Strategy and Long-term Outcomes of Endovascular Treatment for Budd–Chiari Syndrome Complicated by Inferior Vena Caval Thrombosis

ObjectivesThe aim of this study was to evaluate the strategy and long-term outcomes of endovascular treatment of Budd–Chiari syndrome (BCS) complicated by inferior vena cava (IVC) thrombosis.MethodsThe treatment strategy and outcomes of BCS complicated by IVC thrombosis were retrospectively evaluated in a single-center study. The treatment was aimed at the IVC thrombus, not hepatic vein occlusion. All 133 patients with BCS complicated by IVC thrombosis from February 2003 to March 2013 underwent endovascular treatment. For the fresh thrombus group (n = 75) recanalization was performed after transcatheter thrombolysis with urokinase. For the mixed thrombus group (n = 19) a small balloon pre-dilation of the IVC was performed first, followed by transcatheter thrombolysis using urokinase and a large balloon dilation of the IVC. For the old thrombus group (n = 39) a large balloon dilation or/and stent placement was performed directly. Pre- and post-treatment follow-ups were recorded.ResultsThe endovascular treatment was successful in 131 out of 133 patients (98.5%). Thirty seven patients had synchronous hepatic vein occlusion. The incidence of serious complications was 4.5% (6/133). Symptomatic pulmonary embolism occurred in three cases, cerebral hemorrhage in two, and cardiac tamponade in one. The cumulative 1-, 5-, and 10-year primary patency rate was 96.3%, 84.0%, and 64.6%, respectively. The cumulative 1-, 5-, and 10-year secondary patency rate was 99.0%, 96.1% and 91.3%, respectively. Segmental occlusion of the IVC and duration of anticoagulant therapy less than 6 months were independent risk factors for reocclusion.ConclusionsFor patients with BCS complicated by IVC thrombosis, an individualized treatment strategy based on the property of the thrombus can result in excellent long-term patency

Ferromagnetism and Canted Spin Phase in AlAs/GaMnAs Single Quantum Wells: Monte Carlo Simulation

The magnetic order resulting from a confinement-adapted Ruderman-Kittel-Kasuya-Yosida indirect exchange between magnetic moments in the metallic phase of a AlAs/Ga(1-x)Mn(x)As quantum well is studied by Monte Carlo simulation. This coupling mechanism involves magnetic moments and carriers (holes), both coming from the same Mn(2+) ions. It leads to a paramagnetic, a ferromagnetic, or a canted spin phase, depending on the carrier concentration, and on the magnetic layer width. It is shown that high transition temperatures may be obtained.Comment: 7 figure

Nivolumab in Advanced Hepatocellular Carcinoma: Safety Profile and Select Treatment-Related Adverse Events From the CheckMate 040 Study

Background. CheckMate 040 assessed the efficacy and safety of nivolumab in patients with advanced hepatocellular carcinoma (HCC). Understanding the safety profile of nivolumab is needed to support the management of treatment-related adverse events (TRAEs). This analysis assessed the safety of nivolumab monotherapy in the phase I/II, open-label CheckMate 040 study. Materials and Methods. Select TRAEs (sTRAEs; TRAEs with potential immunologic etiology requiring more frequent monitoring) occurring between first dose and 30 days after last dose were analyzed in patients in the dose-escalation and -expansion phases. Time to onset (TTO), time to resolution (TTR), and recurrence of sTRAEs were assessed, and the outcome of treatment with immune-modulating medication (IMM) was evaluated. Results. The analysis included 262 patients. The most common sTRAE was skin (35.5%), followed by gastrointestinal (14.5%) and hepatic (14.1%) events; the majority were grade 1/2, with 10.7% of patients experiencing grade 3/4 events. One patient had grade 5 pneumonitis. Median (range) TTO ranged from 3.6 (0.1–59.9) weeks for skin sTRAEs to 47.6 (47.1–48.0) weeks for renal sTRAEs. Overall, 68% of sTRAEs resolved, with median (range) TTR ranging from 3.7 (0.1–123.3+) weeks for gastrointestinal sTRAEs to 28.4 (0.1–79.1) weeks for endocrine sTRAEs. Most gastrointestinal and all hepatic events resolved with treatment in accordance with established toxicity management algorithms. In 57 patients (40%), sTRAEs were managed with IMM. Reoccurrence of sTRAEs was uncommon following rechallenge with nivolumab. Conclusion. Nivolumab demonstrated a manageable safety profile in this analysis of patients with advanced HCC. A majority of sTRAEs resolved with treatment

High Altitude test of RPCs for the ARGO-YBJ experiment

A 50 m**2 RPC carpet was operated at the YangBaJing Cosmic Ray Laboratory (Tibet) located 4300 m a.s.l. The performance of RPCs in detecting Extensive Air Showers was studied. Efficiency and time resolution measurements at the pressure and temperature conditions typical of high mountain laboratories, are reported.Comment: 16 pages, 10 figures, submitted to Nucl. Instr. Met

\eta-superconductivity in the Hubbard chain with pair hopping

The ground state phase diagram of the 1D Hubbard chain with pair-hopping interaction is studied. The analysis of the model is performed using the continuum-limit field theory approach and exact diagonalization studies. At half-filling the phase diagram is shown to consist of two superconducting states with Cooper pair center-of-mass momentum Q=0 (BCS-\eta_0 phase) and Q=\pi (\eta_\pi-phase) and four insulating phases corresponding to the Mott antiferromagnet, the Peierls dimerized phase, the charge-density-wave (CDW) insulator as well as an unconventional insulating phase characterized by the coexistence of a CDW and a bond-located staggered magnetization. Away from half-filling the phase diagram consists of the superconducting BCS-\eta_0 and \eta_\pi phases and the metallic Luttinger-liquid phase. The BCS-\eta_0 phase exhibits smooth crossover from a weak-coupling BCS type to a strong coupling local-pair regime. The \eta_\pi phase shows properties of the doublon (zero size Cooper pair) superconductor with Cooper pair center-of-mass momentum Q=\pi. The transition into the \eta_\pi- paired state corresponds to an abrupt change in the groundstate structure. After the transition the conduction band is completely destroyed and a new \eta_\pi-pair band corresponding to the strongly correlated doublon motion is created.Comment: 15 pages Revtex, 15 embedded eps figure

Association of inflammatory biomarkers with clinical outcomes in nivolumab-treated patients with advanced hepatocellular carcinoma

Background & Aims: Nivolumab, a programmed death (PD)-1 (PD-1) inhibitor, led to durable responses, manageable safety, and increased survival in patients with advanced hepatocellular carcinoma (HCC). In our retrospective analysis, we studied the immunobiology and potential associations between biomarkers and outcomes with nivolumab in HCC. Methods: Fresh and archival tumour samples from dose-escalation and dose-expansion phases of the CheckMate 040 trial were analysed by immunohistochemistry and RNA sequencing to assess several inflammatory gene expression signatures, including CD274 (PD-ligand 1 [PD-L1]), CD8A, LAG3, and STAT1. Biomarkers were assessed for association with clinical outcomes (best overall response by blinded independent central review per RECIST v1.1 and overall survival [OS]). Results: Complete or partial tumour responses were observed in PD-L1-positive and PD-L1-negative patients treated with nivolumab monotherapy. Median OS was 28.1 (95% CI 18.2-n.a.) vs. 16.6 months (95% CI 14.2-20.2) for patients with tumour PD-L1 >= 1% vs. <1% (p = 0.03). Increased CD3 and CD8 showed a non-significant trend towards improved OS (both p = 0.08), and macrophage markers were not associated with OS. Tumour PD-1 and PD-L1 expression were associated with improved OS (p = 0.05 and p = 0.03, respectively). An inflammatory gene signature consisting of 4 genes was associated with improved objective response rate (p = 0.05) and OS (p = 0.01). Conclusions: PD-1 and PD-L1 expression, biomarkers of inflammation, and inflammatory gene signatures trended with improved survival and response. While further confirmation within a larger phase III trial is needed to evaluate predictive value of these biomarkers, these exploratory analyses suggest that anti-tumour immune response may play a role in the treatment benefit of nivolumab in HCC. Lay summary: Certain tests may be used to provide a picture of how a tumour is escaping the immune system, allowing it to continue to grow and create more tumours. Therapies such as nivolumab are designed to help the immune system fight the tumour. These tests may be used to determine how effective such therapies will be in the treatment of advanced liver cancer. (C) 2020 European Association for the Study of the Liver. Published by Elsevier B.V