Successful Treatment of Subcapsular Hepatic Hemorrhage Concomitant with Diffuse Arterioportal Shunt by Transcatheter Arterial Embolization.

We present a case of subcapsular hepatic hemorrhage with a concomitant diffuse arterioportal shunt successfully treated with transcatheter arterial embolization. An 85-year-old man with duodenal carcinoma developed hemorrhagic shock three days after pancreaticoduodenectomy. Contrast-enhanced computed tomography revealed an extensive subcapsular hepatic hematoma with extravasation. At the same time, diagnostic angiography showed innumerable foci of petechial extravasation from disrupted isolated arteries and the right inferior phrenic artery. In addition, a comorbid diffuse arterioportal shunt in the hematoma area was detected. We performed transcatheter arterial embolization on the peripheral side of the hepatic artery while preserving the proximal portion. Subsequently, the transcatheter arterial embolization for the right inferior phrenic artery was also performed. Complete hemostasis and occlusion of the arterioportal shunt were successful without fulminant liver failure.

Spontaneous regression of a pulmonary arteriovenous malformation during endocrine therapy for breast cancer.

A 52-year-old woman with right-sided breast cancer was diagnosed with a left pulmonary arteriovenous malformation (PAVM) by computed tomography (CT). Percutaneous embolization of the PAVM after treatment of the breast cancer was scheduled to prevent a paradoxical embolic event. She underwent lumpectomy, followed by systemic chemotherapy in combination with tangential field radiotherapy. Subsequently, she received endocrine therapy with tamoxifen, anastrozole, and exemestane, sequentially. There was no change in the PAVM on CT performed during the administration of anastrozole. Subsequently, CT performed five months after switching to exemestane showed obviously decreased size of the affected vessels, and the sac had almost disappeared. To the best of our knowledge, this is the first case report to describe the spontaneous regression of a PAVM during endocrine therapy for breast cancer.

Uncovering the protein translocon at the chloroplast inner envelope membrane.

Chloroplasts require protein translocons at the outer and inner envelope membranes, termed TOC and TIC, respectively, to import thousands of cytoplasmically synthesized preproteins. However, the molecular identity of the TIC translocon remains controversial. Tic20 forms a 1-megadalton complex at the inner membrane and directly interacts with translocating preproteins. We purified the 1-megadalton complex from Arabidopsis, comprising Tic20 and three other essential components, one of which is encoded by the enigmatic open reading frame ycf1 in the chloroplast genome. All four components, together with well-known TOC components, were found stoichiometrically associated with different translocating preproteins. When reconstituted into planar lipid bilayers, the purified complex formed a preprotein-sensitive channel. Thus, this complex constitutes a general TIC translocon.

In vivo studies on the roles of two closely related Arabidopsis Tic20 proteins, AtTic20-I and AtTic20-IV.

Protein translocation across the inner envelope of plastids is mediated by the TIC (translocon at the inner envelope membrane of chloroplasts) protein translocation machinery. Tic20 has been shown to function as a central component of TIC machinery. The Arabidopsis genome encodes four Tic20 homologous proteins, AtTic20-I, AtTic20-II, AtTIC20-IV and AtTic20-V, among which only AtTic20-I has been extensively characterized and demonstrated to be essential for protein import into chloroplasts. AtTic20-I is more closely related to AtTic20-IV than to AtTic20-II or AtTic20-V, whereas AtTic20-II and AtTic20-V show higher similarities to each other than to AtTic20-I or AtTic20-IV. Here, we show that AtTic20-IV is expressed mainly in roots whereas AtTic20-I is more abundant in shoots than in roots. Although AtTic20-IV is dispensable for viability in the wild-type background, interestingly, expression of AtTic20-IV is markedly elevated in both shoots and roots in the tic20-I knockout mutant that exhibits severe albino and seedling-lethal phenotypes. The albino tic20-I seedlings do not accumulate any of the photosynthetic proteins analyzed, but the plastids can still import non-photosynthetic housekeeping proteins. This residual import ability of the tic20-I mutant can be attributed to partial compensation by the elevated expression of AtTic20-IV, since a double knockout mutant of AtTic20-I and AtTic20-IV exhibits more severe embryonic lethality. Further overexpression of AtTic20-IV in the tic20-I mutant can only marginally rescue the accumulation of photosynthetic proteins in the albino seedlings. These data demonstrate an absolute requirement of at least one of the two closely related Tic20 proteins in protein translocation across the inner envelope of plastids and also suggest their distinct substrate preferences.

A 1-megadalton translocation complex containing Tic20 and Tic21 mediates chloroplast protein import at the inner envelope membrane.

Chloroplast protein import is mediated by two hetero-oligomeric protein complexes, the Tic and Toc translocons, which are located in the inner and outer envelope membranes. At the inner membrane, many Tic components have been identified and characterized, but it remains unclear how these Tic proteins are organized to form a protein-conducting channel or whether a stable Tic core complex that binds translocating preproteins exists. Here, we report the identification of a 1-megadalton (MD) translocation complex as an intermediate during protein translocation across the inner membrane in Arabidopsis thaliana and pea (Pisum sativum). This complex can be detected by blue native PAGE using the mild detergent digitonin without any chemical cross-linkers. The preprotein arrested in the 1-MD complex can be chased into its fully translocated form after a subsequent incubation. While Tic20 and Tic21 appear to be involved in the 1-MD complex, Tic110, a well-characterized Tic component, exists as a distinct entity from the complex. Several lines of evidence suggest that the 1-MD complex functions in between the Toc and Tic110-containing complexes, most likely as a protein-conducting channel at the inner envelope.