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The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of the ultrasound-guided supraclavicular brachial plexus block (BPB) during angioplasty of dysfunctional arteriovenous access.Materials and Methods: Eighty study participants with dysfunctional arteriovenous access were enrolled in this prospective, randomized clinical trial between November 2016 and February 2018. Eighty patients were randomized to either the ultrasound-guided supraclavicular BPB group (mean age ± standard deviation [SD], 65.1 ± 12.4; male:female = 17:23) or the no regional anesthesia group (mean age ± SD, 64.0 ± 11.7; male:female = 25:15). Pain was assessed on the 10-point Visual Analogue Scale. Participant satisfaction was examined. Six-month clinical follow-up was done to evaluate arteriovenous access patency and long-term complications.Results: The BPB group showed a lower average pain score than the control group (mean ± SD, 0.9 ± 1.9 vs 6.4 ± 2.5; P < .001). Participant satisfaction (mean ± SD, 2.8 ± 0.5 vs 2.1±0.8; P < .001) was also higher in the BPB group. Six-month patency was 65% (26/40) in the BPB group and 59% (23/39) in the control group, with no significant difference between the 2 groups (P = .59). No major immediate or delayed complications were observed.Conclusions: Ultrasound-guided BPB is highly effective in reducing pain during angioplasty of dysfunctional arteriovenous access with an acceptable safety profile. [ABSTRACT FROM AUTHOR]

Ploeotids are an assemblage of rigid phagotrophic euglenids that have 10–12 pellicular strips and glide on their posterior flagellum. Molecular phylogenies place them as a poorly resolved, likely paraphyletic assemblage outside the Spirocuta clade of flexible euglenids, which includes the well-known phototrophs and primary osmotrophs. Here, we report SSU rRNA gene sequences from 38 ploeotids, using both single-cell and culture-based methods. Several contain group I or non-canonical introns. Our phylogenetic analyses place ploeotids in 8 distinct clades: Olkasia n. gen., Hemiolia n. gen., Liburna n. gen., Lentomonas , Decastava , Keelungia , Ploeotiidae, and Entosiphon. Ploeotia vitrea , the type of Ploeotia , is closely related to P. oblonga and Serpenomonas costata , but not to Lentomonas. Ploeotia cf. vitrea sensu Lax and Simpson 2013 is not related to P. vitrea and has a different pellicle strip architecture (as imaged by scanning electron microscopy): it instead represents a novel genus and species, Olkasia polycarbonata. We also describe new genera, Hemiolia and Liburna , for the morphospecies Anisonema trepidum and A. glaciale. A recent system proposing 13 suprafamilial taxa that include ploeotids is not supported by our phylogenies. The exact relationships between ploeotid groups remain unresolved and multigene phylogenetics or phylogenomics are needed to address this uncertainty. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Saccharina japonica was fermented by Monascus for anti-adipogenic extract production. • Ethyl acetate extract contained lovastatin and different bioactive compounds. • Lovastatin rich extract prevented adipogenic differentiation in 3T3L-1 cells. • Sample treated 3T3L-1 cells exhibited reduced lipid accumulation. • Adipogenic differentiation inhibited by adipogenic related gene was analyzed by Q-PCR. Abstract Monascus -fermented Saccharina japonica extract was evaluated to prevent preadipocyte to adipogenic differentiation in 3T3L-1 cells. The Oil red O staining of sample treated 3T3L-1 cells showed reduction of lipid accumulation and adipocyte differentiation in a dose dependent manner. The mRNA gene expression measured by real-time polymerase chain reaction (Q-PCR) for adipogenic gene expression showed that the C/EBP-α expression was significantly (p < 0.05) lower in lovastatin rich fermented extract than unfermented one. The gene expression of PPAR-γ displayed significant difference between the fermented extract treated cells and control cells. The relative gene expression of FAS, LPL and SREBP1 were significantly lower in Monascus -fermented extract than unfermented one. Furthermore, the cell cycle of the 3T3L-1 cells also arrested in G1/S phase which was expressed by the significant reduction of gene expression, Cyclin A and CDK4 in Monascus -fermented extract than unfermented one. So, Monascus -fermented brown seaweed effectively controlled the adipogenic gene expression and inhibited lipid accumulation. [ABSTRACT FROM AUTHOR]

Two species of brown seaweeds, Saccharina japonica and Undaria pinnatifida were fermented by the red molds; Monascus purpureus and Monascus kaoliang to increase their bio-functional properties. The phenolic contents of S. japonica fermented by M. purpureus (SjMp) and M. kaoliang (SjMk) were the highest 71.53 ± 2.25 and 66.50 ± 4.64 mg gallic acid equivalent/g extract, respectively, whereas the highest flavonoid content was evident in S. japonica fermented by M. purpureus (SjMp) and U. pinnatifida fermented by M. purpureus (UpMp) (27.93 ± 0.28 and 26.88 ± 1.24 mg quercetin equivalent/g extract, respectively). Reducing sugar, protein and essential fatty acids levels also increased in fermented seaweeds. The antioxidant activities of fermented seaweed extracts exhibited significantly ( p < 0.05) lower IC 50 values than those of unfermented extracts. S. japonica fermented by M. purpureus (SjMp) exhibited the lowest IC 50 values of antidiabetic activities mediated by α-amylase and rat intestinal α-glucosidase (maltose and sucrose): 0.98 ± 0.10, 0.02 ± 0.07 and 0.08 ± 0.13 mg/mL, respectively. M. purpureus fermented S. japonica extract at 4.58 ± 0.85 μg/mL afforded 50% inhibition of lipase, which was the most effective of all samples tested in this regard. Extracts from brown seaweeds fermented by Monascus spp. exhibited increased phenolics and flavonoids contents associated with strong in vitro bio-potential, DNA protection and the absence of any toxic effect on intestinal epithelial Caco-2 cells. Thus, fermented seaweed extracts may be recommended as food ingredients or therapeutic diet for patient suffering from oxidative stress, hyperglycemia and hyperlipidemia. [ABSTRACT FROM AUTHOR]

Summary Background This study aimed to demonstrate the safety and reliability of combined preoperative angioplasty and free flap transfer in patients with peripheral arterial occlusive disease (PAOD) by analyzing the surgical outcomes. Methods Between October 2011 and October 2015, patients who had undergone lower extremity angiography and subsequent free flap transfer were retrospectively reviewed. Data collected included demographics, perioperative data, and postoperative outcomes. The cases were divided into two groups: one group with microanastomosis performed on revascularized artery by balloon angioplasty and the other group performed on native artery. Multiple logistic regression model using propensity score and linear regression was computed to determine the association between preoperative angioplasty and the surgical outcomes. Results A total of 62 lower limb reconstruction cases (19 angioplastied cases and 43 nonangioplastied cases) were included in the study. Complications occurred in 6 cases in the angioplastied group and in 11 cases in the control group. The overall limb salvage rate was 100% during the average follow-up of 29.5 months in the angioplastied group and 97.7% in the nonangioplastied control group during the average follow-up of 31.1 months. Preoperative angioplasty was not a significant predictor of increased complications and longer postoperative downtime in logistic and linear regression model, both in the weighted and unweighted model. Conclusions The combined approach of preoperative endovascular revascularization and free flap transfer for limb reconstruction in PAOD patients can be performed safely and effectively with acceptable morbidity. [ABSTRACT FROM AUTHOR]

To assess outcome and predictors of outcome after lymphatic embolization (LE) for early postoperative lymphatic leak after pelvic surgery. Lymphangiography (LG) procedures performed between May 2015 and February 2020 for postoperative intraperitoneal lymphatic leaks after pelvic surgery were reviewed. Treatment indication was lymphatic drainage of >500 mL/d persisting for >1 week. LE was performed by injecting glue into the iliac lymph node. Fisher exact and Wilcoxon rank-sum tests were used for comparative analysis, and logistic regression was used to assess predictors of outcome. LG was performed in 71 patients. A leak was demonstrated in 69 patients who underwent LE. The mean drainage was 1,329 mL/d ± 773. Catheters were removed in 49 (69.0%) patients after 1 procedure and in 69 (97.2%) patients after a mean of 1.3 procedures. The mean drainage at the time of catheter removal was 157 mL/d ± 100. Failure occurred in 12 (16.9%) cases, including 2 (2.8%) cases of unsuccessful catheter removal and 10 (14.1%) cases of catheter reinsertion owing to recurrent ascites (n = 3) and lymphoceles (n = 7). Older age and drainage of >1,500 mL/d were associated with failure (P =.004). Drainage of >1,500 mL/d was associated with a post-LE catheter dwell time of longer than 1 week (P =.024). Minor adverse events were noted in 4 (5.6%) patients who presented with transient leg swelling. LE was effective for treating pelvic surgery-related lymphatic leaks. Reintervention may be required. Drainage of >1,500 mL/d was associated with clinical failure and a post-LE catheter dwell time of longer than 1 week. [Display omitted] [ABSTRACT FROM AUTHOR]

Chylous ascites occurs as a result of lymphatic leakage, which contains high concentration of triglycerides. The leakage is caused by various benign or malignant etiologies ranging from congenital lymphatic abnormality to trauma. Lymphangiography has been shown to be effective in the diagnosis of lymphatic leakage and has also been reported to have therapeutic outcome. The development of intranodal technique for lymphangiography has recently made the procedure more widespread. As an adjunctive procedure, percutaneous embolization may be performed which involves use of embolic agents such as N-butyl cyanoacrylate and coil to occlude the leak. Embolization in the lymphatic system was first made popular by the introduction of thoracic duct embolization by Cope et al and has recently led to the development of various techniques for percutaneous embolization. This article reviews the options and techniques for percutaneous treatment of lymphatic leaks in patients presenting with chylous ascites. [ABSTRACT FROM AUTHOR]

Purpose: To assess the feasibility and outcome of transjugular access for endovascular treatment of immature arteriovenous fistulae (AVFs).Materials and Methods: Between August 2013 and January 2016, 90 patients (mean age, 64.5 y ± 12.8) underwent endovascular treatment of immature AVFs via transjugular access. The mean age of fistulae was 3.3 months ± 1.8. Total procedure time and technical and clinical success rates of endovascular procedures were assessed. Primary and secondary patency rates were calculated according to the Kaplan-Meier method, and complications were assessed.Results: All patients had inflow lesions, among which 19 (21.1%) had occlusions. The juxtaanastomotic segment was the most common site (44.3%). Transjugular access was successful in 83 patients (92.2%), and 7 required additional standard or transarterial access. The mean procedure time was 36.5 minutes. Technical and clinical success rates were 98.9% and 90.5%, respectively. Mean primary and secondary patency durations were 14.3 months ± 1.7 and 31.0 months ± 0.7, respectively. Primary patency rates at 3, 6, and 12 months were 84.4%, 67.3%, and 48.8%, respectively. Secondary patency rates at 6 and 18 months were 98.6% and 95.5%, respectively. Venous rupture occurred as a result of balloon inflation in 9 patients (10%), and was managed by balloon tamponade. There were no complications related to transjugular access during a mean follow-up period of 12.6 months.Conclusions: Transjugular access for angioplasty of immature AVFs is feasible and safe. Potential problems associated with access in the outflow vein could be avoided by transjugular access. [ABSTRACT FROM AUTHOR]

Two heterotrophic flagellate strains were isolated from marine sediment samples off eastern Canada and Korea. These new isolates are indistinguishable by light microscopy from the unclassified protist Cyranomonas australis . The organisms are ovoid-shaped cells, 3.5–6 μm long, laterally compressed, and somewhat flexible. They have two unequal flagella, about 1.1–2.5 times body length. Typically, the cells show a gliding motility and do not exhibit any amoeboid form or pseudopodia. 18S rDNA phylogenies clearly indicate that the isolates can be assigned to the taxon Filosa, within Cercozoa. The isolates are closest to an environmental sequence (CYSGM-16; 99% identity). Cyranomonas , CYSGM-16, and uncultured eukaryote RM1-SGM46 form a clade with strong statistical supports, here called novel clade CU ( Cyranomonas plus Uncultured eukaryotes). This clade may be sister to the order Marimonadida. The novel clade CU and the Marimonadida have been detected only in marine habitats. Our findings suggest that C. australis may not belong to any previously described family within Filosa and Cercozoa. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively assess the outcome of lymphatic embolization in the treatment of pelvic lymphoceles.Materials and Methods: From July 2014 to December 2015, a retrospective analysis was performed in 5 consecutive female patients (mean age, 54.6 y; range, 45-65 y) who underwent lymphangiography for the management of symptomatic pelvic lymphoceles that developed after gynecologic surgery. Sclerotherapy had failed in 4 patients. Lymphangiography was performed through an inguinal lymph node to reveal disrupted lymphatic vessels draining into the lymphocele. This inflow vessel was targeted with a fine needle, and N-butyl cyanoacrylate (NBCA) was injected. Outcomes and complications were assessed by reviewing electronic medical records and computed tomography (CT).Results: Lymphangiography revealed disrupted lymphatic vessels draining into the lymphocele in all patients. A single inflow vessel was seen in 3 patients and was subsequently embolized. Catheters were successfully removed upon decrease of drainage. Multiple inflow vessels were seen in the remaining 2 patients. Therapeutic effect was anticipated in 1 patient after lymphangiography alone, whereas only the dominant feeding vessel was embolized in the other. The initial procedures failed in both patients, prompting repeat embolization with adjunctive sclerotherapy. Both patients showed improvement and had their catheters removed. Follow-up CT was available in 3 patients. Two patients showed complete regression of lymphoceles, and 1 showed an asymptomatic lymphocele. No procedure-related complications occurred during a mean follow-up period of 35 weeks (range, 2-73 wk).Conclusions: Lymphatic intervention was technically feasible in treating lymphoceles. However, those with multiple inflow vessels were relatively difficult to treat. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and efficacy of ultrasound-guided and fluoroscopically guided percutaneous pericardial effusion drainage as performed by interventional radiologists in patients with symptomatic pericardial effusion.Materials and Methods: From July 2002 to December 2013, 93 patients were treated with percutaneous pericardial effusion drainage. Pericardial effusion drainage was performed via 3 routes: apical, subxiphoid, and transhepatic routes. After puncturing the pericardial sac with a 22-gauge needle under ultrasound guidance, a drainage catheter was inserted under fluoroscopic guidance. Pericardial effusion was categorized according to its distribution in the pericardial cavity: "circumferential even," "circumferential uneven" (predominant site specified), and "loculated." Technical success, recurrence, and complication rates were assessed.Results: The technical success rate was 99%. Pericardial effusion drainage was performed via the subxiphoid approach in 54 procedures, transhepatic approach in 30 procedures, and apical approach in 13 procedures. The transhepatic approach was mainly performed in cases where the effusion was distributed posteriorly to the heart (80%). One patient died of uncontrolled hypotension without evidence of hemopericardium.Conclusions: Ultrasound-guided and fluoroscopically guided pericardial effusion drainage is a safe and effective procedure for patients with symptomatic pericardial effusion. The transhepatic approach may be preferable for posteriorly distributed pericardial effusion that would otherwise be inaccessible by a traditional subxiphoid or apical approach. [ABSTRACT FROM AUTHOR]

Heteronema is a commonly encountered genus of phagotrophic euglenids that contains very different morphotypes, including elongate gliding species and ovoid skidding forms. We report the first ultrastructural and sequence data from a culture of an ovoid skidding heteronemid, KM051. Cells were 8-23.5 μm long with 22 pellicular strips and a fibrous extracellular layer. The tubular extrusomes had dense centre sections. The feeding apparatus was barely visible by light microscopy, but included two microtubule-supported rods. The flagella had hollow, inflated transition zones, heteromorphic paraxonemal rods, and sheaths of flagellar hairs. The posterior flagellum bore a knob that, unusually, sat >2 μm distal to the flagellar base. No ultrastructural features were uniquely shared by KM051 and the elongate, gliding species Heteronema scaphurum. Conversely, the pellicular microtubule array resembles that in deep-branching primary osmotrophs (Aphagea). 18S ribosomal DNA (18S rDNA) phylogenies showed that KM051 is related to a recently obtained Heteronema c.f. exaratum sequence. These skidding heteronemids are not closely related to H. scaphurum , and instead are closely related to Dinema , Anisonema and specifically, Aphagea. The skidding species in Heteronema are transferred to Neometanema gen. nov. (along with most species of Metanema Klebs, 1893), with KM051 described as Neometanema parovale sp. nov. [ABSTRACT FROM AUTHOR]

Summary Objective Most patients with peripheral arterial occlusive disease undergo lower limb amputation due to complex wounds on their lower extremities. We have taken the challenging approach of combining angioplasty and free tissue transfer for limb salvage. Methods Between October 2011 and December 2013, 11 patients (average age of 56.8 years; ranged from 43–72 years old) with peripheral arterial occlusive disease of main tibioperoneal arteries underwent preoperative angioplasty. Afterward, free tissue transfers (nine anterolateral thigh free flaps, one vastus lateralis muscle free flap, and one deep femoral artery perforator flap) were performed on these patients for lower extremity salvage and reconstruction. Results All 11 free tissue transfers after angioplasty were successful without operative mortality or major complications. Minimal wound dehiscence was seen in one case, and partial flap necrosis was seen in the other cases. During the follow-up period, all of the patients had their wounds healed completely and achieved acceptable contour and quality of gait. Conclusion The preoperative angioplasty provides well-vascularized tissue that both controls infection and helps free flaps to survive. Therefore, the patients due to receive leg amputation in spite of the free tissue transfer can achieve limb salvage by using the additional technique of angioplasty. This combined approach was successful in preserving the functional aspects along with the aesthetic results for the lower limb reconstruction. [ABSTRACT FROM AUTHOR]

Summary: The latent infection is unique characteristic of Mycobacterium tuberculosis to overcome human immune response for its survival. The M. tb develops adaptation to extreme stress conditions to increase the viability, thus easily acquires drug resistance than any other bacteria and maintains a long-term infection status without any symptoms. Rv0569 is a conserved hypothetical protein that overexpresses under dormant state induced by hypoxia, starvation, and medication. To study function and structure in detail, we determined the solution structure of Rv0569 by NMR. NOE and RDC restraints were used to calculate the structure, which was further refined with AMBER. Rv0569 is composed of five antiparallel β-sheets and one α-helix. Rv0569 shows structural similarity with its homolog Rv2302, yet there is a big difference in the orientation of C-terminal α-helix between Rv0569 and Rv2302. According to previous studies, Rv0569 might comprise a hypoxia induced operon with the Rv0570 which is located 29 bp downstream of the Rv0569 and Rv0570 plays an important role in the latent infection. From our structure and bioinformatics research, we suggest that Rv0569 contributes to signaling transduction in hypoxic condition by binding with DNA for upregulation of Rv0570 or supporting Rv0570 for binding ATP during dormancy of tuberculosis. [Copyright &y& Elsevier]

Objective: The aim of this study was to evaluate the lip and perioral soft tissue changes after bracket bonding. Methods: The soft tissue changes in 45 adult patients (age greater than 18 years and less than 29 years) without severe skeletal discrepancy were evaluated using three-dimensional images acquired with a laser scanner before and after bracket bonding was performed using 4 types of labial orthodontic brackets. Results: Among the statistically significant changes in distance observed for the landmarks, the biggest change was observed in forward movement. The landmarks on the lateral sides also showed significant changes. While the landmarks on the upper lip showed significant upward movement, those on the lower lip showed significant downward movement. However, the changes were smaller for the landmarks on the upper lip (average, 0.87 mm) than for the landmarks on the lower lip (average, 1.21 mm). The type of bracket used did not significantly affect the soft tissue changes. Conclusions: These findings will help predict soft tissue changes after bracket bonding for orthodontic treatment. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To report the use of a newly constructed, covered, retrievable, expandable nitinol stent with barbs to overcome the problem of stent migration associated with conventional covered prostatic expandable stents and to evaluate prospectively the technical feasibility and clinical effectiveness of the stents in patients with benign prostatic hyperplasia (BPH). Materials and Methods: A covered retrievable expandable nitinol stent with four barbs was placed with use of an 18-F stent delivery system in seven consecutive patients with symptomatic BPH who had high operative risks. Age range of patients was 62–83 years (mean 74 years). In cases in which the stent migrated, it was replaced with a stent with eight barbs. The stents were routinely removed 4 months after placement using a 21-F stent removal set. Results: Stent placement was technically successful and well tolerated in six of the seven patients. The remaining patient needed a second stent placement after removal of the first stent. The stent with four barbs migrated into the urinary bladder in four patients (57%); three of these patients received a second stent with eight barbs with good results, and the fourth patient did not need further treatment because his symptoms improved. Routine removal of the stent 4 months after placement was performed in three of the seven patients with good results. Conclusions: Retrievable stents with eight barbs seem to overcome the problem of stent migration associated with conventional prostatic expandable stents. Preliminary results suggest that stents with barbs are both feasible and effective in patients with BPH. [Copyright &y& Elsevier]

Purpose: Chemical ablation of the gallbladder may be a useful alternative to surgery for inoperable disease. The purpose of this study was to investigate the feasibility of chemical ablation of the gallbladder with acetic acid in a canine model. Materials and Methods: Five beagle dogs underwent percutaneous transhepatic cholecystostomy. Percutaneous occlusion of the cystic duct was performed with use of n-butyl cyanoacrylate (NBCA) and coils. After confirmation of occlusion of the cystic duct, sclerotherapy of the gallbladder was performed with 4–7 mL of 50% acetic acid through the drainage catheter. Acetic acid was retained for 20 minutes with intermittent position change. The drainage catheter was removed immediately after sclerotherapy. The dogs were euthanized 8 weeks after the procedure. The gallbladders and adjacent organs were evaluated grossly as well as microscopically. Results: All dogs survived without serious complications during the experimental period. Sclerotherapy was technically successful in all dogs. Gross specimens of the gallbladder showed shrinkage and fibrotic change without retention of any bile, mucus, or pus. Histologic examinations from the body and fundus of the gallbladder demonstrated complete ablation of the mucosa. However, the neck region of the gallbladder near the cystic duct, where NBCA and coils for cystic duct occlusion were located, had focal areas of remnant or regenerating mucosa. Conclusions: Chemical ablation of the gallbladder with 50% acetic acid was effective and safe. Complete ablation was achieved in the majority of gallbladder mucosa except for a small portion located in the gallbladder neck. [Copyright &y& Elsevier]

Purpose: To evaluate the feasibility of transarterial prostate embolization for reducing the volume in hormone-induced canine prostate hyperplasia. Materials and Methods: Nine beagle dogs were included in this study. Prostate hyperplasia was induced by administering dihydrotestosterone and β-estradiol. The hormones were given for 12 weeks in group A (n = 4) and 24 weeks in group B (n = 5). Twelve weeks after initiating the hormone treatment, two animals in group A and three in group B underwent prostate embolization with polyvinyl alcohol (PVA) particles. The volume of each prostate was measured three times with magnetic resonance (MR) imaging: once before hormone treatment and at 12 and 24 weeks after initiation of hormone administration. The prostates and bladders were harvested after the third MR study and were grossly and microscopically evaluated. Results: The mean volume of the prostate increased by 156.13% ± 110.01% in the nine dogs after 12 weeks of hormone administration. In group A (n = 4), the third MR study showed a 67.74% mean decrease in prostate volume in nonembolized dogs and an 81.04% mean decrease in embolized dogs compared with the second MR study. In group B (n = 5), the mean increases in prostate volume between the second and third MR studies were 40.79% in embolized dogs (n = 3) and 75.15% in nonembolized dogs. There was no gross or microscopic change in the bladders except for a focal hemorrhage in one specimen. Conclusions: Transcatheter arterial embolization is feasible for reducing prostate volume without serious complications in hormone-induced canine prostate hyperplasia. [Copyright &y& Elsevier]

Purpose: Hepatocellular carcinoma with hepatic artery to hepatic vein (AV) shunt has increased risk of pulmonary complications during transcatheter arterial chemoembolization (TACE). The purpose of this study is to assess temporary balloon occlusion as a means of preventing pulmonary complications during TACE of hepatocellular carcinoma with AV shunt.Materials and Methods: Eleven hepatocellular carcinoma patients (M: F = 9:2; mean age, 48 years) with angiographically evident AV shunt underwent TACE with occlusion of the shunt-draining hepatic veins using temporary occlusion balloon catheters. All tumors were in the right lobe, and all AV shunts were between the right hepatic artery and right hepatic vein. The occlusion balloon was inserted via femoral (n = 6) or jugular (n = 5) venous access. The balloon diameter ranged from 8.5 to 11.5 mm and time of ballooning was 3 to 15 minutes (mean, 9.5 minutes). TACE was performed using emulsion of iodized oil and doxorubicin, followed by Gelfoam embolization. The balloon was deflated immediately after chemoembolization, and physical examination and chest radiography were performed. Follow-up computed tomography was performed within 2 weeks after TACE to evaluate the result and pulmonary complications.Results: The technical success rate was 100%. There was no symptom, sign, or radiographic evidence of pulmonary complication. Follow-up computed tomography revealed complete iodized oil uptake by the tumor in eight patients and incomplete uptake by the tumor in three patients. There was no iodized oil uptake in the lungs.Conclusions: Temporary balloon occlusion of the hepatic vein in hepatocellular carcinoma with AV shunt allowed completion of TACE using conventional method while preventing pulmonary complications. [ABSTRACT FROM AUTHOR]

Purpose: A specially designed self-expandable covered metallic stent incorporated with beta-emitting radioisotope, Holmium-166 (Ho-166), was developed for delivering intraluminal brachytherapy as well as for internal bile drainage in malignant biliary stricture. The purpose of the study was to demonstrate the safety and tissue response of the radioactive metallic stent on the normal canine common bile duct (CBD) prior to the clinical application. Materials and Methods: Nitinol self-expandable stents (diameter; 4 mm, length; 20 mm) were covered with polyurethane membrane (50 microm thick) containing 21 to 135 muCi of Ho-166 (mean, 77.9 microCi). To prevent migration of stent, the membrane covered only the middle 1 cm of the stent and the ends of the stent were left uncovered. The stents were placed in the CBD of 20 healthy beagle dogs. For control, non-radioactive covered stents were placed in another three dogs. The dogs were killed 3 to 6 months after stent insertion and histopathologic examination of CBD was performed. Results: There was no stent migration in all cases. Varying degrees of papillary mucosal hyperplasia leading to significant narrowing of the lumen was observed within the lumen of the bare portion and under the mucosal surface of the non-radioactive covered stents. However, fibrosis was noted in Ho-166 coated area, instead of mucosal hyperplasia. Severity of fibrosis was correlated with estimated radiation dose. Despite high dose, there was no perforation of CBD wall. The membrane of Ho-166 coat was disrupted in some cases of 6 months follow-up. Conclusions: Holmium-166 incorporated covered stents demonstrated fibrosis of CBD wall and inhibition of ingrowth of mucosal hyperplasia without serious complication such as perforation, while control group showed severe mucosal hyperplasia. [ABSTRACT FROM AUTHOR]

A new microcatheter–arterial port system for transarterial regional therapy was evaluated in a swine model. Subclavian or femoral access was followed by superselective catheterization of target arteries (hepatic, n = 6; splenic, n = 3). A hemostatic sleeve was placed at the arterial puncture site. Implantation into the target vessel succeeded in all nine placements (100%). After animal movement, no microcatheter tip moved by more than 10 mm. A small hematoma developed at one of the subclavian insertion sites. This system holds promise for transarterial therapies for regional cancer therapy. [Copyright &y& Elsevier]

Five patients with moderate to massive hemoptysis who had a bronchial artery of anomalous origin or a nonbronchial systemic artery originating from the proximal subclavian artery underwent microcatheter placement through a created side hole of a 5-F catheter. All patients had pulmonary tuberculosis and had undergone bronchial artery embolization for hemoptysis. The side holes were made in the lesser (n = 2) or greater curvature sides (n = 3) of 5-F nonbraided Headhunter catheters. A microcatheter was passed through the side hole of the 5-F catheter into the target artery for embolization. Polyvinyl alcohol particles were used as the embolic material. The technical success rate was 100%, and immediate control of hemoptysis was achieved in all patients without complication. [Copyright &y& Elsevier]

Purpose: To evaluate the efficacy of percutaneous image-guided sclerotherapy of lymphangiomas with use of acetic acid.Materials and Methods: Twelve patients with lymphangiomas were treated with acetic acid as the sclerosant. There were eight male patients and four female patients, ranging in age from 1 to 29 years (mean, 11 years). The lymphangiomas were located at the neck (n = 5), upper extremity (n = 3), axilla (n = 1), cervicomediastinum (n = 1), anterior chest wall (n = 1), and retroperitoneum (n = 1). Two patients had recurrent lymphangiomas after surgery and two patients had undergone failed sclerotherapy with another sclerosant. The acetic acid used as the sclerosant was 40%-50% in concentration, and the amounts used ranged from 2 mL to 70 mL (mean, 11.3 mL), which was equivalent to 4.6%-50% (mean, 30.6%) of the aspirated lymphatics. All procedures were performed under ultrasonographic and fluoroscopic guidance. The sclerosant was removed after sclerotherapy. All patients except one underwent one treatment session.Results: Complete resolution of the lymphangioma was achieved in eight patients (66.7%), good resolution (>50% reduction) was achieved in three (25.0%), and poor resolution (<50% reduction) was seen in one (8.3%). Complications encountered included pneumonitis adjacent to the lymphangioma (n = 1), pain (n = 2), hematuria (n = 1), and tingling sensation in the forearm (n = 1).Conclusion: Percutaneous sclerotherapy of the lymphangiomas with use of acetic acid is an effective method without serious complications. [ABSTRACT FROM AUTHOR]

[Display omitted] • Pediococcus acidilactici FS2 was isolated from Korean traditional food. • The probiotic properties of Pediococcus acidilactici FS2 were investigated. • Dietary supplementation of FS2 downregulated the blood cholesterol levels. • Supplementation with FS2 increased the intestinal lactobacilli in BALB/c mice. In the present study, the probiotic properties of Pediococcus acidilactici FS2 isolated from Korean traditional food, gajami-sikhae (fermented flounder), and the effect of its oral administration on the reduction in blood cholesterol in mice were investigated. Analysis of probiotics properties, such as acid and bile resistance, antibiotic resistance, cell adhesion, antioxidant activity, antibacterial activity, and enzyme activity, demonstrated that FS2 is a potential probiotic candidate. FS2 showed a high growth rate when isomalto-oligosaccharides (IMO) were used as a prebiotic. Moreover, an oral administration of the combination of FS2 and IMO to the mice for 5 weeks increased the number of intestinal lactic acid bacteria and decreased the levels of serum total triglyceride, cholesterol, and low-density lipoprotein cholesterol. Therefore, the findings of the present study suggest that FS2 is functional and safe as a probiotic and can reduce blood cholesterol levels when taken along with IMO. [ABSTRACT FROM AUTHOR]