Purpose: To evaluate the effectiveness of the transradial artery approach (TRA) for treating malfunctioning arteriovenous fistulas (AVFs) in patients on hemodialysis. Materials and Methods: A retrospective analysis was conducted in this single-center study of TRA endovascular procedures in 73 patients (43 male and 30 female; mean age of 67.4 years (range, 42–92 years) with malfunctioning AVFs, between January 2008 and April 2019. Patients’ baseline and lesion characteristics, technical and clinical success, and complications were evaluated, and functional patency was analyzed using the Kaplan-Meier method. Results: Radial artery approaches were successful in all patients. Angioplasty performed using the TRA achieved technical and clinical success rates of 98.6%(72/73) and 91.7%(67/73), respectively. The median primary patency time was 18.8 ± 15.9 months. The primary functional patency rates at 3, 6, and 12 months were 82.1%, 68.6%, and 63.9%, respectively. There were no major complications or adverse events, such as hand ischemia, related to the radial artery approach. Conclusion In selected cases, the TRA can be used complementary to the transvenous approach to treat malfunctioning AVFs.

BACKGROUND: Transforming growth factor-beta (TGF-beta) is a multifunctional cytokine involved in immune disorders, cancer, asthma, lung fibrosis, and chronic kidney disease, and its signal pathways are considered crucial mediators of a variety of cellular processes. In addition, several recent studies have reported that TGF-beta receptor (TGF-betaR) gene polymorphism is associated with chronic kidney disease. However, the association between end-stage renal disease (ESRD) and the TGF-beta gene polymorphism has not been sufficiently investigated. In this study, we hypothesized that polymorphisms of the TGF-beta ligands or their receptors may be related to ESRD. METHODS: We assessed the relationship between four single-nucleotide polymorphisms (SNPs) in the TGF-betaR2 and TGF-beta2 genes and ESRD, in 312 patients with ESRD and 258 controls. RESULTS: Compared with the control participants, the frequencies of the TGF-betaR2 (rs764522*C) and TGF-betaR2 (rs3087465*G) alleles were significantly higher in the patients with ESRD. Genotyping analysis demonstrated that two SNPs in TGF-betaR2 of the four SNPs included in the study were significantly associated with ESRD in the codominant 1 [rs764522, odds ratio (OR)=1.65; rs3087465, OR=1.63], dominant (rs764522, OR=1.63; rs3087465, OR=1.57), and log-additive (rs764522, OR=1.54; rs3087465, OR=1.39) models after adjusting for age and sex. CONCLUSION: We suggest that TGF-betaR2 polymorphisms (rs764522 and rs3087465) increase the risk of development of ESRD.
Alleles ; Asthma ; Fibrosis ; Humans ; Immune System Diseases ; Kidney Failure, Chronic* ; Ligands ; Lung ; Odds Ratio ; Polymorphism, Single Nucleotide ; Receptors, Transforming Growth Factor beta ; Renal Insufficiency, Chronic ; Signal Transduction ; Transforming Growth Factor beta ; Transforming Growth Factor beta2

OBJECTIVE: Currently, there are a few biological markers to aid in the diagnosis and treatment of depression. However, it is not sufficient for diagnosis. We attempted to identify differentially expressed proteins during depressive moods as putative diagnostic biomarkers by using quantitative proteomic analysis of serum. METHODS: Blood samples were collected twice from five patients with major depressive disorder (MDD) at depressive status before treatment and at remission status during treatment. Samples were individually analyzed by liquid chromatography-tandem mass spectrometry for protein profiling. Differentially expressed proteins were analyzed by label-free quantification. Enzyme-linked immunosorbent assay (ELISA) results and receiver-operating characteristic (ROC) curves were used to validate the differentially expressed proteins. For validation, 8 patients with MDD including 3 additional patients and 8 matched normal controls were analyzed. RESULTS: The quantitative proteomic studies identified 10 proteins that were consistently upregulated or downregulated in 5 MDD patients. ELISA yielded results consistent with the proteomic analysis for 3 proteins. Expression levels were significantly different between normal controls and MDD patients. The 3 proteins were ceruloplasmin, inter-alpha-trypsin inhibitor heavy chain H4 and complement component 1qC, which were upregulated during the depressive status. The depressive status could be distinguished from the euthymic status from the ROC curves for these proteins, and this discrimination was enhanced when all 3 proteins were analyzed together. CONCLUSION: This is the first proteomic study in MDD patients to compare intra-individual differences dependent on mood. This technique could be a useful approach to identify MDD biomarkers, but requires additional proteomic studies for validation.
Biomarkers ; Ceruloplasmin ; Complement System Proteins ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Mass Spectrometry ; Neurotransmitter Agents ; Proteomics ; ROC Curve

We identified a gene for beta-1,3-glucan synthesis (GBG1), a nonessential gene whose disruption alters cell wall synthesis enzyme activities and cell wall composition. This gene was cloned by functional complementation of defects in beta-1,3-glucan synthase activity of the the previously isolated Saccharomyces cerevisiae mutant LP0353, which displays a number of cell wall defects at restrictive temperature. Disruption of the GBG1 gene did not affect cell viability or growth rate, but did cause alterations in cell wall synthesis enzyme activities: reduction of beta-1,3-glucan synthase and chitin synthase III activities as well as increased chitin synthase I and II activities. GBG1 disruption also showed altered cell wall composition as well as susceptibility toward cell wall inhibitors such as Zymolyase, Calcofluor white, and Nikkomycin Z. These results indicate that GBG1 plays a role in cell wall biogenesis in S. cerevisiae
Aminoglycosides ; Benzenesulfonates ; beta-Glucans ; Organelle Biogenesis ; Cell Survival ; Cell Wall ; Chitin Synthase ; Clone Cells ; Complement System Proteins ; Genes, vif ; Humans ; Hydrolases ; Saccharomyces ; Saccharomyces cerevisiae

BACKGROUND: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. OBJECTIVE: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. METHODS: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. RESULTS: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. CONCLUSION: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis.
Anoxia ; Fibroblasts ; Humans ; Keloid ; Oxygen ; Shoulder ; Thorax ; Tissue Donors ; Vascular Endothelial Growth Factor A ; Wound Healing

We report the case of a 77-year-old woman who presented with periumbilical pain from perforation of jejunal diverticula. The patient underwent surgery and multiple jejunal diverticula were found distributed from 30 cm to 60 cm distal to the ligament of Treitz. A segment of the jejunum containing all diverticula was resected and end-to-end anastomosis was performed. The postoperative course was uneventful. The patient continued to do well at last follow-up, 26 months after operation. Diverticulum of the jejunum is uncommon and the majority of patients are asymptomatic. Symptoms indicating diverticulum are few and often nonspecific; they may present either as generalized abdominal pain associated with intestinal disturbances or in more serious case, they can lead to complications requiring emergency surgery. In light of these considerations, we thought it useful to report a case of complicated multiple jejunal diverticula and draw attention to its complications that can be a source of gastrointestinal symptoms.
Abdominal Pain ; Aged ; Diverticulum* ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Jejunum ; Ligaments ; Peritonitis*

High salt intake produces volume expansion and electrolyte imbalance in chronic renal failure and modifies the synthesis and secretion of atrial natriuretic peptide(ANP) to compensate the abnormalities in fluid and sodium handling. This study was performed to investigate the effect of high salt intake on modulation of cardiac and noncardiac ANP mRNA as well as plasma ANP levels in 5/6 subtotal nephrectomized (NPX) rats as a model of chronic renal failure. Adult male Sprague-Dawley rats were divided into sham and NPX rats. NPX rats were induced by 2/3 pole ligation and contralateral nephrectomy. Sham and NPX rats had access to normal chow with tap water for 8 weeks or normal chow with 0.45% NaCl solution(HS) for last 2 weeks. Plasma ANP levels were measured by radioimmunoassay. ANP mRNA from the right atrium, left ventricle, hypothalamus and kidney were analyzed by RT-PCR with 32P-dCTP at 8 weeks after surgical operation in both sham and NPX rats. Blood urea nitrogen(BUN) was measured to evaluate impaired renal function. Body weight, daily water intake, hemoglobin, red blood cell, hematocrit, arterial pressure and heart rate were also monitored. Arterial pressure in NPX+HS rat was significantly increased. Both percent increase of body weight and hematologic findings were decreased in NPX rats. Daily water intake was increased in NPX rats, especially in NPX+HS rat. BUN also increased in NPX rats. Plasma ANP concentration was significantly increased in sham+HS rat, but other significant increases were not shown in NPX rats. The levels of right atrial ANP mRNA represented the increasing trend like as plasma ANP. Left ventricular ANP mRNA was increased in sham+HS rat, while the level in NPX+HS rat was decreased comparing with that of sham+HS rat. Hypothalamic ANP mRNA was decreased in NPX+HS rat. In the kidney, the level of ANP mRNA in sham+HS rat was increased comparing with sham rat, but ANP synthesis in NPX+HS rat was significantly lower than in sham, sham+HS and in NPX rats. These findings represent that the high salt intake in NPX rat does not alter the plasma levels and cardiac synthesis of ANP but suppresses the renal ANP mRNA. The diminished renal ANP synthesis may attenuate the regulatory role of ANP system in the kidney and result in volume expansion and hypertension.
Adult ; Animals ; Arterial Pressure ; Atrial Natriuretic Factor ; Body Weight ; Drinking ; Erythrocytes ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hematocrit ; Humans ; Hypertension ; Hypothalamus ; Kidney ; Kidney Failure, Chronic ; Ligation ; Male ; Nephrectomy ; Plasma* ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger* ; Sodium ; Urea ; Water

OBJECTIVE: This study has been carried out to evaluation the effect of fertilization promoting peptide (FPP) on the kinematic parameters, capacitation and acrosome reaction of the frozen-thawed human spermatozoa. METHODS: After FPP treatment, we examined kinematic parameters, capacitation and acrosome reaction, using the methods of computer-aided sperm analysis (CASA) and chlortetracycline (CTC) fluorescence analysis. RESULTS: We have obtained the evidence that FPP can promote the capacitation and inhibit the spontaneous acrosome reaction of frozen-thawed human spermatozoa in vitro. Fpp (25~100 nM) induced a significant increase in the proportion of B-pattern capacitated spermatozoa, and a significant decrease in the proportion of F-pattern uncapacitated ones without significant stimulation of acrosomal exocytosis. In the kinematic parameters treatment, FPP treated groups maintained higher LIN, BCF and STR than those of control. The VAP, VSL, VCL and ALH were not different. Therefore it is suggested that FPP in human seminal plasma may play a positive role in promoting human sperm function.
Acrosome Reaction* ; Acrosome* ; Chlortetracycline ; Exocytosis ; Fertilization* ; Fluorescence ; Humans* ; Male ; Semen ; Spermatozoa*

In the studies on the hatching mechanisms in mammals, many investigators focused on the embryonic intrinsic factor(s) in in vitro culture, but the uterine environment as the extrinsic factor(s) is thought to play an important role in hatching mechanism. Therefore, to evaluate the effect of uterine environment on the hatching event in vivo, the immature(GV) and ovulated(MII) oocytes, and the late 2-cell embryos of mouse were transferred to pseudopregnant foster mother's uterus during peri-implantation period. So it was verified whether there would happen hatching by only uterine environment independently on embryonic stage. The ultrastructural changes of the zona surface of transferred group were compared with those of in vivo and vitro group by SEM. 36 hrs after transfer, the immature and ovulated oocytes almost degenerated, and the late 2-cell embryos developed to various embryonic stages. However, the embryos which didn't develop to blastula stage did not hatch. The ultrastructural network of ZP in transferred group seemed to be smoothed uniformly, which was different from in vitro group. In conclusion, it is suggested that the uterine environment during peri-implantation period enhances the embryo hatching by provoking the structural change of ZP.
Animals ; Blastula ; Embryonic Structures* ; Herpes Zoster* ; Humans ; Mammals ; Mice* ; Oocytes* ; Research Personnel ; Uterus ; Zona Pellucida*

The aim of this study was to assess the adaptive changes in plasma level of atrial natriuretic peptide(ANP) and its atrial mRNA expression in experimental rat model of chronic renal failure(CRF). Male Sprague-Dawley rats weighing 250-300g were divided into control rats, sham operated rats and 5/6 nephrectomized rats. CRF was induced by 5/6 nephrectomy, in that two thirds of the left kidney was ligated and the contralateral kidney was removed 1 week later. In the rats with 2/3 pole ligation, there were no significant changes in mean arterial pressure(MAP), heart rate, BUN and serum creatinine compared to sham operated rats. Expression of atrial ANP mRNA showed initially higher values and plasma renin activity(PRA) was lower than the sham operated rats. After 5/6 nephrectomy, MAP, heart rate, BUN and serum creatinine increased, and PRA showed the sustained lower values than the control rats. The changing pattern of plasma ANP level was similar to the that of ANP mRNA expression that showed biphasic peaks with the first increase at 1 to 3 days and the second increase at 28 days after nephrectomy. There were a significant positive correlation between plasma ANP level and MAP, and a negative correlation between plasma ANP and PRA. These results suggest that the secretion and the synthesis of ANP respond rapidly to the reduced renal mass, and ANP may play an important regulatory role during the renal adapting process in rats with experimental CRF.
Animals ; Atrial Natriuretic Factor* ; Creatinine ; Heart Rate ; Humans ; Kidney ; Kidney Failure, Chronic* ; Ligation ; Male ; Models, Animal ; Nephrectomy ; Plasma* ; Rats* ; Rats, Sprague-Dawley ; Renin ; RNA, Messenger*