Media coverage of liver transplant events promotes donations from the deceased

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Management of recurrent hepatocellular carcinoma after liver transplant – a single center experience

Background: Hepatocellular carcinoma (HCC) recurs in 10-60% of patients after liver transplantation and carries very dismal prognosis. Optimal management of this condition has yet to be defined. Patients and Methods: All adult patients with HCC within the UCSF (University of California, San Francisco) criteria who underwent liver transplantation at Queen Mary Hospital during the period from July 1995 to September 2013 were reviewed. Two hundred and fifty-two patients were included in the analysis. They were divided into three groups for comparison: with intrahepatic recurrence (IR), with multiple or extrahepatic recurrence (MR), with no recurrence (NR). Results: HCC recurrence occurred in 35 (13.9%) patients, 3 with IR and 32 with MR. Patients in the IR and MR groups had a younger age (51 vs. 51 vs. 56 years; p=0.007), a higher pretransplant serum α-fetoprotein level (27 vs. 97.5 vs. 18 ng/mL; p=0.005), more tumor nodules (4 vs. 2 vs. 1; p=0.003) and a higher incidence of lymphovascular permeation (33% vs. 59% vs. 27%; p=0.001) than patients in the NR group. More patients in the IR and MR groups had tumors beyond the UCSF criteria on histopathology (67% vs. 56% vs. 17%) when compared with the NR group. Treatments for IR included hepatectomy, radiofrequency ablation and transarterial chemoembolization. One patient with IR remained alive 3 years after last treatment. Overall survival in the IR group was longer than that in the MR group (59 vs. 30.4 months; p<0.001). Time from transplant to recurrence was similar between the two groups (23.1 vs. 12 months; p=0.141). Conclusions: Recurrence of HCC after liver transplantation is not uncommon. Aggressive surgical treatment may prolong survival in patients with IR only. Prognosis for patients with MR is dismal. Effective systemic therapy is urgently needed.published_or_final_versio

Help-seeking behaviours for psychological distress amongst Chinese patients

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Electric-field-induced alignment of electrically neutral disk-like particles: modelling and calculation

This work reveals a torque from electric field to electrically neutral flakes that are suspended in a higher electrical conductive matrix. The torque tends to rotate the particles toward an orientation with its long axis parallel to the electric current flow. The alignment enables the anisotropic properties of tiny particles to integrate together and generate desirable macroscale anisotropic properties. The torque was obtained from thermodynamic calculation of electric current free energy at various microstructure configurations. It is significant even when the electrical potential gradient becomes as low as 100 v/m. The changes of electrical, electroplastic and thermal properties during particles alignment were discussed

New insights after the first 1000 liver transplantations at The University of Hong Kong

Background/objective: One thousand liver transplantations have been performed at the only liver transplant center in Hong Kong over a period of 22 years, which covered the formative period of living donor liver transplantation. These 1000 transplantations, which marked the journey of liver transplantation from development to maturation at the center, should be educational. This research was to study the experience and to reflect on the importance of technical innovations and case selection. Methods: The first 1000 liver transplantations were studied. Key technical innovations and surgical therapeutics were described. Recipient survival including hospital mortality was analyzed. Recipient survival comparison was made for deceased donor liver transplantation and living donor liver transplantation indicated by hepatocellular carcinoma and other diseases. Results: Among the 1000 transplantations, 418 used deceased donor grafts and 582 used living donor grafts. With the accumulation of experience, hospital mortality improved to < 2% in the past 2 years. In the treatment of diseases other than hepatocellular carcinoma, living donor liver transplantation was superior to deceased donor liver transplantation, with a 10-year recipient survival around 90%. Conclusion: Transplant outcomes have been improving consistently over the series, with a very low hospital mortality and a predictably high long-term survival. © 2015

Unique reporter-based sensor platforms to monitor signalling in cells

Introduction: In recent years much progress has been made in the development of tools for systems biology to study the levels of mRNA and protein, and their interactions within cells. However, few multiplexed methodologies are available to study cell signalling directly at the transcription factor level. &lt;p/&gt;Methods: Here we describe a sensitive, plasmid-based RNA reporter methodology to study transcription factor activation in mammalian cells, and apply this technology to profiling 60 transcription factors in parallel. The methodology uses two robust and easily accessible detection platforms; quantitative real-time PCR for quantitative analysis and DNA microarrays for parallel, higher throughput analysis. &lt;p/&gt;Findings: We test the specificity of the detection platforms with ten inducers and independently validate the transcription factor activation. &lt;p/&gt;Conclusions: We report a methodology for the multiplexed study of transcription factor activation in mammalian cells that is direct and not theoretically limited by the number of available reporters

Atlanto-axial rotatory fixation in a girl with Spondylocarpotarsal synostosis syndrome

We report a 15-year-old girl who presented with spinal malsegmentation, associated with other skeletal anomalies. The spinal malsegmentation was subsequently discovered to be part of the spondylocarpotarsal synostosis syndrome. In addition, a distinctive craniocervical malformation was identified, which included atlanto-axial rotatory fixation. The clinical and the radiographic findings are described, and we emphasise the importance of computerised tomography to characterize the craniocervical malformation complex. To the best of our knowledge, this is the first clinical report of a child with spondylocarpotarsal synostosis associated with atlanto-axial rotatory fixation

The origins of belonging : Social motivation in infants and young children

Our reliance on our group members has exerted a profound influence over our motivation: successful group functioning requires that we are motivated to interact, and engage, with those around us. In other words, we need to belong. In this article, I explore the developmental origins of our need to belong. I discuss existing evidence that, from early in development, children seek to affiliate with others and to form long-lasting bonds with their group members. Furthermore, when children are deprived of a sense of belonging, it has negative consequences for their well-being. This focus on social motivation enables us to examine why and in what circumstances children engage in particular behaviours. It thus provides an important complement to research on social cognition. In doing so, it opens up important questions for future research and provides a much-needed bridge between developmental and social psychology