CEA (group 3) had significantly poorer OS and DFS (P < 0.001 each) than those without CEA expression and elevated serum CEA (group 1) and those with either tissue CEA expression or elevated serum CEA (group 2). OS (P = 0.006) and DFS (P = 0.027) were both significantly greater in group 1 than in group 2.

CONCLUSION

Tissue CEA expression is a prognostic factor in patients with colorectal cancer. Analysis of tissue CEA expression may be helpful in determining the clinical utility of serial measurements of serum CEA as surveillance in patients with curatively resected colorectal cancer.

Pancreaticoduodenectomy for advanced gastric carcinoma patients

OBJECTIVE

The prognosis for patients with gastric carcinoma that has invaded adjacent organs, especially the pancreas, is very poor. We evaluated the survival of patients following pancreaticoduodenectomy (PD) and the survival benefit of intravenous chemotherapy in these patients.

METHODS

We reviewed the hospital records of 16 gastric carcinoma patients who underwent PD during the period from 2001 to 2005.

RESULTS

Half of the patients undergoing PD had Borrmann type III gastric carcinoma (8/16; 50%). Using Cox's proportional hazards regression model, only one factor was identified as an independent, statistically significant prognosticator intravenous chemotherapy (risk ratio, 0.054; 95% confidence interval, 0.01-0.45; p < 0.01). The 5-year survival rate was higher for patients who had intravenous chemotherapy than for patients who did not (22.2% vs. 0%; p < 0.01).

CONCLUSION

The results highlight the improved survivorship of gastric carcinoma patients with PD who received intravenous chemotherapy compared with those who did not. We recommend resection in these patients and the administration of intravenous chemotherapy to improve their survival.

Expression analysis of rice VQ genes in response to biotic and abiotic stresses

WRKY transcription factors are encoded by a large gene superfamily with a broad range of roles in plants. Proteins containing a short VQ (FxxxVQxLTG) motif have been recently shown to interact with WRKY transcription factors, implying that AtVQ proteins are important in the plant defense responses in Arabidopsis, either as positive or negative cofactors of WRKY transcription factors. Thirty-nine Oryza sativa genes containing the VQ motif (OsVQs) were identified and the genome structures of OsVQ proteins were characterized through genome-wide analysis in rice. Also, phylogenetic tree analysis was performed with the VQ domain of Arabidopsis and rice. The expression patterns of these OsVQ genes in plants under several stress treatments were assessed, specifically, following infection with the bacterial pathogen Xanthomonas oryzae pv. oryzae (Xoo), treatment with abscisic acid (ABA), or exposure to drought. The cellular localization of a few OsVQ proteins was examined using rice protoplast system. Based on our results, we suggest that OsVQ proteins function as important co-regulators during the plant defense response to biotic and abiotic stresses.

Utility of proton MR spectroscopy for differentiating typical and atypical primary central nervous system lymphomas from tumefactive demyelinating lesions

BACKGROUND AND PURPOSE

It may be challenging to differentiate primary CNS lymphomas, especially primary CNS lymphomas with atypical MR features, from tumefactive demyelinating lesions by the use of conventional MR. This study aimed to investigate the usefulness of (1)H-MR spectroscopy for making this discrimination.

MATERIALS AND METHODS

Forty-four patients with primary CNS lymphomas and 21 with tumefactive demyelinating lesions were enrolled. Single-voxel (TE = 144 ms) (1)H-MR spectroscopy scans with the use of the point-resolved spectroscopy sequence were retrospectively analyzed. The Cho/Cr and Cho/NAA area ratios were calculated. The lipid and/or lactate peak was visually categorized into 5 grades on the basis of comparison with the height of the Cr peak. The (1)H-MR spectroscopy findings were compared in all of the primary CNS lymphomas and the tumefactive demyelinating lesions and in the subgroup of atypical primary CNS lymphomas and tumefactive demyelinating lesions. The thresholds and added value of (1)H-MR spectroscopy to conventional MR were calculated by use of receiver operating characteristic curves.

RESULTS

Discrepancies between all of the primary CNS lymphomas and tumefactive demyelinating lesions were found in the Cho/Cr ratio (P = .000), Cho/NAA ratio (P = .000), and the lipid and/or lactate peak grade (P = .000). Lymphoma rather than tumefactive demyelinating lesions was suggested when the Cho/Cr ratio was >2.58, the Cho/NAA ratio was >1.73, and a high lipid and/or lactate peak grade (grade >3) was seen. Higher Cho/Cr ratios, Cho/NAA ratios, and lipid and/or lactate peak grades were found in atypical primary CNS lymphomas when compared with those of tumefactive demyelinating lesions. The area under the receiver operating characteristic curve of conventional MR was improved from 0.827 to 0.870 when Cho/NAA ratio was added in the uncertain cases.

CONCLUSIONS

(1)H-MR spectroscopy may be useful for differentiating primary CNS lymphomas from tumefactive demyelinating lesions. Cho/NAA ratio could provide added value to conventional MR imaging.

Evidence of a new narrow resonance decaying to χ(c1)γ in B→χ(c1)γK

We report measurements of B→χ(c1)γK and χ(c2)γK decays using 772×10(6) BB[over ¯] events collected at the Υ(4S) resonance with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. Evidence of a new resonance in the χ(c1)γ final state is found with a statistical significance of 3.8σ. This state has a mass of 3823.1±1.8(stat)±0.7(syst) MeV/c(2), a value that is consistent with theoretical expectations for the previously unseen 1(3)D(2) cc[over ¯] meson. We find no other narrow resonance and set upper limits on the branching fractions of the X(3872)→χ(c1)γ and χ(c2)γ decays.

A comparison of inflammatory mediator expression between palmoplantar pustulosis and pompholyx

BACKGROUND

Both palmoplantar pustulosis (PPP) and pompholyx are clinically characterized by acute eruptions of vesicles or pustules on the palms or soles.

OBJECTIVES

This study aims to compare the expression of certain inflammatory mediator genes and proteins between patients with PPP and pompholyx using skin tissue samples.

METHODS

Skin biopsies obtained from lesional skin from patients with PPP (n = 7) and pompholyx (n = 5) were analysed by quantitative RT-PCR to measure the mRNA levels of nine genes, including IL-4, IL-8, IL-9, IL-17, IL-22, IFN-γ, CCL-20, granzyme and perforin. For immunohistochemical analysis, 34 paraffin-embedded skin specimens (PPP, n = 22; pompholyx, n = 12) were stained with anti-IL-8, IL-17A, IL-22 and granzyme B antibodies.

RESULTS

Of genes analysed, IL-8 and IL-17A mRNA expression levels were significantly higher in the PPP group than the pompholyx group (P = 0.012 in both), whereas the mRNA expression of granzyme B was significantly higher in pompholyx when compared with PPP (P = 0.004). Regarding the IL-17A immunohistochemical staining, tissue from the PPP lesions contained significantly more IL-17A(+) cells in both the epidermis and papillary dermis when compared with pompholyx (P < 0.001 and P = 0.019 respectively). Moreover, the intensity of the IL-8 immunoreactivity was also greater in the PPP skin lesions than the pompholyx tissue (P < 0.001).

CONCLUSIONS

IL-8 and IL-17A, both are increased in PPP tissue, may represent important immunologic mediators that help to differentiate this clinical entity from pompholyx. This study may provide useful clues in distinguishing PPP from pompholyx, as well as helping to understand the pathogeneses of these two diseases.

Copper toxicosis in New Zealand White rabbits (Oryctolagus cuniculus)

Six 12- to 14-month-old New Zealand White rabbits were diagnosed with copper toxicosis. These rabbits were part of a group of 110 purchased and shipped overnight for research purposes. On arrival, the group experienced an abrupt diet change. Eight died over 3 weeks and 6 were submitted for postmortem examination. Microscopic findings included severe centrilobular to midzonal hepatocellular necrosis with rhodanine stain-positive copper granules in the remaining hepatocytes. Mild periportal fibrosis and biliary hyperplasia, hemoglobinuric nephrosis, and splenic erythrophagocytosis were also observed. Hepatic copper concentrations were elevated, ranging from 319 to 997 ppm. Clinical disease was not previously observed in younger rabbits gradually transitioned from the supplier's copper-supplemented diet. Copper toxicosis likely occurred in these rabbits from a combination of (1) increased duration of copper supplementation leading to increased hepatocellular stores and (2) stress leading to anorexia and release of hepatocellular copper stores similar to chronic copper toxicosis as described in sheep.

Early bloodstream infection after pediatric living donor living transplantation

To determine the perioperative risk factors for bacterial infections after pediatric living donor liver transplantation (LDLT), we investigated the clinical profiles of 149 children who underwent pediatric LDLT between 1994 and 2008. Bacterial infections were diagnosed based on guidelines proposed by the Centers for Disease Control. We observed 36 bloodstream infections (BSIs) in 32/149 (21.5%) patients (0.24 infections per patient), which, 21 (58.3%) BSIs in 19 patients were due to gram-positive and 15 (41.7%) in 13 patients to gram-negative organisms. The most common pathogens of early BSI were coagulase-negative Staphylococcus; (n = 11; 30.6%) and Klebsiella pneumoniae (n = 8; 22.2%). The most common site of early BSI was catheter-related (n = 14; 38.9%). Multivariate analysis showed that age ≤ 1 year (P < .05; odds ratio [OR] = 3.90; 95% CI, 1.83-15.26) and bile duct complications (P < .05; OR = 6.2, 95% CI = 3.21-35.23) were significant independent risk factors for early BSIs. More cautious management of pediatric LDLTs may be necessary for younger age children particularly with postoperative biliary complications.

Radiological response predicts survival following transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma

BACKGROUND

It remains unclear whether initial compact lipiodol uptake after transarterial chemoembolisation (TACE) is associated with improved survival in patients with hepatocellular carcinoma (HCC).

AIM

To reveal the clinical relevance of compact lipiodolisation after TACE.

METHODS

We studied 490 patients with unresectable HCC who had first been treated with TACE. Compact lipiodolisation was defined as the absence of an arterial enhancing lesion, reflecting complete lipiodol uptake, as assessed by dynamic computed tomography (CT) 1 month after treatment. The rate of initial compact lipiodolisation was analysed according to multiplicity and size of tumour, and survival of patients who achieved compact lipiodolisation was compared to that of patients who did not.

RESULTS

Of the 490 patients, 409 (83.5%) were in Child-Pugh class A and 81 (16.5%) in class B. The rate of initial compact lipiodolisation in single HCCs was higher than that in multinodular HCCs (33.7% vs. 14.6%, P < 0.001). Among single HCCs, the rate of compact lipiodolisation in tumours ≤5, 5-10 and >10 cm was 46.6%, 13.6%, and 0% respectively. The 1-, 3- and 5-year survival rates of patients with compact uptake were 92.7%, 70.7% and 52.4% compared to 60.8%, 28.0% and 16.9% in patients with noncompact lipiodolisation. Multivariate analysis revealed that Child-Pugh class, alpha-fetoprotein level, tumour node metastasis stage, portal vein thrombosis and initial compact lipiodolisation were independent predictors of survival.

CONCLUSIONS

Initial compact lipiodol uptake after transarterial chemoembolisation is associated with improved survival in patients with unresectable hepatocellular carcinoma. Accordingly, initial complete lipiodolisation should be considered a relevant therapeutic target.

Formation of NaCl-type monodeuteride LaD by the disproportionation reaction of LaD2

Previous x-ray diffraction measurements revealed the pressure-induced decomposition of an fcc LaH2.3 into H-rich and H-poor fcc phases around 11 GPa. The present neutron diffraction measurements on LaD2 confirm the formation of NaCl-type LaD as a counterpart of the D-rich LaD2+δ by disproportionation. First-principles enthalpy and lattice dynamic calculations demonstrate that the NaCl-type LaH is stabilized at high pressures and can be recovered at ambient conditions. Finding the NaCl-type LaH will pave the way for investigations on the site-dependent nature of hydrogen-metal interactions.

The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery

BACKGROUND

We conducted a population-based retrospective cohort study to investigate the influence of hospital volume, delay of surgery, and both together on the long-term survival of postoperative cancer patients.

METHODS

Using information from the Korea Central Cancer Registry from 2001 through 2005 and the National Health Insurance claim database, we determined survival for 147 682 patients who underwent definitive surgery for any of six cancers.

RESULTS

Regardless of cancer site, surgical patients in low- to medium-volume hospitals showed significantly worse survival [adjusted hazard ratio (aHR) = 1.36-1.86] than those in high-volume hospitals in multivariable analyses. Among the latter, treatment delays > 1 month were not associated with worse survival for stomach, colon, pancreatic, or lung cancer but were for rectal [aHR = 1.28; 95% confidence interval (CI), 1.17-1.40] and breast (aHR = 1.59; 95% CI, 1.37-1.84) cancer. For patients in low- to medium-volume hospitals, treatment delay was associated with worse survival for all types of cancer (aHR = 1.78-3.81).

CONCLUSION

Our findings suggest that the effect of hospital volume and surgical treatment delay on overall survival of cancer patients should be considered in formulating or revising national health policy.

Lymph node ratio is an independent prognostic factor in patients with rectal cancer treated with preoperative chemoradiotherapy and curative resection

PURPOSE

To evaluate the prognostic effect of lymph node ratio (LNR) in patients with locally advanced rectal cancer who were treated with curative resection after preoperative chemoradiotherapy (CRT).

METHODS

Between October 2001 and December 2007, 519 patients who had undergone curative resection of primary rectal cancer after preoperative CRT were enrolled. Of these, 154 patients were positive for lymph node (LN) metastasis and were divided into three groups according to the LNR (≤ 0.15 [n=80], 0.16-0.3 [n=44], >0.3 [n=30]) to evaluate the prognostic effect on overall survival (OS) and disease-free survival (DFS).

RESULTS

LNR (≤ 0.15, 0.16-0.3, and >0.3) was significantly associated with 5-year OS (90.3%, 75.1%, and 45.1%; p<0.001) and DFS (66.7%, 55.8%, and 21.9%; p<0.001) rates. In a multivariate analysis, LNR (≤ 0.15, 0.16-0.3, and >0.3) was a significant independent prognostic factor for OS (hazard ratios [HRs], 1, 3.609, and 8.197; p<0.001) and DFS (HRs, 1, 1.699, and 3.960; p<0.001). LNR had a prognostic impact on OS and DFS in patients with <12 harvested LNs, as well as in those with ≥ 12 harvested LNs (p<0.05).

CONCLUSION

LNR was a significant independent prognostic predictor for OS and DFS in patients with locally advanced rectal cancer who were treated with curative resection after preoperative CRT.