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Long-term outcomes of hepatocellular carcinoma that underwent chemoembolization for bridging or downstaging

World Journal of Gastroenterology 2019年第37期25卷 5687-5701页

作者： Breno Boueri Affonso Francisco Leonardo Galastri Joaquim Mauricio da Motta Leal Filho Felipe Nasser Priscila Mina Falsarella Rafael Noronha Cavalcante Marcio Dias de Almeida Guilherme Eduardo Goncalves Felga Leonardo guedes Moreira Valle nelson Wolosker department of Interventional Radiology Hospital Israelita Albert EinsteinSao Paulo 05651-901Sao PauloBrazil department of Liver Transplant Hospital Israelita Albert EinsteinSao Paulo 05651-901Sao PauloBrazil department of Vascular Surgery Hospital Israelita Albert EinsteinSao Paulo 05651-901Sao PauloBrazil

BACKGROUND Prospective study of 200 patients with hepatocellular carcinoma(HCC)that underwent liver transplant(LT)after drug-eluting beads transarterial chemoembolization(deB-TACE)for downstaging versus *** survival and tumor recurrence rates were calculated,eligibility for LT,time on the waiting list and radiological response were *** TACE,only patients within Milan Criteria(MC)were *** patients underwent LT in bridging ***-year post-transplant overall survival,recurrence-free survival has no difference between the *** response was observed more frequently in bridging *** in DS group can achieve posttransplant survival and HCC recurrence-free probability,at five years,just like patients within MC in patients undergoing *** To determine long-term outcomes of patients with HCC that underwent LT after deB-TACE for downstaging vs *** Prospective cohort study of 200 patients included from April 2011 through June *** group included patients within *** group(out of MC)was divided in 5 subgroups(G1 to G5).Total tumor diameter was≤8 cm for G1,2,3,4(n=42)and was>8 cm for G5(n=22).Downstaging(n=64)and bridging(n=136)populations were not significantly *** survival and tumor recurrence rates were calculated by the Kaplan-Meier ***,eligibility for LT,time on the waiting list until LT and radiological response were *** After TACE,only patients within MC were *** patients underwent LT in bridging group 65.9%(P=0.001).Downstaging population presented:higher number of nodules 2.81(P=0.001);larger total tumor diameter 8.09(P=0.001);multifocal HCC 78%(P=0.001);more post-transplantation recurrence 25%(P=0.02).Patients with maximal tumor diameter up to 7.05 cm were more likely to receive LT(P=0.005).Median time on the waiting list was significantly longer in downstaging group 10.6 mo(P=0.028).Five-year posttransplant over

关键词： Hepatocellular carcinoma Down-staging Liver transplantation Localregional therapy Bridging

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Stereological Evaluation of Precipitates within Ferrite Grains in Heat-Treated 1.25Cr0.5Mo Steel Previously Exposed to Service

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Journal of Metallic Material Research 2019年第2期2卷 1-8页

作者： Rafael Fernandez-Fuentes Americo Scotti Amado Cruz-Crespo Roberto Silva Gonzalez Rafael Ariza nelson guedes de alcantar. Universidad Central Marta Abreu de Las Villas–UCLV Cuba Universidade Federal de Uberlandia–UFU Brazil Universidade Federal de Sao Carlos-UFSCar Brazil University of West Department of Engineering ScienceTrollhattanSweden

The objective of this work was to study the effect of the heat treatment and further operation aging on the stereological parameters(size,quantity and volume fraction)of precipitates within ferrite grains of a creep-resistant 1.25Cr0.5Mo steel after long-term *** heat treatment was similar to the treatment that is carried out in industrial steam pipelines after welding(post weld heat treatment-PWHT)during installation and/or *** operation aging corresponds to a subsequent long in-service operation after *** determine the stereological parameters,SEM digital images were taken from samples of this material after conditions of in-service-aged(after long-term operation),in-service-aged and heat-treated(simulating repairing)and in-service-aged,heat-treated and in-laboratory aged(simulating subsequent long-term operation after repairing).The results indicate that the changes in the stereological parameters of the precipitates within ferrite grains after PWHT is associated with the coarsening process of the within-ferrite-grain precipitates as well as stabilizing the microstructure,since the material aging after PWHT of an in-serviced aged material would not change the stereological parameters.

关键词： Creep-resistant 1.25Cr0.5Mo Steel Repairing PWHT Precipitation coarsening

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Imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma

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World Journal of Hepatology 2020年第1期12卷 21-33页

作者： Francisco Leonardo Galastri Felipe Nasser Breno Boueri Affonso Leonardo guedes Moreira Valle Bruno Calazans Odísio Joaquim Mauricio Motta-Leal Filho Paolo Rogério Salvalaggio Rodrigo Gobbo Garcia Márcio Dias de Almeida Ronaldo Hueb Baroni nelson Wolosker department of Interventional Radiology Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil department of Diagnostic Radiology The University of Texas MD Anderson Cancer CenterHoustonTX 77230United States Radiology department Radiology DepartmentHeart Institute(InCor)University of São PauloSão Paulo 05403-900Brazil Teaching and Research Institute São PauloBrazilHospital Israelita Albert EinsteinSão Paulo 05652-000Brazil department of Liver Transplant Hospital Israelita Albert EinsteinSão Paulo 05652-900Brazil department of Radiology Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil department of Vascular Surgery Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil

BACKGROUND Drug-eluting bead transarterial chemoembolization(deB-TACE)is an endovascular treatment to release chemotherapeutic agents within a target lesion,minimizing systemic exposure and adverse effects to ***,identifying which patient characteristics may predict imaging response to deB-TACE can improve treatment results while selecting the best *** of the response after deB-TACE still have not been fully *** is the first prospective study performed with standardized deBTACE technique that aim to identify predictors of radiological response,assessing patients clinical and laboratory characteristics,diagnostic imaging and intraprocedure data of the hepatocellular carcinoma treated in the neoadjuvant context for liver *** To identify pre-and intraoperative clinical and imaging predictors of the radiological response of drug-eluting bead transarterial chemoembolization(deB-TACE)for the neoadjuvant treatment of hepatocellular carcinoma(HCC).METHODS This is prospective,cohort study,performed in a single transplant center,from 2011 to *** patients with HCC considered for liver transplant who underwent deB-TACE in the first session for downstaging or bridging purposes were *** and post-chemoembolization imaging studies were performed by computed tomography or magnetic *** radiological response of each individual HCC was evaluated by objective response using mRECIST and the percentage of *** Two hundred patients with 380 HCCs were *** of the objective response(nodule-based analysis)demonstrated that HCC with pseudocapsules had a 2.01 times greater chance of being responders than those without pseudocapsules(P=0.01),and the addition of every 1mg of chemoembolic agent increased the chance of therapeutic response in 4%(P<0.001).Analysis of the percentage of necrosis through multiple linear regression revealed that the addition of each 1mg of the

关键词： Hepatocellular carcinoma Liver transplantation Response evaluation criteria in solid tumors Neoadjuvant therapy Liver neoplasms

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Diagnosis and management of hepatic artery in-stent restenosis after liver transplantation by optical coherence tomography:A case report

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World Journal of Hepatology 2020年第7期12卷 399-405页

作者： Francisco Leonardo Galastri Guilherme Moratti Gilberto Breno Boueri Affonso Leonardo guedes Moreira Valle Priscila Mina Falsarella Adriano Mendes Caixeta Camila Antunes Lima Marcela Juliano Silva Lucas Lembrança Pinheiro Conrado Dias Pacheco Annicchino Baptistella Márcio Dias de Almeida Rodrigo Gobbo Garcia nelson Wolosker Felipe Nasser Hospital Israelita Albert Einstein Department of Interventional RadiologySão Paulo 05652900Brazil Hospital Israelita Albert Einstein Department of Interventional CardiologySão Paulo 0562900Brazil Hospital Israelita Albert Einstein Department of Liver TransplantSão Paulo 05652900Brazil Hospital Israelita Albert Einstein Department of Vascular SurgerySão Paulo 05652-000Brazil

BACKGROUNDPercutaneous transluminal angioplasty and stenting represent an effectivetreatment for hepatic artery stenosis after liver transplantation. In the first yearafter stenting, approximately 22% of patients experience in-stent restenosis,increasing the risk of artery thrombosis and related complications, and 50%experience liver failure. Although angiography is an important tool for diagnosisand the planning of therapeutic interventions, it may raise doubts, especially insmall-diameter arteries, and it provides low resolution rates compared withnewer intravascular imaging methods, such as optical coherence tomography(OCT).CASE SUMMARYA 64-year-old male developed hepatic artery stenosis one year after orthotropicliver transplantation and was successfully treated with percutaneous transluminalangioplasty with stenting. Five months later, the Doppler ultrasound resultsindicated restenosis. Visceral arteriography confirmed hepatic artery tortuositybut was doubtful for significant in-stent restenosis (ISR) and intrahepatic flowreduction. To confirm ISR, identify the etiology and guide treatment, OCT wasperformed. OCT showed severe stenosis due to four mechanisms: Focal andpartial stent fracture, late stent malapposition, in-stent neointimal hyperplasia,and *** diagnostic methods can be useful in evaluating cases in which initialangiography results are not sufficient to provide a proper diagnosis of significantstenosis, especially with regard to ISR. A wide range of diagnoses are provided byOCT, resulting in different treatment options. Interventional radiologists shouldconsider intravascular diagnostic methods as additional tools for evaluatingpatients when visceral angiography results are unclear.

关键词： Liver transplantation Hepatic artery restenosis Tomography Optical coherence Case report Endovascular procedures Angiography

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酒店改造如何实现新旧、内外的统一——葡萄牙米尼奥酒店改造与扩建

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设计家 2015年第1期 60-65页

作者： JP Pereira Pedro guedes Teresa Aguiar Leonor Macedo Eva Sousa nelson Garrido Vírgula i

米尼奥酒店在原有建筑基础上重新设计了公共区和水疗中心,并扩建了酒店面积。新设计保持了原建筑简洁朴素的特点,同时又提升了酒店形象。酒店建筑决定了室内设计必将是整个设计非常重要的一部分,建筑是外壳,室内是核心,内外之间的差异... 详细信息

米尼奥酒店在原有建筑基础上重新设计了公共区和水疗中心,并扩建了酒店面积。新设计保持了原建筑简洁朴素的特点,同时又提升了酒店形象。酒店建筑决定了室内设计必将是整个设计非常重要的一部分,建筑是外壳,室内是核心,内外之间的差异被有意地简化成单一的解决方案。由于建筑原本就存在,扩建建筑在外观上要保持原有特征。

关键词：原有建筑米尼室内设计公共区设计过程主设计师 Laura 内外空间表达情绪周围环境

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