Background/Aim: We investigated the antiproliferative effect of quercetin on liver cancer cell lines. Materials and Methods: Thirteen liver cancer cell lines were cultured followed by treatment with varying concentrations of quercetin (0-100 μM) or quercetin and 5-FU, and the cell viability was analysed by the MTT assay. Flow cytometry was also used to examine cell cycle progression after treatment with quercetin. Results: The addition of quercetin resulted in a dose-and time-dependent suppression of cell proliferation. In some cell lines, treatment with quercetin and 5-FU caused an additional or synergistic effect. Most cell lines displayed cell cycle arrest at different phases of the cell cycle. Conclusion: Quercetin inhibits the proliferation of liver cancer cells via induction of apoptosis and cell cycle arrest.Hepatocellular carcinoma (HCC) is the most frequent primary cancer, and an important medical problem (1). Many HCC patients have a history of chronic hepatitis or liver cirrhosis caused by Hepatitis B virus (HBV) or Hepatitis C virus (HCV) infection (2-4). Treatments for poor liver function associated with hepatitis are limited and outcomes are poor. Even with the most successful treatments, the 5year recurrence rate of HCC is very high (1). Treating and preventing recurrence is critical for improving survival rates.Quercetin is a type of flavonoid contained in many plants, and possesses antioxidant, anti-inflammatory, and immuno-logical capabilities (5). Quercetin can suppress cell proliferation and induce apoptosis in human cancers, including breast, lung, oral, and prostate; however, there is no report on its effect on liver cancer (6-9). In the current study, we examined the antitumor effects of quercetin on 13 HCC cell lines in vitro. Materials and MethodsCell lines and cell culture. This study utilized 11 HCC cell lines (KIM-1, KYN-1, KYN-2, KYN-3, HAK-1A, HAK-1B, HAK-2, HAK-3, HAK-4, HAK-5, and HAK-6), and 2 human combined hepatocellular and cholangiocarcinoma (CHC) cell lines (KMCH-1 and KMCH-2). The cell lines were originally established in the Department of Pathology, Kurume University Faculty of Medicine, and each of them retains the morphological and functional features of the original tumor as previously described (10-18). Each cell line was grown in Dulbecco's modified Eagle medium (Nissui Seiyaku, Co., Japan) supplemented with 2.5% heat-inactivated (56˚C, 30 min) fetal bovine serum (Bioserum, Victoria, Australia), 100 U/ml penicillin, 100 μg/ml streptomycin (GIBCO BRL/Life Technologies, Inc., Gaithersburg, MD, USA) and 12 mmol/l sodium bicarbonate, in a 5% CO 2 humidified atmosphere at 37˚C. Effects of quercetin on the proliferation of hepatocellular carcinoma and combined hepatocellular and cholangiocarcinoma cell lines in vitro.The effects of quercetin with and without 5-FU on proliferation were examined using 3-(4,5-dimethylthiazol-2yl-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay kit (Chemicon, Temecula, CA, USA) as previously described (10). Quercetin was obtained from Sigma Chem...

Summary Although an accurate anatomical understanding of the hepatic arteries is the most and essential step in living‐related liver transplantation (LRLT), the need to reduce the burden place on the donor should be considered in imaging diagnosis. The present study examined the reliability of intravenously enhanced three‐dimensional (3D) angiography from multidetector‐row computed tomography (MDCT) in evaluating the anatomical configuration of the hepatic arteries comparing with those from conventional angiography by Seldinger method. A total of 109 patients underwent MDCT and 3D images were reconstructed on arterial phase using the volume rendering (VR) method. In the case of 3D angiography, at an infusion rate of 4 ml/s, the extrahepatic hepatic arteries were visualized successfully in all cases (the right, left and middle hepatic artery). The aberrant hepatic arteries were successfully visualized in 23 of 24 cases. The 3D angiography is a reliable method of visualizing the extrahepatic and aberrant hepatic arteries. This minimally invasive examination procedure is useful in individual operative planning and is help to increase the safety of surgery.

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Summary: T2 (tumor invades perimuscular connective tissue; no extension beyond serosa or into liver) gallbladder cancer has generally been treated by S4aS5 subsegmentectomy (S4aS5 HR). We investigated the therapeutic effect of full-thickness cholecystectomy (FC) and gallbladder bed resection (GBR), in terms of tumor location and resection margin (distance from the tumor). At our department we employ the following protocol to determine the extent of resection needed to achieve R0 status: (1) A tumor located in the gallbladder fundus (Gf) or body (Gb) and only on the free peritoneal side was classified as P-type, for which full-thickness cholecystectomy and regional lymph node dissection were performed. (2) A tumor located in Gf or Gb and in contact with the liver bed was classified as H-type, for which gallbladder bed resection and regional lymph node dissection were performed. (3) A tumor located in the gallbladder neck (Gn) was classified as N-type, for which gallbladder bed resection, bile duct resection, and regional lymph node dissection were performed.Twenty-two patients admitted to our department between January 2000 and December 2014 with pT2gallblad-der cancers were included in our study. Surgical procedures performed were compared with those specified in our protocol, and patients in whom the extent of resection was greater than that specified in our strategy were evaluated clinicopathologically and in terms of recurrence and the prognosis.Six (27.2%), 7 (31.8%), and 9 (40.9%) patients underwent limited, standard, and extended surgery, respectively. Ten (66.7%) of 15 patients with tumors close to the liver bed underwent cholecystectomy or extended surgery, 7 (85.7%) of 8 patients with tumors close to the bile duct underwent bile duct resection, and 16 (72.7%) of 22 patients underwent regional lymph node dissection.Recurrence at the bile duct resection margin, para-aortic lymph node metastasis, and hepatic metastasis occurred in 2, 1, and 3 patients, respectively. The 3-year survival rates (for patients including those dying of noncancer causes) were 50, 100, and 75% after limited, standard, and extended surgery, respectively.There was a significant difference in the survival rate of patients who underwent standard or extended surgery (P=0.0273).Favorable results were obtained in T2 gallbladder cancer patients without performing S4aS5 subsegmentectomy. Depending on the tumor location, neither full-thickness cholecystectomy nor gallbladder bed resection appeared to pose problems regarding recurrence or prognosis.In conclusion, surgical treatment based on our protocol, which aims to achieve the condition of R0, may result in a sufficient therapeutic effect.

Background/Aim: The aim of this study was to investigate the effects of preoperative chemotherapy on the healthy, metastasis-free part of the liver in colorectal cancer patients with liver metastasis, and the relationship between chemotherapy and postoperative complications. Patients and Methods: Our study included 90 cases of colorectal cancer liver metastasis resected after preoperative chemotherapy. The patients were divided into three groups according to the received chemotherapy regimen: 20 cases received mFOLFOX6, 54 cases a combination of mFOLFOX6 with bevacizumab, and 16 cases a combination of mFOLFOX6 and cetuximab or panitumumab. Results: The mean numbers of sinusoidal injuries for each chemotherapy type were compared. The group treated with the combination of mFOLFOX6 and bevacizumab showed a lower extent of sinusoidal injury relative to other groups; this intergroup difference became increasingly remarkable as the number of chemotherapy cycles increased. Complications of various extents were found in all three groups, but no significant differences were observed between the three groups. Conclusion: In cases where preoperative chemotherapy was extended over a long period, combined use of bevacizumab was thought to be effective because of stabilization of disturbed liver hemodynamics resulting from sinusoidal injury suppression effects, allowing effective distribution of anti-cancer agents to tumors. Colorectal cancer is one of the most frequently occurring malignant tumors worldwide (1). Approximately 60% of colon cancer patients have been reported to have complications of liver metastasis during the course of their disease (2). Surgical treatment presents the only possibility of curative treatment for colorectal cancer liver metastasis and has a strong impact on prognosis. A variety of efforts in recent years including preoperative liver function evaluation, preoperative chemotherapy, surgical procedures, preoperative management, and so on, have been reported to improve prognosis and liver resectability. Still, the major factor is the burden of chemotherapy itself (3-7). It has been reported (8) that, in cases where radical resection is possible, colorectal cancer liver metastasis shows approximately 60% recurrence, 80% of which are unresectable. Thus, chemotherapy will certainly play an increasingly important role in the future. Preoperative chemotherapy for colorectal cancer liver metastasis plays an important role in a regimen of multidisciplinary treatment. Chemotherapy also involves tissue adverse effects, and there are apprehensions regarding the effects on remnant liver when hepatectomy is performed following systemic chemotherapy (9). Veno-occlusive disease (VOD) (10), also known as sinusoidal obstruction syndrome (SOS), is a pathology that causes injury to sinusoidal and venule endothelial cells and is reported to be caused by radiotherapy, chemotherapy, and so on. Numerous reports have stated that SOS incidence is high in chemotherapy for colorectal cancer liver metastasis, especially in re...