Degradation of PVC waste into a flexible polymer by chemical modification using DINP moieties

In consideration of the toxicity and high migration capacity of plasticizers, the possibility to obtain flexible PVC via chemical modification of PVC was investigated for feedstock recycling. In this work, some Cl atoms of PVC were substituted with fragments of the common plasticizer DINP (diisononyl phthalate) in the presence of K₂CO₃ (potassium carbonate) or DIEA (N,N-diisopropylethylamine), and the simultaneous elimination of PVC was suppressed. ¹H NMR (¹H nuclear magnetic resonance spectroscopy) and ¹H–¹H COSY (¹H–¹H correlation spectroscopy) were used to evaluate the substitution while a novel method of calculating the substitution and elimination ratios was developed using a combination of ¹H NMR and elemental analysis. A maximum substitution rate of 35.7% was achieved using thiophenol as a nucleophile in the presence of DIEA, while the corresponding elimination of HCl was just 4.4%. In addition, the thermal stability of the modified PVCs was very close to that of pure PVC, which suggested that the main characteristics of PVC were preserved. Moreover, the T_g values of all the modified PVCs were less than that of PVC, which means it is feasible to improve the plasticity of PVC via substituting some Cl on PVC with DINP moieties. Therefore, an alternative approach for feedstock recycling of PVC by chemical modification was developed in this work.

We propose a chemical modification method to produce flexible PVC with DINP moieties.     

Indocyanine green (ICG)-based fluorescence navigation system for discrimination of kidney cancer from normal parenchyma: application during partial nephrectomy

Purpose

To determine the definite border between normal and tumor kidney tissues during partial nephrectomy (PN) procedures using intraoperative indocyanine green (ICG)-based fluorescence imaging.

Methods

Sixteen potential candidates for PN with organ-confined, small renal masses treated between July 2008 and June 2011 at Shimane University Hospital were enrolled. An ICG-based fluorescence navigation (FN) system was used to evaluate the border between the tumor and normal kidney parenchyma (step 1), the cavity following tumor excision (step 2), and the negative surgical margin of resected tissues (step 3). The R.E.N.A.L nephrometry score (RNS) was applied to evaluate the correlation between tumor anatomy and ICG-based fluorescence imaging.

Results

In step 1, in vivo probing revealed 14 tumors with a mean RNS of 7 points that showed quite low ICG fluorescence signals in the tumor mass as compared with normal kidney parenchyma. In step 2, in vivo probing around the bed revealed highly fluorescent signals with no remnant tumor residing in 10 cases with a mean RNS of 6 points. In step 3, ex vivo probing revealed cancer tissues involving normal parenchyma that were completely excised with minimum amounts of normal parenchyma in all 16 resected specimens.

Conclusions

ICG-based FN system was very helpful for confirming negative margin status in even the most complex cases. Further evaluations may open the door for widespread use of this ICG-based FN system as a feasible and attractive alternative during a PN procedure.     

Role of the Hypoxia-Related Gene,JMJD1A,in Hepatocellular Carcinoma: Clinical Impact on Recurrence after Hepatic Resection

Background and Aims

Intratumoral hypoxia affects every major aspect of cancer biology, but the relationship between hypoxia-induced genes and hepatocellular carcinoma has not been fully investigated. From a previously ranked microarray of hypoxia-inducible genes related to hepatocellular carcinoma, we focused on a histone H3 lysine 9 demethylase, known as Jumonji domain containing 1A. One function of this demethylase is to amplify hypoxia-inducible gene expression. We hypothesized that the demethylase would be a significant marker of hepatocellular carcinoma.

Methods

We examined Jumonji domain containing 1A expression in 110 hepatocellular carcinoma samples with quantitative real-time polymerase chain reaction and immunohistochemistry. We performed a small interfering RNA suppression analysis to determine the biological roles of the demethylase in proliferation, invasion, and the expression of epithelial–mesenchymal transition-related genes.

Results

The level of Jumonji domain containing 1A in cancer tissues was higher than in normal tissues (P < 0.0001). Protein expression was significantly related to gene expression (P < 0.0001). Samples with high Jumonji domain containing 1A expression (n = 47) had higher recurrence rates (P = 0.0006) than those with low expression. Multivariate Cox regression analysis revealed that Jumonji domain containing 1A expression was an independent predictor of recurrence (P = 0.0016), but was not significantly associated with any clinicopathological characteristics. Moreover, suppression of Jumonji domain containing 1A expression in hepatocellular carcinoma cell lines under hypoxic conditions reduced cell growth inhibition, reduced invasion ability, and arrested epithelial–mesenchymal transitions.

Conclusion

Jumonji domain containing 1A is a useful prognostic marker and may ameliorate malignant transformation in hepatocellular carcinoma.

     

Spontaneous spinal epidural hematoma with hemiparesis mimicking acute cerebral infarction: two case reports

Context

Acute hemiparesis is a common initial presentation of ischemic stroke. Although hemiparesis due to spontaneous spinal epidural hematoma (SSEH) is an uncommon symptom, a few cases have been reported and misdiagnosed as cerebral infarction.

Design

Case reports of SSEH with acute hemiparesis.

Findings

In these two cases, acute stroke was suspected initially and administration of intravenous alteplase therapy was considered. In one case, the presentation was neck pain and in the other case, it was Lhermitte''s sign; brain magnetic resonance imaging (MRI) and magnetic resonance angiography were negative for signs of ischemic infarction, hemorrhage, or arterial dissection. Cervical MRI was performed and demonstrated SSEH.

Conclusion

Clinicians who perform intravenous thrombolytic treatment with alteplase need to be aware of this possible contraindication.     

Associations of Dietary Iron Intake With Mortality From Cardiovascular Disease: The JACC Study

Background

We investigated the relationship between dietary iron intake and mortality from cardiovascular disease (CVD) in a population-based sample of Japanese adults.

Methods

The study cohort consisted of 58 615 healthy Japanese (23 083 men and 35 532 women), aged between 40 and 79 years, who had no history of stroke, coronary heart disease (CHD), or cancer at baseline. Dietary iron intake was assessed at baseline by a validated food frequency questionnaire administered between 1988 and 1990 as part of the Japan Collaborative Cohort (JACC) Study.

Results

We documented 2690 (1343 men and 1347 women) deaths from CVD: 1227 (607 men and 620 women) deaths from total stroke, 651 from ischemic stroke (355 men and 296 women), 459 (196 men and 263 women) from hemorrhagic stroke, and 557 (311 men and 246 women) from CHD. Dietary intake of total iron was positively associated with mortality from total and ischemic stroke and total CVD in men. The multivariable hazard ratio for the highest versus the lowest quintile of total iron intake was 1.43 (95% CI, 1.02–2.00; P for trend = 0.009) for total stroke and 1.27 (1.01–1.58; 0.023) for total CVD in men. Dietary total iron intake was not associated with mortality from other endpoints in men, and was not associated with any endpoints in women.

Conclusions

Dietary intake of total iron was positively associated with mortality from stroke and total CVD in Japanese men.Key words: dietary iron, mortality, stroke, coronary heart disease, cardiovascular disease, follow-up studies     

Successful treatment with lamivudine may correlate with reduction of serum ferritin levels in the patients with chronic hepatitis and liver cirrhosis type B

Purpose  To study the changes in serum ferritin levels in lamivudine (LAM)-treated patients with chronic hepatitis and liver cirrhosis type B and determine whether successful treatment with LAM results in a reduction of serum ferritin levels. Methods  Thirty patients with chronic hepatitis B virus (HBV) infection were followed prospectively during their treatment with LAM for 12 months. Serum HBV DNA, ferritin levels, and emergence of YMDD mutants were monitored. A case of severe liver cirrhosis with hepatic hemosiderosis that was treated successfully with LAM also is shown as a representative case. Results  Serum alanine aminotransferase and ferritin levels decreased significantly more in the patients treated with LAM without YMDD mutants (n = 23) than those with mutants (n = 7). Hepatic hemosiderosis along with serum iron markers improved greatly in the representative patient. Conclusion  Successful treatment with LAM may reduce serum ferritin levels and improve hepatic siderosis in a subset of patients with chronic HBV infection. A study of Niigata-Zeffix investigation meeting.     

Hepatectomy with transcatheter arterial embolization for large hepatoma in the caudate lobe

The prognosis of hepatocellular carcinoma originating from the caudate lobe (caudate HCC) is generally poor, and surgical treatment for caudate HCC is difficult to perform due to the location. We postulate that a combination of surgical resection and transcatheter arterial embolization improves the prognosis, and that operative procedure is straightforward. We examined three cases of large solitary caudate HCC. Three patients (a 68-year-old woman, 65-year-old man, and 71-year-old man) with caudate HCC and viral chronic hepatitis were treated with preoperative transcatheter arterial embolization and partial resection of the caudate lobe. After transcatheter arterial embolization, the solitary hepatocellular carcinomas decreased in size (9 to 6, 10 to 8, and 7 to 5 cm in diameter, respectively) which simplified surgical resection (1120, 3010, and 2110 cc blood loss; 4.5, 7, and 7 hours of operative time, respectively). All the hepatocellular carcinomas were poorly differentiated, and had infiltrated microscopically into the portal vein. The outcome was satisfactory (18, 16, and 10 months after the operation, two cases were alive, and one dead, respectively). The combination of preoperative transcatheter arterial embolization and partial resection for caudate HCC, especially large solitary caudate HCC, works well as a multimodal therapy.