Clinical Results of Distal Embolization in Grade V Splenic Injury: Four-Year Experience from a Single Regional Trauma Center.

PURPOSE: To evaluate the benefits and risks of splenic artery embolization (SAE) in patients with American Association for the Surgery of Trauma (AAST) grade V blunt spleen injury (BSI) MATERIALS AND METHODS: Medical records of 88 patients treated with SAE between April 2013 and May 2017 at a regional trauma care center were reviewed retrospectively. The BSI grade according to the AAST spleen injury scale (revised version 2018) was determined by using computed tomography (CT) images. A total of 42 patients (46.6%) had AAST grade V injury and were included in the analysis. Patient demographics, angiographic findings, embolization techniques, and technical and clinical outcomes, including splenic salvage rate and procedure-related complications, were examined. RESULTS: SAE was performed within 2 hours after admission for 78.5% of the patients. All patients underwent selective distal embolization (n = 42). Primary clinical success rate was 80.9% (n = 34), and secondary clinical success rate was 88.1% (n = 37). The clinical failure group consisted of 5 patients. Four patients underwent splenectomy, and 1 patient died due to acute respiratory distress syndrome after embolization. The splenic salvage rate was 85.7% (n = 36). No patient had sepsis at follow-up (median, 247.0 days; interquartile range, 92.0-688.0). Clinical success rates (P = .356) and spleen salvage rates (P = .197) of patients who were hemodynamically stable (n = 19) showed no significant differences from those who were unstable (n = 23). CONCLUSIONS: Distal embolization of grade V BSI is a safe and feasible procedure which is effective for successful spleen salvage.

A new ursane-type triterpenoid glycoside from Centella asiatica leaves modulates the production of nitric oxide and secretion of TNF-α in activated RAW 264.7 cells.

One new ursane-type triterpenoid glycoside, asiaticoside G (1), five triterpenoids, asiaticoside (2), asiaticoside F (3), asiatic acid (4), quadranoside IV (5), and 2α,3ß,6ß-trihydroxyolean-12-en-28-oic acid 28-O-[α-L-rhamnopyranosyl-(1→4)-ß-D-glucopyranosyl-(1→6)-ß-D-glucopyranosyl] ester (6), and four flavonoids, kaempferol (7), quercetin (8), astragalin (9), and isoquercetin (10) were isolated from the leaves of Centella asiatica. Their chemical structures were elucidated by mass, 1D- and 2D-nuclear magnetic resonance (NMR) spectroscopy. The structure of new compound 1 was determined to be 2α,3ß,23,30-tetrahydroxyurs-12-en-28-oic acid 28-O-[α-L-rhamnopyranosyl-(1→4)-ß-D-glucopyranosyl-(1→6)-ß-D-glucopyranosyl] ester. The anti-inflammatory activities of the isolated compounds were investigated on lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. Asiaticoside G (1) potently inhibited the production of nitric oxide and tumor necrosis factor-α with inhibition rates of 77.3% and 69.0%, respectively, at the concentration of 100 µM.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization.

Purpose: We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods: Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results: Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion: TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Rhizospheric Bacillus amyloliquefaciens Protects Capsicum annuum cv. Geumsugangsan From Multiple Abiotic Stresses via Multifarious Plant Growth-Promoting Attributes.

Plant growth-promoting rhizobacteria (PGPR) are beneficial microorganisms that can be utilized to improve plant responses against biotic and abiotic stresses. In this study, we investigated whether PGPR (Bacillus amyloliquefaciens) isolated from the endorhizosphere of Sasamorpha borealis have the potential to sustain pepper growth under drought, salinity, and heavy metal stresses. The bacterial strain was determined based on 16S rDNA and gyrB gene sequencing and characterized based on the following biochemical traits: nitrogen fixation; 1-aminocyclopropane-1-carboxylate deaminase activity; indole acetic acid production; inorganic phosphate, potassium, zinc, and silicon solubilization; and siderophore production. Various abiotic stresses were applied to 28-day-old pepper seedlings, and the influence of the PGPR strain on pepper seedling growth under these stress conditions was evaluated. The application of PGPR improved survival of the inoculated pepper plants under stress conditions, which was reflected by higher seedling growth rate and improved physiochemical traits. The PGPR-treated plants maintained high chlorophyll, salicylic acid, sugar, amino acid, and proline contents and showed low lipid metabolism, abscisic acid, protein, hydrogen peroxide contents, and antioxidant activities under stress conditions. Gene expression studies confirmed our physiological and biochemical findings. PGPR inoculation led to enhanced expression of XTH genes and reduced expression of WRKY2, BI-1, PTI1, and binding immunoglobulin protein (BiP) genes. We conclude that the PGPR strain described in this study has great potential for use in the phytoremediation of heavy metals and for enhancing pepper plant productivity under stress conditions, particularly those involving salinity and drought.

A critical element of the light-induced quaternary structural changes in YtvA-LOV.

YtvA, a photosensory LOV (light-oxygen-voltage) protein from Bacillus subtilis, exists as a dimer that previously appeared to undergo surprisingly small structural changes after light illumination compared with other light-sensing proteins. However, we now report that light induces significant structural perturbations in a series of YtvA-LOV domain derivatives in which the Jα helix has been truncated or replaced. Results from native gel analysis showed significant mobility changes in these derivatives after light illumination; YtvA-LOV without the Jα helix dimerized in the dark state but existed as a monomer in the light state. The absence of the Jα helix also affected the dark regeneration kinetics and the stability of the flavin mononucleotide (FMN) binding to its binding site. Our results demonstrate an alternative way of photo-induced signal propagation that leads to a bigger functional response through dimer/monomer conversions of the YtvA-LOV than the local disruption of Jα helix in the As-LOV domain.

Analysis of Kaposi's sarcoma-associated herpesvirus latent replication using a real-time polymerase chain reaction technique.

Kaposi's sarcoma-associated herpesvirus (KSHV) undergoes replication independently via latent and lytic pathways. Latent replication is mediated by latent-associated nuclear antigen (LANA), the sole viral trans element for genome maintenance and replication. According to previous studies, LANA tethers the KSHV genome to the host chromosome during latency and interacts with host factors to ensure proper latent replication. Studies using Southern blot experiments have revealed consistently that vector constructs containing the viral terminal repeat (TR) region as a cis element in latent replication are replicated in the presence of LANA. However, Southern blotting is a time-intensive, complicated technique that requires multiple reagents. In addition, it has a limited ability to detect slight changes in replication efficiency under different conditions owing to its relatively low sensitivity. In the current study, a real-time polymerase chain reaction method was developed for detecting transient KSHV replication and was found to be capable of further identifying several factors that affect latent replication. This technique should provide a useful tool for the detection of KSHV latent replication under various conditions, including overexpression of viral or cellular factors and chemical stimulation.

Human papillomavirus type 16 E6 protein inhibits DNA fragmentation via interaction with DNA fragmentation factor 40.

The E6 oncoprotein of human papillomavirus (HPV) is critical in cervical cancer development. Using the yeast two-hybrid assay, we showed that HPV-16 E6 (16E6) interacts with one of the DNA fragmentation factors (DFFs), DFF40, which mediates DNA degradation during apoptosis. Furthermore, 16E6 interacts with DFF40 through its zinc finger motif 2 and a bridge section linking the two zinc finger motifs. DNA fragmentation assays disclosed that 16E6 binding to DFF40 leads to blockage of DNA cleavage. Our data collectively suggest that suppression of DNA fragmentation through 16E6-DFF40 interaction is a central event promoting tumorigenesis.

Inhibitory effect of kyungohkgo in the development of 2,4-dinitrochlorobenzene-induced atopic dermatitis in NC/Nga mice.

Kyungohkgo (KOG) is one of the most important formulas in traditional oriental medicine. We investigated the remedial effect of KOG on the development of atopic dermatitis (AD) in female NC/Nga mice. AD-like lesion was induced by the application of 2,4-Dinitrochlorobenzene on to the back skin repeatedly; KOG was administered orally (12.5 and 25.0 mg/kg) and topically (0.5 and 1.0 mg/mouse) to NC/Nga mice once a day for all through the period of this experiment and every mouse body weight was periodically taken. The effects of KOG on 2,4-Dinitrochlorobenzene-treated NC/Nga mice were determined by measuring AD-like skin lesions, the infiltration of mast cells and serum immunoglobulin E concentration. After the KOG applications are over, the KOG groups had less skin lesions than the atopy one, their immunoglobulin E levels were significantly downregulated and the infiltration of mast cells in the dorsal skin were reduced. Our results suggest that KOG may be effective in alleviating the development of AD. The inhibition of AD in NC/Nga mice may be influenced by the prevention of mast cell activation.

Nafamostat mesilate attenuates colonic inflammation and mast cell infiltration in the experimental colitis.

Serine proteases are important in the pathogenesis of intestinal inflammation. Recent studies have shown that nafamostat mesilate (NM) can inhibit the colonic mucosal inflammation induced by TNBS in rats. The aim of this study was to investigate the anti-inflammatory effects of NM on a DSS-induced colitis. Colitis was induced in female BALB/c mice by 5% dextran sulfate sodium (DSS) for 6 days. NM (2 or 20mg/kg body weight) was orally administered once a day for 6 days during treatment of the mice with DSS. The inflammatory response of the colon was assessed 1 week after DSS treatment. NM at a high dose, but not at a low dose significantly decreased disease activity index (DAI) and myeloperoxidase (MPO) induced by DSS. Furthermore, NM (20mg/kg) inhibited the production of tumor necrosis factor (TNF)-α, cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) in the colonic tissues treated with DSS. The increase in chymase activity by DSS treatment was also attenuated by the administration of NM (20mg/kg). NM (20mg/kg) significantly decreased the colonic mucosal injury and the infiltrated mast cell number induced by DSS. These results indicate that NM might inhibit the colonic inflammation through inhibition of both chymase activity and mast cell infiltration in colon tissues of DSS-induced colitis.