Arteriopathy after transarterial chemo-lipiodolization for hepatocellular carcinoma.

OBJECTIVES: The purpose of this study was to investigate the incidence of and the risk factors for arteriopathy in hepatic arteries after transarterial chemo-lipiodolization in patients with hepatocellular carcinoma and the subsequent treatment strategy changes due to arteriopathy. PATIENTS AND METHODS: A total of 365 arteries in 167 patients (126 men and 41 women; mean age, 60.4±15.0 [SD] years [range: 18-87 years]) were evaluated for the development of arteriopathy after chemo-lipiodolization with epirubicin- or doxorubicin-Lipiodol® emulsion. The development of arteriopathy after chemo-lipiodolization was assessed on arteriograms performed during subsequent transarterial treatments. The treatment strategy changes due to arteriopathy, including change in the chemo-lipiodolization method and the application of alternative therapies was also investigated. Univariate and multivariate binary logistic regression models were used to identify risk factors for arteriopathy and subsequent treatment strategy change. RESULTS: One hundred two (27.9%) arteriopathies were detected in 62/167 (37.1%) patients (45 men, 17 women) with a mean age of 63.3±7.1 [SD] years (age range, 50-86 years). The incidence of arteriopathy was highly patient dependent, demonstrating significant correlation in a fully-adjusted multivariate regression model (P<0.0001). Multivariate-adjusted regression analysis with adjustment for the patient effect showed a statistically significant association of super-selective chemo-lipiodolization (P=0.003) with the incidence of arteriopathy. Thirty of the 102 arteriopathies (29.4%) caused a change in treatment strategy. No factors were found to be significantly associated with the treatment strategy change. CONCLUSION: The incidence of arteriopathy after chemo-lipiodolization is 27.9%. Among them, 29.4% result in a change in treatment strategy.

The effects of several nucleotides on the molecular state and catalytic activity of Thiobacillus novellus cytochrome c oxidase. ATP affects the oxidase uniquely.

The catalytic activity and molecular aspects of Thiobacillus novellus cytpchrome c oxidase were affected by ATP. The steady-state kinetics in the oxidation of ferrocytochrome c by the oxidase varied with the presence or absence of ATP; the [S]-v curve of the reaction was sigmoid in the absence of ATP whereas it was a Michaelis-Menten-type hyperbola in the presence of 700 microM ATP. The oxidase was a dimer of the minimal structural subunit consisting of one molecule each of two subunits in the presence of Tween 20 and in the absence of ATP. The dimer dissociated into monomers in the presence of 700 microM ATP. The trough at 452 nm seen in the second derivative absorption spectrum of the CO compound of the oxidase in the absence of ATP, a characteristic of the cytochrome a component of cytochrome aa3, dissappeared in the presence of 700 microM ATP. However, ADP, AMP, GTP, CTP and UTP had little affect on both the [S]-v curve and the molecular mass of the oxidase when used in place of ATP.

Expression of type I interleukin-1 receptor mRNA and its regulation in cultured astrocytes.

The expression of type I interleukin-1 receptor (IL-1RI) mRNA enriched astrocytes and microglia was investigated by Northern blot analysis. IL-1RI mRNA was expressed in untreated astrocytes, but not in microglia. This expression was markedly suppressed by a treatment with isoproterenol, a beta-adrenoceptor agonist (1 x 10(-8) to 1 x 10(-6) M). This suppression was clearly reversed by propranolol, a beta-adrenoceptor antagonist. Dibutyryl cAMP (dbcAMP) also suppressed the expression of IL-1RI mRNA. The suppression by isoproterenol or dbcAMP was blocked by H8 or H89, inhibitors of cAMP-dependent protein kinase. The present results suggest that IL-1RI mRNA expression in cultured astrocytes may be regulated by intracellular cAMP, elevated upon the activation of beta-adrenoceptors as an example, and cAMP-dependent protein kinase.

Participation of cAMP and cAMP-dependent protein kinase in beta-adrenoceptor-mediated interleukin-1 beta mRNA induction in cultured microglia.

We previously reported evidence of beta-adrenoceptor-mediated induction of IL-1 beta mRNA in the rat hypothalamus. The present in vitro studies using northern blot analysis showed that the beta-adrenoceptor agonist isoproterenol (1 x 10(-8) to 1 x 10(-5) M) caused a marked induction of IL-1 beta mRNA in microglia, but not in astrocytes. This induction was remarkably suppressed by pretreatment of cells with the beta-adrenoceptor antagonist propranolol. These phenomena were confirmed by in situ hybridization with digoxigenin-labelled IL-1 beta RNA probe. Furthermore, dibutyryl cyclicAMP (dbcAMP) (5 x 10(-4) and 5 x 10(-5) M) markedly induced IL-1 beta mRNA in microglia. The intracellular level of cAMP in microglia was elevated in a dose-dependent manner when they were treated with isoproterenol, and this elevation was completely blocked by propranolol. The induction of IL-1 beta mRNA by either isoproterenol or dbcAMP was strongly inhibited by a cAMP-dependent protein kinase inhibitor, H8. These results, taken together, suggest that (1) microglia primarily induce IL-1 beta mRNA by stimulation of beta-adrenoceptors, and (2) cAMP and cAMP-dependent protein kinase presumably participate in a signal transduction mechanism involved in the induction of IL-1 beta mRNA via beta-adrenoceptors.

Clonal sublines of rat neurotumor RT4 and cell differentiation. V. Comparison of Na+ influx, Rb+ efflux, and action potential among stem-cell, neuronal, and glial cell types.

A multipotential stem-cell-type cell line (RT4-AC) isolated from a rat peripheral neurotumor differentiates in culture into two neuronal-type cells (RT4-B and RT4-E) or into a glial-type cell (RT4-D). The neuronal classification of RT4-B and RT4-E cells is based on their positive response to veratridine in the tetrodotoxin-sensitive Na+-influx and Rb+-efflux assays and on the action potential observed upon hyperpolarized stimulation. In addition, these neuronal cell types do not synthesize two glial proteins, S100 protein (S100P) and glial fibrillary acidic protein (GFAP). The glial classification of RT4-D is based on the syntheses of S100P and GFAP. Additionally, RT4-D does not display veratridine-activated Na+ influx and Rb+ efflux nor action potential. The stem cell type, RT4-AC, expresses both neuronal and glial properties to a lesser degree. In the neuronal-type cell lines of the RT4 family (RT4-B and RT4-E), the large veratridine-activated Na+ influx can further be stimulated by scorpion toxin. The Na+ influx of the stem cell (RT4-AC), however, is only slightly stimulated by veratridine alone, but greatly stimulated by the addition of veratridine and scorpion toxin. These observations suggest that a progressive differentiation of voltage-dependent Na+ channels may have occurred by the cell-type conversion from the stem cell type to the neuronal cell types. The exact nature of the change in Na+ channels is currently not known.

In vitro segregation of different cell lines with neuronal and glial properties from a stem cell line of rat neurotumor RT4.

A clonal stem cell line, RT4-AC, of the rat peripheral neurotumor RT4 differentiates in culture into morphologically distinct cell types RT4-B, RT4-D, and RT4-E (cell type conversion). The multipotential stem cell type RT4-AC and cell type RT4-D produce a glial marker, S100 protein, but RT4-B and RT4-E do not. The stem cells also show a small but significant response to veratridine on voltage-dependent Na+ influx. Cell types RT4-B and RT4-E show a clear response of voltage-dependent Na+ influx to veratridine, typical of neuronal cells, whereas cell type RT4-D is completely negative. These results indicate that (i) the stem cell type RT4-AC shows both neuronal and glial properties, (ii) cell types RT4-B and RT4-E have a neuronal property, and (iii) cell type RT4-D has a glial property. Therefore, cell type conversion of stem cell RT4-AC to RT4-B and RT4-E cells seems to result in differentiation towards neuronal cell types, and cell type conversion of RT4-AC to RT4-D results in differentiation towards a glial type in culture.