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During the catalytic cycle of GPX4, the active selenol (-SeH) is oxidized by peroxides to selenenic acid (-SeOH), which is then reduced with glutathione (GSH) to an intermediate selenodisulfide (-Se-SG)

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The success of newer options such as chemoembolization, metronomic therapy, antiangiogenic drugs, and tyrosine kinase inhibitors in the treatment of these patients has not been clearly established.41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53 Hepatocellular Carcinomas The macroscopic presentation is clinically very important (see Figure 61-26 ), as 100% of the diffuse forms have metastasis at the time of diagnosis, versus 37% of the isolated (massive or nodular) clinical presentations