Percutaneous cryoablation in early stage hepatocellular carcinoma: analysis of local tumor progression factors

PURPOSEWe aimed to evaluate the effectiveness and safety of percutaneous cryoablation (PC) for early or very early stage hepatocellular carcinoma (HCC) and assess the risk factors for local tumor progression (LTP) after PC.METHODSA total of 45 treatment-naïve patients treated with PC for early or very early stage HCCs were included in this retrospective study. The safety of PC was assessed by evaluating procedure-related complications and comparing hepatic function before and after the procedure. The effectiveness was assessed by evaluating technical success, LTP rates, and disease progression (DP) rates. Prognostic factors associated with LTP after PC were also analyzed.RESULTSTechnical success and complete response were achieved in all patients (100%) by 1 month after PC. During a mean of 28.1±15.6 months of follow-up, the incidences of LTP and DP were 11.1% and 37.8%, respectively. The LTP-free and DP-free survival rates were 93.3% and 84.4% at 1 year and 88.9% and 62.2% at 2 years, respectively. Hepatic function was normalized within 3 months after PC. There were no major complications and only one minor complication of small hematoma. On univariate and multivariate analysis, minimal ablative margin <5 mm was the only significant risk factor associated with LTP.CONCLUSIONPC is a safe and effective therapy for patients with early or very early stage HCC. Minimal ablative margin <5 mm was a significant prognostic factor for LTP

Percutaneous Stent Placement for Pancreatic Duct Stricture in a Patient with Previous Gastric and Pancreatic Surgery

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Real-time simultaneous endoscopic combined intrarenal surgery with intermediate-supine position: Washout mechanism and transport technique

Endoscopic combined intrarenal surgery (ECIRS) with simultaneous retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) has been proposed as a new surgical treatment to overcome the disadvantage of RIRS and PCNL monotherapies in the treatment of renal stone. One of advantages of ECIRS is that it can increase stone-free rates in complex renal stone within single-session. Intermediate-supine position in real-time simultaneous ECIRS can prevent an anesthesiologic problem, and patient's burden is small even for long-term operation. Thus, we will share the experience and advantages of real-time simultaneous ECIRS and introduce techniques to increase the stone-free rate

Brazilin Limits Inflammatory Responses through Induction of Prosurvival Autophagy in Rheumatoid Fibroblast-Like Synoviocytes.

Brazilin is an active compound of Caesalpinia sappan L. (Leguminosae), which possesses pro-apoptotic and anti-inflammation potentials depending on the specific cell type. However, it is largely unknown whether autophagy is implicated in the mechanism underlying its chemotherapeutic and anti-inflammatory effects in rheumatoid arthritis (RA). Here, we show that treatment of RA fibroblast-like synoviocytes (FLS) with brazilin results in enhanced level of autophagic flux, evidenced by accumulation of autophagosome and increased level of lipidated LC3 (LC3-II), which is mainly mediated by enhanced production of reactive oxygen species (ROS). Interestingly, long-term exposure of brazilin was able to restore cell survival against the cytotoxity, exclusively in RA FLS, but not in normal fibroblast. Importantly, such a restoration from brazilin-induced cytotoxity in RA FLS was completely abrogated after co-treatment with autophagy inhibitors including NH4Cl or chloroquine. Furthermore, we found that the pretreatment of RA FLS with brazilin reduced LPS- or TNF-induced NF-κB activation and the secretion of inflammatory cytokines in parallel with the enhanced autophagic flux. Such anti-NF-κB potentials of brazilin were drastically masked in RA FLS when autophagy was suppressed. These results suggest that brazilin is capable of activating autophagy exclusively in RA FLS, and such inducible autophagy promotes cell survival and limits inflammatory response