published_or_final_version / Anatomy / Doctoral / Doctor of Philosophy

published_or_final_version / Anatomy / Master / Master of Philosophy

Background: Hepatocellular carcinoma is one of the most fatal diseases worldwide. Liver transplantation dramatically improved the survival rate of HCC patients. However, tumor recurrence remains a huge threat to HCC patients without any promising curative treatment. Chemotherapy, as one of the potential treatments to recurrent HCC, did not show any significant effect either. Objective: We aim to investigate the role of interferon-gamma inducible protein 10 (IP10) in acute-phase liver graft injury induced late-phase cisplatin resistance after liver transplantation and to explore the underlying mechanism. Furthermore, a potential adjuvant therapy was expected to be identified to sensitize cisplatin treatment in HCC. Materials and methods: A rat orthotopic liver transplantation model was established with applying whole or small-for-size (50%) graft. Afterwards, a rat hepatoma cell (MH7777) was injected via portal vein to generate recurrent tumor. The expressions of genes linked to multi-drug resistance and graft injury were compared between tumors developed after liver transplantation using small and whole grafts. IP10 expression was further validated in clinical samples from two cohorts of patients including HCC patients with hepatectomy and HCC patients with liver transplantation. The extracellular and intracellular roles of IP10 were examined in vitro by using IP10 recombinant protein and IP10 stable transfectants in HCC cell lines. The correlation between IP10 expression and tumor growth was investigated in three in vivo nude mice models including a subcutaneous model, an orthotopic model and ischemia reperfusion injury model. The underlying mechanism was further explored in vitro, in vivo and in clinical samples. IP10 neutralizing antibody was employed as an adjuvant therapy to identify its effect on sensitizing cisplatin treatment in HCC. Results: The expressions of multidrug resistant genes were significantly up-regulated in liver and tumor from small-for-size group in rat liver transplantation model. IP10 was selected as the potential target for its constantly higher expression in liver and tumor tissues in small-for-size group. In clinical studies, IP10 was overexpressed in around 45% HCC patients with hepatectomy. The expression of circulating IP10 well correlated with tumor recurrence and small graft ratio in HCC patients after liver transplantation. In in vitro studies, it was demonstrated that overexpression of IP10 could significantly promote HCC cell proliferation either in short term or in long term cisplatin administration. In in vivo studies, subcutaneous and orthotopic nude mice models showed that the overexpression of IP10 have significant correlations with larger tumor volume and less tumor necrosis after cisplatin treatment. In mechanism studies, IP10 overexpression was found to be well correlated with the activation of endoplasmic reticulum (ER) stress signaling pathways in vitro and further validated in vivo models and in clinical specimens. IP10 neutralizing antibody was identified as a potential therapy which could sensitize cisplatin treatment in vitro and in vivo. Conclusions: The high expression of IP10 was identified in two cohorts of clinical samples and showed significant correlations with tumor recurrence. Graft injury induced IP10 overexpression could significantly increase cisplatin resistance after liver transplantation via ER stress signaling pathways. IP10 neutralizing antibody may be applied as an alternative treatment for recurrent HCC after liver transplantation. / published_or_final_version / Surgery / Doctoral / Doctor of Philosophy

abstract / Electrical and Electronic Engineering / Doctoral / Doctor of Philosophy

As compared with other imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) provides distinctive advantages with better contrast and resolution in imaging brain anatomy and function in vivo. As compared with electrophysiological and histological tracing techniques, MRI enables longitudinal investigation with higher efficiency, lower labor cost and less possibility of sampling error. The major objective of this doctoral work is to utilize cellular and molecular MRI to investigate normal brain functions and injuries in vivo. The results successfully demonstrated MRI as an efficient and sensitive tool for providing comprehensive assessment of brain injuries for promoting accurate prognosis and timely intervention, and for studying fundamental questions with regard to cortical adaptations to challenges in the young adulthood. Firstly, diffusion tensor imaging (DTI) and T2-weighted imaging were employed to characterize longitudinal neuronal and axonal changes of pyramidal tract (PY), a critical part of corticospinal tract, following experimental intracerebral hemorrhage (ICH). Combining DTI with T2-weighted imaging results, ipsilateral PY injuries following ICH were diagnosed as four stages. Quantitative analysis revealed transient diffusivity decreases in PY both contralateral and ipsilateral to the primary hemorrhagic site. Evolution of the ipsilateral DTI parameters correlated with histological findings and indicated evolving and complex pathological processes underlying monotonic FA decrease. These results demonstrated multi-parametric DTI as a valuable imaging tool for non-invasive and longitudinal monitoring of secondary PY injuries. Secondly, DTI and manganese-enhanced MRI (MEMRI) were utilized to detect neuronal changes of substantia nigra (SN) following experimental ICH in rodents. DTI revealed early changes in SN both contralateral and ipsilateral to the primary hemorrhagic site. Evolution of the ipsilateral parameters correlated with the histological results. MEMRI provided insights into the cellular phenotype changes at the late stage. DTI can serve as a valuable imaging tool for non-invasive early detection and longitudinal monitoring of secondary SN injuries, while MEMRI could complementally provide information regarding the late stage inflammation process. Multi-parametric MRI could facilitate clinical and preclinical investigations of SN injuries for exploring disease mechanisms and developing new therapeutic strategies. Thirdly, MEMRI was performed to characterize the interhemispheric interactions in normal and monocularly deprived rodent visual brain. Characteristic transcallosal manganese labeling was observed in the normal group in a manner consistent with previous histological findings. Significant decrease of such labeling was observed in rats with left or right eyelid suturing, or with left eye enucleation, but not in rats with right eye enucleation. These results demonstrated MEMRI as an efficient tool for investigating interhemispheric interactions both anatomically and functionally. These results also indicated that the adult brain recruits different mechanisms for its adaptations to eyelid suturing and enucleation, thus shedding light on our understanding of the transcallosal interhemispheric excitation and inhibition. Lastly, new paradigms other than pressure injection for intracortical manganese administration in MEMRI were introduced to minimize the neuro-toxicity of manganese and maximize the sensitivity of MEMRI for studying cortical functional changes. Transmeningeal diffusion, osmotic pump-based infusion, and intranasal instillation were demonstrated to be successful in tracing interhemispheric connections and detecting stress-related cortical and subcortical changes. / published_or_final_version / Electrical and Electronic Engineering / Doctoral / Doctor of Philosophy

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Surgery / Master / Master of Surgery

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Surgery / Master / Master of Surgery

published_or_final_version / abstract / toc / Anatomy / Doctoral / Doctor of Philosophy