Efficacy and safety of transcatheter chemoembolization of the internal thoracic artery in patients with hepatocellular carcinoma.

BACKGROUND: Embolization of collateral arteries is important for transcatheter hepatic arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). We evaluated the efficacy and safety of TACE, and the prevention and management of complications among patients in whom the internal thoracic artery (ITA) was involved. METHODS: A total of 3614 cases of HCC were treated with 12 645 TACEs and 211 of these cases were given ITA angiography, including 156 cases of which the ITA was involved. We performed 562 TACEs in the 156 cases. We analyzed imaging examinations, types of embolization, and the incidence, prevention, and treatment of complications. RESULTS: The ITA was successfully embolized in 156 cases. Angiography of the ITA showed that the major trunks were thickened with an increased number of branching vessels, contributing to intrahepatic and extrahepatic tumor blood supply. Different embolization methods were selected according to the blood supply, to effectively embolize the tumor and mitigate or avoid serious complications. TACE with ITA embolization extended the mean interval time between two treatments from 2.54 months (1 - 17 months) to 4.23 months (1 - 30 months) compared with that without ITA embolization. The ITA supplied the HCC in the following instances: HCC was located in the ventral hepatic area and abutted the diaphragm (P = 0.0064) and repeated TACE (P = 0.0003). The survival rate of TACE with ITA embolization for HCC was better than TACE without ITA embolization (P < 0.00001). CONCLUSIONS: In cases with massive HCC or nodular HCC, the ITA may be involved in supplying blood to the tumor. This occurs when the tumor is positioned in the ventral hepatic area and abuts the diaphragm (S2, S4, and S8), and especially if cases have a previous history of TACE. In this case series, embolization was effective, extended the mean interval time of interventional therapy, and prolonged survival time.

In vitro culture and study of the biological characteristics of rabbit keratocytes.

OBJECTIVE: To improve the technique for culturing rabbit keratocytes in vitro and investigate the biological characteristics of these cells. METHODS: Fresh rabbit corneas were obtained and the epithelial and endothelial cells were removed after digestion with trypsin. The stroma was rinsed, minced, and incubated in DMEM/F12 medium supplemented with 10% fetal bovine serum and the biological characteristics of the keratocytes were observed with MTT assay and compared with those of the cells in serum-free culture media. RESULT: On about the third day of incubation, some keratocytes germinated from the stromal tissues and migrated onto the flask surface presenting fibroblast-like arrangement with spindle-shaped appearance. The keratocytes became confluent after 10 day's incubation and the peak of cell proliferation occurred on day 8 in the presence of serum in the media, while in the absence of serum, the peak took place on day 10. CONCLUSION: The method improved for in vitro keratocyte culture is convenient and effective, and the presence of serum in the media may to some degree affect the growth of the keratocytes.

Changes in content of macrophage migration inhibitory factor secreted by Schwann cells after peripheral nerve injury.

OBJECTIVE: To investigate whether Schwann cells can secrete macrophage migration inhibitory factor (MIF) after peripheral nerve injury. METHODS: Two kinds of infant rat Schwann cells(which were derived from intact and injured nerves respectively) were cultured in 10% newborn calf serum (NCS) DMEM/F12 medium for 72 h. Then the level of MIF in the conditioned media was determined by an enzyme-linked immunoadsordent assay (ELISA). As control,MIF level was also determined in 10% NCS DMEM/F12 medium without any cells. RESULTS: The concentration of MIF in the conditioned medium of Schwann cells derived from injured nerves was significantly higher than that of control samples (P<0.05), while the concentration of MIF in the conditioned medium of Schwann cells from intact nerves was not elevated. CONCLUSION: After peripheral nerve injury, Schwann cells can secrete MIF which may play an important role as an immunomodulatory cytokine for macrophage activation, inflammatory reactions and immune responses.