Background Osteopenia, loss of bone mineral density (BMD), was recently identified to be independently associated with early marker of deconditioning that precedes sarcopenia in patients with hepatocellular carcinoma (HCC). The aim of this study was to clarify the impact of osteopenia as the risk factor for mortality after living donor liver transplantation (LDLT) compared with already‐reported biological markers. Methods Data were collected retrospectively for all consecutive patients who underwent LDLT for HCC at our institution between January 1998 and December 2015. BMD was evaluated with computed tomographic measurement of pixel density in the midvertebral core of the 11th thoracic vertebra. Data related to clinicopathological parameters and prognosis were analyzed. Results The median value of BMD was 163.6 Hounsfield units and osteopenia was identified in 103 (53.4%) of the 193 recipients, according to the age‐specific formula. In addition to the other tumor burdens, such as tumor numbers ≥5 (HR 2.521, P = 0.027), DCP levels >200 mAU/mL (HR 2.678, P = 0.006), and neutrophil‐to‐lymphocyte ratio ≥3.01 (HR 2.068, P = 0.025), osteopenia (HR 2.106, P = 0.024) was independent risk factor for mortality by multivariate analysis. Overall survival of the patients who met the two risk factors and more was significantly lower than the others (HR 5.382, P < 0.001). Besides, the calibration plot for the 5‐year overall survival using nomogram was predicted very well (C‐index 0.746). Conclusions Preoperative osteopenia was independently associated with post‐LDLT mortality among patients with HCC. Moreover, risk score and nomogram with calibration curve were developed to confirm the clinical usefulness of osteopenia for post‐LDLT patients.

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Inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) are reportedly predictive of long-term outcomes in several cancers. We evaluated their correlations with post-surgical long-term outcomes in patients with mass-forming (MF) intrahepatic cholangiocarcinoma (ICC). Methods:We included 52 patients who underwent hepatic resection for MF-ICC at our hospital. We determined cutoff values of NLR, LMR and PLR, using receiver operating characteristics curves, and compared survival rates of patients with high-and low values. We also evaluated a prognostic scoring system based on significant inflammatory biomarkers.Results: Cutoff values were determined as NLR: 1.93, LMR: 4.78, and PLR: 98. The high-NLR and low-LMR groups had significantly worse prognoses than the low-NLR and high-LMR groups, respectively. We therefore designed a scoring system (inflammation score [IS]) based on NLR and LMR values that stratified patients into three groups (scores 0, 1, or 2). IS was significantly correlated with overall survival 4

A sensitive and accurate internal standard method to determine melatonin in mammalian tissues and physiological fluids has been described. This method includes the oxidation of melatonin to a highly fluorescent compound, N-[(6-methoxy-4-oxo-1,4-dihydroquinolin-3-yl)methyl]acetamide (6-MOQMA), and the determination of 6-MOQMA by a reversed-phase HPLC system. For the accurate and reliable determination, several melatonin analogs were designed and utilized as the internal standards, and ethyl and isopropyl analogs (having the corresponding alkyl group via the amide bond of melatonin instead of the methyl group) were found to be promising. Using these internal standards, highly accurate and sensitive determination could be accomplished using rat pineal gland samples, and the clear circadian rhythms are demonstrated. This method was also successfully applied to the determination of melatonin in a small amount (20 microL) of human saliva.