The effects of Pycnogenol, a pine bark extract on pulmonary inflammation by Asian sand dust in mice.

Asian sand dust (ASD), also called China dust or yellow dust, mainly occurs in East Asia during spring and autumn. Because ASD enters the body mainly through the respiratory system, it can cause respiratory disorders or worsen underlying diseases. Because of this, it has become an important health concern that threatens the well-being of humans and animals. In this study, we investigated the effects of 15 and 30 mg/kg of Pycnogenol (PYC15 and 30 groups), a pine bark extract, on ASD-induced pulmonary inflammation in mice. We evaluated the inflammatory cell counts, inflammatory cytokines, and matrix-metalloproteinase (MMP)-9 expression in animal models. PYC administration significantly decreased inflammatory cell infiltration into lung tissue; this was accompanied by a reduction in the levels of proinflammatory mediators including interleukin (IL)-1ß (P < 0.01), IL-6 (P < 0.01) and tumour necrosis factor-α (P < 0.01) in bronchoalveolar lavage fluids of ASD-exposed mice (ASD group). Histological analysis revealed that PYC suppressed ASD-induced pulmonary inflammation. Moreover, PYC suppressed the levels of matrix-metalloproteinase (MMP)-9 in the lung tissue of ASD-exposed mice, indicating that PYC reduced ASD-induced pulmonary inflammation by suppressing MMP-9. Together, these results indicate that PYC as the potential to treat ASD-driven pulmonary inflammation.

The Involvement of PDE4 in the Protective Effects of Melatonin on Cigarette-Smoke-Induced Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) is a significant disease threatening human health. Currently, roflumilast, a phosphodiesterase (PDE)4 inhibitor, is recommended as a therapeutic agent for COPD. In this study, we investigated the therapeutic effects of melatonin against COPD, focusing on determining whether it is a PDE4 inhibitor via in vivo and in vitro experiment using cigarette smoke (CS) and cigarette smoke condensate (CSC), respectively. In the in vivo experiments, melatonin treatment reduced inflammatory responses, including inflammatory cell counts. Melatonin treatment also suppressed the CS-exposure-induced upregulation of cytokine and matrix metalloproteinase (MMP)-9, reduced the PDE4B expression, and elevated cAMP levels. In addition, these effects were synergistic, as melatonin and roflumilast cotreatment eventually ameliorated the CS-exposure-induced worsening of lung function. In the CSC-stimulated NCI-H292 cells, melatonin inhibited elevation in the levels of inflammatory cytokines, MMP-9, and PDE4, and elevated cAMP levels. Furthermore, melatonin and roflumilast cotreatment was more effective on inflammatory responses than only melatonin or roflumilast treatment. Our results indicate that melatonin relieves inflammatory response and loss of lung function in COPD, which is associated with decreased PDE4 expression. Therefore, we suggest that melatonin is a putative candidate for the treatment of COPD.

CT Angiographic Evaluation of Congenital Anastomoses between Femoropopliteal Vein and Deep Femoral Vein: Types and Incidence.

PURPOSE: To evaluate congenital anastomotic channels between femoropopliteal veins and deep femoral veins with the use of computed tomographic (CT) venography. MATERIALS AND METHODS: CT venography of 488 limbs in 244 patients (105 men; mean age, 61 y; age range, 18-96 y) performed between January 2016 and December 2016 was retrospectively evaluated. The presence or absence of anastomotic channels (> 3 mm in diameter) connecting a femoropopliteal vein to a deep femoral vein was determined, and the observed channels were classified based on their location and course. RESULTS: Two types of anastomotic channels were observed in 32 patients (13%): a persistent sciatic vein (PSV) in 24 limbs of 15 patients (6%) and a retrofemoral channel (RFC) in 22 limbs of 19 patients (8%). A PSV anastomosed with the popliteal vein in the popliteal fossa, coursed posterior to the adductor magnus muscle, and drained into the deep femoral vein. An RFC anastomosed with the femoral vein at the level of the adductor hiatus, coursed posterior to the femoral shaft, and drained into the deep femoral vein. PSVs and RFCs were of similar size or larger than adjacent femoropopliteal veins in 50% (12 of 24) and 22% of limbs (4 of 22), respectively. CONCLUSIONS: Anastomotic channels connecting a femoropopliteal vein to a deep femoral vein are not a rare variation and may have an important role in collateral venous drainage of the lower extremities.

Clinical Outcomes of the Seal® Thoracic Stent Graft for Traumatic Aortic Injury in a Korean Multicenter Retrospective Study.

BACKGROUND: Thoracic endovascular aneurysm repair (TEVAR) has been used as a primary treatment for blunt traumatic aortic injury (TAI). However, the outcomes of midterm surveillance of Seal® stent-graft durability for TAI have not been extensively studied. Thus, we aimed to report the midterm outcomes of TEVAR using the Seal® stent graft for blunt TAI. METHODS: Patients with blunt TAI treated with TEVAR using the Seal® thoracic stent graft between 2007 and 2013 in Korea were included. Midterm outcomes included technical/clinical success, in-hospital death, aorta/procedure/device-related adverse events, secondary procedures, and 30-day and all-cause mortality. RESULTS: A total of 99 patients (54% men; mean age, 48 years) were included. Grade III or higher injuries were present in 95% of patients, including 15 free ruptures of the thoracic aorta, and 64% of injuries were located in zone III. The median procedure and hospitalization duration were 90 min and 11 days, respectively. The technical success rate was 98%. The number of in-hospital mortalities (n = 8) and stroke (n = 2) were observed at 30 days. Late stroke and paraplegia (>30 days) were not observed during the mean 49 ± 26 months of follow-up (median, 48 months; range, 0-117 months). There were no aorta-related mortalities or conversions to open repair. Secondary procedures were performed in 8 patients, all of which were carotid-subclavian bypasses for delayed left subclavian occlusion. The all-cause mortality rate was 5% at 30 days and 8% at 1 year. The survival rate was 95% at 30 days, 92% at 1 year, 92% at 3 years, and 89% at 5 years. One type Ia endoleak occurred at 18 months after the procedure. CONCLUSIONS: TEVAR with the Seal® stent graft for TAI showed favorable midterm outcomes. The incidence of major adverse events after the procedure was low.

The blind pushing technique for peripherally inserted central catheter placement through brachial vein puncture.

OBJECTIVE: The objective of this study was to conduct a prospective clinical trial evaluating the technical feasibility and short-term clinical outcome of the blind pushing technique for placement of pretrimmed peripherally inserted central catheters (PICCs) through brachial vein access. METHODS: Patients requiring PICC placement at any of the three participating institutions were prospectively enrolled between January and December 2016. The review boards of all participating institutions approved this study, and informed consent was obtained from all patients. PICC placement was performed using the blind pushing technique and primary brachial vein access. The following data were collected from unified case report forms: access vein, obstacles during PICC advancement, procedure time, and postprocedural complications. RESULTS: During the 12-month study period, 1380 PICCs were placed in 1043 patients. Of these, 1092 PICCs placed in 837 patients were enrolled, with 834 PICCs (76%) and 258 PICCs (34%) placed through brachial vein and nonbrachial vein access, respectively. In both arms, obstacles were most commonly noted in the subclavian veins (n = 220) and axillary veins (n = 94). Successful puncture of the access vein was achieved at first try in 1028 PICCs (94%). The technical success rate was 99%, with 1055 PICCs (97%) placed within 120 seconds of procedure time and 1088 PICCs (99%) having the tip located at the ideal position. Follow-up Doppler ultrasound detected catheter-associated upper extremity deep venous thrombosis (UEDVT) for 18 PICCs in 16 patients and late symptomatic UEDVT for 16 PICCs in 16 patients (3.1%). Catheter-associated UEDVT was noted for 28 PICCs (82%) and 6 PICCs (18%) placed through brachial vein and nonbrachial vein access, respectively. The incidence of obstacles and the procedure time (<120 seconds) differed significantly between brachial vein and nonbrachial vein access (P = .001). There was no statistically significant difference between brachial vein and nonbrachial vein access in the incidence of UEDVT (odds ratio, 0.68; 95% confidence interval, 0.59-3.52; P = .22). CONCLUSIONS: The placement of pretrimmed PICCs by the blind pushing technique and primary brachial vein access is technically feasible and may represent an alternative to the conventional PICC placement technique, having low incidences of UEDVT and other complications, with no significant difference in outcomes between brachial vein and nonbrachial vein access.

The most downloaded and most cited articles in radiology journals: a comparative bibliometric analysis.

OBJECTIVES: To evaluate and compare the characteristics of the most downloaded and most cited articles in radiology journals. METHODS: We selected 41 radiology journals that provided lists of both the most downloaded and most cited articles on their websites, and identified the 596 most downloaded articles and 596 most cited articles. We compared the following characteristics of the most downloaded and most cited articles: year of publication, journal title, department of the first author, country of origin, publication type, radiologic subspecialty, radiologic technique and accessibility. RESULTS: Compared to the most cited articles, the most downloaded articles were more frequently review articles (36.1% vs 17.1%, p < 0.05), case reports (5.9% vs 3.2%, p < 0.05), guidelines/consensus statements (5.4% vs 2.7%, p < 0.05), editorials/commentaries (3.7% vs 0.7%, p < 0.05) and pictorial essays (2.0% vs 0.2%, p < 0.05). Compared to the most cited articles, the most downloaded articles more frequently originated from the UK (8.7% vs 5.0%, p < 0.05) and were more frequently free-access articles (46.0% vs 39.4%, p < 0.05). CONCLUSION: Educational and free-access articles are more frequent among the most downloaded articles. KEY POINTS: • There was only small overlap between the most downloaded and most cited articles. • Educational articles were more frequent among the most downloaded articles. • Free-access articles are more frequent among the most downloaded articles.

Intraobserver and Interobserver Variability in Ultrasound Measurements of Thyroid Nodules.

OBJECTIVES: The purpose of this study was to assess the intraobserver and interobserver variability in ultrasound (US) measurements of thyroid nodules. METHODS: We performed a prospective study of the US examinations of 73 patients with 122 thyroid nodules greater than 5 mm in size. Ultrasound measurements in 4 dimensions (anteroposterior, transverse, longitudinal, and maximum diameters) and measurement of the estimated volume (using the ellipsoid formula) of each thyroid nodule were performed twice by 2 independent radiologists (A and B, with 10 years and 6 months of experience, respectively). The intraobserver and interobserver variability in measurements of thyroid nodules was assessed by a Bland-Altman analysis of agreement. The absolute values for intraobserver and interobserver variability were compared by a paired t test. RESULTS: The 95% intraobserver and interobserver limits of agreement for the anteroposterior, transverse, longitudinal, and maximum diameters and estimated volume of thyroid nodules were ±18.2%, ± 14.3%, and ±21.0%; ± 17.2%%, ± 17.3%, and 18.2%; ± 14.6%, ± 15.5%, and ±22.3%; ± 13.8%, ± 15.5%, and ±19.6%; and ±30.2%, ± 27.7%, and ±44.1%, respectively. The absolute values for intraobserver variability were lower than those for interobserver variability for all measurements. CONCLUSIONS: There was considerable intraobserver and interobserver variability in US measurement of thyroid nodules, which must be taken into account during follow-up US examinations of patients with thyroid nodules.

Galgeun-tang Attenuates Cigarette Smoke and Lipopolysaccharide Induced Pulmonary Inflammation via IκBα/NF-κB Signaling.

Galgeun-tang water extract (GGWE) is used to treat various diseases such as the common cold, eczema and asthma in China and Korea. In this study, we investigated the anti-inflammatory effect of GGWE using a cigarette smoke (CS)- and lipopolysaccharide (LPS)-induced induced pulmonary inflammation mouse model. The mice were exposed to CS for a total of seven days (eight cigarettes per day for 1 h) and LPS was administered intranasally to mice on day 4. GGWE was administered by oral gavage at doses of 50 mg/kg or 100 mg/kg 1 h before exposure to CS. GGWE decreased inflammatory cell counts, and expression of inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) in bronchoalveolar lavage fluid (BALF) from mice exposed to CS and LPS. GGWE reduced the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), as well as the phosphorylation of inhibitor of kappa-B subunit alpha (IκBα) and nuclear factor kappa-B (NF-κB) in CS- and LPS-exposed mice. Histological examinations revealed that GGWE suppressed inflammatory cell infiltration into lung tissue compared to untreated CS- and LPS-exposed mice. In conclusion, GGWE effectively suppressed CS- and LPS-induced pulmonary inflammation. Our results indicate that GGWE may be used as a protective drug to control pulmonary inflammation diseases such as chronic obstructive pulmonary disease.

Outcomes of Esophageal Arterial Embolization for Treatment of Hemoptysis.

PURPOSE: To investigate safety and efficacy of esophageal arterial embolization (EAE) in addition to bronchial arterial embolization (BAE) for treatment of hemoptysis as well as the importance and characteristics of esophageal arteries in patients with hemoptysis. MATERIALS AND METHODS: Between January 2013 and December 2014, 20 patients (13 men and 7 women, mean age 58.4 y) underwent EAE in addition to BAE for hemoptysis. Retrospective review of patient records was performed to evaluate major causes of hemoptysis, treatment indications based on CT findings, esophageal angiography findings, and outcomes after embolization including clinical success rate and complications. RESULTS: Hemoptysis was caused by bronchiectasis (12 patients), tuberculosis (7 patients), and lobectomy (1 patient). CT showed lower lobe lung lesions in all (100%) patients. The esophageal arteries originated from the aorta between the carina and diaphragm (18 patients) or from the inferior phrenic arteries (2 patients) and were tortuous with longitudinal off-midline courses. Communications between the esophageal and the bronchial or inferior phrenic arteries were present in 12 patients. One patient who was treated using N-butyl cyanoacrylate developed dysphagia that resolved with medical treatment. Repeat BAE was performed in 2 patients 5 days and 20 days later, and the clinical success rate was 90% (18/20). CONCLUSIONS: EAE in addition to BAE is safe in the treatment of hemoptysis and should be considered for lower lobe lesions.

Clinical Outcomes for Endovascular Repair of Thoracic Aortic Disease Using the Seal Thoracic Stent Graft: A Korean Multicenter Retrospective Study.

PURPOSE: To investigate the midterm outcomes of thoracic endovascular aneurysm repair (TEVAR) with the use of the Seal stent graft for four categories of thoracic aortic disease. MATERIALS AND METHODS: This retrospective multicenter study evaluated the records of 216 Korean patients who underwent TEVAR with the Seal stent graft during 2007-2010. The study outcomes were (i) perioperative death, (ii) endoleak, (iii) repeat intervention, (iv) aortic-related death, and (v) all sudden unexplained late deaths. RESULTS: The overall technical success rate was 94% (203 cases), and the disease-specific rates were 97% (88 cases) for aneurysms, 96% (71 cases) for dissections, 82% (32 cases) for traumatic aortic disease, and 100% (12 cases) for intramural hematoma and/or penetrating aortic ulcer. There were 6 acute surgical conversions (2 for aneurysms and 4 for dissections). There were 18 endoleaks, 4 retrograde ascending aortic dissections, and 6 stent graft-induced new entries. The 1-, 3-, and 5-year overall survival rates were 93% ± 3, 90% ± 4, and 90% ± 4, respectively. CONCLUSIONS: TEVAR with the Seal thoracic stent graft provided a high technical success rate and low mortality and complication rates during midterm follow-up. However, additional long-term studies are needed to evaluate the durability and late complications associated with this device.

Characteristics and quality of published animal research in the field of radiology.

Background Animal research has played an important role in the field of radiology. Purpose To evaluate the characteristics and quality of published radiological animal research. Material and Methods A PubMed search was performed for radiological animal research articles (defined as studies using animal models with a radiologist as the first author) published in 1994, 2004, and 2014. The following information was extracted from each article: journal name, radiological subspecialty, imaging technique, animal species, number of animals used, number of authors, declared funding, country of origin, methodological quality, and ethical quality. Methodological and ethical quality of studies were assessed with seven-item (sample size calculation, animal age, animal sex, animal weight, inclusion and exclusion criteria, randomization, and blinded outcome assessment) and four-item (ethical review committee approval, anesthesia, pain control, and euthanasia) scales, respectively. Results The numbers of radiological animal studies markedly increased, from 91 in 1994 to 163 in 2004 and to 305 in 2014. One hundred and sixty-two (29.0%) articles focused on the neuroradiology/head and neck subspecialty, 233 (41.7%) used magnetic resonance imaging (MRI), 190 (34.0%) used mice, 254 (45.4%) used 10-30 animals, 297 (53.1%) had 4-7 authors, 392 (70.1%) were funded, and 222 (39.7%) were from the USA. Six of 7 methodological and 3/4 ethical quality items significantly improved over time. Conclusion The quantity and quality of radiological animal research has increased over the last two decades; however, methodological and ethical quality remains suboptimal.

Clinical outcomes for endovascular repair of abdominal aortic aneurysm with the Seal stent graft.

OBJECTIVE: Since 2007, the availability of the Seal (S & G Biotech Inc, Seong-nam, Gyeonggi-do, Korea) stent graft for endovascular aneurysm repair (EVAR) has improved short-term outcomes in Korea. However, midterm outcome data are lacking. This retrospective study evaluated the midterm outcomes of 126 patients who underwent EVAR using the Seal stent graft between 2007 and 2010. METHODS: Data regarding use of the Seal stent graft for EVAR were collected from 16 Korean centers, and were analyzed retrospectively using Kaplan-Meier and Cox univariate and multivariate analyses. RESULTS: The mean patient age was 71 ± 8 years (median, 70; range, 49-87 years). Patients who were treated using a bifurcated graft (113; 90%) were generally symptomatic (56; 44%, which included 13 ruptured abdominal aortic aneurysms [10%]) and male (105; 83%). The primary technical success rate was 99%. Four patients (3%) died within 30 days, 5 patients (4%) died after 30 days, and 12 patients (9%) were lost to follow-up. The survival rates were 97% ± 2% (1 month), 97% ± 2% (3 months), 96% ± 2% (6 months), 96% ± 2% (1 year), 94% ± 3% (3 years), and 81% ± 10% (5 years). During a mean follow-up of 55 ± 22 months (median, 40; range, 0.03-91.2 months), 18 reinterventions were performed for 16 patients (13%). The freedom from reintervention rates were 96% ± 2% (1 month), 96% ± 2% (3 months), 94% ± 2% (6 months), 89% ± 3% (1 year), 84% ± 4% (3 years), and 57% ± 17% (5 years). The mean aneurysm diameter significantly decreased from 69.6 to 46.6 mm during the follow-up (P < .0001). A proximal neck of less than 15 mm, different simultaneous endoleaks, and insufficient bilateral coverage of the iliac aneurysm were associated with significantly higher rates of increased or unchanged aneurysm diameters (all P < .0001). Significantly higher rates of clinical failure were observed in patients who were less than 70 years old (P = .04), had a neck length of less than 15 mm (P = .02), and had a neck diameter of greater than 28 mm (P = .02). CONCLUSIONS: Most Seal stent grafts were implanted successfully (even in cases with a physical status of grade IV or higher or a ruptured abdominal aortic aneurysm), had an appropriate reintervention rate, and were stable during the midterm follow-up. However, there was a high rate of type I endoleak, which may be related to the early device model that we used. Therefore, long-term radiologic follow-up is recommended for the early detection of stent graft migration or endoleaks.

Characteristics and Quality of Radiologic Randomized Controlled Trials: A Bibliometric Analysis Between 1995 and 2014.

OBJECTIVE: The aim of this bibliometric study was to assess the characteristics and quality of radiologic randomized controlled trials (RCTs) over the past 20 years. MATERIALS AND METHODS: A PubMed search was conducted to identify radiologic RCTs (defined as RCTs in which the first author or corresponding author is affiliated with a radiology department) published between 1995 and 2014. The following information was extracted from each article: journal, radiologic subspecialty, imaging technique, number of subjects, study result, funding, number of authors, number of institutions, country of origin, and methodologic quality (assessed using the Jadad scale). RESULTS: A total of 358 radiologic RCTs were published between 1995 and 2014. Dramatic increases in the numbers of radiologic RCTs were found, from 43 conducted in 1995-1999 to 172 conducted in 2010-2014. One-hundred seventeen (32.7%) RCTs were concerned with the field of vascular and interventional radiology; 78 (21.8%) evaluated more than one imaging technique; 164 (45.8%) had a sample size of 50-150 subjects; 246 (68.7%) showed positive study results; 185 (51.7%) were not funded; 179 (50.0%) had four to seven authors; 263 (73.5%) were single-center trials; 88 (24.6%) had a first author or corresponding author located in the United States; and 187 (52.2%) were of low quality. In the time trend analysis, the following variables showed a significantly positive trend: abdominal imaging subspecialty, CT as the imaging technique, more than 150 subjects, more than seven authors, and high methodologic quality. CONCLUSION: The quantity and quality of radiologic RCTs have significantly increased over the past 2 decades; however, the methodologic quality remains suboptimal.

Incidental focal FDG uptake in the parotid glands on PET/CT in patients with head and neck malignancy.

OBJECTIVES: To evaluate the prevalence and clinical significance of focal parotid lesions identified by (18)F- FDG PET/CT in patients with nonparotid head and neck malignancies. METHODS: From 3,638 PET/CT examinations using (18)F-FDG conducted on 1,342 patients with nonparotid head and neck malignancies, we retrospectively identified patients showing incidental focal FDG uptake in the parotid glands. The diagnosis of parotid lesions was confirmed histopathologically or on imaging follow-up. Patient demographics, clinical features, maximum standardized uptake value (SUV(max)) on PET images, size and attenuation on corresponding contrast-enhanced CT images were assessed and correlated with the final diagnosis. RESULTS: The prevalence of incidental focal parotid FDG uptake on PET/CT was 2.1% (95% CI 1.4 - 3.0%). Among 21 patients with focal parotid lesions confirmed histologically or on imaging follow-up, 7 (33.3%) had malignant lesions (all metastases) and 14 (66.7%) had benign lesions (four pleomorphic adenomas, two Warthin's tumours, one benign lymph node, one granulomatous lesion, six lesions without histopathological confirmation). There were no significant differences in age, sex, SUV(max) or CT findings between patients with benign and those with malignant lesions. CONCLUSION: Focal parotid FDG uptake on PET/CT in patients with head and neck malignancy warrants further investigations to ensure adequate therapy for incidental parotid lesions. KEY POINTS: • The prevalence of parotid incidentaloma on PET in head and neck malignancy was 2.1% • The malignancy rate of incidental focal parotid FDG uptake was 33.3% • SUV max could not reliably differentiate malignant from benign incidental parotid lesions.

Trend Toward an Increase in Authorship for Leading Radiology Journals.

OBJECTIVE: The purpose of this study was to determine authorship trends in two leading radiology journals over the past 2 decades. MATERIALS AND METHODS: All original articles (n = 5195) published in AJR and Radiology for the periods 1991-1993, 2001-2003, and 2011-2013 were reviewed. The following variables were extrapolated from each article: number of authors, radiologic subspecialty, and country of origin. The number of authors listed per article was correlated with the publication period, journal, radiologic subspecialty, and country of origin. RESULTS: The mean number of authors per article increased from 5.1 in 1991-1993 to 6.2 in 2001-2003 and to 7.1 in 2011-2013 across both journals (p < 0.0001). Both AJR and Radiology had statistically significant increases in the number of authors per article over time, but the number of authors per article in Radiology was significantly higher than that in AJR (p < 0.0001 for all study periods). The number of authors per article significantly increased for all radiologic subspecialties. The mean numbers of authors per article by country of origin are as follows: Italy, 8.3; Japan, 7.6; France, 7.5; Germany, 7.4; China, 7.3; Austria, 7.2; and South Korea, 6.8. These were significantly higher than the mean number of authors from Switzerland, which was 6.3. CONCLUSION: The number of authors significantly and consistently increased in two leading radiology journals over the past 2 decades.

Loranthus tanakae Franch. and Sav. Attenuates Respiratory Inflammation Caused by Asian Sand Dust.

Asian sand dust (ASD), generally produced in East Asia, including China, Japan, and Korea, directly leads to the development of pulmonary disease and exacerbates underlying pulmonary diseases. Loranthus tanakae Franch. and Sav. is a traditional herbal medicine applied to improve various inflammatory conditions. Here, we evaluated the curative properties of L. tanakae ethanol extract (LTE) against pulmonary inflammation caused by ASD. Additionally, to investigate the mechanism of action of LTE, we performed network pharmacological analysis. ASD was administrated on day 1, 3, and 5 by intranasal instillation, and LTE was orally administered for 6 days. Administration of LTE significantly decreased inflammatory cytokines and the number of inflammatory cells in bronchoalveolar lavage fluid, which was accompanied by a decrease in inflammatory cell accumulation in pulmonary tissue. Administration of LTE decreased the expression of cyclooxygenase2 and matrix metalloproteinase-9 in mice exposed to ASD with the decline in p65 phosphorylation. Additionally, administration of LTE significantly elevated hemeoxygenase (HO)-1 expression in the pulmonary tissue of mice exposed to ASD. These results were consistent with the data of network pharmacological analysis. This experiment showed that LTE attenuated pulmonary inflammation caused by ASD via inhibition of NF-κB and elevation of HO-1. Therefore, LTE may have potential as a therapeutic agent to treat pulmonary inflammation caused by ASD.

Spontaneous rupture of a middle colic artery aneurysm arising from superior mesenteric artery dissection: Diagnosis by color Doppler ultrasonography and CT angiography.

Both middle colic artery (MCA) aneurysm and spontaneous dissection of the superior mesenteric artery (SMA) are rare. We report the first case of concomitancy of both conditions, diagnosed by ultrasonography and CT angiography. A 56-year-old man with abrupt abdominal pain and hypovolemic shock was diagnosed initially with ruptured MCA aneurysm by color Doppler ultrasonography. Computed tomography and angiography confirmed MCA aneurysm and showed that it was arising from the false lumen of an SMA dissection and was probably associated with segmental arterial mediolysis. The MCA aneurysm was treated successfully by transcatheter coil embolization, and the SMA dissection was treated conservatively.

Melatonin Alleviates Silica Nanoparticle-Induced Lung Inflammation via Thioredoxin-Interacting Protein Downregulation.

Silica dioxide nanoparticles (SiONPs) have been increasingly used in various industries; however, this has raised concerns regarding their potential toxicity. SiONPs are also a major component in the Asian sand dust that causes pulmonary diseases among the general public. Melatonin exerts some inhibitory effects against lung inflammation. In this study, we explored the therapeutic properties of melatonin against lung inflammation using an SiONPs-induced lung inflammation murine model and SiONPs-stimulated H292 cells, human airway epithelial cell line, by focusing on the involvement of thioredoxin-interacting protein (TXNIP) in the modulation of the MAPKs/AP-1 axis. We induced an inflammatory response by exposing mouse lungs and the H292 cells to SiONPs and confirmed the anti-inflammatory effect of melatonin. Melatonin inhibited the expression of various inflammatory mediators, including TNF-α, IL-6, and IL-1ß, in SiONPs-exposed mice and SiONPs-stimulated H292 cells; this inhibition contributed to a decline in inflammatory cell accumulation in the lung tissues. Furthermore, melatonin treatment decreased the expression of MAPKs and AP-1 by downregulating TXNIP, eventually decreasing the production of SiONPs-induced inflammatory mediators. Overall, these data suggest that melatonin reduces SiONPs-induced lung inflammation by downregulating the TXNIP/MAPKs/AP-1 signalling pathway, thereby supporting the use of melatonin as an effective approach to control SiONPs-induced lung inflammation.

An infrarenal aortic hypoplasia presented with claudication.

We describe a case of infrarenal aortic hypoplasia in a 52-yr-old woman who presented with claudication. Computed tomographic angiography revealed an abrupt absence of the infrarenal aorta, with collateral flow reconstituting the iliofemoral systems. After a polytetrafluoroethylene graft was interposed between the aortic stump and the iliac bifurcation, the patient's claudication resolved.

Outcome of Percutaneous Intervention in Dysfunctional Loop versus Straight Arteriovenous Grafts in Hemodialysis Patients.

OBJECTIVE: To compare the patency control of dysfunctioning forearm arteriovenous graft (AVG) using percutaneous transluminal angioplasty (PTA) in patients with loop versus straight grafts. MATERIALS AND METHODS: Between January 2012 and March 2017, hemodialysis patients with forearm AVG were treated with PTA at two hospitals. We reviewed technical and clinical success rates of each procedure. Procedure time and patency of the graft were compared for all patients as well as for subgroups of stenosis only and thrombosis using paired-sample t-test and Kaplan-Meier analysis. RESULTS: Sixty-six patients (mean age, 62.11 ± 11.85 years) underwent PTA. Thirty-eight patients (58%) had loop grafts and 28 (42%) had straight grafts. Among 66 patients, 54 (82%) had thrombosis. Technical success rate was 95.5% (only stenosis: 100%; thrombosis: 94%) and the mean procedure time was 48.00 ± 16.75 minutes in all patients. Although there was a tendency towards shorter procedure time in patients with loop grafts (45.24 ± 20.24 minutes) than those with straight grafts (51.85 ± 22.76 minutes), the difference was not statistically significant (p = 0.217), with or without thrombi. There was no statistical significance in primary and assisted primary patency (log rank 0.78, p = 0.38 in primary patency; log rank 0.88, p = 0.35 in assisted primary patency). CONCLUSION: Our study suggests there is no different patency outcome between straight and loop arteriovenous grafts after PTA.