Construction and expression of circular RNA in vitro / 中国生物制品学杂志

@#Objective To construct encoding RNA that can be cyclized in vitro by using the permuted intron exon(PIE)strategy in the maturation process of eukaryotic mRNA,and transfect it into HEK-293T cells for expression.Methods The sequences of 5'and 3'cyclic arms with groupⅠcatalytic intron,the internal ribosome entry sites(IRES)of Coxsackievirus B3(CVB3)and the target gene were selected to construct the template plasmid. Linearization plasmid template obtained by PCR was used to synthesize linear RNA through in vitro transcription(IVT),which then started in vitro cyclization(IVC)by the addition of cyclization reagents to obtain circular RNA(circRNA). RNA cyclization was confirmed by agarose gel electrophoresis and ribonuclease R(RNase R)digestion. HEK-293T cells were transfected with circRNAs respectively carrying enhanced green fluorescent protein(EGFP),firefly luciferase(Fluc),and influenza virus hemagglutinin(HA)IVR-180 genes,to verify their expression with in vitro.Results With RNA cyclization,the main band of agarose gel electrophoresis became smaller and small fragments appeared. After RNase R digestion,only some circRNA bands remained.HEK-293T cells transfected with EGFP-circRNA showed significant green fluorescence under the fluorescence microscope.The Fluc expression values of HEK-293T cells transfected with Fluc-circRNA were on average 20 times higher than non cyclized RNA,and the relative light unit(RLU)scaled up with the increase of Fluc-circRNA transfection dose. Western blot analysis showed that HA protein was successfully expressed in HEK-293T cells transfected with HA-circRNA.Conclusion In this study,linear RNA was successfully cyclized in vitro and different proteins were expressed,which lays a foundation of the research of new influenza vaccines and mRNA vaccines.

Rare case of concomitant juxtarenal aortic aneurysm and type 1 Inferior Vena Cava duplication: -intraoperative challenges to avoid catastrophe / Caso raro de aneurisma de aorta justarrenal e duplicação do tipo 1 concomitantes na veia cava inferior - desafios intraoperatórios para evitar catástrofes

Abstract Duplication of the inferior vena cava is a rare congenital anomaly, with an incidence of 0.2-3%. Despite being asymptomatic, anomalies of IVC are important in aortoiliac and retroperitoneal surgeries. Preoperative CT imaging is essential to identify any IVC anomaly and to prevent unexpected hemorrhage during surgery. Here, we report a case of a juxtarenal abdominal aortic aneurysm in which we encountered a type I IVC duplication anomaly intraoperatively while performing transperitoneal aneurysmorrhaphy and took precautions to avoid any iatrogenic injuries to either of the two trunks or the pre-aortic trunk of the anomalous duplicate IVC.

Resumo A duplicação da veia cava inferior (VCI) é uma anomalia congênita rara com incidência de 0,2 a 3%. Apesar de assintomáticas, anomalias da VCI são importantes em cirurgias aortoilíacas e retroperitoneais. A imagem da tomografia pré-operatória é essencial para identificar qualquer anomalia de VCI e para evitar hemorragia inesperada durante a cirurgia. Relatamos um caso de aneurisma de aorta abdominal justarrenal, no qual encontramos uma anomalia de duplicação de VCI do tipo 1 intraoperatório enquanto realizávamos correção cirúrgica de aneurisma transperitoneal. Por isso, tomamos a precaução para evitar qualquer lesão iatrogênica nos dois troncos e no tronco pré-aórtico de VCI duplicada anômala.

Plethysmographic variability index as a tool to assess fluid responsiveness in critically ill patients: a correlation study with inferior vena cava distensibility index

Background: In critically ill patients in the intensive care unit (ICU), early aggressive fluid replacement is the cornerstone of resuscitation. Traditionally employed static measures of fluid responsiveness have a poor predictive value. It is therefore imperative to employ dynamic measures of fluid responsiveness that take into account the heart lung interactions in the mechanically ventilated patients. The main objective of this study was to evaluate the reliability of one such non-invasive dynamic index: Plethysmographic variability index (PVI) compared to the widely employed Inferior vena cava distensibility index (dIVC).Methods: Seventy-six adult patients admitted at a tertiary care mixed ICU, who developed hypotension (MAP<65mmHg), were included in the study. PVI was recorded using the MASIMO-7 monitor and dIVC measurements done using Terason ultrasound. Based on the dIVC measurement threshold of 18%, the patients were classified into volume responders and non-responders. The hemodynamic, PVI and dIVC measurements were recorded at pre specified time points following a fluid challenge of 20 ml/kg crystalloid infusion.Results: Baseline PVI values were significantly higher in the responders (22.3±8.2) compared to non-responders (10.1±2.9) (p<0.001) and showed a declining trend at all time points in the responders. Similar declining trend was observed in the dIVC measurements. Overall, the Pearson correlation graph showed strong correlation between dIVC and PVI values at all time points (r=0.678, p=0.001). The ROC curve between the dIVC and PVI values revealed that Baseline PVI (Pre PVI) >15.5% discriminated between responders and non-responders with a 90.2% sensitivity and 75% specificity with an AUC of 0.84 (0.72-0.96) (p<0.001).Conclusions: There is good correlation between PVI values and measured dIVC values at baseline and following a fluid challenge. Thus, PVI may be an acceptable, real time, continuous, surrogate measure of fluid responsiveness in critically ill patients.

Budd Chiari syndrome due to inferior vena cava web complicating pregnancy in patient with bad obstetric history: an interesting case

Presenting an unusual case of 27 years old female who presented at 18 weeks of pregnancy with second trimester bleeding per vaginum. Patient had history of recurrent abortions on examination was found to have hypertension and thrombocytopenia. Usg done revealed severe oligohydramnios. Patient was managed conservatively but aborted spontaneously at 22 weeks of gestation. Post-abortionl on day 2 patient developed abdominal distension and liver function tests were found to be deranged. USG and CT abdomen and pelvis was done, which revealed Budd chiari syndrome due to inferior vena cava (IVC) web. This extremely rare condition is characterized by obstruction of inferior vena cava by membrane or fibrous band. This condition is diagnosed by radiological techniques which in our patient revealed classical findings of caudate lobe hypertrophy, non-visualization of hepatic veins, moderate hepatomegaly and spleenomegaly and multiple collaterals. Esophagogastroduodenoscopy done which revealed large varieces for which endoscopic variceal ligation was done. IVCgram and IVC plasty was done by interventional radiology department 6 weeks after abortion. The aim of this case report is to highlight an extremely rare cause of Budd Chiari syndrome and IVC web in patient with recurrent abortion with spleenomegly leading to thrombocytopenia. It is important to rule out other differential diagnosis in these patients like APLA, ITP.

A Man with Gastrointestinal Bleeding and Pleuritic Chest Pain

Cancer and thromboembolism relationship has been acknowledged for many years. Pulmonary embolism is associated with significant morbidity and mortality in patients with cancer. A more significant line of research needs to be done to investigate thromboembolism in cancer. Ultrasonography is a reliable diagnostic bedside test for PTE in critically ill and immobile patients. In this review, we want to display a case with both obstructive and hypovolemic shock and how ultrasonography can assist us to diagnose it.

Radical Resection of Primary Leiomyosarcoma of Inferior Vena Cava

@#Leiomyosarcoma of the Inferior Vena Cava (IVC) is a rare soft tissue tumour which accounts for only 0.5% of all soft tissue sarcomas. The patients usually presented with non specific clinical signs and often diagnosed at advanced stage. We reported a case of a 58-year-old lady who presented with right sided abdominal pain for 6 months. CT scan showed large Level 2 IVC tumour which encased the right renal vein and had no clear plane of demarcation with the caudate lobe of the liver. She underwent radical resection of the IVC tumour with the right kidney removed en bloc. Vascular reconstruction was not performed as established collateral veins present. She was nursed in Intensive Care Unit for 2 days and discharged well at day 5 post operatively. Histopathological examination results revealed leiomyosarcoma of IVC.

Preoperative inferior vena cava filter implantation to prevent pulmonary fat embolism in a patient showing renal angiomyolipoma extension into the renal vein: A case report and literature review / Journal of Rural Medicine

Renal angiomyolipoma without local invasion is usually considered benign entity, however, it may extend into the renal vein or the inferior vena cava. Renal angiomyolipoma with venous extension should be treated; however, surgical complications such as iatrogenic pulmonary fat embolism remain a serious concern. We present a case of a 66-year-old Japanese woman without tuberous sclerosis in whom a right-sided renal tumor was incidentally detected on ultrasonography during a health check-up. Further evaluation showed that the tumor extended into the renal vein, and she was successfully treated using preoperative inferior vena cava filter placement and radical nephrectomy. An inferior vena cava filter can prevent catastrophic pulmonary fat embolism during nephrectomy.

The "Fisherman`s Waders" Sign on Bone Scan: A Case Report.

Fisherman`s Waders sign is caused by several medical conditions including venous thrombosis, portal hypertension and lymphoma. It is characterized by increased uptake of radiotracer in soft tissues below the mid-thorax level with normal tracer clearance above that level in bone scan. This case reports the Fisherman`s Waders sign in a patient with lymphoma complicated by Inferior Vena Cava (IVC) obstruction by the aid of CT scan and bone scan. Also, literature review of this rare sign is performed in this report. This sign can be found incidentally on bone scan and high level of awareness by the nuclear medicine physicians may alert the treating team for the underlying diagnosis.

Effects from right hepatic vein and inferior vena cava position on mechanism of Budd-Chiari syndrome / 医用生物力学

Objective To investigate the effects from various angles between inferior vein cava (IVC) and right hepatic vein (RHV) on pathogenesis of IVC membranous obstruction for patients with Budd-Chiari syndrome (BCS). Methods The normal 3D solid model of IVC and hepatic veins was reconstructed using MRI angiograms, and the angle between IVC and RHV was 56°. The two models with IVC-RHV angle of 30° and 120° were established, respectively, based on the reconstructed model. The distributions of wall shear stress, static pressure and blood velocity of the 3 models were calculated by numerical simulation. Results The wall shear stresses, static pressure and blood velocity of the 3 models displayed significantly differences. Compared with the normal 56° model, the 30° model showed a higher wall pressure and lower blood velocity, while the 120° model presented a lower wall pressure and blood velocity with turbulence of blood flowing, and such hemodynamic changes would increase the risk of thrombosis. The 56° model had the fastest blood velocity. Conclusions Numerical simulation of the flow in IVC and RHV can promote to discover the pathogenesis of BCS, and help to predict risk of IVC membranous obstruction, and provide theoretical references for BCS treatment.

Management of Inferior Vena Cava Injury in a Non Specialized Tertiary Hospital-a Case Report.

Abdominal vascular injury are among the most challenging and lethal injuries in the traumatized patients. Inferior vena cava (IVC) is the most frequently injured vein during the blunt or penetrating trauma. Ligation of IVC, venorrhaphy, venoplasty, end to end anastomosis, endovascular stenting or graft interposition should be considered in selected cases. However most of the procedures require special setting and surgical team. Relatively simple procedure e.g. venorrhaphy produces narrowing of lumen in many cases. Ligation of IVC may result in thrombosis and embolism thus increases morbidity of patients. Here, in the present case the authors report a patient with IVC injury repaired by venoplasty (cavaplasty) with great saphenous vein patch in a non specialized tertiary hospital and it can be performed by a team led by general surgeon.

Effect of environmental humidity and ventilation rate on the microenvironmental humidity and ammonia concentration in individually ventilated cages (IVC) / 中国比较医学杂志

Objective To assess the changes of humidity and ammonia concentration in rat and mouse individually ventilated cages (IVC) based on macroenvironmental humidity and air ventilation changes .Methods Three kinds of rat and mouse IVC in barrier facilities were set as research objective .The changes of micronvironmental humidity and ammonia concentration at 40 times/h and 60 times /h air changes were detected continuously for a 7-days-cycle relative to low (40%), moderate (50%), and high (60%) macroenvironmental humidity.Results Mouse and rat IVC with 40 times /h air changes under low macroenvironmental humidity condition , mouse IVC with 40 times/h and rat IVC with 60 times/h air changes under moderate macroenvironmental humidity condition , mouse IVC with 60 times /h air changes under high macroenvironmental humidity condition , basically meet the GB14925-2010 requirements.While under macroenvironmental high humidity condition, the microenvironments of rat and mouse IVC with 60 times/h air changes could not satisfy the requirements.Conclusions The environmental humidity and ventilation frequency are the key index of IVC microenvironment.Only on the basis of external environment conditions to set up reasonable IVC ventilation frequency in order to better maintain the IVC microenvironment so that to achieve the goal of effective management .

Comparison of growing male Balb/c mice living in IVC and open-top cages in barrier / 中国比较医学杂志

Objective To accumulate operating experience and background data for housing mice in individually ventilated cages (IVC).Methods 5 weeks old Balb /c male mice(n =80) were allocated to 8 groups(n =10), which then housed in 5 or 10 per cage in 3 IVC systems(30,50 and 70 air changes /h, respectively) and one open-top cages (OTC) shelf for 8 weeks.Body weight was assessed at the initial date and every week .By the end of the experiment, necropsy was done and organs were separated and weighed .Excelland SPSS software statistics was made to draw the growth curve, and comparative analysis of body weight and organ coefficients was performed between the groups .Results 1.The growth curves of 5-mice per cage were better than that of 10-mice per cage.2.In the IVC groups, the curves trend and fluency of 50 air changes /h were more similar to that of 5-mice housed OTC group.3.The previously mentioned differences were statistically not significant (P >0.05).4.In the liver coefficients, there was a statistically significant difference between the 10-mice housed OTC group and 5-mice housed IVC group with 30 air changes /h(P 0.05).Conclusions Based on the results of this study, the air change frequency on 50 times per hour and keeping 5 Balb/c mice per cage is recommended as the best condition for mouse housing in IVC .

Radiological interventions in HVOTO – Practical tips.

Hepatic venous outflow tract obstruction (HVOTO) comprises of constellation of disorders causing obstruction of hepatic venous outflow or suprahepatic inferior vena cava (IVC) or both and leading to increased hepatic sinusoidal pressure and portal hypertension. Clinical presentation in HVOTO includes both acute onset or chronic insidious onset of the disease and predominant clinical manifestations consist of ascites, hepatomegaly, and portal hypertension. IVC/hepatic vein (HV) web or thrombosed hepatic veins replaced by fibrotic constriction or thrombus in suprahepatic IVC is encountered as the pathogenic process at such obstructions. Due to advances in radiologic techniques there has been a changes in the management protocol of HVOTO with surgery or liver transplantation reserved for patients not suitable for radiological interventions or requiring liver transplantation. The present article reviews the techniques of various radiological interventions in HVOTO and their efficacy.

Experience without using venoveno bypass in adult orthotopic liver transplantation / 대한마취과학회지

BACKGROUND: Venoveno bypass (VVB) has been used to achieve hemodynamic stability and decrease the incidence of renal dysfunction. However, VVB has many complications. The purpose of this study is to verify the safety of total clamping of the suprahepatic inferior vena cava (IVC) without VVB during orthotropic liver transplantation (OLT) in terms of anesthetic management. METHODS: Twenty-five patients without preoperative renal dysfunction who underwent primary OLT were enrolled in this study. Hemodynamic data and blood gas measurements were collected 1 hour after incision, 30 minutes after IVC total clamping and 30 minutes after reperfusion. Postoperative laboratory data, including blood urea nitrogen (BUN), creatinine (Cr) and glomerular filtration rate (GFR), were assessed at postoperative day (POD) 0-7, 30, 90, 180 and 1 year. RESULTS: Mean blood pressure was well maintained during IVC total clamping with infusion of inotropics. There was no case of severe acidosis (pH < 7.2) during the anhepatic period. The immediate postoperative Cr and GFR were not significantly different from those of the preoperative values. BUN increased from POD 1 and decreased after POD 6, while Cr increased at POD 90 only. CONCLUSIONS: In patients without preoperative renal dysfunction, when IVC was totally clamped, VVB does not need to be routinely performed to maintain hemodynamics during the anhepatic phase and renal function after OLT.

IVC filter: Review.

Thrombo-embolic disease continues to be the paramount cause of morbidity as well as mortality in those afflicted despite amelioration in diagnostic imaging and anticoagulation regimens. Sometimes, standard medical therapy for thrombo-embolism is contraindicated, for it results in complications, or fails to adequately protect patients from pulmonary embolism (PE). These patients are treated by insertion of inferior vena cava (IVC) filters. Although IVC filters diminish long-term risk of pulmonary embolism (PE), they are associated with increased risk of IVC thrombosis and lower-extremity deep venous thrombosis (DVT) as compared to anticoagulation alone. Despite their prolonged use for more than 40 years, there are limited randomized clinical trials, comparing oral anticoagulation with IVC filters. Also, data on long term use of IVC filter is scarce. This article will address traits of an ideal IVC filter, different types of filters available and complications involved in the use of the diffrent IVC filter.

Temporary Inferior Vena Cava Filter Placement in Patients withDeep Vein Thrombosis

PURPOSE: To evaluate the effectiveness and complications of temporary inferior vena cava filters in deep vein thrombosis. METHOD: We retrospectively evaluated the clinical data of 35 patients who underwent percutaneous insertion of a temporary, retrievable IVC filter during treatment of deep vein thrombosis between 2003 and 2006. A Tulip(R) was used in 25 patients, and an OptEase(R) was used in 10 patients. Indications for filter insertion included thrombolytic therapy (n=29), long floating IVC thrombosis (n=4), and pulmonary thromboembolism history with recurrent venous-thromboembolism (n=2). Deep vein thrombosis was treated with an endovascular procedure in 33 patients and anticoagulation therapy in 2 patients. RESULT: Complete symptom resolution was achieved in all patients. The temporary IVC filters were successfully retrieved in 28 of 35 patients (mean duration of filter placement: 9.57 days), but retrieval failed in 7 patients (thrombus in filter, 3 cases; remnant IVC thrombosis, 1 case; remnant iliac vein thrombosis/venous stenosis in high risk patient, 2 cases; in-hospital mortality due to underlying heart disease, 1 case). There were no cases of pulmonary embolism and no serious IVC filter-related complications during insertion, retraction, or remnant IVC filter follow-up. CONCLUSION: Temporary, retrievable IVC filters were effective in the prevention of pulmonary embolism. Further investigations are necessary to determine long-term outcome data for filters left in place.

A Case of Primary Leiomyosarcoma of the Liver Presenting with Acute Bleeding / 대한소화기학회지

Leiomyosarcoma is a rare tumor of the liver. It usually arises from many other organs including uterus, gastrointestinal tract, retroperitoneum, and soft tissues. Primary hepatic leiomyosarcoma progresses very slowly and is not associated with chronic liver disease. When the tumor is detected early enough to be treated by operation, the prognosis is favorable. While several cases of primary hepatic leiomyosarcoma have been reported in Korea, there was no case associated with acute bleeding. We report a 80-year old male patient with huge primary hepatic leiomyosarcoma, who presented with acute bleeding and IVC obstruction. The patient was treated by embolization and IVC stenting.

Placement of an Inferior Vena Cava Filter usingTransabdominal Duplex Scan Guidance: Report of Two Cases

An inferior vena cava (IVC) filter is a useful treatment to prevent a pulmonary embolism (PE) in patients with DVT. Since the introduction of IVC filters more than 30 years ago, there has been a steady improvement in the design, ease and safety of the delivery system. The use of a temporary filter has also increased as performing thrombolysis and thrombectomy has increased. Today all of the commonly used filters can be placed via a peripheral vein by using the standard percutaneous Seldinger (Ed note: check the spelling) technique. However this typically requires fluoroscopy, intravenous contrast agents, radiation exposure and transport of the patient to the interventional or operating suite. As the multiple trauma injured or critically-ill intensive care unit patients often require inotropic and ventilator support, transporting these patients to these facilities can be hazardous. The following report describes two cases of VTE patients who underwent percutaneous placement of an IVC filter with using duplex ultrasound guidance. Identification of the renal vein and artery is important to decide the infrarenal level. The first case was an 84 years female with right ilio-femoral DVT and pulmonary embolism. To prevent recurrence of PE, we decided to insert an IVC filter. The second case was a 47 years female with right femoral DVT together with left pulmonary embolism and infarction. She also had thrombocytopenia, which is a contraindication for anticoagulation. IVC filter insertion can be safely performed under ultrasound guidance. This technique will reduce the risk and complexity of inserting an IVC filter in selected multiple injured trauma patients.

Rupture of the Inferior Vena Cava Associated with Complete Thrombotic Occlusion after Placement of a Caval Filter / 日本心臓血管外科学会雑誌

We reported a case of a 41-year-old woman with a ruptured inferior vena cava (IVC): this was revealed by a swelling in the lower extremities and bursting pain. This condition was diagnosed on laparotomy. The operation involved repair of the IVC tear and thrombectomy. In this patient, a permanent IVC filter had been placed previously due to deep vein thrombosis. The head of the IVC filter had been covered by a fibrous membrane. Entrapment of the thrombus in the IVC filter might have resulted in high venous pressure in the IVC and a subsequent predisposition of the IVC to rupture. The swelling in the legs diminished slowly, and the patient was discharged with oral anticoagulation and elastic stockings. Despite clinical features and computed tomography findings, the physician's awareness of this disease remains the most important factor for early treatment.

A Comparative Genome-Wide Analysis of GATA Transcription Factors in Fungi

GATA transcription factors are widespread eukaryotic regulators whose DNA-binding domain is a class IV zinc finger motif in the form CX(2)CX(17-20)CX(2)C followed by a basic region. In fungi, they act as transcriptional activators or repressors in several different processes, ranging from nitrogen source utilization to mating-type switching. Using an in-house bioinformatics portal system, we surveyed 50 fungal and 9 out-group genomes and identified 396 putative fungal GATA transcription factors. The proportion of GATA transcription factors within a genome varied among taxonomic lineages. Subsequent analyses of phylogenetic relationships among the fungal GATA transcription factors, as well as a study of their domain architecture and gene structure, demonstrated high degrees of conservation in type IVa and type IVb zinc finger motifs and the existence of distinctive clusters at least at the level of subphylum. The SFH1 subgroup with a 20-residue loop was newly identified, in addition to six well-defined subgroups in the subphylum Pezizomycotina. Furthermore, a novel GATA motif with a 21-residue loop (CX(2)CX(21)CX(2)C, designated 'zinc finger type IVc') was discovered within the phylum Basidiomycota. Our results suggest that fungal GATA factors might have undergone multiple distinct modes of evolution resulting in diversified cellular modulation in fungi.