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LIVER TRANSPLANTATION A simple inflammation marker predicts liver cancer prognosis

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY 2011年第7期8卷 367-368页

作者： Tang, Zhao-You Liver Canc Inst Shanghai 200032 Peoples R China Zhongshan Hosp Shanghai 200032 Peoples R China

Owing to the shortage of donor organs, improved selection criteria are needed for allocating patients with hepatocellular carcinoma (HCC) to receive orthotopic liver transplantation (OLT). A study has found that the neutrophil: lymphocyte ratio independently predicts tumor recurrence after OLT for HCC and, therefore, might constitute a simple entry criterion that measures host inflammation status.

关键词： Hepatocellular Cancer molecular biology clinic human-centered computing Researchers Molecular Signature Inflammation Gene Signature

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pIgR: Frenemy of Inflammation, EMT, and HCC Progression

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JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE 2011年第22期103卷 1644-1645页

作者： Sphyris, Nathalie Mani, Sendurai A. Univ Texas MD Anderson Canc Ctr Dept Mol Pathol Houston TX 77054 USA Univ Texas MD Anderson Canc Ctr Metastasis Res Ctr Houston TX 77054 USA

Hepatocellular carcinoma (HCC) is the fifth most common neoplasm worldwide and a major cause of cancer-related death. The development of HCC has long been associated with inflammation-causing agents such as chronic viral infection with hepatitis B or C, alcoholic cirrhosis, or dietary exposure to fungal aflatoxins (1-3). Consequently, HCC progression unravels against a backdrop of persistent inflammation, extensive tissue remodeling, and excessive deposition of extracellular matrix components (2-4).

关键词： progressions Alcoholic Liver Cirrhosis Hepatitis B Virus Diseases Emergency Medical Technicians SLC22A3 gene backdrop human-centered computing Inflammation Common Neoplasm

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Rate of Tumor Growth Predicts Recurrence of Hepatocellular Carcinoma After Liver Transplantation in Patients Beyond Milan or UCSF Criteria

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TRANSPLANTATION PROCEEDINGS 2011年第10期43卷 3813-3818页

作者： Hanouneh, I. A. Macaron, C. Lopez, R. Aucejo, F. Zein, N. N. Cleveland Clin Dept Gastroenterol & Hepatol Cleveland OH 44195 USA Cleveland Clin Dept Quantitat Hlth Sci Cleveland OH 44195 USA Cleveland Clin Dept Gen Surg Transplant Ctr Cleveland OH 44195 USA

Background. It is likely that some patients whose tumor burdens exceed the current transplant criteria have favorable tumor biology, and that these patients would have low risk of tumor recurrence after liver transplantation (LT). To assess the rate of tumor growth as selection criteria for LT in patients with hepatocellular carcinoma (HCC). Methods. We identified all patients who underwent LT for HCC in our institution from 2002 to 2008. Total tumor volume (TTV) was calculated as the sum of the volumes of all tumors on pretransplantation imaging [(4/3)pi(3), where r is the maximum radius of each HCC]. The rate of tumor growth was calculated as per-month change in TTV on sequential pretransplantation imaging before any locoregional therapy. A Kaplan-Meier plot was constructed and Cox regression analysis performed. Results. Ninety-two patients were included in the study. The median follow-up was 19.5 (range 10.7-30.7) months during which 12 patients (13%) experienced recurrence of HCC. Twenty-four patients (26%) had HCC beyond the Milan criteria, and the overall survival rate of the entire group was 72%. Higher pre-LT alpha-fetoprotein (hazard ratio [HR] 1.01;P = .001), poorly differentiated tumors (HR 13;P = .039), the presence of microvascular invasion (HR 7.9;P = .001), higher TTV (HR 1.03;P < .001), and faster tumor growth (HR 1.09;P < .001) were significantly associated with the risk of recurrence. A cutoff value of tumor growth of 1.61 cm(3)/mo was chosen on the basis of the risk of recurrence with the use of a receiver operating characteristic curve. Patients beyond the Milan criteria with tumor growth <1.61 cm(3)/mo experienced less recurrence (11% vs 58%;P = .023) than those beyond the Milan criteria with tumor growth >1.61 cm(3)/mo. Similarly, rate of tumor growth predicted HCC recurrence in those beyond the University of California of San Francisco (UCSF) criteria. Conclusions. Patients with slowly growing tumor who would be currently excluded from LT beca

关键词： Level Trigger Hepatocellular Cancer tumor growth Tumours Liver Transplantation Tumor Burden human-centered computing Relapse Patients Heart Rate Recurrent Neoplasm

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Marker panels for the diagnosis of small hepatocellular carcinoma, a never-ending story

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CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY 2011年第8-9期35卷 513-515页

作者： Bioulac-Sage, Paulette Balabaud, Charles Hop Pellegrin CHU Bordeaux Serv Anat Pathol F-33076 Bordeaux France Univ Bordeaux Segalen U1053 F-33076 Bordeaux France

Small hepatocellular carcinoma (SHCC), smaller than 2 cm in diameter, are classified into two major types: small HCC of distinct nodular type (DNT-SHCC) and small HCC of indistinct (vague) nodular type (INT-SHCC), also called early HCC. DNT-SHCC are well demarcated and frequently encapsulated, and appear barely different from classical HCC despite small tumor size. They are detected as hypervas-cular nodules by radiographic imaging. Histologically, ~80% of DNT-SHCC are moderately differentiated, and the remaining 20% consist of varying mixtures of well and moderately differentiated cancerous tissues.

关键词： Hepatocellular Cancer differentiated batholith Diameter RADIOGRAPHIC IMAGING tumor size SHC3 protein, human small tumor human-centered computing Marker panels

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University of Modena Experience in HIV-Positive Patients Undergoing Liver Transplantation

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TRANSPLANTATION PROCEEDINGS 2011年第4期43卷 1114-1118页

作者： Di Benedetto, F. Tarantino, G. De Ruvo, N. Cautero, N. Montalti, R. Guerrini, G. P. Ballarin, R. Spaggiari, M. Smerieri, N. Serra, V. Rompianesi, G. D'Amico, G. Mimmo, A. Iemmolo, R. M. Codeluppi, M. Cocchi, S. Guaraldi, G. Gerunda, G. E. Univ Modena & Reggio Emilia Liver & Multivisceral Transplant Ctr I-41100 Modena Italy Univ Modena & Reggio Emilia Dept Med & Med Specialties Infect Dis Clin I-41100 Modena Italy

Introduction. Highly effective antiretroviral therapy in the last decade has increased the survival rates of HIV-positive patients, yielding a greater number of HIV patients suffering from liver-related disease. Liver transplantation (LT) is the only curative treatment for end-stage liver disease (ESLD) associated or not with hepatocellular carcinoma (HCC). Patients and methods. From June 2003 to September 2010, 23 patients underwent cadaveric donor LT for ESLD at our institution. Inclusion criteria followed the Italian Protocol for LT in HIV-positive patients. Immunosuppressive regimens were based on cyclosporine or tacrolimus, eventually switched to Rapamycin. Results. The median CD4 T-cell count was 275/mmc (range = 119-924). All patients were affected by ESLD, which was associated with HCC in 14 cases. Ten patients were within the Milan criteria and four patients exceeded them but were within the San Francisco criteria. Conversion from calcineurin inhibitors (CNI) to rapamycin occurred in ten cases. Hepatitis C virus (HCV) recurrence occurred in 13/21 HCV-positive patients. Acute cellular rejection occurred in eight patients with one developing chronic cellular rejection. Overall patient and graft survivals at 80 months were 50% and 45% respectively. Discussion. LT in HIV-positive patients is a feasible procedure, even if in our experience was burdened by a greater incidence of complications including HCV recurrence and infection compared with HIV-negative patients.

关键词： Level Trigger Graft Survival negative HIV curative treatment experience Survival Rate Sirolimus Seroconversion Liver Transplantation human-centered computing Patients universities

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Toward a Simulation and Assessment Method for the Practice of Camera-Guided Rigid Bronchoscopy

Toward a Simulation and Assessment Method for the Practice o...

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18th Medicine Meets Virtual Reality Conference / NextMed Conference

作者： Salud, Lawrence H. Peniche, Alec R. Salud, Jonathan C. De Hoyos, Alberto L. Pugh, Carla M. Northwestern Univ Dept Surg Feinberg Sch Med Chicago IL 60611 USA

ISBN: (纸本)9781607507062

We have developed a way to measure performance during a camera-guided rigid bronchoscopy using manikin-based simulation. In an effort to measure contact pressures within the airway during a rigid bronchoscopy, we instrumented pressure sensors in a commercially available bronchoscopy task trainer. Participants were divided into two groups based on self-reported levels of expertise: novice (none to minimal experience in rigid bronchoscopy) and experts (moderate to extensive experience). There was no significant difference between experts and novices in the time taken to complete the rigid bronchoscopy. However, novices touched a greater number of areas than experts, showing that novices induce a higher number of unnecessary soft-tissue contact compared to experts. Moreover, our results show that experts exert significantly less soft tissue pressure compared to novices.

关键词： Bronchoscopy Simulation Surgical Simulation Sensors Learning Technologies Simulation Support Systems Evaluation/methodology human-centered computing

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Risk score for development of HCC: ready for use in practice?

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LANCET ONCOLOGY 2011年第6期12卷 517-518页

作者： Keeffe, Emmet B. Stanford Univ Med Ctr Dept Med Div Gastroenterol & Hepatol Stanford CA 94305 USA

Surveillance is widely accepted in clinical practice in patients who are at increased risk of developing hepatocellular carcinoma (HCC), including those with chronic hepatitis B virus (HBV) infection. Surveillance in patients with HBV infection has been recommended on the basis of findings from one randomised controlled trial from China showing a survival benefit, and other non-randomised or observational studies showing that surveillance detects earlier disease and improves survival. The most recent update of practice guidelines from the American Association for the Study of Liver Diseases (AASLD) recommends surveillance for HCC in Asian male hepatitis B carriers older than 40 years, Asian female hepatitis B carriers older than 50 years, hepatitis B carriers with a family history of HCC, African and North American black patients with hepatitis B, and hepatitis B carriers with cirrhosis.

关键词： Genealogical Tree clinical practice Hepatitis B human-centered computing Practice Guideline

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Loose Ontological Coupling and the Social Semantic Web 1

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7th Atlantic Web Intelligence Conference

作者： Cudre-Mauroux, Philippe Univ Fribourg EXascale Infolab CH-1700 Fribourg Switzerland

ISBN: (数字)9783642180293

ISBN: (纸本)9783642180286

Best practices for the publication of Semantic Web data currently place an unacceptably high burden on the end-user, who is supposed to locate and embrace third-party ontological structures prior to publishing any information. In this paper, I argue for a different publication paradigm where end-users are encouraged to publish potentially incomplete or conflicting information according to their own local context, and where heterogeneous data is consolidated a posteriori through bottom-up, decentralized processes. This approach simplifies both the publication and curation processes, while opening the door to pay-as-you-go knowledge integration and human-centered social semantics. However, it also profoundly alters the semantics of the overall resulting system.

关键词： Social Semantics human-centered computing Loosely-Coupled Semantics Web of Data Emergent Semantics

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Use of Sensor Technology to Explore the Science of Touch

Use of Sensor Technology to Explore the Science of Touch

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18th Medicine Meets Virtual Reality Conference / NextMed Conference

作者： Salud, Lawrence H. Pugh, Carla M. Northwestern Univ Dept Surg Feinberg Sch Med Chicago IL 60611 USA

ISBN: (纸本)9781607507062

Two, world-renown researchers in the science of touch (Klatzky and Lederman) have shown that there are a set of reproducible and subconscious maneuvers that humans use to explore objects. Force measuring sensors may be used to electronically identify and quantify these maneuvers. Two sensored silicone breast models were configured to represent two different clinical presentations. One-hundred clinicians attending a local breast cancer meeting performed clinical breast examinations on the models, and their performance was captured using sensor-based data acquisition technology. We have found that Klatzy and Lederman's previously defined touch maneuvers are used during the clinical breast examination and can be identified and quantified for the first time using sensor technology.

关键词： Haptics Medical Simulation Sensors Learning Technologies Simulation Support Systems Evaluation/methodology human-centered computing

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Empowering Individuals with Do-It-Yourself Assistive Technology 11

Empowering Individuals with Do-It-Yourself Assistive Technol...

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13th International ACM SIGACCESS Conference on Computers and Accessibility

作者： Hurst, Amy Tobias, Jasmine Univ Maryland Baltimore Cty Baltimore MD 21250 USA

ISBN: (纸本)9781450309196

Assistive Technologies empower individuals to accomplish tasks they might not be able to do otherwise. Unfortunately, a large percentage of Assistive Technology devices that are purchased (35% or more) end up unused or abandoned [7,10], leaving many people with Assistive Technology that is inappropriate for their needs. Low acceptance rates of Assistive Technology occur for many reasons, but common factors include 1) lack of considering user opinion in selection, 2) ease in obtaining devices, 3) poor device performance, and 4) changes in user needs and priorities [7]. We are working to help more people gain access to the Assistive Technology they need by empowering non-engineers to "Do-It-Yourself" (DIY) and create, modify, or build. This paper illustrates that it is possible to custom-build Assistive Technology, and argues why empowering users to make their own Assistive Technology can improve the adoption process (and subsequently adoption rates). We discuss DIY experiences and impressions from individuals who have either built Assistive Technology before, or rely on it. We found that increased control over design elements, passion, and cost motivated individuals to make their own Assistive Technology instead of buying it. We discuss how a new generation of rapid prototyping tools and online communities can empower more individuals. We synthesize our findings into design recommendations to help promote future DIY-AT success.

关键词： Assistive Technology Do-It-Yourself Empowerment human-centered computing Online Communities Personal-scale Manufacturing Rapid Prototyping

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