Acute liver failure (ALF) refers to the sudden loss of liver function and is accompanied by several complications. In a previous study, we revealed the protective effect of Centella asiatica 50% ethanol extract (CA-HE50) on acetaminophen-induced liver injury. In the present study, we investigate the hepatoprotective effect of CA-HE50 in a lipopolysaccharide/galactosamine (LPS-D-Gal)-induced ALF animal model and compare it to existing therapeutic silymarin, Lentinus edodes mycelia (LEM) extracts, ursodeoxycholic acid (UDCA) and dimethyl diphenyl bicarboxylate (DDB). Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were decreased in the CA-HE50, silymarin, LEM, UDCA and DDB groups compared to the vehicle control group. In particular, AST and ALT levels of the 200 mg/kg CA-HE50 group were significantly decreased compared to positive control groups. Lactate dehydrogenase (LDH) levels were significantly decreased in the CA-HE50, silymarin, LEM, UDCA and DDB groups compared to the vehicle control group and LDH levels of the 200 mg/kg CA-HE50 group were similar to those of the positive control groups. Superoxide dismutase (SOD) activity was significantly increased in the 100 mg/kg CA-HE50, LEM and UDCA groups compared to the vehicle control group and, in particular, the 100 mg/kg CA-HE50 group increased significantly compared to positive control groups. In addition, the histopathological lesion score was significantly decreased in the CA-HE50 and positive control groups compared with the vehicle control group and the histopathological lesion score of the 200 mg/kg CA-HE50 group was similar to that of the positive control groups. These results show that CA-HE50 has antioxidant and hepatoprotective effects at a level similar to that of silymarin, LEM, UDCA and DDB, which are known to have hepatoprotective effects; further, CA-HE50 has potential as a prophylactic and therapeutic agent in ALF.

The strut chordae (SC) have a unique structure and play an important role in reinforcing the tunnel-shaped configuration of the mitral valve (MV) at the inflow and outflow tracts. We investigated the effect of varying the SC insertion location on normal MV function and dynamics to better understand the complex MV structures. A virtual parametric MV model was designed to replicate a normal human MV, and a total of nine MV modes were created from combinations of apical and lateral displacements of the SC insertion location. MV function throughout the full cardiac cycle was simulated using dynamic finite element analysis for all MV models. While the leaflet stress distribution and coaptation showed similar patterns in all nine MV models, the maximum leaflet stress values increased in proportion to the width of the SC insertion locations. A narrower SC insertion location resulted in a longer coaptation length and a smaller anterior coaptation angle. The top-narrow MV model demonstrated the shortest anterior leaflet bulging distance, lower stresses across the anterior leaflet, and the lowest maximum stresses. This biomechanical evaluation strategy can help us better understand the effect of the SC insertion locations on mechanism, function, and pathophysiology of the MV.