Synthesis and necrosis target of necrosis-avid MRI contrast agent Gd-DO3A-rhein / 中国药科大学学报

The purpose of this study was to synthesize and evaluate the necrosis target of MRI contrast agent based on rhein.The novel ligand 10-{ [6-(1,8-dihydroxyanthraquinone-3-carboxamido) hexyl] amino} acetyl-1,4,7,10-tetraazacyclododecan-1,4,7-triacetic acid (DO3A-rhein) was synthesized by two-step acylation and two-step deprotection.The paramagnetic contrast agent gadolinium 10-{ [6-(1,8-dihydroxyanthraquinone-3-carboxamido) hexyl] amino} acetyl-1,4,7,10-tetraazacyclododecan-1,4,7-triacetate (Gd-DO3A-rhein) was obtained by coordination of Gd3+ with the synthesized ligand.Its necrosis affinity was evaluated by liver infarction and muscular necrosis on rat models.The MRI was performed before administration of Gd-DO3A-rhein and during 0 h to 12 h after administration of Gd-DO3A-rhein (0.1 mmol/kg),respectively,and Gd-DOTA was used as control.After MRI scanning,rats were sacrificed and necrotic tissues were stained using triphenyltetrazolium chloride (TTC) and hematoxylin-eosin (HE).MRI images of liver infarction and muscular necrosis on rat models showed significantly enhanced signal intensity compared with normal tissues.The contrast ratios of necrotic liver/normal liver were 1.61 ±0.14 and 2.36 ±0.20 at 3 h and 12 h postinjection of Gd-DO3A-rhein (0.1 mmol/kg) respectively,demonstrating a significant difference compared with pre-administration of Gd-DO3A-rhein (1.16 ±0.10;P ＜ 0.05).The same results were obtained from necrotic muscles.These findings suggested that Gd-DO3A-rhein possessed the necrosis target and imaging capability of necrotic tissues.

A Case Report of Severe Preeclampsia with HELLP Syndrome and Hepatic Infarction / 대한산부인과학회잡지

Liver hematomas, infarction and ruptures complicated with preeclampsia are fatal to pregnant woman and fetus. So, close observation and proper diagnosis are demanded for treatment. Although the incidence of HELLP syndrome in severe preeclampsia and eclampsia woman is about 20%, liver rupture and infarction complicated with HELLP syndrome were reported very rarely in 1/15,000. Of course, liver rupture and infarction could be complicated with normal pregnant women, but the incidence of liver rupture and infarction complicated with HELLP syndrome was higher. Suspicious earliest physical findings of liver rupture and infarction are tenderness and rebound tenderness of right upper quadrant of abdomen. Radiologic evaluations such as liver USG, CT, MRI and angiography would be chosen for proper diagnosis. Treatment of liver rupture and infarction was varied from conservative treatment to surgical treatment like liver transplantation when bleeding was not controlled. The liver infarction complicated with preeclampsia was unusual and fatal to pregnant woman and fetus, so we report a case of liver infarction occured in HELLP syndrome patient with a brief review of literatures.

Hepatic Infarction Complicating Acute Pancreatitis: A Case Report

Hepatic infarction is relatively uncommon and is usually related to surgery or interventional procedures. Pancreatitis-associated hepatic infarction has not been reported in the literature, and we now describe a case of hepatic infarction in a 31-year-old man with acute pancreatitis. Initial CT scanning demonstrated an enlarged pancreas with multifocal fluid collection, and a large wedge-shaped low attenuation lesion was seen in the right lobe of the liver along with thrombi in the posteroinferior branch of the right portal vein. Hepatic arteri-ography and SMA portography revealed a pseudoaneurysm in the right hepatic artery, thrombi in the main portal vein and its posteroinferior branch, and perfusion defects confined to S6 of the liver.

Hepatic Infarction in HELLP Syndrome: A Case Report

Hepatic infarction is a rare but potentially life-threatening complication of pregnancy-associated preeclampsia or HELLP (hemolysis, elevated liver function tests, low platelets) syndrome. We present a case of hepatic infarction subsequent to HELLP syndrome and occurring during the immediate postpartum, and the associated radiologic findings. Sonography revealed poorly defined hypoechoic zones of infarctioin. Computed tomography(CT) demonstrated the characteristic features of nonenhancing, low attenuation, relatively well-defined, wedge shaped or geographic hepatic lesions, without mass effect.

A Case of Liver Infarction after a Histoacryl R Injection for Duodenal Ulcer Bleeding / 대한소화기내시경학회지

Injection of the tissue adhesive Histoacryl (N-butyl-2-cyanoacrylate, enbucrilate) has been more effective than conventional sclerosants in the treatment of active upper G-I bleeding. Histoacryl is an effective sclerosant that is polymerized immediately after contact with blood, and has been used for the treatment of bleeding gastric and esophageal varices. We present here a case of infarction of the caudate lobe that developed after an injection of a Histoacryl -Lipiodol mixture for the hemostasis of duodenal ulcer bleeding.