Database analysis of patients with hepatocellular carcinoma and treatment flow in early and advanced stages.

Despite recent developments in treatment modalities and diagnosis, the prognosis of advanced hepatocellular carcinoma (HCC) remains unsatisfactory. To gain insight into treatment decisions for HCC patients, their characteristics and treatment flow in the early and advanced stages were examined. HCC patients' characteristics and treatment flow were retrospectively analyzed using the Japanese medical claims database. The 8999 patients' mean age at HCC diagnosis was 71.1 years, with no difference between early (Stage I/II) and advanced (Stage III/IV) stages. The mean observation period was 26.2 months, shorter in advanced than in early stages. HCV hepatitis was reported in 52.0% of HCC patients, with concomitant hypertension in 53.4%, type 2 diabetes in 45.8%, cirrhosis in 39.3%, and hyperlipidemia in 15.5%. The rates of HCV hepatitis, hypertension, and hyperlipidemia decreased with stage progression. Analysis of treatment flow showed that, at all disease stages, transcatheter arterial chemoembolization (TACE) was the most common first to fourth-line treatment. Epirubicin was the most frequently (44.1%) used chemotherapeutic agent for first-line TACE, followed by miriplatin (23.6%) and cisplatin (12.3%). With stage progression, cisplatin use increased. Sorafenib was used concomitantly for first-line TACE in 3.2% of patients, and its use increased significantly in advanced stages. Clear differences in baseline characteristics and treatment flow between early and advanced stages were identified. Continuous analysis of the database with longer follow-up may provide useful information about treatment selection and prediction of outcome such as survival.

Thermodynamic theory of the shock wave structure in a rarefied polyatomic gas: beyond the Bethe-Teller theory.

The structure of a shock wave in a rarefied polyatomic gas is studied on the basis of the theory of extended thermodynamics. Three types of the shock wave structure observed in experiments, that is, the nearly symmetric shock wave structure (type A, small Mach number), the asymmetric structure (type B, moderate Mach number), and the structure composed of thin and thick layers (type C, large Mach number), are explained by the theory in a unified way. The theoretical prediction of the profile of the mass density agrees well with the experimental data. The well-known Bethe-Teller theory of the shock wave structure in a polyatomic gas is reexamined in the light of the present theory.

Shock-induced phase transition in systems of hard spheres with internal degrees of freedom.

Shock waves and shock-induced phase transitions are theoretically and numerically studied on the basis of the system of Euler equations with caloric and thermal equations of state for a system of hard spheres with internal degrees of freedom. First, by choosing the unperturbed state (the state before the shock wave) in the liquid phase, the Rankine-Hugoniot conditions are studied and their solutions are classified on the basis of the phase of the perturbed state (the state after the shock wave), being a shock-induced phase transition possible under certain conditions. With this regard, the important role of the internal degrees of freedom is shown explicitly. Second, the admissibility (stability) of shock waves is studied by means of the results obtained by Liu in the theory of hyperbolic systems. It is shown that another type of instability of a shock wave can exist even though the perturbed state is thermodynamically stable. Numerical calculations have been performed in order to confirm the theoretical results in the case of admissible shocks and to obtain the actual evolution of the wave profiles in the case of inadmissible shocks (shock splitting phenomena).

Prediction and simulation of compressive shocks with lower perturbed density for increasing shock strength in real gases.

In this paper we predict and simulate a peculiar type of compressive shock in a real gas modeled by the van der Waals constitutive equation. This shock produces a phase transition from the gas to the liquid phase and, under some special circumstances, back to the gas phase. This shock has a quite unusual property that when the perturbed pressure (the pressure after a shock) increases, the perturbed density decreases and tends to a limit value from above, in contrast with the ordinary well-known compressive shock in which the density tends to the limit value from below. To achieve such a compressive upper shock, it is necessary to choose the unperturbed state (the state before the shock) in a very thin region in the ρp plane, characterized by low values of density and pressure, near the gas-liquid coexistence curve. This region, which depends on the internal degrees of freedom of a constituent molecule, is completely identified.