Solitary Asymptomatic Thyroid Metastasis from Hepatocellular Carcinoma Detected by FDG-PET/CT

Thyroid metastases from hepatocellular carcinoma (HCC) seldom occur and are often difficult to diagnose because of their asymptomatic clinical course. We evaluated a very rare case of solitary thyroid metastasis from HCC that showed high uptake of fluorine-18 fluorodeoxyglucose (FDG), when imaged using fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). The patient was a 74-year-old man and presented with a remarkably elevated des-gamma-carboxy prothrombin level of 1,157 mAU/ml 22 months after hepatic lobectomy. FDG-PET/CT imaging revealed a hypodense tumor with high FDG uptake, with a maximum standardized uptake value of 5.2 in the thyroid left lobe. Solitary thyroid metastasis from HCC was suspected and subsequent fine needle aspiration did indeed reveal HCC. The patient received left thyroidectomy with left regional lymph node dissection. Two months after left thyroidectomy, contrast-enhanced computed tomography showed local recurrence, and the patient received ongoing radiotherapy treatment. To our knowledge, the present study is the first to demonstrate the feasibility of FDG-PET/CT in the diagnosis and management of clinically diagnosed, asymptomatic, solitary thyroid metastasis from HCC

Effects of canagliflozin on NT-proBNP stratified by left ventricular diastolic function in patients with type 2 diabetes and chronic heart failure : a sub analysis of the CANDLE trial

Background: Identification of the effective subtypes of treatment for heart failure (HF) is an essential topic for optimizing treatment of the disorder. We hypothesized that the beneficial effect of SGLT2 inhibitors (SGLT2i) on the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) might depend on baseline diastolic function. To elucidate the effects of SGLT2i in type 2 diabetes mellitus (T2DM) and chronic HF we investigated, as a post-hoc sub-study of the CANDLE trial, the effects of canagliflozin on NT-proBNP levels from baseline to 24 weeks, with the data stratified by left ventricular (LV) diastolic function at baseline. Methods: Patients (n = 233) in the CANDLE trial were assigned randomly to either an add-on canagliflozin (n = 113) or glimepiride treatment groups (n = 120). The primary endpoint was a comparison between the two groups of the changes from baseline to 24 weeks in NT-pro BNP levels, stratified according to baseline ventricular diastolic function. Results: The change in the geometric mean of NT-proBNP level from baseline to 24 weeks was 0.98 (95% CI 0.89–1.08) in the canagliflozin group and 1.07 (95% CI 0.97–1.18) in the glimepiride group. The ratio of change with canagliflozin/glimepiride was 0.93 (95% CI 0.82–1.05). Responder analyses were used to investigate the response of an improvement in NT-proBNP levels. Although the subgroup analyses for septal annular velocity (SEP-e′) showed no marked heterogeneity in treatment effect, the subgroup with an SEP-e′ < 4.7 cm/s indicated there was an association with lower NT-proBNP levels in the canagliflozin group compared with that in the glimepiride group (ratio of change with canagliflozin/glimepiride (0.83, 95% CI 0.66–1.04). Conclusions: In the subgroup with a lower LV diastolic function, canagliflozin showed a trend of reduced NT-pro BNP levels compared to that observed with glimepiride. This study suggests that the beneficial effects of canagliflozin treatment may be different in subgroups classified by the severity of LV diastolic dysfunction

Assembly and Function of a Bioengineered Human Liver for Transplantation Generated Solely from Induced Pluripotent Stem Cells

The availability of an autologous transplantable auxiliary liver would dramatically affect the treatment of liver disease. Assembly and function in vivo of a bioengineered human liver derived from induced pluripotent stem cells (iPSCs) has not been previously described. By improving methods for liver decellularization, recellularization, and differentiation of different liver cellular lineages of human iPSCs in an organ-like environment, we generated functional engineered human mini livers and performed transplantation in a rat model. Whereas previous studies recellularized liver scaffolds largely with rodent hepatocytes, we repopulated not only the parenchyma with human iPSC-hepatocytes but also the vascular system with human iPS-endothelial cells, and the bile duct network with human iPSC-biliary epithelial cells. The regenerated human iPSC-derived mini liver containing multiple cell types was tested in vivo and remained functional for 4 days after auxiliary liver transplantation in immunocompromised, engineered (IL2rg−/−) rats.Fil: Takeishi, Kazuki. University of Pittsburgh; Estados UnidosFil: Collin de I'Hortet, Alexandra. University of Pittsburgh; Estados UnidosFil: Wang, Yang. University of Pittsburgh; Estados UnidosFil: Handa, Kan. University of Pittsburgh; Estados UnidosFil: Guzman Lepe, Jorge. University of Pittsburgh; Estados UnidosFil: Matsubara, Kentaro. University of Pittsburgh; Estados UnidosFil: Morita, Kazutoyo. University of Pittsburgh; Estados UnidosFil: Jang, Sae. University of Pittsburgh; Estados UnidosFil: Haep, Nils. University of Pittsburgh; Estados UnidosFil: Florentino, Rodrigo M.. University of Pittsburgh; Estados UnidosFil: Yuan, Fangchao. University of Pittsburgh; Estados UnidosFil: Fukumitsu, Ken. University of Pittsburgh; Estados UnidosFil: Tobita, Kimimasa. University of Pittsburgh; Estados UnidosFil: Sun, Wendell. University of Pittsburgh; Estados UnidosFil: Franks, Jonathan. University of Pittsburgh; Estados UnidosFil: Delgado, Evan R.. University of Pittsburgh; Estados UnidosFil: Shapiro, Erik M.. University of Pittsburgh; Estados UnidosFil: Fraunhoffer Navarro, Nicolas Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Duncan, Andrew W.. University of Pittsburgh; Estados UnidosFil: Yagi, Hiroshi. University of Pittsburgh; Estados UnidosFil: Mashimo, Tomoji. University of Pittsburgh; Estados UnidosFil: Fox, Ira J.. University of Pittsburgh; Estados UnidosFil: Soto Gutierrez, Alejandro. University of Pittsburgh; Estados Unido

Cellular Location of HNF4α is Linked With Terminal Liver Failure in Humans

Hepatocyte nuclear factor 4 alpha (HNF4α) is a transcription factor that plays a critical role in hepatocyte function, and HNF4α-based reprogramming corrects terminal liver failure in rats with chronic liver disease. In the livers of patients with advanced cirrhosis, HNF4α RNA expression levels decrease as hepatic function deteriorates, and protein expression is found in the cytoplasm. These findings could explain impaired hepatic function in patients with degenerative liver disease. In this study, we analyzed HNF4α localization and the pathways involved in post-translational modification of HNF4α in human hepatocytes from patients with decompensated liver function. RNA-sequencing analysis revealed that AKT-related pathways, specifically phospho-AKT, is down-regulated in cirrhotic hepatocytes from patients with terminal failure, in whom nuclear levels of HNF4α were significantly reduced, and cytoplasmic expression of HNF4α was increased. cMET was also significantly reduced in failing hepatocytes. Moreover, metabolic profiling showed a glycolytic phenotype in failing human hepatocytes. The contribution of cMET and phospho-AKT to nuclear localization of HNF4α was confirmed using Spearman's rank correlation test and pathway analysis, and further correlated with hepatic dysfunction by principal component analysis. HNF4α acetylation, a posttranslational modification important for nuclear retention, was also significantly reduced in failing human hepatocytes when compared with normal controls. Conclusion: These results suggest that the alterations in the cMET-AKT pathway directly correlate with HNF4α localization and level of hepatocyte dysfunction. This study suggests that manipulation of HNF4α and pathways involved in HNF4α posttranslational modification may restore hepatocyte function in patients with terminal liver failure.Fil: Florentino, Rodrigo M.. Univeristy of Pittsburgh. School of Medicine; Estados Unidos. Universidade Federal de Minas Gerais; BrasilFil: Fraunhoffer Navarro, Nicolas Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Morita, Kazutoyo. University of Pittsburgh at Johnstown; Estados UnidosFil: Takeishi, Kazuki. University of Pittsburgh at Johnstown; Estados UnidosFil: Ostrowska, Alina. University of Pittsburgh at Johnstown; Estados UnidosFil: Achreja, Abhinav. Michigan State University; Estados UnidosFil: Animasahun, Olamide. Michigan State University; Estados UnidosFil: Haep, Nils. University of Pittsburgh at Johnstown; Estados UnidosFil: Arazov, Shohrat. University of Pittsburgh at Johnstown; Estados UnidosFil: Agarwal, Nandini. University of Pittsburgh at Johnstown; Estados UnidosFil: Collin de lHortet, Alexandra. University of Pittsburgh at Johnstown; Estados UnidosFil: Guzman Lepe, Jorge. University of Pittsburgh at Johnstown; Estados UnidosFil: Tafaleng, Edgar N.. University of Pittsburgh at Johnstown; Estados UnidosFil: Mukherjee, Amitava. University of Pittsburgh at Johnstown; Estados UnidosFil: Troy, Kris. University of Pittsburgh at Johnstown; Estados UnidosFil: Banerjee, Swati. University of Pittsburgh at Johnstown; Estados UnidosFil: Paranjpe, Shirish. University of Pittsburgh at Johnstown; Estados UnidosFil: Michalopoulos, George K.. University of Pittsburgh at Johnstown; Estados UnidosFil: Bell, Aaron. University of Pittsburgh at Johnstown; Estados UnidosFil: Nagrath, Deepak. Michigan State University; Estados UnidosFil: Hainer, Sarah J.. University of Pittsburgh at Johnstown; Estados UnidosFil: Fox, Ira J.. University of Pittsburgh at Johnstown; Estados UnidosFil: Soto Gutierrez, Alejandro. University of Pittsburgh at Johnstown; Estados Unido

Interdot carrier and spin dynamics in a two-dimensional high-density quantum-dot array of InGaAs with quantum dots embedded as local potential minima

Interdot carrier and spin dynamics were studied in a two-dimensional array of high-density small quantum dots (SQDs) of InGaAs with an average diameter of 16 nm and a sheet density of 1.2 x 10(11) cm(-2), in which 24 nm diametric large QDs (LQDs) were embedded as local potential minima. We observed a delayed photoluminescence (PL) rise from the lower-lying LQD states and a considerably faster PL decay from the higher-lying SQD states, indicating carrier transfer from the two-dimensionally coupled SQDs into the LQDs. In addition, inverse carrier tunneling from the LQDs into the SQDs was thermally induced, which is characterized by the thermal activation energy between the LQDs and SQDs. Moreover, circularly polarized transient PL behavior from the SQD states exhibits a suppression of the spin polarization decay in the initial time region, depending on the excited spin density. This tentatively suppressed spin relaxation can be quantitatively explained by selective interdot transfer of minority-spin electrons from the SQDs into LQDs, when the majority spin states in both QDs are sufficiently populated by excited spins. These findings indicate that the high-density SQDs behave as the main emitters with suppressed spin relaxation, while the scattered LQDs with lower potential behave as the receivers of minority-spin electrons

Persistent High Polarization of Excited Spin Ensembles During Light Emission in Semiconductor Quantum-Dot-Well Hybrid Nanosystems

We demonstrate persistent high degrees of spin polarization (SPD) up to 70% during light emission in (In1-xGax) As quantum-dot-well (QD-QW) hybrid nanosystems, where QD excited states are laterally tunnel coupled through the adjacent two-dimensional QW potential depending on the QW thickness. Spinpolarized electrons are photo-excited by using circularly polarized light pulses. The decay time of spin relaxation, obtained by that of the SPD, is 70 times larger than the photoluminescence decay time. The temporally constant SPD is sustained by a selective transfer of minority spins among QDs after flipping from the majority spins, which is promoted by a moderate state filling of lower-energy spin sublevels in surrounding QDs. The spin transfer times are deduced as functions of the QW thickness and excited-spin density. These results can provide a precise control of lateral interdot spin-transfer dynamics and resultant suppression of spin relaxation in QD ensembles

Interdot spin transfer dynamics in laterally coupled excited spin ensemble of high-density InGaAs quantum dots

Interdot spin transfer dynamics is studied in a laterally coupled excited spin ensemble of high-density InGaAs quantum dots (QDs). We observe a rise time of the photoluminescence intensity of similar to 100 ps and a simultaneous increase in the spin polarization of the excited spin ensemble, indicating spin injection from higher-energy levels in smaller QDs. Moreover, this coupled ensemble exhibits decay properties of the spin polarization that vary with the excited spin density. This phenomenon can be quantitatively understood by considering interdot spin transfer into lower-energy levels of the surrounding QDs, where the transfer rate depends on the degree of state filling of each QD level. Published by AIP Publishing