Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

BACKGROUND: Recently, stroke therapy is focused on reperfusion therapies for restoring cerebral blood flow (CBF) and minimizing the undesired effects of neuron ischemia. However, the thrombolytic therapy to restore CBF was restricted with narrow time window. On other hands, not many patients can reach the treatment immediately after the onset of stroke. A wider time window therapy that might increase CBF would probably helpful. This study aims to investigate the CBF improvement after intra arterial heparin flushing (IAHF) therapy in chronic stroke patients.METHODS: A clinical trial was conducted with time sampling. We collected chronic ischemic stroke subjects (with stroke onset ≥30 days) within periods February-September 2015. We investigated CBF before and after IAHF treatment in 75 chronic stroke patients. The difference before and after IAHF treatment in subgroup which is classified with infarct size and lesion area was tested. CBF was measured using MRI Quality Arterial Spin Labeling (qASL) with region of interest around infarct lesion.RESULTS: We found a significant CBF improvement (p<0.001) around infarct area after IAHF treatment with average 10.39mL/100g/min raised. CBF improvement was found in lacunar infarct (p<0.001) and non lacunar (p<0.001), also in infarct in cortical (p<0.05), subcortical (p<0.001) and both area (p<0.05).CONCLUSION: IAHF is associated with increased CBF around infarct area and IAHF probably offers some benefit for chronic stroke.KEYWORDS: IAHF, CBF, chronic stroke, ischemic, lacunar, non lacunar, cortical lesion, subcortical lesion

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a world-wide pandemic. Internationally, because of availability, accessibility, and distribution issues, there is a need for additional vaccines. This study aimed to: establish the feasibility of personal dendritic cell vaccines to the SARS-CoV-2 spike protein, establish the safety of a single subcutaneous vaccine injection, and determine the antigen-specific immune response following vaccination. In Phase 1, 31 subjects were assigned to one of nine formulations of autologous dendritic cells and lymphocytes (DCL) incubated with 0.10, 0.33, or 1.0 µg of recombinant SARS-CoV-2 spike protein, and admixed with saline or 250 or 500 µg of granulocyte-macrophage colony-stimulating factor (GM-CSF) prior to injection, then assessed for safety and humoral response. In Phase 2, 145 subjects were randomized to one of three formulations defined by incubation with the same three quantities of spike protein without GM-CSF, then assessed for safety and cellular response. Vaccines were successfully manufactured for every subject at point-of-care. Approximately 46.4% of subjects had a grade 1 adverse event (AE); 6.5% had a grade 2 AE. Among 169 evaluable subjects, there were no acute allergic, grade 3 or 4, or serious AE. In Phase 1, anti-receptor binding domain antibodies were increased in 70% of subjects on day-28. In Phase 2, in the 127 subjects who did not have high levels of gamma interferon-producing cells at baseline, 94.4% had increased by day 14 and 96.8% by day 28. Point-of-care personal vaccine manufacturing was feasible. Further development of such subject-specific vaccines is warranted.

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