Exosomal noncoding RNAs (ncRNAs) have unique expression profiles reflecting the characteristics of a tumor, and their role in tumor progression and metastasis is emerging. However, the significance of circulating exosomal ncRNAs in the prognosis of hepatocellular carcinoma (HCC) remains to be elucidated. We therefore determined the prognostic significance of circulating exosomal ncRNAs (miRNA-21 and lncRNA-ATB) for human HCC. This prospective study enrolled 79 HCC patients between October 2014 and September 2015. Exosomes were extracted from serum samples using the ExoQuick Exosome Precipitation Solution. To validate the isolation of the exosomes from serum, immunoblotting for exosome markers and characterization of nanoparticle using NanoSight were performed. NcRNAs were isolated from exosomes using the miRNeasy serum/plasma micro kit. Both circulating exosomal miRNA-21 and lncRNA-ATB were related to TNM stage and other prognostic factors, including the T stage and portal vein thrombosis. Multivariate analysis using the Cox regression test identified that both higher miRNA-21 and higher lncRNA-ATB were independent predictors of mortality and disease progression, along with larger tumor size and higher C-reactive protein (all p < 0.05). The overall survival and progression-free survival were significantly lower in patients with higher circulating levels of exosomal miRNA-21 (≥0.09) and lncRNA-ATB (≥0.0016) (log-rank test: p < 0.05). In conclusion, our study has provided strong evidence that circulating exosomal ncRNAs (miRNA-21 and lncRNA-ATB) are novel prognostic markers and therapeutic targets for HCC.

According to recent international consensus conferences, pure laparoscopic donor hepatectomy (PLDH), particularly right and left hepatectomies, is not yet considered a standard practice because studies remain limited. Thus, we present the outcomes of more than 500 PLDH patients, mostly receiving a right hepatectomy. To our knowledge, this is the largest study to date on PLDH. Data from all living liver donors who underwent PLDH at 5 centers in Korea until June 2018 were retrospectively analyzed. The outcomes of both donors and recipients were included. Pearson correlation analysis was used to explore the relationship between the duration of surgery and cumulative experience at each center, which reflects the learning curve. Overall, 545 PLDH cases were analyzed, including 481 right hepatectomies, 25 left hepatectomies, and 39 left lateral sectionectomies (LLS). The open conversion was necessary for 10 (1.8%) donors, and none of the donors died or experienced irreversible disability. Notably, there were 25 (4.6%) patients with major complications (higher than Clavien-Dindo grade 3). All centers except one showed a significant decrease in surgery duration as the number of cases accumulated. Regarding recipient outcomes, there were 110 cases (20.2%) of early major complications and 177 cases (32.5%) of late major complications. This study shows the early and late postoperative outcomes of 545 donors and corresponding recipients, including 481 right hepatectomies and 25 left hepatectomies, from 5 experienced centers. Although the results are comparable to those of previously reported open donor hepatectomy series, further studies are needed to consider PLDH a new standard practice.

Background: The tumor biology of hepatocellular carcinoma (HCC) affects recurrence after liver transplantation (LT), but most selection guidelines are based only on tumor size and number. The aim of the study is to evaluate the possibility of expanding the selection criteria in living donor LT (LDLT) without compromising patient survival by adding α-fetoprotein (AFP) in selection guideline. Methods: One hundred thirty-nine patients who received LDLT with the diagnosis of HCC and survived more than 3 months were enrolled. The operability was based on Milan criteria but LT beyond the criteria was performed when requested by the patients and/or the guardian after thorough explanation. Results: The median follow-up duration was 28 months. One-, three- and five-year survival rates were 92.2, 82.6, and 79.9%. There was no survival difference between patients within or beyond Milan (p = 0.76). Serum AFP level >400 ng/ml, tumor size >5 cm, and vascular invasion were significant on univariate analysis, but only vascular invasion was significant on multivariate analysis (p = 0.007). Patients with >3 tumor nodules had better survival compared to ≤3 nodules (p = 0.196). Patient selection using tumor size ≤5 cm and AFP ≤400 ng/ml without limitation of tumor numbers could expand patient selection and improve patient survival. Conclusion: Application of serum AFP level to selection of HCC for LT affords better patient selection criteria.

The green macroalga Ulva pertusa Kjellman produced UV-B absorbing compounds with a prominent absorption maximum at 294 nm in response only to UV-B, and the amounts induced were proportional to the UV-B doses. Under a 12:12-h light: dark regime, the production of UV-absorbing compounds occurred only during the exposure periods with little turnover in the dark. There was significant reduction in growth in parallel with the production of UV-B absorbing compounds. The polychromatic action spectrum for the induction of UV-B absorbing compounds in U. pertusa exhibits a major peak at 292 nm with a smaller peak at 311.5 nm. No significant induction was detected above 354.5 nm, and radiation below 285 nm caused significant reduction in the levels of UV-B absorbing compounds. After UV-B irradiation at 1.0 W . m À 2 for 9 h, the optimal photosynthetic quantum yield of the samples with UV-B absorbing compounds slightly increased relative to the initial value, whereas that of thalli lacking the compounds declined to 30%-34% of the initial followed by subsequent recovery in dim light of up to 84%-85% of the initial value. There was a positive and significant relationship between the amount of UV-B absorbing compounds with antioxidant activity as determined by the a,a-diphenyl-b-picrylhydrazyl scavenging assay. In addition to mat-forming characteristics and light-driven photorepair, the existence and antioxidant capacity of UV-B absorbing compounds may confer U. pertusa a greater selective advantage over other macroalgae, thereby enabling them to thrive in the presence of intense UV-B radiation.

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The chlorophyte Ulva is perceived as a simple and uniform algal form, with little functional differentiation within a thallus. We compared morphology, pigmentation, photosynthesis, growth, reproduction, and UV‐B sensitivity between different thallus regions of Ulva pertusa Kjellman. Thallus thickness and cell size were significantly greater, whereas cell number was less in the basal region than in other regions. Photosynthetic pigment contents were lowest in the basal region and increased toward the marginal region. Photosynthetic capacity and photosynthetic efficiency normalized to fresh weight, area, volume, and cell number showed a progressive increase from the basal to marginal parts; however, on a chl basis those values were equal regardless of thallus part. Values of light saturation point were not statistically different between regions. Growth rates increased from marginal to basal and to middle parts of the thallus, whereas sporulation was highest in marginal (100%) followed by middle (30%) and basal parts (0%). Daily observation over 9 days showed that 56% of the basal cells divided once and did not produce spores, whereas every marginal cell went through its first division and 89% of the primary daughter cells also divided, resulting in 100% sporulation. A 7‐day treatment with PAR and PAR + UV‐A caused a significant decrease in the effective quantum yield of all thallus regions, followed by a recovery toward the initial values, whereas PAR + UV‐A + UV‐B irradiation led to greater photoinhibition and less recovery. Marked differences in the UV‐B sensitivity were observed, with marginal parts being more sensitive and basal parts most resistant.

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ARFI elastography and TE yield comparable predictors of HCC recurrence after RFA.