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Macrovascular invasion

Konstantina Dipla, Areti Triantafyllou, Iris Grigoriadou, Evangelia Kintiraki, Georgios A Triantafyllou, Pavlos Poulios, Ioannis S Vrabas, Andreas Zafeiridis, Stella Douma, Dimitrios G Goulis
AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is a risk factor for the development of endothelial dysfunction and cardiovascular disease. However, in vivo microvascular endothelial function in GDM has not been investigated. This study aimed to examine, using near-infrared spectroscopy (NIRS), whether: (1) there are differences in microvascular reactivity and skeletal muscle oxygen consumption (m[Formula: see text]) at rest and during exercise between GDM and uncomplicated pregnancies; and (2) there is an association of NIRS indices with macrovascular function and cardiovascular disease risk factors...
October 8, 2016: Diabetologia
Vatche G Agopian, Michael P Harlander-Locke, Daniela Markovic, Ali Zarrinpar, Fady M Kaldas, Elaine Y Cheng, Hasan Yersiz, Douglas G Farmer, Jonathan R Hiatt, Ronald W Busuttil
Importance: Serum α-fetoprotein (AFP) is a biomarker for hepatocellular carcinomas (HCCs) associated with a more aggressive tumor phenotype and inferior outcomes after a liver transplant (LT). Data on the outcomes for patients with HCCs that do not produce AFP are limited. Objective: To compare characteristics and outcomes among LT recipients with radiographically apparent HCC lesions with AFP-producing tumors or with tumors that do not produce AFP (hereafter referred to as non-AFP-producing tumors), and to identify factors influencing recurrence in LT recipients with non-AFP-producing tumors...
October 5, 2016: JAMA Surgery
Jun-Tao Tan, Chang Zhao, Ning-Fu Peng, Yang Yang, Jian-Hong Zhong, Tian Yang, Ming-Hua Zheng, Yan-Yan Wang, Wen-Feng Gong, Bang-De Xiang, Le-Qun Li
AIM: The suitability of hepatic resection for older patients remains controversial. This study aimed to investigate whether age influences overall survival of patients with hepatocellular carcinoma (HCC) after resection. METHODS: Records of 1,132 patients with HCC after hepatic resection were retrospectively reviewed. Overall survival (OS) was compared between younger and older patients based on five cut-off ages (30, 40, 50, 60, and 70 years). RESULTS: Across all patients, OS was 89...
September 16, 2016: Journal of Surgical Oncology
Christina Brock, Birgitte Brock, Anne Grave Pedersen, Asbjørn Mohr Drewes, Niels Jessen, Adam D Farmer
The global prevalence of diabetes mellitus is increasing; arguably as a consequence of changes in diet, lifestyle and the trend towards urbanization. Unsurprisingly, the incidence of both micro and macrovascular complications of diabetes mirrors this increasing prevalence. Amongst the complications with the highest symptom burden, yet frequently under-diagnosed and sub-optimally treated, is diabetic autonomic neuropathy, itself potentially resulting in cardiovascular autonomic neuropathy and gastrointestinal (GI) tract dysmotility...
August 25, 2016: World Journal of Diabetes
Ji Hyun Noh, Tae-Seok Kim, Keun Soo Ahn, Yong Hoon Kim, Koo Jeong Kang
PURPOSE: This study aimed to determine which factors affect the prognosis of hepatectomy for hepatocellular carcinoma (HCC) larger than 5 cm, including the prognostic difference between tumor sizes from 5-10 cm and larger than 10 cm. METHODS: The medical records of 114 patients who underwent hepatectomy for single HCC larger than 5 cm were reviewed and analyzed retrospectively. RESULTS: In the analysis of the entire cohort of 114 patients, the 5-year overall and diseases-free survival rates were 50% and 29%, respectively...
September 2016: Annals of Surgical Treatment and Research
Fritz-Line Vélayoudom-Céphise, Kalina Rajaobelina, Catherine Helmer, Sovanndany Nov, Emilie Pupier, Laurence Blanco, Marie Hugo, Blandine Farges, Cyril Astrugue, Henri Gin, Vincent Rigalleau
BACKGROUND: We aimed to analyze the relationships between skin autofluorescence (SAF) and incident macrovascular events and renal impairment after 4 years of follow-up in patients with type 1 diabetes (T1D). METHODS: Two hundred and forty-three patients (51.2 ± 16.7 years old) with T1D participated. SAF was measured by AGE-Reader-TM at inclusion. Macrovascular events (MVE), estimated glomerular filtration rate (eGFR) and urinary albumin excretion rate (AER) were recorded then and 4 years later...
2016: Cardiovascular Diabetology
Zsófia Meiszterics, Orsolya Tímár, Balázs Gaszner, Réka Faludi, Dániel Kehl, László Czirják, Gabriella Szűcs, András Komócsi
OBJECTIVE: Cardiopulmonary manifestations have an important impact on the life expectancy of SSc patients. Functional and morphological macrovascular changes may appear early before the development of ischaemic symptoms. Several non-invasive methods are used in cardiovascular risk assessment. Heterogeneous data are available regarding these in SSc. We aimed to perform a systematic review and meta-analysis to characterize the importance of atherosclerosis in SSc. METHODS: A systematic literature search was performed to identify controlled studies on carotid intima-media thickness, flow- or nitrate-induced vasodilatation (flow-mediated dilatation, nitroglycerine-mediated dilatation), pulse wave velocity, augmentation index and ankle-brachial pressure index...
August 25, 2016: Rheumatology
K Dipla, E Kintiraki, I Grigoriadou, G Triantafyllou, A Triantafyllou, I Zografou, I S Vrabas, A Zafeiridis, D G Goulis, S Douma
OBJECTIVE: Patients with Gestational diabetes mellitus (GDM) are at increased risk for gestational hypertension. Although GDM is considered a mild metabolic dysfunction, some studies have associated GDM with alterations of endothelial responsiveness, whereas, other studies suggested that the time of exposure to hyperglycemia might be insufficient to induce micro- and macrovascular dysfunction. Near-infrared spectroscopy (NIRS) allows a non-invasive monitoring of functional changes in oxygenated hemoglobin (O2Hb) and oxygen tissue saturation (TSI) and the assessment of microvascular function within the skeletal muscle...
September 2016: Journal of Hypertension
W B Gao, S Xiao, X Lei, L Y Yang
Objective: To explore the prognostic factors that have affected the long-term survival of solitary large hepatocellular carcinoma (SLHCC) patients after hepatectomy. Methods: The clinical data of 215 SLHCC patients accepted hepatectomy in the Xiangya Hospital, Central South University from January 2004 to December 2012 were retrospectively analyzed. There were 182 males and 33 females aged from 24 to 69 years(median age was 46 years). Using a variety of statistical methods, including the Kaplan-Meier estimator and the Log-rank test, the impacts of an array of clinicopathologic factors, such as age, gender, liver cirrhosis, chronic viral hepatitis, the Child-Pugh grading, microvascular invasion, macrovascular invasion and TNM staging, on the overall survival and the disease-free survival of SLHCC patients after hepatectomy were analyzed...
July 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Dawei Chen, Shuanghai Liu, Sheng Chen, Zhaowen Wang, Zehua Wu, Kai Ma, Junwei Fan, Zhihai Peng
BACKGROUND: Application of the Milan criteria is an effective strategy to select patients with hepatocellular carcinoma (HCC) for liver transplantation, but HCC recurrence is still a major concern. The aim of this study was to determine whether interleukin 6 (IL6) polymorphisms and clinical variables are potential predictors for HCC recurrence and prognosis after transplantation. METHODS: A total of 110 consecutive patients with HCC undergoing liver transplantation were enrolled in the study...
July 1, 2016: International Journal of Clinical Oncology
Julien Calderaro, Benoît Rousseau, Giuliana Amaddeo, Marion Mercey, Cécile Charpy, Charlotte Costentin, Alain Luciani, Elie-Serge Zafrani, Alexis Laurent, Daniel Azoulay, Fouad Lafdil, Jean-Michel Pawlotsky
: The prognosis of hepatocellular carcinoma (HCC) remains poor, with only one third of patients eligible to curative treatments and very limited survival benefits with the use of sorafenib, the current standard-of-care for advanced disease. Recently, agents targeting the PD-L1/PD-1 immune checkpoint were shown to display impressive antitumor activity in various solid or hematological malignancies, including HCC. PD-L1 immunohistochemical expression is thought to represent a biomarker predictive of drug sensitivity...
June 30, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Feng Xia, Li-Li Wu, Wan-Yee Lau, Hong-Bo Huan, Xu-Dong Wen, Kuan-Sheng Ma, Xiao-Wu Li, Ping Bie
AIM: To investigate the efficacy and safety of adjuvant sorafenib after curative resection for patients with Barcelona Clinic Liver Cancer (BCLC)-stage C hepatocellular carcinoma (HCC). METHODS: Thirty-four HCC patients, classified as BCLC-stage C, received adjuvant sorafenib for high-risk of tumor recurrence after curative hepatectomy at a tertiary care university hospital. The study group was compared with a case-matched control group of 68 patients who received curative hepatectomy for HCC during the study period in a 1:2 ratio...
June 21, 2016: World Journal of Gastroenterology: WJG
Andreas Andreou, Marcus Bahra, Moritz Schmelzle, Robert Öllinger, Robert Sucher, Igor M Sauer, Safak Guel-Klein, Benjamin Struecker, Dennis Eurich, Fritz Klein, Andreas Pascher, Johann Pratschke, Daniel Seehofer
BACKGROUND: Recurrence of hepatocellular carcinoma (HCC) in patients treated with liver transplantation (LT) is associated with diminished survival. Particularly, extrahepatic localization of HCC recurrence contributes to poor prognosis. PATIENTS AND METHODS: Clinicopathological data of patients who underwent LT for HCC between 1989 and 2010 in a high-volume transplant center were retrospectively evaluated, and predictors of extrahepatic recurrence were identified...
July 2016: Clinical Transplantation
Marcus Larsson, Riccardo Favilla, Tomas Strömberg
Several studies have shown that advanced glycation end products (AGE) play a role in both the microvascular and macrovascular complications of diabetes and are closely linked to inflammation and atherosclerosis. AGEs accumulate in skin and can be detected using their auto fluorescence (AF). A significant correlation exists between AGE AF and the levels of AGEs as obtained from skin biopsies. A commercial device, the AGE Reader, has become available to assess skin AF for clinical purposes but, while displaying promising results, it is limited to single-point measurements performed in contact to skin tissue...
April 12, 2016: Computers in Biology and Medicine
Barbora Obermannova, Lenka Petruzelkova, Terezie Sulakova, Zdenek Sumnik
BACKGROUND: The prevalence of macrovascular complications is probably underestimated in children with type 1 diabetes (T1D). Arterial stiffness (AS) is a subclinical marker of cardiovascular (CV) risk. The most validated, non-invasive method for AS measurement is pulse wave velocity (PWV). Only a few PWV studies have been performed in children with T1D. OBJECTIVE: To explore the risk factors associated with AS in adolescents with suboptimally controlled T1D. PATIENTS AND METHODS: Seventy-seven adolescents with T1D were included (39 girls, 38 boys) in this study...
April 14, 2016: Pediatric Diabetes
Ryan T Groeschl, David M Nagorney
PURPOSE OF REVIEW: Complete surgical resection is the only curative-intent therapy for patients with hilar cholangiocarcinoma, and obtaining negative pathologic margins is crucial to allow for prolonged disease-free survival. Macrovascular tumor invasion adds technical complexity to surgical extirpation, but can be achieved with en bloc vessel resection. This tumor extension adversely affects overall prognosis, but is nonetheless technically feasible. RECENT FINDINGS: Several recent meta-analyses have studied the short and long-term results of concomitant vascular resection during surgery for hilar cholangiocarcinoma...
May 2016: Current Opinion in Gastroenterology
Suresh Navadgi, Chi-Chun Chang, Adam Bartlett, John McCall, Sanjay Pandanaboyana
INTRODUCTION: This meta-analysis aimed to compare perioperative and survival outcomes in patients who underwent hepatectomy with and without Bile Duct Tumour Thrombus (BDTT). METHODS: A comprehensive search of Cochrane Library, PubMed, MEDLINE and EMBASE was performed to identify relevant articles. The perioperative, postoperative and long term outcomes were compared. RESULTS: Eleven studies including 6051 patients met the inclusion criteria...
April 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Sonia Pascual, Iván Herrera, Javier Irurzun
Hepatocellular carcinoma (HCC) is the leading cause of deaths in cirrhotic patients and the third cause of cancer related deaths. Most HCC are associated with well known underlying risk factors, in fact, HCC arise in cirrhotic patients in up to 90% of cases, mainly due to chronic viral hepatitis and alcohol abuse. The worldwide prevention strategies are conducted to avoid the infection of new subjects and to minimize the risk of liver disease progression in infected patients. HCC is a condition which lends itself to surveillance as at-risk individuals can readily be identified...
March 28, 2016: World Journal of Hepatology
Bert Bond, Craig A Williams, Alan R Barker
BACKGROUND: Impairments in macrovascular, microvascular and autonomic function are present in asymptomatic youths with clustered cardiovascular disease risk factors. This study determines the within-day reliability and between-day reliability of a single protocol to non-invasively assess these outcomes in adolescents. METHODS: Forty 12- to 15-year-old adolescents (20 boys) visited the laboratory in a fasted state on two occasions, approximately 1 week apart. One hour after a standardized cereal breakfast, macrovascular function was determined via flow-mediated dilation (FMD)...
March 22, 2016: Clinical Physiology and Functional Imaging
Tsung-Han Wu, Etsuro Hatano, Kenya Yamanaka, Satoru Seo, Kojiro Taura, Kentaro Yasuchika, Yasuhiro Fujimoto, Takashi Nitta, Masaki Mizumoto, Akira Mori, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto
PURPOSES: Microvascular invasion (mVI) is known to be a risk factor of hepatocellular carcinoma (HCC) recurrence. Several factors such as the tumor grade, tumor size, tumor margin status on imaging studies, fluorine-18 fluorodeoxyglucose-positron emission tomography ((18)F-FDG-PET) results, and tumor markers have been proposed to predict mVI of HCC. However, the values of these factors have not yet been validated. METHODS: Among the patients evaluated using enhanced CT/MRI, (18)F-FDG-PET, and tumor markers prior to hepatectomy from 2007 to 2012, 79 HCC patients without apparent macrovascular invasion in preoperative imaging were enrolled in this study...
November 2016: Surgery Today
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