Hepatic falciform ligament artery in patients with chronic liver diseases: detection on computed tomography hepatic arteriography

BACKGROUND

The detection rate of hepatic falciform ligament artery (FLA) has been reported as ranging from 2-25%. The rate of FLA on laparotomy, however, is reported to be higher, at 68%.

PURPOSE

To compare the detection rate of FLA on computed tomography hepatic arteriography (CTHA) with that on angiography and dynamic CT, and to clarify the clinical significance of FLA in patients with chronic liver disease.

MATERIAL AND METHODS

126 consecutive patients underwent CTHA angiography and dynamic CT to evaluate suspected liver tumors. Liver function was classified as follows: normal, n=5; Child-Pugh class A, n=94; B, n=21; and C, n=6. All CT images were obtained using multidetector (MDCT) scanners (Aquilion; Toshiba, Tokyo, Japan). For CTHA, CT images were obtained during contrast material injection through the left hepatic, proper, or common hepatic artery. On CT, FLAs were retrospectively identified within the hepatic falciform ligament and the hepatic round ligament by the paging method on a workstation (TWS-5000; Toshiba, Tokyo, Japan). The detection rates were compared among the three modalities (hepatic arterial phase of dynamic CT, CTHA, and angiography). The calibers of FLA were also correlated with the hepatic function of the patients.

RESULTS

The detection rates of FLA by angiography, dynamic CT, and CTHA were 37% (47/126), 10% (13/126), and 77% (97/126), respectively. The calibers of FLA increased as the hepatic function deteriorated (P=0.001).

CONCLUSION

The detection rates of FLA with CTHA are far higher than those with angiography and dynamic CT. Careful interpretation with recognition of FLA on CTHA images is important, as inadvertent embolization or chemotherapeutic infusion of the FLA may result in supraumbilical skin rash.

Antiviral effect of arginine against herpes simplex virus type 1

We investigated the effects of arginine on the multiplication of herpes simplex virus type 1 (HSV-1) and the potential of arginine as an antiherpetic agent. Arginine suppressed the growth of HSV-1 concentration-dependently. Inhibition of HSV-1 by arginine leveled off at 50-60 mM, although the higher concentration was not suitable as an antiviral agent due to cytotoxicity. 'Time of addition' experiments revealed that arginine was particularly effective when added within 6 h post-infection (h p.i.), suggesting that the reagent sensitive step is in the early stages of the infection. A one-step growth curve of HSV-1 in the presence of 30 mM arginine revealed that: i) the latent period was significantly extended, ii) the rate of formation of progeny infectious virus decreased and iii) the final yield of progeny virus decreased to 1%. The addition of arginine at 8 h p.i., after the completion of viral DNA replication in the virus multiplication, allowed the normal formation of progeny virus in the subsequent 4 h, confirming that arginine does not directly interfere with the formation of progeny infectious virus. In addition, arginine also inhibits several RNA viruses.

A ROLE FOR APOPTOSIS INDUCED BY ACUTE HERPES SIMPLEX VIRUS INFECTION IN MICE

Acute herpes simplex virus (HSV) infection causes apoptosis in the adrenal cortex and myenteric plexus of the gut, ovary, pituitary gland, and liver of mice. Apoptosis of infected cells is increased in immunosuppressed regions of the adrenal cortex and liver of macrophage-depleted mice. HSV carries the US3 gene which interferes with host cell apoptosis. When the livers of macrophage-depleted mice are infected with a US3-null virus, apoptosis occurs in the narrow areas of inflammatory cell infiltration, restricting viral replication and spread. Thus, these data suggest that apoptosis may function as a primitive immune response to HSV infection in mice.

Biodistribution and ultrastructural localization of single-walled carbon nanohorns determined in vivo with embedded Gd2O3 labels

Single-walled carbon nanohorns (SWNHs) are single-graphene tubules that have shown high potential for drug delivery systems. In drug delivery, it is essential to quantitatively determine biodistribution and ultrastructural localization. However, to date, these determinations have not been successfully achieved. In this report, we describe for the first time a method that can achieve these determinations. We embedded Gd(2)O(3) nanoparticles within SWNH aggregates (Gd(2)O(3)@SWNHag) to facilitate detection and quantification. Gd(2)O(3)@SWNHag was intravenously injected into mice, and the quantities of Gd in the internal organs were measured by inductively coupled plasma atomic emission spectroscopy: 70-80% of the total injected material accumulated in liver. The high electron scattering ability of Gd allows detection with energy dispersive X-ray spectroscopy and facilitates the ultrastructural localization of individual Gd(2)O(3)@SWNHag with transmission electron microscopy. In the liver, we found that the Gd(2)O(3)@SWNHag was localized in Kupffer cells but were not observed in hepatocytes. In the Kupffer cells, most of the Gd(2)O(3)@SWNHag was detected inside phagosomes, but some were in another cytoplasmic compartment that was most likely the phagolysosome.

Microcoil embolization through a downsized coaxial catheter system: an experimental study

BACKGROUND

Most of the recently developed microcatheters for abdominal angiography still have large diameters at their trailing ends, and thus cannot be used for microcoil embolization in combination with a 3-French (F) system.

PURPOSE

To evaluate the in vitro passage of microcoils through a newly developed 2-F microcatheter (Meister Cath Superselective Plus, MC6) that is compatible with a downsized coaxial catheter system (3-F system) in an experimental study.

MATERIAL AND METHODS

We evaluated the passage of microcoils through MC6 within a blood vessel model using the saline flush technique. Six types of microcoils and 17 size variations (maximal curled diameter 2-10 mm, total length 20-140 mm) were used. We evaluated the passage and post-deployment shape of the microcoils as well as the volume of saline required to flush them.

RESULTS

In the experimental study, all microcoils passed through the MC6 and deployed in a satisfactory manner without catheter occlusion. The mean volumes of saline required to flush the TORNADO (n=1), Reverse TORNADO (n=6), HILAL (n=1), Micronester (n=3), VortX (n=4), and C-Stopper Coil (n=2) were 0.7 ml, 0.58+/-0.20 ml, 0.5 ml, 0.57+/-0.058 ml, 3.5+/-1.5 ml, and 0.70+/-0.14 ml, respectively. There was a statistically significant difference in the mean volume of saline required between the VortX and Reverse TORNADO (P=0.029), and between the VortX and C-Stopper Coil (P=0.031). The VortX required the greatest volume of saline.

CONCLUSION

Microcoil embolization through a 3-F system appears to be feasible for the coils examined in this study.

Efficacy of left ventricular restoration with mitral valve surgery for endstage ischemic cardiomyopathy

Patients with ischemic cardiomyopathy (ICM) are at an extremely high risk of death and ischemic events. This study aims to evaluate the impact of left ventricular restoration (LVR) and mitral valve surgery on the cardiac and clinical functional status of the patients with ICM. Twenty-six patients (46-80 years, mean: 64 years) with severely dilated heart (left ventricular end-systolic volume index: LVESVI > or = 100 ml/m2) who had coronary artery bypass grafting (2.8+/-1.3), mitral valve surgery, and LVR were enrolled in this study. Left ventricular end-diastolic volume index and LVESVI significantly decreased (from 169+/-44 to 130+/-41 ml/m2, P=0.0005, from 120+/-33 to 89+/-43 ml/m2, P=0.0012). Left ventricular ejection fraction showed no change. MR showed significant improvement (from 2.7+/-0.6 to 1.0+/-0.4, P<0.0001) and NYHA functional class showed improvement (from 3.2+/-0.8 to 1.5+/-0.9, P<0.0001). A 5-year survival rate was 71.2%. In conclusion, this aggressive approach with LVR aiming to treat end-stage ICM by relief of ischemia, reduction of LV wall tension by decreasing LV volume and stopping mitral leak, is effective for LV volume reduction and improvement of clinical functional status.

Visible light-induced degradation of ethylene glycol on nitrogen-doped TiO2 powders

The photocatalytic degradation processes of ethylene glycol (EG) during the UV or visible light irradiation of pure anatase and nitrogen (N)-doped TiO2 powders (TiO(2-x)N(x), x = 0, 0.002, 0.003, and 0.007) were investigated using time-resolved diffuse reflectance (TDR) and solid-state NMR spectroscopies. The TDR spectra and time traces observed for the charge carriers indicated that the scavenging of photogenerated holes (h+) by EG occurred during the 355-nm laser photolysis of the N-doped TiO2 powders, while no direct oxidation reaction of EG by h+ occurred during the 460-nm laser photolysis, although the charge carriers were sufficiently generated upon excitation. The solid-state magic-angle spinning (MAS) NMR measurements revealed that EG is preferentially chemisorbed on the surface of the N-doped TiO2 powders, in contrast to the pure TiO2, and degrades under visible light irradiation.

Visible Light Sensitive Photocatalyst, Delafossite Structured α-AgGaO2

Delafossite structured alpha-AgGaO(2) powder was successfully synthesized through a cation exchange reaction. alpha-AgGaO(2) has a band gap of 2.4 eV, absorbs visible light up to 520 nm, and effectively decomposes 2-propanol to CO2 via acetone by irradiating with either UV light (300-400 nm) or visible light (420-530 nm). The values of the quantum efficiency are similar (ca. 0.6%) under light irradiations with wavelengths of 365, 390, 430, 470, and 510 +/- 10 nm, but steeply decrease with wavelengths longer than 530 +/- 10 nm, which support a 2.4 eV band gap. In contrast, the other polymorph, alpha-AgGaO(2) powder, which has a band gap of 2.1 eV, shows a negligible activity when irradiating with either UV light or visible light. The higher oxidation activity of alpha-AgGaO(2) is probably due to its larger band gap, which is formed at the top of its valence band in a lower energy region as compared to alpha-AgGaO(2). Moreover, the first-principle calculations of alpha-AgGaO(2) and alpha-AgGaO(2) clearly indicate that alpha-AgGaO(2) has a remarkably larger dispersed valence band as compared to alpha-AgGaO(2), which is advantageous to the photocatalytic activity due to the efficient hole conduction.

Pathogenesis of herpes simplex hepatitis in macrophage-depleted mice: possible involvement of tumor necrosis factor-alpha and inducible nitric oxide synthase in massive apoptosis

Massive liver cell death provoked in silica-treated mice subsequently infected with herpes simplex virus (HSV)-1 is very similar pathohistologically to the cell death observed in human fulminant hepatitis. Previously, we have shown this liver cell death to be extensive apoptosis. In the present study, we examined various factors related to liver damage patho- and immunologically, as well as by reverse transcription-polymerase chain reaction. Tumor necrosis factor (TNF)-alpha, inducible nitric oxide synthase (iNOS), interferon (IFN)-alpha, and interleukin-6 mRNAs were detected to a much greater extent in silica-treated mice compared with control mice after HSV-1 infection, and excessive expression of iNOS mRNA and cytokine mRNAs in the liver may be closely related to massive liver cell apoptosis. The apoptosis was less related to the fas ligand than to TNF-alpha. Silica blockage of macrophages makes the liver cell extremely vulnerable to HSV-1 infection, and it induced expression of E-selectin and neutrophil margination in the liver. Subsequent HSV-1 infection induced excessive production of iNOS and cytokines, particularly TNF-alpha, but administration of anti-TNF-alpha antibody or NG-monomethyl-L-arginine was not completely efficacious for the survival of the mice. Overproduction of free radicals in combination with cytokines, such as TNF-alpha, IL-6 and IFN-alpha, may result in hepatic cell apoptosis.