AMP-activated protein kinase inhibits TGF-β-induced fibrogenic responses of hepatic stellate cells by targeting transcriptional coactivator p300

Liver fibrosis is a common consequence of various chronic liver injuries, including virus infection and ethanol. Activated hepatic stellate cells (HSCs) contribute to liver fibrosis through the accumulation of extracellular matrix proteins, including type I alpha collagen (COL1A). The activation of adenosine monophosphate-activated protein kinase (AMPK) modulates HSCs activation, but its underlying mechanism remains unclear. Here, we report that AMPK inhibits transforming growth factor (TGF)-β-induced fibrogenic property of HSCs by regulating transcriptional coactivator p300. We treated human (LX-2) and rat (CFSC-2G) HSC lines with TGF-β to induce fibrogenic activation of HSCs. Pharmacological activation of AMPK by treatment with 5-aminoimidazole-4-carboxamide-1-beta-4-ribofuranoside (AICAR), metformin, or adiponectin lowered TGF-β-induced expression of COL1A and myofibroblast marker alpha-smooth muscle actin (α-SMA). Transient transduction of constitutively active AMPKα (caAMPKα) was sufficient to attenuate COL1A and α-SMA expression, whereas an AMPK inhibitor considerably abrogated the inhibitory effect of AICAR on fibrogenic gene expression. Although AMPK significantly suppressed Smad-dependent transcription, it did not affect TGF-β-stimulated phosphorylation, nuclear localization, or DNA-binding activity of Smad2/3. AICAR rather attenuated TGF-β-induced Smad3 interaction with transcriptional coactivator p300 accompanying with reduction of Smad3 acetylation. Moreover, AICAR induced not only physical interaction between AMPK and p300 but also proteasomal degradation of p300 protein. Our data provide substantial evidence that AMPK could be a novel therapeutic target for treatment of liver fibrosis, by demonstrating the underlying mechanism of AMPK-induced antifibrotic function in HSCs.

The emerging echogenic tract sign of pyriform sinus fistula: an early indicator in the recovery stage of acute suppurative thyroiditis

AST is commonly associated with pyriform sinus-thyroid fistula in children. Radiologic findings of AST are documented in a few reports. We report a new sign we term the "emerging echogenic tract sign," which reflects a patent air-containing pyriform sinus-thyroid fistula on follow-up US. Recognition of this sign is an important finding suggesting an associated pyriform sinus-thyroid fistula in a patient with AST and also suggesting the adequate timing of barium esophagography to confirm the fistula.

Emergent self-expanding stent placement for acute intracranial or extracranial internal carotid artery dissection with significant hemodynamic insufficiency

BACKGROUND AND PURPOSE

ICAD with hemodynamic insufficiency may present with either fulminant infarct or with progressive neurologic deterioration. The purpose of this study was to evaluate the safety and efficacy of emergent self-expanding stent placement for acute intracranial or extracranial ICAD with significant hemodynamic insufficiency.

MATERIALS AND METHODS

Eight patients (7 men and 1 woman; age range, 20-55 years; NIHSS score, 5-21) underwent emergent self-expanding stent placement for treatment of significant hemodynamic insufficiency due to acute ICAD. The safety and efficacy of emergent self-expanding stent placement were retrospectively evaluated.

RESULTS

All patients presented with progressive (n = 6) or fluctuating (n = 2) neurologic deficits and revealed markedly decreased perfusion on CT or MR perfusion studies. Conventional angiography revealed acute occlusion (n = 2) or critical stenosis (n = 6) in intracranial (n = 3) or extracranial (n = 5) carotid arteries with a lack of sufficient collaterals. Stent placement was successful in all patients without any procedure-related complications. In all patients, hemodynamic insufficiency was corrected immediately after stent placement, and neurologic symptoms were completely resolved during several days. Mean improvement of the NIHSS score between baseline and discharge was 11.6 (range, 5-21). All patients remained neurologically intact (mRS, 0) during clinical follow-up for a mean of 21 months (range, 8-50 months). Angiographic follow-up was available for 6 patients at 3-12 months. None of the 6 patients revealed residual or in-stent restenosis.

CONCLUSIONS

Self-expanding stent placement is a safe and effective option for selected patients with significant hemodynamic insufficiency due to acute intracranial or extracranial ICAD.

Self-expanding stent for recanalization of acute embolic or dissecting intracranial artery occlusion

BACKGROUND AND PURPOSE

Stent placement may be an effective and last resort method for recanalization of recalcitrant intracranial artery occlusion. The purpose of this study was to evaluate the safety and efficacy of a self-expanding stent for the recanalization of acute embolic or dissecting intracranial artery occlusion.

MATERIALS AND METHODS

Nine patients (mean age, 66 years; NIHSS score, 10-23) with acute embolic (n = 8) or dissecting occlusion (n = 1) of the intracranial arteries (ICA terminus in 5, MCA in 3, and BA in 1) were treated with a recapturable self-expanding stent. The safety and efficacy of the stent for recanalization were evaluated retrospectively.

RESULTS

The emboli were entrapped against the vessel wall by the stent, resulting in immediate recanalization (TIMI 2) in all embolic occlusions. The dissecting occlusion was recanalized completely (TIMI 3). Adjunctive thrombolytics (n = 8, urokinase, 100,000-300,000 U) and/or GP IIb/IIIa antagonist (n = 7, tirofiban, 0.5-1 mg) were administered intra-arterially, and the degree of recanalization further improved in 4 embolic occlusions (TIMI 3). Acute in-stent thrombosis occurred in 2 patients, who received only urokinase without GP IIb/IIIa antagonist. Both of the reoccluded arteries were reopened, by stent recapture in 1 and by intra-arterial administration of GP IIb/IIIa antagonist in the other. Recapture was attempted in 7 cases, of which there were 3 successful outcomes. There was 1 asymptomatic hemorrhagic conversion at the infarction site. The mean improvement of the NIHSS score between baseline and discharge was 12.3 (range, 3-22).

CONCLUSIONS

Preliminary results of this study suggest that a self-expanding stent may be safe and efficient for recanalization of acute embolic or dissecting intracranial artery occlusion.

Endovascular coil embolization of aneurysms with a branch incorporated into the sac

BACKGROUND AND PURPOSE

Because of the concern for occlusion of the incorporated branch artery, an aneurysm with a branch incorporated into the sac has been regarded as a contraindication for coiling. The aim of this study is to evaluate the feasibility, techniques, and clinical and angiographic outcomes of coiling for aneurysms with a branch incorporated into the sac.

MATERIALS AND METHODS

The medical records and radiologic studies of 69 patients with 79 aneurysms having a branch incorporated into the sac (26 ruptured, 53 unruptured) were retrospectively reviewed and evaluated.

RESULTS

Coiling was accomplished in 78 aneurysms in 68 patients but was suspended in 1 due to incorporated branch occlusion. The aneurysms were treated by using the following techniques: single-catheter (n = 37), multicatheter (n = 22), balloon-remodeling (n = 7), stent-assisted coiling (n = 6), and combined (n = 7). Postembolization angiography revealed the following: near-complete occlusion in 71 (89.8%), remnant neck in 4 (5.1%), and incomplete occlusion in 4 (5.1%) aneurysms. Procedure-related permanent morbidity and mortality rates were 5.8% (4/69) and 0%, respectively. All patients with unruptured aneurysms had a modified Rankin Scale (mRS) score of 0, except for 1 patient who had an mRS score of 3. Of the 26 patients with ruptured aneurysms, 18 had favorable outcome (mRS 0-2) but 8 had poor outcome (mRS 3-6). Follow-up angiography was available at least once at 6-50 months (mean, 15 months) in 55 aneurysms (69.6%), of which 45 showed stable or improved occlusion; 4, minor recurrences; and 6, major recurrences. All 6 major recurrent aneurysms were retreated without complication by using a single-catheter (n = 1), multicatheter (n = 2), or balloon-assisted technique (n = 3).

CONCLUSIONS

With appropriate techniques, most aneurysms with a branch incorporated into the sac could be safely treated by coiling, with acceptable outcomes.

A critical role of STAT1 in streptozotocin-induced diabetic liver injury in mice: controlled by ATF3

It is well-established that the administration of streptozotocin accelerates diabetic liver injury as well as type-I diabetes, however the underlying mechanisms are poorly understood. Here we investigated the molecular mechanisms of diabetic liver injury in a model of streptozotocin (STZ)-induced type-I diabetes. STZ administration induced type-1 diabetes and chronic liver injury was associated with increased STAT1, which is implicated in diabetic liver injury by virtue of its ability to promote hepatocyte apoptosis, in the liver and pancreas, which were all strongly inhibited in STAT1(-)(/-) mice. Similarly, STZ-induced ATF3, a stress-inducible gene, was completely abolished in the liver of IFN-gamma(-/-) mice, but not in STAT1(-/-) mice. Inhibition of STAT1 by siRNA or dominant-negative DNA did not affect ATF3 protein expression but blocked IFN-gamma-induced ATF3 translocation from the cytosol into the nucleus. In contrast, inhibition of ATF3 by using siRNA diminished STAT1 protein expression and IFN-gamma/STZ-induced hepatocyte apoptosis. Furthermore, GST pull-down and co-IP assay showed that STAT1 bound to C-terminal domain of ATF3. Such direct interaction increased the stability of STAT1 by inhibiting its ubiquitination as well as proteasome activity. Our results suggest that STAT1 is a common signaling pathway contributing to STZ-induced diabetes and diabetic liver injury. ATF3 functions as a potent regulator of STAT1 stability, accelerating STZ-induced diabetes and diabetic liver injury.

Isolation and characterization of microsatellite loci from rock shell, Thais clavigera

Imposex (superimposition of male genital organs on female phenotype) of the rock shell or whelk, Thais clavigera, shows typical evidence of endocrine disruption by organotin compounds within inter-tidal zones polluted by such compounds. It will be informative to see how low fertility caused by imposex of this species finally affects the genetic diversity of polluted populations. For future use in population genetic research of the rock shell, we report the isolation and characteristics of 11 highly polymorphic microsatellite markers with a mean of 11.7 alleles per locus. We observed heterozygosities of these sequences ranging from 0.43 to 0.95. These markers will be useful for future ecological genetic studies of rock shell.

Guanine deaminase functions as dihydropterin deaminase in the biosynthesis of aurodrosopterin, a minor red eye pigment of Drosophila

Dihydropterin deaminase, which catalyzes the conversion of 7,8-dihydropterin to 7,8-dihydrolumazine, was purified 5850-fold to apparent homogeneity from Drosophila melanogaster. Its molecular mass was estimated to be 48 kDa by gel filtration and SDS-PAGE, indicating that it is a monomer under native conditions. The pI value, temperature, and optimal pH of the enzyme were 5.5, 40 degrees C, and 7.5, respectively. Interestingly the enzyme had much higher activity for guanine than for 7,8-dihydropterin. The specificity constant (k(cat)/K(m)) for guanine (8.6 x 10(6) m(-1).s(-1)) was 860-fold higher than that for 7,8-dihydropterin (1.0 x 10(4) m(-1).s(-1)). The structural gene of the enzyme was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analysis as CG18143, located at region 82A1 on chromosome 3R. The cloned and expressed CG18143 exhibited both 7,8-dihydropterin and guanine deaminase activities. Flies with mutations in CG18143, SUPor-P/Df(3R)A321R1 transheterozygotes, had severely decreased activities in both deaminases compared with the wild type. Among several red eye pigments, the level of aurodrosopterin was specifically decreased in the mutant, and the amount of xanthine and uric acid also decreased considerably to 76 and 59% of the amounts in the wild type, respectively. In conclusion, dihydropterin deaminase encoded by CG18143 plays a role in the biosynthesis of aurodrosopterin by providing one of its precursors, 7,8-dihydrolumazine, from 7,8-dihydropterin. Dihydropterin deaminase also functions as guanine deaminase, an important enzyme for purine metabolism.

Down-regulation of FoxO-dependent c-FLIP expression mediates TRAIL-induced apoptosis in activated hepatic stellate cells

Activated hepatic stellate cells which contribute to liver fibrosis have represented an important target for antifibrotic therapy. In this study, we found that TRAIL inhibited PI3K/Akt-dependent FoxO phosphorylation and relocated FoxO proteins into the nucleus from the cytosol in activated human hepatic stellate LX-2 cells. The accumulated FoxO proteins in the nucleus led to down-regulation of c-FLIP(L/S) expression, resulting in the activation of apoptosis-related signaling molecules including the activation of caspase-8, -3, and Bid, as well as mitochondrial cytochrome c release. These results were supported by showing that siRNA-mediated knockdown of FoxO led to restoration of c-FLIP(L/S) expression and resistance to TRAIL-induced apoptosis after treatment of LX-2 cells with TRAIL. Furthermore, c-FLIP(L/S)-transfected LX-2 cells showed the decreased sensitivity to TRAIL-induced apoptosis. Collectively, our data suggest that sequential activation of FoxO proteins under conditions of suppressed PI3K/Akt signaling by TRAIL can down-regulate c-FLIP(L/S), consequently promoting TRAIL-induced apoptosis in LX-2 cells. Therefore, the present study suggests TRAIL may be an effective strategy for antifibrotic therapy in liver fibrosis.

Clinical and angiographic follow-up of stent-only therapy for acute intracranial vertebrobasilar dissecting aneurysms

BACKGROUND AND PURPOSE

Little has been known about the clinical and angiographic follow-up results of stent-only therapy for intracranial vertebrobasilar dissecting aneurysms (VBDA). The purpose of this study was to evaluate the feasibility, safety, clinical, and angiographic follow-up of stent-only therapy for VBDA.

MATERIALS AND METHODS

Twenty-seven patients with 29 VBDAs (11 ruptured, 18 unruptured), not suitable for deconstructive treatment, underwent stent-only therapy. Feasibility, safety, clinical, and angiographic follow-up were retrospectively evaluated. Angiographic outcomes were compared between single-stent and multiple-stent groups.

RESULTS

All attempted stent placements were successfully accomplished without any treatment-related complication. Of the 11 ruptured VBDAs, 4 were treated by single stents, 6 by double overlapping stents, and 1 by triple overlapping stents. Of the 18 unruptured VBDAs, 6 were treated by stents, and 12 by double overlapping stents. One patient with a ruptured VBDA, treated by single stent, had rebleeding and died. None of the remaining patients had posttreatment bleeding during follow-up (mean, 28 months; range, 7-50 months). Eight patients with ruptured VBDA and all patients with unruptured VBDA had excellent outcomes (modified Rankin Scale, 0-1). The remaining 2 patients with ruptured VBDA were moderately disabled because of the initial damage. Angiographic follow-up was available in 27 VBDAs, 4 to 42 months (mean, 12 months) after treatment. Follow-up angiograms revealed complete obliteration of the dissecting aneurysm in 12, partial obliteration in 12, stable in 1, enlargement in 1, and in-stent occlusion in 1. Angiographic improvement (complete or partial obliteration) was more frequent in the multiple-stent group (17/17) than in the single-stent group (7/9; P < .05).

CONCLUSIONS

In this small series, stent-only therapy was safe and effective in the treatment of VBDAs that were not deemed suitable for treatment with parent-artery occlusion.

An anomalous left anterior descending artery with myocardial bridging in a patient with a true left anterior descending artery

We report the case of an anomalous left anterior descending (LAD) artery with myocardial bridging, which originated from the proximal right coronary artery in a patient with a true LAD artery.

GO6976 prevents TNF-alpha-induced suppression of adiponectin expression in 3T3-L1 adipocytes: putative involvement of protein kinase C

Adiponectin, one of the adipokines secreted by adipocytes, possesses insulin sensitizing and anti-atherosclerotic properties. Tumor necrosis factor-alpha (TNF-alpha) is known to suppress the expression and secretion of adiponectin in adipocytes; however, the underlying mechanism remains poorly understood. Here, we demonstrate that GO6976 (a selective inhibitor of conventional protein kinase C (PKC)) prevents TNF-alpha-induced suppression of adiponectin secretion and expression in fully differentiated 3T3-L1 adipocytes, accompanied by attenuation of c-Jun N-terminal kinase (JNK) activation. Additionally, the transcriptional activity of peroxisome proliferator-activated receptor-gamma (PPARg) (a strong inducer of adiponectin) on the adiponectin promoter was inhibited in a PKC isoform-specific manner. These results raise the possibility that PKC is involved in TNF-alpha-induced suppression of adiponectin in 3T3-L1 adipocytes.

Management and clinical outcome of acute basilar artery dissection

BACKGROUND AND PURPOSE

There have been inconsistencies on the prognosis and controversies as to the proper management of acute basilar artery dissection. The aim of this study was to evaluate acute basilar artery dissection and its outcome after management.

MATERIALS AND METHODS

A total of 21 patients (mean age, 53 years; range, 24-78 years) with acute basilar artery dissection were identified between January 2001 and October 2007. Clinical presentation, management, and outcomes were retrospectively evaluated.

RESULTS

The patients presented with subarachnoid hemorrhage (n = 10), brain stem ischemia (n = 10), or stem compression sign (n = 1). Ruptured basilar artery dissections were treated by stent placement with coiling (n = 4), single stent placement (n = 3), or conservatively (n = 3). Of the patients treated with endovascular technique, 6 had favorable outcome (modified Rankin scale [mRS], 0-2) and the remaining patient, who was treated by single stent placement, died from rebleeding. All 3 conservatively managed patients experienced rebleeding, of whom 2 died and the other was moderately disabled. Unruptured basilar artery dissections were treated conservatively (n = 7) or by stent placement (n = 4). Of the patients with unruptured basilar artery dissection, 9 had favorable outcome and the remaining 2 patients, both of whom were conservatively managed, had poor outcome because of infarct progression. The group with the ruptured basilar artery dissection revealed a higher mortality rate than the group with the unruptured dissection (30% vs 0%). The group treated with endovascular means revealed more favorable outcome than the group that was treated with conservative measures (90.9% vs 50%).

CONCLUSION

The ruptured basilar artery dissections were at high risk for rebleeding, resulting in a grave outcome. Stent placement with or without coiling may be considered to prevent rebleeding in ruptured basilar dissections and judiciously considered in unruptured dissections with signs of progressive brain stem ischemia.

Role of activating transcription factor 3 on TAp73 stability and apoptosis in paclitaxel-treated cervical cancer cells

Taxol (paclitaxel) is a potent anticancer drug that has been found to be effective against several tumor types, including cervical cancer. However, the exact mechanism underlying the antitumor effects of paclitaxel is poorly understood. Here, paclitaxel induced the apoptosis of cervical cancer HeLa cells and correlated with the enhanced activation of caspase-3 and TAp73, which was strongly inhibited by TAp73beta small interfering RNA (siRNA). In wild-type activating transcription factor 3 (ATF3)-overexpressed cells, paclitaxel enhanced apoptosis through increased alpha and beta isoform expression of TAp73; however, these events were attenuated in cells containing inactive COOH-terminal-deleted ATF3 [ATF3(DeltaC)] or ATF3 siRNA. In contrast, paclitaxel-induced ATF3 expression did not change in TAp73beta-overexpressed or TAp73beta siRNA-cotransfected cells. Furthermore, paclitaxel-induced ATF3 translocated into the nucleus where TAp73beta is expressed, but not in ATF3(DeltaC) or TAp73beta siRNA-transfected cells. As confirmed by the GST pull-down assay, ATF3 bound to the DNA-binding domain of p73, resulting in the activation of p21 or Bax transcription, a downstream target of p73. Overexpression of ATF3 prolonged the half-life of TAp73beta by inhibiting its ubiquitination and thereby enhancing its transactivation and proapoptotic activities. Additionally, ATF3 induced by paclitaxel potentiated the stability of TAp73beta, not its transcriptional level. Chromatin immunoprecipitation analyses show that TAp73beta and ATF3 are recruited directly to the p21 and Bax promoter. Collectively, these results reveal that overexpression of ATF3 potentiates paclitaxel-induced apoptosis of HeLa cells, at least in part, by enhancing TAp73beta's stability and its transcriptional activity. The investigation shows that ATF3 may function as a tumor-inhibiting factor through direct regulatory effects on TAp73beta, suggesting a functional link between ATF3 and TAp73beta.

Induction of Id2 expression by cardiac transcription factors GATA4 and Nkx2.5

Inhibitor of differentiation/DNA binding (Id) proteins function as a regulator of helix-loop-helix proteins participating in cell lineage commitment and differentiation. Here, we observed a marked induction of Id2 during cardiomyocyte differentiation from P19CL6 murine embryonic teratocarcinoma stem cells, prompting us to investigate the upstream regulatory mechanism of Id2 induction. Computer analysis of Id2 promoter and subsequent electrophoretic mobility shift assay revealed several binding sites for GATA4 and Nkx2.5 within the Id2 promoter. By further deletion and mutation analysis of the respective binding site, we identified that two motifs located at -497/-502 and -264/-270 were functionally important for Id2 promoter activation by GATA4 and Nkx2.5, respectively. Overexpression of GATA4 and/or Nkx2.5 induced not only Id2 promoter activity but also Id2 protein expression. Additionally, Id proteins significantly inhibit the GATA4 and Nkx2.5-dependent transcription, suggesting Id proteins may play a regulatory role in cardiogenesis. Collectively, our results demonstrate that GATA4 and Nkx2.5 could be one of the upstream regulators of Id2.

Exploratory calcineurin inhibitor-free regimens in living-related kidney transplant recipients

Chronic allograft nephropathy is among the major causes of graft loss even in low-risk kidney transplant recipients and correlates with acute nephrotoxic events during the first year post-transplant. Therefore, calcineurin inhibitor-free regimens may improve patient and graft survival among recipients of living-related kidney transplants. To confirm this hypothesis, we evaluated the efficacy and safety of two calcineurin inhibitor-free regimens in 92 low-risk recipients of one-haplotype living-related kidney transplants. Immunosuppression consisted of tacrolimus, azathioprine and prednisone (group I, GI, N = 38), 2 doses of daclizumab, mycophenolate mofetil (MMF), and prednisone (GII, N = 33) and 2 doses of daclizumab, MMF, sirolimus and prednisone (GIII, N = 21). At 12 months, treatment failure (biopsy-confirmed acute rejection, graft loss or death) was higher in GII compared to GIII and GI (54.5 vs 24.0 vs 13.1%, P < 0.01, respectively). In patients of black ethnicity the incidence of acute rejection was 25 vs 83.3 vs 20% (P = 0.055), respectively. Patient and graft survival was comparable. There were no differences in mean creatinine or calculated creatinine clearance at 12 months. Overall incidence of post-transplant diabetes mellitus (3.3%) and cytomegalovirus disease (4.3%) was similar in all groups. Further development of effective calcineurin inhibitor-free regimens should exclude patients of black ethnicity and may need full-induction therapy, perhaps with depleting agents, and concentration-controlled use of sirolimus and MMF.

Involvement of TGF-beta1 signaling in cardiomyocyte differentiation from P19CL6 cells

Stem cell-based therapy is being considered as an alternative treatment for cardiomyopathy. Hence understanding the basic molecular mechanisms of cardiomyocyte differentiation is important. Besides BMP or Wnt family proteins, TGF-beta family members are thought to play a role in cardiac development and differentiation. Although TGF-beta has been reported to induce cardiac differentiation in embryonic stem cells, the differential role of TGF-beta isoforms has not been elucidated. In this study, employing the DMSO-induced cardiomyocyte differentiation system using P19CL6 mouse embryonic teratocarcinoma stem cells, we investigated the TGF-beta-induced signaling pathway in cardiomyocyte differentiation. TGF-beta1, but not the other two isoforms of TGF-beta, was induced at the mRNA and protein level at an early stage of differentiation, and Smad2 phosphorylation increased in parallel with TGF-beta1 induction. Inhibition of TGF-beta1 activity with TGF-beta 1-specific neutralizing antibody reduced cell cycle arrest as well as expression of the CDK inhibitor p21WAF1. The antibody also inhibited induction of the cardiac transcription factor Nkx2.5. Taken together, these results suggest that TGF-beta1 is involved in cardiomyocyte differentiation by regulating cell cycle progression and cardiac gene expression in an autocrine or paracrine manner.

Clinical outcome and ischemic complication after treatment of anterior choroidal artery aneurysm: comparison between surgical clipping and endovascular coiling

BACKGROUND AND PURPOSE

Although coiling has been favorably comparable with clipping for treatment of most intracranial aneurysms, there is a controversy on which modality is safer for anterior choroidal artery (AchoA) aneurysm. We retrospectively evaluated the clinical outcomes and treatment-related complications after surgical clipping and endovascular coiling of AchoA aneurysms.

MATERIALS AND METHODS

Seventy-three AchoA aneurysms were recruited from 1895 intracranial aneurysms, which were treated either by surgical clipping or by endovascular coiling in 4 institutions between May 1999 and December 2006. The AchoA aneurysms were dichotomized according to the modality of treatment, the coil group (37 patients; 38 aneurysms) and the clip group (35 patients; 35 aneurysms). Clinical outcomes and incidence of treatment-related complications between 2 groups and the factors influencing the clinical outcomes were evaluated.

RESULTS

There was no rebleeding in both groups during follow-up, for 4-72 months (mean, 27 months) in the coil group and for 3-84 months (mean, 34 months) in the clip group. In the coil group, 31 patients (83.8%) had favorable outcome (modified Rankin Scale score [mRS], 0-3). In the clip group, 31 patients (88.6%) had favorable outcome. The complication of coiling was transient contralateral hemiparesis in 2 patients, who recovered completely. The complications of clipping were permanent contralateral hemiparesis due to AchoA infarction in 4 patients and third-nerve palsy in 1 patient. Hunt and Hess grade 4 or 5 and AchoA infarction were significantly correlated with poor outcome (mRS, < or =4). Clipping had significantly higher incidence of AchoA infarction than coiling (P < .05).

CONCLUSION

Coiling of AchoA aneurysms appears comparable with clipping in clinical outcome and prevention of rebleeding, with significantly lower incidence of AchoA infarction than clipping.

Detection and molecular characterization of calf diarrhoea bovine coronaviruses circulating in South Korea during 2004-2005

Although the widespread occurrence of calf diarrhoea (CD) bovine coronavirus (BCoV) infections have been reported in most cattle producing countries, only the genetic differences in the BCoVs from American and Canadian isolates and/or strains have been identified and compared. Hence, it is unclear if the BCoVs circulating in the other countries have distinct genetic characteristics. The aim of this study was to determine the prevalence and genetic diversity of CD BCoVs based on the deduced amino acid (aa) sequences of the spike (S) and haemagglutinin/esterase (HE) proteins in South Korea. RT-PCR and nested PCR using the primer pairs specific to the nucleocapsid gene, BCoVs detected the BCoVs in 56 (15.6%) of 359 diarrhoeic faecal samples. Phylogenetic analysis of the entire S gene indicated that 10 Korean CD BCoV strains clustered with other Korean BCoV strains with different clinical forms but were different from the American and Canadian BCoV strains. Moreover, the phylogenetic data of the aa sequences of the HE gene revealed all the Korean CD strains to be distinct from the other Korean BCoV strains with different clinical forms. These results suggest that the Korean BCoVs cause endemic infections in diarrhoeic calves in Jeonnam province and have taken a different evolutionary pathway from the BCoVs in other countries. Moreover, the different BCoV strains are circulating in the different clinical forms in South Korea. These results also suggest that vaccines against the BCoVs can be developed with each Korean BCoV in different clinical forms.

Ultrasonographic findings of small bowel intussusception, focusing on differentiation from ileocolic intussusception

The purpose of this study was to evaluate the typical ultrasonographic findings of transient small bowel intussusception (SBI) and to differentiate it from ileocolic intussusception (ICI) in paediatrics. 22 transient SBI (male:female = 13:9, age: 7-132 months (mean 38 months)) and 27 ICI (male:female = 19:8, age: 1-60 months (mean 13 months)) patients diagnosed on ultrasonography were retrospectively evaluated. The findings of location, diameter, thickness of outer rim, and inclusion of mesenteric lymph nodes within intussuscipiens were compared. In the transient SBI, the head of intussusception was located in the right lower quadrant (RLQ) in 11 (50%), the right upper quadrant (RUQ) in 2 (9.1%) and the periumbilical area in 9 (40.9%) cases. The anteroposterior (AP) diameter ranged from 0.84-2.4 cm (mean 1.38 cm), and thickness of outer rim ranged from 0.10-0.34 cm (mean 0.26 cm). No mesenteric lymph nodes were contained within the intussuscipiens. In the ICI, the head was located in the RUQ in 17 (63%), the epigastrium in 7 (25.9%) and the left upper quadrant in 3 (11.1%) cases. The AP diameter ranged from 1.89-3.32 cm (mean 2.53 cm), and the thickness of the outer rim ranged from 0.30-0.86 cm (mean 0.53 cm). Mesenteric lymph nodes were contained within the intussuscipiens in 26 (96.3%) cases. In conclusion, when compared with ICI, the transient SBI occurs predominantly in the RLQ or periumbilical region, has a smaller AP diameter, a thinner outer rim, and dose not contain mesenteric lymph nodes.

Coxsackievirus B3 modulates cell death by downregulating activating transcription factor 3 in HeLa cells

Activating transcription factor 3 (ATF3) is an early-induced gene involved in diverse cellular functions in response to various stresses including viral infection. Here we observed marked reduction of ATF3 by coxsackievirus B3 (CVB3) infection and investigated the regulation and functional role of ATF3 in HeLa cells for the understanding of biological significance of ATF3 downregulation. CVB3 infection markedly reduced ATF3 expression at mRNA and protein levels in parallel with p53 degradation, and preservation of p53 expression rescued CVB3 infection-induced ATF3 downregulation. ATF3 overexpression stimulated apoptotic cell death following CVB3 infection, accompanying with augmentation of CVB3 infection-induced eIF2alpha phosphorylation. However, ATF3 overexpression did not affect viral protein production but promoted virus progeny release. Taken together, our results suggest that ATF3 is under control of p53 in part and that the ATF3 downregulation via p53 degradation may contribute to effective viral production as a modulation mechanism of CVB3 infection-induced cell death.

Dual enteric and respiratory tropisms of winter dysentery bovine coronavirus in calves

Although winter dysentery (WD), which is caused by the bovine coronavirus (BCoV) is characterized by the sudden onset of diarrhea in many adult cattle in a herd, the pathogenesis of the WD-BCoV is not completely understood. In this study, colostrum-deprived calves were experimentally infected with a Korean WD-BCoV strain and examined for viremia, enteric and nasal virus shedding as well as for viral antigen expression and virus-associated lesions in the small and large intestines and the upper and lower respiratory tract from 1 to 8 days after an oral infection. The WD-BCoV-inoculated calves showed gradual villous atrophy in the small intestine and a gradual increase in the crypt depth of the large intestine. The WD-BCoV-infected animals showed epithelial damage in nasal turbinates, trachea and lungs, and interstitial pneumonia. The WD-BCoV antigen was detected in the epithelium of the small and large intestines, nasal turbinates, trachea and lungs. WD-BCoV RNA was detected in the serum from post-inoculation day 3. These results show that the WD-BCoV has dual tropism and induces pathological changes in both the digestive and respiratory tracts of calves. To our knowledge, this is the first detailed report of dual enteric and respiratory tropisms of WD-BCoV in calves. Comprehensive studies of the dual tissue pathogenesis of the BCoV might contribute to an increased understanding of similar pneumoenteric CoV infections in humans.

15-Deoxy-Δ12,14-prostaglandin J2-induced down-regulation of endothelial nitric oxide synthase in association with HSP70 induction

A natural ligand of peroxisome proliferator-activated receptor gamma (PPARgamma), 15-deoxy-Delta(12,14)-prostaglandin J(2) (15d-PGJ(2)), decreases endothelial nitric oxide synthase (eNOS) expression by an unknown mechanism. Here we found that 15d-PGJ(2)-induced eNOS reduction is inversely associated with heat shock protein 70 (HSP70) induction in endothelial cells. Treatment of cells with 15d-PGJ(2) decreased eNOS protein expression in a concentration- and time-dependent manner, but independently of PPARgamma with no effect on mRNA levels. Although 15d-PGJ(2) elicited endothelial apoptosis, inhibition of both pan-caspases and cathepsins failed to reverse reduction of eNOS protein. Interestingly, we observed that 15d-PGJ(2) induced HSP70 in a dose-dependent manner. Immunoprecipitation and heat shock treatment demonstrated that eNOS reduction was strongly related to HSP70 induction. Cellular fractionation revealed that treatment with 15d-PGJ(2) increased eNOS distribution 2.5-fold from soluble to insoluble fractions. These findings provide new insights into mechanisms whereby eNOS regulation by 15d-PGJ(2) is related to HSP70 induction.

The role of STAT1/IRF-1 on synergistic ROS production and loss of mitochondrial transmembrane potential during hepatic cell death induced by LPS/d-GalN

Previously, we demonstrated that signal transducer and activator of transcription factor 1 (STAT1) plays an essential role in liver injury induced by lipopolysaccharide (LPS)/D-galactosamine (D-GalN); however, the underlying mechanism involved remains unclear. Here, we showed that LPS/D-GalN administration induced secretion of tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma), which mediated apoptosis synergistically. Moreover, LPS/D-GalN-induced apoptosis was associated with increased inducible nitric oxide synthase (iNOS) and nitric oxide (NO) production, as well as elevated reactive oxygen species (ROS) production, which were all strongly inhibited by treatment with the antioxidant N-acetyl-L-cysteine (NAC) and an iNOS/NO inhibitor, L-NMMA. Although STAT1 activation and expression did not change significantly in TNF-alpha/IFN-gamma-cotreated cells compared with cells treated with IFN-gamma alone, the absence of STAT1 or interferon regulatory factor 1 (IRF-1) in genetic knockout mice strongly abrogated the observed effects of TNF-alpha/IFN-gamma on iNOS/NO induction, ROS production, loss of mitochondrial transmembrane potential (DeltaPsim), and apoptosis compared with STAT1(+/+) and IRF-1(+/+) mice. Additionally, the synergistic effects of TNF-alpha/IFN-gamma on iNOS/NO induction, ROS production, and apoptosis were significantly inhibited by overexpression of dominant negative STAT1 in contrast to overexpression of wild-type STAT1. In STAT1-deficient mice, nuclear factor kappaB (NF-kappaB) activation by TNF-alpha/IFN-gamma was attenuated and strongly inhibited by both NAC and L-NMMA. Moreover, the proteasome inhibitor, MG132, inhibited NF-kappaB activation and strongly inhibited iNOS/NO induction, ROS production, and loss of DeltaPsim induced by TNF-alpha/IFN-gamma, thereby inhibiting apoptosis. Interestingly, it appears peroxynitrite, which is produced by TNF-alpha/IFN-gamma, may interfere with STAT1 phosphorylation by inducing STAT1 nitration. Collectively, these findings demonstrate that TNF-alpha/IFN-gamma synergistically potentiates iNOS/NO induction, ROS production, and loss of DeltaPsim via STAT1 overexpression, playing an important role in promoting apoptosis and liver injury induced by LPS/D-GalN.