Comparison of conservative treatment versus transcatheter arterial embolisation for the treatment of spontaneously ruptured hepatocellular carcinoma

Purpose: To elucidate the prognostic factors in the spontaneous rupture of hepatocellular carcinoma (HCC) and to determine whether transcatheter arterial embolisation (TAE) is associated with better prognosis compared to conservative treatment. Material and methods: A retrospective multicentre study was conducted involving 71 patients with spontaneous rupture of HCC. A conservative treatment group (Cons T group) included 20 patients, while a transcatheter arterial embolisation group (TAE group) included 51 patients. Results: The median survival time (MST) in the Cons T group was only 16 days and the survival rate was 39% at one month, whereas the MST in the TAE group was 28 days and the one month survival rate was 63%. However, there is no statistically significant difference in the overall survival between Cons T and TAE groups (p = 0.213). Multivariable analysis identified only the presence of distant metastasis as an independent prognostic factor (p = 0.023). A subanalysis including patients without distant metastasis showed that the presence of portal vein tumour thrombosis was a significant prognostic factor (p = 0.015). Conclusions: Distant metastasis appears to be a prognostic factor in spontaneous rupture of HCC. In cases without distant metastasis, portal vein tumour thrombosis could influence the prognosis. Our data failed to prove any benefit of TAE as the primary management

The politics of economic collapse: a comparative historical sociology of the 2008 crisis

The 2008 financial crisis was the second major financial crisis in modern history. Like the 1930s Great Depression, the 2008 Great Recession shook political and social arenas. From socio-economic policy reforms to popular political mobilisations, advanced capitalist countries underwent important political and institutional reconfigurations. Yet 12 years later, and despite the depth and scale of these initial responses, neoliberal domestic configurations that had been in place since the 1980s withstood in the longer term. Institutional and social responses suggest that the postwar market embeddedness that facilitated unprecedented levels of social and economic welfare in Europe is perhaps now in terminal regression. Given the historical magnitude of the Great Recession and the responses it occasioned, this study asks: can we empirically establish (a) historical path(s) between the Great Depression in the 1930s and the Great Recession in 2008 amongst the selected Western European countries? Viewed comparatively and being mindful of their longer trajectories, how did they converge or diverge in the run-up to 2008 and how their convergence/divergence explains their institutional response to the crisis? And, can we identify opportunities for significant paradigm-changing reactions from the Western European publics or civil societies? Recent sociological work has sought to understand 2008 by examining sociodemographic, institutional and attitudinal data (e.g. Hooghe and Quintelier, 2014; Kern et al., 2015; Marien et al., 2010). Much of this scholarly work has arguably paid insufficient attention to the deeper historical embedding of the Great Recession and its political and civil society responses. By contrast, economic historians have examined the Great Recession in light of previous crises (e.g. Bordo, 2018; Kobrak and Wilkins, 2011; Nayak, 2013) but with little attention paid to civil society responses, and thereby also neglecting an important political dimension of the economic crisis. This study broadly draws on these bodies of work but seeks also to make a contribution by using a comparative historical sociological approach to explore three distinct dimensions of the Great Recession. The first is presented in Chapter 4. It positions Western European political elites’ responses to the Great Recession in a historical long-run, in which 2008 is considered in the light of the 1930s and the responses that the Great Depression had occasioned. The second dimension is presented in Chapter 5, which turns the macro-historical comparative lens of the previous chapter to what might be termed a meso-level analysis. Chapter 5 thus presents a comparative examination of Western European states’ political responses according to a regime-typology (the Anglos, the Euros, and the Nordics). Finally, Chapter 6 comparatively examines survey data from the European Social Survey (ESS) to allow reflection on how Western publics responded to these various measures. Central to this thesis is the retrieval of the comparative historical sociology of Polanyi (1957), Mann (1983; 1993; 2012; 2013), and Esping-Andersen (1990). Drawing from Polanyi, I use his concepts of ‘market embeddedness’ and ‘double movement’ to examine the historical drift from welfarism to today’s neoliberalism; from Mann, I take his comprehensive ideological, economic, military, and political (IEMP) model to dissect the different causal sources of the crisis and the responses to it; and from Esping-Andersen, I employ his ideal-typical classification of modern capitalist welfare states. Following the introduction, theory, and methods discussion, Chapter 4 traces the broad lineages of the development of welfare states across Western Europe from the beginning of the 20th century and, crucially, as punctuated by the Great Depression. I show that there was a common path-dependent movement towards welfare policies after a series of major historical disruptions, but this was then reversed in the late 1970s in a new iteration of Polanyi’s double movement. Expanding the analysis of such critical juncture, Chapters 5 offers a typology to explore the varying responses to the Great Recession across three geopolitical regions: the liberal Anglos, the conservative Euros, and the social-democratic Nordics. I argue that whilst initial political responses converged in 2008 to follow an expansionary rationale reminiscent of 1930s Keynesian logic, each soon reverted fully to historical form, i.e., the neoliberal logic of austerity and fiscal discipline. More, and based on accompanying analysis of ESS data, I find that Western European publics are deeply mistrusting of democratic institutions and political actors. This supports contemporary views that see liberal democracy under threat (e.g., Runciman, 2018; Applebaum, 2020). Today’s low levels of political trust can be seen as positive feedback reinforcements of the neoliberal pathway Western Europe took in the 1980s, thus suggesting that European publics will not exert pressure for a new socially embedding move as it had partially happened in the 1930s. Yet, also importantly, this reasserts Mann’s (1970) classical argument that liberal democracy’s stability requires apathetic, non-committed publics. On this basis, I conclude that the impacts of the Great Recession are best understood against longer-term historical path-dependent political lineages

Time-resolved magnetic resonance angiography as a follow-up method for visceral artery aneurysm treated with coil-embolisation

Purpose: The purpose of this study is to assess the feasibility and usefulness of time-resolved magnetic resonance angiography (TR-MRA) for follow-up of visceral artery aneurysms (VAAs) after embolotherapy. Material and methods: Twenty-one VAAs (11 splenic, six renal, three internal iliac, and one superior pancreaticoduodenal artery aneurysms) in 18 patients (median age, 64 years; range, 36-88 years) previously treated by embolisation with platinum coils, were evaluated. The mean size of the aneurysm was 10.5 cm3 (range, 0.3-132 cm3). Among them, 19 lesions were treated by aneurysmal packing with or without distal-to-proximal embolisation. For the remaining two lesions, distal-to-proximal embolization alone was performed. The mean observation period after embolotherapy was 35 weeks (range, 4-216). All patients underwent TR-MRA following an intravenous bolus injection of gadolinium chelate. Recanalisation was diagnosed when any portion of the aneurysmal sac was enhanced in the arterial phase. Results: On TR-MRA, two lesions were diagnosed as recanalised. They were confirmed by transcatheter arteriography and re-treated by embolotherapy. For the remaining 19 lesions, there were no findings of recanalisation on TR-MRA. Conclusions: TR-MRA appears to be a feasible method for follow-up examination of VAAs treated by embolotherapy

Modelling the human epidermis in vitro: tools for basic and applied research

Culture models of tissues and organs are valuable tools developed by basic research that help investigation of the body functions. Modelling is aimed at simplifying experimental procedures in order to better understand biological phenomena, and consequently, when sufficiently characterized, culture models can also be utilized with high potential in applied research. In skin biology and pathology, the development of cultures of keratinocytes as monolayers has allowed the elucidation of most functional and structural characteristics of the cell type. Beside the multiple great successes that have been obtained with this type of culture, this review draws attention on several neglected characteristics of monolayer cultures. The more sophisticated models created in order to reconstruct the fully differentiated epidermis have followed the monolayers. The epidermal reconstruction produces all typical layers found in vivo and thus makes the model much less simple, but only this kind of model allows the study of full differentiation in keratinocyte and production of the cornified barrier. In addition to its interest in basic research, the reconstructed epidermis is currently gaining a lot of interest for applied research, particularly as an alternative to laboratory animals in the chemical and cosmetic industry. Today several commercial providers propose reconstructed skin or epidermis, but in vitro assays on these materials are still under development. In order to be beneficial at long term, the validation of assays must be performed on a material whose availability will not be interrupted. We warn here providers and customers that the longevity of in vitro assays will be guaranteed only if these assays are done with well-described models, prepared according to published procedures, and must consider having a minimum of two independent simultaneous producers of similar material

Merkel Cells as Putative Regulatory Cells in Skin Disorders: An In Vitro Study

Merkel cells (MCs) are involved in mechanoreception, but several lines of evidence suggest that they may also participate in skin disorders through the release of neuropeptides and hormones. In addition, MC hyperplasias have been reported in inflammatory skin diseases. However, neither proliferation nor reactions to the epidermal environment have been demonstrated. We established a culture model enriched in swine MCs to analyze their proliferative capability and to discover MC survival factors and modulators of MC neuroendocrine properties. In culture, MCs reacted to bFGF by extending outgrowths. Conversely, neurotrophins failed to induce cell spreading, suggesting that they do not act as a growth factor for MCs. For the first time, we provide evidence of proliferation in culture through Ki-67 immunoreactivity. We also found that MCs reacted to histamine or activation of the proton gated/osmoreceptor TRPV4 by releasing vasoactive intestinal peptide (VIP). Since VIP is involved in many pathophysiological processes, its release suggests a putative regulatory role for MCs in skin disorders. Moreover, in contrast to mechanotransduction, neuropeptide exocytosis was Ca2+-independent, as inhibition of Ca2+ channels or culture in the absence of Ca2+ failed to decrease the amount of VIP released. We conclude that neuropeptide release and neurotransmitter exocytosis may be two distinct pathways that are differentially regulated

Nociceptin/orphanin FQ and opioid receptor-like receptor mRNA expression in dopamine systems

Although nociceptin/orphanin FQ (N/OFQ) influences dopamine (DA) neuronal activity, it is not known whether N/OFQ acts directly on DA neurons, indirectly by means of local circuitry, or both. We used two parallel approaches, dual in situ hybridization (ISH) and neurotoxic lesions of DA neurons by using 6-hydroxydopamine (6-OHDA), to ascertain whether N/OFQ and the N/OFQ receptor (NOP) mRNA are expressed in DA neurons in the ventral tegmental area (VTA) and substantia nigra compacta (SNc). In the VTA and SNc, small populations (∼6–10%) of N/OFQ-containing neurons coexpressed mRNA for tyrosine hydroxylase (TH), the rate-limiting enzyme for DA synthesis. Similarly, very few (1–2%) TH-positive neurons contained N/OFQ mRNA signal. A majority of NOP-positive neurons (∼75%) expressed TH mRNA and roughly half of the TH-containing neurons expressed NOP mRNA. Many N/OFQ neurons (∼50–60%) expressed glutamic acid decarboxylase 65 and 67 mRNAs, markers for Γ-aminobutyric acid (GABA) neurons. In the 6-OHDA lesion studies, NOP mRNA levels were nearly 80 and 85% lower in the VTA and SNc, respectively, on the lesioned side. These lesions appear to lead to compensatory changes, with N/OFQ mRNA levels approximately 60% and 300% higher in the VTA and SNc, respectively, after 6-OHDA lesions. Finally, N/OFQ-stimulated [ 35 S]guanylyl-5′-O-(Γ-thio)-triphosphate levels were decreased in the VTA and SNc but not the prefrontal cortex after 6-OHDA lesions. Accordingly, it appears that N/OFQ mRNA was found largely on nondopaminergic (i.e., GABA) neurons, whereas NOP mRNA was located on DA neurons. N/OFQ is in a position to influence DA neuronal activity by means of the NOP located on DA neurons. J. Comp. Neurol. 444:358–368, 2002. © 2002 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34463/1/10154_ftp.pd