Nonocclusive mesenteric ischemia (NOMI) on Roux limb after biliary reconstruction successfully treated by interventional radiology (IVR).

Nonocclusive mesenteric ischemia (NOMI) is a life-threatening disorder. Early diagnosis is challenging because NOMI lacks specific symptoms. A 52-year-old man who received extended cholecystectomy with Roux-en-Y hepaticojejunostomy for gallbladder cancer (GBC) presented to our hospital with nausea and vomiting. Neither tender nor peritoneal irritation sign was present on abdominal examination. Blood test exhibited marked leukocytosis (WBC:19,800/mm3). A contrast-enhanced abdominal computed tomography (CT) scan revealed remarkable wall thickening and lower contrast enhancement effect localized to Roux limb. On hospital day 2, abdominal arterial angiography revealed angio-spasm at marginal artery and arterial recta between 2nd jejunal artery and 3rd jejunal artery, leading us to the diagnosis of NOMI. We then administered continuous catheter-directed infusion of papaverine hydrochloride until hospital day 7. Furthermore, the patient was anticoagulated with intravenous unfractionated heparin and antithrombin agents for increasing D-dimer level and decreasing antithrombin III level. On hospital day 8, diluted oral nutrition diet was initiated and gradually advanced as tolerated. On hospital day 21, the patient was confirmed of improved laboratory test data and discharged with eating a regular diet. We experienced a rare case of NOMI on Roux limb after 2 years of extended cholecystectomy with hepaticojejunostomy for GBC, promptly diagnosed and successfully treated by interventional radiology (IVR).

Gallbladder fossa nodularity in the liver typically observed in patients with alcoholic liver disease; comparison with chronic hepatitis C patients.

BACKGROUND AND PURPOSE: Gallbladder fossa nodularity (GBFN) is often observed in patients with alcoholic liver disease (ALD), and we hypothesized this may be due to the cholecystic venous drainage (CVD), sparing this area from portal perfusion containing alcohol absorbed in the alimentary tract, and also escaping from alcohol-induced fibrotic and atrophic change of the liver parenchyma. The purpose of this study is to verify our hypothesis, using chronic hepatitis C (CHC) patients as a control. MATERIALS AND METHODS: Between 2013 and 2017, consecutive 45 ALD and 46 CHC patients who had contrast-enhanced CT were retrospectively recruited. Those who had interventions or disease involvement around gallbladder fossa were excluded. All CT images, and angiography-assisted CT(ang-CT) images , when available, were reviewed. GBFN was subjectively classified into grades 0-3, depending upon the conspicuity of nodularity, which was compared between the groups, and was also correlated to various clinicoradiological factors, including the alcohol consumption grades (ACG). RESULTS: GBFN was more frequently observed in ALD than in CHC patients, and higher grade GBFN was associated with ALD rather than CHC (all p < 0.05). Multivariable analysis revealed independently significant factors related to GBFN grades were ACG and albumin-bilirubin grades. Ang-CT images were available in 11 patients, all of whom exhibited portal perfusion diminishment and faint arterial enhancement, suggesting CVD, at the region of GBFN. When GBFN grade 3 was considered to discriminate ALD from CHC, the value of sensitivity/specificity/accuracy is 9%/100%/55%. CONCLUSION: GBFN may represent spared liver tissue from alcohol-containing portal venous perfusion due to CVD, which may serve as an adjunctive sign of ALD or alcohol overconsumption with high specificity, but low sensitivity.

Intracellular Protein Photoactivation Using Sterically Bulky Caging.

Methods for intracellular protein photoactivation have been studied to elucidate the spatial and temporal roles of proteins of interest. In this study, an intracellular protein photoactivation method was developed using sterically bulky caging. The protein of interest was modified with biotin via a photocleavable linker, and then conjugated with streptavidin to sterically block the protein surface for inactivation. The caged protein was transduced into cells and reactivated by light-induced degradation of the conjugates. A cytotoxic protein, saporin, was caged and photoactivated both in vitro and in living cells with this method. This method achieved control of the cytotoxic activity in an off-on manner, introducing cell death selectively at the designed location using light. This simple and versatile photoactivation method is a promising tool for studying spatio-temporal cellular events that are related to intracellular proteins of interest.

Usefulness of iodine-blood material density images in estimating degree of liver fibrosis by calculating extracellular volume fraction obtained from routine dual-energy liver CT protocol equilibrium phase data: preliminary experience.

PURPOSE: To assess whether extracellular volume fraction (ECV) calculated from iodine(-blood) density images (I-B) of dual-energy liver CT (DECT) equilibrium phase data (EqD) is useful in estimating the degree of liver fibrosis. MATERIALS AND METHODS: Consecutive 52 patients with chronic liver disease who underwent fast kV switching DECT and liver MR elastography (MRE) were retrospectively enrolled. Iodine(-water) density images (I-W) and I-B generated from EqD and ECV were calculated. As blood pools, abdominal aorta (Ao) and suprahepatic inferior vena cava (IVC) were chosen, and, therefore, 4 types of ECV (ECVI-W Ao, ECVI-W IVC, ECVI-B Ao, ECVI-B IVC) were obtained. ECV was also calculated using conventional method (ECVconv Ao). The correlation coefficients (R2 or rho) of these five ECVs versus liver stiffness (MRE) or pathologically proven fibrosis grades were compared. RESULTS: As for correlation with liver stiffness, R2 for ECVconv.Ao, ECVI-W Ao, ECVI-B Ao, ECVI-W IVC, and ECVI-B IVC, were 0.26, 0.34, 0.44, 0.39, and 0.52, respectively (all p < 0.0001). Histopathological correlation was available in 28 patients, and rho values were 0.61, 0.60, 0.71, 0.68, and 0.76, respectively (all p < 0.001). CONCLUSION: ECVI-B IVC calculated from EqD of DECT is useful in estimating the degree of liver fibrosis.

Design, synthesis, and biological evaluation of a highly water-soluble psoralen-based photosensitizer.

In recent years, photodynamic therapy (PDT) has been approved for treating various medical conditions, including cancer. PDT is a treatment that employs a particular drugs, called photosensitizers which work along with specific light source. The growth of this medical industry is expanding as it is another promising alternative to treat cancer which lessen the burden of treatments in patients. This includes the benefits of minimally invasive procedures and delivering high accuracy in targeting mutations. In recent two decades, cancer researchers have produced remarkable studies on developing photosensitizers that enhance understanding of biology and genetics of cancer. It is unfortunate that not all PDT can work as well as other profound treatment because PDT has various limitations like PDT leads photosensitivity reaction that arises when the photosensitizer remains in the body for a long period of time. In this paper, our studies centers on synthesizing a highly soluble photosensitizing agent with improved effectiveness on detecting cancer cells.

Scopoletin is biosynthesized via ortho-hydroxylation of feruloyl CoA by a 2-oxoglutarate-dependent dioxygenase in Arabidopsis thaliana.

SUMMARY: Coumarins are derived via the phenylpropanoid pathway in plants. The 2H-1-benzopyran-2-one core structure of coumarins is formed via the ortho-hydroxylation of cinnamates, trans/cis isomerization of the side chain, and lactonization. Ortho-hydroxylation is a key step in coumarin biosynthesis as a branch point from lignin biosynthesis; however, ortho-hydroxylation of cinnamates is not yet fully understood. In this study, scopoletin biosynthesis was explored using Arabidopsis thaliana, which accumulates scopoletin and its beta-glucopyranoside scopolin in its roots. T-DNA insertion mutants of caffeoyl CoA O-methyltransferase 1 (CCoAOMT1) showed significant reduction in scopoletin and scopolin levels in the roots, and recombinant CCoAOMT1 exhibited 3'-O-methyltransferase activity on caffeoyl CoA to feruloyl CoA. These results suggest that feruloyl CoA is a key precursor in scopoletin biosynthesis. Ortho-hydroxylases of cinnamates were explored in the oxygenase families in A. thaliana, and one of the candidate genes in the Fe(II)- and 2-oxoglutarate-dependent dioxygenase (2OGD) family was designated as F6'H1. T-DNA insertion mutants of F6'H1 showed severe reductions in scopoletin and scopolin levels in the roots. The pattern of F6'H1 expression is consistent with the patterns of scopoletin and scopolin accumulation. The recombinant F6'H1 protein exhibited ortho-hydroxylase activity for feruloyl CoA (K(m) = 36.0 +/- 4.27 microM; k(cat) = 11.0 +/- 0.45 sec(-1)) to form 6'-hydroxyferuloyl CoA, but did not hydroxylate ferulic acid. These results indicate that Fe(II)- and 2-oxoglutarate-dependent dioxygenase is the pivotal enzyme in the ortho-hydroxylation of feruloyl CoA in scopoletin biosynthesis.

Membrane potential across anion-exchange membranes in acidic solution system.

The membrane potential across anion-exchange membranes in H2SO4 and Na2SO4 solutions was measured, and the experimental results were fitted to the theory in the 2-1 electrolyte system based on the Donnan equilibrium and the Nernst-Planck flux equations. For the Na2SO4 solution, the Donnan potential makes a significant contribution to the membrane potential, but for the H2SO4 solution, the diffusion potential significantly contributes to the membrane potential. The diffusion potential has a greater contribution to the membrane potential across AEM-2 with a high water content than that across AEM-1. These results suggest that a proton with a high mobility can move without substantial influence of electrostatic interaction in a positively charged membrane.

Membrane potential across low-water-content charged membranes: Effect of ion pairing.

In the present paper, we systematically examined the ion-pairing effect in low-water-content charged membranes. Cation- and anion-exchange membranes with various water contents and homogeneous fixed-charge distribution were prepared by radical copolymerization and then characterized by membrane potential measurements. The experimental results were analyzed by our recently developed theoretical model (Yamamoto, R.; Matsumoto, H.; Tanioka, A. J. Phys. Chem. B 2003, 107, 10615), which is based on the Donnan equilibrium, the Nernst-Planck equation for ion flux, and the Fuoss formalism for ion-pair formation between the fixed-charge group and the counterion in the membrane. The theoretical predictions agreed well with the experimental results for both cation- and anion-exchange membranes. This supported the belief that the ion-pairing effect was substantial in a low-water-content membrane system. Our theoretical analysis also showed the following results: (i) the dielectric constant in the membrane, epsilon(r), was smaller than the value in bulk water, (ii) the center-to-center distance of the ion pair, a, was independent of the water content of the membranes, and (iii) the charge effectiveness of all membranes, Q, was small (<0.35).