22% of gastric cancers are HER-2 positive. Therapy targeting HER-2 oncogene with the monoclonal antibody trastuzumab (Herceptin) is prohibitive in our country due to high costs. Methods: Case description:

Patient of 41 years presented with a diagnosis of stage IV gastric adenocarcinoma, documented in July 2012 based on following criteria: clinical (abdominal pain), endoscopic (infiltrative tumor of 4-5 cm on the greater curvature), histology RG7204 order (tubulo-papillary adenocarcinoma, GII, infiltrative) imaging (CT infiltrative tumor 5.5/4 cm on the greater curvature invading the pole of the spleen, liver and multiple peritoneal metastases). He made 8 cycles of polychemotherapy in Milan, with EFC (Epirubicin, 5-Fluorouracil, Cisplatin), with documented disease progression in October 2012 by TC: increasing spleen infiltration, increased size of liver metastases, new liver lesions. He came for begging of salvage therapy. We performed immunohistochemistry of gastric biopsies documenting HER-2 status: 3+. We initiated therapy with Docetaxel and, given the patient’s young age, Transtuzumab (Herceptin) from his own resources. Results: Evaluation after 5 cycles of docetaxel and

4 cycles of Herceptin (April Target Selective Inhibitor Library high throughput 2013) documents the following: the almost complete morphologic remission of the gastric tumor and mesenteric determinations; morphological and numerical remission of liver and spleen injuries. Patient continues Herceptin with a new evaluation in 3 months time. Conclusion: This patient is, the first from the Oncologic Registry Bihor treated with Herceptin who went into almost complete remission, despite disease progression after first-line

therapy, thanks to administration of Herceptin, underlining the importance of both standardization of immunohistochemical assessment for HER2 overexpression in all patients with gastric cancer and of obtaining financial resources for Herceptin biological tratament. Key Word(s): 1. gastric cancer; 2. her-2; 3. transtuzumab; Presenting Author: YUN SHAO Additional Authors: WEIHAO SUN Corresponding medchemexpress Author: WEIHAO SUN Affiliations: the first affiliated hospital with nanjing medical university Objective: The specific cyclooxygenase (COX)-2 inhibitor have the anti-proliferative and pro-apoptotic effects on gastric cancer cells. There are somerandomized, double-blind, placebo-controlled trials with COX-2 inhibitors (coxibs) showing an increased rate of thrombotic vascular events in patients treated with coxibs. Ursolic acid (UA), a natural pentacyclic triterpenoid carboxylic acid, is largely distributed in medical herbs. UA has a wide range of anticancer functions such as proapoptosis, antiangiogenesis, antimetastasis and cytotoxicity in stomach, liver, lung and bladder cancers.

22% of gastric cancers are HER-2 positive. Therapy targeting HER-2 oncogene with the monoclonal antibody trastuzumab (Herceptin) is prohibitive in our country due to high costs. Methods: Case description:

Patient of 41 years presented with a diagnosis of stage IV gastric adenocarcinoma, documented in July 2012 based on following criteria: clinical (abdominal pain), endoscopic (infiltrative tumor of 4-5 cm on the greater curvature), histology Selleckchem NVP-BGJ398 (tubulo-papillary adenocarcinoma, GII, infiltrative) imaging (CT infiltrative tumor 5.5/4 cm on the greater curvature invading the pole of the spleen, liver and multiple peritoneal metastases). He made 8 cycles of polychemotherapy in Milan, with EFC (Epirubicin, 5-Fluorouracil, Cisplatin), with documented disease progression in October 2012 by TC: increasing spleen infiltration, increased size of liver metastases, new liver lesions. He came for begging of salvage therapy. We performed immunohistochemistry of gastric biopsies documenting HER-2 status: 3+. We initiated therapy with Docetaxel and, given the patient’s young age, Transtuzumab (Herceptin) from his own resources. Results: Evaluation after 5 cycles of docetaxel and

4 cycles of Herceptin (April YAP-TEAD Inhibitor 1 nmr 2013) documents the following: the almost complete morphologic remission of the gastric tumor and mesenteric determinations; morphological and numerical remission of liver and spleen injuries. Patient continues Herceptin with a new evaluation in 3 months time. Conclusion: This patient is, the first from the Oncologic Registry Bihor treated with Herceptin who went into almost complete remission, despite disease progression after first-line

therapy, thanks to administration of Herceptin, underlining the importance of both standardization of immunohistochemical assessment for HER2 overexpression in all patients with gastric cancer and of obtaining financial resources for Herceptin biological tratament. Key Word(s): 1. gastric cancer; 2. her-2; 3. transtuzumab; Presenting Author: YUN SHAO Additional Authors: WEIHAO SUN Corresponding 上海皓元医药股份有限公司 Author: WEIHAO SUN Affiliations: the first affiliated hospital with nanjing medical university Objective: The specific cyclooxygenase (COX)-2 inhibitor have the anti-proliferative and pro-apoptotic effects on gastric cancer cells. There are somerandomized, double-blind, placebo-controlled trials with COX-2 inhibitors (coxibs) showing an increased rate of thrombotic vascular events in patients treated with coxibs. Ursolic acid (UA), a natural pentacyclic triterpenoid carboxylic acid, is largely distributed in medical herbs. UA has a wide range of anticancer functions such as proapoptosis, antiangiogenesis, antimetastasis and cytotoxicity in stomach, liver, lung and bladder cancers.

Details are described in the Supporting Materials and Methods. Details are described in the Supporting Materials and Methods. ACignal Finder 10-Pathway Reporter Array (SABiosciences) was employed for the study. A reverse transfection technique was implemented. Cells

were treated with overexpression miR-140-5p or negative control. Relative firefly luciferase activity was calculated and normalized to the constitutively expressed Renilla luciferase. Luciferase activity was assessed Compound Library chemical structure according to the Dual-Luciferase Reporter Assay protocol (Promega, Madison, WI) using a Veritas 96-well Microplate Luminometer (Promega) with substrate dispenser (Promega). HEK293T cells transduced with leti-miR-140-5p or control virus were seeded in 96-well plates with

70% confluence. Twelve hours later, the cells were cotransfected with 50 ng pGL3-Promoter -UTR and 10 ng pRLTK using Lipofectamine LTX. After 24 hours of transfection, the cells were harvested for firefly and Renilla luciferase activity assay. The Renilla luciferase activities were used LEE011 manufacturer to normalize the transfection efficiency. The HCC model in nude mice was constructed as described.26 Details are described in the Supporting Materials and Methods. The expression levels for TGFBR1 and FGF9 in the local tumor tissues were determined by immunostaining with antibodies against TGFBR1 and FGF9 (Santa Cruz Biotechnology, Santa Cruz, CA). All animal studies were conducted at the Animal Institute of CSU according to the protocols approved by the Medical Experimental Animal Care Commission of CSU. Statistical analysis was performed using

SPSS (v. 13.0, Chicago, IL). Data for miR-140-5p expression in fresh specimens were analyzed using the Mann-Whitney U test. The Fisher’s exact test was used for statistical analysis of categorical data. A Spearman correlation test was used for analyzing the correlations between miR-140-5p expression level and the clinical and pathological variables. Survival curves were constructed using the Kaplan-Meier method and evaluated using the log-rank test. The Cox proportional hazard regression model was used to identify factors that were independently associated with overall survival and disease-free survival. P < 0.05 was considered statistically significant. Our miRNA microarray analysis MCE公司 revealed that miR-140-5p was significantly down-regulated in HCC tissues (Fig. 1A). To confirm this result, we performed qRT-PCR in 120 cases of HCC tissues and ANLTs. In general, a 3.4-fold decrease for miR-140-5p expression was noted in HCC tissues as compared with that of ANLTs (Fig. 1B). Comparative analysis of paired HCCs with ANLTs further revealed that reduced miR-140-5p expression (more than 2-fold [i.e., log2 (fold change) > 1]) was observed in 89 (74.2%) cases, suggesting that reduction of miR-140-5p was a frequent event in human HCC (Fig. 1B).

Mice with liver-specific knockdown of BAF60a show abnormalities in the rhythmic expression pattern of clock Obeticholic Acid and metabolic genes and in the circulating metabolite profile. Consistently, knockdown of BAF60a impairs the oscillation of clock genes in serum-shocked HepG2 cells. At the molecular level, BAF60a activates Bmal1 and G6Pase transcription by way of the coactivation of retinoid-related orphan receptor alpha (RORα). In addition, BAF60a is present near ROR response elements (RORE) on the proximal Bmal1 and G6Pase promoters and turns the chromatin structure into the active state. Conclusion: Our data suggest a critical role for BAF60a in the coordinated regulation of hepatic circadian clock and energy metabolism

in mammals. (HEPATOLOGY 2011;) Many physiological events in mammals, including locomotor activity, sleep, blood

pressure, circulating hormones, and energy metabolism show diurnal fluctuation.1, 2 These intrinsic biological rhythms are mainly entrained by light-dark (LD) and feeding cycles. The mammalian master clock resides in the hypothalamic suprachiasmatic nucleus (SCN) and drives slave oscillators distributed selleck screening library in various peripheral tissues through behavioral and neuroendocrine signals. However, Damiola et al.3 found that peripheral oscillators can be uncoupled and reset from the central pacemaker by restricted feeding. Their findings are supported by the subsequent report showing that restricted feeding entrains the circadian rhythms in peripheral tissues, dominantly in the liver, but leaving SCN rhythms unaffected.4 Also, both food availability and the temporal pattern of feeding determine the repertoire, phase, and amplitude

of the circadian transcriptome in mouse liver.5 All these studies indicate that nutritional signals play a dominant role in the regulation of peripheral clock function. At the molecular level, Clock and Bmal1 are two basic helix-loop-helix transcription factors that activate the transcription of period (Per) and cryptochrome (Cry) genes.6 Per and Cry proteins in turn inhibit their own expression by repressing Clock/Bmal1 activity, forming the critical feedback medchemexpress loop within the clock circuitry. In addition, the orphan nuclear receptors of the ROR and Rev-erb families are also implicated in the control of circadian clock function.7, 8 It has been shown that neuroendocrine and metabolic systems are subjected to strong circadian control. Recent transcriptional profiling studies indicate that ≈10% of all genes in the genome display rhythmic expression under constant dark conditions,2, 9 many of which encode enzymes involved in glucose, lipid, amino acids, heme, and mitochondrial oxidative metabolism. In particular, hepatic lipogenesis, gluconeogenesis, heme, and bile acid biosynthesis as well as xenobiotic detoxification are cyclic in rodents and humans.10-13 In contrast, some key regulators in circadian clock have their own metabolic functions.

g. basal cell hyperplasia, papillary elongation, ISD, infiltration with intraepithelial eosinophils, neutrophils, and mononuclear cells etc.). Results: The light microscopy quantitative analysis showed that the mean ISD value of GERD was larger than that in FH and control (p < 0.05), and there was no statistically difference between

FH and control group (p = 0.13); According to the results of 24-hour pH impedance monitoring, the mean ISD value in the subjects with acid reflux was much higher than that of the subjects without acid reflux (p = 0.001). When the cut-off value for mean ISD was 0.90 μm, the sensitivity of GERD diagnosis was 65.6% and specificity was 56.8%, the total consistent rate was 62.9%. Two hundred and fifty-three were underwent the histological evaluation. When the optimal cut-off value was 3.5, the sensitivity was 55.2% and specificity was 60.5%, the total consistent PD-0332991 ic50 rate was 62.7%. Combination the ISD value and histological evaluation, the sensitivity of GERD diagnosis was 80.6% and specificity was 36.1%. Conclusion: The mean ISD value was

closely related to the acid reflux. The diagnostic value of the mean ISD value was as same as histological evaluation. Combination this two methods can only improve the sensitivity of diagnosis of GERD. Key Word(s): 1. GERD; 2. Histological scores; 3. ISD; 4. Function heartburn; Presenting Alisertib mw Author: TONGYU TANG Additional Authors: YUQIN LI, LIHONG MA Corresponding Author: TONGYU TANG Affiliations: No.1 hospital of jilinuniversity; Np.1 hospital of jilin university; NO.1hospital of jilin university Objective: Our aim was to study clinical classification

and characteristics among the different heartburn groups. Methods: All patients were initially evaluated by a symptom questionnaire under the guidance of digestive physician, and thereafter underwent an upper endoscopy, patients with damaged esophageal mucosa were classified into RE type in GERD group, those with normal-appearing esophageal mucosa were followed by ambulatory 24 h esophageal pH monitoring including counting symptom index and then administrated by PPI trial, those patients having a normal esophageal mucosa were stratified into NERD and FH based on 24 h esophageal pH monitoring, symptom index and PPI trial, and the last analyse the medchemexpress different Characteristics of different heartburn groups. Results: There was no statistically significant difference between three groups of age and gender. Combined with esophageal pH monitoring, symptom index and PPI trial, and NERD subdivided into 3 subgroups:20 patients were testified with excessive acid exposure; 13 patients were found with normal acid exposure and positive SI at the same time; the other 13 cases had positive PPI trial although they had normal pH monitoring and negative SI. After complete classification, comparing the differences in esophageal pH monitoring of different classification.

When it is released into the blood during the interdigestive state, motilin binds to motilin receptor and promotes

the propulsion of gut contents along the gastrointestinal tract by provoking phase III interdigestive migrating contractions. It has been suggested that there are two substyles of motilin receptors: “M (muscle)” and “N (nerve)”. The aim of this study was to identify motilin receptor expression in dogs enteric nervous system. Methods: We detected motilin receptor by immunohistochemistry. Tissues of antrum, duodenum, jejunum, ileum, proximal colon, middle colon, and distal colon were extracted from six dogs. Formalin-fixed, paraffin-embedded sections, cut at a thickness of 4 μm, were deparaffinized, rehydrated selleck compound and boiled in retrieval solution. After blocking non-specific binding see more by incubation in normal horse serum, sections were incubated with primary antibody (1:200) overnight at 4°C. Next day sections were incubated with biotinylated goat anti-rabbit antibody and horse radish peroxidase conjugated avidin 30 mins respectively. Stained sections were incubated with diaminobenzine, weakly counterstained with hematoxylin, and mounted. Results: Nerve fibers among smooth muscles and neuronal cell bodies in the myenteric plexus expressing motilin receptor immunoreactivity

were observed in antrum, duodenum, jejunum, ileum, proximal MCE公司 colon and middle colon of dogs. No motilin receptor immunoreactivity was found in smooth muscle cells. The duodenum and ileum were strongly immunoreactive than other regions and motilin receptor immunoreactivity weakened gradually in the lower part of digestive tract. Conclusion: Motilin receptors were specifically localized in dogs enteric nervous system of total gastrointestinal tract

except distal colon. Sections from duodenum and ileum exhibited strong motilin receptor immunoreativity and the expression of motilin receptor weakened gradually in the lower part of digestive tract. Key Word(s): 1. motilin receptor; 2. immunohistochemistry; 3. dog; 4. enteric nervous; Presenting Author: HONGYAN Z Additional Authors: NALI MENG, SHANSHAN CHEN Corresponding Author: NALI MENG Affiliations: The First Affiliated Hospital of Zhejiang Chinese Medical University Objective: Studying the role of the RAS – p38MAPK signaling pathway in the non-steroidal anti-inflammatory drugs-induced small intestinal injury, and its mechanism. Methods: Thirty-two male, health and clean Sprague-Dawley rats, divided randomly into blank group, model group, Valsartan group, and DX600 group, with eight for each group. The rats of blank group were given 0.9 percent normal saline 1 ml/100 g by gavage every day. The rats of model group were given diclofenac sodium and referenced to the long-term of human oral dose (75 mg/d), then conver into rats oral dose7.5 mg/d by gavage every day.

Table 1. Conventional white light gastroscopy findings Adenocarcinoma 2 Esophagitis RG7420 12 Hiatal hernia 9 Gastropathy (hyperemic) 71 Gastropathy (erosive) 7 Gastric atrophy 19 Metaplasia 2 Gastric ulcer 3 Of the 19 patients with endoscopic signs of atrophy 17 (90%) were confirmed by histology, in 14 patients (74 %) mild (OLGA stage I) and in 3 (16%) patients moderate (OLGA II) atrophy. Moreover 54 patients (67%) of endoscopically negative patients (n = 81) were diagnosed gastric mucosa atrophy histologically (47 (87%) = OLGA I, 6 (11%) = OLGA II and 1 (2%) = OLGA III. The negative predictive

value (NPV) is 34%. The sensitivity and specificity of endoscopy for the diagnosis of atrophy based on histological diagnosis of atrophy were 57.7% and 93.5%. Conclusion: Conventional white light endoscopy

cannot accurately diagnose atrophic gastritis in patients with changed serum pepsinogen tests (high risk group). Advanced endoscopy tecniques: magnification chromoendoscopy or narrow-band imaging (NBI)/flexible spectral imaging color enhancement (FICE) endoscopy with or without magnification may be offered in high risk patients as it improves diagnosis of such lesions. Key Word(s): 1. gastroscopy; 2. gastric atrophy; 3. serum pepsinogens; 4. diagnosis of atrophy; Presenting Author: RUSTEMOVIC NADAN Additional Authors: CUKOVIC-CAVKA SILVIJA, OPACIC MILORAD, BRINAR MARKO Corresponding Author: RUSTEMOVIC NADAN Affiliations: Dasatinib chemical structure Univ.Hospital Rebro Zagreb Objective: Recognition of specific IBD phenotype is sometimes difficult. The lack of specificity for the early diagnosis of pancreatic cancer(PC) based on symptoms that are also features of chronic pancreatitis(CP) requires histological proof. The aim of the study was to evaluate the real potentials of elastography in the field of inflammation and malignancy. Methods: A total of 55 IBD patients (30 with CD, 25 with UC), 48 patients with PC and 34 patients with CP

were included. Transrectal EUS-E was performed in all IBD patients, and standard EUS-E in other group. Results: A significant difference in strain ratio (SR) (median 1.18 vs 0.65; p = 0.0001) medchemexpress was detected between CD and UC groups. Active CD patients had a significantly higher SR compared to active UC patients. A significant difference in SR was observed between patients with PC and CP. In patients with pancreatic disease, ROC curve analysis detected SR value of 11.85 that had a 97,5% sensitivity and 95% specificity for PC. Patients with PC had a significantly higher SR in comparison with patients with all IBD phenotypes (median 22.54 vs 0.82; p = 0.0001). Conclusion: EUS-E shows highly significant sensitivity and specificity for distinction between PC and CP. On the other hand, single endoscopy presentation often combined with histology is not conclusive enough for defining the phenotype of IBD in most cases.

The variables hemoglobin and albumin 3-deazaneplanocin A price may explain the lower miR-122 levels identified in HIV infection, as HIV is known to cause anemia and has been associated with under-nutrition (HIV co-infected serum had lower median values for both hemoglobin and albumin, though not significantly). Additionally, the absence of an association between miR-122 and cirrhosis suggests that care must be taken when evaluating miR-122, as it may be influenced by factors distinct from liver injury. Disclosures: Mamta K. Jain – Advisory Committees or Review Panels:

Merck, Vertex, Boehringer Ingelheim ; Grant/Research Support: Vertex, Bristol-Myers Squibb, Pfizer, Janssen, Gilead, Boehrnger Ingelheim , Viiv Healthcare, EMD Serono William M. Lee-Consulting: Eli Lilly, Novartis; Grant/Research Support: Gilead, Roche, Vertex, BI, Anadys, BMS, merck; Speaking and Teaching: Merck The following people have nothing to disclose: Perry H. Dubin The natural alkaloid berberine (BRB) is commonly used as a supplement in the US, and has been shown to possess a wide range of pharmacological and biochemical effects, including protection against liver injury. In this study, we analyzed the effects of BRB in different murine models of liver injury, and investigated the

underlying mechanism of action. BRB (5 mg/kg i.p.) was tested in steatohepatitis induced by administration of a methionine and choline deficient (MCD) diet selleck compound and in acute acetaminophen (APAP) intoxication. The mechanism of action of BRB was further investigated 上海皓元医药股份有限公司 in LPS-stimulated murine macrophages (RAW 264.7) in vitro. Activation of the P2X7 receptor was assessed by measurement of calcium transients. BRB markedly suppressed ALT elevation and necroinflammation in MCD-fed mice. In addition, intrahepatic gene expression of CD11 b, CCL2, TGF-b, type I procollagen, andTNF were significantly downregulated in MCD-fed, BRB-treated mice. Feeding a MCD diet increased hepatic levels of mature IL-1 β and expression of all components of the NALP3 inflammasome pathway,

while these effects were limited by BRB. Surprisingly, administration of BRB to MCD-fed mice caused an excess of mortality, which could not be attributed to increased serum levels of BRB, measured by LC/MS mass spectrometry. In the model of APAP-induced hepatotoxicity, pretreatment with BRB reduced ALT elevation. Moreover, upregulation of the expression of NALP3 inflammasome components induced by APAP was limited by BRB, which also reduced mortality. Inflammasome activation in LPS-stimulated RAW 264.7 was markedly decreased by BRB, demonstrating a direct interference with activation of the inflammasome pathway. BRB did not affect the activation of NF-κB pathway, which provides an initial signal leading to inflammasome activation. However, exposure of RAW 264.

The tumor involved the medulla oblongata and the upper cervical spinal cord. Traditional MR imaging findings were unclear with regard to the differential

diagnosis between intramedullary glioma or a tumefactive demyelinating lesion, but an increase in regional cerebral blood volume and a decrease in fractional anisotropy of the lesion correctly suggested a high-grade glioma. MR PWI and DTI may prove helpful to diagnose glioblastoma of the cervical cord when other imaging features are inconclusive. “
“The integrity of the fornix using diffusion tensor imaging (DTI) in adolescent participants with acute mild traumatic brain injury (mTBI) compared to a demographically matched control group was examined. Fractional anisotropy (FA) in the fornix was elevated in the mild traumatic brain injured group. Performance on the Automated Neuropsychological Assessment Metrics (ANAM) was lower in the group with mTBI. A relation was found between lower performance find more on cognitive tasks and higher FA. The potential role of fornix injury as a basis of memory and processing speed deficits in mTBI is discussed. “
“The use of

an Metformin ultrasound-based evaluation of the optic nerve sheath diameter (ONSD) has previously been demonstrated for detecting raised intracranial pressure. In order to be feasible in clinical workup, the test qualities of transorbital ultrasonography need to be determined. The aim of this study was therefore to establish normal values and to assess the intra- and interobserver reliability of this method. Using a 9-3 MHz linear array transducer, the ONSD of 40 healthy subjects was independently measured by 2 investigators. Depicting the optic nerve and its sheath was possible in all individuals. The mean ONSD was 5.4 ± .6 mm with a range of 4.3-7.6 mm. The intraobserver reliability analyzed with Cronbach’s Alpha was found to be high with values

between .92 and .97. Pearson’s correlation coefficient between the 2 investigators was .81 on the right side and MCE .84 on the left. There was no correlation between ONSD and age, body mass index, or gender. Transorbital B-mode sonography is a feasible method to assess the ONSD with a high intra- and interobsever reliability. Normal values on ONSD are presented in this study that will be useful in future studies on pathological conditions. “
“Amygdala enlargement (AE) has been reported as an epileptogenic focus in subtypes of temporal lobe epilepsy (TLE). The purpose of this study was to investigate the clinical, morphological, and pathological characteristics of AE. We retrospectively reviewed the clinical data and imaging findings of 23 TLE patients with ipsilateral AE. We performed morphological MR analyses using FreeSurfer and voxel-based morphometry (VBM) in 14 of the 23 patients and in 20 controls whose images were obtained by a 3.0-Tesla MRI. A pathological study was also performed in 2 patients who underwent operations.

41-43 Consistent with our previous study which focused on recurrent HCC in patients with HBV infection,21

this study also uncovered an inverse association between the use of aspirin or NSAID and risk of HCC recurrence. The mechanism of this intriguing finding may involve induction of cell cycle arrest and apoptosis in HCC cells,44, 45 and should inspire more investigation. This study has applied a number of methodological procedures to avoid a biased or confounded result, in addition to adjusting for multiple parameters in the multivariate analyses. First, enrollment was explicitly restricted to patients who could tolerate and recover from liver resection, whose BTK pathway inhibitors performance status as well as hepatic reserve was therefore unlikely to contraindicate use of interferon and ribavirin. Second, in order to ensure comparability of the study cohorts, enrolled patients were matched by age, gender, and cirrhosis. The treated and untreated cohorts were consequently similar in their baseline characteristics including the comorbidity index,

i.e., the Charlson’s score. Moreover, matching in the time period from surgery to administration of antiviral therapy prevented the immortal time bias.23 Third, the universal coverage of Taiwan National Health Insurance, which fully reimbursed peg-interferon and ribavirin for treating HCV infection, AZD2014 research buy precluded healthcare accessibility or financial disparity as a determinant for receiving treatment or not. Last, but not least,

we recognized how mortality might have confounded the estimation of the association with HCC recurrence.46 Since antiviral treatment MCE公司 could have affected survival by ameliorating the background liver disease, without relation to any effect on HCC, the higher mortality in the untreated patients would have overestimated their HCC recurrence rate and spuriously exaggerated the difference between the study cohorts, had the censoring caused by death been simply dismissed as noninformative.47, 48 All in all, information from these careful analyses should be valuable for physicians and surgeons who need to weigh the pros and cons of using peg-interferon and ribavirin after resection of HCC, even though the observational nature of this study prevented definite ascertainment of the causal relationship. Several limitations warrant discussion. First, a lack of direct laboratory results in the Taiwan NHIRD prohibited exploration in terms of virological response, viral genotype, baseline viral load, size and number of tumors, and histological differentiation. Second, we were unable to determine the adverse reactions related to peg-interferon and ribavirin. Nevertheless, nearly 90% of those who ever started postoperative antiviral therapy eventually completed a minimum of a 16-week course, indicating tolerability of this regimen in these patients.