We demonstrated here that near-infrared fluorescence imaging system is a novel and reliable intraoperative technique to identify hepatic segment and subsegment for anatomical hepatic resection.
Hepatocyte transplantation to treat liver disease is largely limited by the availability of useful cells. Amniotic epithelial cells (hAECs) from term human placenta express surface markers and genes characteristic of embryonic stem cells and have the ability to differentiate into all three germ layers, including tissues of endodermal origin (i.e. liver). Thus, hAECs could provide a source of stem cell-derived hepatocytes for transplantation. We investigated the differentiation of hAECs in vitro and after transplantation into the liver of SCID/Beige mice. Moreover, we tested the ability of rat amniotic epithelial cells (rAECs) to replicate and differentiate upon transplantation into a syngenic model of liver repopulation. In vitro results indicate that the presence of extracellular matrix proteins together with a cocktail of growth factors, cytokines and hormones are required for differentiation of hAECs into hepatocyte-like cells. Differentiated hAECs expressed hepatocyte markers at levels comparable to those of fetal hepatocytes. They were able to metabolize ammonia, testosterone and 17α-hydroxyprogesterone caproate, and expressed inducible fetal cytochromes. After transplantation into the liver of Retrorsine (RS) treated SCID/beige mice, naïve hAECs differentiated into hepatocyte-like cells which expressed mature liver genes such as cytochromes, plasma proteins, transporters and other hepatic enzymes at levels equal to adult liver tissue. When transplanted in a syngenic animal pretreated with RS, rAECs were able to engraft and generate a progeny of cells with morphology and protein expression typical of mature hepatocytes. Conclusion amniotic epithelial cells possess the ability to differentiate into cells with characteristics of functional hepatocytes, in vitro and in vivo, thus representing a useful and non controversial source of cells for transplantation.
We retrospectively investigated the efficacy and feasibility of concurrent chemoradiotherapy for patients with severe dysphagia caused by oesophageal squamous cell carcinoma. Concurrent chemoradiotherapy was performed in 57 patients with T3 or T4 disease containing M1 lymph node (LYM) disease. Chemotherapy consisted of protracted infusion of 5-fluorouracil (5-FU) 400 mg m À2 24 h À1 on days 1 -5 and 8 -12, combined with 2-h infusion of cisplatin (CDDP) 40 mg m À2 on days 1 and 8. Radiation treatment at a dose of 30 Gy in 15 fractions of the mediastinum was administered concomitantly with chemotherapy. A course schedule with 3-week treatment and a 1 to 2-week break was applied twice, with a total radiation dose of 60 Gy, followed by two or more courses of 5-FU and CDDP. In all, 24 patients (42%) achieved a complete response, and the 3-year survival rate was 19%. Major toxicities were leukocytopenia and oesophagitis, and there were two (4%) treatment-related deaths. In contrast, 22 patients with T3 disease survived longer than 35 patients with T4 disease (P ¼ 0.001); however, the survival rate in 15 patients with M1 LYM disease did not differ significantly from that in 42 patients without M1 LYM disease (P ¼ 0.3545). Our results indicate that definitive chemoradiotherapy is potentially curative for locally advanced oesophageal carcinoma with malignant stricture. The efficacy and survival of patients treated with this regimen are related to the T factor.
1liver-infiltrating lymphocytes 4 of patients with chronic hepa-A cytotoxic T lymphocyte (CTL) response to the hepatitis C, the role of CTL responses in HCV infection is untitis C virus (HCV) nucleoprotein residues 88-96 that are known. HCV infection frequently persists and is implicated the minimal and optimal epitope for human leukocyte in the development of chronic hepatitis, cirrhosis, and hepatoantigen (HLA) B44-restricted CTLs was assessed in 27 cellular carcinoma. 5 Posttransfusion HCV infection has de-HLA B44-positive patients with chronic HCV infection.creased substantially after introduction of an anti-HCV assay Serum HCV RNA concentration and the amino acid sefor blood screening, but community-acquired HCV infection quence of the residues 81-100 were also determined.still occurs. Interferon therapy is effective in less than 50% Three patients were infected with HCV with uncommon of patients with chronic hepatitis C. 6 Understanding the role amino acid substitutions within the epitope. One was of CTL responses in HCV infection may contribute to the infected with HCV with an amino acid substitution in development of strategies for the prevention of HCV infection the flanking residues of the epitope. To stimulate CTLs and the elimination of HCV from infected individuals. in the peripheral blood, 9-mer peptides that correRecently, we showed the presence of CTLs that recognize sponded to the residues 88-96 of the individual patients endogenously synthesized HCV antigen in the peripheral were synthesized and used. Seven of the 27 patients demblood of some patients with HCV infection by stimulation onstrated a CTL response to the residues 88-96 with of peripheral blood lymphocytes (PBLs) with HCV synthetic specific cytotoxic activities higher than 20%. The CTL peptides.3 activities were significantly higher in patients with a The CTLs recognized an epitope in the HCV nucleoprotein low titer of serum HCV RNA than in those with a high residues 81-100 in association with human leukocyte antigen titer of serum HCV RNA (P Å .0006). Some of the patients (HLA) B44. The minimal and optimal epitope was further dethat demonstrated a CTL response to the residues 88-fined to be the residues 88-96. 7 The 9-mer peptide of the resi-96 also demonstrated a CTL response to a newly identidues 88-96 was recognized by and stimulated the CTLs more fied HLA B44-restricted CTL epitope or a known HLA efficiently than the 20-mer peptide of the residues 81-100. A11-restricted CTL epitope or both. No apparent associa-In a characteristic antiviral CTL response in vivo, immunotion was observed between the CTL response and the dominant CTLs recognize only one or a few multiple immunostage of disease, or between the CTL response and the genic CTL epitopes in the antigen, 8,9 but as many as five grade of necroinflammatory activity. The results suggest different epitopes for HCV-specific CTLs were detected in a that the HLA B44-restricted CTLs together with other single individual. 10 CTL activities to HCV could not be dem-HCV-specific CTLs ...
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