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Akira Umemura,Hiroyuki Nitta,Takeshi Takahara,Yasushi Hasegawa,Hirokatsu Katagiri,Shoji Kanno,Megumi Kobayashi,Taro Ando,Taku Kimura,Akira Sasaki 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.4
A 57-year-old Japanese female was considered for living donor liver transplantation (LDLT) due to end-stage liver cirrhosis caused by primary biliary cholangitis with portal vein thrombosis (PVT) formation. A 26-year-old daughter of the patient was selected as a living donor; however, a computed tomography examination revealed trifurcated-type portal vein anomaly (PVA). Preoperative liver volumetry showed that the right lobe graft was necessary for the recipient; therefore, reconstruction of the portal vein bifurcation during LDLT was necessary. We planned to extract the recipient’s own hepatic vein grafts after total hepatectomy, and these would be attached with anterior and posterior portal branches as jump grafts. We performed laparoscopic donor hepatectomy as usual, and the recipient’s hepatic vein grafts were anastomosed on the bench. Then, the liver graft was inserted, and the hepatic vein reconstruction was routinely performed. We confirmed the alignment between the recipient’s portal vein and the bridged hepatic vein graft of the liver graft’s posterior branch, and anastomosed these two vessels. Moreover, we confirmed the front flow and expansion of the reconstructed posterior branch by declamping only the suprapancreatic side of the portal vein. The decision regarding the punch-out location was crucial. We confirmed the alignment between the reconstructed posterior branch and the bridged hepatic vein graft of the anterior branch, and anastomosed these two vessels employing the punched-out technique. In LDLT, liver transplant surgeons occasionally encounter living donors with PVA or recipients with PVT. Our contrivance may be useful when the liver graft needs reconstruction of portal vein bifurcation.
Sudarat Kasemcholathan,Akira Kanno,Anupan Kongbangkerd,Pattamon Sangin 한국원예학회 2021 Horticulture, Environment, and Biotechnology Vol.62 No.5
Rhynchostylis retusa (L.) Blume is a popular and scarce orchid species with attractive fl owers arranged in a racemose cluster. To study this fl ower’s complex fl oral perianth formation, MADS-box genes that play an important role in fl ower morphogenesiswere investigated. Four B-class DEF -like MADS-box genes, RrDEF1 , RrDEF2 , RrDEF3 , and RrDEF4 , and twoE-class AGL6 -like MADS-box genes, RrAGL6-1 and RrAGL6-2 , were identifi ed, and their expression was characterizedby qRT-PCR. These genes were expressed in every developmental stage of reproductive organs but not in the vegetativeleaves, except for RrDEF2 . Most of these genes revealed similar expression patterns in stage 3 and mature fl owers. HigherRrDEF1 and RrAGL6-1 expression was detected in the sepals and petals rather than the lips, while RrDEF3 , RrDEF4 , andRrAGL6-2 were highly expressed in the lips but exhibited low expression in the sepals. RrDEF3 was also strongly expressedin petals. These gene expression patterns supported current profi les involving sepal/petal/lip determination, with RrDEF1and RrAGL6-1 promoting sepal/petal formation, while RrDEF3 , RrDEF4 , and RrAGL6-2 promoted lip formation. Our fi ndingssupport revised ‘orchid code’ and ‘perianth code’ hypotheses in which fl oral organs are regulated by combined levelsof expression from each clade of DEF -like genes and AGL6 -like genes. These four RrDEF and two RrAGL6 genes promoteand enrich our knowledge and understanding concerning the fl oral development of orchids.