Anomalous upper critical field in CeCoIn5/YbCoIn5 superlattices with a Rashba-type heavy Fermion interface

We report a highly unusual angular variation of the upper critical field (H(c2)) in epitaxial superlattices CeCoIn(5)(n)/YbCoIn(5)(5), formed by alternating layers of n and a 5 unit-cell thick heavy-fermion superconductor CeCoIn(5) with a strong Pauli effect and normal metal YbCoIn(5), respectively. For the n=3 superlattice, H(c2)(θ) changes smoothly as a function of the field angle θ. However, close to the superconducting transition temperature, H(c2)(θ) exhibits a cusp near the parallel field (θ=0°). This cusp behavior disappears for n=4 and 5 superlattices. This sudden disappearance suggests the relative dominance of the orbital depairing effect in the n=3 superlattice, which may be due to the suppression of the Pauli effect in a system with local inversion symmetry breaking. Taking into account the temperature dependence of H(c2)(θ) as well, our results suggest that some exotic superconducting states, including a helical superconducting state, might be realized at high magnetic fields.

Surgical treatment for neonatal Ebstein's anomaly with circular shunting

We report a case of surgical treatment for neonatal Ebstein's anomaly with circular shunting. A prenatal diagnosis of Ebstein's anomaly was made at 30 weeks of gestation. In addition to severe tricuspid regurgitation, severe pulmonary regurgitation was also noted, resulting in a 'circular shunt'. At 38 weeks and 2 days of gestation, the baby was delivered by Caesarean section. A two-stage palliative operation was planned. As the first palliation, the pulmonary artery was ligated 1 h after birth to eliminate the circular shunt. Lipo-prostaglandin E(1) was administrated continuously to keep the ductus arteriosus patent. Four days after first operation, modified Starnes operation was performed as the second-stage palliation. The tricuspid valve was closed by an ePTFE patch with 3-mm fenestration. Pulmonary blood flow was supplied by a right modified Blalock-Taussig shunt with a 3.5-mm diameter ePTFE graft. The infant's postoperative haemodynamic status was stable. The patient is being followed up carefully and is scheduled to have a univentricular repair in the future.

[Surgical treatment of coronary aneurysm after percutaneous coronary intervention]

A 61-year-old man with acute myocardial infarction underwent percutaneous coronary intervention with stent for the left main coronary artery (LMT) and the left anterior descending artery (LAD). Three months later, we recognized the LMT aneurysm complicated with possible thrombus formation, which developed in size during 6 months. In addition, the LAD stent showed significant in-stent stenosis. For the purpose of supplying blood flow to the distal of LAD, and avoiding myocardial infarction due to distal thrombosis possibly originated from LMT aneurysm, we decided to perform surgical operation. On preoperative examination, this patient had an obstruction of the right internal carotid artery. Although the direct repair of LMT aneurysm requires conventional approach with cardiopulmonary bypass, we applied off-pump coronary artery bypass grafting( OPCAB) considering the risk of cerebrovascular event. Consequently, OPCAB was performed in usual fashion [right internal thoracic artery (RITA) -LAD, left internal thoracic artery-left circumflex artery (LITA-LCX)] followed by the ligation of the proximal of LAD and LCX without cardiopulmonary bypass. The patient had a good operative course.

Ischemic Colitis Following Transarterial Embolization for Type 2 Endoleak of EVAR: Report of a Case

A 71 year old man was diagnosed to have enlargement of abdominal aortic aneurysm due to type 2 endoleak two years after endovascular aneurysm repair (EVAR). 3D-CT demonstrated a type 2 endoleak that originated from the superior mesenteric artery that fed the inferior mesenteric artery and the right iliolumbar artery that flowed into the 4th lumbar artery. Transarterial embolization was performed by means of N-butyl-2-cyanoacrylate (NBCA). After the treatment, he suffered ischemic colitis that extended from the sigmoid colon to the descending colon. Conservative treatment was mainly performed, and clinical improvement was observed over time. He was discharged after 73 postoperative days.

Conversion to Open Repair from Emergency EVAR in a Patient with Ruptured AAA: Report of a Case

A 77-year-old woman with a ruptured abdominal aortic aneurysm (AAA) was transferred to our hospital. Due to a severe comorbidity, endovascular aortic repair of the ruptured AAA was proposed. During the operation, although a Zenith(®) AAA endovascular graft was deployed, digital subtracted angiography revealed an enhancement of the endoleak, and the patient became hemodynamically unstable. Therefore, we decided to convert to graft replacement of the abdominal aorta through a median laparotomy. During the postoperative period, the patient suffered from ischemic colitis, which resolved with conservative therapy. She was discharged after 33 postoperative days.

Cellulose sulfate suppresses immunoglobulin E production by murine B lymphocytes in vitro

BACKGROUND

Immunoglobulin (Ig) E plays an important role in the pathogenesis of allergic diseases such as atopic dermatitis and allergic asthma.We previously reported that a sulfate polysaccharide, fucoidan, suppressed IgE production by murine B cells in vitro. However, the mechanism by which fucoidan suppresses IgE production remains unclear.

OBJECTIVE

We incorporated sulfate groups into cellulose and studied their biological characteristics in vitro to explore the possibility of converting biologically neutral polysaccharides to active reagents with antiallergic functions.

MATERIAL AND METHODS

Cellulose was chemically processed using N,N-dimethylformamide (DMF) and DMF-sulfurtrioxide and recovered as cellulose sulfate with a molecular weight of around 10 kDa. We then studied the effect of cellulose sulfate on IgE production from B cells, IgE class-switching, and populations of IgE-secreting B cells prepared from murine spleen. We also investigated the effects of sulfated cellulose on the production of interleukin (IL) 4 and interferon (IFN) gamma and the expression of T-bet mRNA by splenic T cells. The cytotoxicity of cellulose sulfate was also examined.

RESULTS

Cellulose sulfate suppressed IgE production in B cells stimulated with IL-4 and anti-CD40 antibody by inhibiting IgE class-switch recombination and decreasing the number of IgE-secreting B cells in vitro. Moreover, both cellulose sulfate and fucoidan suppressed IL-4 production and enhanced IFN-gamma production by murine T cells stimulated with anti-CD3 and anti-CD28 antibodies, despite the decrease in T-bet mRNA expression.

CONCLUSIONS

Cellulose gains an antiallergic effect on B cells and T cells with the addition of sulfate groups.

Thoracic endovascular aortic repair and off-pump coronary artery bypass grafting after renal transplantation: a case report

Twelve years after receiving a renal transplant, a 50-year-old woman developed asthmatic symptoms. Chest CT revealed a descending thoracic aortic aneurysm. She had undergone percutaneous coronary intervention to treat the left anterior descending artery 10 years earlier. Coronary artery angiography revealed restenosis of the left anterior descending artery (99%, #6 in-stent). Because cardiopulmonary bypass may cause problems for transplanted kidney, we performed off-pump coronary artery bypass grafting (left internal thoracic artery to left anterior descending artery) and thoracic endovascular graft placement to treat the aortic aneurysm. Considering that the artery of the transplanted kidney was attached to the right iliac artery, and then the left common femoral artery was selected as the access root for GORE TAG(®) endografts (34 × 200 and 34 × 150 mm) (stentgrafts were deployed for the descending aortic artery). Postoperative angiography showed a patent bypass graft. Postoperative CT confirmed the absence of endoleaks. The postoperative course was uneventful, and she was discharged without complications. Ischemic heart disease and descending thoracic aortic aneurysm in recipients of kidney transplants can be treated using off-pump coronary bypass grafting and thoracic endovascular graft placement. The transplanted kidney was protected without using cardiopulmonary bypass (CPB).

Fetal cardiac dimensions at 14-40 weeks' gestation obtained using cardio-STIC-M

OBJECTIVES

To establish normative reference ranges of fetal cardiac dimensions derived from volume datasets acquired using spatiotemporal image correlation with M-mode display (cardio-STIC-M).

METHODS

A cross-sectional study was undertaken on singleton pregnancies with normal fetuses and accurate gestational ages. Cardio-STIC volume datasets were acquired by experienced operators using a high-resolution ultrasound machine; these were maneuvered to obtain a four chamber-view with exactly horizontal interventricular septum (IVS). Cardiac dimensions were measured in STIC-M-mode using 4D View software.

RESULTS

A total of 657 measurements, at a rate of between 15 and 37 per week, were obtained. Normal reference ranges for biventricular outer diameter, left and right ventricular inner diameter, left and right ventricular wall thickness, IVS thickness, left to right ventricular diameter ratio and left and right ventricular shortening fractions were constructed based on best-fit equations as a function of gestational age, fetal head circumference and biparietal diameter. Thirty-four volume datasets of abnormal fetal hearts were also separately assessed, many of which showed abnormal cardiac dimensions.

CONCLUSIONS

This is the first report on normal ranges of fetal cardiac dimensions constructed using the new cardio-STIC-M technology. Preliminary evaluation suggests that these reference ranges may be a useful tool in the assessment of fetal cardiac abnormalities.

True Atomic Resolution Imaging on Semiconductor Surfaces with Noncontact Atomic Force Microscopy

The constant vibration mode and the constant excitation mode in noncontact atomic force microscopy were compared to investigate the force interaction between tip and surface. As a result, we found that the constant excitation mode is much more gentle than the constant vibration mode. We also succeeded in atomic resolution imaging on InP(110) surface not only in the noncontact region but in the contact region for the first time. Furthermore, we found the discontinuity of the force gradient curve on reactive Si(111)7×7 reconstructed surface. We proposed a model to explain the discontinuity with the crossover between the physical and chemical bonding interaction.

Surgical treatment for aortic coarctation with chronic type B dissection: report of a case

The aim of this paper is to report a rare case of aortic coarctation with type B aortic dissection. A 37 year-old man had sudden, intense back pain. Enhanced computed tomography revealed aortic coarctation (CoA) at the proximal descending aorta and acute type B aortic dissection just distal to the CoA. The dissecting, descending aortic aneurysm had expanded to a maximal diameter of 52 mm. The aortic coarctation was resected and then the descending aorta was replaced with prosthetic grafts in an uneventful procedure. Surgical repair resulted in a good outcome.

[Extirpation of a thrombus during pulmonary metastasectomy in a patient with chronic pulmonary thromboembolism]

A 57-year-old woman with chronic pulmonary thromboembolism was diagnosed to have metastatic lung tumors 6 months after an operation performed for colon cancer. There were no respiratory symptoms associated with the pulmonary thromboembolism. Computed tomography showed 2 pulmonary masses in the right middle and lower lobes, and a thrombus in the inferior trunk of the right pulmonary artery. Excision of the 2 pulmonary metastases was performed and the thrombus in the pulmonary artery was also removed at the same time. Partial improvement of the pulmonary blood flow was observed in the postoperative pulmonary scintigram. Chronic pulmonary thromboembolism without respiratory symptoms is not usually an indication for extirpation of thrombus. However, incidental extirpation of a pulmonary thrombus at the time of other pulmonary surgery should be considered, as it may yield an improvement of the pulmonary blood flow.

[Off-pump coronary artery bypass surgery for the ischemic cardiomyopathy patient with moderate mitral regurgitation and stenosis of bilateral vertebral arteries]

We report a 71-year-old man who had severe coronary and cerebral vascular disease with moderate mitral regurgitation (MR). Left ventricular reconstruction and mitral valve surgery were considered for poor left ventricular function and dilatation with MR. However, low blood pressure during cardiac arrest was risk for stroke due to severe stenosis of bilateral vertebral arteries. The myocardial viability of the anterior wall and inferior wall was confirmed by thallium-201 rest-redistribution single photon emission computed tomography (SPECT). Therefore, off-pump coronary artery bypass grafting (OPCAB) was selected for the patient. Only three Lima sutures were used for keeping the optimal heart position. Coronary anastomoses were done in sequence right gastroepiploic artery (RGEA)-#4 posterior descending (PD), left internal thoracic artery (LITA)-#9-#14 (sequential), RITA-#8 left anterior descending (LAD). No neurological complication occurred postoperatively. Left ventricular function and MR gradually improved. Final ejection fraction (EF) is 51% and MR is trivial. This case demonstrated improvement of MR by only revascularization according to preoperative viability assessment.

[Infective endocarditis with acute embolism to the lower extremity artery caused by a vegetation: report of a case]

Successful surgical treatment of a case of infective endocarditis with embolism to a lower extremity artery is reported. A 71-year-old man was referred to our hospital for the treatment of infective endocarditis. Echocardiography showed a vegetation on the non-coronary cusp of the aortic valve measuring 19 mm in diameter. We planned surgical treatment, including aortic valve replacement, however, embolism of a lower extremity artery by the vegetation occurred during the waiting period for the operation. We removed the offending vegetation from the popliteal artery and replaced the peccant aortic valve with a prosthetic valve in separate operations. The postoperative course was uneventful and the patient was transferred to another hospital on the 33rd day after the valve replacement surgery.

Nephropathy of cyanotic congenital heart disease: clinical characteristics and effectiveness of an angiotensin-converting enzyme inhibitor

AIMS

Nephropathy has long been recognized as a potential complication of cyanotic congenital heart disease (CCHD). There have been few large-scale studies or clinical reports on renal impairment in patients with CCHD; similarly, very few studies have examined the drug treatment of nephropathy in CCHD. We examined the clinical characteristics and effectiveness of enalapril, an angiotensin-converting enzyme inhibitor (ACE-I), in patients with CCHD complicated with significant proteinuria.

MATERIALS AND METHODS

The clinical records of 37 patients with CCHD were evaluated; all were older than 10 years of age (median 19, range from 10 to 27) and had regular check-ups, including urinalysis. The treatment criteria for enalapril administration included significant proteinuria (urinary excretion > 1.0 g/24 h), stable cardiac condition and blood pressure within the normal range.

RESULTS

Eleven patients (29.7%) had persistent proteinuria, 6 patients met the enalapril treatment criteria and 5 patients were treated for more than 12 months. Enalapril apparently reduced the urinary protein excretion in 4 of the 5 patients (80%). No consistent improvement of renal function, as evidenced in the glomerular filtration rate (GFR), renal plasma flow (RPF) or filtration fraction (FF) was found in these patients, but neither were any significant adverse effects noted.

CONCLUSION

The incidence of nephropathy among patients with CCHD was about 30%, which was consistent with previous studies. It is worth considering the use of ACE-I when nephropathy accompanies CCHD.

Immunological detection of a novel advanced glycation end-product

BACKGROUND

The advanced stage of the Maillard reaction that leads to the formation of advanced glycation end-products (AGEs) plays an important role in the pathogenesis of angiopathy in diabetic patients and in the aging process. Recently, it has been proposed that the intermediates contributing to AGE formation include dicarbonyl intermediates such as glyoxal, methylglyoxal, and 3-deoxyglucosone (3-DG). In the present study, we developed a novel, non-carboxymethyllysine (CML) anti-AGE antibody that recognizes serum proteins and peptides modified by 3-DG in vivo.

MATERIALS AND METHODS

AGE-modified serum albumins were prepared by incubation of rabbit serum albumin with 3-DG or D-glucose. After immunization of rabbits, anti-AGE antisera were subjected to affinity chromatography on a Sepharose 4B column coupled with CML-BSA, or AGE-BSA created by incubation with 3-DG (AGE-6) or D-glucose (AGE-1). The AGE-Ab-6 and AGE-Ab-1 thus obtained was used to investigate AGEs in serum from diabetic patients on hemodialysis.

RESULTS

Characterization of the novel AGE-Ab-6 obtained by immunoaffinity chromatography was performed with a competitive ELISA and immunoblot analysis. This antibody specifically cross-reacted with proteins modified by 3-DG. AGE-6 was detected in diabetic serum as three peaks with apparent molecular weights of 200, 1.15, and 0.85 kD, while AGE-1 was detected as four peaks with apparent molecular weights of 200, 65, 1.15, and 0.85 kD.

CONCLUSION

This study provides new data on the pathways of AGE formation from 3-DG and methods for the immunochemical detection of AGEs. We also provide immunochemical evidence for the existence of six distinct AGEs in vivo among the AGE-modified proteins and peptides in the serum of diabetic patients on hemodialysis.

Neostriatal stimulation activates tongue-protruder muscle, but not tongue-retractor or facial muscles: an electrical and chemical microstimulation study in rats

Whether electrical microstimulation of a rat's striatal jaw region (SJR) in fact induced tongue or facial muscle activity in addition to jaw muscle activity was tested. Microstimulation of SJR-evoked EMG activity in a jaw-opener (anterior digastricus) and tongue-protruder (genioglossus). No activity was evoked in jaw-closers (temporalis or masseter), tongue-retractor (hyoglossus) or in facial muscles. In addition, the EMG effect could still be induced after extensive ablation of the neocortex; it was reproduced by microinjection of 50 mM kainic acid into SJR. The effective sites were histologically localized to a small central striatal region adjoining the anterior commissure. These findings may be of considerable value in understanding the striatal mechanism of orolingual dyskinesia involving involuntary jaw and tongue movements.

Analysis of mother-to-infant transmission of hepatitis C virus: quasispecies nature and buoyant densities of maternal virus populations

Mother-to-infant transmission of hepatitis C virus (HCV) was analyzed by sequencing of viral RNA and semiquantitative polymerase chain reaction following ultracentrifugation of maternal sera. In two mother-infant pairs, the hypervariable region 1 (HVR1) and carboxyl terminus of envelope 1 (E1) were sequenced. Both viral sequences in the infants were less diverse than those of their mothers. Although the E1 sequences were almost identical in each mother-infant pair, the HVR1 sequences of the infants were related, but not identical, to those of the mothers. Serial examinations of one infant revealed that the HVR1 nucleotide sequence did not change from 10 days to 3 months of age. In six mothers with uninfected infants, all of the dense fractions of sera contained significant amounts of HCV RNA, whereas in six mothers with infected infants, only two of those fractions contained significant amounts of HCV RNA. These results indicate that the strains of HCV detected in the infants were not dominant in the mothers, but were still transmissible to the infants. As dense fractions are known to contain antibody-bound HCV particles, maternal antibodies against HCV may inhibit viral transmission.

[Analysis of nuclear DNA heterogeneity of the hepatocellular carcinoma (HCC)]

To evaluate the objective proliferative activity in HCC nuclear DNA contents were measured by means of microspectrophotometry and at the same time the immunohistochemical technique using anti-PCNA antibody was employed. Surgically resected 26 HCCs were analyzed in terms of cell proliferative activity and regional heterogeneity. The analysis was performed by immunohistochemical demonstration of PCNA and pathologic histochemical study in formalin-fixed, paraffin-embedded specimens and cytophotometric measurements of nuclear DNA contents in fresh specimens. The results were as follows. 1) Nine HCCs showed regional ploidy heterogeneity. 2) PCNA labeling index and histological grade of the marginal area was much higher than that of the central area. From these results, we concluded that in the process of the HCC progression proliferative activity was decreased in the central area and was not decreased in the marginal area.