OBJECTIVETo observe the influence of electroacupuncture (EA) on indocyanine green (ICG) metabolism in the liver and the action mechanism of acupuncture for hepatic regulation.

METHODSForty Kunming mice were randomly divided into an EA group and a control group, 20 cases in each one. Combined with classical hepatic metabolism test of ICG, after tail vein injection of ICG, twenty mice were treated with EA at "Zusanli" (ST 36) for 20 min. The ICG fluorescence intensity and distribution in the liver were observed with animal in vivo fluorescence imaging apparatus during 20 min of EA and 60 min of needle withdrawal. Twenty mice, taken as control group, were treated with ICG injection and no EA. The differences of fluorescence intensity and distribution in both groups were compared.

RESULTS(1) There was blocking and gathered fluorescent sign in both groups when ICG was injected immediately. With the extension of observation time, the fluorescence brightness and area were increased until 30 min of injection. This was in accordance with known metabolism activities of ICG in the liver. (2) At 10 min and 20 min of EA and after needle withdrawal, compared with the control group, the fluorescence intensity in the liver of the EA group was weaker and the distribution area was smaller. (3) According to quantitative statistics of fluorescence intensity, at each time point of treatment, the value in the control group was higher than that in the EA group, which appeared regularly all along. As for the total mean difference of ICG fluorescence intensity at all time points, there was statistical difference between the two groups (P < 0.05).

CONCLUSIONEA could reduce fluorescence intensity and lasting time of ICG, indicating that EA accelerates metabolic process of ICG in the liver. Also it is feasible to apply animal in vivo fluorescence imaging technology to the principle research of acupuncture effect.

Animals ; Electroacupuncture ; Female ; Fluorescent Dyes ; chemistry ; metabolism ; Indocyanine Green ; chemistry ; metabolism ; Liver ; chemistry ; metabolism ; Male ; Mice ; Whole Body Imaging

OBJECTIVETo determine the effect of pneumoperitoneum on liver indocyanine green (ICG) metabolism and the hepatic blood flow in normal and cirrhotic rats.

METHODSThirty male Wistar rats were randomized into five groups: normal anaesthesia group, normal laparotomy group, normal pneumoperitoneum group, cirrhosis + anaesthesia group, and cirrhosis + pneumoperitoneum group. Liver cirrhosis was induced in two groups by injecting carbon tetrachloride subcutaneously plus drinking 5% alcohol. ICG clearance tests were performed in all the rats.

RESULTSThe ICG level in the normal laparotomy group (0.662 micro g/ml) was higher than that in the normal anesthesia group (0.645 micro g/ml), but the difference was not significant (P > 0,05). The ICG level in the normal pneumoperitoneum group (0.967 micro g/ml) was significantly higher than that in the normal anesthesia and normal laparotomy groups (P < 0.05). The ICG levels in two cirrhotic groups were significantly higher than those in the other three groups (P < 0.05). The ICG level in the cirrhosis + pneumoperitoneum (1.348 micro g/ml) was significantly higher than that in the cirrhosis + anesthesia group (1.198 micro g/ml) (P < 0.05).

CONCLUSIONSDuring laparoscopic surgery, pneumoperitoneum could decrease the liver ICG clearance rate and the hepatic blood flow, which are of clinical significance in determining the state of liver cirrhotic.

Animals ; Disease Models, Animal ; Indocyanine Green ; metabolism ; Liver Circulation ; Liver Cirrhosis, Experimental ; physiopathology ; Male ; Pneumoperitoneum, Artificial ; Rats ; Rats, Wistar

As a recently emerging molecular imaging technique, fluorescent molecular imaging has the advantage of fast imaging, simple operation, high sensitivity, low cost, nonionizing radiation and so on. Through the real-time, non-invasive, specific tracking and detection of tumorigenesis, metastases, angiogenesis, and the therapeutic response to antitumor drugs in vivo, we can study the physiological and pathological processes within tumors at cellular and molecular levels. Fluorescent molecular imaging provides effective methods for the early detection and targeted therapy of tumor, for the intraoperative visualization of tumor foci, as well as for the development of new antitumor drugs in the future clinical practice.
Animals ; Green Fluorescent Proteins ; metabolism ; Humans ; Indocyanine Green ; Molecular Imaging ; methods ; Molecular Probe Techniques ; Neoplasms ; blood supply ; diagnosis ; Neoplasms, Experimental ; blood supply ; diagnosis ; Neovascularization, Pathologic ; diagnosis

Adult ; Aged ; Female ; Hepatitis B ; metabolism ; physiopathology ; Humans ; Indocyanine Green ; pharmacokinetics ; Liver ; metabolism ; Liver Function Tests ; Male ; Middle Aged ; Young Adult

BACKGROUND: The maximal removal rate of indocyanine green (ICG Rmax), which has been used as a useful indicator of quantitative assessment of the hepatic function, has some disadvantages such as high cost, requirement of multiple sampling, and long turn-around time. This study was designed to clarify that the measurement of the lidocaine metabolite, monoethylglycinekylidide (MEGX) test, can replace the ICG Rmax. And in healthy adults, MEGX forma pion was measured and compared according to methods of measurement and serf. METHOD: In 18 patients to whom ICG Rmax test was requested, ICG Rmax test was carried out at two doses of 0.5 mg/kg and 5 mg/kg and MEGX formation after 15 minute of 1 mg/kg lidocaine Injection was measured by fluorescence polarization immunoassay (FPIA) method. The correlation between them was analyzed, To 25 healthy volunteers included in this study as normal control, lidocaine was given intravenously at, a dose of 1 mg/kg and MEGX forma pion was measured IS and 30 minute later (MEGX15, MEGX30) using both high performance liquid chromatography (HPLC) and FPIA methods. RESULT: Patient group resealed significant correlation between ICG Rmax and MEGX15 (r=0.7674, p<0.001) and also between ICG Rl5 and MEGX15 (r=0.5612, p=0.008). There was significant difference between MEGX15 of 9 patients with chronic liver diseases and those of normal controls (22.24+/- 13.18 and 35.40+/- 14.43 ng/mL, respectively) (p=0.01). In normal controls, the correlation between methods was significant (p=0.001) and the values measured by FPIA method was significantly higher than that by HPLG (p(0.001). Of the normal controls, male group had higher MEGX15 values than female group in both methods (in HPLC method 33.89+/-15.95 and 22.53+/- 8.36, and in FPIA method 41.48+/-16.61 and 28.81+/-7.88 ng/mL, respectively), and in female group MEGX30 values was significantly elevated compared to MEGX15 (p<0.001). CONCLUSION: Inferred from the fact that the correlation between ICG Rmax and MEGX was good, MEGX test can be considered a replacement for ICG Rmax. In healthy adults, it is considered that there is serf-related difference In the rate of lidocaine metabolism so we should pay attention to it in interpreting the MEGX results.
Adult ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Female ; Fluorescence Polarization Immunoassay ; Healthy Volunteers ; Humans ; Indocyanine Green* ; Lidocaine ; Liver Diseases ; Male ; Mesons ; Metabolism

OBJECTIVETo noninvasively evaluate hepatic functional blood flow, intrahepatic shunt rate and hepatic functional reserve in both normal and cirrhotic liver using D-sorbitol and indocyanine green measured by high performance liquid chromatography (HPLC).

METHODSMale Sprague-Dawley (SD) rats were divided into normal control and cirrhotic group in which the rats were administrated with tetrachloride. Then the isolated perfused liver models were established. The pharmacokinetic indexes of D-sorbitol and indocyanine green (ICG) were measured by the traditional spectrophotometry (SPEC) and HPLC respectively.

RESULTS(1) HPLC showed that ICG contained genuine ICG (ICGg) and ICG degraded products (ICGdp), which had similar spectrum but metabolic kinetics different with the retention time of 8.9 minutes and 24.2 minutes respectively. (2) Hepatic intrinsic metabolic capacity (QINT, I) was (36.57+/-13.03) ml/min in control group and (14.39+/-5.13) ml/min in cirrhotic group (t=7.08, P<0.01). (3) Hepatic functional blood flow (QFUNC) in cirrhotic group declined, compared with that in control group (34.06 ml/min+/-5.12 ml/min vs. 17.54 ml/min+/-7.02 ml/min, t=8.41, P<0.01), while intrahepatic shunt rate (QIHS) increased markedly (9.9%+/-1.4% vs. 47.5%+/-20.9%, t=8.35, P<0.01).

CONCLUSION(1) HPLC method is superior to SPEC in measuring ICG, because it can avoid the disturbance from ICGdp, so that ICG measured by HPLC is valid for QINT, I evaluation. (2) The hepatic clearance of D-sorbitol measurement is a noninvasive and reliable method for evaluating the total blood flow in normal liver, and hepatic functional blood flow and intrahepatic shunt rate in cirrhotic liver. (3) Combining D-sorbitol with indocyanine green measurement is helpful for assessment of liver functional reserve.

Animals ; Carbon Tetrachloride Poisoning ; physiopathology ; Indicators and Reagents ; pharmacokinetics ; Indocyanine Green ; pharmacokinetics ; Liver ; physiopathology ; Liver Cirrhosis, Experimental ; chemically induced ; metabolism ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Sorbitol ; pharmacokinetics

Fabry disease (FD) is an X-linked, recessively inherited, rare, progressive, disorder of glycosphingolipid metabolism affecting multiple organs resulting in organ dysfunction. It is rare to find only one FD affected subject with a de novo mutation. Here we report a case of a 41-year-old Asian male diagnosed with de novo FD. Comprehensive ophthalmological evaluation was performed using slit lamp, color fundus photography, optical coherence tomography, fluorescein angiography, and indocyanine green angiography. On slit lamp examination, cornea verticillata and slightly tortuous, and aneurysmal dilatation of inferior bulbar conjunctival vessels were observed. Other imaging modalities showed unremarkable findings. Cornea verticillata and inferior bulbar conjunctival vascular abnormalities may be detected earlier than other ocular abnormalities in de novo FDs like hereditary FDs.
Adult ; Aneurysm ; Angiography ; Asian Continental Ancestry Group ; Cornea ; Dilatation ; Fabry Disease ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Male ; Metabolism ; Photography ; Slit Lamp ; Tomography, Optical Coherence

OBJECTIVE: Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a newly developed MR contrast agent. After intravenous injection, Gd-EOB-DTPA is gradually taken up by the hepatocytes and eventually excreted via the biliary pathway without any change to its chemical structure. Because of these characteristics, it can be used as a tracer for quantitative liver function testing. The purpose of this study is to develop a noninvasive method of quantitation of the hepatic function using Gd-EOB-DTPA through the deconvolution analysis. MATERIALS AND METHODS: Adult New Zealand white rabbits (n = 10, average body weight = 3.5 kg) were used in the present study. Hepatic injury was induced to by the intragastric administration of carbon tetrachloride (CCl4) three times a week for three weeks. Liver enzyme (aspartate aminotransferase, AST; alanine aminotransferase, ALT) levels and the plasma indocyanine green (ICG) retention rate 15 minutes after an intravenous injection of ICG (ICG R15), was checked before and after the three-week administration of CCl4. At the end of experimental period, an observer "blinded" to the treatment given the rabbits performed the histological examination. MRI studies were performed before and after the three-week administration of CCl4 on a 1.5 T scanner using a human extremity coil. After intravenous bolus injection of Gd-EOB-DTPA (0.3 mL of Gd-EOB-DTPA freshly prepared in 2.7 mL of normal saline) through the ear vein, the 250 axial single level dynamic MR images were obtained using a fast low angle shot (FLASH, TR/TE = 11/4.2 msec, flip angle = 15, acquisition time 1 second, slice thickness = 5 mm, matrix = 128x128, field of view = 120 mm) sequence with 1.5 sec time intervals. The time-intensity curves were obtained at the abdominal aorta and the liver parenchyma that was devoid of blood vessels. Deconvolution analysis of the aortic (input function) and hepatic parenchymal (output function) time-intensity curves was performed with a modified Fourier transform technique to calculate the hepatic extraction fraction (HEF). The presence and type of hepatic injury were determined by the histopathologic examination and statistical analysis of the changes of the hepatic enzyme levels, the ICG R15 and Gd-EOB-DTPA HEF values between the time before and after CCl4 administration with Wicoxon signed rank test. Correlation between the Gd-EOB-DTPA HEF and the change of the ICG R15 were analyzed with Pearson's correlation coefficient. RESULTS: Histopathologic examination showed findings that were compatible with hepatic fibrosis caused by chronic liver injury. The initial blood biochemical studies before the administration of carbon tetrachloride showed that the mean AST and ALT levels were 39.8+/-5.2 IU/L and 59.1+/-11.7 IU/L, respectively. The AST and ALT levels increased to 138.4+/-50.5 IU and 172.0+/-71.6 IU/L, respectively, after the three week administration of CCl4. The ALT and AST levels were significantly increased after the three weeks of CCl4 administration (p=0.018). The ICG R15 values were 4.47+/-2.08% and 19.43+/-3.98% before and after three-week administration of CCl4, respectively. The ICG R15 values were significantly increased after hepatic injury (p=0.018). After normalizing the HEF as 100% in each rabbit before CCl4 administration, the deconvoluted curve after CCl4 administration revealed less hepatocyte extraction efficiency with a mean value of 77.7+/-3.6. There was a significant correlation between the HEF and changes of the ICG R15 by the Pearson correlation coefficient assessment (correlation coefficient = -0.965, p=0.000). CONCLUSION: The Gd-EOB-DTPA HEF could be calculated from deconvolution analysis of aortic and hepatic parenchymal time-intensity curves obtained by dynamic MRI. The Gd-EOB-DTPA HEF was well correlated with changes of the ICG R15, which is the most common parameter used in the quantitative estimation of the hepatic function. The Gd-EOB-DTPA HEF is a direct, noninvasive technique for the quantitative evaluation of liver function. It could be a promising alternative for the determination of noninvasive hepatic function in those patients with liver disease.
Alanine Transaminase/blood/drug effects ; Animals ; Aspartate Aminotransferases/blood/drug effects ; Biological Markers/blood ; Carbon Tetrachloride ; Coloring Agents/metabolism ; Contrast Media/*administration & dosage ; Disease Models, Animal ; Fibrosis/chemically induced ; Gadolinium DTPA/*administration & dosage ; Indocyanine Green/metabolism ; Injections, Intravenous ; Liver/*enzymology/*pathology ; Liver Function Tests/*methods ; *Magnetic Resonance Imaging ; Rabbits