[Surgical Cases of Rupture of Hepatocellular Carcinoma after Transcatheter Arterial Embolization].

Rupture of hepatocellular carcinoma(HCC)is a disease wherein the prognosis is poor. In this study, we investigated cases of rupture of HCC that we encountered over 18 years. The age of onset ranged 48-76 years(67 years on average). The patients included 5 males and 1 female. All the cases experienced onset with rapid abdominal pain or loss of consciousness. Shock conditions appeared in 3 cases. Arrest of bleeding was possible by transcatheter arterial embolization(TAE)in all the cases. Subsequently, systemic search and evaluation of hepatic functional reserve were conducted. Hepatectomy was performed in all the cases. No notable complications occurred after the surgery. Two patients with recurrent peritoneal dissemination died of the original disease within 2 years. In the other 3 patients, recurrence has not occurred, and 2 of them have achieved long-term recurrence-free survivals for 4 years or longer. Therefore, based on the findings, we consider that longterm survival can be expected, depending on individual cases.

A unique N-glycan on human transferrin in CSF: a possible biomarker for iNPH.

Idiopathic normal pressure hydrocephalus (iNPH) is an elderly dementia caused by abnormal metabolism in the cerebrospinal fluid (CSF). The tap test is the current basis for confirming iNPH, but it shows very low sensitivity, indicating that many patients who might be cured by a shunt operation will be missed. On sodium dodecyl sulfate-polyacrylamide gel electrophoresis, we found two transferrin isoforms: one had a unique N-glycan (Tf-1) whereas the other had N-glycan similar to that of serum transferrin (Tf-2). Glycan analyses revealed that Tf-1 had branching (biantennary) asialo- and agalacto-complex type N-glycans (N-acetylglucosamine [GlcNAc]-terminated glycans), which carried bisecting ß1,4-N-acetylglucosamine and core α1,6-fucose. To examine glycoform whether changes in iNPH, we introduced the Tf-2/Tf-1 ratio as a diagnostic index, which minimized blot-to-blot variations in measurement. The Tf-2/Tf-1 ratios of iNPH patients are significantly higher than those of controls (p = 0.0019) and Alzheimer's patients (p = 0.0010). This suggests that the Tf-2/Tf-1 ratio could distinguish iNPH from Alzheimer's disease, and possibly other dementias. In conclusion, glycoform analysis has diagnostic potential in neurological diseases.