scholarly journals Clinical Role of Newly Developed ALBI and mALBI Grades for Treatment of Hepatocellular Carcinoma

2020 ◽  
Vol 10 (20) ◽  
pp. 7178
Author(s):  
Atsushi Hiraoka ◽  
Takashi Kumada
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Function ◽  
Tumor Burden ◽  
Clinical Role ◽  
Hepatic Reserve ◽  
Therapeutic Modalities ◽  
Recent Developments ◽  
Detailed Assessment ◽  
Relationship Of

Hepatocellular carcinoma (HCC) is a leading cause of death worldwide. The selection of therapeutic modalities and the prognosis of affected patients are well known to be dependent not only on the tumor burden but also on the hepatic reserve function. Antiviral treatments for chronic hepatitis related to a viral infection and an increase in cases of nonviral HCC associated with the aging of society have resulted in dramatic changes regarding the characteristics of HCC patients. With recent developments in therapeutic modalities for HCC, a more detailed assessment of hepatic function has become an important need. Studies in which the relationship of albumin-bilirubin (ALBI) grade with the prognosis of HCC patients was investigated were reviewed in order to evaluate the usefulness of newly developed ALBI and modified ALBI (mALBI) grades for HCC treatment, as those scoring methods are considered helpful for predicting the prognosis and selecting therapeutic modalities based on the expected prognosis.

scholarly journals Changes in Background Liver Function in Patients with Hepatocellular Carcinoma over 30 Years: Comparison of Child-Pugh Classification and Albumin Bilirubin Grade

Liver Cancer ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 518-528 ◽  
Author(s):  
Takashi Kumada ◽  
Hidenori Toyoda ◽  
Toshifumi Tada ◽  
Satoshi Yasuda ◽  
Junko Tanaka
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Hepatic Function ◽  
Hepatic Reserve ◽  
Significant Survival ◽  
Detailed Evaluation ◽  
Group A ◽  
Group B ◽  
Survival Differences ◽  
Group D

Background: Background liver function in patients with hepatocellular carcinoma (HCC) has improved remarkably with advances in various treatments. Recently, the Child-Pugh classification (CPC) system has been recognized as limited in its ability to assess patients with good hepatic reserve. We compared the albumin-bilirubin (ALBI) grade, which is suitable for a more detailed evaluation of patients with good liver function, with CPC over a 30-year period. Methods: A total of 2,347 patients were analyzed. Patients were stratified by year of diagnosis into 6 groups: Group A (1990–1994, n = 376), Group B (1995–1999, n = 434), Group C (2000–2004, n = 438), Group D (2005–2009, n = 444), Group E (2010–2014, n = 392), and Group F (2015–2018, n = 263). We compared ALBI grade and CPC across the groups. Results: The prevalence of patients with CPC A at diagnosis increased throughout the study period, reaching nearly 80% in Groups E and F (p < 0.001). By contrast, the percentage of patients with ALBI grade 1 disease remained approximately 50% in Groups E and F (p < 0.001). Modified ALBI (mALBI) grade 2a corresponds to patients with CPC A who have poor hepatic function. There were significant survival differences between patients with mALBI grade 1 versus 2a, 1 versus 2b, and 2a versus 2b disease, respectively (p < 0.0001), in patients with CPC A. Conclusions: CPC is not suitable for assessing patients with recently diagnosed HCC and good remnant hepatic function. In such patients with HCC, the prognosis can be stratified by ALBI grade rather than CPC.

Clinical role of MMP-2/TIMP-2 imbalance in hepatocellular carcinoma

2002 ◽  
Vol 97 (4) ◽  
pp. 425-431 ◽  
Author(s):  
Gianluigi Giannelli ◽  
Carlo Bergamini ◽  
Felice Marinosci ◽  
Emilia Fransvea ◽  
Michele Quaranta ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Role

scholarly journals Hepatocellular carcinoma: epidemiology, screening, and assessment of hepatic reserve

2020 ◽  
Vol 27 (S3) ◽  
Author(s):  
J.M. Schwartz ◽  
S.Z. Frager
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumour Detection ◽  
Hepatic Reserve ◽  
Screening And Surveillance ◽  
Related Mortality

Hepatocellular carcinoma is a leading cause of cancer-related mortality worldwide. This review summarizes the epi­demiology, causes, and roles of screening and surveillance for early tumour detection. It also highlights the important role of assessment of hepatic reserve in consideration of appropriate staging and treatment.

Liaison Psychiatry

1983 ◽  
Vol 143 (5) ◽  
pp. 519-520 ◽  
Author(s):  
Richard Mayou
Keyword(s):  
Liaison Psychiatry ◽  
Clinical Role ◽  
Psychological Reactions ◽  
Recent Developments ◽  
Consultation Liaison Psychiatry ◽  
Medical Wards ◽  
Practical Impact ◽  
Quality Of Research

A previous paper in this series with the same title (Lipowski, 1979) described the history and recent developments in the organisation of consultation liaison psychiatry. I therefore cover two other aspects, the nature of the psychological reactions to physical illness and the clinical role of the psychiatrist working on general surgical and medical wards. Lipowski remarked on the “generally mediocre quality of research” and on the lack of a “single fully adequate textbook”. These deficiencies remain all too apparent and the increasingly large literature is still mainly “clinical and anecdotal”. However straightforward clinical descriptions do provide an essential background to understanding the practical impact on patients' and families' lives of illnesses and of their treatment. A good knowledge of medicine is also essential and the liaison psychiatrist requires an up to date textbook and should try and read review papers and editorials in the general medical journals.

The Synoptic Problem: Where to from here?

2017 ◽  
Vol 30 (1) ◽  
pp. 72-87
Author(s):  
Christopher John Monaghan
Keyword(s):  
Oral Tradition ◽  
First Century ◽  
Synoptic Problem ◽  
Wide Range ◽  
Recent Developments ◽  
Relationship Of ◽  
The Relationship

The study of the Synoptic Problem continues with a wide range of hypotheses proposed to explain the relationship of Mark, Matthew and Luke to the early Jesus tradition, and to each other. This article reviews recent developments in synoptic studies highlighting the recognition of the ongoing role of the oral tradition, the ways in which scribal compositional practices in the first century have been used to test the major hypotheses, and the methodological constraints that accompany research in this area.

scholarly journals Bridging to Liver Transplant: Role of Percutaneous Ethanol Injection in Patients with Hepatocellular Carcinoma and Marginal Hepatic Reserve

2017 ◽  
Author(s):  
Michael Heller ◽  
Nicholas Fidelman ◽  
Maureen Kohi ◽  
Kanti Kolli ◽  
Andrew Taylor ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplant ◽  
Percutaneous Ethanol Injection ◽  
Ethanol Injection ◽  
Hepatic Reserve

scholarly journals NLRP12 suppresses hepatocellular carcinoma via downregulation of cJun N-terminal kinase activation in the hepatocyte

eLife ◽  
2019 ◽  
Vol 8 ◽  
Author(s):  
SM Nashir Udden ◽  
Youn-Tae Kwak ◽  
Victoria Godfrey ◽  
Md Abdul Wadud Khan ◽  
Shahanshah Khan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inflammatory Responses ◽  
Human Cancer ◽  
Tumor Burden ◽  
Negative Regulator ◽  
Hepatocyte Proliferation ◽  
Kinase Activation ◽  
Jnk Activation ◽  
Proliferation Of Hepatocytes

Hepatocellular carcinoma (HCC) is a deadly human cancer associated with chronic inflammation. The cytosolic pathogen sensor NLRP12 has emerged as a negative regulator of inflammation, but its role in HCC is unknown. Here we investigated the role of NLRP12 in HCC using mouse models of HCC induced by carcinogen diethylnitrosamine (DEN). Nlrp12-/- mice were highly susceptible to DEN-induced HCC with increased inflammation, hepatocyte proliferation, and tumor burden. Consistently, Nlrp12-/- tumors showed higher expression of proto-oncogenes cJun and cMyc and downregulation of tumor suppressor p21. Interestingly, antibiotics treatment dramatically diminished tumorigenesis in Nlrp12-/- mouse livers. Signaling analyses demonstrated higher JNK activation in Nlrp12-/- HCC and cultured hepatocytes during stimulation with microbial pattern molecules. JNK inhibition or NLRP12 overexpression reduced proliferative and inflammatory responses of Nlrp12-/- hepatocytes. In summary, NLRP12 negatively regulates HCC pathogenesis via downregulation of JNK-dependent inflammation and proliferation of hepatocytes.

scholarly journals Early Antibiotic Exposure Is Not Detrimental to Therapeutic Effect from Immunotherapy in Hepatocellular Carcinoma

Liver Cancer ◽  
2021 ◽  
pp. 1-10
Author(s):  
Petros Fessas ◽  
Muntaha Naeem ◽  
Matthias Pinter ◽  
Thomas U. Marron ◽  
David Szafron ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Immune Checkpoint Inhibitor ◽  
Therapeutic Option ◽  
Progression Free Survival ◽  
Tumor Burden ◽  
Free Survival ◽  
Programmed Cell Death 1 ◽  
Predictive Role ◽  
Pugh Class

<b><i>Background and Rationale:</i></b> Immune checkpoint inhibitor (ICI) therapy is an expanding therapeutic option for hepatocellular carcinoma (HCC). Antibiotics (ATB) taken prior to or early during ICI therapy can impact immunotherapy efficacy across indications; however, the effect of ATB is undefined in HCC. <b><i>Methods:</i></b> In a large international cohort of 450 ICI recipients from Europe, North America, and Asia, we categorized patients according to timing of ATB focusing on exposure within −30 to +30 days from ICI (early immunotherapy period [EIOP]). EIOP was evaluated in association with overall survival (OS), progression-free survival (PFS), and best radiologic response using RECIST 1.1 criteria. <b><i>Results:</i></b> Our study comprised mostly cirrhotic (329, 73.3%) males (355, 79.1%) with a Child-Turcotte Pugh class of A (332, 73.9%), receiving ICI after 1 therapy line (251, 55.9%) for HCC of Barcelona clinic liver cancer stage C (325, 72.4%). EIOP (<i>n</i> = 170, 37.9%) was independent of baseline clinicopathologic features of HCC and correlated with longer PFS (6.1 vs. 3.7 months, log-rank <i>p</i> = 0.0135). EIOP+ patients had similar OS, overall response, and disease control rates (DCRs) compared to EIOP. The effect of EIOP persisted in landmark time analyses and in multivariable models, confirming the independent predictive role of EIOP in influencing PFS following adjustment for covariates reflective of tumor burden, liver function, and ICI regimen administered. In patients receiving programmed cell death-1 receptor/ligand inhibitors monotherapy, EIOP was also associated with higher DCRs (61.4% vs. 50.9%, <i>p</i> = 0.0494). <b><i>Conclusions:</i></b> Unlike other oncological indications, ATB in the 30 days before or after ICI initiation is associated with improved benefit from immunotherapy, independent of disease and treatment-related features. Evaluation of the immune microbiologic determinants of response to ICI in HCC warrants further investigation.

Shear Thickening of Concentrated Suspensions: Recent Developments and Relation to Other Phenomena

2020 ◽  
Vol 52 (1) ◽  
pp. 121-144 ◽  
Author(s):  
Jeffrey F. Morris
Keyword(s):  
Shear Thickening ◽  
Contact Forces ◽  
Concentrated Suspensions ◽  
Solid Deformation ◽  
Dense Suspensions ◽  
Recent Developments ◽  
Extreme Change ◽  
Thickening Behavior ◽  
Relationship Of

Shear thickening is the increase of the apparent viscosity as shear rate or shear stress increases. This phenomenon is pronounced in concentrated (dense) suspensions of both colloidal-scale and larger particles, with an abrupt form, known as discontinuous shear thickening, observed as the maximum flowable solid fraction is approached. An overview of observed shear thickening behavior is presented, with a discussion of present understanding of the relationship of suspension shear thickening to granular jamming. Mechanistic arguments for the extreme change in rheological properties are outlined, and recent evidence from experiment and simulation for the role of contact forces is presented. Interactions of particles by fluid mechanical lubrication, contact, and steric and electrostatic forces, together with extreme stresses that may lead to solid deformation, require consideration of surface interactions and their tribological consequences in describing shear thickening.

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