Abdominal Aortic Aneurysm Shrinkage up to 2 Years Following Endovascular Repair with PEmbolization for Preventing Type 2 Endoleak: A Retrospective Single Center Study.

BACKGROUND: The aim of the present study was to evaluate the efficacy of preemptive embolization of aneurysm side branches that cause type 2 endoleak (T2EL). METHODS: We performed a retrospective review of consecutive patients who underwent endovascular aneurysm repair (EVAR) in our facility between April 2009 and April 2019. All the patients underwent the preemptive embolization for preventing T2EL since April 2014. The patients were divided into the nonembolization group (between April 2009 and May 2014) or the embolization group (between April 2014 and April 2019). We used a support wire to improve a success rate of the preemptive embolization. The aneurysm sac shrinkage (≧5 mm), freedom from all-cause death and aneurysm-related death, T2EL-related reinterventions, aneurysm sac enlargement (≧5 mm), and complications related to the endovascular procedure were compared between the 2 groups. RESULTS: Two-hundred patients with abdominal aortic aneurysm were included. They were divided into the nonembolization group (N = 103) and the embolization group (N = 97). We successfully embolized 89% of all the patent aneurysm side branches in the embolization group. The characteristics of the 2 groups were similar except for hypertension, patent lumbar arteries, and the use of Zenith, Excluder, and Endurant. The preemptive embolization group showed better aneurysm sac shrinkage (73% vs. 42%; P < 0.0001), no aneurysm sac enlargement (0% vs. 5%; P < 0.05), and lower T2EL-related reintervention rate (hazard ratio, 0.11; 95% confidence interval, 0.0061-0.60; P < 0.01) up to 2 years after EVAR. There were no significant differences in freedom from all-cause death, aneurysm-related death, and complications between the 2 groups. CONCLUSIONS: The present study showed the high success rate of preemptive embolization of aneurysm side branches resulting in better anatomical changes in the aneurysm sac and lower T2EL-related intervention rate in the embolization group up to 2 years after EVAR.

Structural Approach to Understanding the Formation of Amorphous Metal Hydroxides.

This study investigates the formation of amorphous tetravalent metal hydroxides, M(OH)4, based on the structural analysis by small- and wide-angle X-ray scattering (SWAXS) and on the electrical potential charge near the surface of M(OH)4 particles. The amorphous zirconium hydroxide solid phases that aged in NaCl and CaCl2 solutions at 25 °C exhibited a hierarchical structure consisting of primary particles of a few nanometers in size and their aggregates more than 100 nm in size. The SWAXS profiles suggested that the size of the primary particles depends on the ionic strength and electrolytes in the sample solutions. The smaller size of the primary particles observed in solutions with higher ionic strength can be explained by the thinner electrical double layer. Additionally, we focused on the ζ potentials of M(OH)4 suspensions in NaCl, NaNO3, and CaCl2 solutions. With the aid of reference systems of metal oxides, MO2, it was found that the ζ potentials were well interpreted by a traditional surface ionization and complexation model, and the size distributions of large aggregates were explained by the classical Derjaguin-Landau-Verwey-Overbeek (DLVO) theory with the ζ potential values. The present study suggests the formation mechanism of amorphous metal hydroxides through a combination of structural analysis and investigation of electrical potentials.

Sorption of Cs+ and Eu3+ ions onto sedimentary rock in the presence of gamma-irradiated humic acid.

The influence of humic acid (HA) and its radiological degradation on the sorption of Cs+ and Eu3+ by sedimentary rock (obtained from the Horonobe Underground Research Laboratory in Japan) was investigated to understand the sorption process of metal ions and humic substances. Aldrich HA solution was gamma-irradiated assuming a strong radiation from a highly radioactive waste to be disposed of in deep geological formations. Batch sorption experiments were performed to evaluate the effect of gamma-irradiated HA on the sorption of Cs+ and Eu3+ ions. The addition of non-irradiated HA weakened the Eu sorption because of the lower sorption of the negatively charged Eu-HA complexes compared with free Eu ions. The sorption of Cs ions was barely affected by the presence of HA and its gamma irradiation. The concentration ratio of metal complexed and non-complexed species in the solid and liquid phases was evaluated by sequential filtration and chemical equilibrium calculations. The ratios were low in both phases for Cs and supported the minimal contribution of HA to Cs sorption. However, the concentration ratio for Eu3+ in the liquid phase was high, indicating that the complexing ability of HA to Eu3+ was higher than that of HA to Cs+.

Gamma-irradiation-induced molecular-weight distribution and complexation affinity of humic acid with Cs+, Sr2+, and Eu3.

Solutions of humic acid (HA) were irradiated with 0, 1, 5, 10, 50, and 100 kGy of gamma irradiation using a 60Co source. The non-irradiated and irradiated HA molecules were fractionated by ultrafiltration into four categories: > 100, 50-100, 10-50, and < 10 kDa. Total organic carbon measurements and potentiometric titration analysis suggested that (1) some gamma-irradiated HA molecules were degraded into smaller molecules and (2) radiolytic degradation caused phenolic -OH became the predominant functional group in the small molecular-weight fractions of HA. The effect of absorbed dose of gamma rays on the distributions of Cs+, Sr2+, and Eu3+ ions in the molecular-weight fractions of the metal-HA systems was examined to discuss the complexation affinity. The metal ions were distributed in the smaller molecular-weight fractions at different doses, which corresponded to the degradation of HA molecules. For a predetermined absorbed dose, Cs+ ions did not change the molecular-weight distribution of the total organic carbon content of the degraded HA molecules. Conversely, the Sr2+ and Eu3+ ions redistributed organic carbon toward the larger molecular-weight fractions.

Purification and Characterization of Double-Stranded Nucleic Acid-Dependent ATPase Activities of Tagged Dicer-Related Helicase 1 and its Short Isoform in Caenorhabditis elegans.

The Dicer-related helicases (DRHs) are members of a helicase subfamily, and mammalian DRHs such as retinoic acid-inducible gene-I (RIG-I), are involved in antiviral immunity. Caenorhabditis elegans DRH-1 and DRH-3 play crucial roles in antiviral function and chromosome segregation, respectively. Although intrinsic double-stranded RNA-dependent ATP-hydrolyzing activity has been observed in the recombinant DRH-3 protein prepared from Escherichia coli, there are no reports of biochemical studies of the nematode RIG-I homolog DRH-1. In this study, the secondary structure prediction by JPred4 revealed that DRH-1 and DRH-3 had distinct N-terminal regions and that a 200-amino acid N-terminal region of DRH-1 could form a structure very rich in α-helices. We investigated expressions and purifications of a codon-optimized DRH-1 with four different N-terminal tags, identifying poly-histidine (His)-small ubiquitin-like modifier (SUMO) as a suitable tag for DRH-1 preparation. Full-length (isoform a) and a N-terminal truncated (isoform b) of DRH-1 were purified as the His-SUMO-tagged fusion proteins. Finally, the nucleic acid-dependent ATPase activities were investigated for the two His-SUMO-tagged DRH-1 isoforms and His-tagged DRH-3. The tagged DRH-3 exhibited dsRNA-dependent ATPase activity. However, detectable dsRNA dependency of ATPase activities was not found in either isoform of tagged DRH-1 and a tag-free DRH-1 (isoform a) treated with SUMO protease. These observations suggest that DRH-1 and its short isoform have no or poor nucleic acid-dependent ATPase activity, unlike DRH-3 and mammalian DRHs.

Effect of gamma-irradiation on complexation of humic substances with divalent calcium ion.

The effect of gamma-irradiation doses of 0, 10, 100, and 500 kGy at the dose rates of 1 or 0.1 kGy/h on the molecular and chemical properties of humic substances (HS) were investigated using total organic carbon measurements, UV-Vis spectrometry, 13C nuclear magnetic resonance, and acid-base titration. A possible mechanism of the radiolysis on HS was also speculated. The complexation ability of irradiated HS with Ca2+ ions was studied using a Ca ion-selective electrode. The apparent formation constants of the Ca-HS complexes increased as the irradiation dose increased, and this was attributed to the relative increase in the ratio of phenolic -OH to carboxylic groups of HS. The contribution of the phenolic -OH groups to Ca-HS complexes was suppressed at pH 5 owing to its high acid dissociation constants. In addition, the radiation dose rates of 1 and 0.1 kGy/h did not significantly affect the properties of HS and the apparent formation constants of the Ca-HS complexes.

Successful recovery from transcatheter aortic valve embolization by thoracic endovascular stent-graft repair.

We report a case of an 84-year-old Japanese female patient with transcatheter valve embolization treated with thoracic endovascular stenting. She was diagnosed with severe aortic stenosis and referred to our hospital. Transapical transcatheter aortic valve implantation (TA-TAVI) was selected because she had multiple comorbidities and peripheral vascular disease. During TA-TAVI, the transcatheter valve (TV) came loose and lodged in the distal aortic arch. The TV was floating and unstable, thereby affecting her hemodynamics. After a second TV was placed in the appropriate position with no trouble, we tried fixing the TV using a thoracic endovascular stent-graft. The procedure was successful, and the patient recovered well. The cause of embolization seemed to be associated with a relatively mild calcification of the native aortic valve. Although this complication is rare, several recovery procedures should be prepared.

Structural Approach to Understanding the Solubility of Metal Hydroxides.

We report the hierarchical structure of zirconium hydroxide after aging at different temperatures to elucidate the factors governing zirconium solubility in aqueous solutions. Zirconium hydroxide solid phases after aging at 25, 40, 60, and 90 °C under acidic to alkaline conditions were investigated using extended X-ray absorption fine structure (EXAFS), wide- and small-angle X-ray scattering (WAXS and SAXS), and transmission electron microscopy (TEM) techniques to reveal the bulk and surface structures of the solid phases from the nanoscale to sub-microscale. After aging at 25 °C, the fundamental building unit of the solid phase was considered to be tetrameric and dimeric hydroxide species. These polynuclear species formed amorphous primary particles that are approximately 3 nm in size, which in turn formed aggregates that are hundreds of nanometers in size. This hierarchical structure was found to be stable up to 60 °C under acidic and neutral conditions and up to 40 °C under alkaline conditions. After aging at 90 °C under acidic conditions and at 60 and 90 °C under alkaline conditions, the WAXS and EXAFS measurements suggested the crystallization of the solid phase. The SAXS profiles and TEM observations supported the existence of crystallized large particles about 60 nm in size, and the appearance of the Guinier region in the SAXS profiles indicated that the crystallization of the amorphous primary particles leads to the reduction of the size of the large aggregates. The transformation of the solid-phase structure by temperature was discussed in relation to the solubility product to understand the solubility-limiting solid phase. The solubility of zirconium hydroxide after aging at different temperatures was governed not only by the size of the amorphous primary particles or crystallized large particles but also by their surface configuration.

The effect of alkaline pretreatment on the biochemical characteristics and fibril-forming abilities of types I and II collagen extracted from bester sturgeon by-products.

Non-mammalian collagens have attracted increasing attention for industrial and biomedical use. We have therefore evaluated extraction conditions and the biochemical properties of collagens from aquacultured sturgeon. Pepsin-soluble type I and type II collagen were respectively extracted from the skin and notochord of bester sturgeon by-products, with yields of 63.9 ±â€¯0.19% and 35.5 ±â€¯0.68%. Collagen extraction efficiency was improved by an alkaline pretreatment of the skin and notochord (fewer extraction cycles were required), but the final yields decreased to 56.2 ±â€¯0.84% for type I and 31.8 ±â€¯1.13% for type II. Alkaline pretreatment did not affect the thermal stability or triple-helical structure of both types of collagen. Types I and II collagen formed re-assembled fibril structures in vitro, under different conditions. Alkaline pretreatment slowed down the formation of type I collagen fibrils and specifically inhibited the formation of thick fibril-bundle structures. In contrast, alkaline pretreatment did not change type II collagen fibril formation. In conclusion, alkaline pretreatment of sturgeon skin and notochord is an effective method to accelerate collagen extraction process of types I and II collagen without changing their biochemical properties. However, it decreases the yield of both collagens and specifically changes the fibril-forming ability of type I collagen.

Anti-obesity effects of chondroitin sulfate oligosaccharides from the skate Raja pulchra.

We aimed to investigate the anti-obesity effects of chondroitin sulfate (CS) oligosaccharides obtained from cartilage of the skate Raja pulchra and to compare them with those of CSs of other molecular weights (MWts) (skate CS polysaccharides) and origins (shark CS, bovine CS). CSs suppressed pancreatic lipase activity as well as proliferation and lipid accumulation in mature adipocytes. Higher MWt CS had a greater lipase inhibitory activity than lower MWt CS. CSs of different origin show differing potencies for lipase inhibition and effects on adipocytes. Also, dietary intake of skate CS oligosaccharides could ameliorate obesity in high-fat diet mice model: it prevented gaining in body weight, liver weight and adipose tissue weight, maintained lower food consumption, inhibited intestinal absorption of triglyceride, and adjusted the serum endotoxin level. In conclusion, skate CS oligosaccharides have an anti-obesity activity, and the MWt and origin of the CSs may affect this activity.

Ruptured Abdominal Aortic Aneurysm Treated by Double-Balloon Technique and Endovascular Strategy: Case Series.

PURPOSE: Mortality in patients with ruptured abdominal aortic aneurysms (rAAAs) has remained high despite advances in interventions. Endovascular aneurysm repair (EVAR) was recently developed for treatment of rAAAs. In this study, we assessed our endovascular strategy including a double-balloon technique for rAAA. METHODS: We analyzed 12 consecutive patients with rAAAs who were treated by our double-balloon technique and endovascular strategy from March 2013 to July 2016. RESULTS: The 30-day and 1-year mortality rates were both 17%. The mean times from admission to arrival at the hybrid operating room, from admission to aortic occlusion, and from admission to completion of EVAR were 46.8, 63.5, and 110.0 minutes, respectively. CONCLUSION: This study indicates that the herein-described double-balloon endovascular technique is feasible for use in the management of rAAA.

Intravascular large B-cell lymphoma associated with t(14;19)(q32;q13) translocation.

We report a 59-year-old man with intravascular large B-cell lymphoma (IVLBCL) associated with hemophagocytic syndrome, disseminated intravascular coagulopathy, and lung involvement. G-banding analysis of the metaphase spreads obtained from the bone marrow showed that the lymphoma cells were near-tetraploid and included two homologues of the 14q+ chromosome. Spectral karyotyping revealed that complex translocations occurred among chromosomes 3, 12, 14, and 19, and additional materials of 14q+ were from chromosome 19 with the breakpoint at 14q32 and 19q13. To the best of our knowledge, this is the first report describing t(14;19)(q32;q13) in IVLBCL.