Postoperative Doppler Ultrasonography in Liver Transplantation.

BACKGROUND: Doppler ultrasonography plays an important role in the postoperative management of liver transplantation. We present our initial experiences evaluating liver transplants with the use of postoperative Doppler sonography. METHODS: In our hospital, we performed 20 liver transplantations from July 2014 to October 2016. Among 20 patients, we performed 15 deceased-donor liver transplantations (DDLTs) and 5 living-donor liver transplantations (LDLTs). For deceased donors, inferior vena cava anastomoses were performed with the use of the piggyback technique, and for living donors, modified right grafts were used with middle hepatic vein reconstruction by Dacron graft. In the intensive care unit, we performed Doppler ultrasound at least once a day and at every clinical need. We checked hepatic blood flow by means of Doppler ultrasound. RESULTS: Eighteen patients underwent Doppler ultrasonography once a day up to postoperative day 6. Of the patients who received LDLT, 2 patients underwent Doppler ultrasonography twice a day because the operator was concerned about the hepatic artery anastomosis. Findings on Doppler ultrasound showed no abnormal wave form in hepatic artery, portal vein and hepatic veins. No patient had abnormal findings on angiographic computerized tomography. There was 1 graft failure in 20 recipients. The graft failure was primary nonfunction, and retransplantation was done. During the hospitalizations, there were no vascular complications. CONCLUSIONS: Doppler ultrasonography can be used to evaluate postoperative vascular complications in liver transplant patients. When the operator checks postoperative Doppler ultrasonography, it is possible to differentiate between patients, and it may help to detect the vascular complications earlier.

Apolipoprotein B: novel indicator of elevated intraocular pressure.

PURPOSE: Many studies have reported associations between elevated intraocular pressure (IOP) and systemic health parameters, which suggest a common mechanism links IOP elevation and various related cardiometabolic risk factors. Furthermore, according to a recent study, serum apolipoprotein B (APO B) level is a predictor of coronary artery disease. This study was undertaken to analyse the relationship between serum apolipoprotein levels and IOP. METHODS: Healthy people (28,852) who attended a community hospital for a health checkup between January 2011 and December 2013 were enroled in the study. We measured age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein A1 (APO A1) and APO B, APO B/APO A1 ratios, and IOP. RESULTS: Univariate regression analysis showed IOP was positively correlated with BMI, SBP, DBP, TC, LDL-C, TG, APO B, and APO B/APO A1 (P<0.001), and negatively correlated with HDL-C (P<0.001). On the other hand, multivariate regression analysis adjusted for age, BMI, SBP, and DBP, revealed IOP was positive correlated with TC, TG, LDL-C, APO B, and APO B/APO A1, and negatively correlated with HDL-C (all <0.05). CONCLUSIONS: Among the various lipid profiles investigated, APO B was found to be most strongly correlated with IOP, regardless of sex. Additional studies are required to confirm the validity of apolipoprotein level as an index for predicting IOP.

Alcohol consumption and persistent infection of high-risk human papillomavirus.

Alcohol consumption is a possible co-factor of high-risk human papillomavirus (HR-HPV) persistence, a major step in cervical carcinogenesis, but the association between alcohol and continuous HPV infection remains unclear. This prospective study identified the association between alcohol consumption and HR-HPV persistence. Overall, 9230 women who underwent screening during 2002-2011 at the National Cancer Center, Korea were analysed in multivariate logistic regression. Current drinkers [odds ratio (OR) 2·49, 95% confidence interval (CI) 1·32-4·71] and drinkers for ⩾5 years (OR 2·33, 95% CI 1·17-4·63) had a higher risk of 2-year HR-HPV persistence (HPV positivity for 3 consecutive years) than non-drinkers and drinkers for <5 years, respectively (vs. HPV negativity for 3 consecutive years). A high drinking frequency (⩾twice/week) and a high beer intake (⩾3 glasses/occasion) had higher risks of 1-year (OR 1·80, 95% CI 1·01-3·36) HPV positivity for 2 consecutive years) and 2-year HR-HPV persistence (OR 3·62, 95% CI 1·35-9·75) than non-drinkers. Of the HPV-positive subjects enrolled, drinking habit (OR 2·68, 95% CI 1·10-6·51) and high consumption of beer or soju (⩾2 glasses/occasion; OR 2·90, 95% CI 1·06-7·98) increased the risk of 2-year consecutive or alternate HR-HPV positivity (vs. consecutive HPV negativity). These findings suggest that alcohol consumption might increase the risk of cervical HR-HPV persistence in Korean women.

Proposed mechanism of inactivating Escherichia coli O157:H7 by ultra-high pressure in combination with tert-butylhydroquinone.

AIMS: Investigating mechanisms of lethality enhancement when Escherichia coli O157:H7, and selected E. coli mutants, were exposed to tert-butylhydroquinone (TBHQ) during ultra-high pressure (UHP) treatment. METHODS AND RESULTS: Escherichia coli O157:H7 EDL-933, and 14 E. coli K12 strains with mutations in selected genes, were treated with dimethyl sulfoxide solution of TBHQ (15-30 ppm), and processed with UHP (400 MPa, 23 +/- 2 degrees C for 5 min). Treatment of wild-type E. coli strains with UHP alone inactivated 2.4-3.7 log CFU ml(-1), whereas presence of TBHQ increased UHP lethality by 1.1-6.2 log CFU ml(-1); TBHQ without pressure was minimally lethal (0-0.6 log reduction). Response of E. coli K12 mutants to these treatments suggests that iron-sulfur cluster-containing proteins ([Fe-S]-proteins), particularly those related to the sulfur mobilization (SUF system), nitrate metabolism, and intracellular redox potential, are critical to the UHP-TBHQ synergy against E. coli. Mutations in genes maintaining redox homeostasis and anaerobic metabolism were associated with UHP-TBHQ resistance. CONCLUSIONS: The redox cycling activity of cellular [Fe-S]-proteins may oxidize TBHQ, potentially leading to the generation of bactericidal reactive oxygen species. SIGNIFICANCE AND IMPACT OF THE STUDY: A mechanism is proposed for the enhanced lethality of UHP by TBHQ against E. coli O157:H7. The results may benefit food processors using UHP-based preservation, and biologists interested in piezophilic micro-organisms.

Alfentanil attenuates phenylephrine-induced contraction in rat aorta.

BACKGROUND AND OBJECTIVES: Alfentanil was reported to relax the rat aorta by direct action on the vascular smooth muscle. The aims of this in vitro study were to examine the effect of alfentanil on phenylephrine-induced contractions in the rat aorta and to determine the cellular mechanism associated with this process. METHODS: Endothelium-denuded aortic rings were suspended in order to record isometric tension. In the rings with or without 10(-6) mol naloxone or 10(-5) mol verapamil, the concentration-response curves for phenylephrine and potassium chloride were generated in the presence or absence of alfentanil (10(-6), 5 x 10(-5), 10(-4) mol). In the rings exposed to a calcium-free isotonic depolarizing solution, the contractile response induced by the addition of calcium was assessed in the presence or absence of alfentanil (5 x 10(-5), 10(-4) mol). RESULTS: Alfentanil (5 x 10(-5), 10(-4) mol) attenuated (P < 0.05) the phenylephrine-induced contraction in the ring with or without 10(-6) mol naloxone but had no effect on the phenylephrine-induced contraction in the rings pretreated with verapamil. Alfentanil (5 x 10(-5), 10(-4) mol) produced a significant rightward shift (P < 0.01) in the potassium chloride dose-response curve, and attenuated the contractile response (P < 0.001) induced by calcium in the calcium-free isotonic depolarizing solution in a dose-dependent manner. CONCLUSIONS: A supraclinical dose of alfentanil attenuates the phenylephrine-induced contraction via an inhibitory effect on calcium influx by blocking the l-type calcium channels in the rat aortic vascular smooth muscle.

A yang-promoting Chinese herbal suppository preparation enhances the antioxidant status of red cells in male human subjects.

In the 16-week pilot study, the effect of a Yang-promoting Chinese herbal suppository preparation (VI-28) on the red cell antioxidant status was examined in 31 healthy male subjects aged 41-66 years old. VI-28 treatment for 12 weeks (one suppository (0.3 g) daily for week 1-4; one every 2 days for week 5-8; one every 3 days for week 9-12) produced a time/dose-dependent alteration in red cell antioxidant status. The VI-28-induced change is characterized by a slight depletion in cellular reduced glutathione (GSH) level and a decrease in susceptibility to peroxide-induced lipid peroxidation as well as increases in catalase (CAT) and Cu-Zn-superoxide dismutase (SOD) activities. While a reversal trend of change was observed in cellular GSH level, the susceptibility to lipid peroxidation as well as the CAT activity after the cessation of treatment for 4 weeks, the SOD activity exhibited a protracted increase. The results indicate that VI-28 treatment enhances red cell antioxidant status in male subjects. The beneficial effect of VI-28 treatment on red cells may re fl ect a corresponding change in antioxidant status of peripheral tissues.

Effect of etomidate on endothelium-dependent relaxation induced by acetylcholine in rat aorta.

The goals of this in vitro study were to investigate effects of etomidate on endothelium-dependent relaxation induced by acetylcholine in rat aorta, and to elucidate the associated cellular mechanism. In endothelium-intact rings precontracted with phenylephrine 10(-6) M, dose-response curves for acetylcholine (10(-9) to 10(-5) M) and calcium ionophore (10(-9) to 10(-6) M) were generated in the presence and absence of etomidate (5 x10(-6) 10(-5) M). In endothelium-intact or -denuded rings precontracted with phenylephrine 10(-6) M, sodium nitroprusside (10(-9) to 10(-6) M) dose-response curves were generated in the presence and absence of etomidate (10(-5)M). Etomidate (5 x10(-6), 10(-5)M) produced a significant rightward shift in the dose-response curves induced by acetylcholine (receptor-mediated endothelium-dependent agonist) and calcium ionophore A23187 (non receptor-mediated endothelium-dependent agonist). Etomidate (10(-5)M) had no effect on sodium nitroprusside (endothelium-independent nitric oxide donor)-induced vasorelaxant response in both endothelium-intact and -denuded rings. These results indicate that etomidate at clinically relevant concentrations attenuates endothelium-dependent relaxation induced by acetylcholine by an acting at a site distal to the endothelial muscarinic receptor, but proximal to guanylate cyclase activation of vascular smooth muscle in rat aorta.

Diagnosing and optimizing water treatment processes by using particle counter: a case study in Korea.

The goal of the flocculation process is to change the particle size distribution to best suit the subsequent processes. Although several methods exist to evaluate the flocculation process, no single universally accepted method has yet to be developed. The purpose of this paper is to present experiences whereby particle counting was used in the diagnosis and optimization of the flocculation process. A commercially available on-line continuous particle counter has been used in evaluating the design and the operation of this process at two conventional Water Treatment Plants. The evaluation is based on particle dynamics, i.e., the change of the number of small and large particles. Some design deficiencies in the distribution channel and flocculation process have been identified from this method, and thus some operational parameters are suggested for optimum performance. Because the optimum condition may be site-specific, the method presented in this paper will be beneficial in the evaluation of the flocculation process at other water treatment plants.

Solitary fibrous tumour of the face: a rare case report.

Solitary fibrous tumour is a rare mesenchymal neoplasm that most commonly involves the pleura. The diagnosis of solitary fibrous tumour is primarily histological. It consists of histological and positive immunohistochemical findings of CD-34 and vimentin. Recently, solitary fibrous tumour has been reported to occur in extrapleural soft tissues, such as the orbit, nasal cavity, abdominal cavity, parotid gland, scalp and neck. In an extensive review of the literature, we found no reports of solitary fibrous tumour arising in the facial soft tissue, other than in the parotid gland. This rare location of an uncommon lesion can lead to a confusing diagnosis. We report a case of solitary fibrous tumour originating in the temporal region of the face, and call for awareness of this tumour among plastic surgeons.

Evaluation of biological and chemical insecticide mixture against Aedes aegypti larvae and adults by thermal fogging in Singapore.

To improve the operational efficiency of dengue vector control in Singapore, larvicide and adulticide were applied together by thermal fog generator (Agrofog AF40). The mixture consisted of Bacillus thuringiensis var. israelensis (Vectobac 12 AS) as biological larvicide at 1.5 L/ha and pirimiphos-methyl (Actellic 50 EC) as adulticide at 100 g ai/ha, diluted 10-fold with water. Aerosol of this mixture was evaluated against the mosquito Aedes aegypti (L.) (Diptera: Culicidae) in bioassays using cages of 10 adult females exposed at heights of 0.3-2.4 m and distances of 3-12 m from the hand-held generator. Cups containing 200 mL water were treated at ground level by exposure to the aerosol application at the same distances from the generator. Subsequent larval bioassays on days 1, 7, 14, 21 and 28 post-spray involved exposing 20 larvae/cup for 48 h. Droplets had VMD 57 microm and female mosquitoes were killed by 2 s exposure to the aerosol at 3 m. We obtained 92-100% mortality of the adult mosquitoes and 100% control of larvae at 3 m distance, but only 10-13% mortality at 12 m from the fogger. In treated cups, larvae showed high mortality (92%) when exposed for 48 h even 1 month post-treatment. Results demonstrate the practical advantage of using this mixture of Vectobac 12AS and Actellic 50 EC for simultaneous control of Aedes adults and larvae, with prolonged larvicidal efficacy in treated containers.

Sensate sole-to-sole reconstruction using the combined medial plantar and medialis pedis free flap.

The coverage of soft-tissue defects of the sole needs special consideration because of the forces of weight bearing on the reconstruction. A variety of free tissue transfers have been advocated for soft-tissue replacement of the weight-bearing portions. However, there is no doubt that the ideal tissue for resurfacing the sole is the plantar tissue itself. The authors present a case of reconstructing the sole with the combined medial plantar and medialis pedis free flap that involves approximately 70% of the weight-bearing portion. This contralateral, combined fasciocutaneous free flap based on the posterior tibial-medial plantar vascular system is a good alternative in covering extensive sole injuries.

DNA-mediated immunization of glycoprotein 350 of Epstein-Barr virus induces the effective humoral and cellular immune responses against the antigen.

Epstein-Barr virus (EBV) is a human pathogen that is involved in numerous diseases and tumors. Since the EBV infection occurs in the early ages of life, and most of the population is subsequently exposed to EBV, the conventional method of vaccination to induce the prophylactic immunity cannot be considered effective in coping with the virus infection. In this study, we tested whether the injection of a plasmid vector that contained the gene for glycoprotein 350 (gp350), which had been identified as a ligand for virus' adsorption and a target for virus neutralizing antibodies, could induce effective immune responses against the antigen. As a result, the injection of the constructed plasmid vector into mice induced the production of gp350-specific antibodies. A major isotype of the gp350-specific antibodies was IgG1. The antibodies efficiently mediated the antibody-dependent cellular cytotoxicity against the cells expressing the gp350 antigen. In addition, the injection of the constructed plasmid vector stimulated the precursor T cell population that was specific to the gp350 antigen. In addition, gp350-specific cytotoxic T lymphocytes were efficiently stimulated by the injection of the constructed plasmid vector. These results suggested that the injection of the plasmid vector, containing the gp350 gene of Epstein-Barr virus, could be one of the most effective ways to induce both prophylactic and therapeutic vaccinations against the virus infection.

The effect of prostaglandin E1 versus ischemia-reperfusion injury of musculocutaneous flaps.

The purpose of this study was twofold. To evaluate whether prostaglandin El can increase the survival of the flap, and to determine its function against ischemia-reperfusion injury in musculocutaneous flaps. Thirty-five Sprague-Dawley rats weighing 250 to 350 g were analyzed. The transverse rectus abdominis musculocutaneous flap was used in all rats. The rats were divided into three groups: group 1 (N = 15), the control group with 4-hour ischemic injury and intraflap injection of normal saline followed by reperfusion; group 2 (N = 15), prostaglandin E1 intraflap injection of 1 microg immediately after ischemic injury and reperfusion 4 hours later; and group 3 (N = 5), the sham-operated group. Analysis consisted of flap skin survival area measurements, immunohistochemical study using anti-intercellular adhesion molecule (anti-ICAM-1) monoclonal antibody, and histological evaluation including endothelium-sticking leukocytes at 24 hours and 5 days after reperfusion. The group treated with prostaglandin E1 showed immunohistochemical findings with decreased expression of ICAM-1 on the surface of the endothelium, and histology showed significant (p < 0.01) reduction of leukocyte adhesion at 24 hours and 5 days after reperfusion. These two factors were considered to play a role against ischemia-reperfusion injury, and led to improved survival of the flap. These results suggest that prostaglandin E1 may increase flap survival and may have a protective mechanism against ischemia-reperfusion injury by decreasing leukocyte-endothelial cell adhesion through decreased expression of ICAM-1.

Inhibitory effect of ursolic acid purified from Origanum majorana L on the acetylcholinesterase.

We screened 139 herbal spices in search of the acetylcholinesterase (AChE) inhibitor from natural resources. AChE inhibitors, which enhance cholinergic transmission by reducing the enzymatic degradation of acetylcholine, are the only source of compound currently approved for the treatment of Alzheimer's Disease (AD). Among these herbs, edible plants and spices, the ethanol extract from Origanum majorana L. showed the highest inhibitory effect on AChE in vitro. By sequential fractionation of Origanum majorana L. the active component was finally identified as ursolic acid (3 beta-Hydroxyurs-12-en-28-oic acid). The ursolic acid of Origanum majorana L. inhibited AChE activity in a dose-dependent and competitive/non-competitive type. The Ki value (representing the affinity of the enzyme and inhibitor) of Origanum majorana L. ursolic acid was 6 pM, and that of tacrine was 0.4 nM. The concentration required for 50% enzyme inhibition of the active component (IC50 value) was 7.5 nM, and that of tacrine was 1 nM. This study demonstrated that the ursolic acid of Origanum majorana L. appeared to be a potent AChE inhibitor in Alzheimer's Disease.

5-Hydroxytryptamine attenuates free radical injury in primary mouse cortical cultures.

The effects of 5-hydroxytryptamine (5-HT) on several types of neuronal injury in mouse cortical cell cultures were tested. Co-treatment with 5-HT prevented free radical-mediated neuronal necrosis induced by FeCl2 or buthionine sulfoximine (BSO) in a dose-dependent manner. Subtype antagonists did not reverse the protective effect and 5-HT showed direct free radical scavenging activity evidenced by its ability to reduce the stable free radical 1,1-diphenyl-2-picrylhydrazyl (DPPH) in a cell-free system. Excitotoxic necrosis induced by NMDA or apoptosis induced by staurosporine was not sensitive to 5-HT treatment. These features raise the possibility that the endogenous neurotransmitter 5-HT may work as an innate antioxidant defense mechanism in the CNS.

Dicobalt octacarbonyl catalyzed carbonylated cycloaddition of triynes to functionalized tetracycles.

[reaction: see text]. We have demonstrated that a dicobalt octacarbonyl catalyzed double [2 + 2 + 1] carbonylative cycloaddition reaction of triyne can be carried out to yield a novel 5.5.5.6 tetracyclic di-enone system.

Haloperidol and clozapine increase neural activity in the rat prefrontal cortex.

Haloperidol and clozapine have been widely used to alleviate schizophrenic symptoms, but their physiological effects in the prefrontal cortex (PFC) are not known. Effects of haloperidol and clozapine on single unit activity were investigated in the medial PFC of anesthetized rats. Injection (intraperitoneal) of haloperidol (1 mg/kg) or clozapine (20 mg/kg) significantly elevated discharge rates of PFC neurons. Considering that hypofrontality is one characteristic of schizophrenic symptoms, these results raise the possibility that enhancement of PFC neural activity contributes to therapeutic effects of haloperidol and clozapine.

Catalytic asymmetric synthesis of cyclopentenones from propargyl malonates and allylic acetate by successive action of homogeneous palladium(II) and cobalt on charcoal catalysts in a one-pot reaction.

The tandem action of a homogeneous chiral Pd(II) catalyst and a heterogeneous Co/C catalyst leads to a two-step one-pot highly enantioselective Pauson-Khand-type reaction.