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The elephant trunk technique is used as a standard method in the approach to staged repair of extensive thoracic aneurysms. Here, we present a rare case of a graft infection, in which vegetation was attached to the distal end of the elephant trunk. A 36-year old male who had undergone total arch replacement with elephant trunk installation for type A aortic dissection was readmitted for high-grade fever. At the time of admission, Osler's nodules were present and brain magnetic resonance imaging showed multiple small emboli and haemorrhages. Transoesophageal echocardiography could not locate any sign of infection within the cardiac chambers, but disclosed vegetation attached to the elephant trunk. He underwent successful emergent graft replacement of the lesion, and no recurrence of the infection has been observed. [ABSTRACT FROM AUTHOR]

Purpose: To demonstrate the protective effect of glucagon-like peptide 1 (GLP-1) signaling on the cardiovascular system, we conducted this study to show that the GLP-1 receptor analog (lixisenatide) could inhibit abdominal aortic aneurysm (AAA) development in rats. Methods: Lixisenatide was injected subcutaneously 7 days after aneurysm preparation. We evaluated reactive oxygen species (ROS) expression by dihydroethidium staining and 8-hydroxydeoxyguanosine (8-OHdG; the oxidation product of DNA) by immunohistochemical staining. We also analyzed the effect of GLP-1 signaling on the inflammatory response. Histopathological examination was done on day 28, and the AAA dilatation ratio was calculated. Results: On day 14, ROS expression and 8-OHdG-positive cells in the aneurysm walls were seen to have been significantly decreased by lixisenatide treatment. Western blot analysis showed decreased ERK expression. There was significantly reduced tumor necrosis factor-α mRNA expression in the aneurysm walls and CD68-positive cell infiltration in the aneurysm walls. On day 28, it was evident that the lixisenatide had dramatically reduced aneurysm development in the rats. Conclusion: GLP-1 elevation inhibits AAA development in rats through its anti-oxidant and anti-inflammatory effects. Thus, GLP-1 could be a potent pharmacological target for AAA treatment. [ABSTRACT FROM AUTHOR]

Although anaphylaxis is an extremely rare vaccine-associated adverse event, it occurred in young children following administration of the 2011/12 seasonal split influenza vaccine, which contained 2-phenoxyethanol as the preservative. These children had high levels of IgE antibodies against influenza vaccine components. We herein investigated why these children were sensitized. One hundred and seventeen series of serum samples were obtained immediately before, and one month after the first and second immunizations with the HA split vaccine of 2011/12. Forty-two sequential serum samples were collected in the acute and convalescent phases (2 and 4 weeks) after natural infection with H1N1 Pdm in 2009. IgE antibodies developed following the vaccination of young children with seasonal split vaccines, whereas no significant IgE response was observed following natural infection with H1N1 Pdm 2009. The prevalence of IgE antibodies was not influenced by outbreaks of H1N1 Pdm. Repeated immunization with the HA split vaccine induced IgE sensitization against the influenza vaccine irrespective of the H1N1, H3N2, or B influenza subtypes. The reasons why anaphylaxis only occurred in recipients of the influenza vaccine containing 2-phenoxyethanol are still being investigated, and the size distribution of antigen particles may have shifted to a slightly larger size. Since the fundamental reason was IgE sensitization, current split formulation for the seasonal influenza vaccine needs to be reconsidered to prevent the induction of IgE sensitization. [ABSTRACT FROM AUTHOR]

Background In Japan, the seven-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2010. PCV13 has replaced PCV7 since November 2013. Methods The effectiveness of PCV7 in protecting against invasive pneumococcal disease (IPD) in children aged <5 years was evaluated in a nationwide active population-based surveillance of IPD in 2008–2013 in 10 prefectures in Japan. Results 1181 cases were identified; 711 pneumococcal strains were analyzed for serotyping and antimicrobial resistance. Compared with the baseline IPD incidence (25.0 per 100,000), a 98% decline in IPD caused by PCV7 serotypes was found after the introduction of PCV7. This was partially offset by an increased incidence of IPD caused by PCV13 minus PCV7 and non-PCV13 serotypes, resulting in a 57% decline in overall IPD incidence. Absolute increases in the incidence rates of IPD caused by PCV13 minus PCV7 and non-PCV13 serotypes were 2.1 and 2.8 per 100,000 during the study period, respectively. The proportion of meropenem-nonsusceptible strains, especially with serotypes 19A and 15A, increased significantly after PCV7 introduction. Conclusions Our data confirmed a 98% decline in IPD incidence caused by PCV7 serotypes in children aged <5 years and serotype replacement after PCV7 introduction. This shows the importance of continuing surveillance of serotypes responsible for IPD and their antimicrobial resistance in Japan. [ABSTRACT FROM AUTHOR]

Pediatric Rheumatology Association of Japan has developed evidence-based guideline of vaccination in pediatric rheumatic diseases (PRDs) as a part of Guideline of Vaccination for Pediatric Immunocompromised Hosts. Available articles on vaccination in both adult rheumatic diseases and PRDs were analyzed. Non-live vaccines are generally safe and effective in patients with PRDs on corticosteroid, immunosuppressant, and/or biologics, although efficacy may be attenuated under high dose of the drugs. On the other hand, efficacy and safety of live-attenuated vaccine for the patients on such medication have not been established. Thus, live-attenuated vaccines should be withheld and, if indicated, may be considered as a clinical trial under the approval by Institutional Review Board. All patients with PRDs anticipating treatment with immunosuppressants or biologics should be screened for infection of hepatitis B and C and tuberculosis before the commencement of medication. Varicella vaccine should be considered in sensitive patients ideally 3 weeks or longer before the commencement of immunosuppressants, corticosteroids, or biologics. Bacille Calmette-Guérin should be withheld at least for 6 months after birth, if their mothers have received anti-tumor necrosis factor-α antibodies during the second or third trimester of pregnancy. [ABSTRACT FROM AUTHOR]

OBJECTIVES This report describes our experience with surgical management of aorta-related infections. METHODS From November 1999 to April 2013, 70 patients underwent surgical management for aorta-related infection, including aortobronchial fistula in 12 patients, aorto-oesophageal fistula in 14 and aortoduodenal fistula in 4. The location of infection was aortic root to arch in 22 patients, descending aorta in 29, thoraco-abdominal aorta in 12 and abdominal aorta in 7. Forty-seven patients had infections of the native aorta and 23 had postoperative graft infections. In situ replacement [bridge thoracic endovascular aortic repair (TEVAR); n = 1] was performed in 45 patients, endovascular aortic repair in 18 and extra-anatomical bypass (bridge TEVAR; n = 2) in 7. Omental flap was installed in 29 patients and a pedicled latissimus dorsi muscle flap was used in 3. Since 2008, we have been trying to resect not only the infected tissues, but also the surrounding aneurysmal wall as well. RESULTS Hospital mortality was 17.1% (12/70). Late death occurred in 15 patients. Overall survival at 3 years was 60.1 ± 6.7%. Freedom from infection-related death of patients who had in situ graft replacement, endovascular repair or extra-anatomical bypass at 3 years was 88.5 ± 4.9, 75.2 ± 10.9 or 14.3 ± 13.2%, respectively (P < 0.01). In situ graft replacement provided a better freedom from aortic event (recurrent infection and reintervention) at 3 years compared with endovascular repair (85.6 ± 5.5 vs 61.8 ± 12.5%, P = 0.029). Freedom from infection-related death at 3 years improved significantly from 61.1 ± 9.7 (before 2008) to 84.7 ± 5.8% (since 2008) (P = 0.044). CONCLUSIONS Surgical treatment for aorta-related infection is still associated with high mortality and morbidity. However, our current strategy, which is aggressive surgical management, including resection of infected tissues, extensive debridement, in situ graft replacement of the aorta and omental or muscle installation provided a better patient survival. [ABSTRACT FROM AUTHOR]

A new version of the Japanese pediatric guideline for the treatment and management of bronchial asthma was published in Japanese at the end of 2011. The guideline sets the pragmatic goal for clinicians treating childhood asthma as maintaining a 'well-controlled level' for an extended period in which the child patient can lead a trouble-free daily life, not forgetting the ultimate goal of obtaining remission and/or cure. Important factors in the attainment of the pragmatic goal are: (i) appropriate use of anti-inflammatory drugs; (ii) elimination of environmental risk factors; and (iii) educational and enlightening activities for the patient and caregivers regarding adequate asthma management in daily life. The well-controlled level refers to a symptom-free state in which no transient coughs, wheezing, dyspnea or other symptoms associated with bronchial asthma are present, even for a short period of time. As was the case in the previous versions of the guideline, asthmatic children younger than 2 years of age are defined as infantile asthma patients. Special attention is paid to these patients in the new guideline: they often have rapid exacerbation and easily present chronic asthmatic conditions after the disease is established. [ABSTRACT FROM AUTHOR]

Midsternotomy in patients with a coexisting tracheostomy is associated with a risk of deep sternal wound infection (DSWI) or mediastinitis. We herein present two cases of total arch replacement using a surgical technique designed to avoid the danger of DSWI. Total arch replacement via an antero-lateral thoracotomy with partial sternotomy can be one of the options for patients with a tracheostoma or after laryngectomy, and can both protect organs and avoid DSWI. [ABSTRACT FROM AUTHOR]

Secundum atrial septal defect (ASD) is the most common form of congenital heart disease in adults. Surgical and transcatheter closures of ASD are widely accepted therapeutic approaches. In patients with severe pulmonary arterial hypertension (PAH), however, the closure of the defect is still controversial. We report two cases of ASD patients with severe PAH successfully repaired subsequent to effective medical therapy. Subsequent shunt closure after targeted medical therapy can be an effective strategy in selected ASD patients with severe PAH. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Palivizumab effectively prevents severe respiratory syncytial virus (RSV) disease in preterm infants. Our objective was to test whether palivizumab prophylaxis given to preterm infants during the first RSV season reduces the incidence of subsequent recurrent wheezing up to 3 years of life. METHODS: We conducted an observational prospective multicenter (52 registered hospitals in Japan) case-control study in preterm infants with a gestational age between 33 and 35 weeks followed for 3 years. During the 2007-2008 RSV season, the decision to administer palivizumab was made based on standard medical practice. In April 2008, 52 hospitals were recruited. Study participants were pro- spectively followed to the age of 3 years. Parents of study subjects reported the infants' physician's assessment of recurrent wheezing, used a report card and a novel mobile phone-based reporting system by using the Internet. The primary end point was the incidence of physician-diagnosed recurrent wheezing. RESULTS: Of 444 preterm infants enrolled, 349 received palivizumab during the first 6 months of life and 95 infants did not. Physician- diagnosed recurrent wheezing was observed in 6.4% and 18.9% of infants in the treated and untreated groups, respectively (P < .001). This difference remained significant after adjustment for known risk factors of recurrent wheezing (P < .001). CONCLUSIONS: Palivizumab prophylaxis administered to preterm infants 33 to 35 weeks' gestational age is associated with a significantly lower incidence of recurrent wheezing during the first 3 years of life. [ABSTRACT FROM AUTHOR]

The article discusses the practice guidelines which review the factors influencing the voriconazole (VRCZ) pharmacokinetic profile conducted by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring (JSTDM). It examines the data that support exposure-toxicity and exposure-effect relationships that cause difficulty for therapeutic drug monitoring for VRCZ. It also mentions indications for VRCZ therapeutic drug monitoring (TDM).

The article discusses the guidelines for drug monitoring (TDM) of vancomycin (VCM) and the reviews for TDM by Japanese Society of Therapeutic Drug Monitoring (JSTDM) and Japanese Society of Chemotherapy (JSC). It says that the guidelines for TDM of VCM were reviewed by the practice guidelines committee. It states that the TDM and VCM dosing recommendations were not stated in the guidelines for patients undergoing continuous renal replacement therapy (CRRT) and with renal function deterioration.

Background: Young infants with influenza virus infection are frequently hospitalized, and are at risk of serious complications including death. With the emergence of pandemic influenza A/H1N1 2009, oseltamivir was approved for use in Europe and the USA, including use in infants aged < 3 months. However, few data are available regarding the safety of oseltamivir treatment for influenza in infants aged < 3 months. Methods: The clinical data from Japanese infants aged < 3 months with laboratory-confirmed influenza virus infections, who were treated with oseltamivir between October 2009 and April 2011, were collected and analyzed. Results: Forty-four infants were included in the study. The median age was 1 month (range 4 days to 2 months) and median body weight was 4.5 kg (range 2.6-7.6 kg). Thirty-eight infants (86%) had no underlying diseases. The most common presenting symptom was fever (42 infants, 95%). There were no cases of influenza-associated encephalopathy or myocarditis. The median time between the onset of influenza symptoms and initiation of oseltamivir treatment was 0 days (range 0-7 days), with treatment initiated within 1 day in 40 infants (91%). The oseltamivir dose was 1.5-2 mg/kg twice daily in 98% of infants. No serious adverse events were identified during treatment. All infants recovered completely. Conclusions: Treatment of influenza with oseltamivir 1.5-2 mg/kg twice daily may be safe in infants aged < 3 months. [ABSTRACT FROM AUTHOR]

Members of the Japanese Society of Pediatric Pulmonology and the Japanese Society for Pediatric Infectious Diseases developed the Guidelines for the Management of Respiratory Infectious Diseases in Children with the objective of facilitating the appropriate diagnosis and treatment of childhood respiratory infections. To date, a first edition (2004) and a revised edition (2007) have been issued. Many problems complicate the diagnosis of the pathogens responsible for bronchopulmonary infections in children. The Guidelines were the first pediatric guidelines in the world to recommend treatment with antimicrobials suited to causative pathogens as identified from cultures of sputum and other clinical specimens collected from infection sites and satisfying assessment criteria. The major causative microorganisms for pneumonia in infants and children were revealed to be Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma pneumoniae. This manuscript describes the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2007, with a focus on pneumonia. [ABSTRACT FROM AUTHOR]

The fourth version of the Japanese Pediatric Guidelines for the Treatment and Management of Bronchial Asthma 2008 (JPGL 2008) was published by the Japanese Society of Pediatric Allergy and Clinical Immunology in December 2008. In JPGL 2008, the recommendations were revised on the basis of the JPGL 2005. The JPGL 2008 is different to the Global Initiative for Asthma guideline in that it contains the following items: a classification system of asthma severity; recommendations for long-term management organized by age; a special mention of infantile asthma; and an emphasis on prevention and early intervention. Here we show a summary of the JPGL 2008 revising our previous report concerning JPGL 2005. [ABSTRACT FROM AUTHOR]

The article presents a study which determines the effect of age in the relationship of fractional concentration of exhaled nitric oxide (FENO) and airways hyperresponsiveness (AHR) in asthmatic children. It states that 267 asthmatics were examined for AHR using acetylcholine chloride (Ach) and FENO with the recommended online method before the Ach. It concludes that AHR is associated with airway inflammations in children while adolescents are associated with changes in the structure of airways.

Abstract: Background: Total arch replacement necessitating deep hypothermia with circulatory arrest has a greater effect on pulmonary function than other cardiac surgery using cardiopulmonary bypass (CPB). Since April 2004, 100mg of sivelestat sodium hydrate was administrated by bolus injection into pulp circuit at the initiation of CPB in every case performed total arch replacement. We investigated the hypothesis that prophylactic use of the drug attenuates post-pump pulmonary dysfunction. Methods: A retrospective analysis of 120 consecutive patients who underwent total arch replacement from August 2001 to December 2006 was conducted. Patients were divided into two groups according to the date of surgery, April 2004, when we started sivelestat administration. Group A (n =60), operated after April 2004, was administrated sivelestat at the initiation of CPB. Group B (n =60), before April 2004, was not administrated. Time courses of hemodynamic variables were evaluated until 24h after surgery and those of respiratory variables and inflammatory markers until 48h after surgery. Results: There were no significant differences in patient age, sex, prevalence of chronic obstructive lung disease, preoperative lung function, time of operation and CPB, minimum temperature, and aprotinin usage. Hospital mortality occurred in two patients in the group B (3.3%) and no patient in group A (0%). Postoperative hemodynamic variables were not different between the two groups. Respiratory index, oxygenation index were significantly better in patients pretreated with sivelestat (respiratory index; p <0.001, oxygenation index; p <0.001, respectively). CRP was significantly lower in patients pretreated with sivelestat (p =0.022). Except for patients who required tracheostomy or re-exploration for bleeding, patients pretreated with sivelestat were extubated significantly shorter (group A: 12.6±10.8h, group B: 25.5±12.9h, p =0.033). No patient with postoperative respiratory failure requiring tracheostomy was noted in sivelestat group. Conclusion: Prophylactic administration of sivelestat at the initiation of CPB results in better postoperative pulmonary function, leading to earlier extubation time. Our study suggests that sivelestat was effective in facilitating postoperative respiratory management in total arch replacement. [Copyright &y& Elsevier]

Abstract: We present the facile technique of colorimetric SNP (single nucleotide polymorphism) analysis through DNA-templated cooperative complexation between a luminescent lanthanide ion (Ln(III): Tb(III) or Eu(III)) and two ODN (oligodeoxyribonucleotide) conjugates carrying a metal chelator. Families of complexane-type chelators and heterocyclic aromatic ligands were covalently attached to ODNs to form conjugates for application as capture and sensitizer probes. The sequences of the conjugates were designed so as to form a ternary tandem duplex with the target, where their auxiliary units face each other, providing a microenvironment to accommodate Ln(III). Only the combination of EDTA (ethylenediaminetetraacetic acid) conjugates and phen (1,10-phenanthroline) conjugates provided significant emissions with quantum yields of 3.3% and 1.5% for Tb(III) and Eu(III), respectively, in the presence of the target. Biallelic polymorphism in the TPMT (thiopurine S-methyltransferase) gene, wt/wt (G/G), mut/mut (C/C), and wt/mut (G/C), were distinguished as emissions in green, red, and yellow, respectively; the colors were identified even by the naked eye. [Copyright &y& Elsevier]

Abstract: The purpose of this study is to examine the influence of acute progressive hypoxia on cardiovascular variability and striatal dopamine (DA) levels in conscious, spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY). After preparation for measurement, the inspired oxygen concentration of rats was decreased to 10% within 5 min (descent stage), maintained at 10% for 10 min (fixed stage), and then elevated back to 20% over 5 min (recovery stage). The systolic blood pressure (SBP) and heart rate (HR) variability at each stage was calculated to evaluate the autonomic nervous system response using the wavelet method. Striatal DA during each stage was measured using in vivo microdialysis. We found that SHR showed a more profound hemodynamic response to progressive hypoxia as compared to WKY. Cardiac parasympathetic activity in SHR was significantly inhibited by acute progressive hypoxia during all stages, as shown by the decrease in the high frequency band of HR variability (HR-HF), along with transient increase in sympathetic activity during the early hypoxic phase. This decrease in the HR-HF continued even when SBP was elevated. Striatal DA levels showed the transient similar elevation in both groups. These findings suggest that acute progressive hypoxic stress in SHR inhibits cardiac parasympathetic activity through reduction of baroreceptor reflex sensitivity, with potentially severe deleterious effects on circulation, in particular on HR and circulatory control. Furthermore, it is thought that the influence of acute progressive hypoxia on striatal DA levels is similar in SHR and WKY. [Copyright &y& Elsevier]

Abstract: Objective: In order to determine whether critical intercostal artery is present in the aneurysm during descending thoracic or thoracoabdominal aortic surgery, changes of transcranial motor-evoked potentials (Tc-MEPs) were monitored following infusion of cold blood into the aorta as an adjunct ‘on-site assessment’. Accuracy of this method was evaluated. Methods: Fourteen patients were examined for Tc-MEPs changes following infusion of cold blood (4°C, 300–450ml) into the aneurysm. The intercostal arteries in the aneurysm were reconstructed when the Tc-MEPs amplitude decreased to below 50% of the baseline within 3min after cold blood infusion. When the amplitude did not decrease, every intercostal artery in the aneurysm was ligated. Results: The Tc-MEPs amplitude did not decrease in eight cases (57%), while it decreased in six cases (43%). In the former, no case presented with paraplegia despite every intercostal artery being ligated. In the latter, the amplitude recovered after reconstruction in four patients, who had no paraplegia postoperatively. In the remaining two cases, however, the amplitude did not recover: one died of multiple organ failure with postoperative assessment unfeasible; the other developed paraplegia following surgery. Except one case with operative death, both sensitivity and specificity of our criteria with cold blood infusion was 100% in this series. Conclusions: Cold blood infusion into the clamped segment of aorta accelerates Tc-MEPs changes and can possibly reduce ischemic insults of spinal cord during diagnostic process, while it accurately detects presence of critical intercostal artery in the segment. This method appears to be promising adjunct on-site assessment. [Copyright &y& Elsevier]

Although various methods for collagen gel-based cell invasion assays have been described, there continues to be a need for a simpler and more objective assay. Here, we describe an easy-to-prepare double-layered collagen gel hemisphere (DL-CGH) system that satisfies these requirements, and we demonstrate the advantages of this new system for visualizing cell movements during invasion. DL-CGH consists of a central core collagen layer surrounded by an outer cover collagen layer. A droplet of collagen I solution (containing cells to be examined) naturally forms a small hemisphere on the bottom of the culture dish. After this central core layer gels, a second droplet is placed atop the first gel, encapsulating it completely. The hemisphere is submerged in the medium and cultured. The invasive activity of cells that infiltrate from the inner to the outer layer can be evaluated optically. Using this in vitro system, we measured the inhibitory effect of E-cadherin expression on cancer cell invasion. DL-CGH also allowed visualization of interactions between invading cancer cells and the stroma. Cancer cells, which lack the proteases required for direct entrance into the three-dimensional collagen matrix, were seen to slip like amoebas through matrix gaps generated by the pericellular proteolytic activity of fibroblasts. [Supplementary materials are available for this article. Go to the publisher's online edition of Cell Communication and Adhesion for the following free supplemental resources: Movies 1-3; 4a and b]. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We investigated whether propofol, a widely used anesthetic, injected into clamped aortic segments quickly attenuated transcranial spinal motor-evoked potential (MEP) amplitudes and protected against spinal cord injury during thoracoabdominal aortic surgery. Methods: Eighteen beagle dogs were divided into three groups (n =6, each group): group 1 (20ml of saline, intra-aortic injection), group 2 (1.5mg/kg of propofol, intravenous injection), and group 3 (1.5mg/kg of propofol, intra-aortic injection). Aortic cross-clamping was performed for 30min. In each group, MEP amplitudes were recorded before, during, and after aortic cross-clamping. Tarlov score and histopathological examination were used to evaluate the protective effects of intra-aortic propofol injections. Results: MEP amplitudes in group 3 attenuated to a value that was 60% of the control in just a minute after aortic cross-clamping, but maintained 40% of the control value during aortic cross-clamping. However, MEP amplitudes in groups 1 and 2 gradually attenuated and almost disappeared. Groups 1 and 2 amplitudes were lower than those in group 3, 30min after aortic cross-clamping (p <0.001). Twenty-four hours after ischemia, the Tarlov score in group 3 was 3.5±0.5 and was higher than scores from groups 1 and 2, which were 0.5±0.5 and 1.3±1.2 (mean±SD, p <0.001, and p <0.001), respectively. Histopathologically, normal spinal cord motor neurons in group 3 were preserved to a significantly greater extent than in groups 1 and 2 (p =0.0031, and p =0.0282, respectively). There was a strong correlation between Tarlov scores at 24h and the number of normal motor neurons in the anterior horns of spinal cords (r =0.897; p <0.001). Conclusions: Intra-aortic propofol injections produce the quick suppression of MEP amplitudes and protect spinal cords from ischemia during aortic cross-clamping. [Copyright &y& Elsevier]

Aortic angiosarcoma is an exceedingly rare clinical entity. A significant delay in diagnosis can occur due to its rareness and lack of specific clinical manifestation. A 71-year-old woman was admitted to the emergency department owing to an acute episode of abdominal pain. A computed tomography (CT) scan showed thoraco-abdominal aortic occlusion and splenic infarction. The patient was initially treated with descending aortic replacement for degenerative atherothrombotic aneurysm. An FDG-positron emission tomography-CT scan and biopsy ultimately confirmed the diagnosis of aortic angiosarcoma. This case highlights the difficulties of making an early diagnosis of aortic angiosarcoma. [ABSTRACT FROM AUTHOR]

To evaluate immunity induced by a novel DNA prime-boost regimen, we constructed a DNA plasmid encoding the gag and pol genes from simian immunodeficiency virus (SIV) (SIVgag/pol DNA), in addition to a replication-deficient vaccinia virus strain Dis recombinant expressing SIV gag and pol genes (rDIsSIVgag/pol). In mice, priming with SIVgag/pol DNA, followed by rDIsSIVgag/pol induced an SIV-specific lymphoproliferative response that was mediated by a CD4+-T-lymphocyte subset. Immunization with either vaccine alone was insufficient to induce high levels of proliferation or Th1 responses in the animals. The prime-boost regimen also induced SIV Gag-specific cellular responses based on gamma interferon secretion, as well as cytotoxic-T-lymphocyte responses. Thus, the regimen of DNA priming and recombinant Dis boosting induced Th1-type cell-mediated immunity, which was associated with resistance to viral challenge with wild-type vaccinia virus expressing SIVgag/pol, suggesting that this new regimen may hold promise as a safe and effective vaccine against human immunodeficiency virus type 1. [ABSTRACT FROM AUTHOR]

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were fortified at a level of 1.5% in a composed diet. The effects were confirmed in 0-year black sea bream Acanthopagrus schlegeli in terms of lipid metabolism and physiological activity. The EPA group was high in EPA in muscle, liver, intraperitoneal fat body (IPF), eye and brain. The levels of DHA in liver, eye, brain and heart were also high in the EPA group, suggesting that conversion of EPA to DHA occurred in those organs. Fortification of DHA increased the levels of DHA in organs except the eye, but did not affect EPA levels. Both the EPA and DHA groups showed smaller adipocytes or lower levels of lipid content than the control group. The starvation followed by feeding experiment caused marked body weight loss in the control group by consumption of muscle protein and lipids in IPF. Fortifications of EPA and DHA induced less mobilization of muscle protein and IPF lipids as energy. Liver function and resistance to air-dipping were improved by both EPA and DHA fortifications. The present results implied conversion of EPA to DHA in the fish with regard to parameters, such as lipid metabolism and physiological vitality. [ABSTRACT FROM AUTHOR]

ABSTRACT: Hatchery-reared black sea bream Acanthopagrus schlegeli juveniles averaging 0.05 g in body weight were fed either a control diet (commercial diet) or an experimental diet in which the commercial diet was fortified with 50 mg l-ascorbyl 2-monophosphate Mg (APM)/100 g diet for 50 days. Calcium ascorbate supplemented as a vitamin mixture in the control diet was completely destroyed during storage. Fortification with APM significantly increased the ascorbic acid levels in the muscle, liver, brain and eye. Although APM fortification did not influence growth, survival or fish body composition, adipocyte diameter in the intraperitoneal fat body (IPF) was significantly reduced. After the feeding experiment, the fish were kept for 39 days without feeding. Fortification with APM resulted in high survival, high muscle protein retention and low body weight loss. The results suggested the necessity of fortification with an adequate amount of ascorbate in the diet. While fatty acid compositions of the IPF, muscle and liver were not significantly influenced by APM fortification, characteristic changes in the fatty acid profile were found after starvation. Vitamin C and highly unsaturated fatty acids seemed crossly interactive in relation to lipolysis activity in black sea bream juveniles. [ABSTRACT FROM AUTHOR]

To investigate whether the use of a stentless porcine aortic xenograft can be an alternative for right ventricular outflow tract (RVOT) reconstruction during the Ross procedure, 9 patients underwent the Ross procedure and RVOT reconstruction with a stentless xenograft since January 2000. After the aortic valve was replaced with a pulmonary autograft, a stentless xenograft with a xenopericardial roll was implanted in the RVOT. One patient required subsequent aortic valve replacement because of severe regurgitation of the pulmonary autograft. All patients recovered well from the operation. The right ventricle-pulmonary arterial pressure gradient was 18 ± 7 mm Hg at discharge and was not significantly increased during the 2-year follow-up period. Although 1 patient died of ventricular arrhythmia 5 months after, his cardiac function was normal, and transpulmonary valve pressure was 19 mm Hg in the follow-up. The other 7 patients are currently in New York Heart Association functional Class I. Although long-term follow-up is required to explain the durability, the stentless xenograft with a pericardial roll is considered to be an alternative for reconstruction of the RVOT within 2 years after the Ross procedure. [ABSTRACT FROM AUTHOR]

Severe local swelling has been regarded as a serious safety problem for the booster immunisations of diphtheria tetanus acellular pertussis combined (DTaP) vaccine and DT combined toxoids (DT-td). We attempted to search for the factor of DTaP vaccines possibly contributing to the enhanced local reaction by using the mouse hind paw swelling reaction. Mice were immunised intramuscularly with DTaP vaccine twice at 1-month interval and were challenged their hind paw with one of the antigens of DTaP vaccine 2 weeks later. D-td was shown to elicit the strongest swelling among the vaccine antigens. No causal relationship was found between the swelling and the level of immunoglobulin G (IgG) or IgE in mice. Residual pertussis toxin (PT) activity of DTaP vaccines for immunisation was shown to play a role in the enhanced sensitisation of mice to the D-td-related hind paw swelling. [Copyright &y& Elsevier]

Activation of the zinc-finger transcription factor early growth response (Egr)-1, initially linked to developmental processes, is shown here to function as a master switch activated by ischemia to trigger expression of pivotal regulators of inflammation, coagulation and vascular hyperpermeability. Chemokine, adhesion receptor, procoagulant and permeability-related genes are coordinately upregulated by rapid ischemia-mediated activation of Egr-1. Deletion of the gene encoding Egr-1 strikingly diminished expression of these mediators of vascular injury in a murine model of lung ischemia/reperfusion, and enhanced animal survival and organ function. Rapid activation of Egr-1 in response to oxygen deprivation primes the vasculature for dysfunction manifest during reperfusion. These studies define a central and unifying role for Egr-1 activation in the pathogenesis of ischemic tissue damage. [ABSTRACT FROM AUTHOR]

Li-Al layered double hydroxide (LDH) and LDH-derived mixed metal oxide (MMO) are promising solid base catalysts due to their instinct and strong surface basicity. Herein, nano Li-Al LDH was synthesized via the crystal growth from metal hydroxide nanoseeds with low crystallinities. The present Li-Al LDH possesses high specific surface area (326 m2 g−1), highly crystalline, and high purity. The present nano LDH undergoes a transformation to Li-Al MMO with a high specific surface area (349 m2 g−1) of abundant strong basic sites. Indeed, the present Li-Al MMO exhibits an enhanced catalytic activity for a transesterification reaction between methanol and soybean oil compared to one prepared through a co-precipitation method, thanks to the larger amount of active sites. [Display omitted] • High specific surface area Li-Al layered double hydroxide (nano LDH) is obtained. • Crystal growth of nano LDH from a hydroxide nanoseed is proposed. • Nano LDH transforms into a mixed metal oxide catalyst with an enhanced basicity. • Enhanced catalytic activity for a transesterification has been achieved. [ABSTRACT FROM AUTHOR]

Investigates the effect of the neuronal nitric oxide (NO) synthase inhibitor 7-nitroindazole on the baroreflex control of heart rate (HR) and renal sympathetic nerve activity (RSNA) in the rabbit. Influence of blockade of neuronal NO synthase on baroreflex control of HR; Role of endogenous brain NO in decreasing the baroreflex control of HR.

Investigates the role of nitric oxide in baroreflex control of heart rate and renal sympathetic nerve activity. Effects of these changes on the assessment of the central effects of nitric oxides on the baroreflex control of heart rate and renal sympathetic nerve activity.

Background. Helicobacter pylori is the causative agent of type B chronic gastritis, and plays a major role in the pathogenesis of gastroduodenal ulcer and gastric cancer. Because gastric cancer has been the leading cause of cancer mortality in Japan and Korea, we conducted a seroepidemiological study to estimate the prevalence of H. pylori infection in Japan and Korea in order to explain the current change in the gastric cancer incidences between two countries. Materials and Methods. Samples used for this study included 1204 sera from Chinju, Korea and 580 sera from Fukuoka, Japan. Immunoblotting, using a sonicated crude H. pylori antigen and 1:5 dilution of serum, was performed, considering the immunoblot shows reactivity to the 120 Kd antigen of H. pylori as a specific marker of H. pylori infection. Results. Seroepidemiology data from Fukuoka, Japan showed a prevalence of H. pylori infection of 20% before school age, 40% by teenage years, and over 80% beyond 20~years of age. Seroepidemiology data from Chinju, Korea, showed a 50% infection rate in preschool ages, and over 80% prevalence rate after 7~years of age. Conclusions. Lower rates of childhood H. pylori infection in Fukuoka may explain the recent decline and shift in the incidence of stomach cancer in Japan, supporting the hypothesis that H. pylori is a major determinant in the pathogenesis of stomach cancer. [ABSTRACT FROM AUTHOR]

Extension of metastatic lung tumors into the left atrium via pulmonary veins is rare. Here, we report the first case of Ewing sarcoma exhibiting such extension. A 31-year-old man with pulmonary metastasis from Ewing sarcoma presented with a mass in the left lung, extending to the left atrium through the left inferior pulmonary vein. As the patient was considered to be at risk of tumor embolism, the mass was excised surgically. [ABSTRACT FROM AUTHOR]

We report a patient with Takayasu''s disease surgically treated who had presented severe manifestation due to aortic coarctation associated with occlusion of all arch branches. This patient had suffered cardiac failure and recurrent fainting attacks before surgery. The operative procedures included ascending to infra-renal aortic bypass grafting combined with reconstruction of the right axillary artery. Cardio-pulmonary bypass (CPB) was used to facilitate the proximal aortic anastomosis. Regional oxygen saturation in the bilateral frontal lobes was measured intraoperatively using near-infrared spectroscopy to detect cerebral ischemia. Regional oxygen saturation was managed above the critical level throughout the CPB. No new cerebral complications occurred in the perioperative period. [Copyright &y& Elsevier]

Members of the Japanese Society of Pediatric Pulmonology and the Japanese Society for Pediatric Infectious Diseases developed the Guidelines for the Management of Respiratory Infectious Diseases in Children with the objective of facilitating the appropriate diagnosis and treatment of childhood respiratory infections. To date, a first edition (2004) and a revised edition (2007) have been issued. Many problems complicate the diagnosis of the pathogens responsible for bronchopulmonary infections in children. The Guidelines were the first pediatric guidelines in the world to recommend treatment with antimicrobials suited to causative pathogens as identified from cultures of sputum and other clinical specimens collected from infection sites and satisfying assessment criteria. The major causative microorganisms for pneumonia in infants and children were revealed to be Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma pneumoniae. This manuscript describes the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2007, with a focus on pneumonia. [ABSTRACT FROM AUTHOR]