Living donor liver transplantation (LDLT) is a definitive procedure for splenomegaly caused by liver cirrhosis and portal hypertension, but splenomegaly persists in some patients. The aim of this ...study was to clarify the long-term changes in the spleen volume after LDLT.
The 13 pediatric patients who survived for >8 years after LDLT were retrospectively analyzed. We calculated the spleen volume/standard spleen volume (SV/SSV) ratio by automated computed tomography (CT) volumetry. We assessed the spleen volumes before LDLT, at roughly postoperative week (POW) 4, at postoperative year (POY) 1, at POY 5, and at POY 10.
With regard to SV as evaluated by CT volumetry, there were no consistent trends, with median values as follows: before LDLT, 282.5 (71–641) cm3; POW 4, 252 (109–798) cm3; POY 1, 222.5 (97–948) cm3; POY 5, 263.5 (123–564) cm3; and POY 10, 377 (201–1080) cm3. In contrast, the SV/SSV ratio decreased chronologically as follows: before LDLT, 5.0 (0.7–6.0); POW 4, 3.7 (2.3–4.3); POY 1, 2.2 (1.7–6.3); POY 5, 1.7 (1.1–5.4); and POY 10, 1.4 (1.1–6.9). In the remote phase after LDLT, many cases showed a trend toward an improved SV/SSV ratio, but splenomegaly was prolonged without improvement in 3 cases (23.1%) with portal vein complications and advanced fibrosis. Furthermore, all 3 cases showed a decreased platelet count due to hypersplenism.
Splenomegaly requires a long time to demonstrate an improvement. In cases without an improvement of splenomegaly, we should suspect abnormalities in the graft liver and portal hemodynamics.
•Our study clarified the long-term changes in the spleen volume after living donor liver transplantation.•Splenomegaly requires a long time to achieve an improvement.•In cases without an improvement of splenomegaly, we should suspect abnormalities in the graft liver and portal hemodynamics.
When there is an anatomic anomaly in the biliary tract of the donor for living-donor liver transplantation, the risk of postoperative biliary tract complications increases in both the donor and the ...recipient. We studied a case of living-donor liver transplantation with a left hepatic lobe graft that had anatomic anomalies, in which the medial segmental branch (B4) joined the anterior segmental branch and the posterior segmental branch formed a common trunk with the lateral segmental branch. A 40-year-old man visited our institution as a candidate organ donor for his mother, who had end-stage liver failure. An anomaly of B4 connecting the anterior segmental branch was suspected on magnetic resonance cholangiopancreatography. On intraoperative cholangiography, confluence of B4 with the anterior segmental branch and connection of the posterior and lateral segmental branches forming a common trunk were confirmed. Accordingly, individual anastomoses of the lateral segmental branch and B4 with the recipient jejunum were planned, and a left-lobe graft was excised. The postoperative recovery was smooth, and the donor was discharged with no complications. Even when an anatomic anomaly is present in the donor bile duct, in urgent cases, accurate evaluation through the use of various modalities may enable living-donor liver transplantation with the use of a graft with an anatomic anomaly.
•Even when an anatomic anomaly is present in the donor bile duct, accurate evaluation through the use of various modalities may enable living-donor liver transplantation.•Magnetic resonance cholangiopancreatography and intraoperative cholangiography are necessary in living-donor liver transplantations to identify accurate morphology of bile ducts.
The relationship between smoking cessation and weight gain is well recognized. Examining the link between smoking cessation and weight gain in donor candidates for living donor liver transplantation ...(LDLT) is an important topic because of the influence of weight gain on the liver. This study assessed body weight (BW) changes after smoking cessation in donor candidates for LDLT.
The 27 donor candidates were retrospectively analyzed. The smoking status was determined based on questionnaires administered at the initial presentation, and the candidates were divided into 2 groups: recent quitters and nonsmokers. The changes in BW were compared between the groups.
The recent quitters group included 10 (37.0%) candidates, and the nonsmokers group included 17 (63.0%). In the nonsmokers group, 1 candidate had gained weight since the initial presentation. In contrast, in the recent quitters group, 70.0% of candidates had gained weight since the initial presentation (P < .01). The change in BW from the initial presentation was greater in recent quitters than in nonsmokers (+1.6 kg +2.4% vs −0.5 kg −0.9%; P < .01). Two candidates in the recent quitters group gained ≥ 5 kg 8% of weight. One of these 2 candidates was judged to be in a donor-inadequate status because of the appearance of fatty liver.
Weight gain due to smoking cessation was observed in donor candidates for LDLT. The amount of weight gain after smoking cessation is highly individualized, so everyone concerned with LDLT must be alert to its potential development.
•Weight gain after smoking cessation was observed in living donor candidates for liver transplantation.•The amount of weight gain after smoking cessation is highly individualized.•One candidate whose weight rapidly increased was judged to be in a donor-inadequate status because of the appearance of fatty liver.
The inferior petrosal sinus (IPS) is the main transvenous access route used to examine or treat lesions involving the cavernous sinus. To carry out these procedures successfully, one must have a ...detailed knowledge of the anatomy of the venous system around the junction of the IPS and the internal jugular vein (IJV).
Eighty-three sides in 63 patients (26 men, 37 women; mean, 56.5 years of age) were examined by using 3D rotational venography (3DRV).
The drainage patterns of the IPS could be classified into the following 6 types, with emphasis on the level of IPS-IJV junction: type A, the IPS drains into the jugular bulb in 1/83 sides (1.2%); type B, the IPS drains into the IJV at the level of the extracranial opening of the hypoglossal canal in 29/83 sides (34.9%); type C, the IPS drains into the lower extracranial IJV in 31/83 sides (37.3%); type D, the IPS forms a plexus and has multiple junctions to the IJV near the jugular foramen in 5/83 sides (6.0%); type E, the IPS drains directly into the vertebral venous plexus (VVP) with no connection to the IJV in 3/83 sides (3.6%); and type F, the IPS is absent in 14/83 sides (16.9%). Each type is also characterized by the way of anastomosis with the VVP.
This classification seemed to be rational from the embryologic viewpoint, and it may be useful in establishing treatment strategies that involve endovascular manipulation via the IPS.
Abstract Background Recent study has demonstrated the important role of endothelial-mesenchymal interactions in 3-dimensional self-organization of immature progenitor populations with the use of ...mimicking of organogenesis. Here, we show that the same principle can be applicable to adult mature cells, ie, human adult hepatocytes (hAHs). Methods We cultivated hAHs with fluorescence-labeled human mesenchymal cells (hMSCs) and human umbilical vein endothelial cells (HUVECs) in micro-well culture plates and observed them for 9 days. Fluorescence microscopy imaging analyses were performed to evaluate the internal structures of generated 3-dimensional tissues. Maintenance of in vitro protein production capacity was examined with the use of enzyme-linked immunosorbent assay (ELISA). Results hAHs started to self-organize into 3-dimensional tissue with the use of coculturing with hMSCs and HUVECs. Live imaging analyses showed that endothelial cells started sprouting inside the generated tissues after 2 days of culture. ELISA showed that human albumin production capacity was improved with the use of coculture compared with hAHs-only culture after 9 days. Conclusions We demonstrated that 3-dimensional vascularized hepatic tissue could be generated from hAHs by reconstituting endothelial-mesenchymal interactions. Future studies are needed to evaluate the therapeutic potential of vascularized hepatic tissue transplantation, and this may pave a new way to establish a new transplantation modality as an alternative to hepatocyte transplantation.
The objective of this experiment was to determine the effects of in vitro fermentation of coconut endosperm fiber (CEF), chicory pulp (CHP), and selective blends of these substrates on SCFA ...production and changes in microbiota using canine fecal inocula. A total of 6 individual substrates, including short-chain fructooligosaccharide (scFOS; a well-established prebiotic source), pectin (PEC; used as a positive control), pelletized cellulose (PC; used as a negative control), beet pulp (BP; considered the gold standard fiber source in pet foods), CEF, and CHP, and 3 CEF:CHP blends (75:25% CEF:CHP B1, 50:50% CEF:CHP B2, and 25:75% CEF:CHP B3) were tested. Triplicate samples of each substrate were fermented for 0, 8, and 16 h after inoculation. A significant substrate × time interaction (P < 0.05) was observed for pH change and acetate, propionate, butyrate, and total SCFA concentrations. After 8 and 16 h, pH change was greatest for scFOS (-2.0 and -3.0, respectively) and smallest for PC (0.0 and -0.1, respectively). After 16 h, CEF had a greater butyrate concentration than CHP and all the CEF:CHP blends and it was not different than PEC. The substrate × time interaction was significant for bifidobacteria (P < 0.05) and lactobacilli (P < 0.05). After 8 h, bifidobacteria was greatest for BP and lowest for PC (12.7 and 10.0 log10 cfu/tube, respectively). After 16 h, PC had the lowest and scFOS had the greatest bifidobacteria (6.7 and 13.3 log10 cfu/tube, respectively). In general, CEF, CHP, and their blends had similar bifidobacteria populations after 8 and 16 h of fermentation when compared with BP and scFOS. After 16 h, lactobacilli populations were greatest for B1, B2, B3, BP, and scFOS, intermediate for PEC, and lowest for PC (P < 0.05). Overall, our data suggest that CEF had a butyrogenic effect and that CEF, CHP, and their blends had similar bifidobacteria and lactobacilli populations as popular prebiotic and fiber substrates. Future research should investigate the effects of CEF, CHP, and their blends on gastrointestinal health and fecal quality in dogs.
Factors that can interfere with the successful treatment of Mycobacterium avium lung infection have been inadequately studied. To identify a potent predictor of therapeutic responses of M. avium lung ...infection, we analyzed variable number tandem repeats (VNTR) at 16 minisatellite loci of M. avium clinical isolates. Associations between the VNTR profiling data and a therapeutic response were evaluated in 59 subjects with M. avium lung infection. M. avium lung infection of 30 subjects in whom clarithromycin-containing regimens produced microbiological and radiographic improvement was defined as responsive disease, while that of the remaining 29 subjects was defined as refractory disease. In phylogenetic analysis using the genotypic distance aggregated from 16-dimensional VNTR data, 59 M. avium isolates were divided into three clusters, which showed a nearly significant association with therapeutic responses (p 0.06). We then subjected the raw 16-dimensional VNTR data directly to principal component analysis, and identified the genetic features that were significantly associated with the therapeutic response (p <0.05). By further analysis of logistic regression with a stepwise variable-selection, we constructed the highest likelihood multivariate model, adjusted for age, to predict a therapeutic response, using VNTR data from only four minisatellite loci. In conclusion, we identified four mycobacterial minisatellite loci that together were associated with the therapeutic response of M. avium lung infections.
Summary
Background Tumour necrosis factor (TNF)‐α‐converting enzyme (TACE) is a metalloproteinase‐disintegrin that releases soluble TNF‐α from cells by cleaving within the extracellular domain of ...membrane‐bound pro‐TNF‐α. It was proposed that TNF‐α is involved in the pathogenesis of psoriasis, and it is therefore suggested that TACE has important roles in psoriasis. However, it is unclear whether TACE is expressed in psoriatic tissue.
Objectives To clarify whether TACE is expressed in psoriatic lesions and whether expression levels of TACE mRNA are increased in lesional compared with nonlesional psoriatic skin.
Methods Skin biopsies were obtained from patients with psoriasis. We examined the expression of TACE in psoriatic tissues using a novel real‐time quantitative reverse transcriptase–polymerase chain reaction method and immunohistochemical analysis.
Results There was a significant rise in the level of TACE mRNA expression in lesional psoriatic skin compared with nonlesional skin in all patients. There was a statistically significant rise in the level of TACE mRNA expression in lesional psoriatic skin compared with nonlesional skin (mean ± SD TACE/glyceraldehyde‐3‐phosphate dehydrogenase ratio 0·031 ± 0·012 vs. 0·009 ± 0·002, P < 0·05). In lesional psoriatic skin, immunostaining with anti‐TACE antibody was present throughout all layers of the epidermis. TACE immunostaining was found in the cytoplasm of keratinocytes. There was staining associated with blood vessels in the papillary dermis and perivascular inflammatory cells. In particular, mast cells showed strong staining. They contained numerous granules that were stained for TACE in the cytoplasm.
Conclusions The findings of the present study suggest that elevation of TACE mRNA in psoriatic lesions is due to many cells, particularly mast cells, that function in lesional psoriatic skin as an important source of TNF‐α and other cytokines.
The growth of solid tumors in vivo beyond 1-2 mm in diameter requires induction and maintenance of an angiogenic response. This can occur through the release of various angiogenic growth factors from ...tumor cells. One such factor is vascular endothelial growth factor/vascular permeability factor (VEGF/VPF), a secreted and specific mitogen for vascular endothelial cells. We show that one of the most commonly encountered genetic changes detected in human cancer, i.e., expression of mutant ras oncogenes, is associated with marked up-regulation of VEGF/VPF in transformed epithelial cells. Thus, elevation of the levels of both VEGF/VPF mRNA and secreted functional protein were detected in human and rodent tumor cell lines expressing mutant K-ras or H-ras oncogenes, respectively. Genetic disruption of the mutant K-ras allele in human colon carcinoma cells was associated with a reduction in VEGF/VPF activity. Furthermore, pharmacological disruption of mutant RAS protein function in H-ras transformed rat intestinal epithelial cells by treatment with L-739,749 (a protein farnesyltransferase inhibitor) caused a significant suppression of VEGF/VPF. The results suggest that dominantly acting ras oncogenes may contribute to the growth of solid tumors in vivo not only by a direct effect on tumor cell proliferation but also indirectly, i.e., by facilitating tumor angiogenesis. Hence, pharmacologically targeting mutant ras oncogenes could conceivably suppress solid tumor growth in vivo, in part, by inhibiting tumor-induced angiogenesis.
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