Inhibitory effect of immature plum on PMA-induced MMP-9 expression in human hepatocellular carcinoma.

The goal of this study was to evaluate the anticancer effect of Prunus salicina Lindl. cv. Soldam at three maturity stages (immature, midmature and mature). In search for anticancer effects of immature plum extract (IPE), we have found its antimigrative property in (phorbol 12-myristate 13-acetate) PMA-induced HepG2 cells, and this effect is associated with inhibition of MMP-9 activity. IPE appeared to have a strong inhibitory effect on the PMA-induced MMP-9 secretion through suppression of the transcriptional activity of the MMP-9 gene independently of the TIMP gene in HepG2 cells. PMA induced the translocation of c-jun and p65 to the nucleus; however, IPE inhibited their nuclear translocations induced by PMA in HepG2 cells. These results clearly indicate that IPE suppresses both AP-1- and NF-kappaB-mediated MMP-9 gene transcriptional activity through inhibiting the nuclear translocations of AP-1 and NF-kappaB. These findings suggest that AP-1 and NF-kappaB activations through the ERK, p38 MAPK and JNK pathways appears to be required for the induction of MMP-9 expression by PMA in IPE, and IPE regulates PMA-stimulated MMP-9 expression by suppressing the p38 MAPK, JNK and ERK pathways. IPE leads to a decrease in the migration potential of HepG2 cells in vitro, and this suggests that the migration inhibition is correlated well with its inhibition of MMP-9 expression.

Modified right liver graft from a living donor to prevent congestion.

BACKGROUND: Right liver grafts without middle hepatic vein (MHV) drainage reconstruction resulted in severe congestion of the anterior segment (AS) in our early experience of adult-to-adult living donor liver transplantation (LDLT). However, a detailed strategy for preventing such congestion or the necessity of MHV reconstruction has not been discussed in LDLT using a right lobe graft. METHODS: From July 1997 to February 1998, two of five right lobe grafts without MHV drainage reconstruction were complicated with severe congestion of the AS. Thereafter, 42 adult recipients who received right liver grafts with sizable MHV tributaries underwent the reconstruction of MHV drainage. All sizable (>5 mm in diameter) MHV tributaries were preserved during donor hepatectomy and were reconstructed with the recipient's autogenous interposition vein grafts at the bench surgery. The reconstructed vein grafts of this modified right lobe graft were anastomosed to the stump of the MHV and/or left hepatic vein of the recipient after graft revascularization. RESULTS: Serial Doppler ultrasonography, which was regularly checked until 30 days posttransplant, revealed the patent interposition vein graft in 38 of 42 recipients (patency rate 90.5%). In these 38 recipients, no evidence of congestion in the AS was recognized on enhanced computed tomography, while providing enough functioning liver mass comparable to an extended right lobe graft. Also, congestion-related graft injury, such as an infarct of the AS, was not observed in these recipients. CONCLUSIONS: Our early experience indicated the necessity of MHV drainage reconstruction in right lobe grafts, which do not have MHV trunk in certain instances. However, preoperatively, it is difficult to predict the degree of AS congestion of the right liver graft without MHV drainage reconstruction. We suggest aggressive reconstruction of MHV drainage tributaries of the AS, under the circumstances that sizable MHV tributaries are encountered, to prevent possible congestion-related complications.