Pulse pressure variation to predict fluid responsiveness in spontaneously breathing patients: tidal vs. forced inspiratory breathing

We evaluated whether pulse pressure variation can predict fluid responsiveness in spontaneously breathing patients. Fifty-nine elective thoracic surgical patients were studied before induction of general anaesthesia. After volume expansion with hydroxyethyl starch 6 ml.kg(-1) , patients were defined as responders by a ≥ 15% increase in the cardiac index. Haemodynamic variables were measured before and after volume expansion and pulse pressure variations were calculated during tidal breathing and during forced inspiratory breathing. Median (IQR [range]) pulse pressure variation during forced inspiratory breathing was significantly higher in responders (n = 29) than in non-responders (n = 30) before volume expansion (18.2 (IQR 14.7-18.2 [9.3-31.3])% vs. 10.1 (IQR 8.3-12.6 [4.8-21.1])%, respectively, p < 0.001). The receiver-operating characteristic curve revealed that pulse pressure variation during forced inspiratory breathing could predict fluid responsiveness (area under the curve 0.910, p < 0.0001). Pulse pressure variation measured during forced inspiratory breathing can be used to guide fluid management in spontaneously breathing patients.

Middle region of FancM interacts with Mhf and Rmi1 in silkworms, a species lacking the Fanconi anaemia (FA) core complex

The Fanconi anaemia (FA) pathway is responsible for interstrand crosslink (ICL) repair. Among the FA core complex components, FANCM is believed to act as a damage sensor for the ICL-blocked replication fork and also as a molecular platform for FA core complex assembly and interaction with Bloom's syndrome (BS) complex that is thought to play an important role in the processing of DNA structures such as stalled replication forks. In the present study, we found that in silkworms, Bombyx mori, a species lacking the major FA core complex components (FANCA, B, C, E, F, and G), FancM is required for FancD2 monoubiquitination and cell proliferation in the presence of mitomycin C (MMC). Silkworm FancM (BmFancM) was phosphorylated in the middle regions, and the modification was associated with its subcellular localization. In addition, BmFancM interacted with Mhf1, a histone-fold protein, and Rmi1, a subunit of the BS complex, in the different regions. The interaction region containing at least these two protein-binding domains played an essential role in FancM-dependent resistance to MMC. Our results suggest that BmFancM also acts as a platform for recruitment of both the FA protein and the BS protein, although the silkworm genome seems to lose FAAP24, a FancM-binding partner protein in mammals.

Synthetic lethal screening reveals FGFR as one of the combinatorial targets to overcome resistance to Met-targeted therapy

Met is a receptor tyrosine kinase that promotes cancer progression. In addition, Met has been implicated in resistance of tumors to various targeted therapies such as epidermal growth factor receptor inhibitors in lung cancers, and has been prioritized as a key molecular target for cancer therapy. However, the underlying mechanism of resistance to Met-targeting drugs is poorly understood. Here, we describe screening of 1310 genes to search for key regulators related to drug resistance to an anti-Met therapeutic antibody (SAIT301) by using a small interfering RNA-based synthetic lethal screening method. We found that knockdown of 69 genes in Met-amplified MKN45 cells sensitized the antitumor activity of SAIT301. Pathway analysis of these 69 genes implicated fibroblast growth factor receptor (FGFR) as a key regulator for antiproliferative effects of Met-targeting drugs. Inhibition of FGFR3 increased target cell apoptosis through the suppression of Bcl-xL expression, followed by reduced cancer cell growth in the presence of Met-targeting drugs. Treatment of cells with the FGFR inhibitors substantially restored the efficacy of SAIT301 in SAIT301-resistant cells and enhanced the efficacy in SAIT301-sensitive cells. In addition to FGFR3, integrin β3 is another potential target for combination treatment with SAIT301. Suppression of integrin β3 decreased AKT phosphorylation in SAIT301-resistant cells and restored SAIT301 responsiveness in HCC1954 cells, which are resistant to SAIT301. Gene expression analysis using CCLE database shows that cancer cells with high levels of FGFR and integrin β3 are resistant to crizotinib treatment, suggesting that FGFR and integrin β3 could be used as predictive markers for Met-targeted therapy and provide a potential therapeutic option to overcome acquired and innate resistance for the Met-targeting drugs.

The novel miR-9500 regulates the proliferation and migration of human lung cancer cells by targeting Akt1

MicroRNAs have crucial roles in lung cancer cell development. They regulate cell growth, proliferation and migration by mediating the expression of tumor suppressor genes and oncogenes. We identified and characterized the novel miR-9500 in human lung cancer cells. The miR-9500 forms a stem-loop structure and is conserved in other mammals. The expression levels of miR-9500 were reduced in lung cancer cells and lung cancer tissues compared with normal tissues, as verified by TaqMan miRNA assays. It was confirmed that the putative target gene, Akt1, was directly suppressed by miR-9500, as demonstrated by a luciferase reporter assay. The miR-9500 significantly repressed the protein expression levels of Akt1, as demonstrated via western blot, but did not affect the corresponding mRNA levels. Akt1 has an important role in lung carcinogenesis, and depletion of Akt1 has been shown to have antiproliferative and anti-migratory effects in previous studies. In the current study, the overexpression of miR-9500 inhibited cell proliferation and the expression of cell cycle-related proteins. Likewise, the overexpression of miR-9500 impeded cell migration in human lung cancer cells. In an in vivo assay, miR-9500 significantly suppressed Fluc expression compared with NC and ASO-miR-9500, suggesting that cell proliferation was inhibited in nude mice. Likewise, miR-9500 repressed tumorigenesis and metastasis by targeting Akt1. These data indicate that miR-9500 might be applicable for lung cancer therapy.

Cortical thickness and hippocampal shape in pure vascular mild cognitive impairment and dementia of subcortical type

BACKGROUND AND PURPOSE

The progression pattern of brain structural changes in patients with isolated cerebrovascular disease (CVD) remains unclear. To investigate the role of isolated CVD in cognitive impairment patients, patterns of cortical thinning and hippocampal atrophy in pure subcortical vascular mild cognitive impairment (svMCI) and pure subcortical vascular dementia (SVaD) patients were characterized.

METHODS

Forty-five patients with svMCI and 46 patients with SVaD who were negative on Pittsburgh compound B (PiB) positron emission tomography imaging and 75 individuals with normal cognition (NC) were recruited.

RESULTS

Compared with NC, patients with PiB(-) svMCI exhibited frontal, language and retrieval type memory dysfunctions, which in patients with PiB(-) SVaD were further impaired and accompanied by visuospatial and recognition memory dysfunctions. Compared with NC, patients with PiB(-) svMCI exhibited cortical thinning in the frontal, perisylvian, basal temporal and posterior cingulate regions. This atrophy was more prominent and extended further toward the lateral parietal and medial temporal regions in patients with PiB(-) SVaD. Compared with NC subjects, patients with PiB(-) svMCI exhibited hippocampal shape deformities in the lateral body, whilst patients with PiB(-) SVaD exhibited additional deformities within the lateral head and inferior body.

CONCLUSIONS

Our findings suggest that patients with CVD in the absence of Alzheimer's disease pathology can be demented, showing cognitive impairment in multiple domains, which is consistent with the topography of cortical thinning and hippocampal shape deformity.

Evaluation of non-thermal effects by microwave irradiation in hydrolysis of waste-activated sludge

The activation energy (Ea) for waste-activated sludge (WAS) hydrolysis was compared between microwave irradiation (MW) and conventional heating (CH) methods to evaluate the non-thermal effect of MW. The microwave-assisted hydrolysis of WAS was assumed to follow the first-order kinetics on the basis of volatile suspended solids (VSS) conversion to soluble chemical oxygen demand (SCOD) for different initial VSS concentrations. By comparing the VSS decrement and the SCOD increment between MW and CH at different absolute temperatures of 323, 348 and 373 K, the average ratio of VSS conversion to SCOD was determined to range from 1.42 to 1.64 g SCOD/g VSS. These results corresponded to the theoretical value of 1.69 g SCOD/g VSS based on the assumption that the molecular formula of sludge was C10H19O3N. Consequently, the Ea of the MW-assisted WAS hydrolysis was much lower than that of CH for the same temperature conditions. The non-thermal effect of MW in the hydrolysis of WAS could be identified with the lower Ea than that of CH.

Genetic characterization of Mytilus coruscus and M. galloprovincialis using microsatellite markers

Korean (hard-shelled) mussels (Mytilus coruscus) are an economically important endemic marine bivalve mollusk of Korea; yet, the population has rapidly declined because of overharvesting and habitat competition from the invasive Mytilus galloprovincialis species. The population structures of M. coruscus and M. galloprovincialis were analyzed by next-generation sequencing using 5 microsatellite markers specifically developed for M. coruscus. M. galloprovincialis had an average of 5.4 alleles per locus (range = 2-10), with an average allelic richness of 4.9 per locus (range = 2.0-9.3). M. coruscus had an average of 5.7 alleles per locus (range = 2-13), with an average allelic richness of 5.2 per locus (range = 2.0-11.9). Excessive homozygosity was observed at 3 loci, which was assumed to be due to the presence of null alleles at these loci. Pairwise multilocus FST estimates showed that the M. coruscus and M. galloprovincialis populations were clearly separated. Six populations of M. galloprovincialis from the western, eastern, and southern coast of Korea formed 2 separate clusters, indicating that more than 2 populations of M. galloprovincialis have been introduced to the Korean Peninsula. Hybrids between M. coruscus and M. galloprovincialis were not identified, probably because of genetic differences or different habitat preferences. Further genetic information is required to perform selective breeding, population management, and restoration of M. coruscus.

Dairy cows increase ingestive mastication and reduce ruminative chewing when grazing chicory and plantain

Although the nutritive value of chicory (Cichorium intybus L.) and plantain (Plantago lanceolata L.) has been thoroughly studied, little is known about the grazing behavior of cattle feeding on chicory and plantain swards. The objective of the present study was to assess and describe the grazing behavior of dairy cows as affected by dietary proportions of chicory and plantain fed as monocultures for part of the day. Ninety Holstein-Friesian cows (489±42 kg of body weight; 4.1±0.3 body condition score, and 216±15 d in milk) were randomly assigned to 15 groups (6 cows per group) and grazed according to 7 treatments: control (CTL, 3 groups), perennial ryegrass (Lolium perenne L.) dominant sward (24-h pasture strip); 3 chicory treatments comprising 20, 40, and 60% of the diet, strip-grazing a monoculture of chicory to a fixed postgrazing residual before strip-grazing a perennial ryegrass dominant sward (2 groups of cows per treatment); and 3 plantain treatments comprising 20, 40, and 60% of the diet, strip-grazing a monoculture of plantain to a fixed postgrazing residual before strip-grazing a perennial ryegrass dominant sward (2 groups of cows per treatment). Four focal animals per group were equipped with 3-dimensional motion sensors, which provided the number of steps taken at each minute of the day. These cows were also fitted with automatic jaw-movement recorders that identified bites, mastication during ingestion, chewing during rumination, and determined grazing, rumination and idling times and bouts. Daily grazing time and bouts were not affected by treatments but rumination time differed and was reduced by up to 90 min when cows were allocated to chicory and plantain as 60% of their diet. Ruminative chewing was reduced in cows grazing chicory and plantain by up to 20% in cows allocated to the 60% treatments. Compared with perennial ryegrass, as the dietary proportion of chicory and plantain increased, cows spent more time idling and less time ruminating, and increased ingestive mastications 5 and 3 times for chicory and plantain, respectively. Cows allocated to chicory and plantain reduced bite rate and bites per grazing step linearly, and increased the number of mastications per bite of pasture dry matter intake while grazing pasture after having grazed chicory and plantain. These results indicate that cows grazing chicory and plantain masticate more during ingestion and reduce rumination time and chewing. They also suggest that chicory presents greater constraints to ingestion than does plantain. Thus, although chicory has been considered to have a greater nutritive value than plantain, its overall feeding value may be no greater than that of plantain.

A MC motif in silkworm Argonaute 1 is indispensible for translation repression

Small RNA-mediated gene silencing is a fundamental gene regulatory mechanism, which is conserved in many organisms. Argonaute (Ago) family proteins in the RNA-induced silencing complex (RISC) play crucial roles in RNA interference (RNAi) pathways. In the silkworm Bombyx mori, four Ago proteins have been identified, named as Ago1, Ago2, Ago3 and Siwi. Ago2 participates in double-stranded RNA (dsRNA)-induced RNAi, whereas Ago3 and Siwi are involved in the Piwi-interacting RNA (piRNA) pathway. However, there is no experimental evidence concerning silkworm Ago1 (BmAgo1) in the RNAi mechanism. In the present study, we analysed the function of BmAgo1 in the microRNA (miRNA)-mediated RNAi pathway using tethering and miRNA sensor reporter assays. These results clearly demonstrate that BmAgo1 plays an indispensable role in translation repression in silkworm. Moreover, coimmunoprecipitation data indicated that BmAgo1 interacts with BmDcp2, an orthologue of mRNA-decapping enzyme 2 (Dcp2) protein in the Drosophila processing-bodies (P-bodies). Substitutions of two conserved phenylalanines (F522 and F557) by valines in the MC motif strongly impaired the function of BmAgo1 in translation repression and its localization in P-bodies, suggesting that these two amino acid residues in the MC motif of BmAgo1 are prerequisites for mRNA translation repression in B. mori.

Diagnostic value of CA125 as a predictor of recurrence in advanced ovarian cancer

PURPOSE

The aim of this study was to establish the guidelines for detecting early recurrences of advanced epithelial ovarian cancer by use of the CA-125 level.

MATERIALS AND METHODS

Eighty-five of the patients who met the inclusion criteria were enrolled in this study. The authors examined 25 incremental changes of CA125 from one to 25 IU/ml, and compared the CA-125 value with other prognostic factors. Increases in the CA-125 level from the nadir level were expressed as CA-125- increments.

RESULTS

Among the 25 increments, a CA-125-8 (eight IU/ml) was selected as the predictor that was the most efficient and time-effective. CA-125-8 had a sensitivity of 91.5%, a specificity of 84.6%, a positive predictive value of 93.1%, a negative predictive value of 81.5%, an efficiency of 89.4%. and a median lead-time of 68.5 days (p <0.0001).

CONCLUSION

The authors suggest the incremented CA-125-8 as a predictor of recurrent advanced ovarian cancer.

Electronic structure and characteristics of Fe 3d valence states of Fe(1.01)Se superconductors under pressure probed by x-ray absorption spectroscopy and resonant x-ray emission spectroscopy

The electronic structure and characteristics of Fe 3d valence states of iron-chalcogenide Fe(1.01)Se superconductors under pressure were probed with x-ray absorption spectroscopy and resonant x-ray emission spectroscopy (RXES). The intensity of the pre-edge peak at ~7112.7 eV of the Fe K-edge x-ray absorption spectrum of Fe(1.01)Se decreases for pressure from 0.5 GPa increased to 6.9 GPa. The satellite line Kβ' was reduced in intensity upon applying pressure and became absent for pressure 52 GPa. Fe(1.01)Se shows a small net magnetic moment of Fe(2+), likely arising from strong Fe-Fe spin fluctuations. The 1s3p-RXES spectra of Fe(1.01)Se at pressures 0.5, 6.9, and 52 GPa recorded at the Fe K-edge reveal that unoccupied Fe 3d states exhibit a delocalized character, stemming from hybridization of Fe 3d and 4p orbitals arising from a local distortion around the Fe atom in a tetrahedral site. Application of pressure causes suppression of this on-site Fe 3d-Fe 4p hybridization, and thereby decreases the intensity of the pre-edge feature in the Fe K-edge absorption spectrum of Fe(1.01)Se. Compression enhances spin fluctuations at Fe sites in Fe(1.01)Se and increases the corresponding T(c), through a competition between nearest-neighbor ferromagnetic and next-nearest-neighbor antiferromagnetic superexchange interactions. This result aids our understanding of the physics underlying iron-based superconductors.

Dual-source, dual-energy multidetector CT for the evaluation of pancreatic tumours

OBJECTIVE

To investigate the potential diagnostic value of dual-energy CT (DECT) with virtual non-enhanced (VNE) and iodine-only images, and to determine the optimal mixed ratio of blended images for evaluation of pancreatic diseases.

METHODS

Multiphasic DECT was performed in 44 patients with focal pancreatic disease. DECT was used during the pancreatic and hepatic venous phases, and a peak kilovoltage of 120 kVp was used for both non-contrast phases. For qualitative analysis of the CT images, two radiologists assessed three image sets (VNE, iodine-only and blended images) in order to determine the acceptability of VNE in replacing true non-enhanced (TNE) images, the added value of iodine-only images and the preferred blending ratio. For quantitative analyses, the CT numbers and image noise of the pancreatic parenchyma, lesions, aorta and psoas muscle were measured. The contrast-to-noise ratio of the lesion was calculated on the pancreatic phase images. The effective radiation dose for DECT and TNE images was calculated. Statistical comparisons were made using the Friedman test, the Wilcoxon test, the paired t-test and repeated measures of analysis of variation with Bonferroni correction for multiple comparisons.

RESULTS

The level of acceptance of the VNE images in replacing TNE images was 90.9%. Regarding the iodine-only images, 50% of the cases were found to have an added value. The linear-blended images with a weighting factor of 0.5 were preferred.

CONCLUSIONS

DECT was able to provide high-quality VNE images that could replace TNE images and iodine-only images showing an added value. Blended images with a weighting factor of 0.5 were preferred by the reviewers.

Enhancement patterns of hepatocellular carcinomas on multiphasicmultidetector row CT: comparison with pathological differentiation

OBJECTIVE

The objective of this study was to determine the incidence of typical and atypical enhancement patterns of hepatocellular carcinomas (HCCs) on multiphasic multidetector row CT (MDCT) and to correlate the enhancement patterns and morphological image findings of HCC with the degree of tumour differentiation.

METHODS

MDCT images of 217 patients with 243 surgically proven HCCs were evaluated through consensus reading by two radiologists. Our MDCT protocol was composed of precontrast, arterial, portal and delayed phases. The reviewers analysed the CT images for degree of attenuation; relative timing of washout; presence of dysmorphic intratumoral vessels, aneurysms and necrosis; tumour size; tumour margin; presence of pseudocapsule; intratumoral heterogeneity; and determined enhancement pattern. The imaging features were correlated with tumour differentiation using Fisher's exact test or the χ(2) test.

RESULTS

Among 243 HCCs, 137 (56.4%) showed the typical enhancement pattern of HCC, which is arterial enhancement and washout on portal or equilibrium phase images. In the arterial phase, 190 of 243 (78.2%) HCCs showed hypervascularity, with approximately three quarters of poorly differentiated (PD) (34 of 45, 75.6%) and moderately differentiated (MD) HCCs (92 of 123, 74.8%) showing washout during the portal or delayed phases, vs only 50% of well-differentiated (WD) HCCs (11 of 22; p<0.048). The presence of intratumoral vessels and aneurysms, tumour necrosis, attenuation of precontrast, the relative timing of washout, intratumoral attenuation heterogeneity, tumour margin and tumour size were correlated with the pathological differentiation of HCCs (p<0.05).

CONCLUSION

A typical enhancement of HCCs on MDCT was not unusual (43.6%) and WD and PD HCCs account for most of the atypical enhancement patterns. Early washout favoured MD and PD HCCs rather than WD HCCs, whereas in our study the presence of intratumoral aneurysm was a highly specific finding for PD HCC.

Anatomical collateral ligament reconstruction in the hand using intraosseous suture anchors and a free tendon graft

We describe anatomical collateral ligament reconstruction using a free tendon graft and intraosseous suture anchors in the digits. Eleven patients who underwent collateral ligament reconstruction at the proximal interphalangeal or metacarpophalangeal joints were enrolled in this study. Proper and accessory collateral ligaments were reconstructed using a free tendon graft in an anatomical configuration and the grafted tendons were fixed with suture anchors. The mean time from surgery to last follow-up was 9.2 months. All anchors used for fixation of grafted tendons remained securely at their original positions at the last follow-up visits. No significant complications were associated with the use of anchors. Clinical results were excellent in 10 patients and good in one. Anatomical reconstruction of collateral ligaments using suture anchors is simpler, faster, and safer than the conventional bone tunnel technique and it does not have the risks of breakage of bone bridges, skin irritation, or graft loosening.

18F half-life measurement using a high-purity germanium detector

The half-life of (18)F has been measured using HPGe detectors with a (137)Cs reference source. The counting ratio of 511 keV γ-rays from (18)F to 622 keV γ-rays from (137)Cs was fitted for the half-life with a weighted least-square method. Uncertainties due to the systematic effects arising from the measurement of a high activity (18)F source were studied in detail. The half-life of (18)F was found to be (109.72±0.19) min. The result is in a good agreement with the recommended value of (109.728±0.019) min evaluated at the Laborotaire National Henri Becquerel (LNHB).

Effects of a priming dose of fentanyl during anaesthesia on the incidence and severity of fentanyl-induced cough in current, former and non-smokers

Fentanyl is commonly used during anaesthesia and can cause fentanyl-induced cough (FIC). This study investigated whether a priming dose of fentanyl reduced FIC, and determined the factors associated with increased risk of FIC. Subjects undergoing elective surgery under general anaesthesia (n = 800) were randomized into four groups: group 1 received 2 μg/kg fentanyl bolus; groups 2, 3 and 4 received a priming dose of fentanyl 0.5 μg/kg followed by 1.5 μg/kg after 1, 2 or 3 min, respectively. The incidence of FIC was 17.0%, 10.0%, 12.5% and 11.5% for groups 1, 2, 3 and 4, respectively, with no significant between-group differences in FIC incidence or severity. The mean FIC onset time was 22 s. Former smokers were 2.91 times more likely than current smokers to experience cough. A fentanyl priming dose did not reduce the incidence and severity of FIC. Former smokers were hyper-reactive to fentanyl compared with current smokers.

Therapeutic effect of high-intensity focused ultrasound combined with transarterial chemoembolisation for hepatocellular carcinoma <5 cm: comparison with transarterial chemoembolisation monotherapy--preliminary observations

OBJECTIVE

To retrospectively compare the therapeutic effects of combined high-intensity focused ultrasound (HIFU) and transarterial chemoembolisation (TACE) with TACE alone for the treatment of non-advanced hepatocellular carcinomas (HCCs) <5 cm.

METHODS

We retrospectively reviewed the tumour responses of 32 HCCs of 25 patients who underwent combined HIFU and TACE, and 46 HCCs of 32 patients who underwent TACE only. The mean follow-up observation of the TACE+HIFU group was on average 31 months and that of the TACE group was 33 months. Those patients who had undergone any other treatment modality (including systemic chemotherapy) during the follow-up observation period were excluded. The therapeutic effects were classified according to the modified Response Evaluation Criteria In Solid Tumors (mRECIST): complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Additionally, we defined CR', PR', SD' and PD' as the therapeutic effects "per tumour".

RESULTS

The disease control rate calculated using the RECIST criteria (CR+PR+SD/All) was 48% in the HIFU+TACE group and 47% in the TACE group (p=0.78, Fisher's exact test). The disease control rate "per tumour" (CR'+PR'+SD'/All) was 78% in the HIFU+TACE group and 54% in the TACE group (p=0.035, Fisher's exact test). In the HIFU+TACE group, no HIFU-related complications requiring treatment were observed. The median survival time was 57 months in TACE+HIFU group and 36 months in the TACE group (p=0.048).

CONCLUSION

This preliminary study shows that the combination therapy of HIFU and TACE is more effective than TACE monotherapy for treating HCCs <5 cm.

Metformin ameliorates IL-6-induced hepatic insulin resistance via induction of orphan nuclear receptor small heterodimer partner (SHP) in mouse models

AIMS/HYPOTHESIS

IL-6 is a proinflammatory cytokine associated with the pathogenesis of hepatic diseases. Metformin is an anti-diabetic drug used for the treatment of type 2 diabetes, and orphan nuclear receptor small heterodimer partner (SHP, also known as NR0B2), a transcriptional co-repressor, plays an important role in maintaining metabolic homeostasis. Here, we demonstrate that metformin-mediated activation of AMP-activated protein kinase (AMPK) increases SHP protein production and regulates IL-6-induced hepatic insulin resistance.

METHODS

We investigated metformin-mediated SHP production improved insulin resistance through the regulation of an IL-6-dependent pathway (involving signal transducer and activator of transcription 3 [STAT3] and suppressor of cytokine signalling 3 [SOCS3]) in both Shp knockdown and Shp null mice.

RESULTS

IL-6-induced STAT3 transactivation and SOCS3 production were significantly repressed by metformin, adenoviral constitutively active AMPK (Ad-CA-AMPK), and adenoviral SHP (Ad-SHP), but not in Shp knockdown, or with the adenoviral dominant negative form of AMPK (Ad-DN-AMPK). Chromatin immunoprecipitation (ChIP), co-immunoprecipitation (Co-IP) and protein localisation studies showed that SHP inhibits DNA binding of STAT3 on the Socs3 gene promoter via interaction and colocalisation within the nucleus. Upregulation of inflammatory genes and downregulation of hepatic insulin signalling by acute IL-6 treatment were observed in wild-type mice but not in Shp null mice. Finally, chronic IL-6 exposure caused hepatic insulin resistance, leading to impaired insulin tolerance and elevated gluconeogenesis, and these phenomena were aggravated in Shp null mice.

CONCLUSIONS/INTERPRETATION

Our results demonstrate that SHP upregulation by metformin may prevent hepatic disorders by regulating the IL-6-dependent pathway, and that this pathway can help to ameliorate the pathogenesis of cytokine-mediated metabolic dysfunction.

Multiple-electrode radiofrequency ablations using Octopus® electrodes in an in vivo porcine liver model

OBJECTIVES

The objective of this study was to determine the in vivo efficacy of radiofrequency ablation (RFA) in porcine liver using Octopus® electrodes for creating a large coagulation compared with RFA using clustered electrodes.

METHODS

A total of 39 coagulations were created using a 200-W generator and clustered electrodes or Octopus electrodes during laparotomy in 19 pigs. Radiofrequency was applied to the livers using four protocols: (1) Group A-1, monopolar mode using a clustered electrode (n=11); (2) Group A-2, monopolar mode using an Octopus electrode (n=11); (3) Group B-1, consecutive monopolar mode using three, clustered electrodes (n=8); and (4) Group B-2, switching monopolar mode using two Octopus electrodes (n=9). The energy efficiency, shape, diameters (D) and volume (V) of the coagulation volume were compared in each of the two groups.

RESULTS

The mean maximum D and V of the coagulations in Group A-2 (4.7 cm and 33.1 cm(3), respectively) were significantly larger than those in Group A-1 (4.1 cm and 20.3 cm(3), respectively) (p<0.05). Furthermore, the mean minimum D, maximum D and V of the coagulations in Group B-2 were significantly larger than those in Group B-1, i.e. 5.3 vs 4.0 cm, 6.6 vs 4.9 cm and 66.9 vs 30.2 cm(3), respectively (p<0.05). The energy efficiencies were also significantly higher in Groups A-2 and B-2 than in Groups A-1 and B-1 (p<0.05).

CONCLUSION

The Octopus electrodes were more efficient for creating a large ablation zone than clustered electrodes, and the efficacy of RFA with Octopus electrodes can be amplified in the switching monopolar mode.