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BackgroundLiver cirrhosis results from chronic hepatitis, and is characterized by advanced fibrosis due to long-term hepatic inflammation. Cirrhosis ultimately leads to manifestations of jaundice, ascites, and encephalopathy, and increases the risk of hepatocellular carcinoma. Once cirrhosis is established, resulting in hepatic failure, no effective treatment is available. Therefore, novel therapies to inhibit disease progression of cirrhosis are needed. ObjectiveThe objective of this investigator-initiated clinical trial is to assess the safety and efficacy of autologous adipose tissue-derived regenerative (stem) cell therapy delivered to the liver via the hepatic artery in patients with liver cirrhosis. MethodsThrough consultation with the Japan Pharmaceuticals and Medical Devices Agency, we designed a clinical trial to assess a therapy for liver cirrhosis based on autologous adipose tissue-derived regenerative (stem) cells, which are extracted using an adipose tissue dissociation device. The primary endpoints of the trial are the serum albumin concentration, prothrombin activity, harmful events, and device malfunction. ResultsEnrollment and registration were initiated in November 2017, and the follow-up period ended in November 2019. Data analysis and the clinical study report will be completed by the end of March 2020. ConclusionsCompletion of this clinical trial, including data analysis, will provide data on the safety and efficacy of this novel liver repair therapy based on autologous adipose tissue-derived regenerative (stem) cells using an adipose tissue dissociation device. Trial RegistrationUMIN Clinical Trials Registry UMIN000022601; https://tinyurl.com/w9uqw3q International Registered Report Identifier (IRRID)DERR1-10.2196/17904

Objective: To clarify the role of N-methyl-D: -aspartate (NMDA) receptors upon [(14)C]acetate uptake in the rodent central nervous system (CNS), ibotenic acid (IBO) was infused into the right striatum of the rat brain. Methods: Autoradiograms of [(14)C]acetate uptake in the brain for 2 h following the infusion of IBO (10 microg/microl) were obtained in both non-treated and MK-801 (1 mg/kg, i.v.) pretreated rats. The effect of MK-801 on [(14)C]acetate uptake in the normal rat brain was also studied. Results: Infusion of IBO significantly decreased [(14)C]acetate uptake in the infused side of the striatum. The expression of monocarboxylate transporter-1 was not altered, suggesting that the activity of tricarboxylic acid (TCA) cycle in glial cells might be depressed. Pretreatment with MK-801 completely blocked the decreasing effect of IBO on [(14)C]acetate uptake. MK-801 also increased [(14)C]acetate uptake in the whole brain of normal rats. Conclusions: These results indicate the important roles of NMDA receptors on [(14)C]acetate uptake in the intact rat brain. [ABSTRACT FROM AUTHOR]

The sound generated by two square cylinders placed in a side-by-side arrangement in a uniform flow at low Mach numbers is studied by direct solution of the two-dimensional unsteady compressible Navier-Stokes equations. Special attention is paid to the effect of the spacing between the two cylinders on the generation mechanism of the sound. Results show that sound pressure fields as well as flow fields show different features depending on the spacing; six different wake patterns (nonsynchronized, antiphase and in-phase synchronized, flip-flopping, single bluff-body, and steady patterns) are observed and, depending on the wake pattern, sound pressure fields also show different features. Two types of bifurcation phenomenon are observed where two different wake patterns exist for the same spacing and either of the two patterns appears depending on an initial condition; different sound pressure fields appear in response to the wake patterns. Results also show that Curle's dipole solution does not predict well the direct numerical simulation results in the antiphase-synchronized pattern at a small spacing and the flip-flopping pattern, but that it gives a good approximation in the nonsynchronized, in-phase-synchronized, and single-bluff-body patterns. [ABSTRACT FROM AUTHOR]

Abdominal sonography is a routinely used noninvasive modality for screening and treatment of liver diseases. We attempted to establish a morphological sonographic staging to predict the severity of liver diseases with their consequent analysis with morphological staging of peritoneoscopy and histology. In all, 136 patients were enrolled for the final confirmation of disease state by peritoneoscopy and histology preceded by abdominal sonography. All patients were categorized from stage 0 to stage 5, depending on a proposed criterion of sonographic features based on surface pattern of liver and the appearance of internal echogenic bands relating to the irregularity of the liver texture. A digitized computer quantitation of histogram-based standard deviation (sd) values from different stages of sonographic images was analyzed, and their values were justified by correlation with the definite appearance of an internal echogenic band. The association of different sonographic stages with disease progression was also demonstrated by their relation with peritoneoscopy and histology. In all patients, the different sonographic staging results were significantly correlated with hepatic surface features of peritoneoscopic staging ( r = 0.939, P < 0.0001) graded from stage 0 to stage 5 and were also correlated with biopsy-proven staging of fibrosis ( r = 0.739, P < 0.0001). The greater sd values of histogram-based echo levels, as analyzed from digitized sonographic images of 90 patients, were associated with the appearance of internal echogenic bands ( P < 0.0001). Furthermore, the corresponding sds were significantly correlated with the qualitative staging of sonographic features ( r = 0.781, P < 0.0001), peritoneoscopy ( r = 0.786, P < 0.0001) and histology ( r = 0.779, P < 0.0001). We concluded that our proposed sonographic staging is well correlated with peritoneoscopic and histological staging of liver diseases, with only a small discrepancy, and can be used clinically to demonstrate the ongoing severity of liver diseases. [ABSTRACT FROM AUTHOR]

Competitive inhibition of 3H-raclopride (RAC) and 3H-N-methylspiperone (NMSP) binding against haloperidol, raclopride and NMSP was measured in the mouse striatum. 3H-RAC binding was more sensitive to competitive inhibition by all three compounds compared with 3H-NMSP. For example, 0.3 mg/kg of haloperidol resulted in 95% inhibition of 3H-RAC binding, however only 60% of inhibition of 3H-NMSP binding was found at the same dose of haloperidol. The cross-inhibition experiments using non-radioactive RAC or NMSP as competitors indicated different binding sites for 3H-RAC and 3H-NMSP in mouse striatum. Specifically, about 40% of 3H-NMSP binding was not displaced by treatment with a very high dose of raclopride (3 mg/kg). The time course of inhibition of the specific binding of 3H-RAC and 3H-NMSP were measured following i.p. injection of 0.5 mg/kg of haloperidol. No significant differences in the kinetics of haloperidol inhibition were observed between two radioligands. [ABSTRACT FROM AUTHOR]

Apparent muscarinic acetylcholine (mAch) receptor occupancy in mouse cerebral cortex, hippocampus, and striatum by scopolamine, an antagonist, and biperiden, a relatively selective M1 antagonist, was estimated with competitive binding studies using two different radioligands: 3H-N-methyl piperidyl benzilate (3H-NMPB) and 3H-quinuclidinyl benzilate (3H-QNB). Both radioligands labeled mAch receptors in these brain regions, and the relative regional distributions of the specific binding of 3H-NMPB in vivo paralleled the distribution of mAch receptors. 3H-NMPB binding in vivo was much more sensitive to direct competitive inhibition by scopolamine than was 3H-QNB. A similar discrepancy in sensitivity to competitors between 3H-NMPB and 3H-QNB was also observed when biperiden was used as a competitor, indicating that binding to different subtypes of the mAch receptor could not account for the observed differences in sensitivity to competition. An in vivo saturation study suggested that the apparent association rate constant (kon) of 3H-QNB binding might be changed by ligand concentration. The heterogeneity of the free ligand concentration in intact brain was assessed in relation to the ligand concentration dependency of the apparent association rate constant (kon) of 3H-QNB binding. This finding, together with the more favorable accumulation of 3H-NMPB in cerebral cortex, hippocampus, and striatum, leads us to conclude that 3H-NMPB, or its positron emitting counterpart, should be the more favorable radiotracer for the estimation of mAch receptor occupancy by cholinergic drugs in the brain. [ABSTRACT FROM AUTHOR]

The in vivo benzodiazepine (BZ) receptor occupancy in mouse brain was measured by employing 3H-flumazenil (FMZ) in comparison with 125I-iomazenil (IMZ), in order to obtain fundamental data for PET and SPECT studies, respectively. Mice were pretreated with various doses of flunitrazepam (FNP) 40 min prior to the tracer injection. At 20 min after the tracer injection, mice were killed by decapitation and receptor occupancy in cerebral cortex, hippocampus, cerebellum and pons-medulla were determined by the modified method reported by Goeders and Kuhar (1985). In all regions studied, BZ receptor occupancy by FNP measured with 3H-FMZ was significantly higher than that of 125I-IMZ. For instance, 0.1 mg/kg of FNP inhibited almost 50% of the specific binding of 3H-FMZ, on the other hand almost no inhibition of 125I-IMZ with the same dose of FNP was seen. This type of discrepancy was also observed in other types of benzodiazepine agonists, nimetazepam and triazolam, or inverse agonist ethyl-β-carboline-3-carboxylate (CCE). It is of interest that in in vitro binding study using brain homogenate, almost the same competitive inhibition curve was observed between these two radioligands, which strongly suggested that discrepancy of receptor occupancy is likely observed in intact brain. The mechanism for such discrepancy is unknown, although the different kinetics properties of these two radioligand seems to be an important factor. [ABSTRACT FROM AUTHOR]

The effect of acute pretreatment with MK-801 on the binding in vivo of both 3H-N-methylspiperone (NMSP) and 3H-raclopride (RAC) were compared in mice. In the striatum, MK-801 significantly increase 3H-NMSP binding, whereas no significant alterations in 3H-RAC binding were seen. In contrast, binding in the cerebral cortex of both radiolabeled ligands was not changed by MK-801. Kinetic analysis revealed that the increase in 3H-NMSP binding induced by MK-801 was due to an increase in the rate constant k3 (k3 = kon·Bmax). In vivo saturation experiments showed that Bmax for 3H-NMSP binding was relatively unchanged and an increase in the apparent association rate constant (kon) was the main reason for an increase in the k3 for 3H-NMSP binding. As 3H-RAC binding is known to be much more sensitive to competitive inhibition than is 3H-NMSP binding, these results strongly suggest that factors other than competition by endogenous dopamine may contribute to changes in receptor binding in vivo caused by NMDA-antagonism. [ABSTRACT FROM AUTHOR]

The effects of muscarinic agonist, oxotremorine (0.3 mg/kg), and antagonist, scopolamine (0.5 mg/kg), on in vivo [3H]raclopride (RAC) and [3H]N-methylspiperone (NMSP) binding were investigated. Following tracer administration to control or pretreated mice, binding potentials, and the rate constants k3 and k4 were determined by kinetic analysis. Oxotremorine resulted in a 70% increase in striatal RAC binding potential compared with controls. RAC and NMSP showed almost identical decreases in k3 (40%), whereas k4 for RAC was unexpectedly decreased by 64%. Scopolamine resulted in no significant changes in RAC or NMSP binding. These results, in combination with previous data obtained in reserpinized mice, show that 1) competition by endogenous ligand may not be the only factor influencing the magnitude of apparent in vivo receptor binding, and 2) interneuronal communication may be partly mediated by changes in the rates of ligand-receptor binding. [ABSTRACT FROM AUTHOR]

Background: Previous studies on the effect of interferon therapy on the incidence of hepatocellular carcinoma have not sufficiently assessed degree of liver fibrosis, a major risk factor for hepatocellular carcinoma.Objective: To evaluate the effect of interferon therapy on incidence of hepatocellular carcinoma, adjusting for risk factors, including the degree of liver fibrosis.Design: Retrospective cohort study.Setting: Seven university hospitals and one regional core hospital in Japan.Patients: 2890 patients with chronic hepatitis C who had undergone liver biopsy since 1986. Of these patients, 2400 received interferon and 490 were untreated.Measurements: The degree of liver fibrosis was assessed from stage F0 (no fibrosis) to stage F4 (cirrhosis). Response to interferon was determined virologically and biochemically. Screening for development of hepatocellular carcinoma was performed periodically during an average follow-up of 4.3 years. Effect of interferon therapy on the risk for hepatocellular carcinoma was analyzed by using Cox proportional hazards regression.Results: Hepatocellular carcinoma developed in 89 interferon-treated patients and in 59 untreated patients. Among untreated patients, the annual incidence of hepatocellular carcinoma increased with the degree of liver fibrosis, from 0.5% among patients with stage F0 or F1 fibrosis to 7.9% among patients with stage F4 fibrosis. The cumulative incidence in treated and untreated patients differed significantly for patients with stage F2 fibrosis (P = 0.0128) and for those with stage F3 fibrosis (P = 0.0011). In multivariate analysis, interferon therapy was associated with a reduced risk for hepatocellular carcinoma (adjusted risk ratio, 0.516 [95% CI, 0.358 to 0.742]; P < 0.001), especially among patients with sustained virologic response (risk ratio, 0.197 [CI, 0.099 to 0.392]), among those with persistently normal serum alanine aminotransferase levels (risk ratio, 0.197 [CI, 0.104 to 0.375]), and among those with alanine aminotransferase levels less than two times the upper limit of normal (risk ratio, 0.358 [CI, 0.206 to 0.622]).Conclusions: Interferon therapy significantly reducesthe risk for hepatocellular carcinoma, especially among virologic or biochemical responders. [ABSTRACT FROM AUTHOR]

The in vivo binding of [ H]N-methylspiperone (NMSP) and [ H]raclopride was compared in mice treated with reserpine (5 mg/kg, 24 hr prior to the tracer injection). With both radioligands, selective accumulation of radioactivity in the striatum following intravenous injection was observed, whereas a relatively low accumulation and a rapid decline in radioactivity in the cerebellum was seen. Reserpine significantly decreased [ H]NMSP binding in vivo, however it increased [ H]raclopride binding. By compartment model analysis, it was found that the decrease in [ H]NMSP binding was primarily due to the decrease in the association rate (K3) and the increase in [ H]raclopride was due to the decrease in the dissociation rate (K4) in vivo. As both Kd and Bmax of dopamine D2 receptors have been reported to be unaltered by reserpine, these results suggested that some unknown factors except Kd and Bmax which influence on in vivo binding of receptors might be changed by reserpine. These results revealed that it is of importance to measure kinetics of ligand-receptor binding in vivo rather than static analysis. These two different types of radioligands can be combined to reveal functional roles of dopamine receptor in vivo, especially in the study of the human brain with positron emission tomography (PET). [ABSTRACT FROM AUTHOR]